Cardiovascular (first exam)
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What is the spongy center of bones where red blood cells and platelets are made?
What organ manufactures clotting factors and clears old and damaged RBCs?
What does the spleen remove?
What does blood consist of?
- clotting factors
How many liters of blood does a healthy adult have?
Where are RBCs made and what do they do?
- bone marrow
- transport oxygen from the lungs to the tissues and carbon dioxide from the tissues back to the lungs
What is the life span of a RBC?
Where are platelets made, and what do they do?
- bone marrow
- activate blood clotting system by forming a platelet plug
What is the life span of a platelet?
What are activated with the platelets and form a stable fibrin matrix over the wound?
What is the clear, straw-colored fluid that carries RBC platelets and clotting factors?
What combines with oxygen and carbon dioxide to allow the red blood cells to transport oxygen from the lungs to the tissues and carry carbon dioxide from the tissues back to the lungs for excretion?
hemoglobin in the RBCs
What is the term for the control of bleeding?
What three things occur if a blood vessel is injured?
- blood vessel constricts, reducing the amount of bleeding
- platelets adhere to the injured blood vessel, forming an unstable platelet plug
- the coagulation cascade (clotting) is initiated, forming a stable fibrin matrix which is commonly recognized as a scab
What happens to bone marrow as we age?
becomes less productive
Hematologic function is not affected by age UNLESS:
a person is stressed with trauma, chronic illness, or treatment of cancer
What effect does ASA or NSAIDs have on bleeding?
What is the blood vessel that carries blood from the right ventricle to the lungs?
The left ventricle ejects blood into which vessel?
What AV valve "sees" oxygenated blood?
Which semilunar valve "sees" unoxygenated blood?
The pulmonary veins empty blood into which cardiac chamber?
The venae cavae empties blood into which cardiac chamber?
What is the sling like fold of epicardium that supports the heart?
Actin, myosin, and sarcomeres are the terms that describe which contracting layer?
The mitral valve and the aortic valve are associated with which cardiac chamber?
The pulmonic and tricuspid valves are associated with which structure?
What is the area of the anterior chest wall overlying the heart and great vessesl?
Which blood vessels arise at the base of the aorta just beyond the aortic valve?
What attaches the cusps of the AV valves to the ventricular walls?
What is the cavity located between the epicardium and the parietal pericardium?
What is the condition in which any of the constituents of the blood are abnormal in structure, function, or quantity? (disorder that affects the blood)
Disorders can be either a _______ disease or a complication of another disease.
- produced in the red bone marrow
- normal count: 4.2-6.1
- average life span: 120 days
- function: carrier of gases
- major component: Hgb
Elevation of RBCs may indicate:
body is compensating for chronic hypoxia EG CHF and COPD, by increasing Hgb
values for women:
values for men:
- complex protein-iron compound; gases are transported
- values for women: 12-16 g
- values for men: 14-18 g
- combines with O2 in lungs to form oxyhemoglobin
- combines with CO2 at cells and forms carbonhemoglobin
value for women:
value for men:
- the percentage of solid to liquid; blood cells to plasma
- value for women: 37-47%
- value for men: 42-52%
- increases with dehydration and polycythemia
- decreases with anemia
- produced in red bone marrow, lumph tissues, thymus, and spleen
- normal count: 5,000-10,000
- life span: 4-5 days; monocytes- years
- function: combat infection
- 2 groups: granulocytes and agranulocytes
neutrophils, eosinophils, and basophils are all considered ___________.
What granulocyte ingests bacteria and disposes of dead tissue by phagocytosis?
What does it also release?
bone marrow has a __ day supply.
- lysozyme; destroys certain bacteria
- life span: 7 hrs
- 6 day supply
What granulocytes are active in allergic reactions and parasitic infections?
What granulocytes are stimulated by antigens or tissue injury?
What does it release?
What processes are they active in?
- releases granules: histamine and heparin
- active in inflammatory or allergic processes
Monocytes and lymphocytes are both considered ___________.
What agranulocyte dispose of bacteria and dead cells during the recovery from an acute bacterial infection by phagocytosis?
What agranulocytes are responsible for antibody formation to combat antigens?
What are the two sub-types?
normal time for coagulation:
- produced in red bone marrow
- normal count: 140K-440K (140,000-440-000)
- life span: 6-10 days
- purpose: hemostasis, blood clotting, coagulation
- normal time for coagulation: 5-10 min; shorter time @ risk for thrombus; longer time @ risk for hemorrhage
What is the term for a RBC that is lacking in color?
What is the term for a RBC that is intense in color?
What is the procedure performed to diagnose blood dyscrasia or evaluate the pt/s response to treatment?
bone marrow aspiration/biopsy
What is a bone marrow biopsy/aspiration performed?
- low WBC count; neutropenia, such as with chemotherapy, leukemia
- low RBC count with anemia
- low platelets; thrombocytopenia
Describe a bone marrow aspriation:
- bone marrow is aspirated through a large bore needle
- sites: sternum and iliac crest, tibia
- examined for: type, number, and maturity of cells
- pt postition: if sternal, supine; if iliac crest, lateral or prone if pt can tolerate
What is the term for a reduction in the number of RBCs?
What can anemia result from?
- major loss of blood over a short pd of time
- too few RBCs being made
- increased destrction of RBCs
What 3 ways does the body try to compensate for anemia?
- increase heart/resp rate to circulate RBCs as quickly as possible with as much O2 as possible
- redistributing blood away from the skin, GI tract and kidneys to the brain and heart
- increasing the production of erythropoietin (which stimulates the production of RBCs)
What are some causes of anemia?
- blood loss
- bone marrow dysfunction
- nutritional deficits
- hemoglobin defects
- chronic disease
What is a major cause of iron deficiency in an adult?
How much iron does 2 mL of blood contain?
- blood loss
- 1 mg of iron in 2 mL of blood
How many liters of blood does the average adult have?
How much blood can you lose without serious effects? Why is this?
- 500 mL
- because the spleen releases stored RBCs
What are some s/s of blood loss?
- clammy skin
A pt may be asymptomatic until their RBC count drops to almost 50% of normal if they have ________ blood loss.
Chronic renal failure pts can tolerate ________ levels of 8 without difficulty.
What is the treatment for blood loss?
- identify the source
- blood transfusions only if severe
- whole blood is rarely transfused
- packed RBCs are mainly used; decreased change of pulmonary edema and circulatory overload
Iron is essential for ___ production.
What are s/s of iron deficiency?
- orthostatic changes
- exertional dyspnea
- brittle, spoon-shaped nails with longitudinal ridges
- smooth, shiny tongue
What is the daily requirement of iron for women and men?
What are some food sources of iron?
- red meats
- dried fruits
- dark green veggies
Schilling's test diagnoses what?
What is the disorder in which the bone marrow makes adequate amounts of RBCs, however, when they are released into circulation, they are destroyed?
autoimmune hemolytic anemia
Hemolytic anemia in a new born can accur due to the ___ factor.
Rh factor (mom Rh-; baby Rh+)
With what blood disorder will you see high bilirubin levels from the breakdown of RBCs and positive results on direct coombs test?
autoimmune hemolytic anemia
What type of anemia causes some RBCs to be deformed, shaped like a disc, due to deoxygenation?
sickle cell anemia
What are some s/s of sickel cell anemia?
- persistent low RBC count
- enlarged heart
- severe pain
Sickling of RBCs is triggered by infection, dehydration, overexertion, cold weather, alcohol, smoking, or stress. What does this cause?
- viscosity of blood--->
- venous stasis--->
- occlusion of small blood vessels--->
- peripheral edema and pain r/t hypoxia--->
- hypoxia severe/prolonged?---> infarction!
What is one of the most severe forms of anemia?
- aplastic anemia
- ALL blood cells are reduced
What is the disorder that occurs when there are too many RBCs being produced?
What does it cause?
- polycythemia vera
- causes increase blood viscosity and volume
What are the s/s of polycythemia vera?
Why do they occur?
- ruddy (red) complexion
- ringing in ears
- blurred vision
- may have CVA
- occur because: of hypertension, increased viscosity and volume
What does it cause:
bleeding tendency w/count @:
spontaneous hemorrhage w/ count @:
- a lower than normal number of circulating platelets
- causes a decrease in production, increase destruction, leukemia, severe chronic infection
- s/s: petechias, ecchymoses, purpura
- tx: corticosteroid, eliminate cause, transfuse platelets, speenectomy
- bleeding tendency w/count @:
- spontaneous hemorrhage w/ count @:
What are the 2 major forms?
What chromosome is it carried on?
- genetic bleeding disorder caused by defective or deficient coagulation factors
- forms A and B
- s/s: unvontrollable bleeding
- carried on X chromosome, so women carry the trait and can pass it on to their sons, who will manifest the disease; rare for women to have disease
What happens to the bone marrow in a pt who has leukemia?
bone marrow becomes overcrowded with immature nonfunctional cells and the production of normal cells is reduced
The immaturity of WBCs leads to _______ immunity and _______ susceptibility to infection.
Describe chronic leukemia:
- WBC count slowly increases over months or years
- can usually be controlled with oral chemo
- generally feel healthy
- don't lose their hair
- continue to work
- Gleevec (new med) targets leukemic cells, sparing normal cells
Chronic leukemias often transform into an _______ leukemia that is very difficult to treat.
pts generally die shortly after they enter this phase
_______ leukemias occur very suddenly and leaves the pt at severe risk for infection and bleeding. Chemo must be started IMMEDIATELY!
What are some s/s of acute leukemia?
- night sweats
- low RBC count
Acute leukemia pts have to go through chemo at high doses, then maintenance therapy for __ to __ years.
What vessels supplies the heart muscle with blood?
What vessel does blood come into the right side of the heart?
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