AP2 CH18: BLOOD

• what tissue type is blood?

• 2 main components and their respective %?

  a. what is plasma mainly made of?

  b. what is the minority of plasma made of?

  c. Plasma is also a _____: liquid with stuff suspended in it

  d. what are formed elements?

connective tissue, plasma 55% and formed elements 45%, water, ions proteins nutrients gas hormones, colloid, cells and cell fragments

PLASMA PROTEINS GO:

• most abundant

• transports immunity thingies

• circulates antibodies

• protect from inflammation damage + transport HDL + sex hormones

• transport LDL + transport iron + some are coagulation proteins

• least abundant

• viscosity, osmotic, buffer, transport fatty acid, bilirubin, thyroid hormone

• for blood clotting

• albumins

• globulins

• gammaglobulins

• alphaglobulins

• betaglobulins

• fibrinogens

• albumins

• fibrinogens

NON-WATER PORTION OF PLASMA

• Are these substances minority or majority of plasma?

  a. Ions: ____

  b. Nutrients: ___

  c. Waste: ___

  d. Regulatory substances = ___

  e. gases = ___

minority, electrolytes and bicarb, glucose aminos triglycerides cholesterol, stuff youd find in pee, hormones and enzymes, O2 CO2 and nitrogen

FORMED ELEMENTS OF BLOOD

• what make up most of the volume?

• 2 main types of WBCs?

  a. ____: large granules + multi-lobed nuclei

  b. ____: small granules + non-lobed nuclei

• ____ are cell fragments

rbcs, granulocytes, agranulocytes, platelets

____: ALL blood cells production

• stimulated by ___+ regulated by ___

• when u r a little embryo, this process begins at the ____. but later as we grow, this process happens at the ____

• ____(stem cell) can differentiate into 2 things:

• ____ stem cell →  RBC, WBC, platelets 

  OR

• ____stem cell → ____ (like T and B cells)

hematopoiesis, erythropoietin, colony stimulating factors, yolk sac, red bone marrow and lymph, hemocytoblast, myeloid, lymphoid, lymphocyte

____: hormone that triggers RBC production 

• released from where?

erythropoietin, kidney

RBC STRUCTURE AND FUNCTION

• do mature or young RBCs lack nucleus?

• ____ so it can pass through small vessels

• Contains ___ to transport gases

  a. Transport O2 from ____

  b. Transport CO2 from ____

• what is CO2 carried by?

mature, flexible, gas, lungs to tissues, tissues to lungs, bicarb ions through bloodstream

2 main parts of hemoglobin?

• total polypeptides?

• total irons?

• total oxygens?

• which has more attraction for oxygen, adult hemoglobin or fetal hemoglobin? 

• heme and globin

• 4 peptides, 4 irons, 4 O2

• fetal hemoglobin

• Nitric oxide function?

  a. where is it produced from?

  b. also carried by?

• How does carbon monoxide poisoning work?

relaxes smooth muscle of blood vessel ergo vasodilates to decrease blood pressure, endothelial cells of blood vessels, hemoglobin, carbon strongly bonds to hemoglobin’s iron which blocks oxygen from bonding to hemoglobin

• how many days does RBCs last in circulation before lysis?

• what things breakdown RBCs?

110-120 days, macrophages

explain the process of how low O2 in blood triggers more RBCs to increase blood oxygen

• Hypoxia sensed by ____

• kidney secretes ____ to stimulate RBC production

• now there’s increased blood O2 levels YAY

kidneys, erythropoietin

Understand how hemoglobin is broken down. What happens to the globin part and what happens to the heme part.

• RBC lyses after ____ days of its life

• ____ in liver + spleen digests hemoglobins = this results in ____ (from globin) +___ (from heme)

  • Amino acid:gets used by ___

  • Iron: used in ___ to be part of new hemoglobins

  • Bilirubin (comes from non-iron part of heme): becomes part of ____ in the liver

110-120, macrophages, amino acids, iron and bilirubin, body cells, red bone marrow, liver

What’s the relative percentage of WBCs (from most abundant to least)?

neutrophils, lymphocytes, monocytes, eosinophils, basophils

3 ways WBCs protect us:

1. ____: has projections an amoeba

2. ____: cells leave bloodstream via becoming skinny/elongated → moving between or through endothelial cells (of capillaries)

   • this is good bc WBCs will arrive at injured site ASAP

3. ___: attracted to and moves toward injury site

ameboid movement, diapedesis, chemotaxis

• platelets: are ____ that pinch off a ___ from red bone marrow

cell fragments, megakaryocyte

WBC FUNCTION

• what trait allows WBC to adhere to collagen of a damaged blood vessel?

____: fast reaction to stop bleeding

• requires clotting factors + substances released by platelets

• 3 steps: 

1. ____: temporary blood vessel constrict and blood flow stopped

   • via what 2 chemicals?

2. ____: has 3 steps…

   1. platelet adhesion: roaming platelets stumble upon damaged area > ____ released from endothelial cells allows platelets to stick to collagen > sticky spiky clump formed

   2. platelet activation: _______

   3. platelet aggregation ( platelets “hold hands” while binding to ____)

3. ____: platelet plug reinforced via ____

   • 3 phases?

• glycoproteins

• hemostasis

• vascular spasm

• endothelin and thromboxane

• platelet plug formation

• von willebrand factor

• platelet release rxn releases thromboxanes to call in more platelets to help

• fibrinogen

• coagulation

• fibrin

• common pathway (either instrinsic or extrinsic factor), pathway to thrombin, pathway to fibrin mesh

4 PHASES OF COAGULATION DO LATER

What is endothelin and thromboxanes:

• Both are chemicals released during vascular spasm

• Endothelin = released from ____ (of punctured blood vessel)

• Thromboxanes = released from ____

What is von Willebrand factor:

• during platelet plug formation

• binds ____ with ____ of exposed blood vessel

• produced from _____ of blood vessel

• Where are most of the clotting factors made

  • What vitamin is needed for making four of the factors?

damaged cells, wbc, platelet, collagen, endothelial cells, liver, vitK which is stored in liver

Extrinsic and intrinsic pathway (just write it down somewhere and flip card over)

• extrinsic pathway:

• intrinsic pathway:

• Extrinsic pathway: 3 → 7→ (7 + 3 + calcium) = 10

• Intrinsic pathway: 12 → 11 → 9 → (9+ 8 + calcium) = 10

• Factor X converts ___ (aka factor __) to ___

• thrombin converts ___ (aka factor __) to ___

• Fibrin does what?

prothrombin, factor 2, thrombin, fibrinogen, factor 1, fibrin, forms the actual clot by trapping the blood cells/turning blood into gel

ANTICOAGULANTS

1. ___ (from liver) = slowly inactivates thrombin

2. ___ (from endothelial cells) = causes ____ (note: which is opposite action of vascular spasm) and inhibits release of clotting factors

3. ____: (from basophils and endothelial cells) works with antithrombin

4. ____: (from outside body, duh) contains what substance?

antithrombin, prostacyclin, heparin, transfusions, EDTA

CLOT RETRACTION AND DISSOLUTION

• Blood clot needs to be stabilized via ____, then removed via _____

  1. Clot retraction

     • uses what 2 chemicals from platelets?

     • vessel contraction > pulls fibrin which releases serum > ruptured vessel’s edges pull together > sealed 

  2. Dissolution

     • clot dissolves after clot retraction using _____

clot retraction, dissolution, actin and myosin, plasmin

BLOOD DISORDERS

____: iron deficiency

____: abnormally high RBCs

• due to ____ (from dehydration, diuretics, etc)

____: little WBC count in blood

• leads to ____ in blood vessels

hemophilia: improper clotting due to lack of clotting factor ___

• is this disorder acquired or genetic?

• more common in men or women?

____: bleeding/clotting disorder bc platelets dont plug

anemia, erythrocytosis, decreased blood pressure, leukopenia, chronic bleeding, 8, genetic, men, von willebrand disease

BLOOD TYPES

• Blood type is determined by presence/absence of specific ___ on RBC plasma membrane 

• for this, write down and flip to check:

  • Type A

  • Type B

  • Type AB

  • Type O

• which blood type is the universal donor?

  • even tho its universal donor, this blood type can cause agglutination bc of antibodies in its plasma

antigens, type o

RH BLOOD GROUPING

• ___ = has Rh antigen on RBC membrane 

• ___ = no Rh antigen on RBC membrane 

• ____: mom and fetus have mismatched Rh blood types; can be fatal bc it kills fetus’s RBCs

• Describe blood typing?

• Cross match: donor blood cells mixed with recipient’s serum (or vice versa) to test for ____

rh positive, rh negative, hemolytic disease for newborn, tests for ABO blood type and Rh factor via testing RBCs with antibodies, agglutinations

BLOOD TESTS

1. Complete blood count: involves what things?

2. ____ panel: glucose, CO2, ions, globulin, albumin, bilirubin, creatinine, urea

3. ____ panel: total triglycerides, HDL, LDL  

COMPLETE BLOOD COUNT

• this tests for….

1. Anemia + Erythrocytosis

2. Leukocytosis + Leukopenia

3. Thrombocytosis + Thrombocytopenia

• RBC, WBC, platelets, hemoglobin measurement, hematocrit measurement

• comprehensive metabolic

• lipid

How do you replace blood volume immediately to prevent shock?

• _____(multi-electrolyte solution that mimics blood’s plasma)

ringers solution

what are 2 additional blood tests?

differential white blood count and clotting assessment

____:RBCs are misshaped (end up being c-shape) due to bad protein folding = ___ hemoglobin = blocks blood flow

• is this genetic or acquired?

• ____ = given person to increase fetal hemoglobin to decrease sickle cells 

sickle cell anemia, abnormal, genetic, hydroxyurea

• ____: large proteins (located on RBC membrane) that trigger immune response  

• ____ (produced by B-lymphocytes): bind to antigens

  • cause antigens to either ____ or _____

antigens, antibodies, agglutinate, lyse

TYPES OF WBCS go:

• arrives first at injury site + phagocytize bacteria

• B-tells and T-cells

• becomes macrophage and presents itself as antigen

• inflammatory and destroys worms (tapeworm, hookworm, etc)

• inflammatory and allergic rxns (releases histamine) + also produces heparin

neutrophils, lymphocytes, macrocytes, eosinophils, basophilss