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Ch 16 blood
Terms in this set (121)
anything essential for existance
advocating bleeding is still used for selected hematological disorders. True or False
Blood makes up ____ of the extracellular fluid
the internal environment that bathes cells and acts as a buffer between cells and the external environment
average amount of blood in an average person
4-5 liters of blood
total blood volume in a 70-kg man is equal to about % and ___kg
7% or 4.9 kg
total blood volume in a 58 kg woman has about ___ liters
the fluid matrix of the blood within which cellular elements are suspended
the main component of plasma, accounting for about ___% of its weight, protein makes up %, and the remaining ___% is made up of dissolved organic molecule
plasma is identical in composition to interstitial fluid except for the presence of .....
the most prevalent type of protein in plasma, makes up about ____% of the total
the iron-transporting protein in the plasma
the clotting protein in the plasma
___makes most plasma proteins and secretes them into the blood
the three main cellular elements found in the blood
another name for leukocytes
white blood cells
another name for platelet
the only fully functional cells in the circulatory system
white blood cells
____ are instrumental in coagulation
what is coagulation?
the process by which blood clots prevent blood loss in damaged vessels
the five types of white blood cells
monocytes that leave the circulation and enter the tissues develop into...
___, ____, and ____ are collectively known as phagocytes because they can engulf and ingest foregin particles such as bacteria
neutrophils, monocytes, and macrophages
___ are sometimes called immunocytes because they are responsible for specific immune responses directed against invaders
___, ___, and ____ are called granulocytes because they contain cytoplasmic inclusions that give them a granular appearance
basophils, eosinophils, and neutrophils
where do these different blood cells come from?
they are all descendants of a single precursor cell type known as the pluripotent hematopoietic stem cells
where are pluripotent hematopoietic stem cells located?
the bone marrow
the parent cell of platelets
why are uncommited stem cells so hard to study?
it is estimated that only about one out of every 100,000 cells in the bone marrow are uncommited stem cells, making them difficult to locate
what is hematopoiesis?
the synthesis of blood cells
what could explain why many cytokines that control hematopoeisis are released by the vascular endothelium?
the common embryological origin of the endothelium and blood cells
the liver and spleen no longer produce RBCs after birth. True or False.
Hematopoiesis continues in all the marrow of all bones in skeleton until the age of 10. True or False.
False. it continues until the age of 5
active bone marrow is red because it contains
hemoglobin, the oxygen-binding protein of RBCs
inactive bone marrow is yellow because it contains
an abundance of adipocytes (fat cells)
in the region of marrow that actively producing blood cells, about ___% of developing cells are WBCs.
the life span of RBCs
five cytokines that promote hematopoiesis
-colony stimulating factors
-stem cell factors
locations of colony stimulating factors,interleukins, stem cell factor
molecules made by endothelial cells and bone marrow,and white blood cells
function and location of erthypoietin
-EPO controls RBC synthesis and is located in the kidney
function and location of thrombopoietin
-TPO controls megakaryocytes and is located in the liver
the production and development of leukocytes
one fascinating aspect of leukopoiesis is that the production of new WBCs is
regulated in part by existing WBCs, this control allows a very specific WBCs to be made for the current situation of the body
A person with a viral infection may have a
-high,normal, or low WBC count but often shows an increase in the percentage of lymphocytes
what is leukemias?
a group of diseases characterized by the abnormal growth and development of WBCs.
what are neutropenias?
when they have too few WBCs and are unable to fight off bacterial and viral infections
a glycoprotein that regulates the growth and maturation of megakaryocytes
TPO is produced primarily in the liver, but is also processed in the kidney. True or False
Hypoxia stimulates EPO. true or false
the most abundant cells in the blood
the primary function of RBCs
to facilitate oxygen transport from the lungs to the cells, and CO transport from cells to the lungs
what is hematocrit?
the ratio of RBCs to plasma
the normal range of hematocrit is ___-___% for a man and ___-___% in woman
the final immature cell form, is called a ____, leaves the marrow and enters the circulation, where it matures into an erythrocyte in about 24 hours
mature mammalian RBCs are biconcave disks.True or False
when a RBC becomes spherical this means that
it is located in a hypotonic medium
when a RBC is sickled shaped or a cresent moon
the patient has sickle cell anemia
what is mean red cell volume?
the size of RBCs
RBCs become microcytic in iron-defiency anemia. True or False
True, microcytic= small
if RBCs are pale this means that
they lack hemoglobin, this is also described as hypochromic
the main component of RBCs, best known for its role in oxygen transport
a large, complex protein with four globular protein chains, each of which is wrapped around an iron-containing heme group
about ___% of the iron in the body is found in the heme groups of hemoglobin
good sources of iron are
a carrier protein called ___ binds iron and transport it in the blood
excess iron is stored as ___ in the ___
ferritin, in the liver
initial symptoms of iron overdose
-leads to liver failure
RBCs cannot be recycled. True or False.
False, many components of the destroyed cells are recycles
what do the spleen and liver do with the remnants of the heme groups?
they make them into a colored pigment called bilirubin, they are then binded into albumin in the liver and turned into bile
-elevated bilirubin levels in the blood
-causes the skin and whites of eyes to take a yellow color
when hemoglobin is too low, the blood cannot transport enough oxygen to the tissue
the rate of RBC destruction exceeds the rate of RBC production
the erythrocyte cytoskeletion does not link properly because of defective or deficient cytoskeletal proteins, consequently the cells are shaped more like spheres than biconcave disks
a genetic defect in which glutamate is replaced by valine. the result is an abnormal hemoglobin that crystallizes when it gives up oxygen and this crystallization gives it a cresent shape
sickle cell anemia
what is hydroxyurea used for?
-treatment of sickle cell disease
-inhibits DNA synthesis, alters bone marrow function so that immature RBCs produce the fetal form of hemoglobin instead of adult hemoglobin
iron deficient anemia
when iron loss exceeds iron intake, the marrow does not have adequate iron to make heme groups, and hemoglobin synthesis slows
-a stem cell dysfunction that produces too many RBCs
-the increased number of cells causes the blood to be more viscous and thus more resistant to flow of the circulatory system
the person's RBC number is normal, but the hematocrit is elevated because of low plasma volume
how are platelets formed
-the parent cell megakaryocytes go through mitosis without dividing
-the result is a polypliod with a lobed nucleus
-the edges of the megakaryocytes begin to break off to form cell fragments called platelets
___ are smaller than RBCs, colorless, and have no nucleus
typical life span of platelets
the process of keeping blood within a damaged blood vessel
the opposite of hematostasis
the three major steps of hematostasis
-temporary blockage of a break by a platelet plug
-coagulation, the formation of a clot that seals the hole until tissues are repaired
a blood clot that adheres to the undamaged wall of a blood vessel
the four steps of platelet plug formation
1:exposed collagen binds and activates platelets
2:release of platelet factors
3:factor attracts more platelets
4:platelets aggregate into platelet plug
Platelets adhere to collagen with the help of ___, membrane receptor proteins that are linked to the cytoskeleton
function of PAF
-the binding of platelets and integrins causes the platelets to release PAF, which attracts even more platelets
-and intiates pathways that convert platelet membrane phospholipids into thromboxane A2
Serotonin and thromboxane A2 are
four factors that contribute to platelet aggregation
if platelet aggregation is a positive reflex, what prevents the platelet plug from continuing to form and spread beyond the site of injury to other areas of the vessel wall?
-platelets do not adhere to normal epithelium
-intact vascular epithelial cells convert their membrane lipids into prostacyclin, an eicosanoid which blocks platelet adhesion and aggregation, and is assisted by NO which also inhibits platelet adhesion
what is prostacyclin?
an eicosanoid that is made by intact vascular epithelial cells to prevent platelet adhesion and aggregation
two factors that prevent platelet adhesion and aggregation
prostacycline and NO
what initiates the intrinsic pathway?
-when damage to the tissues exposes collagen
-Collagen activates the first enzyme, factor XII, to begin the coagulation cascade
what initiates the extrinsic pathway?
-starts when damaged tissue expose tissue factor, also called tissue thromboplastic or factor III.
-tissue factor activates factor VII, and this begins the extrinsic pathway
what happens in the common pathway of coagulation pathway?
-the intrinsic pathway and extrinsic pathway united and form the common pathway
-they create thrombin, the enzyme that converts fibrinogen into insoluble fibrin polymers.
-these fibrin fibers become part of the clot
function of fibrin fibers
-fibrin fibers weave through the platelet plug and trap RBCs within their mesh
As the damaged vessel wall slowly repairs itself, the clot disintegrates when fibrin is broken into fragments by the enzyme...
what initiates plasmin
when the inactivated form of plasmin, which is plasminogen, is activiated by thrombin and tissue plasminogen activator (tPA)
what two things activate the conversion of plasminogen to plasmin?
-thrombin and tPA
the breakdown of fibrin fibers causes by plasmin
the two mechanisms that limit the extend of the blood clotting in the vessels
-inhibition of the platelet adhesion
-inhibition of the coagulation cascade and fibrin production
endothelial cells release chemical known as _____, which prevent coagulation from taking place
the body produces three anticoagulants
heparin and antithrombin III work together to inhibit factors
IX, X, XI, XII
Protein C inhibits the clotting factors
V and VIII
what is an important cation in the coagulation cascade?
the order of factors for instrinsic pathway all the way to the common pathway
collagen activates XII, then IX,
-remember that calcium activates them all
the order of factors for extrinsic pathway all the way to the common pathway
damage exposes tissue factor(III) this activates VII, then IX
the order of events for common pathway begin with active factor IX
- activates factor X
-thrombin activates fibrinogen
-fibrinogen converts to fibrin
-fibrin and XIII bind to make cross-linked fibrin
-this is the end of coagulation pathway, however to eliminate the temporary clot is another pathway
when the tissue is repair, what is the pathway for clot removal?
-Plasminogen is activated by thrombin and tPA
-plasminogen converts to plasmin
-plasmin dissolves the fibrin fibers in a process known as fibrinolysis
occurs when a coronary blood vessel is blocked by a blood clot
three drugs that commonly used to dissolve the clot in heart attacks
an agent that prevents platelet plug formation by inhibiting the COX enzymes that promote synthesis of the platelet synthesis of the platelet activator thromboxane A2
-Acetylsalicylic acid, also known as aspirin
aspirin makes your blood thinner. True or False
False, aspirin makes your blood less likely to form clots by blocking platelet aggregation
how does warfarin (coumadin) work?
by blocking the action of the cofactor Vitamin K, which is necessary for the synthesis of action II(thrombin), VII, IX, and X
what is factor II?
what is factor III?
calcium is essential for clotting facor, with no calcium, no coagulation can occur. True or False.
what is hemophilia?
when one of the factors in the coagulation cascade is either defective or lacking
the most common hemophilia and affects what sex the most and and what percentage of hemophilic patients suffer from this condition
-hemophilia A, a factor VIII deficiency
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