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Samenvatting Hematologie
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Complete samenvatting Hematologie jaar 1 Life Sciences, bevat alle lesstof uitgebreid.
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Samenvatting Hematologie,Inhoud
1. Bloed en weefsels ............................................................................................................................... 4
1.1 Circulatie ....................................................................................................................................... 4
1.1.1 De structuur van bloedvaten ................................................................................................. 4
1.2 Capillair endotheel ........................................................................................................................ 5
1.2.1 Colloïd osmotische druk ......................................................................................................... 5
1.2.2 Continue capillairen ............................................................................................................... 6
1.2.3 Gefenestreerde capillairen .................................................................................................... 6
1.2.4 Sinusoïde capillairen .............................................................................................................. 6
1.3 RBC indices .................................................................................................................................... 7
1.4 Bloedcomponenten ...................................................................................................................... 8
1.4.1 Bloedhomeostase .................................................................................................................. 8
2. Leukocyten .......................................................................................................................................... 9
2.1 Celmorfologie ................................................................................................................................ 9
2.2 Leukocyten en hun functies ........................................................................................................ 10
2.3 Bloedafname ............................................................................................................................... 10
2.4 Celtellingen ................................................................................................................................. 11
2.4.1 Statistische variatie in de telling .......................................................................................... 11
2.4.2 Statistische bepaling van een verschil ................................................................................. 11
2.4.3 Standaard deviatie en variatiecoëfficiënt ............................................................................ 11
3. Immunologie ..................................................................................................................................... 13
3.1 Leukopoëse ................................................................................................................................. 13
3.2 Basale immunologie .................................................................................................................... 14
3.2.1 Immuun respons .................................................................................................................. 14
3.2.2 Memory................................................................................................................................ 15
3.2.3 Immunologie definities ........................................................................................................ 15
3.2.4 Immunoglobulinen (Ig) – standaardmodel .......................................................................... 16
3.2.5 Ab-binding ............................................................................................................................ 17
4. Erytrocyten........................................................................................................................................ 18
4.1 Erytropoëse ................................................................................................................................. 18
4.2 Hemoglobine ............................................................................................................................... 18
4.2.1 Afbraak van erytrocyten en hemoglobine ........................................................................... 19
4.3 Gasuitwisseling ........................................................................................................................... 20
4.3.1 CO2-transport in het bloed ................................................................................................... 20
4.4 Anemiën ...................................................................................................................................... 22
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,5. Erytrocytenserologie ......................................................................................................................... 24
5.1 ABO ............................................................................................................................................. 24
5.1.1 Het ABO-systeem ................................................................................................................. 25
5.1.2 Bombay-bloedgroep ............................................................................................................ 25
5.1.3 ABO-bloedgroepenbepaling................................................................................................. 26
5.2 Rhesus ......................................................................................................................................... 26
5.2.1 Antistoffen tegen rhesusantigenen ..................................................................................... 27
5.2.2 Bepaling van het rhesusfenotype ........................................................................................ 27
5.2.3 Rhesusfactor en zwangerschap ........................................................................................... 27
5.3 Transfusie reacties ...................................................................................................................... 28
5.3.1 Klinische verschijnselen bij incompatibiliteit van bloedgroepen......................................... 28
6. Primaire hemostase .......................................................................................................................... 30
6.1 Fasen in de hemostase................................................................................................................ 30
6.1.1 De vaatwand ........................................................................................................................ 30
6.2 Trombocyten en primaire hemostase ........................................................................................ 30
6.2.1 Trombopoëse ....................................................................................................................... 31
6.2.3 Volgorde proces stolling ...................................................................................................... 32
6.3 Pathologie ................................................................................................................................... 34
7. Secundaire hemostase ...................................................................................................................... 35
7.1 Enzymreacties / introductie stolling ........................................................................................... 35
7.2 Stollingscascade .......................................................................................................................... 36
7.3 Stolling / fibrinolyse .................................................................................................................... 37
7.4 Stoltesten .................................................................................................................................... 38
7.5 Kliniek/therapie........................................................................................................................... 39
8. Bloed, spiegel van de gezondheid..................................................................................................... 41
8.1 Referentiewaarden ..................................................................................................................... 41
8.2 Sensitiviteit, specifiteit en prevalentie ....................................................................................... 41
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, 1. Bloed en weefsels
1.1 Circulatie
Circulatie is nodig voor zuurstof opname en afgifte. De lever heeft zijn eigen bloedsvoorziening
(poortader). De belangrijkste beperking van een gesloten systeem is dat de afstand te groot is voor
diffusie.
O2 – rijk vat = een arterie en O2 – arm vat = een vene. Behalve bij de pulmonale circulatie: de longen.
Hier is dit omgekeerd. De onderdelen die behoren tot de pulmonale circulatie zijn: de longen, de
longader, de longslagader en het hart. Via het linker atrium en linker ventrikel verlaat bloed het hart.
Bloed dat zich onder in het lichaam bevindt komt met behulp van de skeletspieren (zoals de
kuitspieren) door beweging weer terug naar het hart.
Figuur 1.1: Circulatie systeem de mens.
1.1.1 De structuur van bloedvaten
Endotheelcellen zijn zeer dun en maken het transport mogelijk van stoffen naar de interstitiële
ruimte.
Spierweefsel maakt het mogelijk om de bloedtoevoer naar een orgaan te reguleren. Capillairen
hebben géén spierweefsel.
T.o.v. het hart blijft de druk blijft vervallen. De stroming in capillairen is het laagste omdat daar de
totale diameter van het bedvolume het hoogst is.
Structuur bloedvaten:
Capillairen bestaan uit een enkele laag endotheelcellen en een extracellulaire laag genaamd de basal
lamina. Hier alleen uitwisseling stoffen omdat alleen hier de wanden dun genoeg zijn.
Zowel vene als ader bestaan uit 3 lagen: buitenste laag: connective tissue bestaande uit elastische
vezels en collageen (stevigheid).
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