The Language Of Medicine th 11 edition DaviEllen

Chapter 13 Blood System Copyright © 2017, 2014, 2011, 2007 Saunders, an imprint of

Chapter Goals • Identify terms relating to the composition, formation, and function of blood.

Chapter Goals (cont’d) • Describe various pathologic conditions affecting blood. • Describe various laboratory

Chapter 13 Lesson 13. 1 Copyright © 2017, 2014, 2011, 2007 Saunders, an imprint

Introduction Blood: transports foods, gases, and wastes to and from the cells of the

Composition of Blood • Cells – Erythrocytes – Leukocytes – Platelets • Plasma •

Cell Types and Function Cells--45% Blood Volume Erythrocytes: red blood cells transport nutrients and

Cell Types and Function (cont’d) Leukocytes: or white blood cells Basophils: contain heparin (prevents

Stages in Blood Development (Hematopoiesis) Copyright © 2017, 2014, 2011, 2007 Saunders, an imprint

Review: Composition of Blood Copyright © 2017, 2014, 2011, 2007 Saunders, an imprint of

Plasma proteins ØAlbumin ØGlobulins: immunoglobulins (Ig. G, Ig. A, Ig. M, Ig. D, Ig.

Blood Types Type A: A antigen and anti-B antibody Type B: B antigen and

Blood Clotting Coagulation: fibrin clot Anticoagulants: heparin, warfarin (Coumadin) Copyright © 2017, 2014, 2011,

QUICK QUIZ: 1. The blood contains which of the following to transport oxygen? A.

QUICK QUIZ: (cont’d) 2. Blood contains which clotting cells? A. Erythrocytes B. Plasma C.

Vocabulary • albumin • antibody (Ab) • antigen Copyright © 2017, 2014, 2011, 2007

Vocabulary (cont’d) • albumin Protein in the blood; maintains the proper amount of water

Vocabulary (cont’d) • basophil • bilirubin • coagulation Copyright © 2017, 2014, 2011, 2007

Vocabulary (cont’d) • basophil White blood cell that contains granules that stain blue •

Vocabulary (cont’d) • colonystimulating factor (CSF) • differentiation • electrophoresis Copyright © 2017, 2014,

Vocabulary (cont’d) • colonystimulating factor (CSF) Protein that stimulates growth of white blood cells

Vocabulary (cont’d) • eosinophil • erythroblast • erythrocyte Copyright © 2017, 2014, 2011, 2007

Vocabulary (cont’d) • eosinophil White blood cell that contains granules that stain red •

Vocabulary (cont’d) • erythropoietin (EPO) • fibrinogen Copyright © 2017, 2014, 2011, 2007 Saunders,

Vocabulary (cont’d) • erythropoietin (EPO) Hormone secreted by the kidneys that stimulates red blood

Vocabulary (cont’d) • globulin • granulocyte • hematopoietic stem cell Copyright © 2017, 2014,

Vocabulary (cont’d) • globulin Plasma protein • granulocyte White blood cell with numerous dark-staining

Vocabulary (cont’d) • hemoglobin • hemolysis • heparin Copyright © 2017, 2014, 2011, 2007

Vocabulary (cont’d) • hemoglobin Blood protein containing iron; carries oxygen in red blood cells

Vocabulary (cont’d) • immune reaction • immunoglobulin • leukocyte Copyright © 2017, 2014, 2011,

Vocabulary (cont’d) • immune reaction Response of the immune system to foreign invasion •

Vocabulary (cont’d) • lymphocyte • macrophage • megakaryocyte Copyright © 2017, 2014, 2011, 2007

Vocabulary (cont’d) • lymphocyte Mononuclear leukocyte that produces antibodies • macrophage Monocyte that migrates

Vocabulary (cont’d) • monocyte • mononuclear • myeloblast Copyright © 2017, 2014, 2011, 2007

Vocabulary (cont’d) • monocyte Leukocyte with one large nucleus; engulfs foreign material and debris;

Vocabulary (cont’d) • neutrophil • plasmapheresis Copyright © 2017, 2014, 2011, 2007 Saunders, an

Vocabulary (cont’d) • neutrophil Granulocytic leukocyte formed in bone marrow; polymorphonuclear leukocyte • plasma

Vocabulary (cont’d) • platelet • polymorphonuclear • prothrombin Copyright © 2017, 2014, 2011, 2007

Vocabulary (cont’d) • platelet A small blood fragment important in clotting • polymorphonuclear Pertaining

Vocabulary (cont’d) • reticulocyte • Rh factor • serum Copyright © 2017, 2014, 2011,

Vocabulary (cont’d) • reticulocyte Immature erythrocyte • Rh factor Antigen on red blood cells

Vocabulary (cont’d) • stem cell • thrombin • thrombocyte Copyright © 2017, 2014, 2011,

Vocabulary (cont’d) • stem cell Unspecialized cell that gives rise to mature, specialized forms

Combining Forms and Terminology Combining Form. Meaning • • • bas/o chrom/o coagul/o cyt/o

Combining Forms and Terminology (cont’d) Combining Form • • • Meaning granul/o hemat/o hemoglobin/o

Combining Forms and Terminology (cont’d) Combining Form. Meaning • • • leuk/o mon/o morph/o

Combining Forms and Terminology (cont’d) Combining Form • • • phag/o poikil/o sider/o spher/o

Suffixes • • • -apheresis -blast -cyte -cytosis -emia -gen -globin -globulin -lytic •

Chapter 13 Lesson 13. 2 Copyright © 2017, 2014, 2011, 2007 Saunders, an imprint

Diseases of Red Blood Cells Anemia: A deficiency in erythrocytes or hemoglobin Other types

Types of Anemia • Aplastic anemia: failure of blood cell production due to aplasia

Diseases of Red Blood Cells • Hemochromatosis: excess iron deposits throughout the body •

QUICK QUIZ: 3. What is the most common type of anemia? A. Hemolytic anemia

Types of Anemia Copyright © 2017, 2014, 2011, 2007 Saunders, an imprint of Elsevier

Disorders of Blood Clotting Hemophilia: excessive bleeding caused by hereditary lack of factors VIII

Diseases of White Blood Cells Leukemia: an increase in cancerous white blood cells ØAcute

Acute Leukemia • Acute myeloid leukemia • Acute lymphoid leukemia Copyright © 2017, 2014,

Diseases of White Blood Cells Granulocytosis: abnormal increase in granulocytes in the blood Mononucleosis:

Disease of Bone Marrow Cells Multiple myeloma: malignant neoplasm of bone marrow. Malignant cells

Chapter 13 Lesson 13. 3 Copyright © 2017, 2014, 2011, 2007 Saunders, an imprint

Laboratory Blood Tests • • Antiglobulin test (Coombs test) Bleeding time Coagulation time Complete

Laboratory Blood Tests (cont’d) • • • Platelet count Prothrombin time (PT) Red blood

Clinical Procedures Apheresis: separation of blood into component parts and removal of a select

Abbreviations • • • Ab ABMT ABO ALL AML ANC ASCT banda baso BMT

Abbreviations (cont’d) • • • Ab ABMT ABO ALL AML ANC ASCT banda baso

Abbreviations (cont’d) • • • CBC CLL CML DIC diff EBV eos EPO ESR

Abbreviations (cont’d) • • • G-CSF GM-CSF g/d. L GVHD HCL Hct Hgh, HGB

Abbreviations (cont’d) • G-CSF • GM-CSF • • g/d. L GVHD HCL Hct Hgh,

Abbreviations (cont’d) • • • Ig. S, Ig. D, Ig. E, Ig. G, Ig.

Abbreviations (cont’d) • • PT, pro time PTT RBC sed rate segs SMAC WBC

Review Sheet COMBINING FORMS Combining Form • • • bas/o chrom/o coagul/o cyt/o eosin/o

Review Sheet (cont’d) COMBINING FORMS Combining Form • • • bas/o chrom/o coagul/o cyt/o

Review Sheet (cont’d) COMBINING FORMS Combining Form • • • granul/o hemat/o hemoglobin/o is/o

Review Sheet (cont’d) COMBINING FORMS Combining Form • • • leuk/o mon/o morph/o myel/o

Review Sheet (cont’d) COMBINING FORMS Combining Form • • • phag/o poikil/o sider/o spher/o

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Chapter Goals • Identify terms relating to the composition, formation, and function of blood. • Differentiate among the four major blood types. • Differentiate among the different types of blood groups. • Identify terms related to blood clotting. • Build words and recognize combining forms used in blood system terminology. Copyright © 2017, 2014, 2011, 2007 Saunders, an imprint of Elsevier Inc. 3

Chapter Goals (cont’d) • Describe various pathologic conditions affecting blood. • Describe various laboratory tests and clinical procedures used with hematologic disorders, and recognize relevant abbreviations. • Apply your new knowledge to understanding medical terms in their proper contexts, such as medical reports and records. Copyright © 2017, 2014, 2011, 2007 Saunders, an imprint of Elsevier Inc. 4

Introduction Blood: transports foods, gases, and wastes to and from the cells of the body Other transported items: ØChemical messengers ØBlood proteins, white blood cells, and platelets Copyright © 2017, 2014, 2011, 2007 Saunders, an imprint of Elsevier Inc. 6

Composition of Blood • Cells – Erythrocytes – Leukocytes – Platelets • Plasma • Water • Proteins • • • Sugar Salts Hormones Lipids Vitamins Copyright © 2017, 2014, 2011, 2007 Saunders, an imprint of Elsevier Inc. 7

Cell Types and Function Cells--45% Blood Volume Erythrocytes: red blood cells transport nutrients and oxygen Leukocytes: white blood cells Thrombocytes: platelets; clot blood Copyright © 2017, 2014, 2011, 2007 Saunders, an imprint of Elsevier Inc. 8

Cell Types and Function (cont’d) Leukocytes: or white blood cells Basophils: contain heparin (prevents clotting) and histamine (involved in allergic responses) Eosinophils: phagocytic cells involved in allergic responses and parasitic infections Neutrophils: phagocytic cells that accumulate at sites of infection Monocytes: phagocytic cells that become macrophages and digest bacteria and tissue debris Lymphocytes: control the immune response; make antibodies to antigens Copyright © 2017, 2014, 2011, 2007 Saunders, an imprint of Elsevier Inc. 9

Blood Types Type A: A antigen and anti-B antibody Type B: B antigen and anti-A antibody Type AB: A and B antigens and no antibodies (universal recipient) Type O: no A or B antigens and both anti-A and anti-B antibodies (universal donor) Rh factor (positive and negative) Copyright © 2017, 2014, 2011, 2007 Saunders, an imprint of Elsevier Inc. 13

QUICK QUIZ: 1. The blood contains which of the following to transport oxygen? A. White blood cells B. Plasma C. Platelets D. Red blood cells Copyright © 2017, 2014, 2011, 2007 Saunders, an imprint of Elsevier Inc. 15

Vocabulary (cont’d) • albumin Protein in the blood; maintains the proper amount of water in blood • antibody (Ab) A specific protein produced by the lymphocytes in response to bacteria, viruses, or other antigens • antigen A substance that stimulates production of an antibody Copyright © 2017, 2014, 2011, 2007 Saunders, an imprint of Elsevier Inc. 18

Vocabulary (cont’d) • basophil White blood cell that contains granules that stain blue • bilirubin Orange-yellow pigment in bile; formed by breakdown of hemoglobin when RBCs are destroyed • coagulation Blood clotting Copyright © 2017, 2014, 2011, 2007 Saunders, an imprint of Elsevier Inc. 20

Vocabulary (cont’d) • colonystimulating factor (CSF) Protein that stimulates growth of white blood cells • differentiation The change in structure and function of a cell as it matures; specialization • electrophoresis A method of separating serum proteins by electrical charge Copyright © 2017, 2014, 2011, 2007 Saunders, an imprint of Elsevier Inc. 22

Vocabulary (cont’d) • eosinophil White blood cell that contains granules that stain red • erythroblast An immature red blood cell • erythrocyte A red blood cell Copyright © 2017, 2014, 2011, 2007 Saunders, an imprint of Elsevier Inc. 24

Vocabulary (cont’d) • erythropoietin (EPO) Hormone secreted by the kidneys that stimulates red blood cell formation • fibrin Protein that forms the basis of a blood clot • fibrinogen Plasma protein that is converted to fibrin in the clotting process Copyright © 2017, 2014, 2011, 2007 Saunders, an imprint of Elsevier Inc. 26

Vocabulary (cont’d) • globulin Plasma protein • granulocyte White blood cell with numerous dark-staining granules • hematopoietic stem cell A cell in bone marrow that gives rise to all types of blood cells Copyright © 2017, 2014, 2011, 2007 Saunders, an imprint of Elsevier Inc. 28

Vocabulary (cont’d) • hemoglobin Blood protein containing iron; carries oxygen in red blood cells • heparin An anticoagulant found in blood and tissue cells Copyright © 2017, 2014, 2011, 2007 Saunders, an imprint of Elsevier Inc. 30

Vocabulary (cont’d) • immune reaction Response of the immune system to foreign invasion • immunoglobulin A protein with antibody activity • leukocyte A white blood cell Copyright © 2017, 2014, 2011, 2007 Saunders, an imprint of Elsevier Inc. 32

Vocabulary (cont’d) • lymphocyte Mononuclear leukocyte that produces antibodies • macrophage Monocyte that migrates from the blood to tissue spaces; as a phagocyte, it engulfs foreign material and debris; destroys worn out RBCs • megakaryocyte Large platelet precursor cell found in the bone marrow Copyright © 2017, 2014, 2011, 2007 Saunders, an imprint of Elsevier Inc. 34

Vocabulary (cont’d) • monocyte Leukocyte with one large nucleus; engulfs foreign material and debris; becomes macrophage • mononuclear Pertaining to cell (leukocyte) with single round nucleus • myeloblast Immature bone marrow that gives rise to granulocytes Copyright © 2017, 2014, 2011, 2007 Saunders, an imprint of Elsevier Inc. 36

Vocabulary (cont’d) • neutrophil Granulocytic leukocyte formed in bone marrow; polymorphonuclear leukocyte • plasma Liquid portion of blood; contains water, proteins, salts, nutrients, lipids, hormones, and vitamins • plasmapheresis Removal of plasma from withdrawn blood by centrifuge Copyright © 2017, 2014, 2011, 2007 Saunders, an imprint of Elsevier Inc. 38

Vocabulary (cont’d) • platelet A small blood fragment important in clotting • polymorphonuclear Pertaining to a white blood cell with multi-shaped nucleus; neutrophil • prothrombin Plasma protein; converted to thrombin in the clotting process Copyright © 2017, 2014, 2011, 2007 Saunders, an imprint of Elsevier Inc. 40

Vocabulary (cont’d) • reticulocyte Immature erythrocyte • Rh factor Antigen on red blood cells of Rhpositive (RH+) individuals • serum Plasma minus clotting proteins and cells Copyright © 2017, 2014, 2011, 2007 Saunders, an imprint of Elsevier Inc. 42

Vocabulary (cont’d) • stem cell Unspecialized cell that gives rise to mature, specialized forms • thrombin Enzyme that converts fibrinogen to fibrin during coagulation • thrombocyte Platelets Copyright © 2017, 2014, 2011, 2007 Saunders, an imprint of Elsevier Inc. 44

Combining Forms and Terminology Combining Form. Meaning • • • bas/o chrom/o coagul/o cyt/o eosin/o erythr/o base color clotting cell red, dawn, rosy red Copyright © 2017, 2014, 2011, 2007 Saunders, an imprint of Elsevier Inc. 45

Combining Forms and Terminology (cont’d) Combining Form • • • Meaning granul/o hemat/o hemoglobin/o is/o kary/o granules blood hemoglobin same, equal nucleus Copyright © 2017, 2014, 2011, 2007 Saunders, an imprint of Elsevier Inc. 46

Combining Forms and Terminology (cont’d) Combining Form. Meaning • • • leuk/o mon/o morph/o myel/o neutr/o nucle/o white one, single shape, form bone marrow neutral nucleus Copyright © 2017, 2014, 2011, 2007 Saunders, an imprint of Elsevier Inc. 47

Combining Forms and Terminology (cont’d) Combining Form • • • phag/o poikil/o sider/o spher/o thromb/o Meaning eat, swallow varied, irregular iron globe, round clot Copyright © 2017, 2014, 2011, 2007 Saunders, an imprint of Elsevier Inc. 48

Suffixes • • • -apheresis -blast -cyte -cytosis -emia -gen -globin -globulin -lytic • • -oid -osis -penia -phage -philia -phoresis -poiesis -stasis Copyright © 2017, 2014, 2011, 2007 Saunders, an imprint of Elsevier Inc. 49

Diseases of Red Blood Cells Anemia: A deficiency in erythrocytes or hemoglobin Other types of anemia: ØAplastic anemia ØHemolytic anemia ØPernicious anemia ØSickle cell anemia ØThalassemia Copyright © 2017, 2014, 2011, 2007 Saunders, an imprint of Elsevier Inc. 51

Types of Anemia • Aplastic anemia: failure of blood cell production due to aplasia or absence of cell formation of bone marrow cells • Hemolytic anemia: reduction in red cells due to excessive destruction • Pernicious anemia: lack of mature erythrocytes caused by inability to absorb vitamin B 12 into the bloodstream • Sickle cell: hereditary disorder of abnormal hemoglobin producing sickle shape erythrocytes and hemolysis • Thalassemia: an inherited defect in the ability to produce hemoglobin, leading to hypochromia Copyright © 2017, 2014, 2011, 2007 Saunders, an imprint of Elsevier Inc. 52

Diseases of Red Blood Cells • Hemochromatosis: excess iron deposits throughout the body • Polycythemia vera: general increase in red blood cells Copyright © 2017, 2014, 2011, 2007 Saunders, an imprint of Elsevier Inc. 53

QUICK QUIZ: 3. What is the most common type of anemia? A. Hemolytic anemia B. Sickle cell anemia C. Iron deficiency anemia D. Aplastic anemia Copyright © 2017, 2014, 2011, 2007 Saunders, an imprint of Elsevier Inc. 54

Disorders of Blood Clotting Hemophilia: excessive bleeding caused by hereditary lack of factors VIII and IX necessary for blood clotting. Patients often bleed into weight-bearing joints, especially the ankles and knees Purpura: multiple pinpoint hemorrhages and accumulation of blood under the skin Copyright © 2017, 2014, 2011, 2007 Saunders, an imprint of Elsevier Inc. 56

Diseases of White Blood Cells Leukemia: an increase in cancerous white blood cells ØAcute myeloid leukemia (AML) ØAcute lymphoid leukemia (ALL) ØChronic myeloid leukemia (CML) ØChronic lymphoid leukemia (CLL) Copyright © 2017, 2014, 2011, 2007 Saunders, an imprint of Elsevier Inc. 57

Diseases of White Blood Cells Granulocytosis: abnormal increase in granulocytes in the blood Mononucleosis: an infectious disease marked by increased numbers of mononuclear leukocytes and enlarged cervical lymph nodes Copyright © 2017, 2014, 2011, 2007 Saunders, an imprint of Elsevier Inc. 59

Disease of Bone Marrow Cells Multiple myeloma: malignant neoplasm of bone marrow. Malignant cells (lymphocytes called plasma cells that produce antibodies) destroy bone tissue and cause overproduction of immunoglobulins, including Bence Jones protein. Copyright © 2017, 2014, 2011, 2007 Saunders, an imprint of Elsevier Inc. 60

Laboratory Blood Tests • • Antiglobulin test (Coombs test) Bleeding time Coagulation time Complete blood count (CBC) Erythrocyte sedimentation rate (ESR) Hematocrit (Hct) Hemoglobin test (H, Hgb) Partial thromboplastin time (PTT) Copyright © 2017, 2014, 2011, 2007 Saunders, an imprint of Elsevier Inc. 62

Laboratory Blood Tests (cont’d) • • • Platelet count Prothrombin time (PT) Red blood cell count (RBC) Red blood cell morphology White blood cell count (WBC) White blood cell differential Copyright © 2017, 2014, 2011, 2007 Saunders, an imprint of Elsevier Inc. 63

Clinical Procedures Apheresis: separation of blood into component parts and removal of a select part from the blood Blood transfusion: whole blood or cells taken from a donor and infused into a patient Bone marrow biopsy: microscopic examination of a core of bone marrow removed with a needle Hematopoietic stem cell transplantation: peripheral stem cells from a compatible donor administered into a recipient Copyright © 2017, 2014, 2011, 2007 Saunders, an imprint of Elsevier Inc. 64

Abbreviations (cont’d) • • • Ab ABMT ABO ALL AML ANC ASCT banda baso BMT Antibody Autologous bone marrow transplantation Four main blood types – A, B, AB, and O Acute lymphoid leukemia Acute myeloid leukemia Absolute neutrophil count Autologous stem cell transplantation Immature white blood cells (granulocytes) Basophils Bone marrow transplantation Copyright © 2017, 2014, 2011, 2007 Saunders, an imprint of Elsevier Inc. 66

Abbreviations (cont’d) • • • CBC CLL CML DIC diff EBV eos EPO ESR Fe Complete blood count Chronic lymphoid leukemia Chronic myeloid leukemia Disseminated intravascular coagulation Differential count (white blood cells) Epstein-Barr virus Eosinophils Erythropoietin Erythrocyte sedimentation rate Iron Copyright © 2017, 2014, 2011, 2007 Saunders, an imprint of Elsevier Inc. 68

Abbreviations (cont’d) • G-CSF • GM-CSF • • g/d. L GVHD HCL Hct Hgh, HGB H and H HLA Granulocyte colony-stimulating factor Granulocyte-macrophage colony-stimulating factor Gram per deciliter Graft-versus-host disease Hairy cell leukemia Hematocrit Hemoglobin and hematocrit Human leukocyte antigen Copyright © 2017, 2014, 2011, 2007 Saunders, an imprint of Elsevier Inc. 70

Abbreviations (cont’d) • • • Ig. S, Ig. D, Ig. E, Ig. G, Ig. M ITP lymphs MCHC • • • MCV MDS Mm 3 mono Polys, PMNLs Immunoglobulins Idiopathic thromocytic purpura Lymphocytes Mean corpuscular hemoglobin concentration Mean corpuscular volume Microliter Myelodysplastic syndrome Cubic millimeter Monocyte Polymorphonuclear leukocytes Copyright © 2017, 2014, 2011, 2007 Saunders, an imprint of Elsevier Inc. 72

Abbreviations (cont’d) • • PT, pro time PTT RBC sed rate segs SMAC WBC WNL Prothrombin time Partial thromboplastin time Red blood cell; red blood cell count Erythrocyte sedimentation rate Segmented, mature white blood cells Sequential Multiple Analyzer Computer White blood cell; white blood cell count Within normal limits Copyright © 2017, 2014, 2011, 2007 Saunders, an imprint of Elsevier Inc. 74

Review Sheet (cont’d) COMBINING FORMS Combining Form • • • bas/o chrom/o coagul/o cyt/o eosin/o erythr/o Meaning base color clotting cell red, dawn, rosy red Copyright © 2017, 2014, 2011, 2007 Saunders, an imprint of Elsevier Inc. 76

Review Sheet (cont’d) COMBINING FORMS Combining Form • • • granul/o hemat/o hemoglobin/o is/o kary/o Meaning _________ _________ Copyright © 2017, 2014, 2011, 2007 Saunders, an imprint of Elsevier Inc. 77

Review Sheet (cont’d) COMBINING FORMS Combining Form • • • granul/o hemat/o hemoglobin/o is/o kary/o Meaning granules blood hemoglobin same, equal nucleus Copyright © 2017, 2014, 2011, 2007 Saunders, an imprint of Elsevier Inc. 78

Review Sheet (cont’d) COMBINING FORMS Combining Form • • • leuk/o mon/o morph/o myel/o neutr/o nucle/o Meaning _________ _________ Copyright © 2017, 2014, 2011, 2007 Saunders, an imprint of Elsevier Inc. 79

Review Sheet (cont’d) COMBINING FORMS Combining Form • • • leuk/o mon/o morph/o myel/o neutr/o nucle/o Meaning white one, single shape, form bone marrow neutral nucleus Copyright © 2017, 2014, 2011, 2007 Saunders, an imprint of Elsevier Inc. 80

Review Sheet (cont’d) COMBINING FORMS Combining Form • • • phag/o poikil/o sider/o spher/o thromb/o Meaning _______________ ________ Copyright © 2017, 2014, 2011, 2007 Saunders, an imprint of Elsevier Inc. 81

Review Sheet (cont’d) COMBINING FORMS Combining Form • • • phag/o poikil/o sider/o spher/o thromb/o Meaning eat, swallow varied, irregular iron globe, round clot Copyright © 2017, 2014, 2011, 2007 Saunders, an imprint of Elsevier Inc. 82