chapter 19: BLOOD

Know the 4 major elements that make up blood AND which of those are the formed elements 

• Plasma: liquid extracellular matrix of blood 

• Erythrocytes: red blood cells (RBCs) 

• Leukocytes: white blood cells (WBCs) 

• Platelets(thrombocytes): small cellular fragments 

Know the relative abundance of the 4 major elements that make up blood 

• Plasma: MOST ABUNDANT (55%) 

• Erythrocytes: MOST ABUNDANCE FORM ELEMENT IN BLOOD (44%) 

Buffy coat: platelets + leukocytes (1%)

Know what makes up blood plasma

• 90% water (most abundant component) 

• 9% Plasma proteins 🔽

• Albumin: large protein synthesized in liver, responsible for blood colloid osmotic pressure

• Globulins: (antibodies) made by leukocytes 

• Fibrinogen: clotting protein , blood clot 

• The last 1% of plasma vol consists of small molecules dissolved in the water portion forming a solution.

liver produces

plasma proteins

liver disease cirrhosis

decrease in production of plasma proteins

The primary function of erythrocytes 

• To transport gasses (O2 and CO2)

Know what makes up hemoglobin and where hemoglobin can be found + function 

• Hemoglobin is made of 4 protein subunits (2alpha & 2 beta chain) each globin has a heme group and 4 iron atoms which means hemoglobin can carry up to 4 oxygen molecules per iron atom 

• Hemoglobin can be found in erythrocytes 

• Function of hemoglobin is to transport oxygen known as oxyhemoglobin, bind to carbon dioxide known as carbaminohemoglobin

Know what molecule/atom keeps gasses attached to Hb - iron 

• Oxyhemoglobin (HbO2): the iron ion in each heme group is oxidized when it binds to oxygen in areas of high concentration (lungs)

• Carbaminohemoglobin: DOES NOT BIND IRON, proteins of Hb bind to CO2 

• Carboxyhemoglobin: iron can bind to carbon monoxide (CO) + binds strong to iron ion than oxygen 

⬆ changes shape of Hb making it unable to unload oxygen into oxygen deprived tissues

Know the different names given to hemoglobin based on which gas it is carrying

• Oxyhemoglobin: binds to oxygen(lungs) OXYGEN BINDS TO IRON

• Carbaminohemoglobin: proteins of hemoglobin being to carbon dioxide to form carbaminohemoglobin 

Carboxyhemoglobin: iron can bind to carbon monoxide that can change shape of Hb because it binds stronger to iron than oxygen which is unable to make oxygen and can result in death.

Know the steps of erythropoises and where they take place in the body

• Hematopoietic stem stem (HSC) in the red bone marrow receive erythropoietin (EPO) a hormone secreted by the kidneys 

• HSCs differentiate into preoerythroblast

• Preoerythroblast synthesizes hemoglobin and it develops into erythroblasts

• As erythroblasts mature, their nuclei eject/shrink and becomes a reticulocytes 

• Reticulocytes goes through the sinusoidal capillaries of bone marrow and enter the bloodstream

• Once in the blood stream it becomes a true erythrocyte

Know the hormone responsible for erythropoises and what organ that hormone comes from

• The hormone responsible for erythropoiesis is erythropoietin (EPO) and is produced by the kidney to produce RBCS 

Know where erythrocytes are destroyed, what destroys them, and what happens to each of the parts of hemoglobin when erythrocytes are destroyed

• Erythrocytes are destroyed in the spleen due to old or damaged RBCS, with the liver also playing the role

• Macrophages recognize the erythrocytes and engulf them using digestive enzymes (digest erythrocytes) 

• Hemoblonin gets broken down into amino acids, iron ions, and heme 

-   Globin (protein portion) is split into amino acids which are recycled and used to make new proteins 

- Iron ions are transpired through the bloodstream by a protein transferrin. (they’re deprived back to red bone marrow for resume in new hemoglobin) 

-  Heme is broken down into biliverdin (green waste) and converts it in a yellow pigment bilirubin which is sent to liver for excretion 

Recognize the different cause of anemia and ultimately what anemia means 

• ANEMIA DECREASED OXYGEN-CARRYING CAPACITY OF BLOOD*

• Decreased hemoglobin: iron deficiency anemia + inadequate dietary iron intake + reduced intestinal absorption of iron

• Decreased hematocrit: reduce number of erythrocytes in blood (BLOOD LOSS) 

-   Pernicious anemia: vit B12 deficiency

-   Hemolytic anemia: RBCs destroyed before mature 

-  Aplastic anemia: chem treatment destroys RBCs (radiation/medication)

• Abnormal hemoglobin: sickle cell disease produces abnormal Hb known as hemoglobin S (HbS

Know how blood typing works (in relation to antibody and antigen)  

• Type A: only A antigens is present on erythrocytes 

• Type B: only B antigens is present on erythrocytes 

• Type AB: both A and B antigens are present on erythrocytes 

• Type O: neither A nor B antigens are present on erythrocytes + no O antigen + O denotes absence of A and B antigens only

Know the different type of leukocytes, their primary function and what type of ‘infection’ they fight or how they aid the immune system if they don’t actually fight 

• Neutrophils: most abundant/common type, active phagocytes that ingest and destroy bacterial cells “first responders” 

• Eosinophils: bilobed nucleus, phagocytes with parasites worms and allergens ( parasitic worms + allergens) 

• Basophils: least common leukocytes, release histamine and heparin mediate inflammation (inflammatory cells) 

• Lymphocytes: second most common, responsible for immune memory + produce antigens B&T cell - B-cells: produce antibodies, specifically to antigen 

- T cells: activate other imm

        -       Monocytes: largest leukocytes, large become macrophages in tissue- monocyte in bloodstream 

Know which leukocytes are granulocytes and which are agranulocytes 

• Granulocytes: Neutrophils + Eosinophils + Basophils (-phils) 

• Agranulocytes: lymphocytes + monocytes (cytes)

Know the function of granules inside granulocytes 

• To fight off infections

Know which leukocytes are phagocytes

• Neutrophils have active phagocytes that ingest bacteria/fungi or other cells 

• Monocytes once leave the bloodstream and enter the tissues they become macrophages and these are  phagocytic cells that ingest dead and dying cells

Know the difference between the rem acute and chronic in regard to disease 

• Chronic: slow (long lasting) accumulation of abnormal mature leukocytes 

• Acute: rapid increase (short term)  in immature, nonfunctional or poorly functionally blood cells

Know where leukopoises occurs in the body 

WBCs process in bone marrow in which hematopoietic stem cells (HSCs) form new leukocytes; HSCs divide and produce two cell lines: Myeloid cell line & lymphoid cell line

During leukopoises, know which leukocytes are of the myeloid cell line and which are of the lymphoid cell line and what is meant by lymphocytic and myelogenous in regard to leukemia 

• Myeloid cell line: neutrophils, eosinophil, basophil, monocyte 

• Lymphoid cell line: B or T lymphocyte 

• Lymphocytic: from lymphoid cell line, generally abnormal B lymphocytes (B&T cell) - limiting memory 

• Myelogenous: from myeloid cell line, can involve any myeloid cell

During thrombopoises, know the difference between megakaryoblast and megakaryocytes 

HCSs differentiate into a megakaryoblast gets stimulated by hormones thrombopoietin  develop into a megakaryocyte cytoplasmic extensions go through bone marrow sinusoids into B.S.; break off into platelets

Know what a platelet actually is in regard to megakaryocytes 

• Small tiny fragments of megakaryocytes that are in the bloodstream

Know the steps of hemostasis, the order in which they occur, and what is occurring at each step 

• Vascular spasm: blood vessel is injured increase vasoconstriction to minimize blood pressure and blood flow 

• Platelet Plug Formation: weak temporary plug form to stop blood loss made of platelets and vWF

• Coagulation (Intrinsic & Extrinsic Pathway): (molecular glue)  fibrinogen is inactive and gets activated by fibrin to hold the platelets and vWF together (mesh in together) - stable blood clot 

• Clot Retraction: (healing process) pulls the sides of injured tissues together to have a lil space to fill in and heal -  actin & myosin fibers involved platelets contracts; bring edge of wounded vessel closer together 

• Thrombolysis: (once wound is healed) begins with fibrinolysis to start the process that breaks down fibrin glue that was produced during coagulation

Know why vasoconstriction occurs in hemostasis 

When blood vessel is injured, the body launces vascular spasm as a response of vasoconstriction to minimize blood pressure and blood loss and increase resist and decrease blood flow

function of von Willebrand factor

produced by endothelial cell lining blood vessels and megakaryocytes, act as a bridge to help platelets adhere to injured blood vessel walls

function of platelets

produce in the bone marrow, form a temporary plug at the site of injury

function of clotting factors (blood plasma)

include fibrinogen (produce by liver + inactivated) then activated to form a fibrin mesh that strengthens the clot. with fibrinogen being converted to fibrin by the coagulation cascade; all these components work together to stop bleeding