Blood & Heart Quiz Prep
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Blood basic breakdown with percentage?
- 1. Formed Elements (RBC/WBC/Platelets) 45%
- 2. Plasma [H2O (90%) + Solutes (10%)] 55%
List the formed elements...
- RBCs = bags of hemoglobin (carry O2)
- WBCs = true cells (nucleus)
- Leukocytes = 2 types (5 different cells)
- Platelets = fragments in clotting process (not cells)
What potential quantity of O2 molecules do RBC have to carry?
- 1 RBC = 250mm Hgh (hemoglobin) molecules
- Since each RBC carries 4 iron each RBC has the potential to carry 1bn O2 molecules
1RBC = 250mm Hgh x 4 = 1bn
White Blood Cells (WBCs)= Leukocytes; disease fighting cells; (2 types) – only complete cells in the blood. Two major categories by structure and function.
- 1. Granulocytes (have the presence of granules)
- Part of the nonspecific defence mechanism. Get activated whenever there is a problem.
- 1. A-Granulocytes (belong to lymphocyte and
- monocyte category)
- 1. Neutrophils
- 2. Eosinophils
- 3. Basophils
- 1. T Lymphocytes
- 2. B Lymphocytes
- 3. Monocytes
- Kill the virus or pathogen themselves. Inject
- enzyme (Perforin) into the cell wall of the virus. The Perforin will explode the virus.
- i) Produce antibodies for the virus or bacteria that attack us resulting in the antibodies attaching to the specific virus or bacteria and destroying it.
- ii) Produce memory cells. Help us ward off a secondary infection by the same virus twice. They remember what virus attacked us the 1st time. The 2nd time infected by the same virus the memory cells can fight the virus that much quicker & effectively. Not effective when virus mutates.
How do antibodies work?
The cells antibodies attach to are determined by cell markers on the cell. Cell markers are clusters of differentiation on the cell surface or major histocompatibility complex on the cell. If the markers on the cell match that antibody was produced for the antibody will attack the cell.
(phagocytic - they engulf/destroy certain bacteria’s) Active phagocytes. Most numerous of all WBCs (>50% of total WBC population). When examining blood you will see more neutrophils than any other WBC. Attracted by chemo taxis (chemicals that are sent out at the site of infection or inflammation). Identify by multi-lobe (3 or 4) nuclei with granules in them. Stain violet or blue on slides.
(effective against parasites) – Very small part of the WBC population (1% to 4% of total WBC population). Attach to parasite and inject enzymes to destroy. Bi-lobe nucleus (2). Stain orange or red on slide.
mobile macrophages – get called into action but also seek out the action “looking for trouble”. On patrol. Largest WBC by size. No granules & look like a solid mass.
(allergic reaction/histamine – widens blood vessels/vasodilator) Very rare (< .5% of total WBC population) Helps in the inflammatory response. Bi-lobe or multi-lobe nuclei but usually not connected. Stain violet or blue on slides.
How antibodies work.
Cell markers are clusters of differentiation on the cell surface or major histo compatibility complex on the cell. If the markers on the cell match that antibody was produced for the antibody will attack the cell.
- Is it granular or agranular?
- Are their granulars in the cytoplasm.
- Look at shape to see if it is neutrophil, eosinophil or basophil?
- Color of the Stain.
Hematology measured in CBC (complete blood count) List components.
- 1. Red blood cell count (RBC)
- 2. White blood cell count (WBC)
- 3. Platelet count
- 4. Hemoglobin (Hgh)
- 5. Hematocrit (HCT) – pact cell volume, % of RBCs to total amount of blood
- 6. Blood indices (3)
- a. MCB (mean corpuscular volume the RBC) average size of a RBC
- b. MCH (mean corpuscular volume of the hemoglobin) correlates w/ MCB
- c. MCHC (mean corpuscular hemoglobin concentration) average concentration of Hgh per unit volume of RBC
- 7. Differential count – percentage of different
- types of WBC (ie Basophils, T lymphocytes)
too many WBCs
Blood Development + Differentiation
- Myeloed Stem Cell ->...
- Lymphoid Stem Cell ->...
- -Controlled hormonally
- -Erythropoietin: hormone that controls the
- production of RBCs which is secreted by the kidneys.
- -Chemo receptors in the Kidneys that monitor O2 levels in the blood. If blood hypoxic (O2 deficient) they will accelerate production & release of Erythropoietin.
In the liver dying RCBs are engulfed/destroyed by macrophages. Heme molecule is split from the globin. Iron bound to the heme is reused in the body. Balance of the heme is degraded to bilirubin. Bilirubin goes from the liver and is passed out by urobilinogen to the kidneys and it exits the body via the urine.
Blood Type and Rh: (A, B, O & Rh Factor)
- Type A Blood; A Antigen on cell surface. Has B Antibodies.
- (Will be attacked by A antibodies if donated to someone w/ B)
- Type B Blood; B Antigen on cell surface. Has A Antibodies
- (Will be attacked by B antibodies if donated to someone w/ A)
Type AB Blood; A+B Antigen on cell surface. Has no antibodies. [universal recipient]
Type O Blood; NO Antigenic Determinants on cell surface. [universal donor]
Gamagobulin will neutralize it.
- 1. Vascular Spasm
- 2. Platelet Plug Formation
- 3. Clot Retraction & Repair
- 4. Fibrinolysis (Process of Clot Removal)
- a. Constriction of vessels
- b. Minimize blood loss
- c. Endothelial cells release chemicals
Platelet Plug Formation
- a. Collagen fibers extend from the endothelium
- b. Spike processes become very sticky & when
- platelets come together form fibrin mesh
- c. Platelets release Serotonin (enhances the spasm & fills up ADP -> energy needed for the processes)
- d. A lot of neutrophils in the area (WBCs mobile
- macrophages taking out the debris)
- e. Prostaglandins (local hormones - Thromboxane A2 causes positive feedback for more Platelets to come in)
Clot Retraction & Repair
Develops into clot. Clot diminishes over time. Retreats from the periphery inward
Fibrinolysis (Process of Clot Removal)
Removal of clot via clot buster TPA
Blood Flow (from Systemic Circuit)
- 1. Arteries
- 2. Capillaries
- 3. Venules
- 4. Veins (High CO2 low pressure)
- 5. Inferior & Superior Vena Cava
- 6. Right Atrium
- 7. Tricuspid Valve
- 8. Right Ventricle
- 9. Pulmonary Semilunar Valve
- 10. Pulmonary Trunk (Pulmonary Arteries O2 poor)
- 11. Alveolar Sacs (exchange of O2 for CO2)
- 12. Pulmonary Vein (O2 rich)
- 13. Left Atrium
- 14. Bicuspid Valve – Mitral Valve
- 15. Left Ventricle (O2 rich high pressure)
- 16. Aortic Semilunar Valve
- 17. Ascending Aorta (5cm before we go into the Aortic Arch – high presure)
- a. Coronary Arteries (supplies the heart)
- 18. Aortic Arch
- 19. Descending Aorta
- a. Thoracic Aorta – top part of the Descending Aorta (runs down back of spine perpendicular to the vertebral column
- b. Abdominal Aorta
3 Components to the Valves
- 1. Cusps
- 2. Chordae Tendineae
- 3. Papillary Muscle (pulls the Chordae Tendineae which pulls the Cusps)
Coverings of the heart
- 1. Pericardium (layered sack that encloses the
- a. Fibrous Pericardium – outer layer
- b. Serous Pericardium – inner layer (parietal layer)
- 2. Serous Fluid
- 3. Epicardium (visceral layer) 1st layer of the heart wall
- 4. Myocardium (muscle)
- 5. Endocardium (chambers)
Where does the Heart lie?
in the medium Steinem in the Thoracic Cavity
flap on the atrium that provides the atrium with a little more volume.
- Atrioventricular valves & semilunar valves closed.
- Neither the atria nor ventricles are contracting at that time.
- Blood volume is the same both chambers in the heart.
- The pressure gradients are the same.
EDV (End Diastolic Volume)
Volume of blood in the right and/or left ventricle at end load or filling in (diastole) or the amount of blood in the ventricles just before systole.
Amount of blood left in the Ventricles after contraction.
- Ejection Volume / EDV
- Example: 60 / 130 = 46.1%
- Normal =55% to 65%
- Heart Muscle Beginning to Deteriorate <55%
- (Signs - CHF)
- 1 .Sino-atrial Node (SA Node) also known as the “Pacemaker”, has many auto-rhythmic fibers – located in R atrium. (START OF THE CARDIAC CYCLE)
- 2. SA Node will connect to the left atrium (LA) through the Inter-atrial Bundle (helps to depolarize the L atrium?)
- 3. SA Node connects to the AV Node (bundle of auto-rhythmic fibers). It is a continuation of the conduction mechanism started by the SA Node. (It is located close to where the atria and ventricles meet.)
- 4. AV Node connects to the Bundle of His – known as Branch Bundles. Area between the ventricles.
- 4. Bundle of His goes down the area between the L and R ventricles and splits into the left bundle branch and the right bundle branch.
- 5. L & R bundle branches continue to go up the walls of the ventricles from the apex where they are called Purkinjie Fibers.
Contraction Biochemical/Electrical Stages
- 1st Stage: C++ & Na+ channels open C++ & Na+ rush in, mv go up
- 2nd Stage: maintenance/sustained maintains contraction due to C+ opening early and staying open
- 3rd Stage: closure of the C++ channels, open of K+ channels – K+ rushes out, mv decreases, RAPID REPOLARIZATION
- P wave: atrial depolarization, Sodium
- channels open up. Get more +.
- QRS complex: ventricular depolarization, atrial repolarization
- (Buried in the QRS. Reduces this complex somewhat.)
- T wave: ventricular repolarization (Reason it is positive on EKG is due to view of the wall
- EKG is looking at.)
- U wave: late repolarization to some of
- subendocardial branches
- All events associated with one hear beat.
- 1. Atrial Systole: (.1/sec); P wave; depolarization that starts at the SA node to the AV node, to the Bundle of His, to L & R
- bundle branches & around the Purkinje fibers. Also, ventricles are in diastole. When the atrials are contracting the ventricles are relaxing.
- a. AV valves are open. Blood forced into
- b. Add about 25ml/blood to ventricles. (Ventricles have ~105ml/blood before they are loaded by atria. Post load EDV 130ml/blood in ventricles.
- 2. Isovolumetric Contraction: AV valves closed + semilunar valves closed. Pressure in
- atria and ventricles are EQUAL.
- 3. Ventricular Systole: AV valves closed +
- semilunar valves open (contraction mode of the ventricles – ventricular pressure rises above the aortic or pulmonary trunk pressure)
- 4. Ejection of Ventricular Blood
- a. Aorta (LV)
- b. Pulmonary Trunk (RV)
- 5. Ejection Volume = 60ml to 70ml
ESV(End Systolic Volume)
Blood Remaining in each ventricle after ventricular systole.
Stroke Volume (SV)
- EDV – ESV
- 130ml – 60ml = 70ml
Cardiac Output (CO)
- SV x HR
- 70ml x 55bpm = 3850ml blood per minute (ideally 5200ml)
- max cardiac output – CO at rest (HR
- at max effort X SV) – CO at rest
- 8000 – 5200 = 2800ml per min
4 polypeptide chains made up of 2 alpha and 2 beta chains
- The “lub dub”
- 1st sound is longer “lub” It is the AV valves closing. Beginning of ventricular systole.
- 2nd sound is shorter & sharper/crisper “dub”. It is the semilunar valves closing. Beginning of ventricular diastole. The relaxation of the ventricles.
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