BIO 224 Exam 2: The Cardiovascular System - Blood, Heart, Blood Vessels and Circulation

TMCC, Dr. Doe

True/False: Most plasma proteins are produced in the liver

True

Cirrhosis can be a result of chronic liver disease in which the tissue becomes fibrotic. How could this impact the blood?

It can cause a decrease in the ability to clot, It can decrease the ability to fight infection, and It can decrease the viscosity and osmotic pressure of blood.

The volume of erythrocytes to the total volume of a sample is known as the pack cell volume or ____

Hematocrit

True/False: Albumin contributes the most to blood colloid osmotic pressure

True

True/False: Blood is a connective tissue and the matrix is plasma

True

True/False: Serum is plasma without albumin

False

Which condition would stimulate the release of erythropoietin

Hypoxia produced by high altitude, low blood flow to the kidneys, and lung disease

True/False: In the event of bone marrow failure, the spleen may enlarge

True

True/False: Myeloid stem cells differentiate into lymphocytes

False

Prior to birth, blood cells are produced in the

Yolk sac, fetal liver and spleen

Which are normally released from the red bone marrow

Reticulocytes

True/False: Pro-erythroblasts have erythropoietin receptors

True

A single hemoglobin can carry up to ___ molecules of oxygen

4

A single RBC has approximately 280 million hemoglobin molecules meaning it could carry around ___ O2 molecules

1 billion

What is the fate of the proteins in a hemoglobin molecule

They are disassembled into their component amino acids

Jaundice is due to the inability of the ____ to process bilirubin

Liver

Polycythemia is

A condition of too many RBCs

True/False: The spleen is the primary site of iron recycling

True

Which type of WBC is the chief of enemy bacteria

Neutrophil

Which type of WBC is elevated in parasitic infections

Eosinophils

Which leukocytes are pro-inflammatory

Basophils

Which formed element is essential for hemostasis

Platelet

The term diapedesis refers to the ability of leukocytes to

Migrate through capillary walls

Which of the following best describes the clotting factors of the extrinsic cascade

Factor III → Factor VII → Factor X

True/False: The extrinsic and intrinsic clotting cascades will be activated at the same time

True

You cut your finger this morning. The first phase of hemostasis is

Vascular spasm

True/False: A clot formed in the leg and part of it broke off and got stuck in the lungs. This trapped clot is an embolism.

True

True/False: Hemophilia is an inherited disorder where people lack clotting factors

True

Blood clotting factors are primarily produced in the

Liver

Vitamin ___ is essential for normal clotting

K

Which is the most common blood type

O+

Which is the rarest blood type

AB-

Why can’t a person with A- blood safely receive a transfusion from someone with B- blood

The type B blood would agglutinate in the recipient

True/False: If an infant suffers from hemolytic disease of the newborn, the father must be RH+

True

Which ABO/Rh blood type is the universal recipient

AB+

If you have B+ blood, you will have

B antigen, A antibodies, and D antigen

True/False: Type O- blood does not have A, B, or D antigens on the RBC

True

True/False: Diastole is contraction of the heart

False

True/False: A heart murmur is due to abnormal or turbulent blood flow through the heart

True

During ventricular systole, all of the following would occur EXCEPT

The semilunar valves will be forced shut

The first heart sound (S1) is due to

Closing of the AV valves

The volume of blood when the ventricles contain the least amount of blood is called the

End systolic volume (ESV)

True/False: The is an inverse relationship between the volume and pressure

True

How does damage to the cardioinhibitory center change heart rate? why?

Heart rate increases; sympathetic dominance

All of the following will increase heart rate except

Hyperkalemia

All of the following are negative inotropes EXCEPT

Epinephrine

True/False: Hypotension will increase afterload

False

The starling law of the heart states that greater ____ will cause greater contraction strength

Preload

True/False: Heart rate times stroke volume gives you cardia output

True

True/False: Baroreceptors measure blood pressure

True

True/False: The difference between the end diastolic volume and the end systolic volume is the stroke volume

True

Describe the composition of blood

A liquid connective tissue and matrix

Components of blood

Plasma (ground substance). Formed elements: RBC, WBC, Platelets

Sites of Hemopoiesis: Before birth

Yolk sac, Liver, spleen, lymphatic tissue and red bone marrow.

Sites of Hemopoiesis: After birth

Red bone marrow and Extramedullary hemopoiesis

Formed elements

Rbc, Wbc, Platelets

Lymphoid stem cells

B cells, T cells, NK cells

Myeloid stem cells

Neutrophils, monocyte, eosinophils, basophils, RBC, megakaryocytes

Erythropoiesis

RBC production. Myeloid stem cell → proerythroblast (have erythropoietin receptors) → Erythroblasts stages (1. Hemoglobin production, Mitosis, Expel organelles) → Reticulocytes released from bone marrow; contains ribosomes → Mature RBC

Regulation of Erythropoiesis

Erythropoietin (EPO) is the hormone that stimulates erythropoiesis. Blood doping provides an advantage to re-infuse packed RBCs to elevate hematocrit. Erythropoiesis requires amino acids, iron, folic acid, and vitamins b12 and b6.

Pernicious anemia

Lack of vitamin B12

RBC structure

Small, highly specialized cells. Biconcave discs. Has no MHCs due to being anucleated and not having APCs.

RBC structure and determining functions

Contains surface glycoproteins that determine blood type

Impact of RBC structure on function

Large surface area to volume ratio. Form stack. Smooth blood flow through narrow blood vessels. Bend and flex when entering small capillaries

Hemoglobin Structure

Four globular proteins subunits. Two alpha chains and two beta chains. Each with one molecule of heme (nonprotein). Each heme contains one Fe2+ iron.

Iron binds oxygen to form

Oxygemoglobin

CO2 can bind globin forming

Carbanimohemoglobin

Hemoglobin Function

Helps transport oxygen

Hemoglobin recycling

Macrophages of the spleen, liver, and red bone marrow engulf aged RBCs. Remove Hb molecules from hemolyzed RBCs.

Hemoglobin recycling : Globin proteins

Hemoglobin recycling: Heme group

Hemoglobin recycling: Iron

Iron deficiency anemia

Most common. not enough iron

Sickle Cell Anemia

Caused by a mutation in one of the hemoglobin genes. Erythrocytes produce an abnormal type of hemoglobin, which causes the cell to take on a sickle or crescent shape

Pernicious anemia

Poor absorption of vitamin b12

Aplastic Anemia

Red bone marrow doesn’t produce red blood cells

Primary Polycythemia

Cancer of RBC line. Extremely high hematocrit

Secondary Polycythemia

Mild increase in hematocrit. Dehydration decrease plasma volume.

Circulating WBC

All can migrate out of the bloodstream through emigration and diapedesis. All are capable of amoeboid movement. All are attracted to specific chemical stimuli. Some are phagocytic

Neutrophils (granulocyte)

50-70% of circulating WBC. Pale cytoplasmic granules. Attack/digest bacteria.

Eosinophils (granuloytes)

2-4% of circulating WBCs. Microphages. Attack large parasites by releasing toxic compounds. Sensitive to allergens.

Basophils (granulocytes)

less than 1% of circulating WBCs. Cross capillary endothelium and accumulate in damaged tissues. Pro-inflammatory. Release histamine and heparin

Lymphocytes (Agranulocyte)

Slightly larger than RBCs. 20-40% of circulating WBCs. Continuously migrate in/out of bloodstream. Mostly in organs of lymphatic system (spleen, lymph nodes, tonsils) and connective tissues other than blood.

Monocytes (Agranulocyte)

Large, spherical cells. Enter peripheral tissues and differentiate into macrophages

Leukocytosis

High number of WBCs.

Leukopenia

Low number of WBCs.

Leukemia

Cancer of the WBCs in bone marrow

Lymphoma

Solid tumor, abnormal white blood cells

Platelets

Cell fragments involved in clotting. Fragments of megakaryocytes. Releases important clotting chemicals. Temporarily patches damaged vessel walls. Reduce size of break in vessel walls. Stimulates repair of damaged vessel walls.

Thrombocytopoiesis

Platelet production, Occurs in the red bone marrow. The megakaryocytes produce platelets by shedding membrane-enclosed packets of cytoplasm.

Thrombocytosis

Too many platelets. Increases the risk of blood clotting

Thrombocytopenia

Too few platelets, Increases the risk of blood loss

Hemostasis

Cessation of bleeding

3 stages of Hemostasis

Vascular spasm, Platelet plug formation and Coagulation

Vascular Spasm

A cut triggers vascular spasm. Endothelial cells contract and expose basement membrane to bloodstream. Endothelial cells release chemical factors and paracrines causing smooth muscle contraction. Endothelial plasma membranes becomes “sticky”

Platelet plug formation

Platelet adhesion to exposed surfaces. Platelet aggregation (clump of platelets). Activated platelets releases APD to help additional platelets to adhere to injury site. Platelet-derived growth factor (PDGF)

Extrinsic pathway

Activated by factors outside the blood. Damaged endothelial cells or peripheral tissues release factor III (tissue factor). Factor III is exposed to plasma to activate Factor VII. Enzyme complex activates Factor X

Intrinsic pathway

Activated by factors inside the blood. Factor XII is activate by exposed collagen. Factor XII forms a complex with PF-3 (platelet factor 3) to activate Factor XI. Factor XI activated Factor IX. Factor IX activated Factor VIII. Factor VII activates Factor X.

Common pathway

Begins with activated of Factor X. Factor X activate prothrombin activators. Converts prothrombin to thrombin. Thrombin then converts fibrinogen to insolube fibrin.

Ion needed for coagulation

Ca2+