Anatomy & Physiology 34B
Chapter 17: Blood
I.
Overview
A. Functions & Properties of Blood
B. Composition of Blood
1. Plasma
2. Formed Elements
C. Blood Cell Formation
D. Blood types
E. Disorders of Blood
F. Hemostasis
II. Functions & Properties of Blood
A. Transportation
1. Respiratory - RBCs pick up ________ from the lungs and takes 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.
c.
Blood ____ is maintained via a buffering system in blood.
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. Immunity – leukocytes (______) destroy microorganisms and cancer cells
III. Major components of the circulatory (_______________) system are the blood, heart, and
blood vessels
A. The ________ is a 4-chambered pump that pushes blood in the vessels to the lungs &
body cells.
1. The adult heart pumps ___ to ___ L per min. and it takes about one min. for blood to
circulate throughout the body
2. Blood circulates from heart  ___________  ____________  ______________
 ____________  ________  heart
B. All exchanges of fluid, nutrients, & wastes between blood & tissues occur across
______________ walls
IV. Composition of Blood
A. _____________ is the study of blood, blood forming tissues, and their pathology.
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B. Blood consists of:
1. ____________ - the watery portion of blood
2. Formed elements - erythrocytes (____s), leukocytes (_____s), and ___________
(thrombocytes) suspended in the plasma
C. Blood is a dynamic _____________ tissue
1. It is warm at 38C (______C)
2. It has a pH range of ____-____
3. Salinity (mainly NaCl) is _____%
4. Osmolarity (total molarity of dissolved particles) is about ____ ________
a. ____________ regulates the exchange of nutrients and wastes across capillary walls
b. If blood osmolarity is too _____, too much fluid enters the ________ vessels,
resulting in ______ ___
c. If osmolarity is too ____, too much fluid remains in the _________, resulting in
edema and _____ ____
5. _____________ (resistance of flow due to cohesion between a fluid’s particles) is
____-____ times the viscosity of water
a. Viscosity is due to _____s and plasma __________
b. RBC or protein deficiency causes blood to flow too _______
c. Excess RBC or protein causes __________ blood flow
d. Either problem can lead to serious _____________ problems
e. _________________ syndrome is a condition in children who have severe dietary
protein deficiencies; symptoms are emaciated arms and legs and distended abdomen
6. Normal blood volume ranges from __-__ liters
D. Blood _______: watery portion of blood, composes __% of blood; consists of 90%
_______ and 10% solutes. __________ include:
1.
Plasma _________ - 7% of solutes; 3 major types produced by liver:
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 percursor for ____, essential for blood clotting.
(_____ is plasma without clotting factors)
2. ______________ (immunoglobulins) - proteins produced by plasma cells derived from
___ lymphocytes
3. Nonprotein ____________ substances, such as amino acids and nitrogenous wastes
(e.g., urea), the breakdown products of proteins
4. Nutrients – _______, amino acids, lipids, vitamins and minerals
5. Gases – oxygen and ___
6. Electrolytes – ______, especially Na+ ions
7. Other plasma solutes include enzymes and _________
E. Formed Elements: blood cells & platelets, compose __% of blood
1. _________cytes (RBCs) compose ___% of all formed elements
a. Mature RBC is a biconcave disc, 7-8 m wide, that lacks a _________ and most
organelles (thus is not able to divide)
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b. Adults have 4-6 ___________/mm3 (cc) blood
c. Regenerate from red bone ___________ at rate of 2 mil./sec.
d. Contain Hemoglobin (__) - composed of _________ protein consisting of 2-alpha
& 2-beta chains, and 4 _______ groups, each of which contains an _____ ion that
binds O2
1) Hb can combine with oxygen (____hemoglobin) and transport it to cells via the
blood stream, or with
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. Also contain ________ ____________ (CAH) enzyme that catalyzes the reaction:
CO2 + H2O  H2CO3
f.
RBCs live about ____ days, then they are destroyed in the liver & _________
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 & stored in liver & muscles
4) Iron is picked up by RBC precursors in red bone _______________.
5) Heme is converted to bili______, then bili______, which is secreted in ____ by
the liver, gives color to urine and feces.
a) A high level of biliruben in the blood causes _______________, 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
2.
________cytes (WBCs) – 5-10 __________/cc blood (about 1% of whole blood);
nucleated, no hemoglobin, live hrs-years, function in immunity. Leukocytes are
classified according to their ____________ appearance:
a.
_________cytes - have visible _________ in their cytoplasm; all are phagocytic.
1) ________phils (60%) - have pale ____ granules, 2-5 lobed nucleus; are
___________, destroy bacteria with lysozyme & defensins. Sometimes called
polymorphonuclear leukocytes (_____s) due to variably shaped nuclei
2) ______phils (1%)- stain dark ____, has S-shaped nucleus; similar to mast
cells that release histamine and _________ in allergic & parasitic reactions;
intensifies inflammatory response.
3) ______phils (3%) - stain ___; 2 nuclear lobes; counteracts effects of
____________ (which increases vascular permeability) in allergic reactions;
also destroy parasites
b.
__________cytes - have no visible cytoplasmic _________.
1) ________cytes (30%) - nucleus takes up most of cell; mediate _______
responses in blood and lymphoid tissues. Types include:
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a)
___ cells - develop into memory cells and _______ cells that secrete
_________ against antigens (esp. bacterial)
b) __ cells - attack fungi, transplanted cells, _______ cells.
c) Cytotoxic (_________) T cells attack tumor cells & virus infected cells
2) _______cytes (6%) - largest WBCs; nucleus is kidney-horseshoe shaped;
develop into phagocytic ___________ that destroy pathogens.
(Remember quantities by: Never Let Monkeys Eat Bananas)
3.
____________ (thrombocytes) - megakaryocyte fragments that contain many granules
but no nuclei. Functions:
a.
b.
c.
Initiate blood _________
Secrete ________, which stimulates blood vessel constriction
Life span is 5-9 days
V. ________________ - Formation of Blood Cells
A. Blood cells are first produced in the ___________ of the embryo, then in the bone
marrow, liver, _______, and thymus in the fetus
B. From infancy onward, all formed elements are produced in the red bone ________;
lymphocytes are also formed in lymphoid tissues
C. Blood cells are formed from hemopoietic _______ cells (__________blasts), which give
rise to 5 different -blast cells (nucleated precursor cells):
1.
2.
Proerythroblasts - become mature _________cytes (RBCs).
3.
Monoblasts - become mature _____cytes (agranular WBCs), which become
phagocytic ____________.
4.
Lymphoblasts - become mature _________cytes (agranular WBC __ & __
lymphocytes, natural killer cells).
______blasts - become mature neutrophils, eosinophils, and basophils
(___________ WBCs).
5.
Megakaryoblasts - form mature __________ (thrombocytes).
D. Hemopoeitic __________________ stimulate differentiation & proliferation of the
different blood cells.
1.
Erythropoietin (___) - hormone produced by kidneys & liver in response to
_________, increases proerythroblasts.
2.
_________ - small glycoproteins produced by red bone marrow cells, lymphocytes,
macrophages, and fibroblasts; Colony Stimulating Factor & Interleukins stimulate
WBC formation.
3.
Thrombopoeitin – a hormone produced by the liver and kidneys stimulates formation
of ___________
E. Red Bone _________ (myeloid tissue) - produces all types of blood cells.
F. _____________ tissue – also produces agranular leukocytes.
VI. 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 ____________ on the RBC
2. Type B has the ____________ on the RBC
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3. Type AB has both __ and __ antigens
4. Type O has neither __ nor __ antigens
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 (______) against type __ antigen
2. Type B blood has antibodies (______) against type __ 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. Rh Group is determined by the presence or absence of __ antigens (__) 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 ________ 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 _______________ fetalis. RhoGAM is given to
prevent this
VII. 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.
_____________ disease - inherited condition in which abnormal hemoglobin
crystalizes, causing RBCs to become _______ shaped and agglutinate; new treatments
allow patients to survive longer
B. ____________ - cancer of leukocyte forming cells in bone marrow causes high WBC
count, cancer cells crowd out normal stem cells in marrow; leukemia patients suffer from
_________, 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
1. Hematocrit (____) is measurement of ____% in whole blood; 37-52% is normal;
less = _______, greater = ______________
2.
A Differential _____ Count counts the number of each WBC type to diagnose
disease
a.
_________phils - normal is 50-60%; higher indicates _________________
infection, burns, stress, or inflammation.
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3.
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,
___________ disease, or leukemia.
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.
VIII. ______________ – the Control of Bleeding
A. Platelets are small fragments of ___________cytes, and contribute to hemostasis (the
cessation of bleeding). Their functions include
1. Secretion of procoagulants (clotting __________) and vasoconstrictors
2. Formation of platelet _______ to stop bleeding
3. Dissolution of old blood ______
4. ______________ of bacteria
5. Chemical secretion to attract ______phils and ______cytes to areas of inflammation
6. _______ __________ secretion to stimulate mitosis in fibroblasts and smooth muscle 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 _______ (I-XIII) and other enzymes produced mainly in
the liver, as well as platelet factors (________) produced by platelets
a. ________ mechanisms begin outside the blood stream. Damaged vessel cells release
tissue ___________ (factor III), which leads to activation of __________ __ (a
procoagulant)
b. ____________ mechanisms employ factors in the blood plasma and platelets; it begins
with factor ___ (Hageman factor) and also leads to activation of factor ___.
___________ is required in both pathways.
c. Activation of factor __ leads to the formation of ___________, which cuts plasma
fibrinogen into ________, which polymerizes to form the clot
d. Platelet-derived growth factor (____) stimulates _________ and smooth _________
cells to repair damaged blood vessel and surrounding connective tissues
e. Tissue repair is followed by ____________, in which the blood clot is dissolved by
_________, an enzyme created from plasminogen by thrombin and tissue
plasminogen activator (t-PA)
1) _______ is used clinically to dissolve blood clots formed during strokes and heart
attacks
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C. Inappropriate coagulation is prevented by
1. Platelet repulsion of by _________ on blood vessel endothelium
2. ________ of small amounts of thrombin 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 A), factor IX (hemophilia B), or factor XII (hemophilia C). Suffers are
treated with clotting ________
2. __________ – abnormal clotting of blood in an unbroken vessel. A __________ (clot)
may block a blood vessel, or break off and travel through the blood stream as an
________, which can block blood flow to a vital organ (e.g., pulmonary embolism)