1. Hematology and Immunology
Hematology is the medical specialty that studies the anatomy and physiology of the blood and uses diagnostic tests, medical and surgical procedures, and drugs to treat blood diseases. 1

2. Hematology and Immunology
Immunology is the medical specialty that studies the anatomy and physiology of the lymphatic system and uses diagnostic tests, medical and surgical procedures, and drugs to treat lymphatic and immune response diseases. 2

3. Figure 6-1 Lymphatic system3

4. Anatomy and Physiology (cont’d)
The Blood
Contains blood cells, blood cell fragments, water, and other substances (proteins, clotting factors, etc.)
Transports oxygen, carbon dioxide, nutrients, and waste products
Contains cells that also function as part of the immune system 4

5. Anatomy and Physiology (cont’d)
The Lymphatic System
Consists of the lymphatic vessels, lymph fluid, lymph nodes, lymphoid tissues, and lymphoid organs
Forms a pathway throughout the body that is separate from that of the cardiovascular system that contains the blood
Defends the body against microorganisms and cancerous cells 5

6. Anatomy of the Blood Plasma
Clear, straw-colored liquid (about 90% water) that makes up 55% of the blood.
The formed elements of the blood (erythrocytes, leukocytes, and platelets) are suspended in the plasma. 6

7. Anatomy of the Blood (cont’d)
Plasma (cont’d)
Contains substances the body produces itself such as: albumin, bilirubin, hormones, complement proteins, and clotting factors.
Contains creatinine and urea, which are waste products of cellular metabolism. 7

8. Figure Plasma 8

9. Anatomy of the Blood (cont’d)
Erythrocytes
Most numerous of the formed elements in the plasma
Red blood cell that is a round, somewhat flattened, red disk
Unique because, unlike other body cells, they have no cell nucleus when they are mature 9

10. Figure 6-3 Hematopoiesis.10

11. Andrew Syred/Photo Researchers, Inc.
Figure Erythrocytes
Andrew Syred/Photo Researchers, Inc. 11

12. Anatomy of the Blood (cont’d)
Erythrocytes (cont’d)
Contain hemoglobin, a red, iron-containing molecule that binds to oxygen molecules to form oxyhemoglobin.
Hemoglobin carries oxygen from the lungs to every cell in the body, and carries carbon dioxide from the cells back to the lungs.
Hematopoiesis, the process by which all blood cells are formed, occurs in the red marrow of long or flat bones. 12

13. Anatomy of the Blood (cont’d)
Erythrocytes (cont’d)
Very immature cells are known as stem cells.
Erythrocyte stem cells mature to become erythroblasts and then normoblasts. 13

14. Anatomy of the Blood (cont’d)
Erythrocytes (cont’d)
Do not have a nucleus, so they cannot divide or repair themselves.
Last 120 days before they begin to deteriorate.
Specialized cells (macrophages) break down erythrocytes’ hemoglobin into heme and globins. 14

15. Anatomy of the Blood (cont’d)
Erythrocytes (cont’d)
Iron stripped from heme molecules is stored in the liver and the spleen; the remainder of heme molecules is converted to bilirubin.
Bilirubin plays an important role as an antioxidant, protecting body cells from damage by free radicals. 15

16. Anatomy of the Blood (cont’d)
Leukocytes
White blood cells that include five types of cells (neutrophils, eosinophils, basophils, lymphocytes, and monocytes)
Can be identified by the presence or absence of granules in their cytoplasm and the shape of their nucleus 16

17. Anatomy of the Blood (cont’d)
Leukocytes (cont’d)
Leukocytes with large granules in their cytoplasm are categorized as granulocytes, which include neutrophils, eosinophils, and basophils.
Leukocytes with few or no granules in their cytoplasm are categorized as agranulocytes, which include lymphocytes and monocytes. 17

18. Anatomy of the Blood (cont’d)
Neutrophils
Most common leukocyte, making up 40 to 60% of leukocytes in blood
Categorized as granulocytes
Nucleus has many segments or lobes, so they are also known as polymorphonucleated leukocytes (PMNs), polys, segs, or segmenters 18

19. Anatomy of the Blood (cont’d)
Neutrophils (cont’d)
Develop in the red marrow
Engulf and destroy bacteria (phagocytosis)
Live only a few days or even just a few hours if they are actively destroying bacteria 19

20. Renumber as Fig. 6-5.
Figure Neutrophil 20

21. Anatomy of the Blood (cont’d)
Eosinophils
Make up just 1 to 4% of leukocytes
Categorized as granulocytes; also known as eos
Nucleus has two lobes
Develop in the red marrow
Engulf and destroy foreign cells (pollen, animal dander, etc.)
Release chemicals that kill parasites 21

22. Renumber as Fig. 6-6
Figure Eosinophil 22

23. Anatomy of the Blood (cont’d)
Basophils
Least common leukocyte, making up 0.5 to 1% of leukocytes
Categorized as granulocytes; also known as basos
Nucleus has more than one lobe
Develop in the red marrow
Release histamine at the site of tissue injury
Release heparin, an anticoagulant 23

24. Renumber as Fig. 6-7.
Figure Basophil 24

25. Anatomy of the Blood (cont’d)
Lymphocytes
Make up 20 to 40% of leukocytes.
Categorized as agranulocytes and are the smallest leukocytes; they are also known as lymphs.
Nucleus is round and nearly fills the cell.
Some lymphocytes live for just a few days, while others live for many years. 25

26. Anatomy of the Blood (cont’d)
Lymphocytes (cont’d)
Begin development in red marrow; some become B cells or natural killer cells; others migrate to the thymus to become T cells
Present in the blood and lymph nodes; destroy viruses and produce antibodies 26

27. Renumber as Fig. 6-8.
Figure Lymphocyte 27

28. Anatomy of the Blood (cont’d)
Monocytes
Make up 2 to 4% of leukocytes
Categorized as agranulocytes and are the largest leukocytes; also known as monos
Have a large amount of cytoplasm, and nucleus is large and kidney bean shaped
Develop in the red marrow 28

29. Anatomy of the Blood (cont’d)
Monocytes (cont’d)
Are phagocytes that engulf and destroy microorganisms, cancerous cells, dead leukocytes, and cellular debris.
Monocytes in the lymph nodes, intestine, liver, pancreas, thymus, spleen, bone, and skin are known as macrophages. 29

30. Figure Monocyte 30

31. Table 6-1 Leukocyte Types and Characteristics31

32. Table 6-1 (continued) Leukocyte Types and Characteristics32

33. Anatomy of the Blood (cont’d)
Thrombocytes
Different from other blood cells because they are only cell fragments
Active in the blood-clotting process
Begin in the red marrow as stem cells that then become megakaryoblasts, and then mature into megakaryocytes, a very large cell
Cytoplasm of the megakaryocyte breaks away at the edges to form cell fragments (thrombocytes) that are released into the blood 33

34. Anatomy of the Blood (cont’d)
Blood Type
Most important blood types are the ABO and Rh blood groups
ABO blood group contains A, B, AB, and O antigens 34

35. Table ABO Blood Group 35

36. Anatomy of the Blood (cont’d)
Blood Type (cont’d)
Rh blood group has 47 different antigens
Rh is positive when antigens are present on erythrocytes
Rh is negative when antigens are not present on erythrocytes 36

38. Shout Pictures/Custom Medical Stock Photo, Inc.
Figure A unit of blood
Shout Pictures/Custom Medical Stock Photo, Inc. 38

39. Physiology of Blood Clotting
Platelet aggregation―Thrombocytes form clumps to decrease blood loss
Coagulation―Blood clot forms
Hemostasis―Cessation of bleeding
When clotting factors in the plasma are activated to form a blood clot, the fluid portion of plasma that remains is known as serum. 39

40. Susumu Nishinaga/Photo Researchers, Inc.
Figure Blood clot
Susumu Nishinaga/Photo Researchers, Inc. 40

41. Table 6-3 Blood Clotting Factors
Title should read Blood Clotting Factors.
Table Blood Clotting Factors 41

42. Table 6-3 (continued) Blood Clotting Factors42

43. Anatomy of the Lymphatic System
Lymphatic Vessels, Lymph, and Lymph Nodes
Lymphatic vessels are similar in structure to blood vessels, but with several important differences.
Begin as tiny lymphatic capillaries in the tissues. 43

44. Anatomy of the Lymphatic System (cont’d)
Lymphatic Vessels, Lymph, and Lymph Nodes (cont’d)
End in ducts that empty into large veins in the neck.
Tissue fluid enters a lymphatic capillary and becomes lymph, the fluid that circulates through the lymphatic system. 44

45. Anatomy of the Lymphatic System (cont’d)
Lymphatic capillaries have large openings in their walls that allow microorganisms and cancerous cells to enter.
Lymphatic capillaries become larger lymphatic vessels that bring lymph to the lymph nodes.
Valves keep the lymph flowing in one direction. 45

46. Anatomy of the Lymphatic System (cont’d)
Lymphoid Organs (cont’d)
Grouped together in chains in areas where there is a high risk of invasion by microorganisms or cancerous cells.
Lymphatic vessels end at ducts in the thoracic cavity: right lymphatic duct and thoracic duct.
Both lymphatic ducts then empty into large veins in the neck. 46

47. Figure 6-12 Lymphatic system47

48. Anatomy of the Lymphatic System (cont’d)
Lymphoid Tissues
Contain lymphocytes and macrophages that are active in the immune response
Tonsils and adenoids in the oral cavity
Appendix and Peyer’s patches in the small intestine 48

49. Anatomy of the Lymphatic System (cont’d)
Lymphoid Organs
Thymus is located within the mediastinum and helps lymphoblasts mature into T lymphocytes
Spleen is located on left side of abdominal cavity and is the largest organ in the lymphatic system
Spleen removes old erythrocytes from the blood 49

50. Anatomy of the Lymphatic System (cont’d)
Lymphoid Organs
Spleen also acts as storage area for whole blood, which is released into the circulatory system during times of danger or injury

51. Diseases and Conditions
Blood
Blood dyscrasia
Hemorrhage
Pancytopenia
Septicemia 51

52. Diseases and Conditions (cont’d)
Erythrocytes
Abnormal red blood cell morphology
Anemia
Aplastic anemia
Folic acid deficiency anemia
Iron deficiency anemia
Pernicious anemia
Sickle cell anemia 52

53. Figure 6-13 Microcytic, hypochromic erythrocytes
Joaquin Carillo Farga/Photo Researchers, Inc. 53

54. Sickle Cell Anemia Video
Click on the screenshot to view a video on the topic of sickle cell anemia.
The video may take a moment before playing.
Back to Directory 54

55. Eye of Science/Photo Researchers, Inc.
Figure Sickle cell
Eye of Science/Photo Researchers, Inc. 55

56. Figure 6-15 Sickle cells in a capillary56

57. Diseases and Conditions (cont’d)
Erythrocytes (cont’d)
Anisocytosis
Poikilocytosis
Polycythemia vera
Thalassemia
Transfusion reaction 57

58. Diseases and Conditions (cont’d)
Leukocytes
Acquired immunodeficiency syndrome (AIDS)
Leukemia
Mononucleosis
Multiple myeloma 58

59. Figure 6-16 Human immunodeficiency virus
Chris Bjornberg/Photo Researchers, Inc. 59

60. Figure 6-17 Acute lymphocytic leukemia
Peres/Custom Medical Stock Photo, Inc. 60

61. Diseases and Conditions (cont’d)
Thrombocytes
Coagulopathy
Deep venous thrombosis (DVT)
Disseminated intravascular coagulation (DIC)
Hemophilia
Thrombocytopenia 61

62. Figure 6-20 Deep venous thrombosis62

63. Diseases and Conditions (cont’d)
Lymphatic System
Graft-versus-host disease (GVHD)
Lymphadenopathy
Lymphedema
Lymphoma
Hodgkin’s lymphoma
Non-Hodgkin’s lymphoma
Splenomegaly
Thymoma 63

64. Figure 6-19 Lymphadenopathy Custom Medical Stock Photo, Inc.64

65. Diseases and Conditions (cont’d)
Autoimmune Disorders
Diabetes mellitus, type 1
Graves’ disease
Hashimoto’s thyroiditis
Inflammatory bowel disease
Multiple sclerosis 65

66. Diseases and Conditions (cont’d)
Autoimmune Disorders (cont’d)
Myasthenia gravis
Psoriasis
Rheumatoid arthritis
Scleroderma
Systemic lupus erythematosus 66

67. Laboratory and Diagnostic Procedures
Blood Cell Tests
Blood type
Complete blood count (CBC) with differential
Peripheral blood smear 67

68. Table 6-4 Complete Blood Count (CBC) with Differential68

69. Table 6-4 Complete Blood Count (CBC) with Differential69

70. Laboratory and Diagnostic Procedures (cont’d)
Coagulation Tests
Activated clotting time (ACT)
Partial thromboplastin time (PTT)
Prothrombin time (PT) 70

71. Laboratory and Diagnostic Procedures (cont’d)
Other Blood Tests
Blood chemistries
Ferritin 71

72. Figure 6-20 Blood chemistry analyzer
Alvis Upitis/Jupiter Images – PictureArts Corporation/Brand X Pictures – Royalty Free 72

73. Laboratory and Diagnostic Procedures (cont’d)
Other Blood Tests (cont’d)
Human immunodeficiency virus (HIV) tests
ELISA―First screening test done for HIV
Western blot―Used to confirm a positive ELISA and make a diagnosis of HIV infection
Viral RNA load test―Measures tiny amounts of HIV RNA and monitors progression of the disease and response to antiretroviral drugs 73

74. Laboratory and Diagnostic Procedures (cont’d)
Other Blood Tests (cont’d)
Human immunodeficiency virus (HIV) tests (cont’d)
p24 antigen test―Detects the protein p24 in HIV
CD4 count―Used to monitor the progression of the disease and response to antiretroviral drugs
Total iron-binding capacity (TIBC) 74

75. Laboratory and Diagnostic Procedures (cont’d)
Saliva Test
OraSure
Quick screening test that is done in the doctor’s office or clinic. It uses the same technology as the ELISA blood test.

76. Laboratory and Diagnostic Procedures (cont’d)
Serum Tests
Electrophoresis
Monospot

77. Laboratory and Diagnostic Procedures (cont’d)
Urine Tests
Bence Jones protein
Schilling test 77

78. Laboratory and Diagnostic Procedures (cont’d)
Radiologic Procedures
Color flow duplex ultrasonography
Lymphangiography 78

79. Medical and Surgical Procedures
Medical Procedures
Bone marrow aspiration
Phlebotomy
Vaccination 79

80. Getty Images – Photodisc-Royalty Free
Figure Phlebotomy
Getty Images – Photodisc-Royalty Free 80

81. Medical and Surgical Procedures (cont’d)
Blood Donation and Transfusion Procedures
Blood donation
Blood transfusion 81

82. Medical and Surgical Procedures (cont’d)
Blood Donation and Transfusion Procedures (cont’d)
Bone marrow transplantation (BMT)
Plasmapheresis
Stem cell transplantation 82

83. Dr. Yorgos Nikas/Photo Researchers, Inc.
Figure Stem cell
Dr. Yorgos Nikas/Photo Researchers, Inc. 83

84. Medical and Surgical Procedures (cont’d)
Lymph node biopsy
Lymph node dissection
Splenectomy
Thymectomy 84