Chapter 18 The Circulatory System: Blood

1. Define circulatory system and describe the three functions of the system. The circulatory system consists of the heart, blood vessels and blood. The fundamental purpose is to transport substances from place to place in the blood. Circulatory system: The system that moves blood throughout the body. The circulatory system is composed of the heart, arteries, capillaries, and veins. It transports oxygenated blood from the lungs and heart throughout the body via the arteries. The blood goes through the capillaries, which are situated, between the arteries and veins. And the blood that has been depleted of oxygen by the body is then returned to the lungs and heart via the veins. The three functions of the circulatory system are: Transport Protection Regulation Transport The blood carries oxygen from the lungs to all the bodys tissues, while it picks up carbon dioxide from those tissues and carries it to the lungs to be removed from the body It picks up nutrients from the digestive tract and delivers them to all the bodys tissues It carries metabolic wastes to the kidney for removal It transports a variety of stem cells from the bone marrow and other origins to the tissues where they lodge and mature It helps regulate the body temperature by carrying heat to the body surface for removal. Protection The blood plays several roles in inflammation, a mechanism for limiting the spread of infection White blood cells destroy microorganisms and cancer cells Antibodies and other blood proteins neutralize toxins and help to destroy pathogens

Platelets secrete factors that initiate blood clotting and other processes for minimizing blood loss. Regulation By absorbing or giving off fluid under different conditions, the blood capillaries help to stabilize fluid distribution in the body By buffering acids and bases, blood proteins help to stabilize the pH of the extracellular fluid. 2. Describe the components and general properties of blood. Blood is a liquid connective tissue with two main components: the plasma and formed elements Plasma Blood plasma is the yellow liquid component of blood in which the blood cells in whole blood are normally suspended. It makes up about 55% of the total blood volume. Plasma is a complex mixture of water, proteins, nutrients, electrolytes, nitrogenous wastes, hormone, and gasses. Formed elements The term formed elements is used to designate the various kinds of blood cells that are normally present in blood. These are the visible portions of the blood, they are cells and cell fragments Red blood cells RBC (erythrocytes) Platelets White blood cells WBC (leukocytes) 3. Distinguish between plasma and serum. Blood serum is the remaining fluid when blood clots and the solids are removed. Serum is essentially identical to plasma except for the absence of the clotting factor fibrinogen. Blood plasma is the yellow liquid component of blood in which the blood cells in whole blood are normally suspended. It makes up about 55% of the total blood volume. Plasma is a complex mixture of water, proteins, nutrients, electrolytes, nitrogenous wastes, hormone, and gasses. 4. List the three major proteins of blood plasma and state their functions. Plasma proteins play a variety of roles including clotting, defenses, and transport of other solutes such as iron, copper, lipids and hydrophobic hormones. There are three categories of proteins:

Albumin Globulins Fibrinogen

Albumin Albumins are the smallest and most abundant plasma protein. It serves to transport various plasma solutes and buffer the pH of the blood plasma. It also makes a major contribution to two physical properties of blood: its viscosity and osmolarity. Albumin concentration can significantly affect blood volume, pressure and flow. Globulins These are divided into three subclasses; from the smallest to the largest in molecular weight, they are the alpha, beta and gamma globulins. Globulins play various roles in solute transport, clotting and immunity. The liver synthesizes most of the alpha and beta globulins, whereas gamma globulins are produced by lymphocytes and plasma cells in lymphoid tissue. Fibrinogen This is the soluble precursor of fibrin, a sticky protein that forms the framework of a blood clot. It is one of the proteins of the blood plasma that is responsible for the clotting of blood. When prothrombin is activated to thrombin in response to injury, it converts fibrinogen to fibrin, which is deposited as strands that form the clot. 5. Define nitrogenous waste. List the major nitrogenous wastes in the blood and explain the source of the wastes. Nitrogenous waste These are the toxic end products of catabolism. About 50% of nitrogenous waste is urea, a byproduct of amino acid catabolism. Other nitrogenous waste are uric acid and creatine produced by the catabolism of nucleic acid and creatine phosphate respectively. These wastes are normally excreted by the kidney at a rate that balances their production. 7. Define viscosity and osmolarity. State what components account for the viscosity and osmolarity of the blood and explain why the viscosity and osmolarity of blood are important. Define colloid osmotic pressure. Viscosity Viscosity is the resistance of fluid to flow, resulting from cohesion of its particles. It is important in the circulatory function because it partly governs the flow of blood through the vessels. An RBC or protein deficiency reduces viscosity and causes blood to flow too easily, whereas excess causes the blood to flow too sluggishly. Either condition puts a strain on the heart and lead to cardiovascular

problems. Osmolarity The osmorlarity of the blood is the total molarity of those dissolved particles that cannot pass through the blood vessel wall. The reabsorption by osmosis of fluids is governed by the relative osmolarity of the blood versus the tissue fluid. If the osmolarity of the blood is too high then the bloodstream absorbs too much water. This raises the blood volume, resulting in elevated blood pressure and a potentially dangerous strain on the heart and arteries. If the osmolarity is too low, too much water remains in the tissue. They become swollen or edematous and the blood pressure may drop to dangerously low levels because of the amount of water lost from the blood stream. It is important that the blood maintain an optimal osmolarity. The osmolarity of the blood is a product mainly of its sodium ions, protein, and erythrocytes, which contribute to the blood osmotic pressure or colloid osmotic pressure (COP). 8. Define hemopoiesis. Explain where blood is produced in fetuses, children, and adults. Define myeloid and lymphoid hemopoiesis. Hemopoiesis is a biological process in which new blood cells are formed, and it usually takes place in the bone marrow. The term hematopoiesis refers to the formation and development of the cells of the blood. In humans, this process begins in the yolk sac in the first weeks of embryonic development. By the third month of gestation, stem cells migrate to the fetal liver and then to the spleen (between 3-7 months gestation these two organs play a major hematopoietic role). In adults the bone marrow becomes the major hematopoietic organ and hematopoiesis ceases in the liver and spleen. Myeloid hemopoiesis is blood formation in the bone marrow Lymphoid hemopoiesis is blood formation in the lymphatic organs. 9. Define erythrocyte. Describe the structure and function of erythrocytes. Describe the role of spectrin and actin. A erythrocyte is a mature red-colored blood cell that normally does not have a nucleus; red blood cell: it is a very small, circular disk with both faces concave, and contains hemoglobin, which carries oxygen to the body tissues A normal, mature RBC has no nucleus; before the cell reaches maturity and enters the bloodstream from the bone marrow the nucleus is extruded. The RBC 4

is shaped like biconcave disc. The mature RBC is also unique in that it does not contain ribosome, mitochondria and other organelles typical of most body cells. The primary component of the RBC is hemoglobin. Erythrocytes or red blood cells (RBC) have two principal functions: 1. To pick up oxygen from the lungs and deliver it to tissues elsewhere 2. To pick up carbon dioxide from tissues and unload it in the lungs. Spectrin is a contractile protein of high molecular weight that is a component of a network in the membrane of red blood cells, giving the cells flexibility. The spectrin fibers, which are a part of the cytoskeleton, adhere to the inside of the erythrocyte plasma membrane. It is the presence of the flexible spectrin fibers that permits the plasma membrane surrounding the RBC to accommodate change from a more typical biconcave to a smaller cup size and then resume its normal size. 10. Describe the structure and function of hemoglobin Hemoglobin is a tetramer composed of 4 globin molecules; 2 alpha globins and 2 beta globins. The alpha globin chain is composed of 141 amino acids and the beta globin chain is composed of 146 amino acids Hemoglobin is found in the red blood cells of the body. Each red blood cell (RBC) contains approximately 280 million hemoglobin molecules. The main function of hemoglobin is to transport oxygen from the lungs to the tissues and then transport CO2 back from the tissues to the lungs. One hemoglobin molecule has the ability to transport up to 4 oxygen molecules. There are two forms of hemoglobin: oxyhemoglobin, which is saturated with oxygen molecules and deoxyhemoglobin, which is desaturated with oxygen molecules. Oxyhemoglobin has a higher affinity for oxygen than deoxyhemoglobin, and deoxyhemoglobin has a higher affinity for CO2 than oxyhemoglobin. Therefore, oxygen binds to oxyhemoglobin in the lungs and is then transported through the blood stream until it reaches the tissues. There, the oxygen is released to myoglobin, which then transports it to the mitochondria where it is used for aerobic respiration. In exchange, the deoxyhemoglobin picks up 2 protons and 2 molecules of CO2 and returns to the lungs, where the CO2 is released through exhalation

11. Define three clinical measurements of RBC and hemoglobin quantities and include normal values for each measurement. The three clinical measurements of RBC are as follows: Hematocrit (packed cell volume, PCV): the percentage of whole blood volume composed of RBCs; Blood to separate Men : 42% - 52% Women: 37% - 48% Hemoglobin Concentration: Men: 13-18 g/dL Women: 12-16 g/dL RBC count: Men: 4.6-6.2 million RBCs/(micrometer)L Women: 4.2-5.4 million/(micrometer)L in women This is often expressed as cells per cubic millimeter 12. Define erythropoiesis and erythropoietin. Describe the life cycle of erythrocytes. Erythropoiesis is the entire process of RBC formation. In the adult the erythrocytes begin their maturation sequence in the red bone marrow and the entire process takes about four days. Erythropoietin is a glycoprotein hormone released by the kidney, which in turn stimulates bone marrow to accelerate its production of red blood cells. The life span of RBC circulating in the bloodstream averages about 105 to 120 days. They often break apart, or fragment, in the capillaries as they age. The process results in breakdown of hemoglobin with the release of amino acids, iron, and the pigment bilirubin. Iron is returned to the bone marrow for the synthesis of new hemoglobin 13. Define antigens, antibodies, agglutination, agglutinogens and agglutinins. Explain what determines a persons ABO and Rh blood types and how this relates to transfusion compatibility. State the universal recipient and universal donor blood types.

Antigens These are complex molecules such as proteins, glycoproteins, and glycolipids that are genetically unique to each individual. They occur on the surface of all 6

cells and enable the body to distinguish its own cells from foreign matter. When a body detects an antigen of a foreign body it activates an immune response.

Antibodies These are also known as immunoglobulins, which are gamma globulin proteins that are found in blood or other bodily fluids of vertebrates, and are used by the immune system to identify and neutralize foreign objects, such as bacteria and viruses. Antibodies bind to antigens and mark them or the cell bearing them for destruction.

Agglutination This is one method of antibody action, in agglutination each antibody molecule binds to two or more antigen molecules and sticks them together. The repletion of this process produces large antigen-antibody complexes that immobilize the antigens until certain immune cells break them down

Blood types are based on antigens called agglutinogens on the surface of RBCs, and antibodies called agglutinins in the blood plasma. These name reflect the fact that that they interact to agglutinate RBCs in the event of mismatched transfusion Blood types A, B, AB and O forms the ABO blood group. Your blood type is determined by the hereditary presence or absence of antigens A and B on your RBCs 1. Type A antigen A on RBCs 2. Type B antigen B on RBCs 3. Type AB both antigen A and antigen B on RBCs 4. Type O neither antigen A nor B on RBCs. The universal donor blood 7

Because type O blood does not contain either antigen A or B it is referred as the universal donor blood. The term implies that it can be given to any recipient.

Universal recipient Universal recipient (type AB) blood contains neither anti-A or anti-B antibodies, so it cannot agglutinate type A or type B donor red blood cells.

The Rh system The term Rh-positive blood means that the Rh antigen is present on its RBC. Rhnegative blood on the other hand is blood whose red blood cells have no Rh antigen present on them.

Transfusion compatibility Blood group AB individuals have both A and B antigens on the surface of their RBCs, and their blood serum does not contain any antibodies against either A or B antigen. Therefore, an individual with type AB blood can receive blood from any group (with AB being preferable), but can donate blood only to another type AB individual. Blood group A individuals have the A antigen on the surface of their RBCs, and blood serum containing IgM antibodies against the B antigen. Therefore, a group A individual can receive blood only from individuals of groups A or O (with A being preferable), and can donate blood to individuals with type A or AB. Blood group B individuals have the B antigen on the surface of their RBCs, and blood serum containing IgM antibodies against the A antigen. Therefore, a group B individual can receive blood only from individuals of groups B or O (with B being preferable), and can donate blood to individuals with type B or AB.

Blood group O individuals do not have either A or B antigens on the surface of their RBCs, but their blood serum contains IgM anti-A antibodies and anti-B antibodies against the A and B blood group antigens. Therefore, a group O 8

individual can receive blood only from a group O individual, but can donate blood to individuals of any ABO blood group (i.e. A, B, O or AB).

14. Define leukocyte, granulocyte, and agranulocyte.

White blood cells (WBCs), or leukocytes are cells of the immune system involved in defending the body against both infectious disease and foreign materials. Five different and diverse types of leukocytes exist, but they are all produced and derived from a multipotent cell in the bone marrow known as a hematopoietic stem cell. Leukocytes are found throughout the body, including the blood and lymphatic system.

Granulocyte These are types of WBC that contain lysosomes and other membrane bounded organelles in their cytoplasm. They are the neutrophils, eosinophils and basophils

Agranulocyte The other two WBC types lymphocytes and monocytes are called agranulocytes because cytoplasm granules are scarce or absent.

15. State the general function that all leukocytes have in common. Name and describe the five types of leukocytes from most common to least 9

common. Include what the differential count of each indicates.

Leukocytes or white blood cells (WBC) are the least abundant formed elements. They differ from erythrocytes in that they retain their organelles throughout life. Among these organelles are the usual instruments of protein synthesis- the nucleus, rough endoplasmic reticulum, ribosomes and golgi bodies. Leukocytes must be able to synthesize proteins in order to carry out their functions. The proteins are packaged into lysosomes and other organelles which appear as conspicuous granules that distinguish one WBC type from another.

The five types of leukocytes from most common to least common

Neutrophils, lymphocytes, monocytes, eosinophils , basophils NLMEB

Neutrophils They are the most abundant WBC Differential count: increases in bacterial infections

Lymphocytes They are second to neutrophils in abundance 25% to 33% Differential count: increases in diverse infections and immune responses

Monocytes These are the largest WBC with a quite visible nucleus Differential count: increases in viral infections and inflammation

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Eosinophils Differential count: it fluctuates greatly from day to night, seasonally, and with phase of menstrual cycle

Increases in parasitic infections, allergies, collagen diseases and diseases of the spleen and CNS central nervous system

Basophils These are the rarest of the WBC Differential count: relatively stable, increases in chicken pox, sinusitis, diabetes mellitus, myxedema, and polycythemia.

16. Define leukopoiesis. Describe the formation and life history of leukocytes.

Leukopoiesis This is the production of white blood cells, which begins with the same pluripotent stem cells (PPSC) as erythropoiesis. The PPSCs differentiate into distinct types of colony forming units which go on to produce the WBC

1. myeloblasts, which differentiate into three types of granulocytes: neutrophils, eosinophils and basophils 2. monoblasts, which become monocytes

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3. lymphoblasts, which gives rise to three types of lymphocytes ( B lymphocytes, T lymphocytes and natural killer cells) Red bone marrow stores granulocytes and monocytes until they are needed. Lymphocytes begin developing in the bone marrow then migrate to the thymus to complete their development, and then they colonize the spleen, lymph nodes and other lymphoid organs and tissue. Leucocytes circulate for 4 8 hours then migrate into tissue where they live for another 4 5 days. Monocytes travel in the blood for 10 20 hours then migrate into tissues and transform into macrophages and can live for as long as a few years. Lymphocytes responsible for long-term immunity, survive from a few weeks to decades. 17. Define hemostasis and platelet. List the functions of platelets. Hemostasis is the process by which the body stops bleeding. It is the stoppage of blood flow through a blood vessel or an organ of the body. Platelets are irregularly shaped, colorless anuclear cell fragment that are present in blood. They circulate in the blood and are involved in hemostasis, leading to the formation of blood clots. Functions of platelets 1. They secrete vasoconstrictors, which are chemicals that cause spasmodic constrictions of broken vessels and thus help reduce blood loss. 2. They stick together to form temporary platelet plugs to seal small breaks in injured blood vessels. 3. They secrete procoagulants, or clotting factors which promote blood clotting 4. They initiate the formation of a clot dissolving enzyme that dissolves blood clots that have outlasted their usefulness 5. They secrete enzymes that attract neurophils and monocytes to sites of inflammation 6. They phagocytize and destroy bacteria.

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7. They secrete growth factors that stimulate mitosis in fibroblasts and smooth muscle and thus help to maintain and repair blood vessels. 18. Define thrombopoiesis and megakaryocyte. Thrombopoiesis is the production of platelets, which is a division of hemopoiesis. The megakaryocyte is a bone marrow cell responsible for the production of blood thrombocytes (platelets), which are necessary for normal blood clotting. 19. Describe in detail the three hemostatic mechanisms. There are three hemostatic mechanisms vascular spasms, platelet plug formation and blood clotting (coagulation) 1. Vascular spasm is a prompt constriction of the broken vessel to reduce bleeding. The vascular spasm is maintained long enough for the other two hemostatic mechanisms to come into play.

2. Platelet plug formation- when a vessel is broken collagen fibers of its walls are exposed to the blood. Upon contact with collagen platelets put out long spiny pseudopods that adhere to the vessel and other platelets. The pseudopods then contract and draw the walls of the vessel together. The mass of platelets thus formed, called a platelet plug, may reduce or stop minor bleeding.

3. Coagulation or the clotting of blood is the last and most effective defense against bleeding. The blood clot forms as platelets become enmeshed in fibrin threads. This forms a longer lasting seal and gives the vessel a chance to repair itself. 20. Explain what happens to blood clots when they are no longer needed When clots are no longer needed they are dissolved through a process called fibrinolysis. In this process the fibrin clot, the product of coagulation, is broken down and dissolved. Its main enzyme plasmin cuts the fibrin mesh at various places, leading to the production of circulating fragments that are cleared by other proteases or by the kidney and liver. 21. Explain what keeps blood from clotting in the absence of injury. 13

Platelet repulsion: Platelets will not adhere to the endothelium or the inner lining of undamaged blood vessels. The endothelium is coated with prostacyclin, which is produced in the walls of blood vessels that acts as a vasodilator and inhibits platelet aggregation. Anticoagulants: An additional deterrent to clotting is anticoagulants substances in the blood called antithrombins. They inactivate thrombin thus preventing it from converting fibrinogen to fibrin. Heparin a natural constituent of the blood acts as an antithrombin.

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