5000 Blood Structure and Function

3 functions of blood

transport, regulation, protection

3 things blood transports

gases, hormones, metabolic substrates

3 things blood regulates

temperature, pH, osmotic pressure

2 things blood protects from

disease/immune response, blood loss

blood volume:

1. males = about ___L

2. females = about ___L

3. has about 55% ________ and 45% _________

5; 4; plasma; hematocrit

hematocrit = % of ______ ________ that are ____; about ___% in males and ___% in females

blood volume; RBC; 45; 42

plasma volume is ___% in males and ___% in females

55; 58

serum = the _______ _______ minus the _______ _________

plasma volume; coagulation proteins

buffy coat = ________ and ________; is under ___% of total BV

leukocytes and platelets; 1

___________ is the formation of blood; it occurs mainly in the ______ ______ from ____ cells; this process makes

1. _____% of thrombocytes/erythrocytes

2. ___-___% of leukocytes

   • the rest of these (___-___%) is formed in the ______/_____/______ _______

hematopoiesis; bone marrow; stem; 100; 60-70; 20-30; thymus/spleen/lymph nodes

leukocytes:

1. make up under ___% of BV

2. have functions for ______ and _______

3. ___ types

4. life span is ___-___ days

5. _____-______ per microliter

1; immune and inflammation; 5; 1-10; 4000-11000

5 types of WBCs

1. neutrophils

2. monocytes

3. eosinophils

4. lymphocytes

5. basophils

1. neutrophils (___-___%) - ________

2. monocytes (___-___%) - ________

3. eosinophils (___-___%) - ________

4. lymphocytes (___-___%) - _______

5. basophils (<___%) - ________

40-80; phagocytoses; 2-8; macrophages; 1-4; phagocytoses; 20-40; immunity; 1; anticoagulation

thrombocytes (aka ________):

1. make up under ___% of BV

2. responsible for ________ and _______ ________

3. about ______ per microliter

4. about ____% in the blood and about ____% in the spleen

platelets; 1; coagulation and tissue repair; 300000; 75; 25

4 phases of atherosclerosis evolution

lesion initiation; fatty streak; fibrous plaque; thrombosis

erythrocytes:

1. 99% are _____

2. have about a ____ day life span

3. made via _________ in the _____ _____ from _____ cells

4. size is ___ by ___ micrometers (which is the size of a _______)

5. men have ____ million/microliter; women have ____ million/microliter

6. can be impacted by ________ (even ____) when it comes into contact with _______ and causes ________

RBCs; 120; hematopoiesis; bone marrow; stem; 2.4; 8; capillary; 5.4; 4.8; ablation; PFA; blood; hemolysis

erythrocyte pt 2 (O2 transport):

1. ________ (___) is the mode of O2 transport on RBCs

2. men have ___ g Hb/deciliter; women have ___ g Hb/deciliter

3. WBC O2 carrying capacity is ___ ml/g Hb

4. to calculate O2 content of blood (____), you multiply the g of ____ times the O2 carrying capacity for each one

5. ____% of O2 is bound to ____ at all times (about ____ ml O2/dL)

6. there is under ___% of O2 ________ in the plasma (about ___ ml O2/dL)

hemoglobin; Hb; 15; 14; 1.34; CaO2; Hb; 99; Hb; 20; 1; dissolved; 0.3

oxyhemoglobin curve shows how much hemoglobin is _______ with O2, and the ____ of the blood at a given ________

saturated; CaO2; pressure

also shows us that the majority of O2 is _____ to ________ and a ______ amount is _______

bound; hemoglobin; tiny; dissolved

it shows that the saturation at the aorta is ____% but it ________ all the way back to the RA (can calculate the ____ difference by taking the mL/dL of O2 _______ the heart and subtracting the mL/dL of O2 _______ to the heart; this tells you how much O2 was _____); during exercise, the O2 content in the _______ does NOT change, but the O2 content ______ to the heart ________ (making the difference _________) because when you exercise, you use _____ O2

99; decreases; AVO2; leaving; returning; used; aorta; returning; decreases; increase; more

oxyhemoglobin curve is divided into ___ phases, the ________ and __________

2; loading and unloading

the _______ _______ ________ of O2 is what drives it to go into the blood and into the tissue; to calculate the value in the air, you multiply the _______ _______ times the _______ of O2 in the air; then the ________ is the difference between the _____ in the ____ and the ______ AND then between the _____ and the ______ AND then between the ______ and the ________

partial pressure gradient; atmospheric pressure; percentage; gradient; PO2; air; lungs; lungs; blood; blood; tissue

PPO2 values at sea level:

1. air =

2. lungs =

3. blood =

4. These values represent the ________ that

159; 100; 40

when you change altitude, you are not changing the _______ of O2 in the air, the _________ _________ is lower, so the ____ is lower and the ________ is less able to drive the O2 into lungs

percentage; atmospheric pressure; PO2; gradient

4 things that can impact oxyhemoglobin curve

PO2; CO2; temperature; pH

PO2 is the ________ factor on the curve; if it increases, there is ______ hemoglobin bound to O2, so the curve shifts ____ and to the _____

greatest; more; up; left

increased CO2 and temperature:

1. Hb saturation _________ (because the ________ phase was ________)

2. when muscles are working, CO2 and temperature _________ meaning the body needs more ____

3. the _______ are what trigger the shift of the curve _____ and to the _____ to increase the _________ phase (by building up CO2 and temp, it _____ O2 to _____ more)

decreases; unloading; increases; increase; O2; muscles; down; right; unloading; drives; dump

decreased CO2 and temperature:

1. Hb saturation _________ (because the ________ phase was _________)

2. CO2 and temperature are the lowest in the ________, so this shifts the curve ____ and to the _____ to enhance the _______ phase

increases; loading; increased; lungs; up; left; loading

CO2 transport:

1. 7% in _______

2. 23% in __________

3. 70% in _____ (bound to _______ by the enzyme ______ _______)

plasma; carbaminohemoglobin; HCO3; bicarbonate; carbonic anhydrase

CO2 + H2O forms ______ (______ acid) via _____ ______ enzyme, but it is a very _______ acid, so it quickly dissociates into ______ and ____

this chemical reaction is what influences ____ values

C2CO3; carbonic; carbonic anhydrase; unstable; HCO3; H+; pH

pH is low when [H+] is _________

pH is high when [H+] is ________

high; low

______ Effect: the _____ produced during exercise ultimately turns into ____ which shifts the curve _____ and to the _____ to enhance the _________ phase

Bohr; CO2; H+; down; right; unloading

BV percentages:

1. ___% is plasma volume

2. ___-___% is water

3. ___% is plasma proteins

4. ___-___% is other

55; 90-92; 7; 1-3

water in blood:

1. serves as ________

2. _______ blood components

3. _______ of molecules

4. transports _________ energy

solvent; suspends; absorption; thermal

plasma proteins in BV:

1. >___ identified

2. exert ______ ________

3. 15% of _____ ________ capacity

4. various functions like ________ and ________

100; osmotic force; blood buffering; anticoagulant and clotting

plasma proteins:

1. 60% = _______

2. 35% = ________ (______, _____, ______)

3. 4% = ________

albumin; globulins; alpha, beta, gamma; fibrogen

albumin:

1. transports _____ and _______ ______

2. main contributor to ________ _______ _________

FFA; steroid hormones; plasma osmotic pressure

globulins:

1. transport _____, ______ ions, and ____-soluble vitamins

2. _______ released by ______ cells

FFA; metal; fat; antibodies; immune

fibrogen:

1. forms _____ _______ of ______ ______

fibrin threads of blood clots

other solutes:

1. __________

2. organic ________

3. organic ________

4. __________ ______

5. ________

electrolytes; nutrients; waste; respiratory gases; hormones

electrolytes:

1. cations and anions like ___, ___, ___

2. help maintain ______ _____ ______ and ____

Ka+; K+; Cl-; plasma osmotic pressure; pH

organic nutrients:

1. materials absorbed from ________ ________ like ____, ______, and ____

digestive tract; FFA; glucose; AA

organic waste:

1. carried to site of ________

breakdown

respiratory gases:

1. ___ and ___ dissolved in ______ and ______

O2 and CO2; plasma; HCO3

whole blood viscosity:

1. can be though of as any _____ that ________ BF

2. it is friction between ______ and ________/_______ ________ in the ______

3. also the friction between _______ _________ and ________ _______

force; opposes; fluid; molecules/formed elements; plasma; flowing blood and vessels lining

viscosity is why there must be a _______ _______ to drive ______ in the CV system

pressure gradient; flow

whole blood viscosity is ___-___ times the viscosity of water

plasma viscosity is ___ times the viscosity of water

3-4; 1.8

viscosity depends on:

1. ________ (linearly)

2. ________ (inversely)

3. ____ (linearly)

4. _____ ______

5. ______ _______ (the concentration of ______ ________)

hematocrit; temperature; RBC; shear rate; plasma viscosity; plasma proteins

hematocrit relationship on viscosity:

1. greater impact in ______ because they are ____ pressure and blood moves more ______, allowing _______ ________ to interact more and cause a higher _________ (has a lower _____ ____)

2. less impact in _______ (has a higher ______ ______)

3. in unit increase in Hct = ___% ______ in viscosity

veins; low; slowly; cellular components; viscosity; shear rate; arteries; shear rate; 4; increase

temperature relationship with viscosity:

1. on degree Celsius increase = ___% ________ viscosity

2; decrease

RBC relationship with viscosity has 3 components:

1. ______/______

2. _________ (like _____ _____ anemia)

3. _________ (i.e. __________)

number/volume; deformability; sickle cell; aggregation; inflammation

all three components of RBCs are ________ related to viscosity and as they _________, viscosity _________

directly; increase; increases

shear rate:

1. is the change in ________ as one ______ of fluid ____ _____ an adjacent _____ of fluid

2. it is ________ related to viscosity

3. at a low rate, cell-to-cell and cell-to-protein _________ __________ will ________ (meaning RBCs ______ _______) and leads to _______ viscosity

velocity; layer; passes over; layer; inversely; adhesiveness interactions; increase; adhere together; increased

Ohm’s law of fluid equation

F = (delta P)/R

resistance equation

R = (n*L)/r^4

Poiseuille equation

F = (delta P*r^4)/(n*L)

rearranged Poiseuille equation to solve for BP

BP = (F*n*L)/(r^4)

this means BF is directly related to ___, ___, and ___, but inversely related to ______, therefore, you would think that as viscosity __________, BP would _________… but not so fast:

1. if BF is increased, then _____ ______ (the tangential force of ______ ______ on ______ _______ of blood vessel) __________

2. then, that activates the release of _______ ____-synthase

3. this causes _______ __________ (in a person with ________ _________ ________)

4. therefore _________ does NOT __________ in a healthy person

F; n; L; radius; increases; increases; shear stress; flowing blood; endothelial lining; increases; endothelial NO; compensatory vasodilation; viscosity; increase

blood flow:

1. ________ flow is ________ and is where the middle flows _______ and velocity ________ as it gets closer to vessel wall

2. ________ flow is _______/________ flow

laminar; parabolic; fastest; decreases; turbulent; chaotic/irregular

turbulent flow is measured by ________ _________ (___); it predicts whether flow is ______ or _______; higher the ___ ______, the greater the chance of _______ flow

Reynolds number; Re; laminar or turbulent; Re number; turbulent

Re = ____/(___*___)

Re = Q/(d*n)

re is directly related to _______, but inversely related to _______ and ______

flow; diameter and viscosity

Re increases with:

1. ________ cardiac output

2. ________ viscosity

3. ________ diameter

4. vessel __________

increased turbulence means:

1. ________ resistance to flow

2. ________ endothelial damage

3. ________ murmurs

increased; decreased; decreased; irregularity; increased; increased; increased

hemostasis: the process of ________ ______ in damaged vessels and preventing _____ ________ while maintaining blood in a _____ state

hemostasis balance: balance between _________ and _________ (process of _____ __________)

forming clots; blood loss; fluid; coagulation; fibrinolysis; clot dissolution

our normal state:

1. ______coagulatory

2. ______thrombotic

3. ____________

other state:

1. ____coagulatory

2. ____thrombotic

3. ____-_________

ANTI; ANTI; fibrinolytic; PRO; PRO; ANTI-fibrinolytic

5 steps of hemostasis

1. vascular spasm

2. platelet plug formation

3. coagulation cascade

4. clot retraction and repair

5. fibrinolysis

vascular spasm:

1. almost _______ with injury/trauma

2. 1) ______/_______ spasm

3. 2) damaged endothelium releases ________ that causes the ______ ________ cells to ______ via a ___ mechanism

4. 3) ________ _________ from damaged cells activate ________ that perceive _____ and activate a ____ reflex ________

5. this lasts ______ to _______

instantaneously; reflex/myogenic; endothelin; smooth muscle; contract; Ca++; inflammatory chemicals; nociceptors; pain; pain; vasoconstriction; minutes; hours

platelet plug:

1. injury causes platelet _______, _______, and _________

2. damaged cell means no ____ or ____ to keep blood from _______

3. 1) _________ ___ binds with ____ that is released and act as glue for platelet __________

4. 2) platelets are ________ (they change _____) and release factors (____, ____, ____, and ________) that _______ more platelets; this causes 1) __________ and 2) enhanced __________ _______

5. 3) _________ ___/___ on platelets binds with _________ to hold platelets together (platelet __________)

adhesion; activation; aggregation; NO or PGI2; clotting; glycoprotein 1b; vWF; adhesion; activated; shape; ADP; PAF; TXA2; fibrinogen; attract; aggregation; muscular spasm; glycoprotein IIb/IIIa; fibrinogen; aggregation

coagulation:

1. starts ___-___ seconds after injury

2. coagulatory factors normally _________ in the blood are now ________

3. the _________ _________ results in _______ and ______ ______; also has a _____-_____, _______ ______ _______ network that prevents clot from embolizing

4. purpose is to decrease _______ ______ and chance of ________

15-20; inactive; active; coagulation cascade; fibrin and platelet plug; cross-linked, stabilized fibrin mesh; blood loss; dislodgement

coagulation cascade Intrinsic pathway:

1. molecules cause a _______ charge around damage and the _______ naturally produces ________ _________ in the _______ form; when they cross the _______ charge, they become ________

2. first factor that crosses is factor ____

3. activated ____ activates factor ____

4. activated ____ activates factor ____

5. activated ____ activates factor ____

6. _________ factor ____ and ___ ion help ____ and ____ interact to come together to activate factor ____ that then becomes the _______ pathway

negative; liver; clotting proteins; inactive; negative; active; XII; XII; XI; XI; IX; VIII; prothrombin; III; Ca++; IX; VIII; X; common

Coagulation cascade extrinsic pathway:

1. factor ____ reacts with factor ____ to help activate factor ____ of the ________ pathway

III; VII; X; common

Coagulation cascade common pathway:

1. factor ____ reacts with factor ____ and ________ factor ___ with ___ ion to activate the ________ _________

2. factor ____ (called _______) reacts with that molecule to become activated (called _______)

3. activated ____ links ___ (number) _________ (a plasma protein that ________ circulates the blood) together to form ________ (_______ in the blood) and the blood becomes _____ to _____ BF through damaged area

4. activated ____ causes ____ and ____ to react and become activated ____

5. activated ____ then _________ the _______ to create a _____ network that prevents plug from embolizing

X; V; prothrombin; III; Ca++; prothrombin activator; II; prothrombin; thrombin; II; 7; fibrinogen; soluble; fibrin; insoluble; jelly; slow; II; XIII; Ca++; XIII; XIII; crosslinks; fibrin; mesh

Drugs on cascade:

1. aspirin inhibits ________ ___ (which promotes platelet ________)

2. eliquis inhibits factor ____

3. warafin inhibits _______ ___ (necessary for cofactor ___, ___, and ___ conversion)

thromboxane A2; aggregation; Xa; II; VII; IX

clot retraction and repair:

1. platelet _________; they have _______ fibers that are triggered by ____, ______ (___), etc that _____ the edges of the _______ together

2. platelets secrete ________ _________ ______ ________ (_____) that 1) triggers _____ _____ cell ________ (a rapid ______ in ______), and 2) triggers the process of ______ and production of _______ ________ to repair the damage

3. platelets secrete _______ _______ _______ _______ (_____) that triggers _________ of _______ ______

contraction; contractile; ADP; thrombin (IIa); pull; endothelium; platelet derived growth factor (PDGF); smooth muscle; proliferation; increase; number; mitosis; connective tissue; vascular endothelial growth factor (VEGF); regeneration; endothelial lining

fibrinolytic pathway:

1. _____ (_______ _________ ________) is normally ________ on the ________ membrane due to ________

2. endothelium releases _______ (___) that activates _______ ___ which _________ the _________ of ____

3. ____ is now able to convert _______ (naturally in blood) into ________

4. _________ breaks down (____) the ______ ______ and degrades the _____

5. the result of a degraded ____ is ___-_____ (if this value is high, docs know the person had a lot of _____ that were _______)

t-PA; tissue plasminogen activator; inactive; endothelial; inhibitors; thrombin; IIa; protein C; inhibits the inhibitors; t-PA; t-PA; plasminogen; plasmin; plasmin; lyses; fibrin mesh; clot; clot; D-dimer; clots; degraded

4 tests of blood functioning…

1. PTT (partial thromboplastin time)

2. PT INR (prothrombin time international normalized ratio)

3. ACT (activated clotting time)

4. D-dimer

PTT:

1. how long it takes for _____ to _____

2. assess the ________ and ________ pathways

3. normal: ___-___ secs (varies with lab)

clot to form; intrinsic and common; 25-35

PT INR:

1. PT is ___-___ seconds

2. INR is ___

3. assess the _______ and ________ pathways

11-16; 1.0; extrinsic and common

ACT:

1. how long it takes for ____ to ____

2. normal: ___-___ secs

clot to form; 70-120

D-dimer:

1. _______ ________ that is released when _____ are _____ _____

2. depends on assay used, typically <___ micrograms per milliliter

protein fragment; clots; broken down; 0.5