how much blood is in the human body and in what percentages is it composed?
5 -6 liters 45% RBC 1% WBC/platelets 54% plasma
4.8 to 5.4 million/cu mm 120 life span biconcave disc (looks like a smartie) contains hemoglobin
what is hemoglobin, how is it composed, and what does it do?
protein carries oxygen and carbon dioxide composed of 2 alpha globin + 2 beta globin binded to 4 iron heme group chains
anemia resultant from a variation in alpha/beta genes in the nucleus of the bone marrow stem cells decreased alpha/beta synthesis genetic generally asymptomatic severe cases = growth retardation/splenomegaly/jaundice/death before 30 treat severe cases with transfusion
RBC production stimulated by erythropoietin released from the kidneys occurs in the bone marrow of the axial skeleton
newly formed RBC recently ejected from from the marrow should be 1-2% of RBC count
formed in liver from unconjugated bilirubin excreted in bile excess causes jaundice
the volume of packed RBCs per 100mL of blood
reduction of # of functioning RBCs circulating/cu mm
bone marrow dysfunction (primary/toxic) nutritional deficiency (iron/folic acid/others) infection chronic renal failure increased RBC destruction blood loss
fatigue/headache/exertional dyspnea pallor/cheilosis/jaundice/beefing red tongue/koilonychia
excess of red blood cells
craving to eat things that are not typically considered food
what are the percentages of hematocrit in the blood?
males 39-49% females 35-45%
how much hemoglobin is in the blood?
males 14-17g/mL females 12-16g/mL
mean corpuscular volume (MCV)
average of the measure of red blood cell size low MCV = microcytic anemia high MCV = macrocytic anemia
what is the average MCV
80-94 fL (fL femtolitre = one quadrillionth of a liter)
mean corpuscular hemoglobin MCH
average mass of hemoglobin per red blood cell low MCH = hypochromic high MCH = hyperchromic
what is the average MCH
27-32 pg (pg picogram = 10 to negative 12 grams)
hypochromic microcytic anemia most common worldwide pica = hallmark symptom elevated total iron-binding capacity (TIBC) eat iron rich foods -or- 325mg bid w/ food body only loses 1mg/day Fe; absorbed in illeum Fe consumption causes: constipation/nausea/black stool/diarrhea 200-250 mg/kg Fe = lethal oral dose
may cause hypochromic microcytic anemia wilson's disease
normochromic normocytic anemias
caused by organ failure: kidney/pituitary/thyroid caused by protein malnutrition/impaired marrow function from injury/infiltrative marrow disease (neoplasm/fibrosis) associated with NORMAL SIZ*E
n - normal pregnacy o - overhydration r - chronic Renal failure m - myelophthisic (tumor/fibrosis/leukemia) a - acute blood loss l - liver disease
si - systemic infection z - zero production e - endocrine disorders
macrocytic anemia sore throat/beefy red tongue/anorexia/nv/indigestion/abd pain/weight loss may lead to irreversible neurological damage clinical findings: stocking glove parasthesias/loss of fine touch and vibratory sensation/altered sphincter control/psychotic behavior/irritability/ataxia
bone marrow failure to produce RBC pancytopenia: all blood cells are decreased can be macrocytic/normocytic avoid ASA
hemolytic RBCs sickle under increased altitude/trauma/physical exertion/cold temperature/dehydration/acidosis painful/swollen joints/splenomegaly/seizures/stroke avascular necrosis of femoral head give pneumococcal vaccine
what is the order of clotting and what nutrients are necessary for it to take place?
order: vasoconstriction -> platelet aggregation -> fibrinogen converts to fibrin -> coagulation system begins needs calcium ions + vitamin K
intrinsic pathway: factors VII, XI, IX, XII, Ca+ extrinsic pathway: factors III, VII, Ca+ tissue factors common pathway: factors V, X, Ca+, platelet phospholipids factor VIII is only factor not made entirely in liver
indicative of platelet function should be 3 to 9.5 mins