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What type of mixture is blood?
Homogeneous, contains both cellular and liquid components, formed elements and plasma.
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What is the average normal PH range of blood?
7.35-7.45
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What is the vicosity of a fluid?
Resistance of a fluid to flow due to cohesion and between its particles.
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What would be a normal hematocrit value range for males/females?
Males-47, females 42
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What unit is used to measure hematocrit?
percentage
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Define hematocrit?
Seperation of formed elements.
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3 major functions of blood?
- Distribution-delivers oxygen from lungs & nutrients from digestive tract to all body cells.
- Regulation-blood clotting to stop bleeding, body temp by absorbing& distrubting heat to body and skin.
- Protection-prevents infection by producing antibodies, WBC's and complements proteins.
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What are formed elements of blood?
- Erythrocytes-92-94%
- Leukocytes
- platelets
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Erythrocytes can transport both oxygen and ____________?
Carbon dioxide
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What is the normal measurable range for hemoglobin in a healthy individual?
- infants 14-20gm
- males 13-18gm
- females-12-16gm
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What unit is used to measure hemoglobin
gms
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What organ in the body regulates erythrocyte production?
Kidney
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What condition and organ triggers erythropoiesis?
Hypoxia or low o2 levels in blood. Kidneys produce erythropoietin which stimulates erythropoiesis.
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_______marrow is the main site of blood cell formation throughout adult life?
Red bone marrow
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_____is the parent cell for all formed elements of blood?
Hemocytoblast
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List the cells in developmental sequence of erythrocytes from hemocytoblast to maturity.
- Proerythroblast
- early erythroblast
- late erythroblast
- normoblast
- reticulocyte
- erythrocyte
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What is the major cause for red blood cells to age and wear out?
Lack of cellular organelles, lack of nucleus, unable to sythesize new proteins
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The __ and __ are involved in breaking up old erythrocytes and disposing of the cellular remains?
Liver and spleen
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__is a bile pigment formed by the breakdown of hemoglobin from expired erythrocytes?
bilirubin
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What characteristics do all leukocytes have in common?
irregular shaped nucleus
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What is leukopoiesis?
process of making leukocytes, production of white blood cells
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% of each leukocyte in normal circulating blood?
- neutrophils 50-70%
- lymphocytes 25%
- monocytes 3-8%
- eosinophils 2-4%
- Basophils 0.5-1%
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Which leukocytes have no visible cytoplasmic granules?
agranulocytes
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The enzyme__ that converts fibrogen to fibrin?
Thrombin
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What is the largest blood developmental cell?
Megakaryocyte
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What are the functions & properties of platelets?
- cytoplasmic fragments of large cells called megakaryocytes.
- exhibit a blue staining outer region and granular inside staining purple
- adhere to damage blood vessels and release enzyme that forms plug, the stoppage of bleeding
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What are the 3 events of hemostatis in order?
- 1-Vascular spasm-responds to injury by constricting
- 2-platelet plug formation-aggregating (sticking together) forming a plug
- 3-coagulation-reinforces the plaelet plug with fibrin threads that act as a molecular glue for the aggregated platelets.
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When platelets degranulate they release a vasoconstrictor called___ which aids in hemostasis?
Serotonin
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What ion is essential to virtually all stages of coagulation?
Calcium ions
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___is the pivotal molecule associated with the negatively charged membranes of aggregated platelets?
PF3
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The slowest step in the clotting process is?
Factor X
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How is a clot that is no longer needed removed?
Fribinolysis
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list naturally occuring chemicals that prevent or oppose coagulation
heparin, nitric oxide, prostacyclin, vitamin e and quinine
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Transfusion of incompatable blood can be?
fatal
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are blood typing for the Kell, Lewis and Duffy factors done before a blood transfusion?
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What occurs in tissure during a transfusion reaction?
oxygen carrying capability of the transfused blood cells is disrupted. clumping of RBC's in small vessels hinders blood flow to tissures beyond that point.
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List each blood type
- AB has AB antigen, no antibodies
- B has B antigen, antibodies A
- A has A antigen, antibodies B
- O has no antigens, both antibodies
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__is the most common blood type occuring in people of the us.
O positive
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__is the least common blood type occuring in the people of us?
AB negative
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Universal donor?
O negative
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Universal receiver?
AB negative
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__ is a regulatory function of Blood?
maintence of normal PH in body tissure
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___is not found in blood?
Glycogen
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___is found in blood?
Fibrinogen, glucose, urea,albumin
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___is not a formed element of blood?
antibodies
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Parent cell for all formed elements of blood?
Hematopoietic stem cell
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lack of intrinsic factor, leading to a deficiency of vitamin B12 & large pale cells called macrocytes is a characteristic of?
Pernicious anemia
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all can be expected with polycythemia?
high hematocrit, increased blood volume, high blood pressure
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Thromboembolic disorder___
include embolus formation, a clot moving within the circulatory system
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not a cause of bleeding disorders
excess secretion of platelet-derived growth factor.
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bleeding disorder causes?
thrombocytopenia, a deficit in the clotting factor, vitamin K deficiency
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the heart chambers are lined by the ____?
endocaridum
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The __is the layer of the heart that actually contracts?
myocardium
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The right atrium receives blood from the __,__,&__?
Systemic circuit, superior and inferior vena cava, and coronary sinus.
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The left atrium receives blood from the ___?
lungs through 4 pulmonary veins
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Which vessels of the heart received blood during left ventricular systole?
aorta
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which vessel of the heart receives blood during rt ventricular systole?
pulmonary trunk
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How does one easily discern the right and left ventricles when viewing a disected heart?
the left ventricle is larger and walls are thicker.
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The coronary arteries arise from ___ and supply the __ for nutrients and gas exchange?
- 1)from the base of the aorta,
- 2) posterior and anterior walls of the ventricles and interventricular septum
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What is the function of arterial anastomoses in the coronary circulation?
provide additional (collateral) routes for blood delivery to the heart muscle.
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Small muscle masses attached to the chordae tendineae are the __?
papillary muscles.
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The __valve seperates the right atrium from the right ventricle?
Tricuspid valve
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The __ valve seperates the left atrium from the left ventricle?
Bicuspid valve
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Aortic and pulmonary valves control the flow of blood into the__ and ___, respectively?
Aorta & pulmonary trunk (systemic and pulmonary circuit)
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The AV valves are supported by__so that regurgitation of blood into the atria during ventricular contraction does nt occur?
Chordae tenodineae-tiny white colagen cords also known as heart strings.
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Properties of cardiac muscle fibers
same-striated/contracts by the sliding filament mechanism
- difference-skeketal-long cylindrical, multinucleated.
- cardiac-short, fat, branched, interconnected and contains one or at most two pale centrally located nuclei.
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What physiological regulation prevents tetanic contractions when the heart beats (which would stop the heart's pumping actions)?
Absolute refactory period-this period is longer than that of a skeletal muscle(about 200 times greater). this prevents tetanus from occuring and insure that each contraction is followed by enough time to allow the heart chamber to refill with blood before the next contraction
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__refers to the entire heart contracting as a unit?
Functional Syncytium
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Th influx of __ ions from extracellular sources is the intiating event in the cardiac muscle contraction?
calcium
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if we were able to artifically alter the membrane permeability of pacemaker cells so that sodium influx is more rapid__?
threshold is reached more quickly and heart rate would increase
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to ausculate the aortic semilunar valve, you would place your sethescope in the __?
second intercostal space to the right of the sternum
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What causes normal heart sounds?
heart valves closing
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how are heart sounds described?
lub dub.
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when do heart sounds occur during the cardiac cycle?
during the begining and end of ventricular contraction.
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the contraction of ventricles that forces blood out of them?
ventricular systole
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the relaxation of ventricles to allow blood to flow back into them?
ventricular diastole
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a measure of how much blood enters th ventricles from atrium?
EDV-end diastolic volume
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the amount of blood remaining in the ventricles after semilunar valves have closed, but before av valves have opened?
at the end of ventricular contraction
ESV-end systolic volume
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the volume of blood pumped out ot the right or left ventricle per minute.
cardiac output
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During the period of ventricular filling blood flows __through the atria and the open av valves into the ventricles?
passively
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a measure of the pressure that must be overcome for ventricles to eject blood.
88mmHg in aorta
8mmHg in pulmonary trunk
afterload
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first phase of ventricular systole. it is the split second when the av valves are forced shut and before the smilunar valves are forced open. the ventricles are completely closed chambers at this time.
Isovolumetric contraction
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__venous return will result in increased end diastolic volume?
increased
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the middle stage of diastole during the cardiac cycle of a heartbeat, wher the initial passive filling of the heart ventricles has slowed down, but before the atria contract to complette the filling?
diastasis
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Stroke volume__if EDV decreases?
drops
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Hemorrhage with a large loss of blood causes a __in BP due to change in cardiac output?
decrease
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factors that increase contractility such as increased calcium levels, hormone & drugs (digitalis)?
Positive inotropic effects.
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factor that decrease contratiliy such as increased levels of potassium, or drugs that lower calcium levels?
negative inotropic effects
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what effect does acetylicholine have on the heart?
reduces heart rate
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what effect does norepinephrin have on the heart?
increases heart rate
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what effect does digitalis have on the heart?
decreases heart rate
-
what effect does nicotine have on the heart?
increases heart rate
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the time of day most hazardous for a heart attack?
morning
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Where is the cardiovascular system within the nervous system?
within the central nervous system, but its ability to contract is intrinsic factor for the heart and does not depend on the nervous system.
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what is the role of the vagus nerve?
decrease heart rate, keep stable at 60-80
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if the vagal nerve was cut, what would happen to heart rate?
increase by 25 bpm
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the function of the foramen ovale in the fetal heart?
connects 2 atria and allows blood entering rt heart to bypass pulmonary circuit and the collapsed nonfunctional fetal lungs.
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Blood leaves the right ventricle through__?
pulmonary semilunar valve
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an anatomical arrangement that reduces the risk of myocardial infarction is?
arterial anastamosis in the coronary circulation
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relatively mild blow to the chest that occurs during a vulnerable interval (2ms) when the heart is repolarizing?
Commotio cords in heart failure.
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what occurs when semilunar valves are open
blood enters pulmonary arteries and the aorta, Av valves are closed, ventricles are in systole.
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compared to skeletal muscles the cardiac muscles___?
has gap junctions that allow it to act as a functional syncytium
-
during contraction of heart muscle cells__?
some calcium enters the cell from the extracellular space and triggers the release of larger amounts of calcium from intracellular stores.
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atrial systole begins__?
immediately after P wave
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amount of blood coming from one ventricle in one heartbeat is called__?
stroke volume
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a__increases end diastolic volume, stroke volume and force of contraction?
slow heart rate
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Histologocally, the __is squamous epithelium supported by a sparse connective tissue layer.
Tunica interna (intima)
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Which tunic of an artery is most responsible for maintaining blood pressure and continous blood circulation?
Tunica media
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Do all arteries carry oxygenated blood away from the heart?
In the circulatory circuit all arteries carry oxygenated blood and veins carry deoxygenated blood, in the pulmonary circuit the pulm. arteries carry deoxygenated blood to the lungs and the pulm. veins carry oxygenated blood to the heart.
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__permit the exchange of nutrients and gases between the blood and tissue cells?
capillaries
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Why are arterioles also known as resistance vessels?
- walls of arterioles create friction because of their size (pushes against blood flow)
- the contraction and relaxation of the smooth muscle in their walls can change their diameter
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__are called capacitance vessles or blood reserviors?
veins because they hold a large amount of blood.
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At any given moment, __% of the body's blood is found in veins?
65
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Blood flow through the entire vascular system is equivalent to__?
Cardiac output
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An increase in cardiac output corresponds to a __ in blood pressure, due to the increased delivery.
decrease
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Excess red blood cell production would cause a blood pressure___?
increase
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What factors increase peripheral resistance in a vessel?
increased blood viscosity, vasoconstriction
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What factors decrease peripheral resistance in a vessel?
anemia, vasodilation
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How does the principle of laminar flow apply to blood flowing through a vessel?
The relative speed and position of fluid or blood will remain constant based on the regions of flow, whether in the center of the vessel or close to the wall.
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Pulse pressure is defined as?
the difference between the systolic and diastolic pressure
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capillaries are fragile and high pressures would __them?
rupture
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What will cause arteriole blood pressure to increase?
increased activity of the musclar and respiratory pumps, increased body temp and size, stressors exercise, trauma, dehydration, high hematocrit, increase in hormones (epi, norepi, antidiuretic and angiotensin II) decrease in atrial natriuretic peptide, heart rate and cardiac output.
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what are the factors that aid in venous return?
respiratory pump-as we inhale abd pressures increase and force blood towards heart and allow thoracic veins to expand, speeding the blood entry to the atrium, muscular pump squeezes veins forcing blood to move forward, cardiac suction during ventricular systole.
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What are the factors that result in the dialation of the feeder arterioles and opening the precapillary sphincters in the systemic capillary beds?
chemical conditions in the body or in the specific location of a capillary bed and arteriolar vasomotor nerve fibers determine the opening of the precapillary sphincters.
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Where are the barorecptors located? what rea they sensitive to?
located in the carotid sinus and aortic arch. sensitive to arterial blood pressure
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What is the long term mechanism of blood pressure regulation?
renal regulation, where the kidneys provide a hormonal mechanism for regulation of blood pressure by maintaining blood volume.
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What is a normal blood pressure reading? What blood pressure reading would be indicative of hypertension?
- normal 120/80
- hypertensive 140/90
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What are possible causes of primary hypertension?
Heredity, diet, obesity, age, diabetes mellitus, stress, smoking
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What are possible causes of secondary hypertension?
obstruction of renal arteries, kidney disease, endrocrine disorders, arteriosclerosis
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What is tissue perfussion? How is MAP and estimate?
- blood flow through the body tissues, which involve delivery of nutrients and gases and removal of waste products.
- MAP is the amount of pressure reaching the capillaries and organs.
(SP-DP=) divided by 3 + diastolic pressure
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What vessel type has the slowest velocity of blood flow?
capillaries
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What vessel type has the fastest velocity of blood flow?
Aorta and large arteries
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How is cerebral blood flow regulated?
intrinsic autoregulatory mechanisms-one of the bodies most precise autoregulatory systems and is tailored to local neuronal needs.
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To what chemicals does the brains autoregulation respond?
Declining PH and increased CO2 levels.
-
How is blood flow to the skin regulated?
autoregulation and neural intervention. increases when environmental temps rise
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Where in the body would you find low oxygen levels causing vasoconstriction and high levels causing vasodilation?
lungs
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Water enters the blood capillaries by means of__?
osmosis
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The net filtration pressure of a blood capillary is the differnece between?
net hydrostatic pressure and oncotic pressure
-
What two pressures regulate capillary dynamics?
hydrostatic pressure and colloid osmotic pressure.
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normal average blood pressure of a newborn?
90/55
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Inadequate pumping activity of the heart is likely to cause__?
Cardiogenic shock
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Positive feedback is most important in __?
Decompensated shock.
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In autorgulation, what chemicals tend to increase blood flow?
Nitric oxide, carbon dioxide, histamine, lactic acid
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found in the skin and muscles, endothelial cell is continuous, allow small solutes to pass through them, most capillaries are of this type.
Continuous capillaries
-
found in the small intestines, kidneys and endocrine glands, their cells have pores and openings to allow greater permeability?
Fenestrated capillaries
-
found in liver, bone marrow, lymphoid tissue, they are leaky, highly permeable capillaries, lined with phagocytes?
Sinusoids (sinusoidal capillaires)
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3 main factors influencing blood pressure?
cardiac output, peripheral resistance, blood volume
-
chemicals that regulate blood pressure?
AHD, atrial natriuretic peptide, angiotnesion II
-
circulatory route the runs from the digestive tract to the liver is called __?
Hepatic portal circulation
-
include aorta and other nearby branches, largest arteries, able to smooth blood flow. (conducting)
Elastic arteries
-
(distributing) distribute blood to the various body regions, regulate blood flow by vasoconstriction or vasodilation, ex:brachial, femoral, splenic arteries.
Muscular arteries.
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have all 3 tunics in their walls, arterioles are the smallest. 3 types: arteriole, terminal and metarterioles.
Restitance arteries.
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aldosterone will__?
promote an increase in blood pressure
-
a late sign of hypovolemic shock?
rapidly falling blood pressure
-
what is likely during vigorous exercise?
capillaries of the active muscles will be engorged.
-
In the dynamics of blood flow through capillaries, hydrostatic pressure__?
is the same as capillary blood pressure
-
the term ductus venosus refers to __?
a special fetal vessel that allows umbilical blood to bypass the liver
-
What influences atrial pulse rate
activity, postural changes, emotions
-
The arteries that directly feed into capillary beds are called__?
arterioles
-
The velocity of blood flow is__
slowest in the capillaries because the total cross sectional ares if the greatest.
-
A thrombus in the first bransh of the arch of the aorta would affect the flow of blood to the__?
right side of the head and neck and right upper arm
-
essential hypertension could result in?
increased work of the lt ventricle, increased incident of coronary artery disease and increased damage to blood vessel endothelium
-
What do the ductus aretiousus and formaen ovale become at birth?
ligamentum arteriosum and fossa oavlis
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