A&P Medic 14 Chapter 11

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A&P Medic 14 Chapter 11
2013-03-29 10:17:31
medic 14

Chapter 11 Blood
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  1. aggluatinins
    gluing; agglutinization
  2. embolos
    plug; embolus
  3. erythros
    red; erythrocytes
  4. haima
    blood; hemostasis
  5. hypo-
  6. karyon
  7. leukos
    white; leukocyte
  8. megas
    big; megakaryocyte
  9. myelos
    marrow; myeloid
  10. -osis
    condition; leukocytosis
  11. ox-
    presence of oxygen; hypoxia
  12. penia
    poverty; leukopenia
  13. poiesis
  14. punctura
    a piercing; venipuncture
  15. stasis
    halt; hemostasis
  16. thrombos
    clot; thrombocytes
  17. vena
  18. Objective: 
    Describe the important components and major functions of blood. (pp.408)
  19. Three components of the Cardiovascular system
    • Blood
    • heart
    • blood vessels
  20. The circulating fluid of the body is _____.
  21. Blood is a specialized __________ tissue, that is suspended in a fluid matrix.
  22. 5 Major Functions of blood
    • 1. Transportation of dissolved gasses,nutrients,hormones,and metabolic wastes.
    • 2.Regulation of the pH and ion composition of interstitial fluids throughout the body.
    • 3.Restriction of fluid losses at injury sites.
    • 4.Defense against toxins and pathogens.
    • 5.Stabilization of body temperature.
  23. The fluid matrix of blood is called
  24. Blood consists of
    • 55% plasma
    • 45% Formed elements
  25. Plasma
    Dissolved proteins as rather then network of insoulable fibers.
  26. Formed elements are
    blood cells, and cell fragments(platelets)
  27. RBC
    • Red blood cells, Or Erythrocytes
    • Transport O2, and CO2
  28. WBC
    • White blood cells, or leukocytes
    • part of body's defense system
  29. Platelets
    small membrane enclosed packets of cytoplasm that contain enzymes and factors important for blood clotting
  30. Plasma and formed elements constitute _____ blood
  31. Arterial puncture
    • arterial stick
    • used to evaluate blood gass exchange at the lungs
  32. Three characteristics of whole blood
    • Temp around 100.4
    • Viscosity- 5 times as viscous as water
    • pH 7.35- 7.45
  33. Objective: Discuss the composition and functions of plasma(pp.408-410)
  34. Plasma
    • Water 92%
    • dissolved proteins 7%
    • Other solutes 1%----->Electrolytes,organic nutrients, organic wastes
  35. Plasma and interstitial fluid account for most of
    the volume of ECF in the body
  36. Plasma Proteins(7%)
    • Albumins
    • Globulins
    • Fibrinogen
    • Regulatory proteins
  37. Plasma Proteins
    Albumins (60%)
    Major contributor to osmotic pressure of plasma;transports lipids,steroid hormnes
  38. Plasma Proteins
    Transports ions,hormones,lipids;immune function
  39. Plasma Proteins
    Essential component of clotting system; can be converted to insoluble fibrin
  40. Plasma Proteins
    Regulatory proteins(<1%)
    enzymes,proenzymes, hormones
  41. Other solutes (1%)
    • Electrolytes 
    • Organic nutrients 
    • Organic wastes
  42. Other solutes
    • Normal extracellular fluid ion composition essential for vital cellular activities
    • Examples are
    • Na+
    • K+
    • Ca2+, Cl-, HCO3-
  43. Other solutes
    Organic nutrients
    • Used for ATP production,growth, and maintenance of cells
    • Example:
    • fatty acids
    • glucose
    • amino acids
  44. Other solutes
    Organic wastes
    • Carried to sites of breakdown or excretion
    • Examples:
    • Urea
    • billrubin
  45. Primary difference between plasma and intersititial fluid:
    • concentrations of dissolved proteins and the levels of respiratory gasses (O2 and CO2)
    • Protein difference due to plas,a proteins are too large to cross walls of capillaries.
    • gas difference is due to respiratory activities of cells
  46. Albumins
    • Most abundent protein
    • contribute to osmotic pressure of plasma
  47. Globulins
    Antibodies and transport proteins.
  48. Antibodies
    Also called immunoglobulins, attack proteins and pathogens
  49. Transport proteins
    bind small ions,hormones, or compounds that might otherwise be lost at the kidney or have very low solubility in water
  50. Both albumins and globulins can bind to
  51. protein/lipid combo readily dissolves in plasma this:
    allows the Cardiovascular system transports insolluable lipids to peripheral tissues
  52. Globular proteinds involved in lipid transport care called
  53. Fibrinogen functions in
    blood clotting
  54. Under certain conditions, fibrinogen molvecules interact and form large insoluable strands of
  55. Serum is the
    fluid left after clotting proteins are removed
  56. What organ synthesizes more then 90% of the plasma proteins including all albumins and fibrinogens, and most of the globulins.
  57. Objective: 
    Describe the origins and production of the formed elements in the blood. (pp. 410-411)
  58. Formed elements in Whole blood are
    • RBC
    • WBC
    • Platelets
  59. Formed elements are produced by
    hemopoiesis, or hemATOpoiesis
  60. Embryonic blood cells appear in the bloodstream in the _ week of development
  61. The primary sites of blood formation for the first 8 weeks of development are:
    Vessels of the yolk sac, which is an embryonic membrane
  62. As organ systems being to develop, what moves out of the bloodstream and into the liver,thymus, and bone marrow.
    Embryonic blood cells
  63. Those embryonic blood cells become:
    • pluripotent stem cells, or hemocytoblasts.
    • which divide to produce myeloid stem cells and lympoid stem cells
  64. From the 2ed to 5th month of development, what two organs become the primary site of hemopoisesis
    Liver and spleen
  65. In Adults the only site where hemopoiesis preformed is:
    • Red bone marrow
    • only site for RBC
    • Primary for WBC
  66. Objective: Discuss the characteristics of RBC's (pp.411-416)
  67. RBC's contain hemoglobin which is?
    a pigment that binds and transports oxygen and CO2.
  68. RBS are most the most abundant blood cell and account for what % of formed elements
  69. RBC's per Microliter of whole blood is
    RBC count

    • Adult males contain roughly 5.4 million RBCs
    • females 4.8 million RBCS

    a single drop contains 260 million RBCs

    1/3 of 75 trillion cells in the human body are RBCs
  70. The percentage of whole blood volume occupied by cellular elements is known as?
  71. Hematocrit values in males VRS females
    • males: 46% range
    • Female: 42% range
  72. Difference between male and female hematocrit levels are due to:
    • Hormones
    • Androgens(male) stimulate RBC production
    • Estrogens (female) do not.
  73. Whole blood contains 1000 RBC for each WBC so
    • hematocrit closely approximates volume of RBS
    • Hematocrit values are often reported as VPRC(volume of packed red cells) or PCV (packed cell volume)
  74. hematocrit decreases due to
    result of internal bleeding or problems with RBC formation
  75. Structure of RBCs
    Biconcave disc with a thin central region and thick outer margin
  76. This shape has two important effects on RBC's
    • Gives each RBC a relatively large surface are volume ratio that increases the rate of diffusion
    • It enables RBCs to bend and flex to squeeze through narrow capillaries
  77. RBCs loose most of their organelles,including mitochondria,ribosomes, and nuclei, during?
    Their formation
  78. RBCS cannot
    Undergo cell division, and syntheize structural proteins
  79. RBC's obtain energy only through
    anaerobic metabolism and rely on glucose obtained from surrounding plasma
  80. The lack of mitochondria insures that the oxygen they absorb will...
    be carried to peripheral tissues and not used by the RBC
  81. Molecules of Hb (hemoglobin) account for over __% of an RBCs intracellular proteins
  82. Hemoglobin is responsible for the cells ability to?
    Transport 02 and CO2
  83. Two pairs of globular proteins combine to form a
    single Hb molecule
  84. Each subunits of Hb contain an organic pigment called
  85. Each heme molecule...
    holds an iron ion so that it can interact with an  O2 molecule
  86. iron-oxygen interaction is very weak, so
    they can easily separate
  87. Amount of 02 that bind to Hb depends of conditions of surrounding plasma:
  88. If O2 is abundent in plasma
    Hb molecules gain O2 until all heme molecules are occupied.
  89. As O2 concentration declines and CO2 rise
    Hb molecules release their oxygen reserves and the globular portion of the  Hb bind to CO2
  90. At the lungs where diffusion brings O2 into the plasma and removes CO2, Hb molecules respond by releasing ___ and absorbing __
    CO2, O2
  91. In the peripheral tissues, active cells consume O2 and produce CO2. As blood flows through these areas, O2 is diffuses out of the plasma and CO2 diffuses in. Hb releases its bound __ and binds ___.
    O2 and CO2
  92. Anemia
    Low hemarocrit or RBCs jave reduced Hb content.

    Premature muscle fatique, weakness, and general lack of energy
  93. Round trip for RBC in the circulatory system usually takes less then?
    1 minute
  94. RBC life span is about
    120 days
  95. 1% of RBC are replaced
    each day and approximately 3 million new RBCs enter circulation each second.
  96. When RBCs age or rupture, Hb is breaks down in the blood and the indivdual polypeptide chains are filtered from the blood by the?
    kidney and is lost in urine
  97. The condition Hemoglobinuria is when?
    large numbers of RBCS break down in the circulation, urine can turn reddish or brown thus producing hemoglobinuria
  98. Only 10% of RBS survive long enough to rupture or_________ in the blood stream
  99. Macrophages  in the liever,spleen, and bone marrow usually recongnise and engulf RBCs before they undergo hemolysis, thus doing what?
    recycling Hb and other components of RBCs
  100. Steps of Hb recycling 1
    • Four globular proteins of each Hb are dissembled into their component amino acids.
    • They are either metabolized by the cell or released into circulation for use by other cells.
  101. Steps of Hb recycling 2
    • Each heme molecule is stripped of its iron and converted to biliverdin, then converted to bilirubin and released into circulation.
    • Liver cells absorb the billirubin and release it into the small intestine within bile.
    • billirubin that reaches the large intestine is converted to related pigment molecules with are either absorbed into the blood stream or excreted in urine
  102. Steps of Hb recycling 3
    • Iron extracted from heme may be stored in the marcophage or realeased into the bloodstream where it binds to transferrin (plasma transport protein)
    • RBCs developing in the bone marrow absorb ammino acids and transferrin from circulation and then make new Hb molecules 
    • Excess transferrins are removed in the liver and spleen
  103. Biliverdin
    an organic compound with a green color
  104. bilirubin
    orange yellow pigment
  105. If bile ducts are blocked, bilirubin diffuses into peripheral tissue giving them a
    yellow color most apparent in the sking and sclera of the eyes
  106. most components of an RBC are recycled either bu
    hemolusis or phagocytosis
  107. Normal iron levels
    • male 3.5g in ionic form Fe2+, 2.5g bound to Hb
    • female 2.4 g and 1.9 g
  108. RBC formation or erythopoiesis occurs in?
    Red bone marrow or Myeloid tissue
  109. Myeloid tissue is located in the
    vertebrae,sternum,scapulae,pelvis, and proximal limb bones
  110. Other marrow ares contain a fatty tissue known as
    yellow bone marrow
  111. Under extreme conditions
    yellow bone marrow can convert to Red bone marrow
  112. Specialists in blood formation and function are
  113. RBCs result from the divsion of ____________ in the red bone marrow.
    hemocytoblasts (pluripotent stem cells)
  114. Hemocytoblasts produce
    myeloid stem cells
  115. Eythroblasts
    • are very immature RBCs that actively synthesize Hb, 
    • After about 4 days of differntiation, each eyrthoblast sheds its nucleus and becomes a reticulocyte.
  116. After about two or three days in the bone marrow synthesizing proteins Reticulocytes enter the
  117. After 24 hrs reticulocytes
    complete their maturation and become mature RBCS
  118. Erythropoisesis needs what to proceed normally
    the red bone marrow must receive adquate supplies of ammino acids, iron and vitamens (B12, B6, and folic acid)
  119. pernicious anemia is a result of
    Lack of B12
  120. EPO
    • erythropoiesis stimulating hormone
    • appears in plasma when peripheral tissues especially kidneys are exposed to low oxygen concentration.
  121. Hypoxia is
    state of low tissue oxygen levels
  122. EPO is released when
    • during anemia
    • when blood flow of the kidneys declines
    • when oxygen content of the air in the lungs declines
    • respiratory surfaces of the lungs are damaged
  123. Two major effects of EPO
    • stimulates increased cell division rates in erythroblasts and in the stem cells that produce erythroblasts
    • speeds up maturation of RBS, primarily acceleration the rate of Hb synthesis
  124. EPO ability is important to
    person recovering from severe blood loss
  125. If hematocrit rise over 65 or ore
    the increase in blood viscosity increases the workload of the heart which can lead to sudden death from heart failure
  126. Objective:
    Explain the factors that determine a persons blood type, and why blood types are important.(pp. 417-419)
  127. Antigens
    most often proteins that can trigger an immune response
  128. All your cell membranes contain antigens, and attack substances they see as
  129. Absence or presence of these antigens determines your blood type
    A,B, and Rh
  130. Type A
    Has only A antigen
  131. Type B
    only B antigen
  132. Type AB
    Has both A and B
  133. Type O
    has neither A or B
  134. Rh+
    indicates presence of the Rh antigen on the surface of RBCs
  135. Rh-
    Absence of the Rh antigen
  136. Plasma contains antibodies/agglutinins that will attack surface antigens of a
    different blood type
  137. Type AB
    universal reciever
  138. Type O
    universal donor
  139. Binding of antigens and antibodies is called
    • Aggllutination 
    • RBCS may hemolyze
  140. Cross reactions or transfusion reacions can be avoided by ensuring blood types of donor and recipient are
  141. Rh- are present only if the indivudal has been
    sentized by a previous exposure to Rh-

    can occur with a Rh- mom carries Rh- positive fetus
  142. Objective:
    Categorize the various WBC on the basis of their structures and functions. (pp. 419-424)
  143. WBCs
    • known as leukocytes
    • Larger then RBC
    • they contain a nucleus and other organelles
    • lack Hb
    • defend body against invasion by pathogens and remove toxins,wastes,abnormal or damaged cells
  144. Tranditionally divided in two groups
    • Granulocytes (with abundent stained granules)
    • agranulocytes (with few if any stained granules)
    • Misleading because grandules in granulocytes are actually secretory vesicles and lysosomes
  145. Granulocytes
    • neutrophils
    • eosinophils
    • basophils
  146. Agranulocytes
    • monocytes
    • lymphocytes
  147. Most WBCs in body are located in
    Connective tissue proper or in organs of the lymphatic system
  148. WBC circulation and movement
    • only circulate for short period of lifespan
    • migrate through loose and bense tissue of body
    • use bloodstream to travel from one organ to another and area of invasion or injury
    • when problems are detected WBC leave bloodsteam to enter damaged area
  149. Circulating WBC have 4 characteristics
    • 1.Capable of amoeboid movement. Allows WBCs to move from walls of blood vessels, and when outside the bloodstream,through surrounding tissues.
    • 2.Migrate out of bloodstream through diapesis
    • 3.Positive chemotaxis-They are attracted to specific chemical stimuli,guides WBS to invading pathogens,damaged tissues, and other active WBCs.
    • 4.Neutrophils,esinophils, and monocytes are capable of phagocytosis.
  150. amoeboid movement
    is gliding motion accomplished by the flow of cytoplasm into slender cellular process extended out from the cell
  151. diapedeis
    WBC can enter surrounding tissue by squeezing between adjacent epithelial cells in the capillary wall
  152. Neutrophils and esinophils are sometimes called
    microphages to distinguish them from lager marcophages in connective tissue
  153. macrophages are
    monocutes that have moved out of the blood stream and have become actively phagocytic
  154. Which WBC contribute to nonspecific defences?
    • neutrophils
    • eosinophils
    • basophils
    • monocytes
  155. non specific defense
    responds to a variety of stimuli but always in the same way.
  156. WBC responsible for specific defenses is
  157. specific defenses
    the body's ability to attack invading pathogens or foreign proteins on a specific basis
  158. Neutrophils
    • 50-70% circulating WBC
    • very dense controted nucleus with 4-5 lobes
    • Usually first WBC to arrive at injury site
    • Very active phagocytes
    • specialize in attacking and digesting bacteria
    • Short life span(10 hrs)
    • during its breakdown releases chemicals that attract other neutrophils
    • dead nutrophils help make puss
  159. Eosinophils
    • 2-4% of WBC
    • simimlar in size to neutrophils 
    • two lobed nuculeus
    • red dye eosin
    • Attack objects coated wtih antibodies 
    • primary mode of attack exocytosis of toxic compounds. 
    • Numbers increase dramatically during aparasitic infection of an allergic reaction
  160. Basophils
    • somewhat smaller then neutrophils
    • relatively rare less then 1% of WBC
    • Migrate to site of injury,cross the capillary wall to accumulate within damaged tissues.
    • Contain heparin and histamine 
    • basophil release of histamine that enhances local inflammation initiated by mast cells
  161. Lymphocytes
    • larger then RBC
    • 20-30% of WBC in blood
    • do not rely on phagocytosis
    • attack foreign/abnormal cells
    • secrete antibodies into circulation
  162. leukopenia
    indicates reduced numbers of WBCs
  163. Leukocytosis
    refers to excessive numbers of WBCs
  164. Leukemia
    usually indicated by extreme ammounts of WBC
  165. Hemocytoblasts produce
    • lymphoid stem cells which give rise to lymphocytes
    • myeloid stem cells which give rise to all other types of formed elements
  166. lyphopoiesis
    process of lymphocyte production
  167. WBCs other then lymphocytes are regulated by hormones cakked
    • CSFs (colony-stimulating factors)
    • 4 CSFs have been identified
    • each targets single stem cell lines or groups of stem cell lines
  168. Platelets
  169. Platelets
    made of thrombocytes
  170. megakaryocytes continusouesly shed cytoplasm in small membrane enclosed packets, those packets are referred to as
  171. Platelets initiate the clotting process and help close injured blood cells. They are a major participant in
    vascular clotting system
  172. individual platelet circulates for
    9-12 days
  173. thrombocytopenia
    abnormally low platelet count
  174. thrombocytosis
    accellerated platelet formation  in response to infection,inflammation or cancer
  175. Objective: Describe mechanisms that reduce blood loos after an injury(pp.425-428)
  176. Hemostasis
    • process that halts bleeding, preventing the loss of blood through the walls of damaged vessels.
    • helps establish framework for tissue repair
  177. Three overlapping steps of hemostasis
    • vascular phases
    • platelet phase
    • coagulation phase
  178. Vascular phase 1
    • Cutting of a blood vessel triggers a contraction in smooth muscle fibers in vessel(vascular spasm)
    • can slow or stop the blood loss through the wall of a small vessel. 
    • vascular spams lasts about 30 min
  179. Platelet phase 2
    • Platelets begin to attach to stiky endothelial surfaces and exposed collagen fibers within 15 seconds of injury.
    • This attachment starts the platelet phase
    • as more platelets stick together they form a platelet plug
  180. coagulation phase 3
    • coagulation phase does not start until 30 seconds or more after vessel has been damaged.
    • involves complex squence of events that convert circulating fibrinogen into fibrin
  181. Normal blood clotting cannot occur unless the plasma contains
    the necessary clotting factors which include calcium ions and 11 different plasma proteins.
  182. During the coagulation phase, clotting proteins interact in sequence known as
    a chain reaction or cascade
  183. Three cascades which result in formation of a blood clot
    • extrinsic
    • intrinsic
    • common
  184. extrinsic begins
    outside the blood steam in the vessel wall
  185. intrinsic begins
    inside the blood steam
  186. The cascades join at the common pathway through the activation of
    factor X, clotting protein produced by liver
  187. extrinsic pathway
    • begins with the release of a lipoprotein tissue factor by damaged endothelial cells or peripheral tissues
    • greater the damage the more tissue factor is released and faster clotng occurs
    • tissue factor combines with calciumions and factor VII to form enzyme capable of activating factor X
  188. intrinsic pathway
    • begins with the activation of proenzymes exposed to collagen fibers at the injury site
    • this pathway proceeds with assistace of platelet facor released by aggregating platelets 
    • after series of linked events, activated clotting proteins form an enzyme capable of activating factor X
  189. Common pathway
    begins when enzymes from either the extrinsic or intrinsic pathway activate factor X, forming the enzyme prothrombinase
  190. Prothrombinase converts the protein prothrombin into
  191. Thrombin then completes the clottong process by converting
    fibrinogen to fibrin
  192. Thrombin stimulates the formation of
    tissue factor and release of platelet factor by platelets
  193. Calcium Ions and Vitamin K affect
    almost every aspect of clotting process
  194. All threepathways require
    calcium ions
  195. Vitamen K must be present so
    the liver can synthesize 4 of the clotting facorts (including prothrombin)
  196. Clot retraction
    once fibrin netowork has appeared, platelets contract pulling the torn edges of the wound closer
  197. fibrinolysis
    as repairs proceed the clot gradually dissolves, beings with the activation of plasminogen by thrombin and t-PA (tissue plasminogen activator) activation of plasminogen produces plasmin
  198. Plasmin
    beings digesting the fibrin stands and breaking down the clot