Principles of Anatomy and Physiology Thirteenth Edition Chapter 19 The Cardiovascular System: The Blood Copyright © 2012 by John Wiley & Sons, Inc. Gerard J. Tortora Bryan H. Derrickson

Plasma (55%) Red blood cells (45%) Buffy coat, composed of white blood cells and platelets (a) Appearance of centrifuged blood

White blood cells 5000–10,000 Formed elements 45% Platelets 150,000–400,000 Red blood cells 4.8–5.4 million Neutrophils 60–70% Lymphocytes 20–25% Monocytes 3–8% Eosinophils 2–4% Basophils 0.5–1.0% PLASMA (weight)SOLUTES FORMED ELEMENTS (number per μL) WHITE BLOOD CELLSVOLUMEBODY WEIGHT Whole blood 8% Other fluids and tissues 92% Blood plasma 55% Proteins 7% Water 91.5% Other solutes 1.5% Albumins 54% Electrolytes Globulins 38% Fibrinogen 7% All others 1% Nutrients Gases Regulatory substances Waste products (b) Components of blood

White blood cell Platelet Red blood cell SEM 3500x (a) Scanning electron micrograph

White blood cell (leukocyte—monocyte) LM 400x (b) Blood smear Platelet Red blood cell (erythrocyte) Blood plasma White blood cell (leukocyte—neutrophil)

Progenitor cells Precursor cells or "blasts" Formed elements of circulating blood Tissue cells ProerythroblastMegakaryoblast Eosinophilic myeloblast Basophilic myeloblast MyeloblastMonoblast T lymphoblast B lymphoblast NK lymphoblast CFU–ECFU–MegCFU–GM CFU–Meg CFU–E Key: Colony-forming unit—erythrocyte Colony-forming unit—megakaryocyte Colony-forming unit—granulocyte macrophage Lymphoid stem cell Pluripotent stem cell Red blood cell (erythrocyte) Platelets (thrombocytes) EosinophilBasophilNeutrophilMonocyte T lymphocyte (T cell) B lymphocyte (B cell) Natural killer (NK) cell ReticulocyteMegakaryocyte Nucleus ejected Granular leukocytesAgranular leukocytes Mast cellMacrophagePlasma cell Myeloid stem cell Key:

8μm Surface view Sectioned view (a) RBC shape

Beta polypeptide chains (globins) Heme Iron (Fe 2+ ) Alpha polypeptide chains (globins) (b) Hemoglobin molecule(c) Iron-containing heme

+ + Circulation for about 120 days Reused for protein synthesis Amino acids Red blood cell death and phagocytosis Macrophage in spleen, liver, or red bone marrow Urine Kidney Feces Bacteria Large intestine Small intestine Liver Erythropoiesis in red bone marrow Erythopoietin Vitamin B 12 Key: in blood in bile Globin Transferrin Ferritin TransferrinFe 3+ Heme Biliverdin Bilirubin Urobilinogen Stercobilin Globin + Urobilin

Some stimulus disrupts homeostasis by Oxygen delivery to kid- neys (and other tissues) Receptors Kidney cells detect low oxygen level Control center Proerythroblasts in red bone marrow mature more quickly into reticulocytes Effectors Larger number of RBCs in circulation Increased oxygen delivery to tissues Return to homeostasis when oxygen delivery to kidneys increases to normal Increased erythropoietin secreted into blood Input Increased erythropoietin secreted into blood Output Decreasing

(a) Eosinophil(b) Basophil(c) Neutrophil(d) Lymphocyte(e) Monocyte LM all 1600x

Interstitial fluid Neutrophil Endothelial cell Rolling Sticking Squeezing between endothelial cells Key: Selectins on endothelial cells Integrins on neutrophil Blood flow

Neutrophils Lymphocytes Monocytes Eosinophils Basophils

Red Blood Cells (RBCs) or Erythrocytes Neutrophils Eosinophils Basophils Platelets (thrombocytes) Monocytes Lymphocytes

Red blood cell Platelet Collagen fibers and damaged endothelium 1 Platelet adhesion

Collagen fibers Liberated ADP, serotonin, and thromboxane A2 2 Platelet release reaction

Collagen fibers Platelet plug 3 Platelet aggregation

Platelet Red blood cell Fibrin threads SEM 1445x (a) Early stage

SEM 900x (b) Intermediate stage

Fibrin threads Red blood cell SEM 3400x (c) Late stage showing red blood cells trapped in fibrin threads

(a) Extrinsic pathway(b) Intrinsic pathway Blood traumaTissue trauma Damaged endothelial cells expose collagen fibers Tissue factor (TF) Damaged platelets Activated XII Activated platelets Ca 2+ Platelet phospholipids Activated X Ca 2+ PROTHROMBINASE V V Prothrombin (II) THROMBIN XIII Activated XIII Loose fibrin threads Fibrinogen (I) STRENGTHENED FIBRIN THREADS (c) Common pathway (c) Common pathway 3 2 1

BLOOD TYPETYPE ATYPE BTYPE ABTYPE O A antigenB antigenBoth A and B antigens Neither A nor B antigen Red blood cells Plasma Anti-B antibody Anti-A antibody Neither antibody Both anti-A and anti-B antibodies

Rh – mother Placenta First Rh + fetus Rh + antigens Anti-Rh antibodies Second Rh + fetus (a)First pregnancy (b) Between pregnancies (c) Second pregnancy

Anti-A serumAnti-B serum Untreated blood Treated with anti-A serum Treated with anti-B serum Blood type A B AB O

CrenatedNormalSickled SEM 1665x Red blood cells