NURS 8022 Advanced Pathophysiology Exam 2 Study Guide-Blood Review
MODULE 3 Hematology Chapter 27-29,
Articles Blood Review
Blood (Figure 28.1, pg 891)
• About 6 quarts (5.5L) in adults
⟶ Fluid, cells, and protein
⟶ Circulate through the body via the vascular system
⟶ Electrolytes and protein maintain the osmolarity and acid-base balance of the
blood
• Functions of blood
⟶ Provide nutrition (protein, carbohydrates, lipids, and vitamins) to cells
⟶ Provide oxygen for cellular metabolism
⟶ Carries cells that protect the body against infection and invading organisms
Plasma
• Solution of protein and inorganic materials
• Approximately 92% water and 8% dissolved substances (solutes)
• 50-55% of the blood volume
• Contains plasma proteins which are mainly synthesized in the liver
⟶ Albumins function as carriers and control plasma oncotic pressure
o Pressure in the capillaries
o Aka protein pressure
o Regulate the movement of fluid and solutes through microcirculation
o Large molecules
Difficult to pass through endothelium to the interstitial space
⟶ Globulins are carrier proteins and immunoglobulins (Ig, antibodies); primarily
IgG
o Made by plasma cells and not synthesized in the liver
⟶ Clotting factors – mainly fibrinogen
o Fibrinogen is the precursor to the fibrin clot
⟶ Lipoproteins – triglycerides, cholesterol, and fatty acids
• Also contains several charged ions that regulate cell function, osmotic pressure,
and blood pH
Serum
• Plasma that has been allowed to clot in the laboratory in order to remove
fibrinogen and other clotting factors
⟶ May interfere with some diagnostic tests
Pleuripotential Cells
• In the bone marrow differentiate into major blood cells
⟶ Red cells – erythrocytes
⟶ White cells – leukocytes
⟶ Platelets – thrombocytes
Cellular Components of Blood
• Erythrocytes
⟶ Most abundant cells of the blood (48% in men; 42% in women)
⟶ Responsible for tissue oxygenation
⟶ Contain hemoglobin
1
, ⟶ Have 120-day life cycle
o No mitotic division
2
, o Replaced by the spleen after removal from circulation
⟶ Bioconcavity
o Optimal for gas diffusion
o Increases surface area
⟶ Reversible deformity
o Reversible deformity allows erythrocyte to become torpedo shape
to squeeze through microcirculation
o Returns to normal
• Leukocytes
⟶ Defend the body against infection and remove debris
⟶ Classified by structure and function
⟶ Granulocytes: Phagocytes
o Neutrophils, basophils, and eosinophils
o Mast cells
⟶ Agranulocytes
o Monocytes and macrophages: Phagocytes
o Lymphocytes: Immunocytes
• Platelets
⟶ Thrombocytes
o 150,000 – 400,000/mm3 = normal
o Irregularly shaped cytoplasmic fragments
o Formed by the fragmentation of megakaryocytes
o Essential for blood coagulation and the control of bleeding
o Incapable for mitotic division
✓ No nucleus or DNA
o Granules are generally proinflammatory
✓ Release biochemical mediators
✓ In response to injury to the blood vessel
o Normal count is 140,000 to 340,000 platelets/mm3
o Live for 5-9 days and then are removed by the spleen
o Produced in the bone marrow and stored in the spleen, where they
are slowly released
Lymphoid Organs
• Sites of residence, proliferation, differentiation, and function of lymphocytes and
mononuclear phagocytes (monocytes and macrophages)
• They are the link to the hematologic and immune systems
• Primary lymphoid organs
⟶ Thymus
⟶ Bone marrow
• Secondary lymphoid organs
⟶ Spleen
⟶ Lymph nodes
⟶ Tonsils
⟶ Peyer patches of the small intestine
• Link the hematologic system to the immune system
• Spleen
⟶ Largest secondary lymphoid organ
⟶ Function
3
, o Site of fetal hematopoiesis
o Filters and cleanses the blood
o Mounts an immune response to bloodborne microorganisms
o Serves as a blood reservoir
• Lymph Nodes
⟶ Site of the development or activity of lymphocytes, monocytes, and
macrophages
⟶ Structurally part of the lymphatic system
o Provide filtration of the lymph
o Fibrous capsules, the branch of which (trabeculae) extend inward to
partition the node into several compartments
o Transport lymphatic fluid back into the circulation
⟶ Functionally part of the immune and hematologic systems
o First encounter between antigen and lymphocytes
o Macrophages reside in the lymph nodes
✓ Filter the lymph of debris, foreign substances, and
microorganisms
✓ Provide antigen-processing functions
Definitions
• Hematocrit: % volume of blood that is red cells
⟶ Men ~ 45%
⟶ Women ~ 40%
• Hemoglobin: Oxygen carrying protein of the erythrocyte; compound of heme and
globin
⟶ 34gm/100ml red cells
⟶ 15-16 (male) gm Hb/100ml blood
⟶ 13-14 (female) gm Hb/100 ml blood
1. Understand basic physiology of hematopoiesis, erythropoiesis, and what erythropoietin
is and what it does.
• Hematopoiesis
⟶ Process of blood cell production in adult bone marrow or in the liver and/or
spleen of the fetus (sometimes in the liver)
o Humans need 100 billion new blood cells per day
⟶ Two stages
o Mitosis (proliferation) – beginning to divide
o Maturation (differentiation)
⟶ Continues throughout life to replace blood cells that grow old and die, are
killed by disease, or are lost through bleeding
⟶ Bone marrow – site of hematopoiesis in adults
o Confined to cavity of bones
o Primary site of residence of hematopoietic stem cells – from which all
blood cells originate
o Also called myeloid tissue
o Red versus yellow bone marrow
✓ Red produces RBCs, Megakaryocytes, and different WBCs
✓ Yellow does not produce RBCs – yellow from large quantity of fat
o Adult active bone marrow
4
MODULE 3 Hematology Chapter 27-29,
Articles Blood Review
Blood (Figure 28.1, pg 891)
• About 6 quarts (5.5L) in adults
⟶ Fluid, cells, and protein
⟶ Circulate through the body via the vascular system
⟶ Electrolytes and protein maintain the osmolarity and acid-base balance of the
blood
• Functions of blood
⟶ Provide nutrition (protein, carbohydrates, lipids, and vitamins) to cells
⟶ Provide oxygen for cellular metabolism
⟶ Carries cells that protect the body against infection and invading organisms
Plasma
• Solution of protein and inorganic materials
• Approximately 92% water and 8% dissolved substances (solutes)
• 50-55% of the blood volume
• Contains plasma proteins which are mainly synthesized in the liver
⟶ Albumins function as carriers and control plasma oncotic pressure
o Pressure in the capillaries
o Aka protein pressure
o Regulate the movement of fluid and solutes through microcirculation
o Large molecules
Difficult to pass through endothelium to the interstitial space
⟶ Globulins are carrier proteins and immunoglobulins (Ig, antibodies); primarily
IgG
o Made by plasma cells and not synthesized in the liver
⟶ Clotting factors – mainly fibrinogen
o Fibrinogen is the precursor to the fibrin clot
⟶ Lipoproteins – triglycerides, cholesterol, and fatty acids
• Also contains several charged ions that regulate cell function, osmotic pressure,
and blood pH
Serum
• Plasma that has been allowed to clot in the laboratory in order to remove
fibrinogen and other clotting factors
⟶ May interfere with some diagnostic tests
Pleuripotential Cells
• In the bone marrow differentiate into major blood cells
⟶ Red cells – erythrocytes
⟶ White cells – leukocytes
⟶ Platelets – thrombocytes
Cellular Components of Blood
• Erythrocytes
⟶ Most abundant cells of the blood (48% in men; 42% in women)
⟶ Responsible for tissue oxygenation
⟶ Contain hemoglobin
1
, ⟶ Have 120-day life cycle
o No mitotic division
2
, o Replaced by the spleen after removal from circulation
⟶ Bioconcavity
o Optimal for gas diffusion
o Increases surface area
⟶ Reversible deformity
o Reversible deformity allows erythrocyte to become torpedo shape
to squeeze through microcirculation
o Returns to normal
• Leukocytes
⟶ Defend the body against infection and remove debris
⟶ Classified by structure and function
⟶ Granulocytes: Phagocytes
o Neutrophils, basophils, and eosinophils
o Mast cells
⟶ Agranulocytes
o Monocytes and macrophages: Phagocytes
o Lymphocytes: Immunocytes
• Platelets
⟶ Thrombocytes
o 150,000 – 400,000/mm3 = normal
o Irregularly shaped cytoplasmic fragments
o Formed by the fragmentation of megakaryocytes
o Essential for blood coagulation and the control of bleeding
o Incapable for mitotic division
✓ No nucleus or DNA
o Granules are generally proinflammatory
✓ Release biochemical mediators
✓ In response to injury to the blood vessel
o Normal count is 140,000 to 340,000 platelets/mm3
o Live for 5-9 days and then are removed by the spleen
o Produced in the bone marrow and stored in the spleen, where they
are slowly released
Lymphoid Organs
• Sites of residence, proliferation, differentiation, and function of lymphocytes and
mononuclear phagocytes (monocytes and macrophages)
• They are the link to the hematologic and immune systems
• Primary lymphoid organs
⟶ Thymus
⟶ Bone marrow
• Secondary lymphoid organs
⟶ Spleen
⟶ Lymph nodes
⟶ Tonsils
⟶ Peyer patches of the small intestine
• Link the hematologic system to the immune system
• Spleen
⟶ Largest secondary lymphoid organ
⟶ Function
3
, o Site of fetal hematopoiesis
o Filters and cleanses the blood
o Mounts an immune response to bloodborne microorganisms
o Serves as a blood reservoir
• Lymph Nodes
⟶ Site of the development or activity of lymphocytes, monocytes, and
macrophages
⟶ Structurally part of the lymphatic system
o Provide filtration of the lymph
o Fibrous capsules, the branch of which (trabeculae) extend inward to
partition the node into several compartments
o Transport lymphatic fluid back into the circulation
⟶ Functionally part of the immune and hematologic systems
o First encounter between antigen and lymphocytes
o Macrophages reside in the lymph nodes
✓ Filter the lymph of debris, foreign substances, and
microorganisms
✓ Provide antigen-processing functions
Definitions
• Hematocrit: % volume of blood that is red cells
⟶ Men ~ 45%
⟶ Women ~ 40%
• Hemoglobin: Oxygen carrying protein of the erythrocyte; compound of heme and
globin
⟶ 34gm/100ml red cells
⟶ 15-16 (male) gm Hb/100ml blood
⟶ 13-14 (female) gm Hb/100 ml blood
1. Understand basic physiology of hematopoiesis, erythropoiesis, and what erythropoietin
is and what it does.
• Hematopoiesis
⟶ Process of blood cell production in adult bone marrow or in the liver and/or
spleen of the fetus (sometimes in the liver)
o Humans need 100 billion new blood cells per day
⟶ Two stages
o Mitosis (proliferation) – beginning to divide
o Maturation (differentiation)
⟶ Continues throughout life to replace blood cells that grow old and die, are
killed by disease, or are lost through bleeding
⟶ Bone marrow – site of hematopoiesis in adults
o Confined to cavity of bones
o Primary site of residence of hematopoietic stem cells – from which all
blood cells originate
o Also called myeloid tissue
o Red versus yellow bone marrow
✓ Red produces RBCs, Megakaryocytes, and different WBCs
✓ Yellow does not produce RBCs – yellow from large quantity of fat
o Adult active bone marrow
4
