Hematology - Lec 2 (Chapter 3,4,5)

Hepa B Virus

can survive on inanimate or dried surfaces for at least 1 week

Diet

fasting means no food or beverages for 8 to 12 hrs before blood draw

Smoking

may increase Wbc and cortisol

Clot activators

allowed to clot to 30-60 min prior to centrifugation

Clot Activators

accelerates the clotting process

Anticoagulants

prevents blood from clotting

EDTA, citrate and oxalate

remove calcium needed for clotting by forming insoluble calcium salts

Heparin

bind to anti-thrombin in the plasma and inhibit thrombin and activated coagulation factor x

Antiglycolytic Agent

inhibits the metabolism of glucose by blood cells

Sodium Fluoride

they yield serum

Separator Gel

inert material that undergoes a temporary change in viscosity during centrifugation process

Separator Gel

serve as separation barrier between the liquid and cells

H pattern

median cubital, cephalic and basilic

H Pattern

this pattern is displayed by about 70% of population

M pattern

median, accessory cephalic, basilic

Median Cubital Vein

first choice for venipuncture

Median Vein

first choice for venipuncture in M pattern

Median Cephalic Vein

second choice for venipuncture in M pattern

Hand Veins

veins that are smaller and less anchored. Can be very painful for the patient

Femoral Vein

puncture is performed only by physicians or specifically trained personnel

Antecubital Area

area to always examine in venipuncture

Basilic Vein

third choice for venipuncture, due to increased risk of injury to the median nerve and/or accidental puncture of the brachial artery

1 Minute

how long the tourniquet should be applied

Prepare the test request order

first step in venipuncture procedure

22-23 Gauge Needle

needle recommended for children

Ecchymosis/Bruise

most common complication in venipuncture, leakage of small amount of blood in tissue around puncture site

Hematoma

complication in venipuncture where large amount of blood leaks, causing swelling

Hemolysis

complication in venipuncture where rupture of red cells causes plasma or serum to appear pink or red

Hemoconcentration

complication in venipuncture with increased concentration of larger molecules and analytes in the blood

Hemoconcentration

caused by leaving the tourniquet on for too long

Petechiae

small red spots indicating small amounts of blood have escaped into the skin

Nerve Damage

patient may complain of shooting or sharp pain, tingling or numbness in arm

Edema

caused by abnormal accumulation of fluid in intercellular spaces of tissues, should be avoided

Lateral and Medial Plantar Surface of Heel

collection site for skin puncture

Palmar Surface of distal portion of 3rd and 4th finger of nondominant hand

collection site for older than 1 year and adults

Collection Procedures

review policies on allowable number of blood collection attempts for unsuccessful blood draws, when patient refuses a draw

Hematopoiesis

process by which blood cells are produced in the bone marrow

Hematopoiesis

continuous, regulated process of blood cell production that includes cell renewal, proliferation, differentiation, and maturation

Mesoblastic Phase

phase in hematopoiesis that occurs on the 19th day of embryonic development

Mesoblastic Phase

phase in hematopoiesis where cells migrate to the aorta-gonad-mesonephros region and give rise to HSCs

Mesoblastic Phase

also known as the yolk sac phase

Hepatic Phase

phase in hematopoiesis that occurs during 5-7 gestational weeks

Hepatic Phase

phase in hematopoiesis with developing erythroblasts, granulocytes, and monocytes colonizing the fetal liver, thymus, spleen, placenta, and bone marrow space

Liver

major site of hematopoiesis during the second trimester

Thymus

major site of T cell production

Kidney and spleen

responsible for producing B cells

Medullary (myeloid) phase

phase in hematopoiesis taking place in the medulla or inner part of the bone marrow cavity

Medullary (myeloid) phase

phase occurring in the 4th and 5th month of fetal development

End of 24 weeks' gestation

when bone marrow becomes the primary site of hematopoiesis

Bone marrow

tissue located within the cavities of the cortical bone

Marrow cellularity

ratio of the red marrow to yellow marrow, decreases with age

Erythroblasts

found in red marrow that develop in small clusters, more mature forms adjacent to the outer surfaces of the vascular

Megakaryocytes

located adjacent to the walls of the vascular sinuses in red marrow, facilitating platelet release into the lumen of the sinus

Immature myeloid cells

located deep within the cords in red marrow

Nutrient artery

part of marrow circulation that supplies blood only to the marrow

Periosteal arteries

part of marrow circulation that provides nutrients for the osseous bone and the marrow

Liver

major site of blood cell production during the second trimester of fetal development

Liver

main site of production of TPO

Spleen

largest lymphoid organ and indiscriminate filter of circulating blood

Spleen

serves as a storage site for platelets

Spleen

generates an environment inherently stressful on cells

White pulp

splenic tissue consisting of scattered follicles with germinal centers containing lymphocytes, macrophages, and dendritic cells

Red pulp

splenic tissue composed primarily of vascular sinuses separated by cords of reticular cell meshwork (cords of Billroth) with loosely connected specialized macrophages

Culling

method for removing abnormal RBCs from circulation, cells phagocytized and cell organelles degraded

Pitting

method for removing abnormal RBCs from circulation, splenic macrophages remove inclusions or damaged surface membrane from circulating RBCs

Lymph nodes

involved in initiation of specific immune response to foreign antigens, filter particulate matter, debris, and bacteria

T cell progenitor

in adults, migrates to the thymus from bone marrow for further maturation

Monophyletic theory

stem cell theory suggesting all blood cells are derived from a single progenitor stem cell called a pluripotent hematopoietic stem cell

Polyphyletic theory

stem cell theory suggesting each blood cell lineage is derived from its own unique stem cell

1. Self-renewal,
2.differentiation, or
3.apoptosis

hematopoietic stem cells are directed to one of three possible fates

Cytokines

also known as hematopoietic growth factors

Cytokines

regulate the proliferation, differentiation, and maturation of hematopoietic precursor cells

Apoptosis

programmed cell death eliminating unwanted, abnormal, or harmful cells

Apoptosis

a natural process that occurs in all organisms, essential for development, growth, and maintaining tissue homeostasis

Erythropoiesis

lineage-specific glycoprotein produced in renal peritubular interstitial cells

Erythropoiesis

complex, regulated process for maintaining adequate numbers of erythrocytes in peripheral blood

Erythropoiesis

recruits CFU-E from the more primitive BFU-E compartment, prevents apoptosis of erythroid progenitors, induces hemoglobin synthesis

Thrombopoietin

controls the production and release of platelets

Pronormoblast

also known as rubriblast

Pronormoblast

maturation sequence with open chromatin, few clumps, dark blue cytoplasm, present only in the bone marrow

Basophilic normoblast

also known as prorubricyte

Basophilic normoblast

maturation sequence where chromatin begins to condense and nucleoli are present early in the stage

Polychromatic normoblast

maturation sequence with condensed chromatin and no nucleoli

Orthochromic normoblast

also known as metarubricyte

Orthochromic normoblast

maturation sequence with completely condensed nucleus and salmon pink cytoplasm

Erythron

collection of all stages of erythrocytes in the body

Erythrokinetics

dynamics of RBC production and destruction

Hypoxia

stimulus to RBC production

Peritubular fibroblasts

primary oxygen-sensing system of the body found in kidneys

Fas

death receptor expressed by young normoblasts

FasL

ligand expressed by older normoblasts

Aged RBCs

cannot regenerate catabolized enzymes, semipermeable membrane becomes more permeable to water