blood quiz

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blood quiz
2014-04-16 10:18:36
ch 17 blood quiz
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  1. blood composition
    • fluid connective tissue
    • plasma: non living fluid matrix
    • formed elements: living blood "cells" suspended in plasma (erythrocytes, leukocytes, platelets)
  2. erythrocytes
    red blood cells
  3. leukocytes
    white blood cells
  4. spun tube of blood yields three layers, what are they
    • plasma on top (55%)
    • erythrocytes on bottom (45%)
    • white blood cells and platelets in buff coat (1%)
  5. hematocrit
    percent of blood volume that is red blood cells
  6. what causes color variation in blood
    • O2 content.
    • high O2=scarlet
    • low O2=dark red
  7. blood makes up what percentage of body weight
    about 8%
  8. average volume of blood
    5 liters
  9. functions of blood
    • distributing substances
    • regulating blood levels of substances
    • protection
  10. distribution functions of blood
    • delivering O2 and nutrients to body cells
    • transporting metabolic wastes to lungs and kidneys for elimination
    • transporting hormones from endocrine organs to target organs
  11. regulation functions of blood
    • maintaing body temp by absorbing and distributing heat
    • maintaing normal pH using buffers; alkaline reserve of bicarbonate ions
    • maintaing adequate fluid volume in circulatory system
  12. protection functions of blood
    • preventing blood loss: plasma proteins and platelets initiate clot formation
    • preventing infection: antibodies, complement proteins, WBCs
  13. blood plasma
    • 90% water
    • over 100 dissolved solutes: nutrients, gases, hormones, wastes, proteins, inorganic ions
  14. what is the most abundant solute in plasma
    • plasma proteins;
    • remain in blood; not taken up by cells
    • proteins produced mostly by liver
    • 60% albumin, 36% globulins 4% fibrinogen
  15. importance of albumin
    • main contributer to osmotic pressure
    • substane carrier
    • blood buffer
  16. importance of globulins
    36% of plasma proteins
  17. important of alpha and beta
    • produced by the liver
    • most are transport proteins
  18. importance of electrolytes
    help maintain plasma osmotic pressure and normal blood pH
  19. importance of gamma
    antibodies released by plasma cells during immune response
  20. importance of fibrinogen
    forms fibrin threads of blood clot
  21. formed elements
    • only WBCs are complete cells
    • RBCs have no nuclei or other organelles
    • platelets are cell fragments
    • most formed elements survive in bloodstream only few days
    • most blood cells originate in bone marrow and do not divide
  22. erythrocytes
    • biconcave discs, anucleate, essentially no organelles
    • diameters larger than some capillaries
    • filled with hemoglobin (Hb) for gas transport
    • contain plasma membrane protein spectrin and other proteins (provides flexibility to change shape)
    • major factor contributing to blood viscosity
    • structural characteristics contribute to gas transport (huge surface area to volume, more than 97% Hb, don't consume O2 they transport b/c no mitochondria)
    • Hb binds reversibly with oxygen
    • RBCs dedicated to respiratory gas transport
  23. hemoglobin structure
    • globin: composed of 4 polypeptide chains (2 alpha, 2 beta)
    • heme: pigment bonded to each globin chain (gives red color)
    • heme's central iron atom binds one O2
    • each Hb molecule can transport 4 O2
    • each RBC contains 250 million Hb molecules
  24. O2 loading in lungs
    produces oxyhemoglobin (ruby red)
  25. O2 unloading in tissues
    produces deoxyhemoglobin (dark red)
  26. CO2 loading in tissues
    creates carbaminohemoglobin
  27. hematopoiesis
    • blood cell formation in red bone marrow: composed of reticular connective tissue and blood sinusoids
    • in adult, found in axial skeleton, girdles, and proximal epiphyses of humerus and femur
    • hematopoietic stem cells (hemocytoblasts): give rise to all formed elements, committed cells cannot change, hormones push cell toward specific pathway of blood cell development)
    • new blood cells enter blood sinusoids
  28. erythropoiesis
    • red blood cell production
    • nucleus is ejected during phase 3 reticulocyte
  29. too few RBCs leads to tissue
  30. too many RBCs increases blood
  31. balance between RBC production and destruction depends on
    • hormonal controls
    • adequate supplies of iron, amino acids, and B vitamins
  32. hormonal control of erythropoiesis
    • hormone erythropoitin (EPO)
    • direct stimulus for erythropoiesis
    • always small amount in blood to maintain basal rate
    • released by kidneys in response to hypoxia
  33. hypoxia
    • decreased RBC numbers due to hemorrhage or increased destruction
    • insufficient hemoglobin per RBC
    • reduced availability of O2
  34. dietary requirements for erythropoiesis
    • nutrients: amino acids, lipids, carbohydrates
    • iron: available from diet, 65% i Hb
    • vitamin B12 and folic acid
  35. fate and destruction of erythrocytes
    • life span 100-120 days: no protein synthesis, growth, or division
    • old RBCs become fragile, Hb begins to degenerate
    • get trapped in smaller circulatory channels especially in spleen
    • macrophages engulf dying RBCs in spleen
    • heme and globin are separated: iron salvaged for reuse, heme degraded to bilirubin, liver secretes bilirubin into intestines, globin metabolized into amino acids and released into circulation
  36. bilirubin
    yellow pigment; bile
  37. anemia
    • blood has abnormally low O2 carrying capacity
    • sign rather than disease itself
    • blood O2 levels cannot support normal metabolism
    • accompanied by fatigue, pallor, shortness of breath, and chills
  38. what are the causes of anemia
    • blood loss
    • low RBC production
    • high RBC destruction
  39. hemorrhagic anemia
    • blood loss is rapid (stab wound e.g.)
    • treated by blood replacement
  40. chronic hemorrhagic anemia
    • slight bu persistent blood loss; hemorrhoids, bleeding ulcer
    • primary problem treated
  41. iron deficiency anemia
    • caused by hemorrhagic anemia, low iron intake, or impaired absorption
    • microcytic, hypochromic RBCs
    • iron supplements to treat
  42. pernicious anemia
    • autoimmune disease -destroys stomach mucosa
    • lack of intrinsic factor needed to absorb B12 (vitamin B12 deficiency)
    • RBCs cannot divide > macrocytes
    • treated with B12 injections or nasal gel
    • also caused by low dietary b12 (vegetarians)
  43. renal anemia
    • lack of EPO
    • often accompanies renal disease
    • treated with synthetic EPO
  44. EPO
    hormone erythropoitin
  45. aplastic anemia
    • destruction of inhibition of red marrow by drugs, chemicals, radiation, viruses
    • usually cause unknown
    • all cell lines affected; clotting and immunity defects
    • treated short term with transfusions; long-term with transplanted stem cells
  46. hemolytic anemias
    • premature RBC lysis
    • caused by Hb abnormalities
    • incompatible transfusions
    • infections
  47. causes of anemia: high RBC destruction
    • usually genetic basis for abnormal Hb
    • globin abnormal; fragile RBCs lyse prematurely
    • th
  48. thalassemias
    • typically mediterranean ancestry
    • one globin chain absent or faulty
    • RBCs thin, delicate, deficient in Hb
    • many subtypes from mild to severe
  49. sickle cell anemia
    • hemoglobin S: one amino acid wrong in globin beta chain
    • RBCs crescent shaped when unload O2 or blood O2 low
    • RBCs rupture easily and block small vessels creating poor O2 delivery and pain
    • treatment: transfusions or inhaled nitric oxide
    • preventing sickling: hydroxurea, blocking RBC ion channels, stem cell transplants, gene therapy
  50. malaria kills
    1 million each year
  51. polycythemia vera
    • bone marrow cancer > excess RBCs
    • severely increased blood viscosity
  52. secondary polycythemia
    • less O2 available (high altitude) or EPO production increases > higher RBC count
    • blood doping
  53. leukocytes
    • make up less than 1% of blood volume
    • function in defense against disease: can leave capillaries via diapedesis, move through tissue spaces by ameboid motion and positive chemotaxis
    • leukocytosis: WBC count over 11,000/ mm3 (normal response to infection)
  54. what are the two categories of leukocytes
    • granulocytes: visible cytoplasmic granules (neutrophils, eosinophils, basophils)
    • agranulocytes: no visible cytoplasmic granules (lymphocytes, monocytes)
    • decreasing abundance in blood
    • *never let monkeys eat bananas*
  55. granulocytes
    • larger and shorter lived than RBCs
    • loved nuclei
    • cytoplasmic granules stain specifically with Wright's stain
    • all phagocytic to some degree
  56. neutrophils
    • most numerous WBCs
    • also called polymorphonuclear leukocytes
    • granules stain ilac; contain hydrolytic enzymes or defensins
    • 3-6 lobes in nucleus; twice size of RBCs
    • very phagocytic "bacteria slayers"
  57. eosinophils
    • red-staining granules
    • bilobed nucleus
    • granules lysosome-like; release enzymes to digest parasitic worms
    • role in allergies and asthma
    • role in modulating immune response
  58. basophils
    • rarest WBCs
    • nucleus deep purple with 1-2 constrictions
    • large, purplish-black granules contain histamine
    • are functionally similar to mast cells
  59. histamine
    inflammatory chemical that acts as vasodilator to attract WBCs to inflamed sites
  60. agranulocytes
    • lack visible cytoplasmic granules
    • have spherical or kidney shaped nuclei
  61. lymphocytes
    • second most numerous WBC
    • large, dark purple circular nuclei with thin rim of blue cytoplasm
    • mostly in lymphoid tissue (lymph nodes/spleen); few circulate in blood
    • crucial to immunity
    • two types: T lymphocytes and B lymphocytes
  62. T lymphocytes
    • T cells;
    • act against virus infected cells and tumor cells
  63. B lymphocytes
    • B cells;
    • give rise to plasma cells, which produce antibodies
  64. monocytes
    • larget leukocytes
    • abundant pale-blue cytoplasm
    • dark purple-staining, U or kidney shaped nuclei
    • leave circulation, enter tissues, and differentiate into macrophages
    • activate lymphocytes to mount an immune response
  65. macrophages
    actively phagocytic cells; crucial against viruses, intracellular bacterial parasites, and chronic infections
  66. leukopoiesis
    • production of WBCs: stimulated by 2 types of chemical messengers form red bone marrow and mature WBCs (interleukins, colony-stimulating factors CSFs)all leukocytes originate from hemocytoblasts
    • lymphoid stem cells -> lymphocytes
    • myeloid stem cells -> all others
    • granulocytes stored in bone marrow
    • 3 times more wBCs produced than RBCs; shorter life span; die fighting microbes
  67. progression of all granulocytes
    myeloblast > promyelocyte > myelocte > mature cell
  68. progression of monocytes
    • live several months;
    • monoblast > promonocyte > monocyte
  69. progression of lymphocyte
    lymphoid stem cell > t lymphocyte precursors travel to thymus and B lymphocyte precursors
  70. leukopenia
    abnormally low WBC count; drug induced
  71. leukemias
    • all fatal if untreated
    • cancer > overproduction of abnormal WBCs
    • named accoridng to abnormal WBC clone involved
    • myeloid leukemia involves myeloblast descendants
    • lymphocytic leukemia involves lymphocytes
    • acute leukemia derives from stem cells; primarily affects children
    • chronic leukemia more prevalent in older people
  72. leukemia
    • cancerous leukocytes fill red bone marrow
    • immature nonfunctional WBCs in blood stream
    • death from internal hemorrhage; overwhelming infections
    • treatments: irradiation, stem cell transplants, antileukemic drugs
  73. infectious mononucleosis
    • highly contagious viral disease: epstein barr virus
    • high numbers atypical agranulocytes
    • symptoms: tired, achy, chronic sore throat, low fever
    • runs course with rest
  74. platelets
    • cytoplasmic fragments of megakaryocytes
    • blue staining outer region, purple granules
    • granules contain serotonin, Ca2+ enzymes, ADP, and platelet derived growth factor (act in clotting process)
    • normal=150,000-400,000 platelets/ml of blood
    • form temporary platelet plug that helps seal breaks in blood vessels¬†
    • circulating platelets kept inactive and mobile by nitric oxide and prostacyclin from endothelial cells lining blood vessels
    • age quickly; degenerate in 10 days
    • formation regulated by thrombopoitin
    • derive from megakaryoblast (mitosis but no cytokinesis)
  75. hemostasis
    • fast series of reactions for stoppage of bleeding
    • requires clotting factors and substances released by platelets and injured tissues
    • three steps: vascular spasm, platelet plug formation, coagulation
  76. what are the three steps of hemostasis
    • vascular spasm
    • platelet plug formation
    • coagulation (blood clotting)
  77. vascular spasm
    • vasocontriction of damaged blood vessel
    • triggers direct injury to vascular smooth muscle, chemicals released by endothelial cells and platelets, pain reflexes
    • most effect in smaller blood vessels
  78. platelet plug formation
    • positive feedback cycle
    • damaged endothelium exposes collagen fibers;¬†
    • platelets stick to collagen fibers via plasma protein¬†
    • swell, become spiked and sticky and release chemical messengers
    • ADP causes more platelets to stick and release their contents
    • serotonin and thromboxane A2 enhance vascular spasm and platelet aggregation
  79. coagulation
    • reinforces platelet plug with fibrin threads
    • blood transformed from liquid to gel
    • series of reactions using clotting factors (procoagulants)
    • vitamin K needed to synthesize 4 of the factors
  80. 3 phases of coagualtion
    • prothrombin activator formed in both intrinsic and extrinsic pathways
    • prothrombin converted to enzyme thrombin
    • thrombin catalyzes fibrinogen > fibrin
  81. coagulation phase 1: 2 pathways to prothrombin activator
    • initiated by either intrinsic or extrinsic pathway (usually both)
    • triggered by tissue damaging evenets
    • involves a series of procoagulants
    • each pathway cascades toward factor X
    • intrinsic pathway: triggered by negatively charged surfaces (platelets, collagen, glass) uses factors present within blood
    • extrinsic pathway: triggered by exposure to tissue factor or factor 3. bypasses several steps of intrinsic pathway so its faster
  82. coagulation phase 2: pathway to thrombin
    • prothrombin activator catalyzes transformation of prothrombin to active enzyme thrombin
    • once prothrombin activator formed, clot forms in 10-15 seconds
  83. coagulation phase 3: common pathway to the fibrin mesh
    • thrombin converts soluable fibrinogen to fibrin
    • fibrin strands form structural basis of clot
    • fibrin causes plasma to become a gel like trap for formed elements
    • thrombin activates factor XIII which cross links fibrin and strengthens and stabilizes clot
  84. clot retraction
    • stabilizes clot
    • actin and myosin in platelets contract with 30-60 minutes
    • contraction pulls on fibrin strands, squeezing serum from clot
    • draws ruptured blood vessel edges together
  85. vessel repair
    • vessel is healing as clot retraction occurs
    • platelet derived growth factor (PDGF) stimulates division of smooth muscle cells and fibroblasts to rebuild blood vessel wall
    • vascular endothelial growth factor stimulates endothelial cells to multiply and restore endothelial lining
  86. fibrinolysis
    • removes unneeded clots after healing
    • begins within 2 days; continues for several days
    • plasminogen in clot is converted to plasmin by tissue plasminogen activator, factor XII and thrombin
    • plasmin is a fibrin digesting enzyme
  87. two mechanisms limit clot size
    • swift removal and dilution of clotting factors
    • inhibition of activated clotting factors
  88. antithrombin III
    inactivates unbound thrombin
  89. platelet adhesion is prevented by
    • smooth endothelium of blood vessels prevents platelets from clinging
    • antithrombic substances nitric oxide, and prostacyclin secreted by endothelial cells
    • vitamin E quinine acts as potent anticoagulant
  90. thrombus
    • clot that develops and persists is unknown blood vessel
    • may block circulation leading to tissue death
  91. embolus
    thrombus freely floating in bloodstream
  92. embolism
    • embolus obstructing a vessel
    • e.g. pulmonary and cerebral emboli
  93. atherosclerosis
    inflammation; slowly flowing blood or blood stasis form immobility
  94. aspirin
    antiprostaglandin that inhibits thromboxane A2
  95. heparin
    anticoagulant used clinically for pre and postoperative cardiac care
  96. warfarin
    • used for those prone to atrial fibrillation
    • interferes with action of vitamin K
  97. dabigatran
    directly inhibits thrombin
  98. transfusions
    • whole blood transfusions used when blood loss rapid and substantial
    • packed red cells (plasma and WBCs removed) transfused to restore oxygen carrying capacity
    • transfusion of incompatible blood can be fatal
  99. agglutinogens
    promoters of agglutination
  100. presence of absense of each antigen is used to classify
    blood cells into different groups
  101. RBC membranes bear 30 types of
    glycoprotein antigens