BMS PPT 1 Quiz

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Questions and Answers

What is the primary function of the tunica media in blood vessels?

Regulates blood pressure and flow through contraction and relaxation. (correct)

Anchors the vessel to surrounding tissues.

Provides a smooth lining for blood flow.

Protects the vessel from damage and infection.

What is the main difference between the systemic and pulmonary circulation?

Systemic circulation carries oxygenated blood, while pulmonary circulation carries deoxygenated blood.

Systemic circulation is responsible for delivering nutrients to all organs, while pulmonary circulation is responsible for delivering oxygen to the lungs.

Systemic circulation originates from the left ventricle, while pulmonary circulation originates from the right ventricle.

All of the above. (correct)

What is the role of the lymphatic system in the circulatory system?

The lymphatic system helps filter waste products from the blood.

The lymphatic system is involved in the immune response and fluid balance in the body. (correct)

The lymphatic system is responsible for the production of blood cells.

The lymphatic system transports blood directly to the heart.

Which of these is NOT a component of the cardiovascular system?

Lymphatic vessels (B) Signup and view all the answers

How do veins prevent backflow of blood?

Veins have valves that prevent blood from flowing back towards the heart. (A) Signup and view all the answers

Which layer of a blood vessel is responsible for anchoring the vessel to the surrounding tissues?

Tunica adventitia (C) Signup and view all the answers

In which type of circulation does blood travel from the heart to the lungs and back?

Pulmonary Circulation (A) Signup and view all the answers

What is the primary function of the lymphatic system?

To return interstitial fluid to the circulatory system and provide immune protection. (B) Signup and view all the answers

Which of the following blood vessels carries oxygenated blood from the lungs to the heart?

Pulmonary vein (A) Signup and view all the answers

What is the correct pathway of blood flow through the systemic circulation?

Left ventricle - aorta - arteries - capillaries - veins - vena cava - right atrium (B) Signup and view all the answers

What is the function of the inferior vena cava?

Carries deoxygenated blood from the legs and lower body to the heart. (B) Signup and view all the answers

Which of the following is a primary lymphatic organ?

Bone marrow (D) Signup and view all the answers

What is the role of the pulmonary trunk?

It carries deoxygenated blood from the right ventricle to the lungs. (D) Signup and view all the answers

Which blood vessel carries blood from the heart to the body?

Aorta (A) Signup and view all the answers

Which of the following is NOT part of the systemic circulation?

Pulmonary artery (C) Signup and view all the answers

What is the function of the brachiocephalic vein?

Carries deoxygenated blood from the head and arms to the heart. (B) Signup and view all the answers

What is the order of lymph fluid flow from the interstitial fluid to the subclavian veins?

Interstitial fluid --> lymphatic capillaries --> afferent lymphatic vessels --> lymph nodes --> efferent lymphatic vessels --> lymphatic trunks --> lymphatic ducts --> subclavian veins (D) Signup and view all the answers

Which of the following is NOT a lymphatic trunk?

Axillary trunk (C) Signup and view all the answers

What is the primary function of red bone marrow?

Producing formed elements of the blood (B) Signup and view all the answers

Where is bone marrow located in an adult?

Both A and B (C) Signup and view all the answers

Which of the following is NOT true about the transport of dietary fats?

Dietary fats are transported in the blood. (B) Signup and view all the answers

What is the role of the lymph nodes in the transport of dietary fats?

Lymph nodes filter the lymph, removing any foreign particles or bacteria. (C) Signup and view all the answers

What is true about the lymph?

Lymph is essentially plasma without the plasma proteins. (C) Signup and view all the answers

What is the relationship between the lymphatic system and the circulatory system?

The lymphatic system drains into the circulatory system. (A) Signup and view all the answers

What is the function of the cisterna chyli?

Both A and B (A) Signup and view all the answers

A patient presents with a bleeding disorder caused by a deficiency in vitamin C. Which aspect of the coagulation process is primarily affected by this deficiency?

Platelet adhesion and aggregation (C) Signup and view all the answers

Which of the following components of blood is responsible for the transport of oxygen from the lungs to the tissues?

Red blood cells (B) Signup and view all the answers

A patient presents with a low platelet count. Which of the following conditions is most likely to be observed in this patient?

Prolonged bleeding time (B) Signup and view all the answers

Which of the following statements accurately describes the function of the buffy coat in a centrifuged blood sample?

It is a thin layer composed of white blood cells and platelets. (A) Signup and view all the answers

Which of the following is NOT a function of blood plasma?

Production of hormones (D) Signup and view all the answers

In a centrifuged blood sample, which component occupies the largest volume?

Plasma (B) Signup and view all the answers

Which of the following scenarios would NOT contribute to a decrease in blood viscosity?

Increased red blood cell count (A) Signup and view all the answers

How does the body regulate its pH balance when the blood becomes acidic?

Increased excretion of carbon dioxide by the lungs (D) Signup and view all the answers

Which of the following best describes the role of megakaryocytes in platelet production?

Megakaryocytes release platelets into the circulation. (B) Signup and view all the answers

Which of the following processes is NOT directly involved in clot retraction?

Fibrinolysis (B) Signup and view all the answers

Which of the following disorders are directly impacted by a deficiency in Vitamin K?

Hemophilia B (A) Signup and view all the answers

Which of the following disorders has both an autosomal dominant and an autosomal recessive form?

Hemophilia C (A) Signup and view all the answers

Which of the following proteins is NOT directly involved in the process of fibrinolysis?

Thrombin (D) Signup and view all the answers

Which of the following statements about the coagulation cascade is TRUE?

It is a highly regulated process with both pro-coagulant and anti-coagulant mechanisms. (C) Signup and view all the answers

Which of the following is NOT a characteristic of an autosomal recessive disorder?

There is a 50% chance that a child of two carriers will inherit the disorder. (C) Signup and view all the answers

Study Notes

Heme/Onc/ID Basic Medical Science I

This is a basic medical science course
Junqueira's Basic Histology (15th Edition) by Anthony L. Mescher is a relevant textbook

Objectives

BMS 0.1: Identify anatomic features, correlate with spatial relationships, and diagram anatomic position (sagittal, coronal, transverse).
BMS 0.4: Identify structures and characterize relationships of body systems (integumentary, fascia, mucous/serous membranes, skeletal, muscular, cardiovascular, lymphoid, nervous).
BMS 1.1: Identify basic structures, functions, and relationships of bone marrow derivatives (erythrocytes, leukocytes, thrombocytes) in the skeletal system.
BMS 1.2: Describe cell nomenclature leading to erythrocyte production.
BMS 1.3: Characterize hematopoiesis (erythrocytes, leukocytes, thrombocytes) in terms of environment, cytokines, nutrition, differentiation/proliferation, and maturation sequence.
BMS 1.4: State erythrocyte lifespan, describe cell removal, hemoglobin production/breakdown, and bilirubin metabolism.
BMS 1.5: Define MCV (mean corpuscular volume) and differentiate microcytosis, normocytosis, and macrocytosis.
BMS 1.11: Describe the molecular basis for activation, progression, and control of hemostasis processes (vascular constriction, platelet adhesion, coagulation [intrinsic & extrinsic pathways], fibrinolysis, von Willebrand factor).
BMS 1.12: Define the role of vitamin K and calcium in coagulation.

Circulation System

Consists of cardiovascular system, heart, blood vessels, and lymphatic system.

Cardiovascular/Circulatory Vessels

Structures and function of arteries, arterioles, capillaries, venules, and veins are discussed.
Diagrams illustrate pathways, showing the direction of blood flow through these vessels.
Details about the structure of blood vessels, including tunica intima, tunica media, and tunica externa.
Information is presented using diagrams and labels.
Detailed description and diagrams of venous return and blood flow mechanisms.
Description and diagrams for understanding the relationship between pulmonary and systemic circulation and the role of the heart, lungs, and major blood vessels in each circulation.
Diagrams and labels to explain names of major blood vessels in the systemic circulation.
Diagrams and labels to show how blood flows from the body to the lungs and back to the body.

Lymphatic System

Functions include interstitial fluid return, immune protection (primary and secondary lymphoid organs), and transport of dietary fats.
Shows different structures like lymph vessels, lymphatic tissue, primary lymphatic organs, secondary lymph structures.

Skeletal System

Bone marrow (red and yellow) is located inside bones.
Red bone marrow produces formed elements.
Yellow bone marrow can be converted back to red bone marrow.
Bones Function in protection, support (collagen & calcium-phosphate salts), levers for movement, mineral storage, and hematopoiesis.

Red Blood Cell Production

Fetal (yolk sac, liver, spleen, lymph nodes) and postnatal (bone marrow) stages of red blood cell production are explained.
Details on bone marrow production of blood cells throughout life stages.

Blood

Specialized connective tissue with cells suspended in a fluid matrix (extracellular matrix).
Described five primary functions: transporting substances, regulating pH/ions, restricting fluid loss, defending against toxins/pathogens, and stabilizing body temperature.
Three general characteristics: temperature (38°C/100.4°F), volume (7% of body weight), high viscosity (~45% solids).
Composition (plasma—water, plasma proteins, other solutes; formed elements—red blood cells, white blood cells, platelets).

Centrifuged Blood

Fractionation of blood into plasma, buffy coat, and erythrocytes.
Percentage composition of each fraction is explained.

Plasma

Similar to interstitial fluid and lymph but contains plasma proteins.
Makes up 55% (50-60%) of blood volume.
Consists primarily of water.
Contains three classes of plasma proteins (albumins, globulins, fibrinogen).

Three Classes of Plasma Proteins

Albumins: transport water-soluble substances, lipid-soluble substances, and hormones.
Globulins: transport hormones, metalloproteins, lipoproteins, and antibodies.
Fibrinogen: important in blood clotting; upon activation, it converts to fibrin.

Composition of Blood Plasma

Composition details of electrolytes, nutrients, respiratory gases, and wastes within plasma.

Platelets (Thrombocytes)

Cell fragments formed in bone marrow.
Function in the blood clotting system.
Involved in releasing granules upon contact with collagen, involved in circulation, and removal by the spleen.
A portion of platelets remain for emergencies.

Role of Platelets

Role in forming a fibrin network (water-insoluble clot), covering platelet plugs, trapping blood cells, and sealing off areas.
Includes discussion of clot retraction, clot removal, and platelet production.

Platelet Production

Occurs in bone marrow, under hormonal control (thrombopoietin, interleukin-6, multi-CSF).
Megakaryocytes (giant cells) manufacture platelets.
Platelets released into circulation.

Hemostasis

Process of stopping bleeding.
Involves vascular, platelet, and coagulation phases.
Detailed descriptions of each phase are included.
Mechanisms for clot retraction and lysis are outlined.

Coagulation Phase

Forming a fibrin network to halt bleeding.
Twelve clotting factors (proteins or ions in plasma) are detailed, including their role in normal clotting, and production (liver, platelets), and their function in different pathways.
Description of the cascade reactions (extrinsic, intrinsic, common pathways) for clotting.
Key players and interactions in each pathway are explained.

Pro vs Anti-Blood Clot

Thrombogenic and antithrombogenic site factors are compared.
Table presenting factors involved in these processes.

Plasma Clotting Factors

A table representing each factor, name, and pathway.
This table aids in understanding the various factors involved.

Coagulation Phase (cont.)

Discusses blood clotting (coagulation), the process of converting soluble fibrinogen into insoluble fibrin, and why fibrin needs to be water-insoluble for clot formation.
Bleeding time—normal duration of bleeding stoppage in response to a small puncture wound—is also explained.

Cascade Reactions

Explains the chain reactions of enzymes and proenzymes forming the three pathways (intrinsic, extrinsic, common).
Discussion on the critical role of calcium ions (Ca²⁺) and Vitamin K in clotting.

Three Coagulation Pathways (Extrinsic Pathway)

Details on the pathway initiation in blood vessel walls (outside bloodstream)
Release of tissue factor (TF) from damaged cells and its role in forming an enzyme complex.
TF along with other compounds forms an enzyme complex to activate factor X of the common pathway.

Extrinsic Pathway (cont.)

Discusses activation of Factor VII to Factor VIla by tissue factor.
Factor X activation (along with Calcium and Factor Va) leads to the formation of Prothrombin activator.

Three Coagulation Pathways (Intrinsic Pathway)

Explanation on the pathway initiation with circulating proenzymes stimulated by collagen or platelets.
Series of reactions activating factor X and the common pathway.

Intrinsic Pathway (cont.)

Explains activation of Factor XII (Hageman factor) and associated platelet activation.
Sequential activation of factors XI, IX, and VIII, culminates in Factor X activation preparing for common pathway activation.

Coagulation Pathway (Common Pathway)

Explains the convergence points for both intrinsic and extrinsic pathways.
Discusses crucial actions of activated Factor X, including the activation of prothrombin to thrombin.
The final step converts fibrinogen into fibrin by thrombin, forming a stable fibrin clot for hemostasis.

PT vs PTT

Discusses Prothrombin time (PT) & partial thromboplastin time (PTT) lab measurements used to assess bleeding time.
How PT assesses the extrinsic pathway (VII) and common pathway, and PTT assesses the intrinsic pathway (XII, XI, IX, VIII) and common pathway.

Functions of Thrombin (IIa)

Functions of thrombin in converting fibrinogen to fibrin and cross-linking fibrin.
Thrombin's positive feedback loops involving factors V, VIII, and XI and the acceleration of clotting.
Thrombin functions as an anticoagulant by binding to thrombomodulin and activating protein C; this activated protein C will inhibit factors V and VIII, thereby helping regulate clotting activity.

Thrombi & Emboli

Defines thrombus as an abnormal clot, and embolus as a clot that moves in the circulatory system.
Causes of thromboembolic conditions are listed.

Bleeding Disorders

Categorizes bleeding disorders by vessel defects (Vitamin C deficiency, bacterial/viral infections), platelet disorders (thrombocytopenia, thrombocytopathy), and genetic factors.

Vessel Wall Abnormalities: Pathogenesis

Normal healthy endothelial cells are anti-thrombotic and help prevent abnormal clot formation, but abnormal or stimulated endothelium becomes pro-thrombotic and activates coagulation pathways.
Endothelial cells secrete vasoconstrictors to further activate platelets.

Three Types of Formed Elements

Describes the three blood components:
- Red blood cells (RBCs) or erythrocytes for oxygen transport
- White blood cells (WBCs) or leukocytes that are part of the immune system
- Platelets or thrombocytes involved in the blood clotting process

Hemostasis (cont.)

Explanation of the three phases of hemostasis (vascular, platelet, and coagulation).

Upon chemical and physical damage of endothelial cells..

Explains activation of thrombocytes when endothelial cells contract causing the exposure of the basal lamina to bloodstream, release chemical factors (ADP, tissue factor, prostacyclin, local hormones, endothelins) , this stimulates smooth muscle contractions and cell division.

Two Steps of the Platelet Phase

Platelet adhesion (attachment) to sticky endothelial surfaces, basal laminae, and collagen fibers.
Platelet aggregation (sticking together) to form a platelet plug that closes small breaks.

Activated Platelets (Aggregation)

Details on cell-to-cell adhesion and release of clotting compounds (ADP, Thromboxane A2, Serotonin, clotting factor, PDGF, Calcium ions, von Willebrand's factor, Platelet receptor Glycoprotein IIb/IIIa).

Platelet Plug: Size Restriction

Prostacyclin released by endothelial cells inhibits platelet aggregation.
Other inhibitory compounds released by white blood cells.

Hypocoagulable States

Excess bleeding conditions arising from deficiencies in platelet number/function, deficiencies in pro-coagulation proteins, and overproduction of anti-coagulation proteins.

Genetic Hypocoagulopathies

Defects in von Willebrand factor, Factor VIII, Factor IX and Factor XI, and potential hereditary disorders are detailed

Autosomal Dominant (AD) Disorders

Details several inherited disorders, describing the associated genes, traits, and risks.

X linked Recessive (XR) Disorders

Details several X-linked recessive inherited disorders associated with the afflicted gene, traits, and potential risks

Autosomal Recessive (AR) Disorders

Discusses several autosomal recessive traits including their inheritance, gene involvement, potential complications, and underlying mechanisms.

Clotting Control

Discusses mechanisms and inhibitors that control clotting, including clot retraction/lysis, fibrinolysis processes to dissolve clots, role of plasminogen activator, and breakdown of fibrin strands by plasmin.

Thrombocytopenia

Describes the condition of having an inadequate number of platelets, including possible causes from autoimmune diseases, drug-induced conditions, bone marrow failure, and hyper-splenism.

Thrombocythemia (Thrombocytosis)

Describes thrombocythemia/thrombocytosis as a condition marked by abnormally high platelet numbers.
Conditions resulting from the overproduction of inflammatory cytokines and mutated progenitor cells are detailed.
Further details with causes include reactions to underlying conditions, such as acute blood loss, allergic reactions, and some malignancies.

Reactive Thrombocytosis

Details the condition defined by elevated platelet counts triggered by underlying conditions (e.g., acute blood loss, allergic reactions, cancer, chronic kidney disease, exercise, infectious diseases).

Thrombocytopathy

Describes the condition of having adequate platelets but abnormal function, leading to prolonged bleeding time and/or bleeding tendencies, and including possible drug-induced cases, bone marrow failure, and hypersplenism.

Secondary (Acquired) Thrombophilia

Describes heparin-induced thrombocytopenia (HIT) syndrome caused by antibody formation to platelet factor IV and heparin complexes.

Disseminated Intravascular Coagulation (DIC)

Describes the spread of clots within blood vessels leading to both thrombosis and bleeding due to active coagulation and abnormalities in fibrinolysis.
Underlying conditions leading to DIC (e.g., severe sepsis, trauma, OB complications).
Explains the pathophysiology of the condition, including consumption of clotting factors, and production of micro-clots.

Coagulation Cascade (cont.)

Explains further details of the intrinsic and extrinsic pathways, showing the convergence steps.

– Also details clotting regulation factors (anti-coagulation proteins, protein C, protein S, or anti-thrombin III).

Prevention of Blood Clotting

Details on mechanisms, including endothelial factors, removal of factors, thrombin inhibitors, and effects of heparin
Role of prostacyclin for inhibiting platelet aggregation.

Hypercoagulability States

Describes situations leading to increased platelet function and increased clotting activity, such as increased platelet responses to stimuli, inflammation, or damage, leading to thrombosis.

Primary Thrombophilia

Details conditions associated with a tendency towards clot formation, including Factor V Leiden, protein deficiencies (e.g., protein C, protein S, antithrombin) and elevated levels of factors I, VIII, IX, & X.

Factor V Leiden

Describes the genetic disorder affecting Factor V, leading to reduced anticoagulant function and increased risk of blood clots.
Inheritance pattern (autosomal dominant).

Protein S deficiency

Describes the hereditary condition resulting from deficiency of Protein S that impairs regulation of blood clot formation.

Protein C deficiency

Describes a hereditary condition where Protein C activity is reduced, increasing blood clot formation risk.
Includes acquired cases.
Explanations on the process and potential impact.

Inherited Thrombophilias: Antithrombin Deficiency

Describes how Antithrombin III (ATIII) inhibits the coagulation cascade by inactivating thrombin and factor Xa.
The role of heparin in increasing this activity.

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Test your knowledge of the circulatory system with this quiz that covers key concepts such as blood vessels, the lymphatic system, and the differences between systemic and pulmonary circulation. Enhance your understanding of how the cardiovascular system functions and its various components.