1. CARDIOVASCULAR SYSTEM BLOODHEART BLOOD VESSELS

2. BLOOD Chapter 17

3. Hematology=the study of blood Click Here For a Blood Tutorial

4. CHARACTERISTICS OF BLOOD  Liquid connective tissue  4-5 times more viscous than water  Slightly alkaline  Warmer than body temperature  Volume is 4-6 liters Men=5-6 LMen=5-6 L Women=4-5 LWomen=4-5 L  Salt concentration of.85-.90%

5. CHARACTERISTICS OF BLOOD Heterogeneous mixture Heterogeneous mixture  Non-living matrix called PLASMA (55%)  Formed elements (45%)

6. PLASMA

7. FORMED ELEMENTS Erythrocytes= red blood cells (RBC) Erythrocytes= red blood cells (RBC) Leukocytes= white blood cells (WBC) Leukocytes= white blood cells (WBC) Thrombocytes= platelets Thrombocytes= platelets

8. FUNCTIONS OF BLOOD Distribution Distribution  Oxygen and carbon dioxide  Hormones  Wastes Protection Protection  Clotting mechanisms  Phagocytosis and antibody production Regulation Regulation  pH  Body temperature  Fluid and electrolyte balance

9. ERYTHROCYTE CHARACTERISTICS CHARACTERISTICS  Most numerous formed element with (4.8 to 5.4 million per mm 3 )  Very flexible  No nucleus  Biconcave disk  Life span about 120 days  Contains hemoglobin

10. HEMOGLOBIN=Transport Pigment Oxyhemoglobin Oxyhemoglobin Deoxyhemoglobin Deoxyhemoglobin Carbaminohemoglobin Carbaminohemoglobin

11. Hemoglobin values: Measured in grams per milliliter Measured in grams per milliliter 14 – 20 g/100 ml in infants 14 – 20 g/100 ml in infants 13 – 18 g/100 ml in adult males 13 – 18 g/100 ml in adult males 12 – 16 g/100 ml in adult females 12 – 16 g/100 ml in adult females

12. ERYTHROPOIESIS =PRODUCTION OF RBC OCCURS IN THE RED BONE MARROW OF FLAT BONES AND IN SOME LONG BONES

13. Regulation of Erythropoiesis Hormonal Controls Hormonal Controls –Erythropoietin –RBC and Hemoglobin amounts –Availability of oxygen Dietary Controls Dietary Controls –Adequate amino acids, lipids, and carbs –Iron –Vitamin B 12 and folic acid

14. Regulation of Erythropoiesis

15. Life Cycle of Erythrocytes

16. ERYTHROCYTE DISORDERS ANEMIA ANEMIA  Insufficient #of RBCs  Hemorrhagic anemia  Hemolytic anemia  Aplastic anemia  Low hemoglobin  Pernicious anemia - macrocytes  Iron deficiency - microcytes  Abnormal hemoglobin  Thalassemia  Sickle cell Anemia POLYCYTHEMIA POLYCYTHEMIA  Primary polycythemia  Secondary polycythemia

17. Erythrocyte Disorder

18. HEMATOCRIT 47% +/- 5% in males 47% +/- 5% in males 45% +/- 5% in females 45% +/- 5% in females

19. LEUKOCYTES CHARACTERISTICS CHARACTERISTICS  Less numerous than RBC (less than 1% of blood with normal range of 4800 – 10,800 WBC/  l)  Critical defense cells of the body  Distinct nuclei present  Capable of diapedesis  Demonstrate positive chemotaxis  Lack hemoglobin

20. TYPES OF LEUKOCYTES GRANULOCYTES GRANULOCYTES  Neutrophils (PMNs)  Eosinophils  Basophils Agranulocytes Agranulocytes  Lymphocytes  Monocytes

21. TYPES OF LEUKOCYTES

22. Mnemonic Devices: Granulated versus agranulated Granulated versus agranulated –“Every Boy Needs Mommies Love!” Relative Quantitates Relative Quantitates –“Never Let Monkeys Eat Bananas!”

23. LEUKOPOIESIS

24. LEUKOCYTE IMBALANCES Leukocytosis (amounts greater than 11,000 WBC/  l) Leukocytosis (amounts greater than 11,000 WBC/  l) Leukopenia (amounts less than 4,000 WBC/  l) Leukopenia (amounts less than 4,000 WBC/  l) Leukemia Leukemia  Acute leukemia  Chronic leukemia Infectious Mononucleosis = kissing disease Infectious Mononucleosis = kissing disease

25. THROMBOCYTES CHARACTERISTICS CHARACTERISTICS  Involved in hemostasis  Less than half the size of RBC  Numerous (250,000- 400,000 per ml 3 )  Actually cell fragments rather than true cells  Life span is about 5-9 days

26. FORMATION OF PLATELETS Regulated by thrombopoietin

27. STAGES OF BLOOD CLOTTING Step 1: Vascular spasms Step 1: Vascular spasms  Endothelin  Serotonin Step 2: Formation of a platelet plug Step 2: Formation of a platelet plug  ADP  Serotonin  Thromboxane A 2  von Willebrand factor

28. STEP 3: COAGULATION Phase 1: Formation of prothrombinase (also known as prothrombin activator) Phase 1: Formation of prothrombinase (also known as prothrombin activator) Phase 2: Conversion of prothrombin to thrombin Phase 2: Conversion of prothrombin to thrombin Phase 3: Conversion of soluble fibrinogen into insoluble fibrin Phase 3: Conversion of soluble fibrinogen into insoluble fibrin

29. Phase 1: Intrinsic versus Extrinsic Pathways

30. Phase 2 and 3:

31. CLOTTING FACTORS

32. Hemostasis Continued Clot Retraction Clot Retraction –Also known as Syneresis –Serum (plasma minus clotting factors) Repair: PDGF Repair: PDGF –Stimulates smooth muscle and fibroblast cells to divide and rebuild the wall Fibrinolysis Fibrinolysis –Plasmin = “clot buster”

33. Factors Effecting Clot Formation Normal coagulation: Normal coagulation:  Normal platelet #s  ALL clotting factors  Vitamin K  Calcium ions  TF and PF 3

34. Preventing Undesirable Clotting Nitric oxide Nitric oxide Prostacyclin (a prostoglandin) Prostacyclin (a prostoglandin) Vitamin E quinone Vitamin E quinone Heparin Heparin Anti-prothrombin III and Protein C Anti-prothrombin III and Protein C

35. PLATELET DISORDERS Thrombus Thrombus Embolus Embolus Hemophilia Hemophilia Thrombocytopenia Thrombocytopenia Impaired liver function Impaired liver function Disseminated Intravascular Coagulation (DIC) Disseminated Intravascular Coagulation (DIC)

36. Effects of Drugs on Clotting Aspirin = antiprostaglandin that inhibits thromboxane A 2 Aspirin = antiprostaglandin that inhibits thromboxane A 2 Heparin = natural anticoagulant produced by basophils and mast cells that inhibits thrombin by enhancing the activity of antithrombin III Heparin = natural anticoagulant produced by basophils and mast cells that inhibits thrombin by enhancing the activity of antithrombin III Warfarin = (a.k.a. Coumadin) interfers with the action of vitamin K Warfarin = (a.k.a. Coumadin) interfers with the action of vitamin K

37. Summary of Formed Elements

39. BLOOD TYPING Blood types are base on the presence of agglutinogens (antigens) present on the red blood cell surface. Blood types are base on the presence of agglutinogens (antigens) present on the red blood cell surface. Also, based on presence of agglutinins (antibodies) in the plasma. Also, based on presence of agglutinins (antibodies) in the plasma. The ABO and Rh systems are based on antigen- antibody type interactions. The ABO and Rh systems are based on antigen- antibody type interactions.

40. ABO BLOOD GROUPS

41. BLOOD TYPES Blood Type Type of Antigen? Type of Antibody? Receive? A A antigen Anti-B A, O B B antigen Anti-A B, O AB Both A and B antigens None A, B, AB, O ONone Both Anti-A and Anti-B O only

42. Rhesus Factor Blood Type Presence of D Antigen? Type of Antibody? Receive? Rh Positive YesNone + and - Rh Negative NoAnti-D - only

43. BLOOD GROUPS

44. Type O 45% Type A 42% Type B 10%Type AB3%

45. ABO BLOOD TYPING

46. BLOOD TYPE TUTORIAL BLOOD TYPE TUTORIAL TEST YOUR KNOWLEDGE TEST YOUR KNOWLEDGE

47. BLOOD GROUPING DISORDERS Transfusion Reaction Transfusion Reaction

48. BLOOD GROUPING DISORDERS Erythroblastosis fetalis Erythroblastosis fetalis