CARDIOVASCULAR SYSTEM BLOODHEART BLOOD VESSELS

BLOOD Chapter 17

Hematology=the study of blood Click Here For a Blood Tutorial

CHARACTERISTICS OF BLOOD  Liquid connective tissue  4-5 times more viscous than water  Slightly alkaline  Warmer than body temperature  Volume is 4-6 liters Men=5-6 LMen=5-6 L Women=4-5 LWomen=4-5 L  Salt concentration of %

CHARACTERISTICS OF BLOOD Heterogeneous mixture Heterogeneous mixture  Non-living matrix called PLASMA (55%)  Formed elements (45%)

PLASMA

FORMED ELEMENTS Erythrocytes= red blood cells (RBC) Erythrocytes= red blood cells (RBC) Leukocytes= white blood cells (WBC) Leukocytes= white blood cells (WBC) Thrombocytes= platelets Thrombocytes= platelets

FUNCTIONS OF BLOOD Distribution Distribution  Oxygen and carbon dioxide  Hormones  Wastes Protection Protection  Clotting mechanisms  Phagocytosis and antibody production Regulation Regulation  pH  Body temperature  Fluid and electrolyte balance

ERYTHROCYTE CHARACTERISTICS CHARACTERISTICS  Most numerous formed element with (4.8 to 5.4 million per mm 3 )  Very flexible  No nucleus  Biconcave disk  Life span about 120 days  Contains hemoglobin

HEMOGLOBIN=Transport Pigment Oxyhemoglobin Oxyhemoglobin Deoxyhemoglobin Deoxyhemoglobin Carbaminohemoglobin Carbaminohemoglobin

Hemoglobin values: Measured in grams per milliliter Measured in grams per milliliter 14 – 20 g/100 ml in infants 14 – 20 g/100 ml in infants 13 – 18 g/100 ml in adult males 13 – 18 g/100 ml in adult males 12 – 16 g/100 ml in adult females 12 – 16 g/100 ml in adult females

ERYTHROPOIESIS =PRODUCTION OF RBC OCCURS IN THE RED BONE MARROW OF FLAT BONES AND IN SOME LONG BONES

Regulation of Erythropoiesis Hormonal Controls Hormonal Controls –Erythropoietin –RBC and Hemoglobin amounts –Availability of oxygen Dietary Controls Dietary Controls –Adequate amino acids, lipids, and carbs –Iron –Vitamin B 12 and folic acid

Regulation of Erythropoiesis

Life Cycle of Erythrocytes

ERYTHROCYTE DISORDERS ANEMIA ANEMIA  Insufficient #of RBCs  Hemorrhagic anemia  Hemolytic anemia  Aplastic anemia  Low hemoglobin  Pernicious anemia - macrocytes  Iron deficiency - microcytes  Abnormal hemoglobin  Thalassemia  Sickle cell Anemia POLYCYTHEMIA POLYCYTHEMIA  Primary polycythemia  Secondary polycythemia

Erythrocyte Disorder

HEMATOCRIT 47% +/- 5% in males 47% +/- 5% in males 45% +/- 5% in females 45% +/- 5% in females

LEUKOCYTES CHARACTERISTICS CHARACTERISTICS  Less numerous than RBC (less than 1% of blood with normal range of 4800 – 10,800 WBC/  l)  Critical defense cells of the body  Distinct nuclei present  Capable of diapedesis  Demonstrate positive chemotaxis  Lack hemoglobin

TYPES OF LEUKOCYTES GRANULOCYTES GRANULOCYTES  Neutrophils (PMNs)  Eosinophils  Basophils Agranulocytes Agranulocytes  Lymphocytes  Monocytes

TYPES OF LEUKOCYTES

Mnemonic Devices: Granulated versus agranulated Granulated versus agranulated –“Every Boy Needs Mommies Love!” Relative Quantitates Relative Quantitates –“Never Let Monkeys Eat Bananas!”

LEUKOPOIESIS

LEUKOCYTE IMBALANCES Leukocytosis (amounts greater than 11,000 WBC/  l) Leukocytosis (amounts greater than 11,000 WBC/  l) Leukopenia (amounts less than 4,000 WBC/  l) Leukopenia (amounts less than 4,000 WBC/  l) Leukemia Leukemia  Acute leukemia  Chronic leukemia Infectious Mononucleosis = kissing disease Infectious Mononucleosis = kissing disease

THROMBOCYTES CHARACTERISTICS CHARACTERISTICS  Involved in hemostasis  Less than half the size of RBC  Numerous (250, ,000 per ml 3 )  Actually cell fragments rather than true cells  Life span is about 5-9 days

FORMATION OF PLATELETS Regulated by thrombopoietin

STAGES OF BLOOD CLOTTING Step 1: Vascular spasms Step 1: Vascular spasms  Endothelin  Serotonin Step 2: Formation of a platelet plug Step 2: Formation of a platelet plug  ADP  Serotonin  Thromboxane A 2  von Willebrand factor

STEP 3: COAGULATION Phase 1: Formation of prothrombinase (also known as prothrombin activator) Phase 1: Formation of prothrombinase (also known as prothrombin activator) Phase 2: Conversion of prothrombin to thrombin Phase 2: Conversion of prothrombin to thrombin Phase 3: Conversion of soluble fibrinogen into insoluble fibrin Phase 3: Conversion of soluble fibrinogen into insoluble fibrin

Phase 1: Intrinsic versus Extrinsic Pathways

Phase 2 and 3:

CLOTTING FACTORS

Hemostasis Continued Clot Retraction Clot Retraction –Also known as Syneresis –Serum (plasma minus clotting factors) Repair: PDGF Repair: PDGF –Stimulates smooth muscle and fibroblast cells to divide and rebuild the wall Fibrinolysis Fibrinolysis –Plasmin = “clot buster”

Factors Effecting Clot Formation Normal coagulation: Normal coagulation:  Normal platelet #s  ALL clotting factors  Vitamin K  Calcium ions  TF and PF 3

Preventing Undesirable Clotting Nitric oxide Nitric oxide Prostacyclin (a prostoglandin) Prostacyclin (a prostoglandin) Vitamin E quinone Vitamin E quinone Heparin Heparin Anti-prothrombin III and Protein C Anti-prothrombin III and Protein C

PLATELET DISORDERS Thrombus Thrombus Embolus Embolus Hemophilia Hemophilia Thrombocytopenia Thrombocytopenia Impaired liver function Impaired liver function Disseminated Intravascular Coagulation (DIC) Disseminated Intravascular Coagulation (DIC)

Effects of Drugs on Clotting Aspirin = antiprostaglandin that inhibits thromboxane A 2 Aspirin = antiprostaglandin that inhibits thromboxane A 2 Heparin = natural anticoagulant produced by basophils and mast cells that inhibits thrombin by enhancing the activity of antithrombin III Heparin = natural anticoagulant produced by basophils and mast cells that inhibits thrombin by enhancing the activity of antithrombin III Warfarin = (a.k.a. Coumadin) interfers with the action of vitamin K Warfarin = (a.k.a. Coumadin) interfers with the action of vitamin K

Summary of Formed Elements

BLOOD TYPING Blood types are base on the presence of agglutinogens (antigens) present on the red blood cell surface. Blood types are base on the presence of agglutinogens (antigens) present on the red blood cell surface. Also, based on presence of agglutinins (antibodies) in the plasma. Also, based on presence of agglutinins (antibodies) in the plasma. The ABO and Rh systems are based on antigen- antibody type interactions. The ABO and Rh systems are based on antigen- antibody type interactions.

ABO BLOOD GROUPS

BLOOD TYPES Blood Type Type of Antigen? Type of Antibody? Receive? A A antigen Anti-B A, O B B antigen Anti-A B, O AB Both A and B antigens None A, B, AB, O ONone Both Anti-A and Anti-B O only

Rhesus Factor Blood Type Presence of D Antigen? Type of Antibody? Receive? Rh Positive YesNone + and - Rh Negative NoAnti-D - only

BLOOD GROUPS

Type O 45% Type A 42% Type B 10%Type AB3%

ABO BLOOD TYPING

BLOOD TYPE TUTORIAL BLOOD TYPE TUTORIAL TEST YOUR KNOWLEDGE TEST YOUR KNOWLEDGE

BLOOD GROUPING DISORDERS Transfusion Reaction Transfusion Reaction

BLOOD GROUPING DISORDERS Erythroblastosis fetalis Erythroblastosis fetalis