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Anatomy And Physiology II

Chapter 14 Alternate Assessment

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14.1 CHARACTERISTICS OF BLOOD

Briefly describe the functions of blood.

Blood is a specialized connective tissue that performs various functions in the body. One

of the functions is transportation. Blood carries oxygen, nutrients, hormones, and waste products

throughout the body. Red blood cells carry oxygen, while white blood cells and plasma carry

nutrients, hormones, and waste products.

Blood helps to regulate body temperature, pH, and fluid balance. It also plays a role in

maintaining the balance of electrolytes and other chemicals in the body. Lastly, Blood contains

white blood cells that help to protect the body against infection and disease. Platelets in the

blood also help to stop bleeding by forming clots.

14.2 BLOOD CELLS

What are the stem cells responsible for blood cell formation?

hematopoietic stem cells

Where are they found?

These cells are found in the bone marrow, the spongy tissue inside bones. They are also in

smaller amounts in the blood.

14.2. BLOOD CELLS

Major Blood Cell Summary Table

Red Blood Cells White Blood Cells Platelets

Major Blood Cell

Type
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Scientific Name erythrocytes leukocytes thrombocytes

Circulating Female: 3.6 to 5 between 4,500 and between 150,000 to

Concentration/ million/mm3 11,000 cells/mm3 of 450,000 platelets per

mm3 blood Male: 4.2 to 5.4 blood millimeter cubed

million/mm3 (mm³)

General Function Erythrocytes are The immune system Prevent and stop

responsible for the aids in the defense bleeding.

transportation of against infections

oxygen from the and various illnesses.

respiratory system to

the peripheral

tissues.

Subsequently, the

carbon dioxide is

transported back to

our lungs to be

exhaled during the

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return journey.

Key Characteristics Red blood cells are Leukocytes lack Platelets possess

minute in size and pigmentation, yet diverse mediators

exhibit a discoid or they may exhibit a that play a crucial

toroidal morphology faint lavender to rosy role in regulating

characterized by a hue when scrutinized hemostasis and

circular perimeter through a thrombosis.

and a central microscope and Additionally, they

concavity, albeit subjected to staining. are involved in

non-cavitary. Despite their various other

diminutive size, the functions such as

cells in question chemotaxis,

exhibit a spherical vasomotor function,

morphology and cell growth, and

possess a discernible inflammation.

central membrane.

Red Blood Cells (Erythrocytes)

Briefly describe the structure of a red blood cell.

Erythrocytes have a unique structure that allows them to perform their primary function

of carrying oxygen throughout the body. Their structures are critical to their function. They are

small and have biconcave round and flat disks, like a donut without a hole in the middle. They

are about 7-8 micrometers in diameter, enclosed by a thin, flexible plasma membrane that allows
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them to squeeze through narrow capillaries.

Define the following terms.

Hemoglobin = Hemoglobin is a globular protein that carries oxygen from the respiratory organs

to the various tissues and organs of the body and as a transporter of carbon dioxide from those

tissues and organs back to the respiratory organs. It is primarily located within the erythrocytes,

or red blood cells.

Oxyhemoglobin = contains iron in its reduced (ferrous) state and is the typical, oxygen-carrying

form of hemoglobin.

Deoxyhemoglobin = is a molecule that exhibits paramagnetism due to the presence of unpaired

iron electrons, generating magnetic moments.

Briefly describe erythropoiesis and where it occurs.

Erythropoiesis is the physiological mechanism that generates fresh erythrocytes within

the human organism. The process predominantly occurs within the bone marrow, a pliable and

porous tissue within bones.

The initial step involves the hormone erythropoietin (EPO), which is synthesized by the

kidneys in reaction to hypoxemia. Erythropoietin (EPO) induces the differentiation of

hematopoietic stem cells in the bone marrow into proerythroblasts, which serve as the antecedent

cells for producing red blood cells. Following the maturation process, proerythroblasts undergo

division and differentiation, leading to the formation of basophilic erythroblasts. These cells

subsequently develop into polychromatic erythroblasts, eventually transforming into

orthochromatic erythroblasts. Orthochromatic erythroblasts undergo enucleation and

differentiate into reticulocytes, which are characterized as nascent erythrocytes that retain certain

organelles.

Following their release from the bone marrow, reticulocytes undergo maturation within
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the circulatory system and differentiate into fully functional erythrocytes within 1-2 days. The

differentiation of hematopoietic stem cells into mature red blood cells typically spans

approximately 7-10 days. Erythropoiesis is a meticulously controlled process that consistently

provides red blood cells to sustain sufficient oxygen transportation to the body's tissues.

Which hormone is responsible for erythropoietin?

Erythropoietin (EPO)

How long does the average blood cell live?

The typical lifespan of red blood cells in the human body is approximately 120 days,

during which time they circulate in the bloodstream. Following this period, macrophages are

responsible for phagocytosing these cells.

Briefly describe the breakdown of red blood cells.

Hemoglobin, a protein in red blood cells (RBCs), transports oxygen from the lungs to the

body. Erythrocyte degeneration occurs when RBCs reach 120 days of age and are withdrawn

from circulation. The liver, spleen, and bone marrow break down RBCs. Heme and globin form

from RBC hemoglobin. Amino acids from the globin protein may be recycled to form new

proteins. Iron and bilirubin are formed from the heme molecule. Iron may be reused to generate

RBCs or stored in the liver or bone marrow. Bilirubin enters the circulation, is processed by the

liver, and is expelled in bile. RBC breakdown and recycling are necessary to maintain healthy

blood and avoid hazardous waste accumulation.

White Blood Cells

Briefly describe the difference between granulocytes and agranulocytes.

Granulocytes and agranulocytes are two distinct subtypes of leukocytes. They play a

crucial role in the body's immune response. The primary distinguishing factor among them is the

existence or nonexistence of granules, which are minuscule sacs containing enzymes and other
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agents that aid in combating infections.

Granulocytes are a type of immune cell that possess granules within their cytoplasm.

These granules contain various enzymes and substances that are crucial to immune function. The

categorization of granulocytes comprises three distinct types: neutrophils, eosinophils, and

basophils. Neutrophils, being the predominant type of granulocyte, are tasked with the role of

combating bacterial infections. Eosinophils play a crucial role in combating parasitic infections

and in the pathogenesis of allergic reactions. Basophils play a crucial role in allergic reactions

and parasite immune responses.

In contrast, Agranulocytes lack granules within their cytoplasm. The two distinct

categories of agranulocytes are lymphocytes and monocytes. Lymphocytes play a crucial role in

the body's immune response by recognizing and combating infections. Monocytes are a subset of

leukocytes that can differentiate into macrophages, tasked with the phagocytosis and degradation

of foreign pathogens and cellular debris.

Describe phagocytosis and which blood cells are capable of it.

Phagocytosis is an essential biological mechanism in which specific cellular entities

within an organism internalize and degrade extraneous particles, including but not limited to

bacteria, viruses, and cellular remnants. Phagocytes are a type of cell that can perform

phagocytosis, a process essential for the immune system's reaction to injury and infection.

What is the function of heparin?

Heparin is administered for preventive measures against thrombus formation in patients

with specific medical conditions or those undergoing certain medical interventions that heighten

the risk of thrombosis.

What is the function of histamine?

Histamine plays a crucial role in regulating various physiological and pathophysiological

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processes, including but not limited to gastric acid secretion, inflammation, and the modulation

of vasodilatation and bronchoconstriction.

White Blood Cell Summary Table

Function/ Differential % Typical Sketch

Specific Event of Increase?

WBC

Neutrophils The increase of The differential  Neutrophils are round and

neutrophils is a crucial percentage of 12-15 μm (humans are eight

aspect of the organism's neutrophils μm).

reaction to infection and exhibits variation  Once triggered, they become

trauma, as it restricts the based on age, amoeboid to fight intruders

dissemination of gender, and with their pseudopodia.

pathogens and facilitates additional  The smallest granulocytes

the recovery of impaired factors. have a multi-lobed nucleus

tissues. Prolonged or However, it is with 3-5 lobes linked by a

excessive neutrophilia commonly thin genetic thread.

may indicate the observed to be  The nucleolus disappears as

presence of underlying within the 40- neutrophils develop.

medical conditions, such 60% range in the  Neutrophils contain many

as cancer or chronic adult population. azurophilic or primary

inflammation, and may granules, which are purple

necessitate further and microbicidal.

examination and  Secondary cytoplasmic

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intervention. granules include lysozyme,

collagenase, and other

enzymes.

 The endoplasmic reticulum,

mitochondria, and Golgi

complex are hardly present.

Eosinophils

Eosinophils capture Depending on  Eosinophils help the immune

substances, destroy cells, the lab, system fight parasite diseases

kill parasites and eosinophils make and allergies.

bacteria, participate in up 0-5% of white  They have bi-lobed nuclei

rapid allergy reactions, blood cells in the and granular cytoplasm.

and modulate blood.  Eosinophil granules contain

inflammatory responses. parasite-toxic enzymes and

proteins that may harm tissue

in allergic responses.

 Eosinophil means "eosin-

loving" because their

cytoplasm is pinkish-red

under certain stains.

Basophils

Basophils help the body's Often make up  Basophils help fight allergies

immune system fight less than 1% of and parasites.

allergies, infections, and white blood  Large, lobulated nuclei and

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parasites. cells. cytoplasmic granules

distinguish them.

 Their cytoplasmic granules

include histamine, heparin,

and other inflammatory and

allergic mediators.

 Basophils are rare in the

blood.

Monocytes

Macrophages engulf and Monocytes make  Monocytes are circulating

destroy germs, absorb between 2%– white blood cells generated

foreign material, 10% of the in the bone marrow.

eliminate dead cells, and differential  Their kidney-shaped nucleus

improve immunity. count. and huge size distinguish

them from other blood cells.

 The light blue cytoplasm of

monocytes is tiny.

 Unlike neutrophils and

eosinophils, the cytoplasm

may include tiny granules,

although they are not as

plentiful or identifiable.

 Monocytes may phagocytose

and digest bacteria, viruses,

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and cell debris.

 Migrating into tissues, they

may develop into

macrophages and dendritic

cells.

 In most tissues, macrophages

are big, highly phagocytic

cells that help the immune

system fight infection and

damage.

 The skin, lungs, and

gastrointestinal systems

include dendritic cells,

specialized cells interacting

with the environment. They

capture and deliver foreign

particles to immune system

cells to start an immune

response.

Lymphocytes

Lymphocytes assist the Adult  White blood cells called

immune system in lymphocytes lymphocytes help fight viral

fighting cancer and make around and bacterial diseases.

foreign viruses and 20%–40% of the  Their huge, spherical nucleus

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germs (antigens). The white blood cell takes up most of the cell's

immune system count. bulk.

remembers every antigen  Lymphocytes have thin

with lymphocytes. cytoplasm surrounding the

nucleus.

 B and T cells are lymphocyte

subtypes.

 B cells produce antibodies,

proteins that identify and

attach to infections,

designating them for immune

system destruction.

 T cells regulate the immune

response and assault infected

or malignant cells.

 Long-lived memory cells can

guard against certain

infections in B and T cells.

 The blood, lymphatic system,

spleen, thymus, and lymph

nodes contain lymphocytes.

 Lymphocyte appearance

depends on cell type, stage of

development, and staining

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and imaging methods.

Briefly describe the process of diapedesis.

Diapedesis occurs when white blood cells (leukocytes) leave blood arteries and enter

surrounding tissues due to infection or damage. This procedure permits immune cells to reach

the site of infection or injury and combat microorganisms.

Diapedesis has numerous steps:

Leukocyte activation: Leukocytes go toward the inflammation after an infection or damage.

Rolling: Leukocytes roll along the endothelial cells lining the blood vessel as they approach it.

Adhesion: Leukocyte adhesion molecules engage with endothelial cell adhesion molecules to

attach them firmly.

Transmigration: Leukocytes cross the endothelial cells and enter the tissue. Leukocytes pass via

endothelial cell layer temporary holes.

Migration: Chemical cues from injured or infected cells lead leukocytes to the infection or

injury.

Platelets (Thrombocytes)

Describe the structure of platelets.

Platelets are minute, discoid cellular fragments in constant circulation within the

bloodstream. Platelets are generated within the bone marrow through the differentiation of

megakaryocytes, characterized by their large size. Platelets are generally characterized by their

diameter, which ranges from 2 to 4 micrometers, and their lack of a nucleus. Platelet cytoplasm

comprises multiple minute granules that house diverse bioactive molecules that play a crucial

role in the process of hemostasis.

Briefly describe the function of platelets.

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Platelets primarily serve the purpose of facilitating hemostasis in reaction to tissue

damage. Upon blood vessel injury, platelets promptly adhere to the site of damage and create a

plug to impede additional hemorrhage. Additionally, they secrete diverse chemical substances

that stimulate the recruitment of additional platelets and other clotting factors to the site of

injury, ultimately establishing a durable hemostatic plug.

14.3 PLASMA

Blood plasma is the liquid component of blood, making up about 55% of the total blood volume.

Describe the components of blood plasma:

Water= Constituting approximately 90% of the plasma volume, the aqueous solution known as

plasm serves as a solvent for numerous other components.

Plasma Proteins= The constituents encompassed are albumin, globulins, and fibrinogen. These

proteins contribute to the regulation of osmotic pressure,

facilitate the transportation of various substances, and are

involved in the process of hemostasis.

Gases= Including oxygen, carbon dioxide, and nitrogen

Nutrients= glucose, amino acids, and lipids, which are important for energy production and

tissue repair

Nonprotein Nitrogenous Substances (Plasma Wastes)= creatinine, and uric acid, which are

byproducts of metabolism that need to be eliminated from the body.

Plasma Electrolytes= include sodium, potassium, chloride, and bicarbonate ions, which help

maintain the blood's pH and fluid balance.

Regulatory Substances= include hormones, enzymes, and vitamins, which play a role in

various physiological processes such as metabolism, growth, and immunity.

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14.4 HEMOSTASIS

Briefly define hemostasis.

When blood vessel damage occurs, the body's natural response is hemostasis, clotting,

and wound sealing. Interactions between blood arteries, platelets, and clotting factors are all

intricately involved.

What are the three steps in hemostasis?

 Vasoconstriction

 platelet plug formation

 and blood coagulation

What are the two pathways of blood coagulation?

 the extrinsic pathway

 , the intrinsic pathway

What are the five steps of the Extrinsic Clotting Mechanism

1. Tissue injury exposes tissue factor (Factor III) to the blood.

2. Factor VII in the blood binds to tissue factor, forming a complex.

3. The complex activates Factor X, which combines with Factor V to form prothrombinase.

4. Prothrombinase converts prothrombin to thrombin.

5. Thrombin converts fibrinogen to fibrin, which forms the clot.

How does the Intrinsic Clotting Mechanism differ in the initial steps or activation?

The intrinsic clotting mechanism is activated by damage to blood vessels' endothelium

(inner lining). It differs from the extrinsic mechanism in that it is initiated by the exposure of

collagen fibers in the damaged vessel wall. This leads to the activation of several clotting

factors, ultimately forming a fibrin clot.

Briefly describe what happens to a blood clot after it forms.

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Clot retraction is when a blood clot contracts and draws the wound's edges together after

it has formed. Then, new blood vessels (angiogenesis) emerge to aid in the healing process.

Fibrinolysis is the procedure that dissolves the clot after it has formed.

Prevention of Coagulation (Fibrinolytic System)

The fibrinolytic system functions as an anticoagulant mechanism in the body, breaking

down blood clots and preventing them from forming in the first place. It achieves this by

transforming plasminogen into the clot-busting protein plasmin. The fibrinolytic system is

crucial in avoiding thrombosis and keeping blood flowing normally.

What is the function of the fibrinolytic system?

The fibrinolytic system is responsible for breaking down old blood clots. It helps keep

blood from clotting too much and clears out any little clots that may develop during normal

circulation. Wound healing and tissue remodeling are only two examples of the many

physiological processes in which the fibrinolytic system plays a role.

Describe the following fibrinolytic substances

tissue plasminogen activator (TPA)= TPA is a protein that is produced by cells in the lining of

blood vessels, and it plays a critical role in fibrinolysis by activating plasminogen, an enzyme

that breaks down blood clots

Heparin= Heparin is a naturally occurring anticoagulant generated by mast cells in the body.

Attaching to and activating an enzyme called antithrombin III inhibits several blood clotting

factors.

Warfarin (Coumadin)= Warfarin is a medication used to prevent blood clots by inhibiting the

activity of vitamin K-dependent clotting factors.

Define the following terms.

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Thrombus = A thrombus is a blood clot that develops within a blood artery and obstructs blood

flow, either temporarily or permanently. Both arterial and venous thrombosis are potentially life-

threatening disorders that may cause strokes and DVTs, respectively.

Embolus = Embolus is a blood clot or other material, such as fat or air, that breaks off from a

thrombus and travels through the bloodstream to another location. Emboli can cause blockages

in blood vessels, leading to conditions such as pulmonary embolism or stroke.

Embolism = An embolism is any blood vessel obstruction by a blood clot, fat clot, or other

substance. Depending on location and size, an embolism may have minor to life-threatening

effects.

14.5 BLOOD GROUPS AND TRANSFUSIONS

What is the roll of antigens in determining blood type?

Antigens are molecules on the surface of red blood cells that determine blood type. The

two most important blood group systems are the ABO and Rh systems. ABO blood group

antigens are either A or B, or both, and Rh blood group antigens are either present (+) or absent

(-).

What role do the antibodies have in the body?

Antibodies are proteins that the body produces in response to foreign antigens. In the

case of blood transfusions, the antibodies in the recipient's blood can recognize and bind to

foreign antigens on the transfused red blood cells, leading to an immune reaction. This can cause

serious complications, including hemolysis (destruction of red blood cells), fever, and shock.

What occurs if there is an interaction between blood group antigens and antibodies?

Red blood cells may clump together (agglutination) if antigens from different blood

types come into contact with antibodies. As a result, oxygen-starved tissues and organs may

suffer from a lack of blood flow. Death or serious organ damage may result in extreme
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circumstances.

ABO Blood Group

Complete the table below.

A B AB O

BLOOD TYPE

ANTIGEN ON

RBC A B A and B H antigen

ANTIBODIES

IN PLASMA Anti-B Anti-A A and B anti-A and anti-B

antibodies. antibodies. antibodies

COMPATIBLE

DONORS A and O B and O A, B, AB, and O O

INCOMPATIBL

E DONORS B or AB A and AB None A, B, and AB

GENOTYPE

AA or AO IBIB or IBi AB OO

PHENOTYPE

A B AB "O negative" or "O

positive"

What is the blood type of a universal donor?

O negative

What is the blood type of the universal recipient?

AB positive
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Rh Blood Group

What are the two blood types in the Rh group?

Rh positive and Rh negative.

How does a person develop anti-Rh antibodies?

Anti-Rh antibodies develop in Rh-negative people who get transfusions or become

pregnant with Rh-positive partners. When the immune system encounters the Rh antigen, it

produces antibodies. The immunological response may be delayed and weak initially, but with

repeated exposure, it may become considerably stronger and quicker.

Why is there a risk of erythroblastosis fetalis only in a second pregnancy and not the first?

Erythroblastosis fetalis, alternatively referred to as hemolytic disease of the newborn, is a

medical condition characterized by the generation of maternal immune system antibodies that

target the erythrocytes of the fetus. The phenomenon may arise in cases where the mother's Rh

factor is negative, and the fetus's is positive. During the first pregnancy, if Rh-positive fetal

blood enters the mother's bloodstream, her immune system may develop sensitivity towards the

Rh antigen.

In the event of initial pregnancy, any sensitization that may occur is typically insufficient

to result in substantial fetal harm. This phenomenon is because the maternal immune response

may exhibit a delayed and feeble reaction, impeding the antibodies from traversing the placenta

and inducing substantial hemolysis, which is the breakdown of red blood cells in the developing

fetus.

In subsequent pregnancies involving an Rh-positive fetus, the mother's immune system

has already been sensitized to the Rh antigen, enabling a more accelerated and vigorous immune

response. The occurrence of an elevated concentration of anti-Rh antibodies in the maternal

bloodstream may lead to intensified hemolysis in the fetus, thereby causing erythroblastosis
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fetalis.

Rh immunoglobulin (RhIg) is administered to Rh-negative mothers during pregnancy

and postpartum to prevent sensitization to the Rh antigen and avoid erythroblastosis fetalis.