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[LEC] HEMA 2 > Blood Vasculature, Megakaryocytes, Platelets > Flashcards

Blood Vasculature, Megakaryocytes, Platelets Flashcards

1
Q

Three classifications of hemostasis

A

→ Primary Hemostasis
→ Secondary Hemostasis
→ Tertiary Hemostasis

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2
Q

Tertiary hemostasis noted for:

A

Fibrinolysis

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3
Q

The maintenance of circulatory hemostasis is
achieved through the process of _____ (_____) and ____
(______).

A

balancing bleeding (hemorrhage)
clotting (thrombosis)

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4
Q

4 MAJOR COMPONENTS OF HEMOSTASIS

A
  1. Vascular System
  2. Platelets (Thrombocytes)
  3. Blood Coagulation Factors
  4. Fibrinolytic Component
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5
Q

PROCESSES INVOLVED IN HEMOSTASIS FOLLOWING INJURY TO A SMALL BLOOD VESSEL

  1. Blood vessel _______
  2. Formation of a ______
  3. Contact among damaged _______, _______, and _________
  4. Development of a ______ around the injury
  5. ________removal of excess hemostatic material
    to reestablish __________
A

spasm

platelet plug

blood vessels, blood platelet, and coagulation proteins

blood clot

Fibrinolytic; vascular integrity

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6
Q

Blood vessel spasm AKA

A

vasoconstriction

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7
Q

Formation of a platelet plug is under what classification of hemostasis

A

Primary hemostasis

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8
Q

includes all the blood vessels
that exist outside the heart

A

Blood vasculature

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9
Q

Blood vessels transport nutrients to
organs/tissues and to transport wastes away from
organs/tissues in the blood

A

VASCULAR SYSTEM

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10
Q

In vascular system, _____ transport nutrients to ______ and to transport wastes ____ from
organs/tissues in the blood

A

blood vessels
organs/tissues
away

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11
Q

Three types of blood vessels

A
  • Arteries and arterioles
  • Veins and venules
  • Capillaries
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12
Q

Bring oxygen-rich blood and nutrients away from
the heart to the tissues and organs

A

Arteries and arterioles

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13
Q

Major role in nourishing organs with blood and
nutrients

A

. Arteries and arterioles

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14
Q

Major role of Arteries and arterioles

A

nourishing organs with blood and
nutrients

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15
Q

Carry deoxygenated blood back to the heart and
start again in superior vena cava for
reoxygenation

A

Veins and venules

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16
Q

Always under high pressure

A

Arteries

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17
Q

Abundance of elastic tissue and less smooth
muscle

A

Arteries

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18
Q

● Presence of elastin in the large blood vessels

A

Arteries

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19
Q

Arteries:

Presence of ____ in the large blood vessels

A

elastin

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20
Q

enables these vessels to increase in
size and alter their diameter

A

elastin

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21
Q

Smaller than arteries but bigger than capillaries

A

Arterioles

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22
Q

Connect arteries and capillaries

A

Arterioles

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23
Q

Thin-walled and are less elastic

A

Veins

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24
Q

● Pressure is low

A

Veins

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25
Q

Can accommodate a large volume of blood

A

veins

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26
Q

One-way valves inside veins that allow for blood
flow, toward the heart, in a forward direction

A

Veins

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27
Q

Venous blood vessels analogous in size with the
arterioles

A

venules

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28
Q

Connects veins and capillaries

A

venules

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29
Q

Nearly _____ of the circulating blood volume is
contained in the venous system.

A

¾

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30
Q

Tiny blood vessels containing structures that

A

Capillaries

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31
Q

Connect arterioles to venules

A

Capillaries

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32
Q

Smallest and most abundant form of blood vessel
in the body

A

Capillaries

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33
Q

Allow gas exchange, nutrient transfer, and waste
removal between blood and tissue fluids

A

Capillaries

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34
Q

Three Layers of Blood Vessels

A

● An inner layer (vascular intima),
● A middle layer (vascular media), and
● An outer layer (vascular adventitia)

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35
Q

inner layer is aka

A

vascular intima

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36
Q

middle layer is aka

A

vascular media

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37
Q

outer layer is aka

A

vascular adventitia

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38
Q

Provided the interface between circulating blood
and the body tissues

A

VASCULAR INTIMA

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39
Q

Innermost lining of blood vessels which is a
monolayer of the metabolically active endothelial
cells (ECs

A

VASCULAR INTIMA

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40
Q

Single layer of squamous endothelial cells that
line the interior surface of blood vessels and
lymphatic vessels

A

ENDOTHELIUM

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41
Q

T/F: Endothelium has a very thick membrane that lies inside the heart of blood vessels

A

F; THIN

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42
Q

ENDOTHELIUM Releases substances that control ______ and _____ and produce ______
that control blood clotting immune functions and
platelet adhesion

A

vascular relaxation
contraction
enzymes

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43
Q

Are small proteins produced by the endothelial
cells in a variety of tissues, where they act as
modulators of vasomotor tone, cell proliferation,
and hormone production.

A

ENDOTHELINS

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44
Q

ENDOTHELINS are produced by the ________

A

endothelial cells

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45
Q

3 Members of the Endothelin Family

A

Endothelin-1
Endothelin-2
Endothelin-3

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46
Q

Is the only family member produced in endothelial
cells and is ______ also produced in vascular smooth
muscle cells

A

Endothelin-1; endothelial cells

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47
Q

Is produced predominantly within the _____ and _____, with smaller amounts produced in the
myocardium, placenta, and uterus.

A

Endothelin-2; kidney and intestine

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48
Q

Has been found in high concentrations in the
_____ and may regulate important functions, such
as proliferation and development in neurons and
astrocytes.

A

Endothelin-3; brain

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49
Q

T/F: Endothelin-3 is also found throughout the
gastrointestinal tract and in the lung and kidneys.

A

T

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50
Q

WHAT ARE THE THREE PROPERTIES OF THE VASCULAR INTIMA THAT INITIATE AND REGULATE HEMOSTASIS AND FIBRINOLYSIS

A

● Anticoagulant
● Procoagulant
● FIbrinolytic

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51
Q

Terms under anticoagulant property

A

Prostacyclin
Nitric oxide
Tissue Factor Pathway Inhibitor (TFPI)
Thrombomodulin

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52
Q

a platelet inhibitor and a
vasodilator, is synthesized through the eicosanoid
pathway and prevents unnecessary or
undesirable platelet activation in intact vessels

A

Prostacyclin

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53
Q

synthesized in ECs, vascular
smooth muscle cells, neutrophils, and
macrophages, induces smooth muscle relaxation
and subsequent vasodilation, inhibits platelet activation, and promotes angiogenesis and
healthy arterioles

A

Nitric oxide

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54
Q

controls activation of the tissue factor pathway,
also called the extrinsic coagulation pathway

A

Tissue Factor Pathway Inhibitor (TFPI)

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55
Q

a known inhibitor of thrombin
formation

A

Thrombomodulin

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56
Q

Vasoconstriction; Collagen binding and platelet activation is under what property of vascular intima

A

Procoagulant

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57
Q

Procoagulant secretes _______ from
storage sites called _____ when
activated by vasoactive agents such as thrombin

A

von Willebrand factor (VFW); Weibel-Palade bodies

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58
Q

Procoagulant acts as the ______

A

necessary bridge

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59
Q

Acts as the necessary bridge that binds platelets to exposed subendothelial collagen in
arterioles and arteries where blood flows rapidly

A

Procoagulant

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60
Q

Exposes tissue factor and activate the coagulation
system

A

Procoagulant

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61
Q

In Fibrinolytic property, _______ activates
fibrinolysis by converting plasminogen to plasmin,
which gradually digests fibrin and restores blood
flow

A

Tissue plasminogen activator (TPA)

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62
Q

In Fibrinolytic property, ______ regulate fibrinolysis by providing ______ to prevent excessive plasmin generation (PAI-1) and ________ (TAFI)

A

ECs
fibrinolysis
inhibitors
plasminogen activator inhibitor-1
thrombin activatable fibrinolysis inhibitor

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63
Q

Elevations in PAI-1 or TAFI can ____ (slow down, speed up) ______ and increase the tendency for
_______

A

slow down
fibrinolysis
thrombosis

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64
Q

is a reflex in which blood vessels narrow to increase blood pressure

A

Vasoconstriction

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65
Q

T/F
Vasoconstriction is a reflex in which blood
vessels narrow to increase blood pressure.

A

T

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66
Q

Vasoconstriction is caused by _______ from activated
platelets and injured epithelial cells, nervous
system reflexes from pain, and direct injury to
vascular smooth muscle

A

thromboxane A2

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67
Q

____ and _____ promotes vasoconstriction

A

Epinephrine; serotonin

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68
Q

Regulates the permeability of the inner vessel wall
and provides the principal stimulus to thrombosis
following injury to a blood vessel.

A

ENDOTHELIUM

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69
Q

ENDOTHELIUM regulates ___

A

permeability of the inner vessel wall
and provides the principal stimulus to thrombosis
following injury to a blood vessel.

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70
Q

Involved in the clotting process by producing or
storing clotting components

A

ENDOTHELIUM

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71
Q

Endothelium is involved in the clotting process by producing or storing _______

A

clotting components

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72
Q

ENDOTHELIUM is rich with _____ which, if
appropriately stimulated, is released and activates
______ , which ensures rapid lysis of _____

A

plasminogen activator
plasminogen
fibrin clots

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73
Q

activates plasminogen

A

plasminogen activator

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74
Q

ensures rapid lysis of fibrin clots

A

plasminogen

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75
Q

ENDOTHELIUM elaborates _____, which is synthesized by the ______ from ______ and strongly inhibits ______ and _______

A

prostacyclin,
endothelium,
prostaglandin precursors,
platelet aggregation,
adhesion

76
Q

Disruption in the normal endothelial function

A

Endothelial Dysfunction

77
Q

Play an important role in the initiation,
progression, and clinical complications of various
forms of inflammatory and degenerative vascular
diseases

A

Endothelial Dysfunction

78
Q

Endothelial Dysfunction play an important role in the initiation, progression, and clinical complications of various forms of ______ and ________

A

inflammatory; degenerative vascular diseases

79
Q

Give the 4 Stimuli to Endothelial Dysfunction

A
  1. Immunoregulatory Substances
  2. Viral Infection and Transformation
  3. Bacterial Toxins
  4. Cholesterol / Oxidatively modified lipoproteins
80
Q

What are the immunoregulatory Substances

A

Tumor Necrosis Factor/TNF & Interleukin- 1/IL1

81
Q

T/F: Disruption of the endothelium directly inactivates
all four components of hemostasis

A

F; ACTIVATES

82
Q

After endothelial dysfunction, the following event takes place:

  1. Initially, rapid vasoconstriction for up to _____ reduces ______ and promotes
    contact ______ of platelets and _______
  2. In the second phase, platelets _______
    immediately to the exposed _______ , particularly _______.
  3. In the third phase, ______ is initiated through
    both the ______ and _____ systems.
  4. Finally, ______ occurs following the release of
    _______ (t-PAs) from the vascular wall. Fibrinolytic removal of excess hemostatic material is necessary to reestablish ________.
A
  1. 30 minutes; blood flow; activation; coagulation factors
  2. adhere; subendothelial connective tissue;
    collagen
  3. coagulation; intrinsic; extrinsic
  4. fibrinolysis; tissue plasminogen activators (t-PAs);
    vascular integrity
83
Q

The aggregated platelets enhance and sustain
vasoconstriction by releasing ____
and _____ , including _____
and ______.

A

thromboxane A2; vasoactive amines; serotonin; epinephrine

83
Q

The aggregated platelets enhance and sustain
vasoconstriction by releasing ____
and _____ , including _____
and ______.

A

thromboxane A2; vasoactive amines; serotonin; epinephrine

84
Q

The capacity of the vessel to properly exert all its
normal functions

A

VASCULAR INTEGRITY

85
Q

WHAT ARE THE THREE ESSENTIAL FACTORS FOR VASCULAR INTEGRITY

A
  1. Circulating functional platelets
  2. Adrenocorticosteroids
  3. Ascorbic acid
86
Q

maintain the vascular tone, endothelial integrity, and vascular permeability

A

Adrenocorticosteroids

87
Q

tightens the endothelial barrier
and maintains its integrity during inflammation

A

Ascorbic acid -

88
Q

A lack of these factors for vascular integrity produces _____ of the _____ which makes them prone to ______.

A

fragility
vessels
disruption

89
Q

The evaluation of the integrity of arterioles and
venules depends on their ability to carry out
the ff functions:

A

→ Vasoconstriction
→ Formation of a plug of fused platelets
over the injury
→ Formation of fibrin clot

90
Q

______ is of ultimate importance in
damaged ____, _____, which contain ____ of
the blood volume, may rupture with a slight
increase in _____

A

Vasoconstriction
arteries
Veins
70%
hydrostatic pressure

91
Q

A complex process that involves the commitment
of hematopoietic stem cells (HSCs) to the
megakaryocyte (MK) lineage, proliferation of the
progenitors, MK maturation and terminal
differentiation that produces platelets

A

MEGAKARYOPOIESIS

92
Q

MEGAKARYOPOIESIS is a complex process that involves the commitment of _______ to the ______, proliferation of the _______, MK ____ and terminal
_____ that produces _______

A

hematopoietic stem cells (HSCs),
megakaryocyte (MK) lineage,
progenitors,
maturation,
differentiation
platelets

93
Q

the hormone thought to
stimulate the production and maturation of
megakaryocytes, which in turn produce platelets,
has recently been purified and cloned.

A

Thrombopoietin

94
Q

Thrombopoietin activity results from several
different cytokines which are?

A

Erythropoietin, IL-3, and
granulocyte-macrophage
colony-stimulating factor (GM-CSF).

95
Q

These substances have been shown to be
able to increase megakaryocyte size,
maturational stage, and ploidy.

A

Erythropoietin, IL-3, and
granulocyte-macrophage
colony-stimulating factor (GM-CSF)

96
Q

MEGAKARYOBLAST size

A

10-24 mm

97
Q

MEGAKARYOBLAST
Nucleus: ___
Nucleoli: ___

A

Round
2-6

98
Q

with homogeneous, loosely organized chromatin

A

MEGAKARYOBLAST

99
Q

MEGAKARYOBLAST cytoplasm: ___

A

Basophilic

100
Q

In MEGAKARYOBLAST, the granules in cytoplasm is absent by _____

A

Wright stain

101
Q

MEGAKARYOBLAST N/C Ratio: ___

A

3:1

102
Q

MEGAKARYOBLAST

REFERENCE INTERVAL:
→ Bone Marrow: _____ of ____ in bone marrow
→ Peripheral Blood: _____

A

20%; megakaryocyte precursors
0%

103
Q

PROMEGAKARYOCYTE Size: ___

A

15-40 mm

104
Q

PROMEGAKARYOCYTE

Nucleus: ___
Nucleoli: ___

A

: Indented
: Variable

105
Q

With condensed chromatin

A

PROMEGAKARYOCYTE

106
Q

PROMEGAKARYOCYTE Cytoplasm

A

Basophilic

107
Q

T/F: Granules are absent in cytoplasm of PROMEGAKARYOCYTE

A

F; present

108
Q

PROMEGAKARYOCYTE N/C Ratio:

A

1:2

109
Q

PROMEGAKARYOCYTE

REFERENCE INTERVAL:
→ Bone Marrow: ____ of _____ in bone marrow
→ Peripheral Blood: ____

A

25%; megakaryocyte precursors
0%

110
Q

largest bone marrow cells

A

MEGAKARYOCYTE

111
Q

MEGAKARYOCYTE size

A

ranging up to 160mm

112
Q

MEGAKARYOCYTE nuclear-cytoplasmic (N;C) ratio: ___

A

can be as high as 1:12

113
Q

T/F Nucleoli in MEGAKARYOCYTE are still visible

A

F; no longer visible

114
Q

Distinctive feature of the megakaryocyte

A

it is multilobular not multinucleated

115
Q

The fully mature____ of the megakaryocyte shed
____ from the ____ on completion of
_____.

A

lobes
platelets
cytoplasm
maturation

116
Q

average diameter of platelets

A

2-4 mm

117
Q

T/F: younger platelets are larger than older ones

A

T

118
Q

t/f in contrast to megakaryocytes, platelets have no
nucleus

A

T

119
Q

PLATELETS cytoplasm is _____, with evenly dispersed, fine _______.

A

light blue,
red-purple granules

120
Q

circulates as a thin, smooth-surfaced disc.

A

inactive or unstimulated platelet

121
Q

An inactive or unstimulated platelet circulates as a
____, _____.

A

thin; smooth-surfaced disc

122
Q

Stronger stimulation causes platelets to become
____ without losing their _____: however,
changes in shape to an ____ with
______ (small protrusion) will occur
with additional stimulation

A

sticky
discoid shape
irregular sphere
spiny pseudopods

123
Q

refers to small protrusion

A

spiny pseudopods

124
Q

This alteration in
cellular shape of platelet is triggered by an increase in the level of _____

A

cytoplasmic calcium

125
Q

All platelet contents help in ____ and
______ hemostasis

A

primary
secondary

126
Q

enumerate the platelet contents under CELLULAR ULTRASTRUCTURE OF A MATURE PLATELET

A
  • GP 1b
  • GP IIb/IIa
  • PF4 (Platelet Factor 4)
  • PDGG (Platelet Derived Growth Factor)
  • TGF-beta (Transforming Growth Factor
    Beta)
  • VWF (Von Willebrand Factor)
127
Q

platelet surface glycoprotein 1b

A

GP 1b

128
Q

significant in hemolysis process

A

GP IIb/IIa

129
Q

potent mitogen responsible for cell
proliferation

A

PDGG (Platelet Derived Growth Factor)

130
Q

having multifunctional cytogenes

A

TGF-beta (Transforming Growth Factor
Beta

131
Q

blood glycogen involving hemostasis

A

VWF (Von Willebrand Factor)

132
Q

helps platelet to stick together so that if there is
hemolysis, they will still stay together

A

VWF (Von Willebrand Factor)

133
Q

VFW together with ____ and ____

A

Factor V
Factor VII

134
Q

Glycocalyx aka

A

FLUFFY COAT

135
Q

aka FLUFFY COAT

A

Glycocalyx

136
Q

This surrounds the cellular membrane of the
platelet externally

A

Glycocalyx

137
Q

Unique among the cellular components of the
blood

A

Glycocalyx

138
Q

Composed of plasma proteins and carbohydrate
molecules that are related to the coagulation,
complement, and fibrinolytic systems

A

Glycocalyx

139
Q

Glycocalyx is composed of ____ and _____ molecules that are related to the _____, _____, and ______

A

plasma proteins

carbohydrate

coagulation, complement and fibrinolytic systems

140
Q

Located directly beneath the cell membrane of
platelet

A

Microfilaments & Microtubules

141
Q

Microfilaments & Microtubules is located directly beneath the _____ of platelet

A

cell membrane

142
Q

Provide the structure of the platelet to maintain its
discoid shape

A

Microfilaments & Microtubules

143
Q

Maintains the position of the organelles

A

. Microfilaments & Microtubules

144
Q

_______ of microfilaments is functional
in internal organization and secretion of blood
coagulation products, such as fibrinogen

A

Secondary system

145
Q

_______ of microfilaments is functional
in internal organization and secretion of blood
coagulation products, such as fibrinogen

A

Secondary system

146
Q

example of blood coagulation products

A

fibrinogen

147
Q

Different types of granules

A

Alpha Granules
Dense or Delta Granules
Lysosomes

148
Q

most abundant granules

A

Alpha Granules

149
Q

Alpha Granules contains:

A

→ heparin-neutralizing platelet factor 4 (PF 4)
→ beta-thromboglobulin
→ platelet-derived growth factor
→ platelet fibrinogen
→ fibronectin
→ von Willebrand factor (vWF)
→ thrombospondi

150
Q

type of granules that contains
→ heparin-neutralizing platelet factor 4 (PF 4)
→ beta-thromboglobulin
→ platelet-derived growth factor
→ platelet fibrinogen
→ fibronectin
→ von Willebrand factor (vWF)
→ thrombospondin

A

Alpha Granules

151
Q

Dense or Delta Granules contains:

A

→ serotonin
→ adenosine diphosphate (ADP)
→ adenosine triphosphate (ATP)
→ calcium.

152
Q

Type of granules that contains:
→ serotonin
→ adenosine diphosphate (ADP)
→ adenosine triphosphate (ATP)
→ calcium.

A

Dense or Delta Granules

153
Q

Type of granules that contains:
→ serotonin
→ adenosine diphosphate (ADP)
→ adenosine triphosphate (ATP)
→ calcium.

A

Dense or Delta Granules

154
Q

store hydrolase enzymes

A

Lysosomes

155
Q

What are the other Cytoplasmic Constituents

A

Contractile proteins,
Glycogen,
Enzymes of the glycolytic and hexose pathways

156
Q

Contractile proteins includes:

A

actomyosin (thrombosthenin), myosin, and filamin,

157
Q

An average megakaryocyte produces about ____ platelets

A

1,000 to 2,000

158
Q

Marrow transit time/maturation period of
megakaryocyte

A

5 days

159
Q

Platelets initially enter the ____ & remains for ____

A

spleen
2 days

160
Q

T/F: Platelets are in either the circulating blood or the
active splenic pool

A

T

161
Q

Approximately _____ of the total number of
platelets are in systemic circulation

A

2/3

162
Q

Approximately ⅔ of the total number of
platelets are in _________

A

systemic circulation

163
Q

The remaining ____ exists as pool of platelets
in the spleen that free exchange with the
general circulation

A

⅓

164
Q

The remaining ⅓ exists as ________
in the spleen that free exchange with the
_____

A

pool of platelets
general circulation

165
Q

A normal person has an average of ____ platelets in
the systemic circulation, with the range of __

A

250 × 10^9/L

150 × 10^9/L to 450 × 10^9/L

166
Q

Platelet turnover or effective thrombopoiesis
averages ___

A

35 × 10^9/L ± 4.3 × 10^9/L/day

167
Q

The life span of a mature platelet

A

9.0 days ± 1 day (8-10 days)

168
Q

At the end of their life span, platelets are
____ by the ___ and ____ , and
other tissues of the _____

A

phagocytized

liver, spleen,

mononuclear phagocytic system

169
Q

conditions under Quantitative Platelet Disorders

A

Thrombocytosis
Thrombocythemia
Thrombocytopenia

170
Q

A condition in which there is an increase of
number or excessive number in the blood;

A

Thrombocytosis

171
Q

Example of Thrombocytosis

A

Myeloproliferative cytoplasm

172
Q

Disease in which the bone marrow produces too
many platelets

A

Thrombocythemia

173
Q

life-threatening disease which causes thrombi

A

Thrombocythemia

174
Q

Example of Thrombocythemia

A

Acute Myelogenous Leukemia
(AML)

175
Q

A condition characterized by abnormally low
levels of platelets

A

Thrombocytopenia

176
Q

Thrombocytopenia happens in: ____, ____, ____, and ___

A

viral infection,
vitamin deficiency,
aplastic anemia, and
drug-induced problems

177
Q

Disorder under QUALITATIVE platelet disorder

A

Qualitative Platelet Disorder (QPD)

178
Q

Disorder under QUALITATIVE platelet disorder

A

Qualitative Platelet Disorder (QPD)

179
Q

is a disorder affecting the structure or function of platelets.

A

Qualitative Platelet Disorder (QPD)

180
Q

Qualitative Platelet Disorder (QPD) is a disorder
affecting the ___ or ____ of platelets.

A

structure; function

181
Q

Patients with this disorder will have an
adequate number of platelets but poor
“quality” of clotting.

A

Qualitative Platelet Disorder (QPD)

182
Q

Common causes of QPD include a ____
or defective ____ on the surface of the
platelet membrane or a deficiency or
abnormality in the ______ or their
content

A

missing
protein
platelet granules

183
Q

Common causes of QPD include:

A
  • a missing or defective protein on the surface of the
    platelet membrane
  • deficiency or abnormality in the platelet granules or their contents
184
Q

deficiency or abnormality in the platelet granules or their contents

A

storage pool disorder

185
Q

Symptoms of a QPD are:
→ Easy _____
→ _____
→ Bleeding of the ____ or ____
→ Heavy _____, ______ (after
childbirth) bleeding
→ Bleeding following _____; and
→ Bleeding with ______

A

bruising
Nosebleeds
mouth or gums
menstrual bleeding; postpartum
dental work
invasive surgical procedures

[LEC] HEMA 2 (1 decks)

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