radi 660 blood and cardiovascular gateway exam

gases, nutrients, hormones, and waste products

what does blood transport?

body temperature, fluid and electrolyte balance, pH

what does blood regulate?

fluid loss and disease

what does blood prevent?

plasma, formed elements

blood is 55% __ and 45% __

water, solutes (proteins, gases, electrolytes, nutrients)

plasma is 90% __ and 10% __

erythrocytes, leukocytes, thrombocytes

formed elements of blood include:

albumins

which plasma protein maintains osmotic pressure?

globulins

which plasma protein involves immune reactions?

fibrinogens

which plasma protein clots blood?

amino acids, urea, uric acid

examples of nitrogen molecules:

Na, K, Cl, bicarbonate and phosphates

examples of electrolytes:

maintain osmotic pressure, membrane potentials, and regulate pH of bodily fluids

what do electrolytes do?

4.5 - 6 million/mm³

normal range for RBCs

iron, B12, and folic acid

what do you need for RBC production?

the percentage of RBCs in whole blood

what is hematocrit?

5000 - 9000/mm³

normal range for WBCs?

250,000 - 500,000/mm³

normal range for platelets?

neutrophils

most numerous and are phagocytic; antibacterial

eosinophils

defense with allergens; antiparasitic

basophils

secrete histamine and heparin

lymphocytes

immune process; attack bacteria directly or produce antibodies

macrophages

monocytes

stopping bleeding

hemostasis is the process of…

vascular constriction, platelet plug, coagulation

3 ways of hemostasis:

prothrombin activator and calcium

prothrombin is converted to thrombin via __

thrombin

fibrinogen is converted to fibrin via _

prothrombin —> thrombin, use thrombin for fibrinogen —> fibrin

process of coagulation:

vitamin K is fat soluble and needed for the liver to produce clotting factors

why is vitamin K important in relationship to clotting?

renal failure

imbalance of nitrogen molecules leads to…

anemia

lack of B12 or folic acid leads to…

bleeding risk

low platelet count can make a patient a…

blood cell or platelet

cancer patients have low __ counts

clotting (anti-coagulant)

heparin is a medication used to prevent…

WBC count and which are low or elevated

differential count tells you what?

arterial (pulsing/spurting blood)

which type of bleeding is most dangerous?

which antigen is carried on the cell’s surface

blood type is named after?

O because the antibodies of A and B won’t interact with anything; downside is O can only get blood from O

who is the universal blood donor?

AB because they don’t have any antibodies to react

who is the universal blood recipient?

both + or - because they don’t have antibodies

Rh+ can get (+/-) ?

Rh- should be given -, can given + but only once because then you’ll make antibodies

Rh- can get (+/-)?

the middle layer (myocardium)

myocardial infarction impacts which layer of the heart?

the heart itself

coronary arteries feed…

pre-ventricular contraction, you see p wave and then multiple QRS waves in a row, ventricles are contracting early, not filling with enough blood, can lead to ventricular tachycardia and then asystole

explain PVC

finds the source of improper firing and burns the circuit

what does ablation do?

valves closing

lub dub sound happens when?

leaking, improper closure

swish sound happens when?

how healthy the heart is

stroke volume is a good indicator of ?

thicker and higher pressure

compared to veins, artery muscles are __

the lungs and the liver, gets oxygen and nutrients from mom

fetus blood flow bypasses what?

the liver filters out toxins; this is why liver damage is bad, then the blood isn’t being filtered before returning to the heart

why does all blood supply returning from the GI tract and spleen go through the liver before entering the IVC/heart?

plasma proteins and electrolytes

osmotic pressure is determined via

pressure

baroreceptors are __ receptors

higher

kidneys like __ pressure for filtration purposes

increases, increases

if pH decreases, heart rate ? blood pressure ?

grief, grief lowers heart rate

all emotions raise heart rate except for __

low platelet count, deficiency in vitamin K and calcium, liver dysfunction

what four things make someone a bleeder?

surface of RBCc versus in the plasma

antigens are located where compared to antibodies

blood from flowing back into the atria when the ventricles contract; tricuspid and bicuspid/mitral)

AV valves prevent what?

blood from flowing back into the ventricles when they relax; pulmonary and aortic

SV valves prevent what?

transcatheter aortic valve replacement; doesn’t have to open chest anymore

TAVR

posterior wall of right atrium near the SVC

where is the SA node located?

floor of right atrium near the interatrial septum

where is the AV node located?

the atria aren’t pumping blood as far as the ventricles are

why is there a shorter systole phase for atria than ventricles?

closure of AV valves at the beginning of ventricular systole

first heart sound is for…

closure of SL valves at the beginning of ventricular diastole

second heart sound is for…

stroke volume (mL/beat) x heart rate (beats/min)

cardiac output (mL/min) = ?

venous return, sympathetic/parasympathetic NS, medulla, contraction strength

cardiac output is affected by…

tunica intima (endothelium), media (muscle), and externa (connective); vein layers are thinner than arteries

three layers of arteries and veins:

the placenta, the fetus

umbilical vein carries blood from __ to __

the placenta

two umbilical arteries carry blood to __

ductus venosus

what allows fetal blood to bypass the liver?

foramen ovale (between the atria) and ductus arteriosus (between pulmonary artery and aorta)

what permits fetal blood to bypass the fetal lungs?

central venous pressure

pressure in the right atrium is called?

capillaries

__ are the most numerous and have the most cross-sectional area so they have the slowest blood flow

the difference between systolic and diastolic pressures, around 40 mm Hg

what is pulse pressure?

stretching, reduce

baroreceptors detect __ in the vessel walls and send signals relayed to the heart and vessels to __ the pressure

increasing blood volume, thus increasing blood pressure

ADH regulates blood pressure by…

renin —> angiotensin —> vasoconstriction and increased aldosterone —> increased resistance and sodium retention (thus water retention) —> increased BP

when blood pressure decreases, what is secreted in the kidneys?

blood viscosity and arteriole diameter

peripheral resistance is affected by what 2 things?

condition of the heart, stretch fibers, anything that affects venous return (plasma volume, venous pumps, ADH/adolsterone/ANH)

what affects stroke volume?

arterial diameter and viscosity of the blood

what affects peripheral resistance?

skeletal contraction, venous pumps, total blood volume, pressure gradients, plasma volume, ADH/aldosterone

what affects venous return?

the amount of water that enters or leaves the blood plasma

what affects total blood volume?

ADH/adolsterone/ANH

what affects plasma volume?

increases/decreases in oxygen, renal or hepatic diseases or burns which lead to loss of plasma proteins, any factors that affect plasma volume

what affects blood cell and plasma protein concentrations?

baroreceptors and input from osmoreceptors; neurohypophysis; reduces amount of water lost by increasing renal absorption

ADH is affected by __ and released by __

overstretching of arterial walls; the loss of water by increasing urine sodium loss; lowers blood pressure

ANH is affected by __ and promotes __

the adrenal cortex; sodium retention; increases the amount of water reabsorbed by the kidneys, increasing blood pressure

aldosterone is released by __ and promotes __

change in pressure in carotid or aorta; symp/parasymp NS

cardiac pressoreflexes are affected by __ and balance through __

decrease in blood flow, causing an increase in CO2 which causes vessel constriction

medullary reflexes are affected by __

increase in CO2 (hypercapnia) and decrease in O2 (hypoxia) to increase BP

vasomotor chemoreflexes are affected by __

nosebleeds or bleeding gums, petechiae, echymoses, persistent bleeding after trauma, hemarthoris, hempotysis, hematemesis, blood in feces, anemia, hypotension, rapid pulse, fainting

list some warning signs of blood clotting disorders

thrombocytopenia (low blood platelet count, from viral infections, autoimmune, HIV, drugs), chemo and radiation therapy, defective platelet formation (ESRD, ASA ingestion), vitamin K deficiency, liver disease, inherited defects, hemorrhagic viruses, anticoagulant drugs

list some causes of blood clotting disorders

deficit of factor VIII (8)

hemophilia cause

prolonged hemorrhage, hemarthrosis, hematuria, and blood in feces

hemophilia signs and symptoms

bleeding time and PT are normal but the PTT, APTT and coag time are prolonged

hemophilia diagnose

precautions, replacement therapy; it’s a genetic disorder so you can’t get rid of it completely

hemophilia treatment

disseminated intravascular coagulopathy - excessive clotting and excessive hermorrhage

DIC meaning

obstetric complications, infarction, carcinomas, burns, crush injuries

DIC causes

hemorrhage, thrombosis, infarcts, respiratory and neurologic impairment

DIC signs and symptoms