- Transports essential oxygen to tissues along with nutrients
required for cellular metabolism
- provides for the necessary
removal of many cell wastes
- plays a critical role in the
body's defenses/immune system
- serves in maintaining body
- Provides a mechanism for controlling body
temperature by distributing Core heat throughout the peripheral
Two Separate Circulations
- The pulmonary circulation
- The systemic
The Pulmonary Circulation
- allows The exchange of oxygen and carbon dioxide in the
- Provides for the exchange of nutrients and wastes between the
blood and the cells throughout the body
- Transports Blood
away from the heart
- The smaller branches of arteries
- Controls the amount
of blood flowing into the capillaries in specific areas through the
degree of contraction of smooth muscle in the vessel wall
- Very small vessels
- Forms the microcirculation
- Blood flow very slowly through capillaries
- Facilitates the exchange of fluid,
oxygen, carbon dioxide, electrolytes glucose, and other
nutrients and waste between the blood and interstitial
- Determines the amount of blood flowing from the arterioles into
the individual capillaries
- depends on the metabolic needs
of the tissues
- conduct blood from the capillary beds toward the heart
- returns blood back to the heart
- Have thinner walls
than arteries and less smooth muscles
- the blood vessels that hold the major portion of
theintravascular blood volume
Walls of arteries and veins
- the inner layer
- endothelium (simple squamous)
- flat so fluid can be
- The middle layer
- Layer of smooth muscle
- Controls the diameter and
- outer connective
- Contains elastic and collagen fibers
- A reflex adjustment in a small area of a tissue
depending on the needs of the cells in the area
Causes of local vasodilation
- decrease in pH
- increase in carbon dioxide
- decrease in oxygen
- Water and its dissolve solutes (plasma) = 55% of the whole
- remaining 45% is composed of the cells or
formed elements erythrocytes, leukocytes, and thrombocytes
- Refers to The proportion of cells in blood
the viscosity of the blood
- The clear yellowish fluid remaining after the cells
have been removed
- water 92%
- other solutes 1%
- Amino acids
- Refers to the fluid and solutes remaining after the cells and
fibrinogen has been removed
Examples of plasma proteins
- Maintains osmotic pressure in the blood
- essential for the formation of blood clots
- Origination of all blood cells
- found in the flat and
irregular bones, ribs, vertebrae, sternum, and pelvis
Erythrocytes or red blood cells
- Biconcave flexible discs
- non-nucleated when mature
- Contain hemoglobin
- Size and structure are
essential for easy passage to small capillaries
- life span =
120 days b/c no nucleus
- Originates in the kidney
- Hormone that stimulates
erythrocyte production in the red bone marrow
- the globlin portion
- two pairs of amino acid chains
- each containing a ferrous iron atom, to
which oxygen molecule can attach
- A bright red color that distinguishes arterial blood from
- Dark bluish red in color and font and venous blood
- Production of white blood cells
- Stimulated by colony
stimulating factors that are produced by cells such as macrophages
and T lymphocytes
- Makes up only about 1% of blood volume
- Subdivided into
- All types develop in differentiate from the original
stem cell in bone marrow
- There are five types of leukocytes
- Makes up 30 to 40% of the white blood cells
- The most common leukocyte
- Makes up 50
to 60% of White blood cells
- Survive only four days
- The first to respond to any tissue damage And
- Increase in numbers by bacterial
- Can release histamine and heparin
- Maybe fixed in
tissues or wandering
- Combat the effects of histamine
- Increase by
allergic rea ctions and parasitic
- can enter the tissue to become macrophages
- Indicates the proportion the specific types of white blood
cells in the blood
- Assist in making a diagnosis
- Essential part of the blood clotting process
- An immediate response of a blood vessel to injury is
vasoconstriction of vascular spasm
- Form a platelet plug in
- Coagulation mechanism
- an anticoagulant
- Released from basophils or mast cells
in the tissues
- Blocks thrombin
- Does not dissolve
clots but prevents further growth of the thrombus
- Determined by the presence of specific antigens on the cell
membranes of erythrocytes
- An inherited characteristic
- Depends on the presence of
type A or B antigens
- Lack A and B antigens
- are considered universal
- May cause blood and incompatibility if the mother is Rh
negative and the fetus is Rh positive
Antigen D in plasma membrane = RH positive
Absence of antigen D = RH negative
Complete blood count (CBC)
diagnostic test for blood
- Includes total red blood cells, white blood cells, platelet
count, and morphology (size and shape), a differential count for
white blood cells, hemoglobin, and hematocrit values
- An increase in white blood cells
- Often associated with
inflammation or infection
- Decrease in leukocytes
- Occurs with some viral
infections as well as with radiation and chemo therapy
- Common with allergic responses and parasitic infections
- Observe with blood sMears
- Shows size, shape,
uniformity, and maturity of cells
- Helps to distinguish
different types of anemia
Hemoglobin (diagnostic test)
- Amount of hemoglobin per unit volume of blood
- Indicates the oxygen-carrying capacity
- Mean corpuscular hemoglobin
- Assessment of bone marrow function
Chemical analysis of the blood
- Determine serum levels of components such as iron, vitamin B12,
folic acid, cholesterol, urea, and glucose
Bleeding time (diagnostic test)
- Measures platelet function
prothrombin time (PT) and partial thromboplastin time (PTT)
- Measures function of various factors in coagulation
- interNational normalized ratio is a standardized
partial thromboplastin time
- Measures the intrinsic pathway
PTT... the 2 t's are in(trinsic) a relationship
- measures the extrinsic pathway
- A reduction in oxygen transport in the blood due to a decrease
in hemoglobin content
- May result from the declining
production of the protein, a decrease in the number of erythrocytes,
or a combination of these factors
- May be classified by
typical cell morphology
oxygen deficiency leads to:
- Less energy production and all cells
metabolism and reproduction diminished
- Compensation mechanism to improve the oxygen supply
- peripheral vasoconstriction
- General signs of anemia
- Fatigue, Pallor,
dyspnea, and tachycardia
regeneration of epithelial cells
- Insufficient iron impairs hemoglobin synthesis
reduces the amount of oxygen transported in the blood
- Red blood cells are microcytic
- Ranges from mild to severe
- Occurs in all
- One in five women is affected
- Proportion increases for pregnant women
- Frequently a sign of an underlying problem
Etiology of iron deficiency anemia
- Dietary intake of iron may be below the minimum
- Chronic blood loss
- duodenal absorption
of iron may be impaired
- Severe liver disease may affect
both iron absorption and iron storage
Manifestations of iron deficiency anemia
- pallor of the skin and mucous membranes
- Due to
- Fatigue,lethargy, and cold intolerance
- b/c cell
central nervous system response to hypoxia
- Degenerative changes
- such as brittle hair, spoon shaped
and rigid nails
- Inflammation of oral mucosa
- Menstrual irregularities
- Tachycardia, heart palpitations, dyspnea,
* People who have iron deficiency anemia may have unusual craving
for nonfood items such as ice, paint, or starch. This craving is
Diagnostic tests for Iron deficiency anemia
- Laboratory test demonstrate low values of hemoglobin,
hematocrit, mean corpuscular volume and mean corpuscular hemoglobin,
serum ferritin and serum iron, and transferrin saturation
Treatment for iron deficiency anemia
- Identified underlying cause and resolves if possible
- Consume Iron rich foods or iron supplements
pernicious anemia: vitamin B12 deficiency (megaloblastic anemia)
- The common form of megaloblastic anemia
- Caused by the
malabsorption of the vitamin B12
- Iron deficiency
may be present as well
- Red blood cells are very large and
- Dietary and sufficiency is a very rare
- May be an outcome of surgeries in which the parietal
cells are removed or resection of the ileum which is a sight of
Vitamin B12 and nerve cells
- Vitamin B12 is needed for the function and
maintenance of neurons
- Deficiency can result in
Manifestations of pernicious anemia
- Tongue is typically in large, red, sore, and shiny
- Decrease in gastric acid leads to digestive discomfort such as
nausea and diarrhea
- Tingling or burning sensations in the
extremities or loss of coordination and ataxia
Diagnostic tests for pernicious anemia
- Microscopic examination (erythrocytes)
- Bone marrow
- Vitamin B12 serum
levels below normal
Treatment for Pernicious Anemia
- Oral supplements are recommended
B12 is administered by injection
- Results from impairment or failure of bone marrow leading to
loss of stem cells and pancytopenia
- may be temporary or
- often idiopathic
- decreased numbers of erythrocytes, leukocytes, and thrombocytes
in the blood.
- results from excessive destruction of RBCs
- leads to a
low erythrocyte count and low hemoglobin
- genetic defects
- Changes in blood chemistry
- Presence of
toxins in the blood
- Infections such as malaria
- Antigen-antibody reaction
- Incompatible blood
What term is used to describe a deficit of all types of blood cells?
Capillary walls consist of:
- multiple endothelial layers.
- a thick layer of smooth
- two or three epithelial layers.
- a single
- a single endothelial layer
Individuals with type O blood are considered to be universal donors
because their blood:
- contains A and B antibodies.
- contains A and B
- lacks A and B antibodies.
- lacks A and B
What causes numbness and tingling in the fingers of individuals with
untreated pernicious anemia?
- Persistent hyperbilirubinemia
- Increasing acidosis
- Vitamin B12 deficit causing
peripheral nerve demyelination
- Multiple small vascular
occlusions affecting peripheral nerves
- Vitamin B12 deficit causing peripheral nerve
What is the cause of oral ulcerations and delayed healing occurring
with any severe anemia?
- Lack of folic acid for DNA synthesis
microinfarcts in the tissues
- Deficit of oxygen for
epithelial cell mitosis and metabolism
- Elevated bilirubin
levels in blood and body fluids
- Deficit of oxygen for epithelial cell mitosis and
Why is pernicious anemia treated with injections of vitamin B12?
- An immune reaction in the stomach would destroy the
- Digestive enzymes would destroy the vitamin.
- The vitamin irritates the gastric mucosa.
- The ingested
vitamin would not be absorbed into the blood.
- The ingested vitamin would not be absorbed into the blood.
Why do vascular occlusions and infarcts occur frequently with sickle
- The red blood cells are abnormally large.
hemolysis of erythrocytes occurs.
- Erythrocytes change to
sickle shape when hypoxia occurs
- HbS is unable to transport
- Erythrocytes change to sickle shape when hypoxia occurs
In cases of polycythemia vera, blood pressure is elevated as a result of:
- increased blood volume.
- frequent infarcts in the
- congested spleen and bone
- increased renin and aldosterone secretions.
In individuals with pernicious anemia, antibodies form to:
- vitamin B12 .
- intrinsic factor or parietal
- mucus-producing glands.
- intrinsic factor or parietal cells.
Petechiae and purpura are common signs of:
- excessive hemolysis.
- hemoglobin deficit.
Which of the following substances acts as an anticoagulant?
- Vitamin K
Why is excessive bleeding a common occurrence with acute leukemia?
- Deficit of calcium ions
- Impaired production of
prothrombin and fibrinogen
- Decreased platelets
- Dysfunctional thrombocytes
Multiple myeloma is a malignant tumor involving:
- plasma cells.
- bone cells.
- lymph nodes.
The Reed-Sternberg cell is diagnostic for:
- chronic myeloblastic leukemia.
- multiple myeloma.
Which of the following applies to the leukemias?
- Chronic leukemias are more common in older people.
- AML is the most common childhood leukemia.
- Exposure to
chemicals is not considered a predisposing factor.
tissue produces abnormal leukocytes.
- Chronic leukemias are more common in older people.
A high percentage of blast cells in the leukocyte population
indicates a poor prognosis for an individual with:
- acute myelogenous leukemia (AML).
- myelodysplastic syndrome.
- multiple myeloma.
- acute myelogenous leukemia (AML).
Which of the following applies to erythropoietin?
- It is produced by the liver.
- It increases iron
absorption for heme production.
- It stimulates production of
red blood cells.
- Hypoxia stimulates the red bone marrow to
- It stimulates production of red blood cells.
Microcytic and hypochromic erythrocytes are commonly found as a
- iron deficiency anemia.
- disseminated intravascular coagulation.