Blood and Hematopoiesis Flashcards Preview

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Flashcards in Blood and Hematopoiesis Deck (33):
1

What is blood?

Blood is a ___ ___ that is comprised of

___ Elements (Blood ___)

____ (the ___ in which peripheral blood cells are ____)

 

What is blood?

Blood is a connective tissue that is comprised of

Formed Elements (Blood cells)

Plasma (the liquid in which peripheral blood cells are suspended)

 

2

Blood separation

Blood can be separated into layers after _____

____= estimate of the volume of packed ____/unit volume of blood

Normal value 40-50% in men, 35-45% in women

 

Blood separation

Blood can be separated into layers after centrifugation

Hematocrit = estimate of the volume of packed erythrocytes/unit volume of blood

Normal value 40-50% in men, 35-45% in women

 

3

Plasma

____

____(Na+, Cl)

7% plasma ____ (Albumin, fibrinogen, globulins)

___, __, __ ,___, ____, ____, other

 

Plasma

Water

Electrolytes (Na+, Cl)

7% plasma proteins (Albumin, fibrinogen, globulins)

Hormone, fats, aa, vitamins, carbohydrates, lipoproteins, other

 

4

Blood Cell Counts ___>___>____

Red blood cells (RBC, _____s)

approximately  4.3 million / mm3 in females

approximately  4.8 million/ mm3 in males

White blood cells (WBC, _____)

Normal levels = 6,000 – 9,000/ mm3

Platelets

approximately 250,000 platelets / mm3

 

Blood Cell Counts RBC>Platelets> WBC

Red blood cells (RBC, erythrocytes)

approximately  4.3 million / mm3 in females

approximately  4.8 million/ mm3 in males

White blood cells (WBC, leukocytes)

Normal levels = 6,000 – 9,000/ mm3

Platelets

approximately 250,000 platelets / mm3

 

5

Erythrocytes

___ ____ approximately 8 microm diameter in wet smears and 7 microm in dried smears

____

biconcave shape

Life span of approximately _____

 

Erythrocytes

Biconcave discs approximately 8 microm diameter in wet smears and 7 microm in dried smears

Anucleate, biconcave shape

Life span of approximately 120 days

 

6

Reticulocytes

1-2% of RBC and are classified as such for ___ days in circulation

Considered to be ___ ____ erythrocytes – they contain residual ___ ____

____s stained in ___

 

Reticulocytes

1-2% of RBC and are classified as such for 1-2 days in circulation

Considered to be less mature erythrocytes – they contain residual ribosomal RNA

Polyribosomes stained in clumps

 

7

Erythrocyte Variations

Decreased erythrocytes = ____

Increased erythrocytes = ____

Presence of a high percentage of erythrocytes of differing sizes = ____

Macrocytes = > _ micro m

Microcytes = < _ micro m

 

Erythrocyte Variations

Decreased erythrocytes = anemia

Increased erythrocytes = polycythemia

Presence of a high percentage of erythrocytes of differing sizes = anisocytosis

Macrocytes = > 9 micro m

Microcytes = < 6 micro m

 

8

Sickle Cell Anemia

Erythrocytes with an amino acid  ____n in hemoglobin rendering them ___

 The cells often assume a ___ shape.

 Important in individuals of ___ ___ descent.

 Severe damage to ___ ___ can occur due to the ____ of small __ ___s.

 

Sickle Cell Anemia

Erythrocytes with an amino acid  substitution in hemoglobin rendering them inflexible.

 The cells often assume a sickle shape.

 Important in individuals of African American descent.

 Severe damage to peripheral circulation can occur due to the blockage of small blood vessels.

 

9

Leukocytes

Granulocytes (______ _____)

___

___

____

Agranulocytes (____ ____)

___

___

 

Leukocytes

Granulocytes (polymorphonuclear leukocytes, PMN)

Neutrophils

Eosinophils

Basophils

Agranulocytes (mononuclear leukocytes)

Lymphocytes

Monocytes

 

10

Neutrophils

______% of leukocytes

Neuts are most numerous of WBC in adult

12-15 micro m

Live for ___ days, half life in blood is 6-8 hours

May have ___ ___

___-___ nucleus

____ cells are immature neutrophils

 

 

Neutrophils

50-75% of leukocytes

Neuts are most numerous of WBC in adult

12-15 micro m

Live for 1-4 days, half life in blood is 6-8 hours

May have Barr Bodies

Multi-lobed nucleus

Band cells are immature neutrophils

 

 

11

Neutrophils

Contain ____

____
____

Contain granules

Specific

Azurophilic

12

Eosinophils

___ % of leukocytes

12-15 mm

Defining characteristics:Usually has a ___ nucleus (can have ___ lobes)

Lobes of nucleus are ____

Last about __ hours in circulation

____ granules in cytoplasm

Lots of ___ ___ granules

Granule matrix=___ ___

FCNS:

Increased in ___ infections, in ___ responses, ___. Also increased in ___ ___

____

 

Eosinophils

1-3% of leukocytes

12-15 mm

Defining characteristics:Usually has a bilobed nucleus (can have 3-4 lobes)

Lobes of nucleus are connected

Last about 8 hours in circulation

Eosinophilic granules in cytoplasm

Lots of small, pink granules

Granule matrix=lysosomal enzymes

FCNS:

Increased in parasitic infections, in allergic responses, asthma.  Also increased in aromatic poisoning

Exocytosis

 

13

Basophils

9-10 mm in diameter

0.5-1.0% of leukocytes (__ ___)

Nucleus contains ___ lobes

___, __ staining ___ granules

Lots of __, ___ granules

Granules contain heparin, histamine, leukotrienes, serotonin

FCNS:

___ reaction

____

____

PAF = platelet activating factor

Allergic response in the skin, can also drive systemic anaphylaxis

 

Basophils

9-10 mm in diameter

0.5-1.0% of leukocytes (least numerous)

Nucleus contains 2-3 lobes

Large, dark-staining specific granules

Lots of fat, purple granules

Granules contain heparin, histamine, leukotrienes, serotonin

FCNS:

Allergic reaction

Anaphylaxis

Shock

PAF = platelet activating factor

Allergic response in the skin, can also drive systemic anaphylaxis

 

14

Monocytes

12-15 mm in diameter (____ cells in peripheral blood)

3-8% of leukocyte population

Life span 5-8 days

___, ____, ___- or ___ -shaped nucleus

___ cytoplasm

___ cells

Very ___ ____ granules (lysosomes)

FCN

Leave the ___ and enter ___. Once they are in the tissue, they are called ____

Macrophages are also “____ ____ ”.

___ and ____  particulate matter, tissue debris, infectious agents

You will observe them later in this course in the spleen, liver, and lungs

An important part of the ___ immune system

 

Monocytes

12-15 mm in diameter (largest cells in peripheral blood)

3-8% of leukocyte population

Life span 5-8 days

Big, ovoid-, peanut- or kidney-shaped nucleus

Pale cytoplasm

Big cells

Very small azurophilic granules (lysosomes)

FCN

Leave the blood and enter tissues.  Once they are in the tissue, they are called macrophages.

Macrophages are also “professional phagocytes”.

Ingest and remove particulate matter, tissue debris, infectious agents

You will observe them later in this course in the spleen, liver, and lungs

An important part of the innate immune system

 

15

Lymphocytes

Can range from ___(6-8 mm), to l____e (>10-12mm)

____ lymphocytes are the most numerous in blood smear

28% of leukocytes

___, __ , ___ nucleus

__ ___ cytoplasm

FCNS

Will be dealt with extensively in your immunology course

B cells (__%)

(___ derived) Originate in __ ___

Can differentiate into ___ cells – these cells secrete ____

T cells (__ %)

Originate in __ ___, mature in ___

___ ___ immunity, ___, help for ___ ___n by B cells, ___of immune response

NK cells (_%)

“Natural killer” – lack cell __ ___ of B or T cells, attack ___ ___ or ___ cells.

You can’t __ the ___ between these cells on a regular blood smear!

 

Lymphocytes

Can range from small (6-8 mm), to large (>10-12mm)

Small lymphocytes are the most numerous in blood smear

28% of leukocytes

Spherical, big purple nucleus

Not much cytoplasm

FCNS

Will be dealt with extensively in your immunology course

B cells (15%)

(Bursa derived) Originate in bone marrow

Can differentiate into plasma cells – these cells secrete immunoglobulins (antibodies)

T cells (80%)

Originate in bone marrow, mature in thymus

Cell mediated immunity, cytoxocity, help for antibody production by B cells, regulation of immune response

NK cells (5%)

“Natural killer” – lack cell surface antigens of B or T cells, attack virus infected or tumor cells.

You can’t tell the difference between these cells on a regular blood smear!

 

16

Platelets

Cell ____ 2-5 mm in diameter

200-400,000/mm3

Defining characteristics:

____ nucleated ___, ___, ___ , ___

___ light-___ stained transparent zone – the hyalomere

____al zone containing __ __s – the granulomere

Open canalicular system

Liberates __ ___

Marginal bundle

Microtubules maintain __ ___

 

 

Platelets

Cell fragments 2-5 mm in diameter

200-400,000/mm3

Defining characteristics:

Non-nucleated flat, biconvex, round or ovoid

Peripheral light-blue stained transparent zone – the hyalomere

Central zone containing purple granules – the granulomere

 

Open canalicular system

Liberates active molecules

Marginal bundle

Microtubules maintain ovoid shape

 

 

17

A Field Guide for Spotting Blood Cells

How numerous is it? 

__<_>

How big is it?   

____<_>

What shape is the nucleus?

RBC = __

Monocyte = ___

Lymphocyte = __, ___

___, ___ = 2 or 3 lobes

___= multilobed

What size and color are the granules?

Basophil = __, ___

Eosinophil = ___, ___

Neutrophil = __ ___

Platelets = ___ and ___

 

 

A Field Guide for Spotting Blood Cells

How numerous is it? BEMLNR

Basophils< Eosinophils< Monocytes< Lymphcytes< Neutrophils< RBC

How big is it?   PRLGM

Platelets< RBC< Lymphocytes< Granulocytes< Monocytes

What shape is the nucleus?

RBC = none

Monocyte = horseshoe

Lymphocyte = large, round

Eosinophil and Basophil = 2 or 3 lobes

Neutrophil = multilobed

What size and color are the granules?

Basophil = big and purple

Eosinophil = smaller and pink

Neutrophil = tiny granules

Platelets = light and dark

 

 

18

Summary

Blood is a connective tissue consisting of formed elements (cells) and plasma

Blood cells may be differentiated by frequency in the blood, cell size, shape of nucleus, and the size and color of granules

Blood cells have unique functions, these functions are dependent upon their structure.

 

Summary

Blood is a connective tissue consisting of formed elements (cells) and plasma

Blood cells may be differentiated by frequency in the blood, cell size, shape of nucleus, and the size and color of granules

Blood cells have unique functions, these functions are dependent upon their structure.

 

19

Clinical Correlates

Gingival infiltration in a patient with fever, fatigue, and weight loss is most suggestive of acute ___, especially monocytic variants of acute myelogenous leukemia. This patient’s gingival infiltration resolved after treatment for acute myelomonocytic leukemia.

AML spreads to the ___, they may swell or bleed, and if the T-cell variety of ALL spreads to the throat, it may cause c____g or suffocation (Oncology Channel, 1998).

 

Clinical Correlates

Gingival infiltration in a patient with fever, fatigue, and weight loss is most suggestive of acute leukemia, especially monocytic variants of acute myelogenous leukemia. This patient’s gingival infiltration resolved after treatment for acute myelomonocytic leukemia.

AML spreads to the gums, they may swell or bleed, and if the T-cell variety of ALL spreads to the throat, it may cause coughing or suffocation (Oncology Channel, 1998).

 

20

Anemias Wreak Havoc in the Oral Cavity

Pernicious anemia, iron deficiency anemia, and Plummer–Vinson syndrome usually affect the oral mucosa. The oral manifestations are early and common, and are characterized by an atrophic, ___,___  tongue. A___ sensation, taste __,  __ __, and rarely ___ may be present.

The differential diagnosis includes atrophic lichen planus and malnutrition disorders. The diagnosis is based on hematological laboratory tests.

 

 

Anemias Wreak Havoc in the Oral Cavity

Pernicious anemia, iron deficiency anemia, and Plummer–Vinson syndrome usually affect the oral mucosa. The oral manifestations are early and common, and are characterized by an atrophic, smooth and red tongue. A burning sensation, taste loss, angular cheilitis, and rarely erosions may be present. The differential diagnosis includes atrophic lichen planus and malnutrition disorders. The diagnosis is based on hematological laboratory tests.

 

 

21

Hematopoiesis

The process of ____

Hematopoeitic tissues   

Any tissue which actively or potentially produces ___ ___

Two types

___– __ __  of ___

___ – elements of the larger ___ ___ (we’ll deal with these later)

 

Hematopoiesis

The process of renewal

Hematopoeitic tissues   

Any tissue which actively or potentially produces blood cells

Two types

Myeloid – red marrow of bones

Lymphoid – elements of the larger lymphatic system (we’ll deal with these later)

 

22

Stem Cells

(___ cells)Divide into ___ lineages (___cells):

Lymphoid

Myeloid

___

___

___

____

 

Stem Cells

(Pluripotential cells)Divide into two lineages (multipotential cells):

Lymphoid

Myeloid

Granulocytes

Monocytes

Erythrocytes

Megakaryocytes

 

23

Bone Marrow

Red vs. Yellow

Yellow = ___ ___

Red = ____

In newborns, bone marrow is all  ___ , gradually replaced by ____ with age

In adult, hematopoeisis mainly occurs in ___ ___ .  ___ and __ ___

 

Bone Marrow

Red vs. Yellow

Yellow = adipose tissue

Red = hematogenous

In newborns, bone marrow is all red, gradually replaced by yellow with age

In adult, hematopoeisis mainly occurs in cancellous bone.  Vertebrae and hip joint

 

24

Bone Marrow Structure

Stroma

3 dimensional meshwork of __ ___s and ___

____ cells and ____

____ and other ___

Sinusoidal capillaries

Formed by a ____s layer of ____ cells

Release of ___ ___ cells is controlled by ___ ___

 

Bone Marrow Structure

Stroma

3 dimensional meshwork of reticular cells and fibers

Hematopoetic cells and macrophages

Collagens and other proteins

Sinusoidal capillaries

Formed by a discontinuous layer of epithelial cells

Release of bone marrow cells is controlled by releasing factors

 

25

Release of cells from bone marrow

Releasing factors

___
___
___

__ ___

Cells crossing into ___ ___

Note gaps between the ___ cells

 

Release of cells from bone marrow

Releasing factors

C3

Glucocorticoids

Androgens

Bacterial toxins

Cells crossing into sinusoid capillaries

Note gaps between the endothelial cells

 

26

Erythrocytes in various stages of erythropoiesis

E1 is least mature – E4 most mature

Note disappearance of ___

Increase in __ ___ of  +___ (ncreasing levels of ___)

 

Erythrocytes in various stages of erythropoiesis

E1 is least mature – E4 most mature

Note disappearance of mitochondria

Increase in electron density of  nucleus (increasing levels of hemoglobin)

 

27

Granulopoeisis

The ____ contains ___ (____ granules)

Specific granules appear ___ ___ into neutrophilic, eosinophilic, or basophilic ____

(sometimes these are all referred to as “_____”)

 

___-->______à à à Neutrophil, Basophil, Eosinophil

Granulopoeisis

The promyelocyte contains lysosomes (azurophilic granules)

Specific granules appear after differentiation into neutrophilic, eosinophilic, or basophilic myelocytes

(sometimes these are all referred to as “metamyelocytes”)

 

MyeloblastàPromyelocyteà à à Neutrophil, Basophil, Eosinophil

28

Band Cells (Immature Neutrophils)

AKA “___ ___”

“Shift to the___

Means you have higher amt of band cells compared to neutrophils

Means you are losing the war

Lots of band cells in the blood = ___ ___

 

Band Cells (Immature Neutrophils)

AKA “Stab cells”

“Shift to the left”

Means you have higher amt of band cells compared to neutrophils

Means you are losing the war

Lots of band cells in the blood = clinical significance

 

29

The difference between a band cell and a monocyte?

Band cell = ___ ___e shaped nucleus

Monocyte ___ or ___shaped nucleus

Monocytes are usually ___

 

The difference between a band cell and a monocyte?

Band cell = thin horseshoe shaped nucleus

Monocyte = peanut or kidney-shaped nucleus

Monocytes are usually bigger

 

30

Other cells in bone marrow

Megakaryocytes

Produce ___

Plasma cells

These are mature ___ ___ that are sequestered in ___ ___

Sometimes observed in bone marrow ___

 

 

Other cells in bone marrow

Megakaryocytes

Produce platelets

Plasma cells

These are mature B lymphocytes that are sequestered in bone marrow. 

Sometimes observed in bone marrow smears

 

 

31

Megakaryocyte

Extensive ___ complex

Granules contain PDGF, VWF, platelet factor ___

Rough er and lots of Golgi present because platelets have ____so they need to originate in the Golgi complex.

 

Megakaryocyte

Extensive Golgi complex

Granules contain PDGF, VWF, platelet factor IV

Rough er and lots of Golgi present because platelets have granules so they need to originate in the Golgi complex.

 

32

Plasma Cells

Can be found in  ___ ___ ___s and in ___ organs

Subset of lymphocytes (B cells)

Characteristics:

“__ ___”, ___ (not center) placed nucleus

___ cytoplasm

 

Plasma Cells

Can be found in all connective tissues and in lymphoid organs

Subset of lymphocytes (B cells)

Characteristics:

“Clock-faced”, eccentrically (not center) placed nucleus

Basophilic cytoplasm

 

33

Summary

Hematopoeisis is the production of new blood cells.

Occurs mainly in___ bone marrow in adults

Stem cells, progenitor cells, precursor cells and mature cells have different growth kinetics and growth factor requirements

Erythropoeitic, granulopoeitic, and thrombopoeitic precursor cells can be distinguished in bone marrow smears 

Megakaryocytes and plasma cells are also easily distinguishable

 

Summary

Hematopoeisis is the production of new blood cells.

Occurs mainly in red bone marrow in adults

Stem cells, progenitor cells, precursor cells and mature cells have different growth kinetics and growth factor requirements

Erythropoeitic, granulopoeitic, and thrombopoeitic precursor cells can be distinguished in bone marrow smears 

Megakaryocytes and plasma cells are also easily distinguishable