Blood

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Author:
Naheer
ID:
177218
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Blood
Updated:
2012-10-14 19:57:17
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KNES 323
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chapter 16
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  1. components of blood
    • red blood cells (erythrocytes) 45%
    • white blood cells (leukocytes) <1%
    • Platelets <1%
    • plasma 55%
  2. Blood Plasma
    • 55%
    • 90-92% water
    • electrlytes/ glucose
    • clotting factors
    • plasma proteins 
    • albumin-transport fatty substances
    • glubulins
    • fibrinogen-blood clotting
  3. 3 components of plasma
    • albumin (liver)-osmotic pressure of plasma and carrier
    • globulin(liver & lymphoid tissue)- clotting, enymes, antibodies and carriers 
    • fibrinogen(liver)- need for blood clotting
    • transferrin- iron transport
  4. 5 types of white blood cells
    • lymphocytes-body immune system
    • monocytes-evolve into macrophages which kill of bacteria
    • neutrophils-phagocytes, first to move to point of inlfammation in an infection (chemotaxis)
    • eosinophils-killing bacteria and parsites
    • basophils- response to allergic symptoms, and contain vasodilator histamine which promotes blood flow
  5. what do megakaryocytes become
    platelets
  6. whast comes from myeloid stem cell?
    • megakaryocytes
    • erythrocytes
    • monocytes
    • granulocytes
  7. what do erythropoietin and thrombopoietininfluence growth of?
    • red blood cells
    • megakaryocytes
  8. normal blood volume is :
    5-6 litres
  9. WBC count and lifespan:
    • 5000-10,000/mm3(mcl)
    • lifespan 13-20 days
  10. lymphocytes

    • specific immunity
    • T-cells and B-cells
    • 20-40%
  11. Monocytes
    • macrphages(big eaters)
    • 2-8%
  12. neutrophils
    • phagocytes
    • 50-70%
  13. Eosinophils
    • allergic reactions/ worms 
    • 1-4%
  14. Basophils
    • histamine- runny nose, eyes. Stops entry of other pathogens
    • <1%
  15. RBC count and lifespan
    • 4.2-5.4 million/ mm3 (mcl)
    • lifespan= 120days 
    • 2 million per sec
  16. Platelets count and lifespan
    • 150,000-350,000
    • lifespan= 5-9 days
    • 5,000-10,000/ megakaryocyte
  17. hemoglobin values in male and females
    • males: 13.5-17.5 g/dL
    • females: 12-16 g/dL
  18. what is hematocrit?
    • ratio of RBC's to total blood volume
    • males: 40-54%
    • females: 37-47%
  19. blood system organs:
    • lymph nodes
    • bone marrow- cell production
    • liver- prothrombin and fibrinogen for blood clotting
    • spleen- lymphocytes, plasma cells, and antibodies
  20. RBC production in bone marrow:
    • erythropoietin- horomone that trigger red cell production
    • w/o this not proper cell formation
    • folic acid, B12- need for proper cell division
    • iron- bind O2 and make hemoglobin
  21. erythropoiesis
    low blood O2 in kidney cause secretion of erythropoietin which stimulates erythropoiesis by bone marrow.  This increases RBC's, increase O2. This help relieve intial erythropoietin secretion.
  22. bi concave disks (RBC)
    • no nucleus
    • flexible
    • more SA, more diffusion and more flexible
    • when red blood cell old can lose felixibility and get stuck in capillaries which can cause problems
  23. osmotic changes to red blood cells
    • cell shape changes with osmolarity of plasma
    •  hyoptonic- more water in cell
    • isotonic- same # of particles in solution and cell
    • hypertonic - crenated shrivel cell
    • water move to outside
  24. red blood cells removed by ______ and ________
    • liver
    • spleen
  25. iron homeostasis and metabolism
    • 1,iron from diet
    • 2. iron absorbed
    • 3.transferrin transport Fe in plasma
    • 4. liver store excess iron as ferritin
    • 5. bone marrow use Fe to make hemoglobin
    • 6. spleen converts to bilirubin
    • 7.liver metabolize bilirubin and excrete in bile
    • 8.bilirubin excreted in urine
  26. Anemia 
    • decrease O2
    • decrease RBC count
    • dreace Hb
    • decrease Hct
    • iron defiency, folic acid deficiency, pernicious, hemolytic, sickle cell, aplastic
  27. symptoms of anemia
    • pallor
    • fatigue
    • shortness breath
    • headache
    • irritability
    • fast HR
  28. iron deficiency anemia (causes and treatment)
    • low Fe-> low Hb-> decrease cell size (RBC count normal)
    • casues:
    • blood loss- lose iron that want to recycle
    • low dietry intake
    • microcytic cells
    • low hct
    • low hb
    • Treatment
    • increase iron intake
  29. folic acid deficiency anemia
    • need folic acid for maturation RBC/ DNA production
    • causes:
    • poor diet
    • over cooked vegetables
    • alchohol= decrease folic acid
    • Treatment
    • increase folic acid intake
    • green and yellow vegetables; citrus fruits

  30. Pernicious Anemia
    • not enough absorption vit B12
    • B12 needed for cell division
    • Macrocytic cells:
    • Low RBC count
    • Hct and Hb normal
    • RBC big in size
    • Treatment:
    • monthly injection vit B12
  31. Hemolytic Anemia
    • destruction RBC
    • antigen-antibody reaction, immune disorder
    • jaundice- yellow skin and eyes
    • Treatment:
    • exchange tanfusion/ splenectomy
  32. Sickle cell anemia
    • hereditary
    • sickle shape RBC
    • doesnt travel smotthly through vessels
    • no cure
  33. Aplastic Anemia
    • bone marrow cannot produce blood components
    • casues:
    • chemotherapy
    • radiation
    • viruses 
    • toxins
  34. other RBC disorders
    • polycythemia (primary, secondary, relative)
    • symptoms:
    • red skin and mucous membranes
    • bloodshot eyes
    • increased blood volume and pressure
    • enlarged spleen
  35. primary polycythemia
    • bone marrow tumor
    • increase RBC b/c increase sensitivity to Epo
  36. secondary polycythemia
    • high levels erythropoietin cause high level RBC
    • RBC abnormal structure
    • not enough oxygen cause high Epo
    • ex: kidney tumor-> increase Epo-> increase RBC
  37. Relative polycythemia
    • increase in Hct= less plasma so increase RBC volume
    • number red blood cell normal
    • ex dehydration
    • danger include
    • decreased oxygen 
    • decreased blood flow
    • increased clotting
    • treatment= blood doping
  38. percentage of hematocrit for normal, anemia, polycythemia and dehydration
    • 45%=normal
    • 30%=anemia
    • 70%=polycythemia
    • 70%=dehydration
  39. white blood cell disorders
    • leukocytopenia
    • leukocytosis
    • neutropenia
    • mononucleosis
    • leukemia
  40. leukocytopenia
    • decrease WBC
    • weaken immune system
  41. leukocytosis
    • increase WBC
    • normal response to small infections
  42. neutropenia
    • decrease neutrophils
    • increase risk for bacterial and fungal infections
    • destruction neutrophils
    • cancer therapy
    • rheumatoid arthritis ( inflammation joint surrounding tissue)
  43. mononucleosis
    • increase monocytes
    • symptoms:
    • fatigue, sore throat swollen glands
    • treatment:
    • rest, analgesics( painkillers)
  44. leukemia
    • cancer
    • increase immature leukocytes
    • acute or chronic
    • myelegenous=affecting bone marrow
    • lymphocyte= affect lymph nodes 
  45. symptoms of leukemia
    • anemia 
    • fatigue
    • headache
    • sore throat
    • bleeding mucous membranes
    • bone and joint pain
    • enlarged lymph nodes, liver and spleen
  46. what is hemostasis and the threee mechanisms
    • stopping bleeding
    • 3mechanisms:
    • vascular spasm-vasoconstriction
    • platelet plug
    • coagulation
  47. Healing process
    • clot formation (intrinsic)
    • clot reaction
    • clot destruction
  48. platelet plug
    • get sticky and adhere to collagen
    • activated platelets secrete chemotaxins
    • -ADP,serotonin and thrombaxane A2
    • attract other paltelets
    • activate and aggregate
  49. platelet plug formation
    • 1.collagen bind and activate platelet
    • 2.release of platelet factors
    • 3.factors attract platelet
    • 4.platelet go into platelet plug
  50. undamaged tissue secrete;
    • prostacyclin
    • prevent platelet aggregation
    • Nitric Oxide
    • vasodilator
  51. Effect of aspirin
    Inhibit thrombaxane->decrease activation platelet->decrease clotting-> can cause heart attacks
  52. what you need for coagulation
    • clotting factors-in the liver
    • platelet factor- if dont have it can bruise easily
    • clotting cofactor
    • plasma calcium- dont have calcium slow down clotting
  53. extrinsic pathway
    • shorter
    • faster 
    • less fibrin
  54. intrinsic pathway
    • longer 
    • slower
    • more fibrin
  55. Anti-clotting system
    • tissue factor pathway inhibitor
    • slows extrinsic pathway
    • Protein C
    • activated by thrombin
    • slow down both pathways
    • Antithrombin
    • secreted by undamaged endothhelium
    • inactivates thrombin
    • Heparin, coumadin
    • inhibit platelets
    • turn of blood formation and intrinsic/extrinsic pathways
  56. fibronolysis
    • break down of clot after healing
    • secrete tPA(tissue plasminogen activator)- this comes from liver to convert to plasmin to make active and break down the clot
  57. disorders of platelets
    • hemophelia
    • thrombocytopenia
    • disseminated intravascular coagulation
  58. hemophelia
    • hereditary bleeding disorder common among males
    • lack protein for clot formation
    • symptoms:
    • nosebleeds
    • bruising
    • lots bleeding
    • treatment:blood transfusion, clotting proteins
  59. thrombocytopenia
    • low platelet-> no platelet plug-> no coagulation
    • know if you have this by platlelt vcount and bleeding time
    • symptoms:
    • abnormal bleeding
    • petechiae- small purple spot on skin from damaged blood vessel
    • ecchymoses-bruising 
    • hematuria
  60. treatment for thrombocytopenia
    • avoid tissue trauma
    • vitamin K
    • transfusion of platelets
    • splenectomy
  61. Disseminated intravascular coagulation
    • abnormal clotting followed by abnormal bleeding
    • followed by major trauma(surgery, complicated child birth)
    • multiple clots in capillaries
    • symptoms:
    • Petechiae/ ecchymosis
    • hematoma
    • hematuria/ hematamesis
    • GI bleeding
  62. treatment of DIC
    • Heparin
    • platelets

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