Blood and Lymphatic


Normal Composition


55% fluid: water and dissolved solutes45% cells and formed elemetns: RBC, WBC, thrombocytes (platelets)


Hematocrit


thickness of bloos # of cells per volume of blood Too high indicates dehydration or increased cell productionHigh Hematocrit = increased stress on heart and increased blood clotting


Hemoglobin


the portion of the mature RBC that is to carry O2


Plasma


clear yellow fuild after cells are removed


Serum


Fluid and solutes remaining after cells and fibrinogen have been removed


Components Required for Blood Clotting


Ca ionsVitamin KClotting Factors produced by the liver


Three steps in Blood Clotting


Immediate VasoconstrictionThrombocytes adhere to underlying tissue - if small vessels forms platelet plugIf large Vessels coagulation mechanism needed (pg 248 in book)


Blood Types


O: universal bonor (lacks A & B antigens)A:B:AB: univeral recipent


Diagnostic Tests


CBC: complete blood countDifferential count: % of each type of WBCHematocrit: RBC's per volume in %Hemoglobin: amount of hgb per cellReticulocyte count, bone marrow aspiration and biopsy: used to confirm abnormal production of blood cells (leukemia)Chemical analysis of blood: (O2, CO2, enzymes)


How Clotting disorders are diagnosised


Bleeding TimeProthrombin time (PT): extrinsic pathwayPartial Thromboplastin time (PTT): intinsic pathwayINR: extrinsic pathway


Blood Therapies


Blood transfusions: whole blood, packed RBC's or packed platelets (administered with severe anemia of thrombocytopenia)Plasma or collaidal volume expanding solutions: high hematocritArtificial blood productsProducts to stimulate formation of RBC's Bone Marrow or stem cell transplants


Lymphatic System


Functions to return excess interstitial fluid & protein to the blooddefense system by filtering out the bad and returing the goodconsists of vessels, nodes, lymphoid tissue (tonsils, spleen, thymus)essential for the proper function of immune systemIf the lymphatic system isn't working the blood values may be off


Types of Anemia


Iron DeficiencyPerniciousAplasticSickle CellThalassemia


Iron Deficiency


low iron in diet; especially in puberty, pregnancy, or with excess blood flow


Pernicious


Deficiency in vitamin B12; during pregnancy can lead to spina bifida


Aplastic


decreased WBC decreased RBC platelets due to damaged bone marrow, virus or idiopathicRBC's are abnormal and large


Sickle Cell


Abnormal Hgn when deoxygenated takes a sickle shopa Genetic recessiveIncreased risk of CVA, Mi by occluding arteriesPainfull Crises


Thalassemia


genetic defect that results in decreased amount of Hgb & RBC's produced


Signs and Symptoms of Anemia


Fatigue, pallor, dyspnea, tachycardia (can progress to arhythmis/death) cold intolerance


Diagnosis of Anemia


Blood TestsHctHbgBlood smears


Treatment for Anemia


depends of causeDiet (iron & pernicious)Blood TransfusionsBone Marrow transplant


Polycythemia


increased production of RBC's, other cells in bone marrow, blood volume & viscosity increase, increased chance for MI


Signs and Symptoms of Polycythemia


cyanotic, bluish red skin, enlarged blood vessels, enlarged liver, spleen, heart, increased BP, Spleen & Liver Congestion


Diagnosis & Treatment for Polycythemia


Diagnosis: Cell countsHgb, HctTreatment: drugs, radiation to suppress bone marrow, plebotomy (removal of blood periodically)


Hemophelia A


Etiology: deficit of normal clotting factorsS&S: prolonged or severe hemorrhage, spontaneous hemarthosisDiagnosis: increased PTT, APPT & coagulation timeThese people need to aviod risky behaviors


Disseminated Intravascular Coagulation


a compication of numerous primary problems. for example OB compications, carcinomas, major trauma, chronic DIC often due to chronic infection


Signs and Symptoms of DIC


excessive bleeding and excessive clotting, more often hemorrhage is critical problem. Low BP, Respiratory impairments, seizures and decreased responviveness


Treatment for DIC


Treat the underlying causetreamtent of coagulation imblance is very difficult. Pt is monitored very carefully


Leukemia


Pathology: WBC's that are undifferentiated immature, non functional multiply uncontrollablyS&S: unresponsive infection, excess bleeding, signs of aneamia, bone pain Wt. loss and fatigueDiagnosis: blood counts, smearsTreatment: chemo, maintain nutritions, transfusions, bone marrow transplantTherapy: indurance and bone pain


Hodgkins Lyphoma


starts as single lymph node, spreadsS&S; enlarged lymph nodes, spleen = pressure effects generals signs of cancer. recurrent infection due to affect on immune systemRx: surgery, chemo, radiationif caught early good prognosis


Non-Hodgkins Lymphoma


Starts as enlarged painless lymph nodeMultiple node involvement scattered throughout body non-organized pattern of widespread metastasesClinical signs staging and treatment similar to hodgkins lymphoma