ap #17 blood

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ap #17 blood

Composition of Blood

Liquid matrix
1. Plasma (55%)
2. Formed elements (45%)
a. Red blood cells
b. White blood cells
c. Platelets
3. Adults have 4-6 L of blood

Red blood cells functions

Transport of oxygen and carbon dioxide

White blood cells functions

Protect body against microorganisms and remove dead cells and debris, infection. Can level the blood vessels. work like an ameoba.

Platelets function

...

functions of blood

1. Transportation of dissolved gases, nutrients, hormones, and metabolic wastes. (by dissolved or a carrier molecule)
2. Regulation of the pH and ion composition of interstitial fluids. (HOMEOSTASIS)
3. Restriction of fluid losses at injury sites. (blood clots)
4. Defense against toxins and pathogens. (WBCs)
5. Stabilization of body temperature.

Formed elements

1. Red blood cells (erythrocytes)
2. White blood cells (leukocytes)
3. Platelets (thrombocytes) - ("blood clots") pieces of cells. involved in blood clotting

Hematocrit

1. Percent of blood (volume) that is RBCs - by centrifruge
2. Indicates problem but not what problem is
3. Normal 38-45%

reason for low hematocrit

1. lack RBCs
2. too much water

reason for high hematocrit

1. too many RBCs
2. dehydration

Red Blood Cells (Erythrocytes)

1. Function: Transport of oxygen and carbon dioxide
2. Biconcave discs (b/c no nucleus)
3. One-third hemoglobin
4. Lacks nuclei, mitochondria and ribosomes
5. can repair itself
6. not much energy
7. limited lifespan
8. carbonic anhydrase can be found in RBC

Hemoglobin

1. Normals
a. Male 14-16 g/dl
b. Female 12-14 g/dl
2. carries oxygen
3. pigment of blood - hemoglobin mixing w/oxygen
4. contain iron, needed to make hemoglobin

RBC abnormalites: Anemia (3)

lack of hemoglobin, lack of RBC, can't carry as much oxygen
1. Iron Deficiency - most common, not enough Hemoglobin due to lack of iron. Iron effects function of making hemoglobin
2. Pernicious - lack of Vit. B12, not enough RBCs
Sickle Cell - destruction of RBCs, cells get trapped in blood vessels & they are broken down, then don't have enough RBCs.

RBC abnormalites: Polycythemia

1. too many RBCs
2. most common in chronic lung disease
3. blood gets thicker
4. high altitude more pressure

RBC formation

1. Erythropoiesis - formation of RBC

2. Erythropoietin - make RBC by releasing this hormone, released by another tissue.

stem cell: divides, one stays stem cell, one becomes WBC, RBC or platelets

Erythropoiesis

1. Decreased blood oxygen causes kidneys and liver to release erythropoietin ---> stimulates bone marrow & says make more RBCs (negative feedback loop)
2. Vitamin B12, folic acid and iron necessary - lack of could cause anemia
2. kidneys are primary control. how many RBCs there are & they ultimately release erythropoietin. Kidneys measure O2 content

Hemoglobin Breakdown

1. RBC life span - 105 to 120 days
2. Damaged RBCs removed by spleen & liver
3. Broken down into heme & globin
4. Globin - amino acids
5. Heme - (iron mostly)
a. Biliverdin (green) by product, breaks down bilirubin
b. Bilirubin (yellow) by product of iron
Bruise - break down hemoglobin
spleen - remove any damaged RBCs, WBCs & platelets

White Blood Cells

1. Protect body against microorganisms and remove dead cells and debris, infection. Can level the blood vessels. work like an ameoba.
2. Diapedesis: cells become thin, elongate and move either between or through endothelial cells of capillaries
3. Chemotaxis: attraction (chemical) to and movement toward foreign materials or damaged cells. Accumulation of dead white cells and bacteria is pus.

White Blood Cells: Diapedesis

1. cells become thin, elongate and move either between or through endothelial cells of capillaries
2. migrate out of blood vessels and into tissue spaces.

White Blood Cells: Chemotaxis

attraction (chemical) to and movement toward foreign materials or damaged cells. Accumulation of dead white cells and bacteria is pus.

Neutrophils

1. die quickly, release chemicals to kill bacteria but you kill them too. they die to protect you.
2. AKA: polymorphonuclear leukocytes or PMNs
3. Highly mobile and very active PHAGOCYTIC cells
4. Diapedesis
5. Secrete lysozyme.
6. Last 1-2 days.
7. Account for 60-70% of the WBC.

Eosinophils

1. Leave circulation (blood) and enter tissues during inflammatory response. (get of stuff after allergic response)
2. Prevalent in allergic reactions.
3. Destroy inflammatory chemicals like histamine.
4. Numerous in lining of respiratory and digestive tracts
5. Account for 2-4% of the WBC.
6. go after parasitic worms

Basophils

1. Least common.
2. Play a role in both inflammatory response & allergic reactions. cause allergic response.
3. Produce histamine and heparin.
4. Account for less than 1% of the WBC.
5. Mast cells - in tissues

Lymphocytes

1. Migrate to lymphatic tissues & proliferate.
2. Responsible for antibody production.
3. Immunity - specific
4. Account for 20-25% of the WBC.
5. 2nd most common
T & B lymphocytes

Monocytes

1. in blood
2. Leave circulation & become macrophages.
3. Mobile and highly PHAGOCYTIC cells (don't die after cleanup)
4. Capable of engulfing large bacterial organisms & viral infected cells
5. Account for 3-8% of the WBC.

heparin

keeps blood from clotting in area of infection

White Blood Cell Counts

1. Procedure used to count number of WBCs per cubic millimeter of blood
a. 5,000 - 10,000 per cubic millimeter of blood
2. Leukopenia
a. Low WBC count (below 5,000)
3. Leukocytosis
a. High WBC count (above 10,000)
4. Differential WBC count
a. Lists percentages of types of leukocytes

Leukopenia

Low WBC count (below 5,000)
Note: don't need to know the numbers

Leukocytosis

High WBC count (above 10,000)
Note: don't need to know the numbers

Differential WBC count

Blood differential
Lists percentages of types of leukocytes

Formation of WBC

1. Stimulated by colony stimulating factor
2. ones that die signal to make new ones
3. interleukin = cause WBC formation

Platelets - function

1. Functions
a. Transport of chemicals important to the clotting process.
b. Formation of a temporary patch in the walls of damaged blood vessels.
c. Active contraction after clot formation has occurred.

Platelets

three characteristics
1. Adhesive - stickey
2. Aggregate - platelets come together
3. Agglutination - large amount clump together, it's NOT a clump
4. Pinched off of megakaryocyte
5. Thrombocytopenia - too little platelets (bleeding to death)
6. Thrombocytosis - too many platelets (too much clotting)

clot

platelets & plasma

Thrombocytopenia

too little platelets (bleeding to death)

Thrombocytosis

too many platelets (too much clotting)

Complete Blood Count (CBC)

1. Hematocrit
2. Hemoglobin concentration
3. Total count for RBCs, reticulocytes, WBCs, and platelets
4. Differential WBC count
5. RBC size and hemoglobin concentration per RBC

Blood Types

1. Based on genetics
2. Four types: A, B, AB & O

3. Agglutination: clumping of red blood cells in response to a reaction between an antibody and an antigen

Agglutination

clumping of red blood cells in response to a reaction between an antibody and an antigen

Antigens (agglutinogens)

1. Molecule that stimulates cells to produce antibodies
2. on the cell - determine what blood type you are
Note: antigens is what on test, not agglutinogens

Antibodies (agglutinins)

1. Protein that reacts against a specific antigen
2. in the plasma
3. goes after foreign blood types. For example, if you are type A & you get type B, antibody will go after type B
Note: antibodies is what on test, not agglutinins

ABO Blood Groups: Type A

Type A
Antigen A on RBC
Anti-B antibody in serum

ABO Blood Groups: Type B

Type B
Antigen B on RBC
Anti-A antibody in serum

ABO Blood Groups: Type AB

Type AB
Both antigen A and antigen B on RBC
No antibody in serum

ABO Blood Groups: Type O

Type O
Neither antigen A nor antigen B on RBC
Both anti-A and anti-B antibodies in serum

Rh Factor

1. Rh-positive
a. Rh antigen on RBC
b. No antibody in serum
2. Rh-negative
a. No Rh antigen on RBC
b. No antibody in serum
3. Anti-Rh antibodies are not normally present in blood

Rhogam Injection

1. Rhogam shot given before and after birth.
2. Contains preformed antibodies against the Rh antigen
3. Antibodies destroy all the fetal Rh+ blood cells that leak back into the mother's blood during biirth.
4. Prevents mother from processing the Rh antigen and developing anti-Rh antibodies.

Plasma: Liquid part of blood

Liquid part of blood.
1. Colloid: liquid containing suspended substances that don't settle out of solution
2. 91% water. Remainder proteins, ions, nutrients, waste products, gases, regulatory substances

Plasma: Proteins

Proteins:
1. Albumins: viscosity, osmotic pressure, buffer, transports fatty acids, free bilirubin, thyroid hormones
2. Globulins: transports lipids, carbohydrates, hormones, ions, antibodies, and complement
3. Fibrinogen: blood clotting
4. Most plasma proteins synthesized by liver
5. Gamma globulins synthesized by plasma cells (B cells)

Plasma Ions:

involved in osmosis, membrane potentials, and acid-base balance

Plasma: Nutrients

glucose, amino acids, triglycerides, cholesterol, vitamins

Plasma: Waste Products

1. Urea, uric acid, creatinine, ammonia salts. Breakdown products of protein metabolism
2. Bilirubin: Breakdown product of RBCs
3. Lactic acid: End product of anaerobic respiration

Plasma: Gases

oxygen, carbon dioxide

Plasma: Regulatory substances

hormones, enzymes

Coagulation (Clotting)

1. Goal: (1) stop bleeding (2) prevent blood loss
2. Requires platelets and plasma proteins
3. Require calcium ions as cofactors

Hemostasis

1. Arrest of bleeding
2. Events preventing excessive blood loss
a. Vascular spasm: Vasoconstriction of damaged blood vessels.
b. Platelet plug formation
c. Coagulation or blood clotting

Blood Clot

1. A network of threadlike fibrin fibers, trapped blood cells, platelets and fluid
2. Clot retraction. Fibrin threads of clot attached to blood vessel walls.
a. Platelets produce processes that attach to fibrin threads.
b. Actin and myosin molecules within platelets contract, pulling edges of wound together and squeezing out serum.

Factors Affecting Coagulation: Factors that prevent clotting

1. Smooth endothelium
2. Heparin

Factors Affecting Coagulation: Factors that promote clotting

1. Stasis
2. Damaged endothelium

thrombosis

Stationary clot

embolus

Mobile clot

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