Exam 3 Hematopoietic CT: Blood Flashcards
(97 cards)
1
Q
Normal blood volume
A
5L or 7% body weight
2
Q
Fluid portion of blood
A
Plasma and Serum
3
Q
Plasma
A
= serum + proteins
Protein carriers, antibodies, coagulation proteins, complement proteins, osmotic proteins
4
Q
Serum
A
=mostly water and electrolytes
devoid of clotting proteins and cells
plasma-clotting factors
5
Q
Cellular portion of blood
A
RBCs
WBCs
Platelets
6
Q
Blood in a test tube
A
RBCs settle to the bottom
Thin layer of WBCs
Plasma/serum at the top (largest portion)
7
Q
Characteristics of Plasma
A
Fluid portion of blood; contains several different soluble molecules:
- plasma proteins = 70% of solutes
- Inorganic salts (NaCl) = 9% of solutes
- Amino acids, vitamins, hormones, lipoproteins, carbohydrates = 21% of solutes
8
Q
Plasma transports
A
- nutrients (O2) to tissues and metabolic waste from tissues to kidneys
- hormones for conveying cellular signals from distant sites
- CO2 to the lungs for expiration
9
Q
Plasma helps maintain the
A
acid-base balance of bodily fluids
10
Q
Blood participates in regulation of
A
body temperature through conduction of heat from cutaneous vessels
11
Q
Plasma proteins
A
Albumin, globulins, fibrinogen, lipoproteins, complement proteins
12
Q
albumin
A
creates osmotic force to “draw” water into the blood
13
Q
Globulins
A
(alpha, beta, and gamma globulins)
-enzymes (alpha and beta)
antibodies for the immune system (gamma)
14
Q
Fibrinogen (and clotting factor proteins)
A
provide coagulation of blood
15
Q
Lipoproteins
A
transport mechanism for lipids/fats
16
Q
Complement proteins
A
assist in immune system function
17
Q
Most plasma proteins are synthesized by the
A
liver
18
Q
Blood cells
A
erythrocyte leukocytes agranulocytes granulocytes platelets stem cells
19
Q
erythrocyte
A
red blood cell (RBC) - O2/CO2 transport
20
Q
leukocytes
A
white blood cells (WBC) - immune system (agranulocytes, granulocytes)
21
Q
agranulocytes
A
lymphocytes (T and B cells), monocytes and macrophages
22
Q
granulocytes
A
neutrophils, eosionophils, basophils, mast cells
23
Q
platelets
A
blood clotting
24
Q
stem cells (bone marrow)
A
pluripotent cells capable of self-renewal to replace all blood cell types
25
Normal concentration of WBCs in Blood
3,900-10,800 cells/uL (mm^3)
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Normal concentration of platelets in blood
150,000-400,000 cells/uL (mm^3)
27
RBCs normal concentration in blood
Female - 3.6-4.8 x 10^6
Male - 4.2-5.2 x10^6
*men have more RBCs than women
28
Stem cell differentiation
- bone marrow consists of a pool of undifferentiated (pluripotent) stem cells
- upon molecular signaling, stem cells become irreversibly differentiated cell types (ie: RBCs, WBCs, platelets - myeloid, lymphoid cells)
- Stem cells that are recruited for differentiation are replaced by proliferation of other undifferentiated cells from the pool - process maintains a constant number of stem cells
29
Erythrocytes characteristics
filled with hemoglobin for transport of O2/CO2
- mature RBCs do not contain mitochondria, ribosomes, or nuclei
- under normal conditions, RBCs never leave the circulatory system
RBCs are flexible, which permits adaptation to irregular shapes and small diameter of capillaries
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RBC Life span =
120 days
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Old RBCs are removed by the
spleen
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Hemoglobin Molecule characteristics
Composed of 4 protein molecules (2 alpha chains, 2 beta chains)
Each chain binds one O2 or CO2 molecule
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Erythrocytes (Hb): Clinical Correlate - Sickle Cell disease
Inherited disorder of RBCs
Single AA mutation of the gene that produces hemoglobin
When deoxygenated, dysfunctional hemoglobin polymerizes abnormally,
Sickle-shaped RNC increases blood viscosity (can reduce or totally block blood flow through capillaries)
34
Normal range of Hemoglobin (gm/dL) Males
14-18
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Normal range of hemoglobin (gm/dL) females
12-16
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Normal range hematocrit (%) male
42-52%
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Normal range hematocrit (%) female
36-48%
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Reduced exercise capacity occurs at what hemoglobin range?
8-10
| exercise cautiously
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Reduced exercise capacity at hematocrit of
< 30%
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Light exercise recommended at hemoglobin
7-8 gm/dL **light exercise if NOT SYMPTOMATIC**
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Light exercise recommended at hematocrit
24-30%
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Hemoglobin value indicating not to perform activity
< 7 g/dL
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Don't perform activity at hematocrit
< 24%
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Life span of neutrophils
6-7 hours in blood, and 1-4 days in connective tissue
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Functions of neutrophils
- 1st line of defense against foreign agents
- phagocytize bacteria and remove cell debris (die in area and release cell contents = pus)
- increased number in the blood in the blood indicates a bacterial infection
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Phagocytosis
- pseudopodia surround microorganism (bacteria)
- internalization into vacuoles called phagosomes
- intracellular granules fuse with phagosomes
- lysosomal enzymes (granules) destroy microorganism
- free radicals are formed by PMN and are released to assist in killing other bacteria
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Steps of phagocytosis
1. Microbe is detected
2. Psuedopodia surround bacterium
3. Bacterium is ingested forming a phagosome
4. Fusion of lysosome and phagosome
5. Digestion of the ingested material
6. Release of digestion products from the cell - includes free radicals that are toxic to bacteria)
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Eosinophils characteristics
Filled with large granules that contain inflammatory mediator molecules
-and increased number indicates an allergic reaction or parasitic infection
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Functions of eosinophils
Phagocytosis of parasites and viruses by recognizing antigen/antibody complexes on the foreign agents
-involved in allergic reaction (release molecules that increase vascular permeability and vasodilation)
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Basophils (mast cells)
release granules (histamine, heparin) associated with bodily reactions to allergens
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Granules released by basophils stimulate
Bronchoconstriction, vasodilation, increased vascular permeability
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Bronchoconstriction
constricts airways
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Vasodilation
increase blood flow to local area
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Increased vascular permeability
creates local edema
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Types of lymphocytes
```
B lymphocytes (B-Cells)
T lymphocytes (T-cells)
```
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Functions of Lymphocytes
immune system
-detect and destroy
invading microorganisms, foreign macromolecules, cancer cells
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B lymphocyte
provide antibody-mediated immunity (humoral immunity)
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Activated B-cells become
Plasma cells
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Plasma cells
synthesize and secrete antibodies (IgM, IgG, IgE)
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Antibodies against microorganisms
IgM, IgG
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antibodies against allergens
IgE (bound to basophils/mast cells)
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Antibodies recognize
specific antigens on the surface of micro-organisms, cancer cells, and foreign molecule
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T-Lymphocyte
Provide cell mediated immunity
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T-cells recognize
Specific antigens on mico-organism, cancer cells, foreign cells, and damaged cells
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T-Cells bind to
pathogenic cells, viruses, cancer cells, and destroy them
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T-cells are responsible for transplant graft
rejection
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Killer T-Cells (Tk) function
Directly kill antigen or non-self cell by inserting a protein channel
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Suppressor T-Cells (T8 or Ts)
Reduce activity of T or B cells, i.e. limit immune response
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Memory T-Cells (Tm)
Activated during initial exposure, can activate quickly with re-exposure
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Lymphokine-producing T Cell
Produce lymphokines that further activate T, B cells, and macrophages
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T-Helper cells (T4 or Th)
Activate Tk and B-cells
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Monocytes
immature macrophages that exist within the circulation
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When monocytes leave the circulation
leave the circulation and differentiate into macrophages
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Monocyte functions (as macrophages)
- phagocytize pathogens, dead neutrophils, and cellular debris
- Activate lymphocytes by "presenting" antigens
- Release cytokines and growth factors that direct inflammation and tissue healing
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Types of macrophages
2
Fixed and wandering
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Fixed macrophages
Located in peripheral tissues/organs outside
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Wandering macrophages
circulate between blood and lymph fluid looking for foreign microbes
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Both types of macrophages serve to
recognize and phagocytize pathogens and present antigens to lymphocytes
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Platelets
Non-nucleated, disk-like cell fragments formed from giant megakaryocytes
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Functions of platelets
blood clotting
- repair gaps in walls of blood vessels
- cell membrane of platelets contains glycoproteins which aid in platelet adhesion to vessel wall and to each other
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150,000-400,00 /uL platelet implications
normal
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50,000-150,000 /uL platelet implications
thrombocytopenia - moderate resistance exercise
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20,000-50,000 /uL platelet implications
light resistive exercise, walk, stationary bike
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<20,000 /uL platelet implications
no activity except ADLs and Ambulation
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<5,000 /uL platelet implications
No activity/bed rest
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Blood clot formation
1. Damage to vessels stimulates platelet activity
(platelets become "sticky when they come in contact with non-endothelial cells/molecules; platelets stick to walls of damaged vessel and to each other - make a platelet plug)
2. Clotting proteins (fibrinogen) are stimulated by contact with damaged endothelium and non-endothelial tissue (enzymatic cascade results in conversion of inactive fibrinogen into active fibrin; fibrin "fibers" adhere to platelet plug and increase blood clot)
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Clotting Cascade: intrinsic pathway
stimulated by contact with extra-vascular tissue
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Clotting cascade: extrinsic pathway
stimulated by contact with damaged endothelial cells
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End result of clotting cascade
is formation of fibrin molecules that provide fiber network for clot - helps trap additional platelets, RBCs, and WBCs
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Blood clotting clinical application: Hemophilia
Sex-linked inherited disorders of blood coagulation
deficient or absent blood clotting factors
blood clotting is time prolonged; allows for pathological bleeding
patients can bleed severely after mild injuries; can result in fatal hemorrhage
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Blood clot removal
Plasminogen - blood protein that is trapped within a blood clot
Tissue plasminogen activator (tPA or PLAT) - protein that is found on endothelial cells, enzymatically converts plasminogen into plasmin
Plasmin - dissolves the clot to restore flow through the previously damaged veseel
92
Blood clotting: clinical application, tPA (tissue plasminogen activator)
used on patients with an acute occlusion of coronary or cerebral arteries (CVA) due to embolic thrombus; dissolves clots and reduces time of ischemia; reduced ischemia reduces the overall cell/tissue damage that occurs; results in fewer deficits for patients
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Thrombi can form pathologically on..
roughened endothelial surface of a vessel due to: arteriosclerosis, atherosclerosis, infection, trauma
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thrombi reduce
blood flow through a vessel
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reduced blood flow through a vessel increases
coagulability of blood, promotes increased "growth" of clot
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Deep vein thrombosis (DVT)
pathological thrombus formation within lower extremity veins
can break away from vessel wall (embolize)
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Embolized DVTs
follow circulation to pulmonary vessels (pulmonary embolus) and create lack of blood flow to lungs
