1. Chapter 12
Blood

2. Blood Smear
Erythrocytes
Neutrophils
Platelets

3.  Introduction
A. connective tissue, mixture of cells, chemicals & fluid
B. transports substances, helps maintain homeostasis
C. includes RBCs, WBCs, platelets & plasma

4.  B. Blood Volume and Composition
1. blood hematocrit = 45% cells & 55% plasma
2. Plasma is a mixture of water, amino acids, proteins, carbohydrates, lipids, vitamins, hormones, electrolytes, and cellular wastes

5. C. Characteristics of Red Blood Cells
1. RBCs (erythrocytes): biconcave disks, contain 1/3 oxygen-carrying hemoglobin by volume
2. O2 + hemoglobin = bright red oxyhemoglobin
3. Deoxygenated blood (deoxyhemoglobin) is darker
4. RBCs discard their nuclei during development :.
cannot reproduce or produce proteins

10. D. Red Blood Cell Counts
1. 4,600,000-6,200,000 cells per mm3 for males
4,500,000-5,400,000 cells per mm3 for females
2. # of RBCs measures blood's oxygen-carrying capacity
3. Adult humans have an avg of 5L = 8% of body weight

11. E. Red Blood Cell Production and Its Control
1. Embryonic & fetal RBC production occurs in the yolk sac, liver, & spleen; after birth, it occurs in the red bone marrow
2. average life span of a RBC is 120 days
3. total # of RBC’s remains relatively constant due to a negative feedback mechanism utilizing erythropoietin (epo), released from the kidneys & liver in response to low oxygen levels

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13. F. Dietary Factors Affecting RBC Production
1. Vitamins B12 & folic acid necessary for DNA synthesis, & reproduction of all body cells, especially in hematopoietic tissue
2. Iron is needed for hemoglobin synthesis
3. deficiency in RBCs or quantity of hemoglobin = anemia

14. G. Destruction of Red Blood Cells
1. With age, RBCs become increasingly fragile & are damaged by passing through narrow capillaries
2. Macrophages in the liver & spleen phagocytize damaged RBCs
3. Hemoglobin from the decomposed RBCs is converted into heme & globin
4. Heme is decomposed into iron which is stored & recycled and biliverdin and bilirubin which are excreted in bile
Jaundice &
yellow bruises
Green bruises

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16. H. Types of White Blood Cells
1. leukocytes help to protect & defend the body against disease
2. formed from hemocytoblasts
3. 5 types, distinguished by size, granular appearance of the cytoplasm, shape of the nucleus, & staining characteristics
Neutrophils
Eosinophils
Basophils
Monocytes
Lymphocytes
Granulocytes- have granules in cytoplasm that can be seen w/ stains
Agranulocytes- do not have granules in cytoplasm

17. J. White Blood Cell Counts
1. 5,000 to 10,000 WBCs per mm3
2. differential WBC count can help pinpoint the nature of an illness, indicating whether it is caused by bacteria or viruses.
a. lists the % of the types of WBCs in a sample
b. Leukocytosis – too many WBCs (infections, vigorous exercise & loss of bodily fluids)
c. Leukopenia –too few WBCs (typhoid fever, flu, measels, mumps, chicken pox)

18. Neutrophils Granulocyte, 54-62% of leukocytes
fine granules stain purple
multilobed nucleus (2-5 segments, often C shaped)
Phagocytize bacteria, fungi & some viruses
diapedesis - squeeze btwn cells lining walls of blood vessels to attack bacteria & debris

19. Eosinophils Granulocyte, 1- 3% of leukocytes
coarse granules, stain deep red
bilobed nucleus
Moderate allergic rxns, defend against certain parasites

20. Basophils Granulocyte, < 1% of leukocytes
fewer granules, stain blue
migrate to damaged tissues, increase blood flow, release histamine to promote inflammation, heparin to inhibit blood clotting

21. Monocytes Agranulocyte, 3-9% of leukocytes largest blood cells
variably-shaped nuclei
Phagocytize bacteria & cellular debris
Can live for weeks even months
Can develop into macrophages

22. Lymphocytes Agranulocyte, 25-33% of leukocytes long-lived (years)
large round nucleus
immune responses, make some antibodies
B cells & T cells

23. Blood 45% 55% Formed elements Plasma Platelets Red blood cells
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Blood
45%
55%
Formed elements
Plasma
Platelets
Red blood cells
White blood cells
Electrolytes
Water
Proteins
Wastes
Nutrients
Gases
(4.8%)
(95.1%)
(0.1%)
(92%)
(7%)
Vitamins
Hormones
Neutrophils
Eosinophils
Basophils
Monocytes
Lymphocytes
Albumins
Globulins
Fibrinogen N2 O2
CO2
(54–62%)
(1–3%)
(<1%)
(3–9%)
(25–33%)

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26. K. Blood Platelets = thrombocytes
1. fragments of megakaryocytes
2. help repair damaged blood vessels by adhering to their broken edges
3. Normal: 130,000 to 360,000 per mm3

27. A. Plasma: clear, straw-colored fluid portion of blood
 Blood Plasma
A. Plasma: clear, straw-colored fluid portion of blood
1. mostly water, contains a variety of substances
2. transports nutrients & gases, regulate fluid & electrolyte balance, & maintains pH (bicarbonate buffer system)
Plasma Proteins
1. most abundant dissolved substances in the plasma
2. not used for energy
3. Types
a. albumins 60%, maintain osmotic pressure of blood
b. globulins 36%, alpha, beta, and gamma
i. Alpha & beta - transport lipids & fat-soluble vitamins
ii. Gamma - a type of antibody
c. fibrinogen 4%, primary role in blood coagulation
d. hormones – control physiological functions

28. Blood Plasma
straw colored
liquid portion of blood
55% of blood
14-21

29. Plasma Proteins Albumins most numerous plasma proteins
originate in liver
help maintain osmotic pressure of blood
Alpha and Beta Globulins
originate in liver
transport lipids and fat-soluble vitamins
Gamma Globulins
originate in lymphatic tissues
constitute the antibodies of immunity
Fibrinogen
originate in liver
plays key role in blood coagulation
14-22

30. 1. most important blood gases are O2 & CO2
C. Nutrients and Gases
1. most important blood gases are O2 & CO2
2. plasma nutrients include: amino acids, monosaccharides, nucleotides, & lipids
a. Since lipids are not soluble in the water of the plasma, they are surrounded by protein molecules for transport through the bloodstream as lipoproteins
b. Lipoproteins: classified based on their densities, which reflects their composition
i. Types: HDL, LDL, VLDL, & chylomicrons
D. Nonprotein Nitrogenous Substances
1. Nonprotein nitrogenous substances: amino acids, urea & uric acid
a. Urea & uric acid: by-products of protein & nucleic acid catabolism

31. Plasma Lipoproteins Chylomicrons high concentration of triglycerides
transport dietary fats to muscles and adipose cells
VLDLs
relatively high concentration of triglycerides
produced in the liver
transport triglycerides from liver to adipose cells
LDLs
relatively high concentration of cholesterol
formed from VLDLs
deliver cholesterol to various cells
HDLs
relatively high concentration of proteins
relatively low concentration of lipids
transport remnants of chylomicrons to liver
14-24

32. E. Plasma Electrolytes
1. absorbed by the intestine or are by-products of cellular metabolism
2. include sodium, potassium, calcium, magnesium, chloride, bicarbonate, phosphate, and sulfate ions
3. maintenance of osmotic pressure & pH of plasma

33.  Hemostasis A. stoppage of bleeding
1. Following injury to a vessel, three steps occur in hemostasis: vasospasm, platelet plug formation, & blood coagulation

34. B. Blood Vessel Spasm
1. Cutting a blood vessel causes the muscle in its walls to contract in a reflex, or engage in vasospasm
2. This reflex lasts only a few minutes, long enough to initiate the second and third steps of hemostasis
C. Platelet Plug Formation
1. Platelets stick to the exposed edges of damaged blood vessels, forming a net with spiny processes protruding from their membranes
2. most effective on a small vessels

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36. D. Blood Coagulation 1. most effective means of hemostasis
2. very complex, uses clotting factors
3. damaged tissues release tissue thromboplastin, which activates the first in a series of factors leading to the production of prothrombin activator
4. Prothrombin activator converts prothrombin in the plasma into thrombin. Which catalyzes a rxn that converts soluble fibrinogen into net like insoluble fibrin causing the blood cells to catch
5. Amount of prothrombin activator formed is proportional to the amount of tissue damage
7. promotes more clotting through positive feedback
8. After a clot, fibroblasts produce fibers throughout the clot
9. A clot that forms abnormally in a vessel is a thrombus; if it dislodges, it is an embolus.

37. Hemophilia Abnormal bleeding caused when blood fails to clot properly
Genetic – X chromosome, recessive, affects males
hemophilia A: missing or have low levels of clotting factor VIII (8). About 9/10 have this type
hemophilia B, missing or have low levels of clotting factor IX (9).

38. Universal Recipient Universal Donor AB+ O-
 Blood Groups and Transfusions
A. After mixed success w/ transfusions, scientists determined that blood was of different types & only certain combinations were compatible.
Universal Recipient
Universal Donor
AB+ O-

39. B. Antigens and Antibodies
1. agglutination - clumping of RBCs following transfusion
2. antigens - proteins on the surface of RBCs
antibodies – proteins carried in the plasma
Antibodies in plasma interact w/ antigens on RBCs
3. Only a few of the antigens produce transfusion rxns
a. ABO group & Rh group

40. C. ABO Blood Group
1. Type A blood: A antigens & anti-B antibodies
2. Type B blood: B antigens & anti-A antibodies
3. Type AB blood: A & B antigens, but no antibodies
4. Type O blood: no antigen, & both antibodies
5. Adverse transfusion rxns are avoided by preventing the mixing of blood that contains matching antigens & antibodies
a. Adverse reactions are due to the agglutination of RBCs

41. Antigens Located on the surface of red blood cells Blood Type
Antigens on RBCs
Antibodies in Plasma A B AB
A and B
None O

43. 1. named after the rhesus monkey
Antigen
Rh+ (have it)
Rh– (don’t have it)
E. Rh Blood Group
1. named after the rhesus monkey
2. If the Rh factor surface protein is present on RBCs, the blood is Rh+ ; otherwise it is Rh-
3. There are no corresponding antibodies in the plasma unless a person with Rh- blood is transfused with Rh+ blood; the person will then develop antibodies for the Rh factor
4. Erythroblastosis fetalis develops in Rh+ fetuses of Rh- mothers but can now be prevented
- baby #2 can be harmed

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45. RhoGam®, is given to Rh- moms after each Rh+ baby
RhoGam®, is given to Rh- moms after each Rh+ baby. It enters the mother's circulatory system & destroys any residual fetal positive RBCs that may be present in her system. This prevents her from producing anti-Rh antibodies.
Rh Pos Father +  +  or  +  - X
Rh Neg Mother -  -
1st Rh Pos Child (+  -) Rh positive RBCs from the fetus enter the mother's circulatory system. After several days, the mother begins to produce anti-Rh antibodies.
2nd Rh Pos Child (+  -) Anti-Rh antibodies from mother pass through placenta and enter fetal circulatory system. The antibodies begin clumping fetal positive RBCs.

46. 8 Possible Blood Types Blood Type White African American Hispanic
Asian
O +
37%
47%
53%
39%
O - 8% 4% 1%
A +
33%
24%
29%
27%
A - 7% 2%
0.5%
B + 9%
18%
25%
B -
0.4%
AB + 3%
AB -
0.3%
0.2%
0.1%

47. Who Can Receive Blood from Whom?
Blood Type of Recipient
Blood Type of Donor
AB+
AB- B+ B- A+ A- O+ O- x

48. Types of Anemia aplastic anemia iron deficiency anemia
bone marrow damaged
toxic chemicals
radiation
iron deficiency anemia
hemoglobin deficient
lack of iron
pernicious anemia
excess of immature RBCs
inability to absorb B12
hemolytic anemia
RBCs destroyed
toxic chemicals
sickle cell anemia
abnormal shape of RBCs
defective gene
thalassemia
hemoglobin deficient
RBCs short-lived
defective gene
14-10

49. Hemolytic Anemia Normal RBCs RBCs of person with hemolytic anemia
14-11

50. Clinical Application Leukemia Myeloid Leukemia
bone marrow produces too many immature granulocytes
leukemic cells crowd out other blood cells
anemia
bleeding
susceptible to infections
Lymphoid Leukemia
lymphocytes are cancerous
symptoms similar to myeloid leukemia
Treatments
blood transfusions
marrow transplants
anti-cancer drugs
stem cell transplants
14-36

51. Animations insert textbook company cd to play
Hemoglobin breakdown
Conducting System of the Heart
Cardiac Cycle
Fluid Exchange in Capillaries