Patho unit 3 ch19

• Straw colored liquid portion of unclotted blood
• 55-60% of blood volume
• 92% water
• 8% solutes
•   -7% plasma proteins: Albumins, Globulins, Fibrinogen
•   -1% other solutes: electrolytes, nutrients, gases, hormones, wastes

• A low-molecular-weight plasma protein synthesized in the liver
• contributes to blood viscosity and maintains blood pressure
•   - does not diffuse freely across the vascular endothelium
• Acts on an osmotically-active carrier molecule- carries billiruben

• Soluble factors (protiens) that are activated to produce a insoluble clot
• Fibrinogen (factor 1) is the most plentiful
• They promote clotting in a cascading fashion

• lifespan 80-120 days
• Functions in gas transport
• high surface-to-volume ratio
• reversible deformity

it has a high surfac-to-volume ratio

• % of whole blood volume occupied by red blood cells
• Females: 38-46% 
• Males: 40-54%

• Oxygen carrying molecule
• Heme (4) +4 globin proteins
• 14-16 g/dl

4.00-6.00 x 10⁶/mm³

• A system consisting of organs and lymph vessels through which lymphatic fluid passes.
• It functions to:
•  -drain interstitial fluid
•  -Transport dietary lipids absorbed by the GI tract to the blood 
•  -Facilitate an immune response

• Primary: Thymus, bone marrow
• Secondary: spleen, lymph nodes, tonsils, and Pever Patches of the small intestine
• Lymph organs ling the hematologic and immune system.

• Lymph Vessels- pass through lymph nodes
• Lymph Nodes- full of WBCs waiting for invaders
• Right and left lymphatic duct
• Tonsils
• spleen
• Thymus
• Bone marrow

• Filters and cleanses the blood from foreign invaders
• Contains masses of lymphoid tissue (whit pulp)
• Remove old or damaged cells from the blood
• Storage area for extra blood that can be released by sympathetic stimulation
• Storage of platelets, up to 1/3 of blood supply

• Serve as filters for lymph fluid
• Foreign objects are trapped and destroyed
• Important groups of lymph nodes: submandibular, cervical, axillary, inguinal
• Lymph node enlargement may often indicate a pathological condition

• Formed element production
• Cells are formed in red bone marrow from pluripotent stem cells and mature in bone marrow or lymphoid tissue (spleen, thymus, tonsils, lymph nodes)

• a cell that can produce any kind of cell
• Ex: Fertilized egg

can become many different things (cells) but not everything

gives rise to only one thing

cant produce cells anymore.

Hematopoietic cells will develop, proliferate, and differentiate if they are provided with specific growth factors (Colony stimulating factors)

• These cytokines act as hormones to stimulate the proliferation of progenitor (early) cells
• Specific CSFs are necessary for growth of myeloid, erythroid, lymphoid and megakaryocitic cells

See table in study guide. p.113

Act individually as carrier molecules. Collectively, they control blood osmotic pressure

Immunoglobulins or antibodies. Made by plasma cells (activated B lymphocytes)

Neutrophils, Eosinophils, Basophilsmost die doing their jobslife span .5-9 days

Monocytes/Macrophages, Lymphocyteslymphocytes live from days to decadesmonocytes live for several monthsphagocytes or immunocytes

• Increase in WBC count >10 thousand (10 x 10^3/mm^3)
• *Normal physiological response to disease, up to a certain point
• Occurs in both viral and bacterial infections

• Decrease in WBC count < 5 thousand (5 x 10^3/mm^3)
• *Never a normal response

• Cell Origin: Macrophage, fibroblastCell
• Stimulated: Granulocytes

• Cell Origin: T cellCell
• Stimulated: Neutrophil, Macrophage

Activated by contact with the injured vessel (collagen and endothelium)

Extrinsic and Intrinsic converge here with Factor X

• Cell fragmants
•   -150-400x10^/mm³
• originate from megakaryocytes
• Aids in clotting by clumping (agglutination) and the release of biochemical mediators
• Thrombocytopenia: Low platelet count
• Thrombocytosis: Increased platelet count

• positive feedback system
• Begins with the activation of several soluble, inactive clotting factors stimulated in cascading fashion
• Two main pathways:
•   -Extrinsic Pathway- activated by things out side of us
•   -Intrinsic Pathway- activated by things inside of us
• Both systems or pathways merge at a common point, forming the common pathway
• coagulation is usually fast and localized

• Extrinsic and intrinsic activation 
• the common pathway begins with the formation of prothrombinase (prothrombin activator)
• The prothrombin activator activates prothrombin to thrombin
• Thrombin induces the formation of fibrin from fibrinogen

• After 30-6- min, the platelets contract 
•   -platelets contain actin and myosin proteins
•   -this squeezes out the serum
• The clot becomes impacted and the edges of the blood vessel are brought closer together
• Healing is also begining
• -Smooth muscle cells & fibroblasts are stimulated to divide
• Endothelial cells begin to restore endothelial lining of the vessel
• Now the clot has to remove
•   -Fibrinolysis- breaking apart the clot

• Removing a clot
• Large amounts of plasminogen (a plasma protein) are incorporated into clots
• when endothelial cells produce tissue plasminogen activator (TPA), it causes the plasminogen to become plasmin
• Factors within the coagulation cascade (factor XII and thrombin) also change plasminogen into its active form, plasmin
• Either way when plasmin is formed it digests clots
•   -TPA ("clot buster") is widely used in stroke/MI patients.

• Small amounts of bone marrow tissue are removed from the bone and observed microscopically 
• Usually collected from the posterior iliac crest
• Assists in the diagnosis of: anemias, leukemias, platelet, disorders, immunoglobulin disorders, etc

• White blood cell (WBC) count
• Whit blood cell differential
• Red blood cell (RBC) count
• Hemoglobin
• Hematocrit
• Platelet count
• MCV
• MCH
• MCHC
• Red cell distribution width (RDW)

• Physicians use the percentage of the individual white blood cells in the blood to aid in the diagnosis of specific diseases 
•   -

• Prothrombin Time/ International Normalized ratiio (PT/NR)
•   -Measures the extrinsic pathway
•   -Usually to check status after anticoagulent administration
• Activated Patial Thromboplastin Time (APTT)
•   -Measures the intrinsic pathaway
• Bleeding Time
•   Measures platelet function, not platelet number
•   -New instrumentation is replacing this test

• Low retic count (<0.5%) indicates low rate of erythropoiesis
• High retic count (>1.5%) indicates high rate of erythroopoiesis