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Exam 2- Anatomy
Unit 8/9- Blood and Lymphatic Systems
| Question | Answer |
|---|---|
| Open vs. Closed Circulatory Systems | Insects and spiders have hemolymph ---> blood and interstitial fluid. These are combined. In humans, these are blood and interstitial fluid are separate |
| How many chambers are there in the heart? | 4 |
| Deoxygenated blood is brought back to the heart by what? | Superior and inferior vena cava |
| Where does the deoxygenated blood enter into first when delivered to the heart? | right atrium |
| Through what valve does the deoxygenated blood flow into the right ventricle from the right atrium? | right AV Valve/Tricuspid valve |
| What valve allows the blood to flow into the pulmonary artery? | semilunar valve |
| The pulmonary artery carries the deoxygenated blood where? | to the lungs |
| What do the lungs do to the deoxygenated blood? | oxygenates the blood |
| From the lungs, where does the oxygenated blood flow to? | left atrium |
| From the left atrium where does the oxygenated blood flow? | through the left AV valve/mitral valve to the left ventriclr |
| When the oxygenated blood is pumped out of the left ventricle, where does it go? | through the bicuspid valve into the aorta which carries it throughout the body |
| How does blood make its way back to the heart in the veins? | There are valves found in veins that close after blood leaves the area and it eventually makes its way back to the heart |
| What 4 components are found in the blood? | RBC (oxygen), plasma (liquid that carries nutrients), WBC (fights infection), platelets (blood clotting) |
| What 2 things are in the cardiac cycle? | systole (contracting) and diastole (relaxing) |
| How does oxygenated blood and nutrients get delivered to the heart itself? | carotid arteries on the outside of the heart |
| What are the 3 branches of the aorta? | brachiocephalic, left common carotid (brain/face), and left subclavian (left arm) |
| What are the 2 branches of the brachiocephalic? | right subclavian (right arm) and right common carotid (brain/face) |
| The immature form of all of the blood stem cells are referred to as? | blasts |
| The mature form of all of the blood stem cells are referred to as? | cytes |
| What are the 2 branches of the blood stem cell? | myeloid and lymphoid |
| What are the 3 branches of the myeloid stem cell? | RBC, Platelets, and Myeloblast |
| What is the general name of the branch of myeloblasts and what cells can be found? | granulocytes: eosinophils, neutrophils, and basophils |
| What is the branch of the lymphoid stem cell? | lymphoblast |
| From the lymphoblast, what are the 3 branches? | B lymphocyte, T lymphocyte, and natural killer cell |
| What is the branch of the B lymphocyte? | plasma cell |
| What is the normal and critical value of a leukocyte (WBC)? | Normal: 5000-10000/mm^3 Critical: 2000/mm^3 |
| What is the normal value of an erythrocyte (RBC) for men and women? | 4.5-5.5 million/mm^3 for men 4.2-4.8 million/mm^3 for women |
| What is the normal and critical value of a thrombocyte (platelet)? | Normal: 200,000-300,000/mm^3 Critical: 50,000-75,000/mm^3 |
| What is the normal value of hematocrit for men and women? | 43%-49% men 37%-43% women |
| What is the normal value of hemoglobin for men and women, and what is the critical value? | Normal: 13.5-18 g/dl for men and 12-16 g/dl for women Critical: 10 g/dl |
| Why is it bad when the WBC get below the critical value? | increased risk of infection |
| Why is it bad for platelets to be higher than the normal value and lower than the critical value? | higher: clotting/bleeding issues lower: risk of spontaneous bleeding |
| Why is bad when hemoglobin is lower than the critical value? | breathing issues due to lack of oxygen |
| What lab test is done once or twice a week for patients receiving treatments that are considered high risk? | CBC |
| What bone marrow stimulant may be given to patients? | Neupogen (Filgrastin) or Neulasta |
| Anemia | a decrease/dysfunction in the number of RBCs |
| Leukopenia | a decrease in the number of WBC |
| Leukocytosis | an above normal WBC count |
| Myelosuppression | a condition in which bone marrow activity is decreased, resulting in fewer RBC, WBC, and/or platelets |
| Neutropenia | a decrease in the number of neutrophils which may lead to a low WBC count |
| Pancytopenia | a decrease in all 3 types of blood cells---> RBC, WBC, and platelets |
| Thrombocytopenia | a decrease in the number of platelets |
| Myeloma | neoplastic disease of plasma cells |
| Lymphoma | neoplastic disease of mature lymphocytes in lymphoid tissue |
| Acute leukemia | neoplastic disease of immature cells (blasts) in the bone marrow |
| Chronic leukemia | neoplastic disease of mature WBC in the bone marrow |
| T or F. It is possible for Chronic Myeloid Leukemia to transform into acute myeloid leukemia. | True |
| Myeloproliferative disease | group of neoplastic disorders involving the bone marrow cells that produce RBC, platelets, or fibroblasts |
| What are 3 myeloproliferative dieases? | polycythaemia rubra vera, essential thrombocythaemia, and myelofibrosis |
| Myelodisplasia | pre-cancerous disease of bone marrow, where the dysplastic cells may cause abnormal or inadequate blood cell production |
| What age group is myelodisplasia most common? | elderly |
| What kind of disease is leukemia classified as? | systemic disease of the blood cells |
| T or F. With acute leukemia, there is an increased risk of infection. | True |
| Most childhood leukemias are what? | acute lymphocytic/blastic leukemia (ALL) |
| With chronic leukemia, the patients are asymptomatic. | Yes |
| Most adult leukemias are what? | chronic lymphocytic leukemia (CLL) |
| What does myeloid leukemia affect? | the myeloid line of cells ---> WBCs |
| What does lymphocytic/blastic leukemia affect? | the lymphoid line of blood cells ---> lymphocytes |
| Explain how leukemia is diagnosed. | Diagnosed via blood counts, bone marrow biopsy, and occasionally the CSF through a spinal tap |
| Where do platelets come from? | fragments of the megakaryocyte |
| Where do the t lymphocytes mature? | the thymus gland |
| What is the most common cancer diagnosed in children younger than 15? | leukemia |
| More than half of all leukemia cases occur in people older then what age? | 65 |
| Where is the incidence of leukemia higher? | Australia, New Zealand, North America, and Western Europe |
| Are males or females more often affected by leukemia? | males |
| Name 4 possible causes of leukemia. | 1.) chemotherapy drugs 2.) radiation therapy 3.) genetic disorders (Down's syndrome) 4.) family hx |
| What is the main treatment for leukemia? | chemotherapy |
| What could happen in conjunction with high dose chemotherapy to treat leukemia? | bone marrow (or peripheral blood stem cell) transplant |
| What is done before a bone marrow (or peripheral blood stem cell) transplant and why? | total body irradiation because you want to eliminate as much bone marrow as possible |
| Plasma cells are differentiated ___-cell lymphocytes. | B |
| With myeloma, plasma cells sometimes are activated to produce M protein which could result in what? | - frequent infections - bone problems (pain from lytic lesions) - reduced kidney function - anemia |
| Myeloma is most often diagnosed after what age? | 65 |
| Are males or females most likely to be diagnosed with myeloma? | males |
| What race is myeloma twice as common in? | African Americans |
| There are no known causes to myeloma, but what are some possible risk factors? | - plasma cell disease - obesity - family hx |
| How does plasmacytoma present itself in the body? | solitary lesion -- isolated disease |
| What percentage of plasmacytomas develop into myeloma? | 60% |
| What is a normal treatment for plasmacytoma? | 4000-4500 cGy in 4-5 weeks via customized fields |
| How does multiple myeloma present itself in the body? | multiple lesions -- widespread disease |
| Is multiple myeloma treated as a curative or palliative case? | palliative |
| What is a normal treatment for multiple myeloma? | 3000 cGy in 2 weeks |
| **Watch the immune system video. Slide 19. | |
| **Watch the lymphatic system video. Slide 20. | |
| ______ of the lymph nodes are found in the head and neck. | 1/3 |
| Describe how infected nodes present. | -soft -tender -movable - < 2 cm |
| Describe how malignant nodes present. | -firm -non-tender -fixed - > 2 cm |
| The _________ node is the first lymph node into which a tumor drains. | sentinel |
| Sentinel node biopsy | surgical procedure used to determine if cancer has spread beyond a primary tumor into the lymphatic system |
| Sentinel node biopsy is used most commonly for evaluating which 2 types of cancer? | breast cancer and melanoma |
| Why is the sentinel biopsy done? | to prevent excessive removal of lymph nodes which could lead to secondary lymphedema |
| Carcinomas typically spread through what type of cells? | epithelial |
| How does the lymphatic system aid in the spread of cancer throughout the body? | the lymphatic system regulates fluids and filters harmful substances. They may inadvertently deliver cancer cells to other parts of the body through lymphatic channels or by dumping cancerous cells into the blood stream |
| What lymphatics does malignant testicular cancer spread to? | lymphatics in the abdomen |
| What 2 categories are lymphomas divided into? | Hodgkin's Disease and Non-Hodgkin's Lymphoma |
| What cells are identified to confirm Hodgkin's Disease? | Reed-Sternberg cells |
| Does Hodgkin's Disease follow a predictable progression? | Yes, and it is treatable and controllable |
| What age is Hodgkin's Disease most commonly diagnosed? | early adulthood (15-35) |
| A second peak of occurrence does happen with Hodgkin's disease, but at what age? | after age 55 |
| Is Hodgkin's Disease more common in males or females? | slightly more common in males |
| What are some etiological factors of Hodgkin's disease? | - family hx of HD - Epstein-Barr virus -immunosuppression |
| How does Hodgkin's Disease usually present itself? | painless mass in the neck; possibly fever, weight loss, night sweats, and pruritis |
| When treating Hodgkin's Disease with radiation therapy what field/s are involved? | the primary site of cancer and the next nodal group that it will spread to (**remember this is the predictable spreading of nodal groups**) |
| What staging system is used for Hodgkin's Disease and explain how it works. | Ann Arbor system and it is based on nodal involvement (above or below the diaphragm); also, A (absence) vs. B (presence) of symptoms |
| Name the old chemotherapy regimens used to treat Hodgkin's Disease. | *MOPP* ---> mustergen, oncovin, procarbazine, prednisone |
| Name the new chemotherapy regimens used to treat Hodgkin's Disease. | *ABVD* ---> adraimycin, bleomycin, vincristine, dacarbazine |
| With Non-Hodgkin's Lymphoma being a vast array of diseases, what percent do B-cell and T-cells represent? | B-cell ---> 85% T-cell ---> 15% |
| T or F. Non-Hodgkin's Lymphoma can affect any of the lymphatic tissues. | Yes, there is no predictibility with this disease. |
| How is Non-Hodgkin's Lymphoma classified? | based on how quickly the tumor is growing - low grade (indolent) OR high grade (aggressive) |
| Non-Hodgkin's Lymphoma can develop at any age but what percentage of cases are seen after age 65? | more than 50% |
| Non-Hodgkin's Lymphoma is more common in males or females? | slightly more common in males |
| What race is Non-Hodgkin's Lymphoma more commone in? | White population |
| Name the etiological factors of Non-Hodgkin's Lymphoma. | - radiation exposure - immunosuppression - autoimmune disease - Epstein-Barr virus - obesity - chemical exposure (benzene, herbicides, pesticides) |
| When a Non-Hodgkin's Lymphoma occurs as a CNS lymphoma, the majority are what cell type and are located where? | B-cell type and located supratentorially |
| Metastasis process. | Cancer cell invasion and migration, intravasation, circulation, extravasation, and secondary site colonization. |
| The 3 natural routes of spread are what? | - local - blood - lymph |
| The 1 unnatural route of spread is what? | - seeding |
| Examples of the natural routes of spread. | - local: brain tumors - lymph: carcinomas/adenocarcinomas (epithelial/glandular epithelial tissue) - blood: sarcomas (connective tissue) |
| Spine TD 5/5 | 4500 |
| Brain TD 5/5 | 6000 |
| Heart TD 5/5 | 4000 |
| Stomach TD 5/5 | 5000 |
| Lung TD 5/5 | 1750 |
| Liver TD 5/5 | 3000 |
| Small Intestine TD 5/5 | 4000 |
| Esophagus TD 5/5 | 5500 |
Created by:
lheard
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