1. Unit Six: Blood Cells, Immunity, and Blood Coagulation
Chapter 32: Red Blood Cells, Anemia, and Polycythemia
Guyton and Hall, Textbook of Medical Physiology, 12th edition

2. Red Blood Cells
Red Blood Cells (Erythrocytes)
Transport hemoglobin
Contain carbonic anhydrase (acid-base buffering)
Shape and size of rbcs-pliable
Concentration in the blood %
Quantity of hemoglobin in the cells g/100 ml
of cells

3. Production of Red Blood Cells
Fig Relative rates of rbc production in the bone marrow of different bones at different ages

4. Pluripotential Hematopoietic Stem Cells
Genesis of Blood Cells
Pluripotential Hematopoietic Stem Cells
Fig. 32.2

5. Stages of Differentiation of RBCs
Genesis of Blood Cells
Stages of Differentiation of RBCs
Fig. 32.3

6. Red Blood Cells (cont.)
Regulation of RBC Production-Erythropoietin
Tissue oxygenation is the most essential regulator
of rbc production
Erythropoietin stimulates rbc production, and its
formation increases in response to hypoxia
Role of the kidney-90% of the erythropoietin is formed
in the kidney (liver-10%)

7. Red Blood Cells (cont.)
Fig Function of the erythropoietin mechanism to increase production
of rbcs when tissue oxygenation decreases.

8. Red Blood Cells (cont.)
Maturation of RBCs
Requirement for Vitamin B12 and Folic acid
Maturation failure with poor absorption of B12-leads
to pernicious anemia
Maturation failure with poor absorption of Folic acid-
leads to sprue (usually occurs in association with the
vitamin deficiency

9. Formation of Hemoglobin
Red Blood Cells (cont.)
Formation of Hemoglobin
Fig Formation of hemoglobin
Fig Basic structure of hemoglobin

10. Red Blood Cells (cont.)
Iron Metabolism
Transport and storage of iron- transferrin, ferritin
Daily loss of iron (0.6 mg/day; feces)
Absorption of iron from the GI tract
Regulation of total body iron by controlling the rate
of absorption

11. Red Blood Cells (cont.) Iron Metabolism
Fig Iron transport and metabolism

12. Red Blood Cells (cont.)
Life Span of RBCs is about 120 Days
Destruction of Hemoglobin
Fe is carried by transferrin to bone marrow
Fe is stored as ferritin
Porphyrin ring is converted to bilirubin

13. Anemias
Blood Loss Anemia- hemorrhage
Aplastic Anemia- lack of functioning bone marrow
Megaloblastic Anemia- slow reproduction of erythroblasts
Hemolytic Anemia- abnormalities of rbcs
Effects on the Circulatory System- low blood viscosity,
decreased resistance to blood flow, increased CO,
increased workload on the heart

14. Polycythemia
Secondary Polycythemia- abnormal quantities of rbcs
Polycythemia vera (Erythremia)- genetic aberration
Effects on the Circulatory System- CO and arterial
pressure is normal, blood is sluggish passing
through the capillaries and skin color may take on a
bluish cast