Flashcards in Diseases of the blood, disease of the heart and blood vessels Deck (103):
Produced in red bone marrow, some in lymphoid tissue.
- 5,000-9,000 cells/microliter of blood
-Function- inflammation, immunity
Leucocytes (White blood cells, WBC)
Produced in red bone marrow.
-4,000,000- 5,000,000 cells/ microliter of blood
-Function- carry oxygen to cells and tissues, and carbon dioxide out of tissues.
Erythrocytes (Red blood cells, RBC)
Produced in red bone marrow
-150,000-450,000 cells/microliter of blood
-Function- blood clotting
Increase in the number of WBC in blood.
-Usually occurs to fight infection.
-May be physiological (protective, transient, more common) or pathological
- more than 9,000 cells/ microliter, up to 50,000
-The more severe the infection, the higher the number.
-50,000 - 800,000 cells/microliter > indicate cancer of WBC producing tissue (leukemia)
Abnormal reduction in the number of WBC in blood.
-Usually due to damage to bone marrow or lymphatic tissue
-results in anemia, infections, bleeding, bruising.
Etiology of Leucopenia
A decrease in the number of erythrocytes, hemoglobin, or both resulting in decreased ability to carry oxygen to the body tissues.
Chronic, hematologic disease that is a result of a love level of RBC or hemoglobin.
Concerned with blood or blood-forming structures.
Develops as a complication of another disease, nonhematologic disease.
-persisting longer than 2-6 months
-May provide a diagnostic clue to a chronic disease, e.g., chronic osteomyelitis
-Increased destruction anemia
-Decreased production anemia
Two types of anemia
RBCs are being destroyed.
Increased destruction anemia
Producing less RBCs than normal.
Decreased production anemia
-Injury or trauma
Etiology of increased destruction anemia
Sickle cell anemia (primary)
Erythroblastosis fetalis (primary)
Types of increased destruction anemia
Genetic mutation resulting in hemoglobin S
-cells of weird shape, form clots > spleen traps and destroys these cells.
-Results in tachycardia, fatigue, dyspnea
Sickle cell anemia (primary)
Hemolytic disease of the newborn. The mother and baby have different Rh blood types.
-baby's RBCs are immature and larger than normal (with nucleus) > may form blood clots > trapped in spleen and destroyed.
Erythroblastosis fetalis (primary)
Overactive spleen due to mononucleosis or liver cancer.
- may cause splenomegaly (spleen enlargement).
Underactive bone marrow due to:
-leukemia or bone cancer (osteosarcoma)
Etiology of decreased production anemia
Types of decreased production anemia
Damage to bone marrow of unknown origin (idiopathic).
-bone marrow does not produce enough, or any, blood cells, especially RBC.
Vitamin B12 deficiency
-due to lack of intrinsic factor produced in the stomach
-common in women following childbirth or malnutrition disorder.
Deficiency of B12 and folic acid.
-associated with pernicious anemia.
Associated with formation of blood and blood components.
Hematopoietic (hemopoietic) disorders
"White blood", cancer of WBC producing structures/organs (bone marrow, lymphatic tissue, or spleen).
-results in overproduction of immature WBC
-WBC count elevated 10-100 times.
Types of leukemia
More common in children
-Acute myelocytic leukemia
-Acute lymphocytic leukemia (ALL)
*in children (age 3-6)
*cause severe anemia, pneumonia, infections
More common in adults.
-Chronic myeloid leukemia
-Chronic lymphocytic leukemia
primary- Bone marrow makes too many RBCs (erythrocytosis) causing thickening of blood > slower blood flow
-Greater risk of forming blood clots
-headache, dizziness, itchiness and redness of skin
-fatigue, shortness of breath
-numbness, tingling, burning or weakness in hands, feet, arms or legs
Symptoms of polycythemia vera
Increase in the number of RBC in blood (increased hematocrit)
-Excess blood in transfusion
-Underactive spleen (does not remove and destroy old RBC)
Etiology of erythrocytosis
Increased blood volume.
-Higher risk or forming blood clots/thrombi
- extra strain on heart > congestive heart failure > ischemia > cyanosis
-Enlarged spleen (splenomegaly), risk of rupture as it gets bigger.
May result from erythrocytosis
Decreased number of RBC in blood (decreased hematocrit), may result in anemia.
Type of hematopoietic disorders
Severe decrease in the number of platelets.
-less than 60,000 platelets/microliter of blood.
-Due to damaged bone marrow, e.g., radiation, chemicals, cancer (leukemia)
-Results in decreased ability to clot or coagulate blood.
*Bruise and bleed easily > results in hemorrhage, circulatory shock.
*Bruising > purple discoloration on the skin > immune thrombocytopenic purpura.
Blue color on lips and fingers due to lack of oxygen.
-Immune system destroys its own platelets.
-Spontaneous bleeding in subcutaneous tissues > purple patches on the skin.
e.g., acute pediatric viral illness
Immune thrombocytopenic purpura
X-linked (more common in males) or somatic inherited hemorrhagic disease.
- abnormal or absent clotting factor > inability to clot blood.
-Excessive, prolonged, sometimes spontaneous bleeding
-Frequent epistaxis (nosebleeds), bruising
-Severe cases > hemarthrosis (bleeding into joints) > painful > may cause joint deformity.
Immune thrombocytopenic purpura
- Diabetes mellitus
- Elevated cholesterol levels
- Social factors: smoking; substance abuse, stress or diet
Predisposing conditions for heart and blood vessel disease
The condition of the heart being enlarged, occurring normally, artificially, or as a result of disease; tends to be chronic.
-Enlarged heart> cannot pump efficiently (abnormal rate) > heart gets bigger> cardiac muscle (myocardial) fibers (cells) stretch and get thinner.
-excess blood left in ventricle > may affect aortic valve
Cardiac dilation (dilation)
Blockage of the thoracic aorta due to arteriosclerosis or plaque > aorta narrows > blood back to heart > heart muscles stretch in response.
Cause of cardiac dilation
The enlargement of the heart ventricles due to the increase in size of the myocardial cells.
-heart pumps faster > thickening of cardiac muscle cells to allow heart to pump faster (compensatory mechanism) > may lead to hypertensive heart disease.
May be from adaptive response to increased cardiac workload such as athletic training or blockage of aorta.
Cause of cardiac hypertrophy
Due to uncontrolled high blood pressure.
-pathological effects on the heart, blood vessels and the body in general including the brain and kidneys.
-heart pumps at pressure greater than normal
Hypertensive heart disease
Normal blood pressure
-90% of all cases, no single cause
-can last for decades, 10-40 years
- predisposing factors - stress, diet (fats, salts), nicotine, obesity, hereditary, arteriosclerosis
Primary (essential) hypertension
Mild, does not threaten health or life- blood pressure 140/90 mmHg.
Blood pressure 160/110+; difficult to lower, even with medications.
-death is usually due to stroke (rupture of blood vessel in the brain), kidney or heart failure.
-10% of all cases, has a definite cause
-acute and life threatening
-BP- 220/110 mmHg
-If the heart weakens over time > congestive heart failure
-Adrenal gland disease, too much adrenaline
-Chemical imbalance: meds, narcotics
Etiology of secondary hypertension
Inflammation of the membrane covering the heart and beginning of the great vessels (pericardium).
-main cause: respiratory viruses and bacteria (lungs and bronchi); or trauma.
-scar tissue forms > resulting in pressure on the heart> heart beats more rapidly > weakened heart action > may lead to heart failure.
Inflammation of the muscular walls of the heart (myocardium); usually wall of the left ventricle.
- caused by bacterial or viral infections such as respiratory infections (strep, flu, staph, or pneumonia)
- scar tissue in heart muscle > interfere with blood flow through coronary arteries > may result in chest pain or dizziness.
Inflammation of the lining membrane of the heart (endocardium); may involve only the membrane covering the valves or the general lining of the chambers of the heart.
-Most often the mitral (bicuspid valve); infected valve results in inflammation> exudate> scar tissue (vegetations) and ulcers form on the valve > makes valve rigid > chunks of scar tissue can break off and become emboli
Bacteria (#1 Streptococcus) and viruses in blood; most often respiratory infections (flu, cold, sore throat).
Cause of Endocarditis
Related to the heart valves.
Failure of a heart valve to close completely, thus allowing regurgitation (leaking back) of blood.
Valvular insufficiency (incompetence)
Abnormally enlarged and floppy valve.
e.g., Mitral valve prolapse
Abnormal narrowing of a valve that restricts flow of blood.
Condition of permanent damage to heart valves.
-usually follows strep throat infection.
-Immune system produces antibodies to fight streptococcus bacteria > antibodies attach to tissues of heart (and joints causing arthritis) > phagocytize the heart by mistake (myocarditis) > scar tissue forms > weaken the valve > valve will leak and regurgitate blood from the left ventricle to the left atrium > heat murmurs
Blockage in coronary artery depriving the heart muscle of oxygen.
-#1 cause for sudden death
- May result in ischemia and myocardial infarction
*most often in left ventricle > chest pain, dizziness > may require by-pass surgery.
Coronary artery disease
-Atherosclerosis > arteriosclerosis
Etiology of coronary artery disease
Inability of the heart to supply adequate blood flow (oxygen and nutrients) to peripheral tissues and organs.
Rapid, may result from:
-cardiopulmonary by-pass surgery
-acute myocardial infarction
Acute cardiac failure
Congestive heart failure
Chronic cardiac failure
General weakening of the heart over time, leading to heart failure.
-heart cannot pump enough blood to supply organs
-Heart cannot clear blood > blood pooling in the heart > the heart drown's in it's own blood > results in severe chest pain.
Congestive heart failure
Due to disorder of the left ventricle; leads to anasarca (hands, feet, abdomen)
Right-sided cardiac failure
Due to hypertension, mitral or aortic valve disease, coronary artery or myocardial disease.
Left-sided cardiac failure
Usually results in damage to the myocardium.
- Area of necrotic tissue in the heart caused by obstruction in the artery supplying the area
e.g., due to coronary thrombosis
Myocardial infarction (Heart attack)
Disease or disorder of the heart muscle (myocardium)
-caused by viral infections, heart attack, alcoholism, long-term severe high blood pressure or other unknown causes.
- can be severely disabling or fatal
Inflammation of the entire heart and its surrounding structures.
Caused by failure to develop normal heart.
e.g., due to infections in utero (rubella, syphilis, HIV)
Congenital heart defects
The apex of the heart is situated on the right side of the body; heart can be smaller.
Rearrangement of valves or abnormal valve structure.
Hole in the septum (wall between the right and left side of the heart).
Four related heart defects:
1. Interventricular septal defect
2. Aorta shifts to the right
3. Pulmonary stenosis
4. Right ventricle hypertrophy
-results in less oxygenated blood to the body
-occurs in 1-300 births
Tetralogy of fallout
Hole between the ventricles.
Interventricular septal defect
The aorta normally arises from the left ventricle, this results in narrowing of the aorta.
Aorta shifts to the right
Narrowing of the pulmonary artery.
Results in compensation of the first three abnormalities of the tetralogy of fallout.
Right ventricle hypertrophy
Aorta and the pulmonary artery are connected to each other.
Patent ductus arteriosus
Constricted segment of the aorta, usually above the heart.
Coarctation of the aorta
Inflammation of medium and large arteries.
-Results in scar tissue, blockage, hemorrhage.
- sometimes defined by it's cause.
Inflammation of the lumen or inner wall of an artery.
-Caused by blood clots, arteriosclerosis, or emboli
Inflammation of the outer wall of an artery.
-caused by external trauma
Disease of the arteries resulting in thickening and loss of elasticity of the arterial wall.
- results in impaired blood circulation
-Develops with aging
-most often caused by atherosclerosis
-hypertension or diabetes mellitus > fat plaques > collect on blood vessel wall > irritate wall > arteritis > calcium deposits > scar tissue
Etiology of arteriocslerosis
A form of arteriosclerosis marked by the deposition of lipids in the inner layer of arterial walls.
- Characterized by deposit of cholesterol plaques, fatty substances, or cellular debris on inner walls of arteries. e.g., aorta.
- can restrict blood flow
Local dilation of the wall of blood vessels, primarily arteries.
-Can rupture (bursting). resulting in hemorrhage in the brain or abdomen.
-Internal blockage due to clot, embolus, arteriosclerosis, plaque.
- external pressure due to tumor
-location determines the shape
Etiology of aneurysms
Resembles a small sack; artery, vein, or heart.
Resembles a swollen tube.
Blood flows between layers of vessel wall, most dangerous, likely to rupture because of pressure in the center of it.
Inflammation of a vein.
Etiology : blockage of a vein, external pressure due to obesity, pregnancy, pressure, weakened heart action.
Results in : local pain (pressure on nerves), veins hold blood (pool with blood), inflammation restricts blood flow, vein blue and stretched > varicose vein.
Enlarged (dilated) tortuous blood vessel.
- more likely to affect ascending veins
Superficial veins of :
- rectal lining (called external and internal hemorrhoids = piles)
Chief locations of varicose veins