Lecture Exam 1: Chapter 14: Blood

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Ivy Tech Community College, Anatomy and Physiology 102 (APHY102), Lab and Lecture Exam 1, Chapter 14, Blood
Karunanithi Dharsan
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What are the three primary functions of blood? Transportation (oxygen, wastes such as carbon dioxide and hydrogen, nutrients from the gastrointestinal tract, heat, and hormones); protection (from blood loss in the form of clotting, disease by immune responses -- antibodies and phagocytes, and proteins), and regulation (pH via buffers, body temperature, cellular water content)
What is the average temperature of blood? 100.4 degrees Farenheit
What is the average pH of blood? Is it better for blood to be more acidic or alkaline? Also, how can you change your blood to become more acidic/alkaline? Blood's pH: 7.35 - 7.45 It's better for blood to be more alkaline because cancer prefers acidity. It can be changed due to your diet (for instance, if you want your pH levels to be more alkaline, stop drinking coffee which is very acidic)
What is the average volume of blood in the human body? Males: 5 to 6 liters Females: 4 to 5 liters Remember, men have greater muscle mass, which means more oxygen.
List the components of blood and their approximate composition. 45% of blood is formed elements (which are cells and cell fragments), 99% of which are erythrocytes and 1% is leukocytes and platelets 55% of blood is blood plasma
What is blood plasma made of? 91.5% water 7% proteins, made by the liver: Most importantly is albumin which maintain blood osmotic pressure. This is followed by globulin (antibodies) and fibrinogen (blood clots). 1.5% solutes other than proteins (electrolytes, nutrients, gases, vitamins, waste)
Describe the three formed elements in terms of living cells vs. cell fragments. Living cells: Erythrocytes (RBCs) and Leukocytes (WBCs) Cell fragments: Thrombocytes (plasma)
Describe hydrostatic vs osmotic pressure. Hydrostatic: Water pressure Osmotic presssure: Elements
What is Hematocrit? Hematocrit is the ratio of red blood cells to the total volume of blood. It can also be used as a test to determine anemia.
Why do men have a higher Hematocrit than women? Men have higher Hematocrit because their testosterone levels are higher, which increases the level of erythrocytes.
Why do women occasionally experience lower levels of Hematocrit during childbearing years? Women may experience lower levels of Hematocrit because they lose blood during menstruation.
What is hemopoeisis? Hemopoeisis is the production of blood cells of plasma in the bone marrow.
What is anemia? What are the causes? Anemia is an iron deficiency, often cuased by inadequate absorption of iron, excession loss of iron, increased iron requirement, and insufficient intake of iron. Iron connects to the hemoglobin to carry oxygen.
Describe Megaloblastic anemia. Megaloblastic anemia causes large, abmnormal erythrocytes. It is caused by inadequeate intake of vitamin B12 or folic acid. It can also be caused by drugs.
Describe Pernicious anemia. Pernicious anemia is caused by insuffieicnt hemopoiesis, which inhibits the body from absorbing enough vitamin B12.
Describe Hemorrhagic anemia. Hemorrhagic anemia is caused by excessive loss of erythrocytes through bleeding.
Describe Hemolytic anemia. Hemolytic anemia is caused by erythrocytes rupturing in the liver and spleen. This causes kidney damage due to the excessive processing of hemoglobin. Hemolytic anemia can result from inherited diseases or outside agents, such as parasites, toxins, and antibodies from incompatible blood transfusions.
Describe Aplastic anemia. Aplastic anemia is caused by the destruction of red bone marrow due to toxins, gamma radiation, and/or certain medications.
What are the two inherited types of anemia? Sickle cell and Thalassemia
Describe sickle cell anemia. Sickle cell anemia is an inherited form of anemia. It is most prevalent in African Americans or those from African descent. The sickle cell trait is passed along when the gene is inherited from one parent; there are no problems with the sickle cell trait. Sickle cell anemia occurs when the gene is inherited from both parents; this causes problems with the formation of the cell.
Describe Thalassemia. Thalassemia is caused by the deficient synthesis of hemogobin. This is hereditary, and primarily seen in those of Mediterranea descent.
Describe Polycythemia. Polycythemia is a significant increase in hematocrit (the opposite of anemia). It is often caused by unregulated increase in production of erythrocyte production, tissue hypoxia (lack of oxygen to tissues, such as in high elevation), dehydration (causes appearance of more erythrocytes), and blood dopong (which is where you give blood and put the blood back into the body before a large athletic event. This is dangeous because it thickens the blood and can cause blood clots).
Describe hemopoiesis. Hemopoiesis is the process by which formed elements develop. Before birth, hemopoiesis occurs in the liver, spleen, thymus, and lymph nodes of the fetus. In a woman's final trimester, the red bone marrow takes over this duty. Red bone marrow is found in the spaces of trabeculae in cancellous bone of the axial skeleton, pectoral and pelvic girdles, and the proximal epiphyses of the humerus and femur. Less thn 1% of erythrocytes are pluripotent stem cells (future blood cells). These continuously undergo differentiation.
Describe erythrocytes. Erythrocytes contain hemoglobin. Adult males have approximately 5.4 million RBCs per microliter of blood, which adult females have approximately 4.8 million RBCs per microliter of blood. RBCs leave bone marrow at 2 million per secon, the same rate that they are destroyed. Production rate must = destruction rate.
_________ increases construction of erythrocytes. Why? Hypoxia increases construction of erythrocytes. Tissue hypoxia increases the erythropoeitin released by the kidneys. This occurs because of high altitude, anemia, and circulatory problems.
Describe the destruction of erythrocytes. Phagocytes in the spleen and liver remove worn-out RBCs from circulation. MAcrophages break down the RBC into their components: globin to amino acids to new proteins. The non-iron portion o heme- is converted to biliverdin (green pigment) which becomes bilirubin (yellow-orange pigment) which goes to the liver, travels to the small intestine, and is converted by bacteria in the large intestine to urobilinogen (brown pigment). Some of the waste is removed via fecal matter, while the rest is absorbed back into the blood stream where it is converted into urobilin (yellow pigment) and passed as waste via urine.
What does a red blood cell look like and what does it consist of? RBCs are a bioconcave discs which is due to the ejection of the nucleus. RBCs cannot reproduce. They are made up of plasma membrane (which contains antigens for blood types and Rh factors), cytosol, and Hb (each RBC contains 280 million Hb). The typical RBC lives for approximately 120 days.
Remember that red blood cells are in charge of O2 transportation, CO2 transportation, and BP regulation. Briefly summarize these three functions. O2 transportation is an anaerobic process, which means there is no oxygen consumption. There is approximately 280 million hemoglobins on each RBC. Remember that Hb is made up of 1 globin (protein) and 4 heme- (non-protein), which contains an iron ion that binds reversibly with O2. CO2 transportation: The CO2 combines with the amino acids in the globin part of Hb. BP regulation: Endothelial cells produce NO (nitric ocide), which is carefully controlled because excess NO can cause vasodilation (fancy term for the increase of a blood vessel's diameter). The NO attaches to the iron on the Hb and is transported into the lungs, where it is exhaled. Iron also carries SNO (super nitric acid) which, in excess, can cause vasoconstriction.
Identify the antigen/antibodies on each blood type. Type A blood: Antigen A, Antibody B Type B blood: Antigen B, Antibody A Type AB blood: Antigen A/B, no antibody (Universal acceptor) Type O blood: No antigen, Antibody A/B (Universal donor)
Describe positive and negative Rh. Rh+ has antigens/Rh- does not. There are no antibodies in the skin
What are the two types of blood transfusions? The two types of blood transfusions are whole blood or bloo components (such as erythrocytes and plasma).
What happens during the transfusion if the blood types are incompatible? If the blood is incompatible, it will cause hemolysis (the ruptuing of erythrocytes) of the donated cells and some of the preexisting recipient's erythrocytes.
Briefly describe leukocytes and their two classifications. Leukocytes have a nucleus and do not contain hemoglobin. There are two classifications of leukocytes: Granular and agranular. Granular leukocytes include neutrophils, eosinophils, and basophils. Agranular leukocytes include lymphocytes and monocytes.
Briefly describe neutrophils. Neutrophils are granular leukocytes. The older they are, the more lobes they have. They are also known as "polymorphonuclear leukocytes," "PMNS, "polymorphs," and "polys." Young neutrophils have bands, which give the nucleus a red appearance. They make up 60 to 70% of WBCs, and are considered the first responders (bacteria, burns, stress, inflammation). They additionally perform phagocytosis -- they release lysozyme, strong oxidents, an defensins.
Briefly describe eosinophils. Eosinophils are granular leukocytes. They make up 2-7% of leukocytes. They mainly combat the effects of histamine, which causes allergic reactions and subsequent inflammation. They additionally perform phagocytosis -- antigen-antibody complexes and some parasitic worms. They are considered phagocytes.
Briefly describe basophils. Basophils are granular leukocytes. They make up 0.5 to 1% of leukocytes. They release heparin, histamine, and serotonin. This intensifies inflammatory responses, which occurs during hypersensitivity (allergic) reactions.
Briefly describe lymphocytes. Lymphocytes are agranular leukocytes. They make up 20 to 25% of leukocytes. They mainly assist in immunity. There are three main types of lymphocytes: B cells (which differentiate into cells that produce antibodies), T cells (which attack viruses, fungi, transplanted cells, cancers, some bacteria, some allergic reactions), and Natural Killer cells (which destroy infectious microbes and some tumors). They vary in size, and often grow during an acute viral infection.
Briefly describe monocytes. Monocytes are agranular leukocytes. They make up 3 to 8% of leukocytes. They mainly clean up cellular debris following an infection. They become macrophages and perform phagocytosis.
Describe fixed vs. wandering macrophages. Fixed: Alveolar (Lung), splenic (spleen), Kupffer's cells (liver) Wandering: Remain in the blood until they reach the site of infection or inflammation
What is the ratio of RBCs to WBCs? 700:1
What is leukocytosis? Leukocytosis in an increase of WBCs (greater than 10,000/microliter of blood). This is a normal, protective response that often occurs during microbes, exercise, anesthesia, and surgery.
What is the average number of WBCs per microliter of blood? 5000 - 10,000/microliter of blood
What is leukopenia? Leukopenia is a decrease of WBCs (less than 5000/microliter of blood). This is always abnormal and occurs as result of radiation, shock, and chemotherapeutic agents.
Describe the life span of a WBC. WBCs live only a few days; during infection, they make only live a few hours. Some B and T cells can live for years.
Briefly describe chemotaxis. Chemotaxis is a phagocytosis or immune response. Pathogens entering the body and/or inflamed tissues release chemicals that attract phagocytes.
Briefly describe emigration. Emigration is the ability of a WBC to cross capillary walls. They roll across the capillary endothelium by squeezing through the cells. There are two different types of adhesion molecules to allow the WBCs to stick: selection (endothelial cells) and integrins (neutrophils).
Briefly describe thrombocytes. Thrombocytes are fragments of a megakaryoblast. Megakaryoblasts split into 2000-3000 parts, which leave the marrow and enter the blood. There are between 150,000-400,000 thrombocytes/microliter of blood. They stop bleeding by releasing chemicals to cause clotting.
Briefly describe hemostasis. Hemostasis is the sequence of responses that stop bleeding. This must be quick, localized, and carefully controlled. This is a form of positive feedback.
List the steps of the hemostasis sequence. 1. Vascular spasm: The smooth muscle contracts immediately after damage. 2. Platelet plug formation: Nearby plates adhere an the platelets release chemicals that bring in more platelets to help sustain the vascular spasm. 3. Platelet adhere to one another and continue releasing chemicals until a plug is formed.
What is coagulation? Coagulation is when the serum (plasma) separates from the blood, forming a fibrin containing gel (clot).
Extrinsic vs. Intrinsic Pathway of hemostasis Extrinsic pathway: This occurs due to tisssue trauma, typially within seconds if the trauma is severe enough. Protein elaks into the blood from outside of the blood vessels. This eventually becomes prothrombinase. Intrinsic pathway: This is due to blood trauma, and typically occurs within minutes. The activators come in direct contact with the blood and prothrombinase is formed.
What is the common pathway of hemostasis? The common pathway occurs when the prothrombinase combines with the calcium ions and becomes thrombin. The thrombin converts fibrinogen to loose fibrin threads and stabilizes them into a clot
Briefly describe clot retraction. Clot retraction occurs when the fibrin clot tightens. The platelets contract, pulling the edge of the damaged vessels closer together. This decreases the chance of further damage. Fibroblasts begin forming new connective tissue over the ruptured area; then, new endothelial cells repair the vessel lining.
What is hemostatic control? Hemostatic control stops inappropriate clot formation. It comes in four different forms: Fibrinolysis (which dissolves small inappropriate clots), plasminogen (an inactive enzyme inside the clot), plasmin (plasminogen becomes activated into plasmin and dissolves clots), and anticoagulants (found in blood and lack clotting factor).
What causes the endothelial lining in blood vessels to become roughened and why can this be negative? Atherosclerosis (which is accumulation of fat/cholesterol), trauma, and infection. The rough surface can signal adhesion, which can cause a clot.
What is thrombosis? Thrombosis occurs when clotting happens in an undamaged vesel. The clot is called a thrombus and can dissolve spontaneously.
What is an embolism? An embolism occurs when a substance transported by the blood steam (blood clot, air bubble, fat from a broken bone, and debris) breaks away from the arterial wall and becomes lodged in a smaller vessel within the body. Brain = stroke; Kidney = kiney damage; Heart = heart attack; Lungs = pulmonary embolism = heart failure and death
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