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Blood (Clinical Considerations (Blood Doping (dangers (Increased blood…

- - - - Increased blood viscosity
      - Heart required to work harder
      - permanent cardiovascular damage
      - Banned from athletic competition
  - - - Can cause hemolysis, rupture of erythrocytes, organ damage
- - - - transport gases
      - Small, flexible
      - Lack nucleus and cellular organelles; packed with hemoglobin
        
        Hemoglobin: red-pigmented protein
        
        Transports oxygen and carbon dioxide
        
        Each hemoglobin molecule is composed of four globins
        
        oxygen binds to the iron
        
        carbon dioxide binds to the globin (not iron)
    - - white blood cells
      - defend against pathogens
      - Contain nucleus and organelles, but not hemoglobin
      - Motile and flexible—most not in blood but in tissues
        
        Diapedesis: process of squeezing through blood vessel wall
        
        Chemotaxis: attraction of leukocytes to chemicals at an infection site
      - Two Types
        
        Granulocytes have visible granules seen with light microscope
        
        Neutrophils
        
        Most numerous leukocyte in blood
        
        Multilobed nucleus
        
        Cytoplasm has pale granules when stained
        
        Enter tissue spaces and phagocytize infectious pathogens
        
        Numbers rise dramatically in chronic bacterial infection
        
        Eosinophils
        
        Bilobed nucleus
        
        1–4% of leukocytes
        
        Cytoplasm has reddish granules
        
        Phagocytize antigen-antibody complexes or allergens
        
        parasitic worm infection
        
        Basophils
        
        0.5–1% of leukocytes
        
        Bilobed nucleus
        
        Cytoplasm has blue-violet granules with histamine and heparin
        
        Agranulocytes have smaller granules that are not visible with light microscope
        
        Lymphocytes
        
        Reside in lymphatic organs and structures
        
        Dark-staining round nucleus
        
        20–40% of blood leukocytes
        
        Three categories
        
        T-lymphocytes manage immune response
        
        B-lymphocytes become plasma cells and produce antibodies
        
        NK cells (natural killer cells) attack abnormal and infected tissue cells
        
        Monocytes
        
        C-shaped nucleus
        
        2–8% of blood leukocytes
        
        in tissues
        
        Transform into large phagocytic cells, macrophages
    - - help form clots to prevent blood loss
      - no nucleus, not even cells
  - - - most proteins are produced in the liver
      - colloid
      - plasma exert colloid osmotic pressure
        
        helps maintain blood volume and pressure
    - - albumins
        
        smallest but most abundant
        
        greatest contributer to colloid osmotic pressure
        
        transports lipids, hormones, and ions
      - globulins
        
        smaller alpha and beta transport water insoluble molecules (hormones, metals, ions...)
        
        gamma globulin/ immunoglobulin/ antibodies are a part of the immune system
      - fibrinogen
        
        coverts to insoluble fibrin strands in case of trauma to contribute to blood clot formation
      - regulatory proteins
        
        smallest percentage in plasma (1%)
        
        enzymes and hormones
- - - - erythrocytes
        
        Erythropoiesis: red blood cell production
        
        Begins with myeloid stem cell—responds to multi-CSF
        
        Forms proerythroblast—a large nucleated cell
        
        Becomes erythroblast—smaller, produces hemoglobin
        
        Becomes normoblast—still smaller, more hemoglobin, anucleate
        
        Becomes reticulocyte—lacks organelles except ribosomes that make hemoglobin
        
        Becomes erythrocyte—ribosomes have degenerated
      - all leukocytes except lymphocytes
        
        Leukopoiesis: production of leukocytes
        
        Granulocytes
        
        neutrophils, basophils, and eosinophils
        
        Progenitor cell becomes myeloblast that becomes a granulocyte
        
        Monocytes
        
        M-CSF prompts progenitor cell to become a monoblast
        
        Monoblast becomes a promonocyte, which matures into a monocyte
      - megakaryocytes
        
        Megakaryoblast produced from myeloid stem cell
        
        Forms megakaryocyte under influence of thrombopoietin
        
        Megakaryocyte produces thousands of platelets
      - Myeloid line forms erythrocytes, all leukocytes except lymphocytes, and megakaryocytes (cells that produce platelets)
    - - forms only lymphocytes
      - Lymphocytes are derived from lymphoid stem cells
        :
        
        Stem cells differentiate into B-lymphoblasts and T-lymphoblasts
        
        Lymphoblasts mature into B-lymphocytes and T-lymphocytes
    - - Multi-colony-stimulating factors (multi-CSF)
        
        increase formation or erythrocytes, granulocytes, monocytes, and platelets
      - Granulocyte-macrophage colony stimulating factor (GM-CSF)
        
        accelerates formation of granulocytes and monocytes
      - Granulocyte colony-stimulating factor (G-CSF)
        
        Stimulates the formation of granulocytes
      - Macrophage colony-stimulating factor (M-CSF)
        
        Stimulates the production of macrophages
      - Thrombopoietin
        
        stimulates the production of platelets
      - Erythropoeitin (EPO)
        
        hormone from the kidneys (not a growth factor)
        
        Liver produces just a little EPO
        
        increases the production and maturation or erythrocytes
        
        Blood Doping
        
        Red marrow myeloid cells respond to EPO by making more erythrocytes and releasing them into circulation
        
        The low oxygen levels at high altitude stimulate EPO production
- - - - blood vessel constriction
      - First phase in response to blood vessel injury
      - Limits blood leakage
      - Greater vasoconstriction with greater vessel damage
    - - blood clotting
      - Network of fibrin (insoluble protein) forms a mesh
      - Mesh traps erythrocytes, leukocytes, platelets, plasma proteins to form clot
      - Clotting requires calcium, clotting factors, platelets, vitamin K
      - Intrinsic (contact activation) pathway
        Initiated by platelets upon damage to inside of vessel wall
        Five steps that are complete in 3 to 6 minutes:
      - Extrinsic (tissue factor) pathway
        Initiated by damage outside of vessel
        Two steps take about 15 seconds
      - Rare example of positive feedback
    - - Normally (when uninjured) platelet activation is inhibited
        
        Vessel’s endothelial wall smooth and coated with prostacyclin
        
        Prostacyclin is an eicosanoid that repels platelets
      - When blood vessel damaged, a platelet plug is formed
        
        Collagen fibers in vessel wall exposed
        
        latelets stick to collagen with help of von Willebrand factor
        
        Platelets develop long processes allowing for better adhesion
        
        Platelet plug forms quickly (1 min) but is prevented from getting too large by prostacyclin secretion by nearby, healthy cells