1. BLOOD

2. Composition
of Blood
Plasma
Formed elements

4. BLOOD FUNCTIONS
TRASPORTATION OF OXYGEN, CARBON DIOXIDE, NUTRIENTS, HORMONES, HEAT AND WASTE.
REGULATION OF pH, BODY TEMPERATURE & WATER CONTENT
PROTECTION AGAINST DISEASE BY WHITE BLOOD CELLS & ANTIBODIES

5. BOOD VOLUMES MEDICAL TERMS: RANGE OF BLOOD VOLUME IS 5 TO 6 LITERS
NORMOVOLEMIC: NORMAL BLOOD VOLUME
HYPOVOLEMIC: LOW BLOOD VOLUME
HYPERVOLEMIC: HIGH BLOOD VOLUME

6. PHYSICAL CHARACTERISTICS
MEAN TEMPERATURE: 38C (100.4F)
VISCOSITY: PLASMA = WHOLE BLOOD = 3
MEAN pH: 7.35 to 7.45

7. PLASMA
COLOR IS YELLOWISH
COMPOSITION
91.5% WATER
7% PROTEINS
1.5% OTHER SOLUTES

8. PLASMA PROTEINS
ALBUMIN – 54%
GLOBULIN – 38%
FIBRINOGEN – 7%

9. OTHER SOLUTES ELECTROLYTES NUTRIENTS ENZYMES HORMONES GASES
WASTE PRODUCTS

10. FORMATION OF FORMED ELEMENTS
HEMOPOIESIS
IN RED BONE MARROW & LYMPH TISSUE
ALL BLOOD CELLS COME FROM PLURIPOTENT STEM CELLS THAT BECOME MYELOID OR LYMPHOID STEM CELLS.
LYMPHOID STEM CELLS PRODUCE THE WBC’s CALLED LYMPHOCYTES.
MYELOID STEM CELLS PRODUCE ALL THE REST (RBC’s, PLATELTES & THE OTHER FOUR WBC’s)

11. RED BLOOD CELLS (RBC’s) (ERYTHOCYTES)
NUMBER: MALE = 5.4 MILLIONS/ uL FEMALE = 4.8 MILLIONS/ Ul
BICONCAVE DISCS, 7-8 um DIAMETER
NO NUCLEUS
EACH CONTAIN ONE HEMOGLOBIN MOLECULE, 4 HEME GROUPS AND 4 IRON IONS.

12. RBC’s FUNCTIONS HEMOGLOBIN TRANSPORT 97% OF OXYGEN.
HEMOGLOBIN TRANSPORT 23% OF CARBON DIOXIDE
HEMOGLOBIN PARTICIPATE IN THE REGULATION OF BLOOD FLOW BY RELEASING NITRIC OXIDE.

13. HEMOGLOBIN
COMPOSED OF A PROTEIN PART CALLED GLOBIN AND FOUR IRON CONTAINING PARTS CALLED HEME.
EACH HEME BIND ONE OXYGEN MOLECULE.
HEMOGLOBIN BIND OXYGEN IN THE LUNGS AND RELEASE IT IN TISSUES.

14. HEMOGLOBIN MOLECULE

15. RBC’s FORMATION CALLED ERYTHROPOIESIS OCCUR IN RED BONE MARROW
HEMOGLOBIN SYNTHESIS OCCUR DURING DEVELOPMENT.
PROCEED THROUGH VARIOUS CELL STAGES AND TAKES ABOUT A WEEK.

16. RBC’s DEVELOPMENT MYELOID STEM CELLS PROERYTHROBLASTS RETICULOCYTES
ERYTHROCYES

18. Requirements for RBC Formation
*IRON *AMINO ACIDS *VITAMIN B12
Supplied by diet and recycled from storage in liver and spleen
Free iron is toxic, so must combine with proteins to be stored or transported
Storage molecule is FERRITIN
Transport molecule is TRANSFERRIN

19. STIMULATION OF RBC FORMATION
DECREASED RBCs NUMBER ↓
TISSUE HYPOXIA
ERYTHROPOIETIN HORMONE
SECRETION BY THE KIDNEYS
BONE MARROW STIMULATION
PROERYTHROBLASTS → ERYTHROCYTES

20. Recycling of RBC’s RBC’s live for about 80 - 120 days Death
Hemolysis in blood
Liver and spleen phagocytes consume them
Hemoglobin degraded to globin and heme
Amino acids of globin recycled
Heme split open releasing iron which is recycled
Heme → Biliverdin → Bilirubin in bile → urobilin in urine or stercobilin in feces

21. RBCs RECYCLING

22. White Blood Cells or Leukocytes
General functions: Protection by immune response or phagocytosis.
Whole count: – 10,000 / uL
Differential: Determining the percentage of each type of white blood cells.

23. WBC’s TYPES & FUNCTIONS
GRANULAR: NEUTROPHILS, EOSINOPHILS AND BASOPHILS.
FUNCTION FOR PHAGOCYTOSIS AND INFLAMMATORY RESPONSE.
AGRANULAR: LYMPHOCYTES AND MONOCYTES.
FUNCTION IN ANTIGEN-ANTIBODY REACTIONS & AS MACROPHAGES.

25. FORMATION OF WBC’s LOCATION
RED BONE MARROW FOR MONOCYTES, NEUTROPHILS, BASOPHILS AND EOSINOPHILS.
LYMPH TISSUE FOR LYMPHOCYTES.

26. DEVELOPMENTAL PATHWAYS
Leukocytes
Myeloid stem cells  myeloblasts and monoblasts
Myeloblasts  Neutrophils, Eosinophils and Basophils.
Monoblasts  Monocytes
Lymphoid stem cells  lymphoblasts
Lymphoblast  lymphocytes

28. Table of WBC’s Ranked by Differential
Function
Differential
NEUTROPHILS (POLYMORPHONUCLEOCYTE) (PMN)
PRIMARY PHAGOCYTES.
SEGMENTED NUCLEUS AND LAVENDER GRANULATER CYTOPLASM
LYMPHOCYTES B-CELLS & T-CELLS
IMMUNITY
SPHERICAL NUCLEUS & BLUE CYTOPLASM
MONOCYTES
TISSUE MACROPHAGES
KIDNEY-SHAPED OR OVAL NUCLEUS
EOSINOPHILS
PHAGOCYTOSIS OF PARASITES AND ANTINFLAMMATORY
BILOBED NUCLEUS & RED GRANULES
BASOPHILS
HISTAMINE & INFLAMMATION
BILOBED NUCLEUS & DARK GRANULES

29. PLATELETS THROMBOPOIETIN: FROM THE LIVER
FUNCTIONS: BLOOD CLOTTING AND PLATELTES PLUG FORMATION.
DEVELOPMENT: MYELOID STEM CELL > MEGAKARYOPLAST > MEGAKARYOCYTE > FRAGMENT INTO PLATELETS.
NUMBER: 150,000 – 400,000 / uL

31. HEMOSTASIS RESPONSES THAT STOP BLEEDING
(1) VASCULAR SPASM: CONTRACTION OF THE INJURED BLOOD VESSEL SMOOTH MUSCLES TO REDUCE THE BLOOD VESSEL DIAMETER AND DECREASE LOSS OF BLOOD.

32. HEMOSTASIS (2) Platelet plug formation
Platelet adhesion ______________________________________________
Platelet release reaction ______________________________________________
Platelet aggregation ______________________________________________

33. HEMOSTASIS (3) CLOT FORMATION: Clot closes the broken blood vessel.
Clot consists of a gel of fibrin and trapped formed blood elements.
When gel separates from liquid, remaining fluid is called serum.
Clotting process is called coagulation.

34. Blood clotting occurs in three stages
Formation of Prothrombinase
Formation of Thrombin
Formation of Fibrin plug (clot)

35. Formation of prothrombinase involves two pathways
Intrinsic pathway results from blood trauma
Damaged vessel
Damaged platelets
Slowest
Extrinsic pathway results from tissue trauma
Damage of cells outside blood
Fastest
Both pathways occur during normal clotting and produce Prothrombinase.

36. Basic Steps in Blood Clotting
Extrinsic Pathway Involves Tissue Trauma and Clotting Factors
Intrinsic Pathway Involves Blood Trauma and Clotting Factors
Ca2+
Ca2+
Prothrombinase
Prothrombin
Thrombin
Ca2+
Thrombin
Fibrinogen
Fibrin (clot)

37. CLOT DISSOLVING
As repair of a cut or damaged vessel proceeds, a series of enzyme catalyzed reactions called ___________ slowly dissolves the clot
An enzyme called _______________________ catalyzes the conversion of inactive enzyme ___________ to active_________
Active enzyme catalyzes the dissolving of clot
fibrinolysis
tissue plasminogen activator
plasminogen
plasmin

38. CLOT DISSOLVING
Tissue plasminogen activator
Plaminogen
Plasmin

39. INTRAVASCULAR CLOT Intravascular clot – clot within closed vessel
Damaged vessel lining or slowing of blood flow
Platelets aggregate and release clotting factors
Resulting clot called a _________
Moving piece of the clot is an ________
Clot moves downstream and blocks smaller vessel _________
May cut off blood supply to organ
thrombus
embolus
embolism

40. ANTICOAGULANTS
Chemicals that decrease or prevent blood clotting are called ____________
Heparin is administered medically and it occurs naturally in our bodies. It works by decreasing thrombin production
Coumadin (warfarin) is effective as a long-term anticoagulant. It is an antagonist of vitamin K.
EDTA and CPD are used in blood banks to keep the donated blood from clotting. They both work by tying-up and removing calcium.
anticoagulants

41. BLOOD TYPES
ABO and Rh
Antigens (glycoproteins and glycolipids) called ____________ on surface of RBC’S determine blood types.
Blood types are inherited
The greatest concern with blood types involves ___________
agglutinogens
transfusions

42. During a transfusion, the person giving the blood is a ______, the person getting the blood is a ________
The immune system may develop antibodies called __________ against certain agglutinogens. These agglutinins float in the plasma.
donor
recipient
agglutinins

43. If RBC’s of a donor are incompatible with the
blood of a recipient, agglutinins in the plasma of the recipient will bind to the agglutinogens of the
donated RBC’s. This reaction will ______ (_________) and destroy (cause hemolysis of) the donated RBC’s, causing a serious and possibly fatal reaction.
clump
agglutinate

44. ABO BLOOD TYPES

45. A A B B A&B AB O ABO Type Antigen on RBC’s Antibodiesin Plasma
Acceptable
Transfusion
Donate to
Receive from
A & AB A A
Anti-B
A&O B B
B&AB
Anti-A
B&O
only AB
A&B AB
Neither O
A,B,AB&O O
Neither
Both
only O

46. Rh blood type and hemolytic disease of the newborn
Rh blood type is determined by presence of absence of Rh _____________ (________) on the surface of RBC’s
If Rh agglutinogens are present, the type is Rh . If no agglutinogens are present, the type is Rh .
agglutinogens
antigens + -

47. People with Rh- type lack anti-Rh agglutinins (antibodies), but if they receive Rh+ blood, their immune systems will be stimulated to produce them, and they are then _________. Future exposure to Rh+ blood will cause a dangerous blood reaction.
sensitized

48. Hemolytic Disease of the Newborn (HDN)
Results from Rh incompatibility between ___ mother and her ____child
If Rh+ RBC’s of first born child enter mother’s circulation, mother will be __________, and her plasma will carry anti-Rh agglutinins (antibodies)
Rh-
Rh+
sensitized

49. The first child is not harmed, but the mother’s ____________, acquired by exposure to the first child’s blood, easily pass across the placenta where they ___________and destroy the second child’s RBC’s.
agglutinins
agglutinate

50. Hemolytic Disease of the Newborn

51. CLINICAL TERMS Polycythemia: High RBC’s number.
Anemia: Low RBC’s number.
Leukemias: High WBC’s number diseases.
Leukopenia: Low WBC’s number.

52. Clinical Terms Continued
Leukocytosis: High WBC’s number.
Hemophilia: Lack of blood coagulation.
Thrombocytopenia: Low platelets number.
Sickle cell disease: Abnormal RBC’s form
Jaundice: bilirubin leak in the blood.