The Blood

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Unit:5 Ch.13

blood

fundamental in maintaining homeostasis; brings nutrients and oxygen to the cells and carries away waste; classified as a connective tissue; blood volume accounts for approximately 8% of total body weight; divided into two main portions: the plasma and the formed elements

gases (blood transportation)

oxygen from inhaled air diffuses into the blood through thin membranes in the lungs and is carried by the circulation to all body tissues; carbon dioxide, a waste product of cell metabolism, is carried from the tissues to the lungs, where it is breathed out

nutrients (blood transportation)

the blood transports nutrients and other needed substances, such as electrolytes (salts) and vitamins, to the cells; these materials enter the blood from the digestive system or are released into the blood from body reserves

waste (blood transportation)

the blood transports the waste products from the cells to sites where they are removed; for example, the kidney removes excess water, acid, electrolytes, and urea (a nitrogen-containing waste); the liver removes blood pigments, hormones, and drugs, and lungs eliminate carbon dioxide

hormones (blood transportation)

blood carries hormones from their sites of origin to the organs they affect

pH (blood regulation)

buffers in the blood help keep the pH of body fluids steady at about 7.4 (the actual range of blood pH is 7.35 to 7.45); recall that pH is a measure of a solution's acidity or alkalinity; at an average pH of 7.4, blood is slightly alkaline (basic)

fluid balance (blood regulation)

the blood regulates the amount of fluid in the tissues by means of substances (mainly proteins) that maintain the proper osmotic pressure; recall that osmotic pressure is related to the concentration of dissolved and suspended materials in a solution; proper osmotic pressure is needed for fluid balance

heat (blood regulation)

the blood transports heat that is generated in the muscles to other parts of the body, thus aiding in the regulation of body temperature

disease (blood protection)

the blood is important in defense against disease; it carries the cells and antibodies of the immune system that protect against pathogens

blood loss (blood protection)

the blood contains factors that protect against blood loss from the site of an injury; the process of blood coagulation, is needed to prevent blood loss

plasma

the liquid portion of blood; accounts for approximately 55% of total blood volume (plasma itself is 91% water), about 8% is protein, and the remaining 1% consists of nutrients, electrolytes, and other materials that must be transported

formed elements

included the cells and cell fragments in blood; falls into three categories: erythrocytes, leukocytes, and platelets

erythrocytes (RBCs)

from erythro, meaning "red", are the red blood cells, which transport oxygen; disc shaped bodies with a depression on both sides; differ from other cells in that the mature form found in the circulating blood lacks a nucleus (is anuclear) and also lacks most of the other organelles commonly found in cells; cannot divide

leukocytes (WBCs)

from leuko, meaning "white", are the several types of while blood cells, which protect against infection; cells are round with prominent nuclei of varying shapes and sizes; colorless; different leukocytes are identified by their size, the shape of the nuclei, and the appearance of granules (lysosomes and other secretory vesicles) in the cytoplasm when the cells are stained (Wright stain)

platelets

aka. thrombocytes; are cell fragments that participate in blood clotting

thrombocytes

aka. platelets; are cell fragments that participate in blood clotting

protein (plasma)

plasma contains approximately 8% protein; plasma proteins include the following: albumin, clotting factors, antibodies, and complement

albumin (plasma protein)

the most abundant protein in plasma, is important for maintaining the blood's osmotic pressure; this protein is manufactured in the liver

clotting factors (plasma protein)

necessary for blood coagulation, are also manufactured in the liver

antibodies (plasma protein)

combat infection; antibodies are made by certain white blood cells

complement (plasma protein)

consists of a group of enzymes that helps antibodies in their fight against pathogens

hematopoietic stem cells

the ancestors of all the blood cells; have the potential to develop into any of the blood cell types produced within the red bone marrow; located in the ends of long bones and in the inner mass of all other bones

hemoglobin

a protein found in red blood cells that contains iron; hemoglobin, combined with oxygen, gives blood its red color; has two lesser functions: carrying hydrogen ions and carrying carbon dioxide from the tissues to the lungs for elimination; ability to carry oxygen can be blocked by carbon monoxide; consists of four amino acid chains (globins), each with an oxygen-binding heme group

erythropoietin (EPO)

a hormone that stimulates the production of red blood cells, which is released form the kidney in repsonse to decreased oxygen

granulocytes

the granular leukocytes; so named because they show visible granules in the cytoplasm when stained; has a very distinctive, highly segmented nucleus; variations are: neutrophils, eosinophils, and basophils

neutrophils

stain with either acidic or basic dyes and show lavender granules; most numerous of the white cells (60%); leukocyte; sometimes called polymorphs

eosinophils

stain with acidic dyes (eosin is one) and have beadlike, bright pink granules; leukocyte

basophils

stain with basic dyes and have large, dark blue granules that often obscure the nucleus; leukocyte

polymorphs

a term used to describe neutrophils, because their nuclei have various shapes

band cells

also called stab or staff cells; a term used to describe a neutrophil before it reaches full maturity and the nucleus looks like a thick, curved band; an increase in these cells is a sign of infection and active neutrophil production

agranulocytes

a category of white blood cells characterised by the absence of granules in their cytoplasm; two types: lymphocytes and monocytes; nuclei are round or curved and are not segmented

lymphocytes

are the second most numerous of the white cells; although they originate in the red bone marrow, they develop to maturity in lymphoid tissue and can multiply in this tissue as well; they circulate in the lymphatic system and are active in immunity; circulating lymphocytes live only 6-8 hours, but those that enter the tissues may survive for longer periods - days, months, or even years

monocytes

are the largest in size of the white cells; they average about 5% of the leukocytes

phagocytosis

the engulfing of foreign matter; whenever pathogens enter the tissues, as through a wound, phagocytes are attracted to the area (they squeeze between the cells of the capillary walls and proceed by ameboid, or amebalike, motion to the area of infection where they engulf the invaders), lysosomes in the cytoplasm then digest the foreign organisms and the cells eliminate the waste products

pus

a mixture of dead and living bacteria, together with dead and living leukocytes

abscess

a collection of pus localized in one area

macrophages

a monocyte which enters the tissues, enlarges, and matures; highly active in disposing of invaders and foreign material

plasma cells

a form of lymphocyte; active in the production of circulating antibodies needed for immunity

blood platelets

thrombocytes; smallest of all formed elements; are not cells in themselves but rather fragments constantly released from giant bone marrow cells called megakaryocytes; do not have a nuclei or DNA, but they do contain active enzymes and mitochondria; lifespan of about 10 days; essential in blood coagulation

megakaryocytes

giant bone marrow cell which releases blood platelets

coagulation

when blood comes in contact with any tissue other than the smooth lining of the blood vessels, as in the case of injury, the platelets stick together and form a plug that seals the wound; the platelets then release chemicals that participate in the formation of a clot to stop blood loss

hemostasis

is the process that prevents blood loss from the circulation when a blood vessel is ruptured by an injury; events include: contraction, platelet plug, blood clot

contraction (hemostasis)

first step of hemostasis; contraction of the smooth muscles in the blood vessel wall (this reduces blood flow and loss from the defect

platelet plug (hemostasis)

second step of hemostasis; formation of a platelet plug; activated platelets become sticky and adhere to the defect to form a temporary plug

blood clot (hemostasis)

third and final step of hemostasis; formation of a blood clot (coagulation)

procoagulants

compound which promotes clotting

anticoagulants

compound which prevents clotting

fibrinogen

plasma protein that is converted to fibrin in blood clotting; converting into fibrin by thrombin

fibrin

blood protein that forms a blood clot; insoluble fibrin, made by fibrinogen converted by thrombin

prothrombinase

a substance that triggers the final clotting mechanism in blood

thrombin

an enzyme in blood formed from prothrombin that facilitates blood clotting by reacting with fibrinogen to form fibrin; aka. Thrombase

serum

the fluid that remains after clotting has occurred; contains all the components of blood plasma except the clotting factors, as expressed in the formula: plasma = serum + clotting factors

hemorrhage

loss of blood

transfusion

introduction of blood or blood components directly into the blood stream; to administer blood from another person into the veins of the patient

hemolyzed

to undergo hemolysis; hemolysis: rupture of red blood cells (v., hemolyze)

antigen

foreign substance that produces an immune response; aka. agglutinogens; located on the surface of the red cells and cause the incompatibility reactions with blood transfusions

anti-A serum

blood serum containing antibodies that can agglutinate (destroy) and destroy red cells with A antigen

anti-B serum

blood serum containing antibodies that can agglutinate (destroy) red cells with B antigen

agglutination

clumping of cells due to an antigen-antibody reaction

Rh factor

named for Rhesus; another red cell antigen group; D antigen

Rh positive

people with the D antigen

Rh negative

people who lack the D antigen protein

hemolytic disease of the newborn (HDN)

condition that results from Rh incompatibility between a mother and her fetus; aka. erythroblastosis fetalis; prevented by the administration of Rh (D), trade name RhoGAM, to the mother during pregnancy and shortly after delivery

autologous

related to self, such as blood or tissue taken from one's own body; self originating

CPDA-1

citrate-phosphate-dextrose-adenine; added to blood to keep it from clotting; as when stored in a blood bank

centrifuge

a common method for separating the blood plasma from the formed elements; a machine that spins in a circle at high speed to separate a mixture's components according to density

hemapheresis

return of blood components to a donor following separation and removal of desired components; from the Greek work apheresis meaning "removal"

plasmapheresis

separation and removal of plasma from a blood donation and return of the formed elements to the donor

plasma

because all the red blood cells have been removed, there aren't any compatibility issues; plasma can be given to anyone

plasma expanders

cell free isotonic solutions used to maintain blood fluid volume to prevent circulatory shock

cryoprecipitate

precipitate formed when plasma is frozen and then thawed

anemia

a disorder in which there is an abnormally low level of hemoglobin or red cells in the blood and thus impaired delivery of oxygen to the tissues

leukemia

a neoplastic blood disease characterized by an increase in the number of white cells

clotting disorders

conditions characterized by an abnormal tendency to bleed because of a breakdown in the body's clotting mechanism

hemorrhagic anemia

hemorrhagic loss of red blood cells may be sudden and acute or gradual and chronic; possible causes: bleeding ulcers, excessive menstrual flow, and bleeding hemorrhoids (piles) - if it takes as long as 6 months for the affected person to recover from these blood loss afflictions, the affected person may have hemorrhagic anemia

hemolytic anemia

anemia caused by excessive red cell destruction (usually caused by the spleen, along with the liver); can also be caused by infections, such as: malarial parasite multiplying and destroying red cells, and certain bacteria, particularly streptococci, which produces a toxin that causes hemolysis

sickle cell anemia

hereditary disease in which abnormal hemoglobin causes red blood cells to change shape (sickle) when they release oxygen

sickle cell crisis

an aspect of sickle cell anemia, in which an obstruction occurs, causing severe joint swelling and pain (especially in the fingers and toes, as well as abdominal pain)

iron-deficiency anemia

the most common nutritional anemia; iron is an essential constituent of hemoglobin, a diet deficient in proteins or vitamins can also result in anemia; red cells are small and pale

folic acid-deficiency anemia

a folic acid deficiency that occurs often in people with alcoholism, in elderly people on poor diets, and in infants or others suffering from intestinal disorders that interfere with the absorption of folic acid

pernicious anemia

characterized by a deficiency in vitamin B-12 (a substance essential for proper red cell formation; the cause is a permanent deficiency of intrinsic factor (a gastric juice secretion that is responsible for vitamin B-12 absorption from the intestine); if neglected pernicious anemia can bring about deterioration in the nervous system and permanent damage to the spinal cord

thalassemia

includes a group of hereditary blood deficiencies in which hemoglobin is normal but is not produced in adequate amounts; compounded by the fact that erythrocytes may be destroyed in the bone marrow before that mature; red cells are small and pale (as in iron-deficiency anemia but have absorbed too much iron, instead of too little); forms vary from causing chronic, life-long anemia to premature death; main types are alpha and beta depending on the part of the hemoglobin molecule affected; severe B thalassemia (beta) is also called Cooley anemia

bone marrow suppression

aka. bone marrow failure, which also leads to decreased red cell production; one type of bone marrow failure is aplastic anemia

aplastic anemia

a disorder in which the bone marrow greatly decreases or stops production of blood cells; most times the cause is unknown but some cases are brought on by certain prescribed drugs and toxic agents such as, gold compounds, arsenic, and benzene (physical agents that may injure the marrow include: x-rays, atomic radiation, radium, and radioactive phosphorus)

luekopenia

a drop in the number of white blood cells; deficiency of leukocytes in the blood; may indicate depressed bone marrow or a bone marrow neoplasm

leukemia

a neoplastic disease of blood-forming tissue; characterized by an enormous increase in the number of white cells (although the cells are high in number, they are incompetent and cannot perform their normal jobs); crowd out the other blood cells

myeloid tissue

aka. red marrow

myelogenous leukemia

leukemia characterized by proliferation of myeloid tissue in areas such as bone marrow and the spleen and by the abnormal increase of granulocytes, myelocytes, and myeloblasts in tissues and in blood (leukemia stemming from cancer of the bone marrow); may be acute or chronic; typically exhibit signs or anemia

lymphocytic leukemia

leukemia (cancer) arising from the lymphoid tissue, so that most of the abnormal cells are lymphocytes; may be acute or chronic; typically exhibit signs or anemia

hemophilia

a rare hereditary bleeding disorder, a disease that influenced history by its occurrence in some Russian and Western European royal families; characterized by a deficiency of a specific clotting factor, most commonly factor VIII; can involve: soft tissue bleeding or joints spontaneously; may be treated with the appropriate clotting factor

von Willebrand disease

a hereditary clotting disorder; involves a shortage of von Willebrand factor, a plasma component that helps platelets to adhere (stick) to damaged tissue and also carries clotting factor VIII; may be treated with the appropriate clotting factor or with a drug similar to the hormone ADH

thrombocytopenia

the most common clotting disorder , in which there is a deficit number of circulating platelets (thrombocytes); results in hemorrhage in the skin or mucous membranes; may result from decreased production or increased destruction of the platelets; causes include: diseases of the red bone marrow, liver disorders, and various drug toxicities

disseminated intravascular coagulation (DIC)

a serious clotting disorder involving excessive coagulation; occurs in cases of tissue damage caused by massive burns, trauma, certain acute infections, cancer, and some disorders of childbirth; as DIC progresses, platelets and various clotting factors are used up faster than they can be produced, and serious hemorrhage may result

complete blood count (CBC)

s series of tests of the peripheral blood, including the hematocrit, the amount of hemoglobin, and the counts of each type of formed element

hematocrit (Hct)

the volume percent of red cells in whole blood, determined by spinning a blood sample in a high speed centrifuge for 3-5 minutes to separate the cellular elements from the plasma; packed cell volume; page: 292

hemocytometer

a ruled slide used to count the cells in a given volume of blood under the microscope

polycythemia

increase in the number of red cells in the blood; people who live at high altitudes may develop this disorder

polycythemia vera

increase in the number of red cells in the bone marrow

leukocytosis

when the white cell count exceeds 10,000 cells per (mcL); this condition is characteristic of most bacterial infections; may also occur after hemorrhage, in case of gout (a type of arthritis), and in uremia, the presence of nitrogenous waste in the blood as a result of kidney disease

differential white count

an estimation of the percentage of each white cell type in the smear; because each type has a specific function, changes in their proportions can be a valuable diagnostic aid

creatinine

nitrogenous waste product eliminated in urine

creatine kinase (CK)

is an enzyme; expressed by various tissues and cell types; CK catalyses the conversion of creatine and consumes adenosine triphosphate (ATP) to create phosphocreatine (PCr) and adenosine diphosphate (ADP). This CK enzyme reaction is reversible, such that also ATP can be generated from PCr and ADP

lactic dehydrogenase (LDH)

is an enzyme; present in a wide variety of organisms, including plants and animals; catalyzes the interconversion of pyruvate and lactate with concomitant interconversion of NADH and NAD+; It converts pyruvate, the final product of glycolysis, to lactate when oxygen is absent or in short supply, and it performs the reverse reaction during the Cori cycle in the liver

alkaline phosphatase

is a hydrolase enzyme responsible for removing phosphate groups from many types of molecules, including nucleotides, proteins, and alkaloids; could indicate liver disorder or metastatic cancer involving bone

bone marrow biopsy

refers to a procedure where a special needle is used to obtain a small sample of red marrow from the sternum, sacrum, or iliac crest

sternal puncture

a term sometimes used to describe a bone marrow biopsy when the marrow is taken from the sternum

reticulocytes

immature red blood cells, typically composing about 1% of the red cells in the human body; develop and mature in the red bone marrow and then circulate for about a day in the blood stream before developing into mature red blood cells; called reticulocytes because of a reticular (mesh-like) network of ribosomal RNA that becomes visible under a microscope with certain stains such as new methylene blue

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