NURS 8022 Advanced Pathophysiology Exam 2 Study Guide
MODULE 3: Hematology
Readings: Ch. 27-29; article – interpretation of iron studies
Blood NOT ON STUDY GUIDE
• Volume: 6 quarts or 5.5 L
• Consists of fluid, cells, and protein
o Electrolytes and proteins maintain the osmolarity an...
nurs 8022 advanced pathophysiology exam 2 study guide module 3 hematology readings ch 27 29 article – interpretation of iron studies blood not on study guide • volume 6 quarts or 55 l • consist
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NURS 8022 Advanced Pathophysiology Exam 2 Study Guide
MODULE 3: Hematology
Readings: Ch. 27-29; article – interpretation of iron studies
Blood NOT ON STUDY GUIDE
Volume: 6 quarts or 5.5 L
Consists of fluid, cells, and protein
o Electrolytes and proteins maintain the osmolarity and acid-base balance of the blood
Functions:
o Provide nutrition to cells; provide O2 for cellular metabolism; removes by-products of
cellular metabolism; carries cells that protect the body against infection and invading
organisms
Plasma
o Solution of protein and inorganic materials
o 92% water, 8% dissolved solutes – 50-55% of blood volume
o Contains plasma proteins which are mainly synthesized in the liver – primary element of plasma
Albumins: function as carriers; control plasma oncotic pressure in blood/capillaries; “protein
pressure”; regulate fluids and solutes through circulation; very large – not easily passed
through microvasculature which is how the maintain oncotic pressure
Globulins will discuss in immunity lecture
Clotting factors: mainly fibrinogen – precursor to fibrin clot
Lipoproteins: triglycerides; cholesterol; and fatty acids
o Also contains several charged ions that regulate cell function, osmotic pressure, and blood pH
Serum
o Plasma that has been allowed to clot in the lab in order to remove fibrinogen and other clotting factors
May interfere with some diagnostic tests
Pluripotent cells NOT ON STUDY GUIDE
“precursor cells” - in the bone marrow that differentiate into major blood cells
o Red cells: erythrocytes
o White cells: leukocytes
o Platelets: thrombocytes
, Erythrocytes
o Most abundant cells of the blood
o Responsible for tissue oxygenation
o Contain hemoglobin; carry gases and electrolytes
o Have limited life span – 120-day life cycle
No mitotic division
Can be removed from circulation by spleen and replaced with new
o Biconcavity: function/efficient shape that allows gas diffusion and ability to change shape
o Reversible deformity: enables torpedo shape to squeeze through microcirculation & return to normal
Leukocytes
o Defend the body against infection and remove debris (dead and damaged cells)
o Classified by structure and function
Granulocytes and agranulocytes – will discuss in immune lecture
Thrombocytes
o 150,000-400,000/mm3 = normal
o Irregularly shaped cytoplasmic fragments; formed by fragmentation of megakaryocytes
o Essential for blood coagulation and the control of bleeding
o Incapable of mitotic division – no nucleus or DNA; limited life span – 5-9 days & removed by spleen
o Granules are proinflammatory – released when there is vessel injury – ATP, ADP, calcium, serotonin,
histamine
o Produced in bone marrow – stored in spleen – slowly released
Lymphoid Organs NOT ON STUDY GUIDE
Sites of residence, proliferation, differentiation, and function of lymphocytes and mononuclear phagocytes
Link to hematologic and immune systems
Primary lymphoid organs:
o Thymus, bone marrow
Secondary lymphoid organs: spleen, lymph nodes, tonsils, peyer patches of the small intestine
Spleen
o Largest secondary lymphoid organ
o Functions: fetal hematopoiesis, filters and cleanses the blood, mounts an immune response
to bloodborne microorganisms, serves as a blood reservoir
Lymph nodes
o Site of the development or activity of lymphocytes, monocytes, and macrophages
o Structurally part of lymphatic system
o Functionally part of the immune and hematologic systems
Understand the basic physiology of hematopoiesis, erythropoiesis, and what erythropoietin is and what it does
Hematopoiesis: process of blood cell production in adult bone marrow or the liver and/or spleen of the fetus
o Two stages
Mitosis (proliferation)
Maturation (differentiation)
o Act on pluripotent cells
o Bone marrow: “myeloid tissue” - primary site of hematopoietic stem cells
Red marrow (produces RBCs) yellow marrow (does not produce RBCs)
Active bone marrow sites: pelvic bones, vertebrae, cranium, mandible, sternum, ribs,
humerus, femur
o Process
STEM CELL POOL contains: hematopoietic stem cell – progenitor cell
BONE MARROW POOL contains: proliferating and maturing cells and storage for those cells
as they prepare for release
o Factors that increase hematopoiesis
Conversion of yellow bone marrow, which does not produce blood cells, to hematopoietic
red marrow by actions of erythropoietin
Faster differentiation of progenitor cells
Faster proliferation of stem cells into progenitor cells
Erythropoiesis: development of RBCs
o Derived from erythroblasts
o Maturation stimulated by erythropoietin
Stimulates stem cells to form proerythroblasts, which are committed into producing erythroid
cells – promotes release of reticulocytes
o Sequence
In each step, the quantity of hemoglobin increases and the nucleus decreases in size
o Erythropoietin: hormone released from the kidney in response to low renal oxygenation
NOT the # of RBCs but rather oxygen delivery
Produced in the peritubular interstitial cells of the kidney - only 10% produced in the liver
The RBC production increases within 24 hours; life span 4-12 hours; increased RBC # in 5 days
EPO is always present in the plasma
Give to dialysis and chemo patients
o Reticulocytes
Last immature form of erythroblast
Contains polyribosomes (globin synthesis) and mitochondria (heme synthesis)
24-48 hours after leaving bone marrow for circulation, matures into erythrocyte
Loses polyribosomes and mitochondria
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