Fig Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. © National Cancer Institute/Science Photo Library/Photo Researchers, Inc. SEM 2600x (a)

Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. Percentage by body weight Percentage by volume Plasma (percentage by weight) Albumins 58% Globulins 38% Fibrinogen 4% Ions Nutrients Waste products Gases Regulatory substances White blood cells Neutrophils 60%–70% Lymphocytes 20%–25% Monocytes 3%–8% Eosinophils 2%–4% Basophils 0.5%–1% Red blood cells 4.2–6.2million Formed elements 45% Buffy coat Plasma 55% Proteins 7% Water 91% Other solutes 2% Formed elements (number per cubic mm) Platelets 250–400 thousand White blood cells 5–10 thousand (left): © liquidlibrary/PictureQuest RF Fig. 11.1

Fig Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. a: © National Cancer Institute/Science Photo Library/Photo Researchers, Inc. Red blood cell White blood cell Platelet SEM 2600x (a) (b) Top viewSide view 7.5 µm 2.0 µm

Red Blood CellBiconcave disk; no nucleus; contains hemoglobin, which colors the cell red; 6.5–8.5 µm in diameter Transports oxygen and carbon dioxide TABLE 11.2Formed Elements of the Blood Cell TypeIllustrationDescriptionFunction Table Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.

Fig Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. Stem cell (hemocytoblast) MegakaryoblastMonoblastProerythroblastMyeloblastLymphoblast Early erythroblast Progranulocyte Megakaryocyte Intermediate erythroblast Basophilic myelocyte Eosinophilic myelocyte Neutrophilic myelocyte Megakaryocyte breakup Platelets Nucleus extruded Immature red blood cell Basophilic band cell Eosinophilic band cell Neutrophilic band cell Monocyte LymphocyteNeutrophilEosinophilBasophilRed blood cell AgranulocytesGranulocytes White blood cells Late erythroblast

Fig Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. Increased blood oxygen Decreased blood oxygen Kidney Red blood cells Increased red blood cell production Red bone marrow Increased erythropoietin

Fig Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display Heme Kidney In macrophages, the globin part of hemoglobin is broken down to individual amino acids (red arrow) and metabolized or used to build new proteins. The heme of hemoglobin releases iron. The heme is converted into bilirubin. Blood transports iron to the red bone marrow, where it is used to produce new hemoglobin (green arrows). Blood transports bilirubin (blue arrows) to the liver. Bilirubin is excreted as part of the bile into the small intestine. Some bilirubin derivatives contribute to the color of feces. Other bilirubin derivatives are reabsorbed from the intestine into the blood and excreted from the kidneys in the urine. Intestines Bilirubin in bile Liver Red blood cell production Red blood cells 120 days in general circulation Aged, abnormal, or damaged red blood cells Macrophage in spleen or liver Hemoglobin Globin Amino acids Bilirubin Iron Bilirubin in blood Bilirubin derivatives in blood Iron

Fig. 11.6

Table Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. Red Blood CellTransports oxygen and carbon dioxide White Blood CellsFive types of white blood cells, each with specific functions Nucleus with two to four lobes connected by thin filaments; cytoplasmic granules stain a light pink or reddish purple; 10–12 μm in diameter Phagocytizes microorganisms and other substances Nucleus with two indistinct lobes; cytoplasmic granules stain blue-purple; 10–12 μm in diameter Nucleus often bilobed; cytoplasmic granules stain orange-red or bright red; 11–14 μm in diameter Participates in inflammatory response of allergic reactions and asthma; attacks certain worm parasites Lymphocyte Nucleus round, kidney-shaped, or horseshoe-shaped; contains more cytoplasm than does lymphocyte; 12–20 μm in diameter Phagocytic cell in the blood; leaves the blood and becomes a macrophage, which phagocytizes bacteria, dead cells, cell fragments, and other debris within tissues TABLE 11.2Formed Elements of the Blood Cell TypeIllustrationDescriptionFunction Granulocytes Basophil Eosinophil Agranulocytes Monocyte Spherical cells with a nucleus Neutrophil Biconcave disk; no nucleus; contains hemoglobin, which colors the cell red; 6.5–8.5 µm in diameter Releases histamine, which promotes inflammation, and heparin, which prevents clot formation Produces antibodies and other chemicals responsible for destroying microorganisms; contributes to allergic reactions, graft rejection, tumor control, and regulation of immune system Round nucleus; cytoplasm forms a thin ring around the nucleus; 6–14 μm in diameter

Fig Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. (a)(b)(c)(d)(e) LM 1200x (a-e): © Ed Reschke/Peter Arnold Inc./Photolibrary.com

Fig. 11.6

Table 11.2 Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. Red Blood CellTransports oxygen and carbon dioxide White Blood CellsFive types of white blood cells, each with specific functions Nucleus with two to four lobes connected by thin filaments; cytoplasmic granules stain a light pink or reddish purple; 10–12 μm in diameter Phagocytizes microorganisms and other substances Nucleus with two indistinct lobes; cytoplasmic granules stain blue-purple; 10–12 μm in diameter Nucleus often bilobed; cytoplasmic granules stain orange-red or bright red; 11–14 μm in diameter Participates in inflammatory response of allergic reactions and asthma; attacks certain worm parasites Lymphocyte Nucleus round, kidney-shaped, or horseshoe-shaped; contains more cytoplasm than does lymphocyte; 12–20 μm in diameter Cell fragment surrounded by a plasma membrane and containing granules; 2–4 μm in diameter Round nucleus; cytoplasm forms a thin ring around the nucleus; 6–14 μm in diameter TABLE 11.2Formed Elements of the Blood Cell TypeIllustrationDescriptionFunction Granulocytes Basophil Eosinophil Agranulocytes Monocyte Platelet Forms platelet plugs; releases chemicals necessary for blood clotting Spherical cells with a nucleus Neutrophil Biconcave disk; no nucleus; contains hemoglobin, which colors the cell red; 6.5–8.5 µm in diameter Releases histamine, which promotes inflammation, and heparin, which prevents clot formation Produces antibodies and other chemicals responsible for destroying microorganisms; contributes to allergic reactions, graft rejection, tumor control, and regulation of immune system Phagocytic cell in the blood; leaves the blood and becomes a macrophage, which phagocytizes bacteria, dead cells, cell fragments, and other debris within tissues

Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. Percentage by body weight Percentage by volume Plasma (percentage by weight) Albumins 58% Globulins 38% Fibrinogen 4% Ions Nutrients Waste products Gases Regulatory substances White blood cells Neutrophils 60%–70% Lymphocytes 20%–25% Monocytes 3%–8% Eosinophils 2%–4% Basophils 0.5%–1% Red blood cells 4.2–6.2million Formed elements 45% Buffy coat Plasma 55% Proteins 7% Water 91% Other solutes 2% Formed elements (number per cubic mm) Platelets 250–400 thousand White blood cells 5–10 thousand (left): © liquidlibrary/PictureQuest RF Fig. 11.1

Fig Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. 0 Hematocrit scale Hematocrit tube Plasma White blood cells and platelets form the buffy coat. Red blood cells FemaleMale Withdraw blood into hematocrit tube Centrifuge blood in the hematocrit tube

Fig Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. Platelet adhesion occurs when von Willebrand factor connects collagen and platelets. During the platelet release reaction, ADP, thromboxanes, and other chemicals are released and activate other platelets. Platelet aggregation occurs when fibrinogen receptors on activated platelets bind to fibrinogen, connecting the platelets to one another. The accumulating mass of platelets forms a platelet plug ADP Thromboxane Platelet Granules von Willebrand factor Collagen Platelet plug Smooth muscle cell Endothelial cell Blood vessel wall Fibrinogen receptor 2

Fig Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. 1 1 Inactive clotting factors in the plasma are activated by exposure to connective tissue or by chemicals released from tissues. Through a series of reactions, the activated clotting factors form prothrombinase. Stage 1 Injury to vessel Connective tissue exposed; chemicals released Inactive clotting factors Calcium and platelet chemicals Prothrombinase Active clotting factors

Fig Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display Inactive clotting factors in the plasma are activated by exposure to connective tissue or by chemicals released from tissues. Through a series of reactions, the activated clotting factors form prothrombinase. Prothrombinase converts prothrombin to thrombin. Stage 1 Stage 2 Injury to vessel Connective tissue exposed; chemicals released Inactive clotting factors Calcium and platelet chemicals Prothrombinase Active clotting factors ThrombinProthrombin

Fig Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display Inactive clotting factors in the plasma are activated by exposure to connective tissue or by chemicals released from tissues. Through a series of reactions, the activated clotting factors form prothrombinase. Thrombin converts fibrinogen to fibrin (the clot). Prothrombinase converts prothrombin to thrombin. Stage 1 Stage 2 Stage 3 Injury to vessel Connective tissue exposed; chemicals released Inactive clotting factors Calcium and platelet chemicals Prothrombinase Active clotting factors Thrombin Prothrombin Fibrin (clot) Fibrinogen

Fig Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display Thrombin and tissue plasminogen activator convert inactive plasminogen into plasmin. Plasmin breaks down the fibrin in a blood clot, resulting in clot fibrinolysis. Thrombin and tissue plasminogen activator PlasminPlasminogen Fibrin breaks down (clot fibrinolysis). Fibrin (clot)

Fig Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. Red blood cells with type A surface antigens and plasma with anti-B antibodies Red blood cells with type B surface antigens and plasma with anti-A antibodies Red blood cells with neither type A nor type B surface antigens but both anti-A and anti-B plasma antibodies Red blood cells with both type A and type B surface antigens and neither anti-A nor anti-B plasma antibodies Neither antigen A nor B Antigens A and BAntigen BAntigen A Red blood cells Plasma Anti-B antibodyAnti-A antibodyAnti-A and anti-B antibodies Neither anti-A nor anti-B antibodies Type AType BType ABType O

Fig Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. (a) No agglutination reaction. Type A blood donated to a type A recipient does not cause an agglutination reaction because the anti-B antibodies in the recipient do not combine with the type A antigens on the red blood cells in the donated blood. (b) Agglutination reaction. Type A blood donated to a type B recipient causes an agglutination reaction because the anti-A antibodies in the recipient combine with the type A antigens on the red blood cells in the donated blood. + + Type A blood of donor Anti-A antibody in type B blood of recipient Agglutination Antigen and antibody match. No agglutination Antigen and antibody do not match. Anti-B antibody in type A blood of recipient Type A blood of donor

Fig Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. Before or during delivery, Rh- positive red blood cells from the fetus enter the blood of an Rh= negative woman through a tear in the placenta. The mother is sensitized to the Rh antigen and produces anti-Rh antibodies. Because this usually happens after delivery, the fetus is not affected in the first pregnancy. During a subsequent pregnancy with an Rh-positive fetus, Rh-positive red blood cells cross the placenta, enter the maternal circulation, and stimulate the mother to produce antibodies against the Rh antigen. Antibody production is rapid because the mother has been sensitized to the Rh antigen. The anti-Rh antibodies from the mother cross the placenta, causing agglutination and hemolysis of fetal red blood cells, and hemolytic disease of the newborn (HDN) develops Maternal circulation Maternal Rh-negative red blood cell Anti-Rh antibodies Maternal circulation Maternal Rh-negative red blood cell Fetal Rh-positive red blood cell in the maternal circulation Maternal circulation Maternal anti-Rh antibodies cross the placenta. Agglutination of fetal Rh-positive red blood cells leads to HDN. Fetal Rh-positive red blood cell