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Transcript
Physiology 31 Lecture
Chapter 16 – Blood
I. Overview
A. Functions & Properties of Blood
B. Plasma & Cellular Elements of Blood
1. Red Blood Cells
2. White Blood Cells
3. Platelets
F. Blood Cell Production
G. Blood Disorders
H. Platelets & Coagulation
II. Functions & Properties of Blood
A. Transportation
1. Respiratory - RBCs pick up _______ from the lungs and take it to tissue cells for
aerobic respiration. ______ from cellular respiration is carried in blood back to lungs
for elimination.
2. Nutritive - blood carries digested _______ molecules through the liver to the body’s
cells.
3. Excretion - metabolic _______, excess water & ions are filtered through kidney
capillaries into tubules and excreted in urine.
4. Regulatory
a. Blood carries _________ from endocrine glands to target tissues.
b. Blood ____ is maintained via a buffering system in blood.
c. Body ______________ is regulated via blood’s high water content.
B. Protection
1. ___________ – platelet factors initiate clotting and minimize blood loss
2. ____________ – blood plays several roles
3. _____________ and other plasma proteins neutralize or destroy pathogens
4. ______________ – leukocytes (WBCs) destroy microorganisms and cancer cells
III. Plasma & Cellular Elements of Blood
A. ______________ is the study of blood, blood forming tissues, and their pathology.
B. Total blood volume in the body is between ___-__ L
C. Blood consists of:
1. _________ - the watery portion of blood (55% of whole blood)
2. Formed Elements (45% of blood) include erythrocytes (_____s), leukocytes
(_____s), and platelets (thrombocytes) suspended in the plasma
D. Normal blood parameters include
1. Blood is warm at 37C (_____F)
2. Blood has a pH range of ____-_____
2
3. Salinity (mainly NaCl) is about ____%
4. Osmolarity (total molarity of dissolved particles) of blood is about _____ mOsm/L
a. Osmolarity regulates the exchange of __________ and ______ across capillary
walls to and from surrounding tissues
b. If blood osmolarity is too high (______tonic), too much fluid enters the blood
vessels, resulting in ______ BP
c. If blood osmolarity is too low (______tonic), too much fluid remains in the tissues,
resulting in edema and _____ BP
5. ______________ (resistance of flow due to cohesion between a fluid’s particles) of
blood is 4.5-5.5 times the viscosity of water
a. Viscosity of blood is due to RBCs and plasma ___________
b. RBC or protein ___________ causes blood to flow too rapidly
c. __________ RBC or protein content causes slow blood flow
d. Either problem can lead to serious ______________ problems
e. Kwashiorkor syndrome is a condition in children who have severe dietary
_____________ deficiencies; symptoms are thin arms and legs and a distended
abdomen
D. Blood ______ - watery portion of blood, composes 55% of blood; consists of about 90%
______ and 10% solutes. _______ include:
1. Plasma __________ - 7% of solutes; 3 major types produced by the ________ are:
a. ___________ (60%) - small protein that makes blood viscous to maintain blood
___________, flow, and fluid balance
b. ___________ (36%) proteins include  globulin,  globulin (transport lipids),
and gamma globulin (build antibodies)
c. _________ (4%) - a protein precursor for fibrin, essential for blood clotting.
(________ is plasma without clotting factors)
2. _______________ (immunoglobulins) - proteins produced by plasma cells derived
from B lymphocytes, function in immunity
3. Nonprotein nitrogenous substances, such as amino acids and nitrogenous wastes (e.g.,
urea), the breakdown products of __________
4. Nutrients – _______, amino acids, lipids, vitamins and minerals
5. _________ – oxygen and CO2
6. Electrolytes – ions such as ____, Cl-, K+, H+, Ca2+ and HCO37. Other plasma solutes include enzymes and _____________.
IV. ___________ (RBCs) compose __% of all formed elements in blood
A. A mature RBC is a biconcave disc, 7-8 m wide, that lacks a __________ and most
organelles (thus is not able to divide)
B. Adults have about 5 _____________ RBCs per cc of blood
C. RBCs regenerate from red bone _________ at rate of 2 mil./sec.
D. Contain Hemoglobin (___) - composed of ______ protein, usually consisting of 2-alpha
& 2-beta polypeptide chains, and 4 _____ (red pigment) groups, each of which contains an
______ ion
1. Hb can combine with oxygen (____hemoglobin) and transport it to cells via the blood
stream, or with
3
2. CO2 (__________hemoglobin) for transport away from cells.
3. Glucose binds to hemoglobin, forming _______hemoglobin (HbA1C). An assay of
HbA1C can determine a diabetic’s average blood _______ level over the past 2-3 months
to assess treatment.
E. RBCs also contain __________ anhydrase (CAH) enzyme that catalyzes the reaction:
CO2 + H2O  H2CO3
F. RBCs live about ____ days, then are recycled in the liver & spleen
G. Worn out RBC components are ___________ by macrophages:
1. Amino acids from ________ are used to make new proteins
2. Iron from heme is transported in blood by ___________ protein
3. Iron attaches to ________ protein & is stored in liver & muscles
4. ______ is picked up by RBC precursors in red bone marrow.
5. Heme is converted to ___________, which is secreted in _____ by the liver and
kidneys; gives color to urine and feces.
a. A high level of bilirubin in the blood causes _____________ (yellowish skin and
sclera), which indicates liver disease or bile duct blockage
b. Newborns sometimes exhibit jaundice due to increased _________ during the rapid
conversion of fetal Hb to adult Hb
V. _____________ (WBCs) compose about __% of the formed elements
A. WBCs are ____________, do not contain hemoglobin, live from hours to years, and
function in ____________
B. Normal blood contains about 5-10 ___________ WBCs/cc of blood
C. WBCs are __________ according to their stained appearance
1. _________phils - have visible granules in their cytoplasm
a. _____________ (60%) - have pale lilac granules, 3-5 lobed nucleus; are
_____________, destroy bacteria with lysozyme & defensins. Sometimes called
polymorphonuclear leukocytes (PMNs) due to variably shaped nuclei
b. _________phils (1%) - stain dark blue, has S-shaped nucleus; similar to ______ cells
that release ___________ (a vasodilator) and ___________ (an anticoagulant) in
allergic & parasitic reactions, intensifies inflammatory response.
c. ________phils (3%) - stain pink; 2 nuclear lobes; destroy ___________, and
counteract effects of histamine
2. _________________ - have no visible cytoplasmic granules.
a. ______________ (30%) - nucleus takes up most of cell; mediate immune responses in
blood and lymphoid tissues. Types are:
1) ___ cells – responsible for __________ immunity: develop into memory cells and
plasma cells that secrete __________ against foreign antigens (esp. bacterial)
2) ___ cells – responsible for _____-mediated immunity: attack fungi, transplanted
cells, and cancer cells
3) Cytotoxic (_________) T cells destroy tumor cells & virus infected cells
b. ___________ (6%) - largest WBC; nucleus is kidney-horseshoe shaped; migrate out of
capillaries and become _____________ that phagocytize pathogens, then present their
antigens for lymphocyte response
(Remember quantities by: Never Let Monkeys Eat Bananas)
4
VI. __________ (thrombocytes) - megakaryocyte fragments that contain many granules but no
nuclei. Functions:
A. Initiate blood _________
B. Secrete ___________, which stimulates blood vessel constriction
C. Life span is 5-9 ______
VII. ___________________ - Formation of Blood Cells
A. Blood cells are first produced in the yolk sac of the _______, then in the bone marrow,
liver, spleen, and thymus in the ________
B. From infancy onward, most formed elements are produced in the red bone ______;
lymphocytes are also formed in lymphoid tissues
C. Blood cells are formed from hemopoietic _______ cells (hemocytoblasts), which give
rise to 5 different -blast cells (nucleated precursor cells):
1. Proerythroblasts - become mature _________cytes (RBCs).
2. Myeloblasts - become mature neutrophils, eosinophils, and basophils
(__________ WBCs).
3. Monoblasts - become mature _____cytes (agranular WBCs), which become
phagocytic _______phages.
4. Lymphoblasts - become mature ________cytes (agranular WBC B & T
lymphocytes, cytotoxic killer cells).
5. Megakaryoblasts – fragment to become mature _________ (thrombocytes).
D. Hematopoeitic _________ factors stimulate differentiation & proliferation of the
different blood cells.
1. Erythropoietin (____) - hormone produced by _________ in response to hypoxia
(low O2), increases pro__________blasts.
2. ___________ - small glycoproteins produced by bone marrow cells, lymphocytes,
macrophages, and fibroblasts; include ________ Stimulating Factor &
Inter________ that stimulate WBC formation.
3. Thrombopoeitin – a hormone produced by the _________ and stimulates formation
of ___________.
E. Red Bone ___________ (myeloid tissue) - produces RBCs, leukocytes, and platelets.
F. Lymphoid tissue – also produce ______________ leukocytes.
VIII. Blood Types
A. The _____ Group includes blood types A, B, AB, and O, and is determined by the
presence or absence of A and B __________ on RBCs (the antigens are glycoproteins
and glycolipids)
1. Type A has the ___ antigen on the RBC
2. Type B has the ___ antigen on the RBC
3. Type AB has both ___ and ___ antigens
4. Type O has neither ___ nor ___ antigens
5
B. People must receive transfusions of similar blood type because they have ____________
(gamma globulins) against certain RBC antigens, which will cause ____________
(clumping of the blood)
1. Type A blood has antibodies (anti-__) against type B antigen
2. Type B blood has antibodies (anti-__) against type A antigen
3. Type AB blood does not have __ or __ antibodies
4. Type O has both ___ and ___ antibodies (anti-A & anti-B)
5. Knowing the above facts, which blood type would be the “universal donor” type?
_______ Which would be the “universal recipient?” ______
C. ____ Group is determined by the presence or absence of Rh ___________ (D) on the
RBC of different blood types
1. ____ has the D antigen and no anti-D antibodies
2. ____ does not have the D antigen, but can develop anti-D antibodies if exposed to
____ blood
3. If an ____ mother carries a second ____ fetus, her antibodies can cross the placenta
and agglutinate the fetal blood, causing erythroblastosis _______. ________ is given
to prevent this
IX. Blood Disorders
A. ______ disorders
1. ____________ - skin is pale due to a deficiency of RBCs or hemoglobin; causes
include
a. Inadequate erythropoiesis or hemoglobin synthesis, due to deficient _____, vit.
_____, or intrinsic factor needed to absorb B12
b. Hemmorrhagic anemia due to blood ______
c. ____________ anemia due to excess destruction of RBCs
2. _____________ - excess RBCs in the blood; may be caused by cancer of bone
marrow; treated by removing some blood
3. _________ cell disease - inherited condition in which abnormal hemoglobin
crystalizes, causing RBCs to become __________ shaped and agglutinate; new
treatments allow patients to survive
B. ____________ - cancer of leukocyte forming cells in bone marrow causes high WBC
count, cancer cells crowd out normal ____ cells in marrow; leukemia patients suffer from
anemia, infections, & internal hemorrhaging; treatment includes bone _______ transplant
C. Thrombocytopenia - low number of __________ in blood; results in diminished ______
formation & increased internal bleeding
D. Blood cell ________ are used to determine the percentage of formed elements in the
blood and disease
1. Hematocrit (___) is measurement of RBC% in whole blood; 37-52% is normal;
less = _______, greater = ____________
2. A ___________ WBC Count counts the number of each WBC type to diagnose
disease
6
a.
3.
_______phils - normal is 50-60%; higher indicates _______ infection, burns,
stress, or inflammation.
b. _______phils - normal is 1-4%; higher indicates allergic reactions, ___________
infections, autoimmune disease, or adrenal insufficiency.
c. _______phils – normal is <1%; higher indicates _________ reactions, leukemia,
cancers, or hypothyroidism.
d. __________cytes – normal is 20-30%; higher indicates viral infection, immune
disease, or ____________.
e. _______cytes – normal is 2-8%; higher indicates ________ (e.g.: Epstein-Barr
virus) or fungal infection, tuberculosis, leukemia or some chronic disease.
f. Bone _________ Transplant is used to treat several types of anemia, leukemia,
and other blood disorders.
Complete Blood Count (____) used to determine RBC count, hemoglobin, hematocrit,
WBC count, differential WBC count, and platelet count.
X. Platelets and Coagulation
A. _________ are small fragments of megakaryocytes that contribute to __________ (the
cessation of bleeding). Their functions include
1. Secretion of procoagulants (_________ factors) and vaso___________
2. Formation of platelet _______ to stop bleeding
3. Dissolution of old blood _______
4. ________________ of bacteria
5. Chemical secretion to attract neutrophils and ____________ to areas of inflammation
6. Growth factor secretion to stimulate mitosis in _____blasts and smooth _________ to
maintain linings of blood vessels
B. Platelets play a role in all 3 ___________ mechanisms – vascular spasm, platelet plug
formation, and blood clotting (coagulation)
1. Vascular spasm – ___________ released by platelets constricts smooth muscle of
broken blood vessels, which reduces bleeding
2. Platelet _______ formation – platelets adhere to exposed __________ fibers in the torn
blood vessel wall, which temporarily seals the break
3. ____________ and blood vessel repair occurs as a mass of sticky _________ proteins
forms via a cascade of protein factors (I-XII) and other enzymes produced mainly in the
_______, as well as platelet factors (PF1-4) produced by __________
a. ______________ mechanisms begin outside the blood stream. Damaged blood vessel
cells release tissue thrombo________ (factor III), which leads to activation of factor
___ (a procoagulant)
b. ____________ mechanisms employ factors in the blood plasma and platelets; exposed
collagen activates factor ____ (Hageman factor), which also leads to activation of
factor __. _________ is required in both pathways.
c. Activation of factor X leads to the formation of ___________, from prothrombin.
d. Thrombin cuts plasma fibrinogen into __________, which polymerizes to form the
clot
7
e. Platelet-derived _______ factor (PDGF) stimulates fibroblasts and smooth muscle
cells to _______ damaged blood vessel and surrounding connective tissues
f. Tissue repair is followed by fibrinolysis, in which the blood clot is dissolved by
________, an enzyme created from plasminogen by thrombin and tissue
plasminogen activator (____)
1) t-PA is used clinically to dissolve blood _____ formed during strokes and heart
attacks
C. Inappropriate _____________ is prevented by
1. Platelet repulsion by ____________ on blood vessel endothelium
2. Dilution of small amounts of _________ that form spontaneously
3. Anticoagulants, such as _________ secreted by basophils and mast cells
D. Coagulation disorders
1. ____________ – inherited inability of blood to clot due to lack of factor VIII
(hemophilia __), factor IX (hemophilia __), or factor XII (hemophilia __). Suffers are
treated with _________ factors
2. __________ – abnormal clotting of blood in an unbroken vessel.
a. A ____________ (clot) may block a blood vessel, or break off and travel through
the blood stream as an
b. ______________, which can block blood flow to a vital organ (e.g., pulmonary
embolism)