Allied Health Sciences I Instructor: Melissa Lewis Hematology Allied Health Sciences I Instructor: Melissa Lewis

How much blood does an average adult have in their body? Eight to Ten pints (8-10) Four to Five Quarts (4-5)

Functions of the Blood: Transporting fluid of the body Carries nutrients from digestive tract to cells Carries waste products from cells to excretory organs Carries hormones and other chemical substances that control proper functioning

Functions of the Blood Cont: Controls body temperature by circulating excess heat to body surfaces and to lungs, through which it is lost. Circulates antibodies and defensive cells throughout body to combat infection and disease.

Objective 1H07. 01: Explain the structure of the blood Blood composition: Blood is made up of plasma, which is the liquid portion of the blood without the cellular elements and the celluar elements which are: 1. Erythrocytes (RBC’s) 2. Leukocytes (WBC’s) 3. Thrombocytes (platelets)

Plasma: Liquid portion of the blood Makes up 55% of the blood volume

Plasma Contains the following Substances: 1. Water which is 92%of the total volume of plasma. 2. Blood proteins-hemoglobin is a protien found in red blood cells. 3. Nutrients- also part of the blood plasma are the nutrient molecules such as glucose, fatty acids, cholesterol, and amino acids that are absorbed from the digestive tract

Cont… 4. Electrolytes- Sodium Chloride (NaCl) and potassium (K) are the most abundant electrolytes 5. Hormones, Vitamins, and enzymes help the body with it’s chemical reactions and are found in very small amounts in the blood plasma. 6. Metabolic waste products- these are carried by the blood plasma to the various excretory organs.

Cont… 7. Plasma proteins- Fibrinogen, serum albumin, and serum globulin are the three most abundant proteins in plasma. A. Fibrinogen- is the protein synthesized by the liver than is necessary for blood clotting B. Albumin- is the protein also synthesized by the liver that maintains the blood’s osmotic pressure and volume. It is the most abundant of the plasma proteins. C. Globulin- formed in the liver and lymphatic system. It has two parts- Gamma globulin is necessary for the synthesis of antibodies to fight organisms. Prothrombin is the other part that is formed continuously in the liver, which helps bloods to coagulate. Vitamin K helps in the synthesis of prothrombin.

Cont… 7. Plasma proteins- Fibrinogen, serum albumin, and serum globulin are the three most abundant proteins in plasma. A. Fibrinogen- is the protein synthesized by the liver than is necessary for blood clotting B. Albumin- is the protein also synthesized by the liver that maintains the blood’s osmotic pressure and volume. It is the most abundant of the plasma proteins. C. Globulin- formed in the liver and lymphatic system. It has two parts- Gamma globulin is necessary for the synthesis of antibodies to fight organisms. Prothrombin is the other part that is formed continuously in the liver, which helps bloods to coagulate. Vitamin K helps in the synthesis of prothrombin.

Red Blood Cells (RBC’s): Called erythrocytes Biconcave Disc-shaped cells Look like donuts Thin in the middle & thicker on the outer edges

Hemoglobin: Red pigment of erythrocyte Composed of a protein molecule called globin and an iron compound called heme. Transports oxygen to tissues and carbon dioxide from tissues Normal Hemoglobin Levels for men =14-18 grams per 100 cc, women = 12-16 grams/100cc

Hemoglobin cont: The RBC’s pick up oxygen from capillaries in lungs as we inhale. The oxygen chemically combines with hemoglobin forming compound oxyhemoglobin. The RBC’s carry the oxyhemoglobin to capillaries of body tissues and releases the oxygen. The carbon dioxide that is formed is picked up by plasma and the RBC’s circulate back to lungs to give up the carbon dioxide and absorb more oxygen. We exhale the carbon dioxide.

Hemoglobin cont: The blood cells of the arteries (except pulmonary artery) carry oxyhemoglobin. This gives blood it’s bright red color. The blood cells of the veins (except pulmonary veins) contain carbominohemoglobin, which is responsible for the dark, crimson-blue color characteristic of venous blood.

Carbon Monoxide Poisoning: Is a serious and sometimes fatal condition. It is an odorless gas present in the exhaust of gasoline engines. Carbon monoxide rapidly combines with hemoglobin; and it binds at the same site on the hemoglobin molecule as oxygen. It crowds the oxygen out. Symptoms are headache, dizziness, drowsiness, and unconiousness.Death can occur.

Carbon monoxide poisoning cont… One should remember that the gas is odorless. It is also present in gas furnaces and gas or oil-fired space heaters. Always allow plenty of ventilation. There are commercial carbon monoxide detectors available to measure for carbon monoxide.

Erythropoiesis: Erythropoiesis is the manufacture of RBC’s. Until adolescence RBC’s are formed in the red marrow of the bones. After adolescence RBC’s are formed in the short and flat bones. RBC’s come from stem cells in the red bone marrow called hemocytoblasts. As it matures into an erythrocyte, it loses it’s nucleus and cytoplasmic organelles. The hemocytoblasts gains hemoglobin and develops into the biconcave shape and enters into the bloodstream.

Cont… Erythrocytes only live 120 days. At the cells age they deteriorate. They are broken down by the spleen and liver. Hemoglobin breaks down into the globin and heme and the iron content of heme is used to make new red blood cells Normal RBC count for men=4.5 to 6.2 Normal RBC count for women=4.2 to 5.4

White blood cells (Leukocytes): Granular or agranular, translucent, and ameboid in shape. Much larger than RBC’s Two major groups: granulocytes and agranulocytes Granulocytes are formed in the red marrow from cells called myeoblasts. Their life span is usually only a few days but does vary.

Three types of Granulocytes: Neutrophils: Phagocytize (surround, engulf, and digest harmful bacteria) bacteria with lysosomal enzymes Eosinophils: Phagocytize antibody-antigen reactions. Also increase allergic conditions. Basophils: Phagocytize. Their count increases during chronic inflammation and during healing of an infection. They produce histamine, which is a vasodilator, and heparin, an anticoagulant.

Agranulocytes: Divided into lymphocytes and monocytes

Lymphocytes: Lymphocytes are divided into B-lymphocytes and T-lymphocytes Life span ranges from few days to several years Synthesize & release antibody molecules Protect against formation of cancer cells

Monocytes: Assist with phagocytosis Able to leave the bloodstream to attach themselves to tissues When they attach themselves to tissues they become macrophages/histiocytes Macrophages/histiocytes help wall off an infected area

Inflammation: Process of our body that protects us Occurs when we have 1. chemical or physical tissue damage or 2. invasion from a microorganism Pathogen= a microorganism that is capable of causing disease

Symptoms of Inflammation: Redness Local heat Swelling Pain

Inflammation Cont… Histamine is released by basophils & this increases blood flow to the area Capillary permeability is increased Neutrophils move through the capillary walls by diapedesis and begin phagocytizing the microorganism

Inflammation Cont… Result equals combination of dead tissue, dead & living bacteria, dead leukocytes, & plasma This all looks like a cream-colored liquid (called pus) If damaged area is below the epidermis an abscess (pus filled cavity) forms If damaged area is on skin or mucosal surface it is called an ulcer

Inflammation Cont… Sometimes during inflammation process pyrogens are formed & they travel to the hypothalamus In the hypothalamus, these pyrogens affect the temperature control center which raises the body temperature causing a fever or pyrexia

Blood Clotting: Thrombocytes are blood platelets Thrombocytes are the smallest of the solid components of the blood Normal platelet count is 250,000 to 450,000 per cubic millimeter of blood

Blood Clotting Process: 1. Platelets come in contact with vessel’s collagen fibers 2. This stimulates the platelets to produce sticky projecting structures, allowing them to stick 3. A platelet plug forms to stop bleeding 4. Platelets secrete a chemical called serotonin 5. Serotonin causes blood vessel spasm which decreases blood flow 6. Clot is formed

Coagulation: Means blood clotting When blood vessel is injured platelets & injured tissue release thromboplastin Thromboplastin is a complex substance that can only allow cause coagulation if calcium ions & prothrombin are present Prothrombin is a plasma protein that is synthesized in the liver

Coagulation cont… The thromboplastin & calcium ions act as enzymes in a reaction that converts prothrombin into thrombin This occurs when there is bleeding Thrombin acts as an enzyme and changes fibrinogen into fibrin The fibrin threads layer themselves over the cut forming a network This network traps RBC’s, platelets, & plasma This creates a blood clot Serum oozes from the cut forming a scab over the fibrin threads & completes the clotting process

Coagulation cont… There are 2 anticoagulants that must be neutralized before clotting can occur They are antithromboplastin & antiprothrombin (heparin) Both of these are neutralized by thromboplastin

Coagulation cont… Prothrombin & fibrinogen are plasma proteins that are made in the liver If liver disease present, the blood clotting process will be affected Prothrombin can not be made without Vitamin K Vit K is manufactured from a type of bacteria found in the intestines

Clotting Time: Time is takes for the blood to clot Normal clotting times for humans is 5-15 minutes A person clotting time should be known prior to doing surgery

Blood Types: There are four major blood types A B AB O

Blood Types Cont… Blood type is determined by presence or absence of blood protein called agglutinogen or antigen that is on the surface of the RBC Type A blood has B antibodies Type B blood has A antibodies Type O blood has A & B antibodies Type AB contains no antibodies

Universal Donor: O blood because it has no A or B antigens O blood could be given to anyone

Universal Recipient: Type AB because has no antibodies Someone with Type AB blood could receive any of the four blood types

Rh Factor: RBC contain Rh antigen This is the Rh factor since it was found in the Rhesus monkey It is found on the surface of the RBC If it is present a person is said to be Rh positive If it is not present a person is said to be Rh negative Most Americans are Rh positive

Rh Factor cont… If a Rh negative person receives a transfusion of Rh positive blood, he or she will develop antibodies to it (takes 2 weeks to acquire new antibodies) Usually there is no problem the first transfusion If a second transfusion occurs with Rh positive blood, the new antibodies will clump with the antigens

Rh Factor & Pregnancy: This same problem can occur with a Rh negative mother who is carrying a Rh positive fetus The problem would occur with the second pregnancy The second baby’s RBC’s would clump & the baby would be born with erythroblastosis fetalis

Rh Factor & Pregnancy cont… Erythroblastosis fetalis is rare today because of a drug call RHO Gam RHO Gam is an immune globulin This injection is given to Rh negative mothers within 72 hours after delivery The antibodies in the RHO Gam will destroy any Rh positive cells of the baby’s which have entered the mother’s blood stream Therefore the mother will not produce antibodies

Disorders of the Blood: Anemia: deficiency of RBC’s & the amount of hemoglobin in the blood Iron deficiency anemia: Caused by inadequate amounts of iron in diet Pernicious anemia: Caused by deficiency of Vit B12 (Vit B12 & Folic acid are necessary for development of RBC’s

Disorders of the Blood cont… Aplastic anemia: Occurs when the bone marrow does not produce enough RBC or WBC (usually occurs in chemo or radition treatment patients) Sickle Cell Anemia: Chronic disease that is inherited from both parents RBC’s are a crescent shape (abnormal) They carry less oxygen & break easily

Disorders of the Blood cont… Cooley’s anemia: Caused by a defect in hemoglobin formation (also called thalassemia) Polycytemia: Condition of too many RBC’s are formed Embolism: Condition where a blood clot or embolus is carried by the blood stream until it reaches an artery that is too small for its passage Embolus could be made of air, cancer cells, blood clot, bacterial clumps, needle or bullet

Disorders of the Blood cont… Thrombosis: formation of a blood clot in a blood vessel Hematoma: Localized clotted mass of blood found in an organ, tissue, or space Hemophilia: Hereditary disease in which the blood clots slowly or abnormally

Disorders of the Blood cont… Thrombocytopenia: Blood disease which there is a decrease in the number of platelets Leukemia: Cancerous or malignant condition in which there is a great increase in the number of the WBC’s

Umbilical Stem Cells: There are immunity-producing stem cells found in the umbilical cord that are the same as the immunity-producing stem cells in the bone marrow Umbilical cells are easier to transplant Stem cells are young & the brand new donor has not yet developed antibodies that turn against the recipient These transplants are highly experimental & have been used mainly in children They aid in the treatment of leukemia, anemia, & Hodgkin’s disease

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