Chapter 13 The Blood System Copyright © 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved.

In this chapter you will Identify terms related to the composition, formation, and function of blood. Differentiate between the different blood groups. Build words and recognize combining forms used in the blood system. Apply new terminology in their proper context.

Introduction – page 504 Blood: Transports foods, gases, and wastes to and from the cells of the body. Other transported items: chemical messengers (Hormones) blood proteins, white blood cells, and platelets What are chemical messengers called? (hormones) What do white blood cells do? (Fight infection) What do platelets do? (Help the blood clot) What is the medical term for WBC? (leukocyte) What is the medical term for platelet? (thrombocyte)

Composition of Blood Cells (45%) plasma water proteins sugar salts hormones vitamins What are cells? (Formed elements, suspended in a clear, straw-colored liquid called plasma) What percentage of blood volume do cells constitute? (45%. The other 55% are items listed here.)

Cell Types and Function Erythrocytes: red blood cells transport nutrients and oxygen Leukocytes: white blood cells Thrombocytes: platelets; clot blood What is an immature red blood cell called? (erythroblast) Where do erythrocytes originate? (In bone marrow) What are cells in the spleen, liver, and bone marrow that destroy worn-out erythrocytes? (macrophages) What is a phagocyte? See next slide. Review a normal differential of these cell types in a smear of whole peripheral blood.

White Blood Cells

Leukocytes: or white blood cells basophils: contain heparin (prevents clotting) and histamine (involved in allergic responses) eosinophils: phagocytic cells involved in allergic responses and parasitic infections neutrophils: phagocytic cells that accumulate at sites of infection What is an immature red blood cell called? (erythroblast) Where do erythrocytes originate? (In bone marrow) What are cells in the spleen, liver, and bone marrow that destroy worn-out erythrocytes? (macrophages) What is a phagocyte? See next slide. Review a normal differential of these cell types in a smear of whole peripheral blood.

Leukocytes monocytes: phagocytic cells that become macrophage and digest bacteria and tissue debris lymphocytes: control the immune response; make antibodies to antigens

STAGES IN BLOOD DEVELOPMENT (HEMATOPOIESIS) – page 505 Explain phagocytosis.

Review: Composition of Blood- 509 Describe each section of the chart.

Plasma Protiens albumin - maintains proper concentration of water in blood globulins: immunoglobulins (IgG,IgA, IgM, IgD, IgE) - Antibodies Fibrinogen – clotting protein Prothrombin – clotting protein What are fibrinogen and prothrombin? (Clotting proteins) What does albumin do? (Maintains the proper proportion and concentration of water in the blood) What are globulins? (Another part of the blood containing plasma proteins: alpha, beta, and gamma globulins) What are immunoglobulins? (Antibodies that bind to and sometimes destroy antigens or foreign substances, ie., IgG, IgA)

Blood Types – page 490 Type A: A antigen and anti-B antibody Type B: B antigen and anti-A antibody Type AB: A and B antigens and no antibodies (universal recipient) Why is blood type matching important for transfusions? What is Rh factor? What is the difference between Rh-positive and Rh-negative? Why is blood type matching important for identification of pregnancy? (Most people are Rh positive so problem arises with Rh negative mother with Rh positive fetus.)

Blood Types Type O: no A or B antigens and both anti-A and anti-B antibodies (universal donor) Rh factor (positive and negative)

Blood Clotting – page 510 Coagulation: fibrin clot Anti-coagulants: heparin, warfarin (Coumadin) What is blood clotting or coagulation? The final result (usually taking less than 15 minutes) is the formation of a fibrin clot from the plasma protein fibrinogen. Why are platelets important in the beginning of the process following injury to tissues or blood vessels?

QUICK QUIZ: The blood contains the following to transport oxygen: white blood cells plasma platelets red blood cells CORRECT Answer is D, red blood cells

QUICK QUIZ: 2. Blood contains these clotting cells: erythrocytes plasma thrombocytes leukocytes CORRECT Answer is C, thrombocytes

Vocabulary – page 512 Albumin – protein in blood; maintains proper amt of water in blood. Bilirubin – orange-yellow pigment in bile formed from breakdown of hemoglobin when RBC die. Coagulation – blood clotting Erythropoietin (EPO) – Hormone secreted by kidneys that stimulates the formation of RBC

Vocabulary Fibrinogen – plasma protein converted to fibrin Hemoglobin – blood protein containing iron, carries oxygen Heparin – Anticoagulant found in blood and tissue cells

Vocabulary – page 513 Plasmapheresis – removal of plasma from withdrawn blood. Donor cells and new plasma are returned back to donor.

COMBINING FORMS - page 514-515 Combining Form Meaning bas/o base chrom/o color coagul/o clotting - anticoagulant

Combining Forms and meaning Combining Form Meaning cyt/o cell – cytology eosin/o red, dawn, rosy erythr/o red - erythrocytopenia

COMBINING FORMS AND TERMINOLOGY Combining Form Meaning granul/o granules – granulocyte hem/o blood – hemolysis hemat/o blood - hematocrit

Combining Forms Combining Form Meaning hemoglobin/o hemoglobin is/o same, equal kary/o nucleus

COMBINING FORMS AND TERMINOLOGY Combining Form Meaning leuk/o white – leukocytopenia mon/o one, single morph/o shape, form

Combining Formw Combining Form Meaning myel/o bone marrow neutr/o neutral nucle/o nucleus

COMBINING FORMS AND TERMINOLOGY Combining Form Meaning phag/o eat, swallow – phagocyte poikil/o varied, irregular sider/o iron

Combining Forms spher/o globe, round thromb/o clot - thrombocytopenia Combining Form Meaning spher/o globe, round thromb/o clot - thrombocytopenia

Suffixes – page 515-516 -apheresis – remove, carry away -blast – immature cell -cyte – cell -cytosis – abnormal condition of - Ask meanings and examples of terms. What is thrombolytic therapy? (Used to dissolve clots) What is plasmapheresis? (A centrifuge spins blood to remove plasma from the other parts of the blood.)

Suffixes emia – blood condition – leukemia -globin – protein – hemoglobin -globulin – protein – immunoglobulin -lytic – destruction - thrombolytic

Suffixes -oid – derived from – myeloid -osis – abnormal condition – thrombosis -penia – deficiency – pancytopenia -phage – eat, swallow - macrophage

Suffixes philia – attraction for, increase in numbers -phoresis – carrying, transmission -poiesis – formation – hematopoiesis -stasis – stop, control - hemostasis

More Blood Terminology

anticoagulant anti- against coagul/o: clotting -ant: one who; a substance A substance that works against blood clotting

Coagulopathy Coagul/o: clotting process -pathy: disease Disease condition of the clotting process DIC is an example

hematocrit hemat/o: -crit: to seperate Separation of blood percentage of red blood cells in a given volume of blood

myeloblast myel/o: bone marrow -blast: immature cell Immature bone marrow cell

myelogenous myel/o: bone marrow -genous: pertaining to produced in Pertaining to produced in the bone marrow

neutropenia neutr/o: neutral -penia: deficiency Deficiency in neutrophils A granulocyte with neutral staining granules

thrombocytopenia thromb/o: clot cyt/o: cell -penia: deficiency Deficiency of clotting cells

plasmapheresis plasm/o: plasma -apheresis: removal, carry away Removal of plasma from the rest of the blood by mechanical means (centrifuge)

hemoglobin hem/o: blood -globin: protein Blood protein in erythrocytes; enables the cell to carry oxygen H&H

thrombolytic therapy thromb/o: blood clot -lytic: destroy Therapy: treatment Treatment to destroy blood clots

pancytopenia pan-: all cyt/o -penia Deficiency of all (blood) cells

hemostasis hem/o -stasis: stop, control Stoppage of blood

Diseases of Red Blood Cells- p. 517 Anemia: deficiency in erythrocytes or hemoglobin aplastic anemia – failure in production hemolytic anemia – excessive destruction pernicious anemia- lack of mature erythrocytes caused by inability to absorb vitamin B12 What is the most common type of anemia? (Iron-deficiency anemia) What is an example of hemolytic anemia? (Congenital spherocytic anemia) B12 cannot be absorbed into the bloodstream with the aid of which substance? (Intrinsic factor, which is normally found in gastric juice.)

Anemia Sickle cell anemia – inherited condition characterized by abnormal sickle shape of erythrocytes and hemolysis Thalassemia – Inherited defect in the ability to produce hemoglobin, usually seen in persons of Mediterranean background

hemochromatosis: Excess iron deposits throughout the body. polycythemia vera: General increase in red blood cells. Persons of what background are prone to thalassemia? (Mediterranean) Sickle cell is prevalent among which group? (Black people of African or African-American ancestry) Why? (Sickling is a genetic response to malaria.) What treatment is used for polycythemia vera? How is this similar to doping?

QUICK QUIZ: 3. What is the most common type of anemia? hemolytic anemia sickle cell anemia iron deficiency anemia aplastic anemia CORRECT Answer is C, iron deficiency anemia (see page 498 of text)

Types of Anemia

Disorders of Blood Clotting – p. 519 hemophilia: Excessive bleeding caused by one of the protein substances necessary for blood clotting. purpura: Multiple pinpoint hemorrhages and accumulation of blood under the skin. What is a treatment for hemophilia? (Administration of the deficient factor) What is autoimmune thrombocytopenic purpura? (A condition in which a patient’s body makes an antibody that destroys platelets)

Diseases of White Blood Cells- 520 leukemia: An increase in cancerous white blood cells. acute myelogenous leukemia (AML) acute lymphocytic leukemia (ALL) chronic myelogenous leukemia (CML) chronic lymphocytic leukemia (CLL) What are characteristics of acute leukemia? What form of leukemia is most often in children and adolescents? (ALL) What form of leukemia usually occurs in the elderly and follows a slowly progressive course? (CLL)

Acute Leukemia Acute Myeloblastic Leukemia Acute Lymphoblastic Leukemia The terms acute and chronic discriminate between leukemias of primarily immature and mature leukocytes.

Diseases of White Blood Cells (cont’d.) granulocytosis: Abnormal increase in granulocytes in the blood. mononucleosis: An infectious disease marked by increased numbers of leukocytes and enlarged cervical lymph nodes. How is mononucleosis usually transmitted? (By oral contact) Is treatment necessary for EBV infections? (No) What is eosinophilia? (An increase in eosinophilic granulocytes, seen in certain allergic conditions)

Disease of Bone Marrow Cells p. 522 multiple myeloma: Malignant neoplasm of bone marrow. Malignant cells destroy bone tissue and cause overproduction of immunoglobulins. The malignant cells destroy bone tissue and cause the overproduction of immunoglobulins, including Bence Jones protein. What is Bence Jones protein? (An immunoglobulin fragment found in urine) How is this treated?

Laboratory Blood Tests – p. 522 antiglobulin test bleeding time coagulation time complete blood count (CBC) erythrocyte sedimentation rate (ESR) – rate at which RBCs settle out of plasma. Elevated ESR is a sign of infection, joint inflammation, and tumor What is a normal coagulation time? (Less than 15 minutes) What is the speed at which erythrocytes settle out of plasma? (ESR or sed rate) What test finds the total amount of hemoglobin in a sample of peripheral blood? (hemoglobin test)

Laboratory Blood Tests – p. 523 hematocrit (Hct) - % of RBCs in a volume of blood. Low levels indicate bleeding or increased destruction of RBCs. hemoglobin test (H, Hg, HGB)- Low levels effect the bodies ability to carry oxygen to the tissues. partial thromboplastin time (PTT) – ability of blood to clot

Laboratory Blood Tests (cont’d.) platelet count prothrombin time (PT) red blood cell count (RBC) red blood cell morphology white blood cell count (WBC) white blood cell differential What is the number of leukocytes per cubic millimeter or microliter? (WBC) What determines the percentage of the total WBC made up by different types of leukocytes? (White blood cell differential)

Clinical Procedures p. 524 apheresis: Separation of blood into component parts and removal of a select part from the blood. blood transfusion: Whole blood or cells are taken from a donor and infused into a patient. What is plasma exchange? (A procedure in which plasma is removed from the patient and fresh plasma is given) What is autologous transfusion? (The collection and later reinfusion of a patient’s own blood or blood components) What is a bone marrow aspirate? (When bone marrow is removed by brief suction produced by a syringe)

Clinical Procedures bone marrow biopsy: Microscopic examination of a core of bone marrow removed with a needle. hematopoietic stem cell transplant: Peripheral stem cells from a compatible donor are administered into a recipient’s vein. (Bone Marrow Transplant)

Stem Cell Research Stem Cells are crucial to develop organisms. They are nonspecialized cells which have the potential to create other types of specific cells, such as blood-, brain-, tissue- or muscle-cells. Some types of stem cells may be able to create all other cells in the body. Others have the potential to repair or replace damaged tissue or cells.

Stem Cell Transplant

Abbreviations – See page 525-526

REVIEW SHEET COMBINING FORMS bas/o base chrom/o color coagul/o clotting cyt/o cell eosin/o red, dawn, rosy erythr/o red Combining Form Meaning

REVIEW SHEET COMBINING FORMS granul/o granules hem/o blood hemat/o blood hemoglobin/o hemoglobin is/o same, equal kary/o nucleus Combining Form Meaning

REVIEW SHEET COMBINING FORMS leuk/o white mon/o one, single morph/o shape, form myel/o bone marrow neutr/o neutral nucle/o nucleus Combining Form Meaning

REVIEW SHEET COMBINING FORMS phag/o eat, swallow poikil/o varied, irregular sider/o iron spher/o globe, round thromb/o clot Combining Form Meaning