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Lecture 3

NURS 364 Lecture Notes - Lecture 3: Bone Marrow, Complete Blood Count, Red Blood Cell


Department
Nursing
Course Code
NURS 364
Professor
Deborah Van Kuiken
Lecture
3

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Alterations in Hematologic Function
NURS 364 - Pathophysiology
What is Blood ?
Blood consists of:
Cells
Red blood cells that contain hemoglobin that binds oxygen.
White blood cells fight infection.
Platelets that help the blood to clot
Plasma
The fluid component of the blood serves as transport medium
Plasma contains various kinds of proteins:
Albumin (pH buffer)
Globulins (antibodies)
Fibrinogen (clotting aid)
Complement protein
Hematopoiesis:
After birth:
Bone marrow gradually takes over
Red bone marrow
Hematopoietically active
Flat bones
Distal ends of humerus/femur
Yellow bone marrow
Fat cells
(Inactive)
Regulation of Hematopoiesis
Hematopoietic Growth factors
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Stimulate proliferation, differentiation and functional activation of various blood cell
precursors in bone marrow
Red Blood Cells:
Hormone Erythropoietin (EPO) from kidneys
Platelets:
Thrombopoietin
WBC:
Colony-stimulating factors
GM-CSF
M-CSF
G-CSF
Cytokines: histamine, TNF, prostaglandins, interleukin
Anemias--- lack of capacity of the blood to carry oxygen
Red Blood Cells (RBCs)—nhave their shape because they have to be flexible and they carry
oxygen and the oxygen has to move easily back and forth…. Hemoglobin is near the surface
Erythrocytes
Non-nucleated biconcave disc
Hemoglobin (Hgb)
2 pairs of polypeptide chains attached to heme unit which surrounds an atom of
iron (Fe)—280 million hemoglobin in each RBC
4 molecules of O2 can be carried by each Hgb
Hgb synthesis depends upon Fe intake
Fe absorbed in GI tract
Carried by transferrin and stored in liver as ferritin
Erythropoiesis
RBCs squeeze through blood vessel membranes to enter the circulation as RETICULOCYTES
(mature into RBC in the blood (24-48 hours)
Kidneys increase ERYTHROPOIETIN
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In response to decreased O2
Kidneys increase ERYTHROPOIETIN
In response to decreased O2
Reticulocytes--- immature rbc’s released if needed
RBC Destruction/ Recycling
Lifespan 120 days----6-8 micrometers in diameter
Destruction via macrophages:
Spleen----some passage ways are a quarter of the size of the RBC
Liver
Lymph nodes
Amino acids from globulin and the iron (Fe) from heme are salvaged and reused
RBC Destruction/ Recycling
Bulk of heme converted to bilirubin
Bilirubin bind to plasma protein (insoluble in plasma) called unconjugated bilirubin
Liver binds bilirubin to glucoronide to make it water soluble: conjugated bilirubin
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