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A&P 302 Blood Lecture Notes
A&P 302 Blood Lecture Notes
Blood Elements:
Erythrocytes
o Red blood cells
Buffy coat
o White blood cells
o Platelets
o Buffy coat is very small
Plasma
There are EQUAL RBCs to Plasma
Blood Hematocrit:
Percentage of blood made up of erythrocytes WILL be on test
Normal:
o Men - 47%
o Women - 42%
Blood Function:
Distribution
Regulation (Hormones are distributed through the blood regulates body
function)
Protection (1. clotting factors prevents bleeding and 2. WBCs &
antibodies protect against pathogens)
Blood (Function) Distribution:
Delivers oxygen and nutrients
Transports metabolic waste
Transports hormone
Blood Components:
Plasma
Formed elements
Plasma Components:
Water 90%
Solutes extremely important.
Solutes have Osmotic pole. If solutes particularly Sodium (and
glucose too) are high they will draw/keep water IN the plasma. If
solutes is, low water will move OUT of the blood/plasma.
Plasma Solutes:
Proteins Also have an Osmotic pole
Non-protein Nitrogenous Substances
Plasma Proteins:
Predominately produced by the liver
Components
o Albumin (protein in the blood)
o Globulins (immunoglobulins)
o Clotting proteins
Proteins are made in the LIVER
o If a pt has liver dz, they will not make as much protein so fluid
will leak out of the blood (causing swelling in the periphery) and
the liver will become stiff. They are also susceptible to ascites
Plasma Non-proteins:
Nutrients (like Glucose)
Electrolytes (Sodium, Potassium, and Chloride)
Respiratory gases (Oxygen and Carbon Dioxide)
Glucose is important because remember, it also has an Osmotic pole
Sodium is highest in the blood in the cell there is lots of potassium
and little sodium and vice versa outside the cell there is little
potassium and lots of sodium.
Erythrocytes Structure:
Biconcave disc with depressed centers
Anucleate
No organelles
Spectrin protein cell wall
RBCs have NO metabolism/organelles why is this important??
o It DELIVERS Oxygen and CARRIES OFF Carbon Dioxide.
o Because it has virtually no metabolism it doesnt USE the
Oxygen it is carrying to the tissues.
Why is it important that is a biconcave disc??
o Firstly, it allows it to bend through tight places easier
o But more importantly the shape Increases SURFACE AREA
(allowing it to pick up more O2 and CO2.)
Erythrocytes Structural Characteristics:
Huge surface area
97% hemoglobin
Does not use oxygen (no mitochondria)
Erythrocytes Function:
Carries oxygen and carbon dioxide via hemoglobin
The hemoglobin carries Oxygen an Carbon Dioxide on DIFFERENT
sites/sides so there is NO competition for the receptor.
Erythrocytes Hemoglobin:
Protein globin
Pigment heme
Normal values:
o Infants 14-20 g/100 ml
o Males 13-18
o Females 12-16
Same thing applies with hemoglobin as with hematocrit.
If taking a pts blood count you would order an H&H (Hemoglobin and
Hematocrit) you will NEVER see where one is low and the other is
high (i.e. Hemoglobin high and Hematocrit low or vice versa) because
their percentages of each other.
Erythrocytes Production:
Process is called erythropoiesis
Hemocytoblast becomes proerythroblasts
Proerythroblasts becomes early erythroblasts and enters a developmental pathway
Dont have to know all the different stages or names (in the picture),
just focus on the bottom of the picture.
Erythropoiesis: - WILL BE ON TEST!
Phase 1 ribosome synthesis (ribosomes in the cell are what makes the
protein aka hemoglobin)
Phase 2 hemoglobin accumulation
Phase 3 ejection of the nucleus
Erythropoiesis Phase 1:
Proerythroblasts become an early (basophilic) erythroblast
Produce huge numbers of ribosome
Hemoglobin synthesis and iron accumulation
Early erythroblasts become late erythroblasts
Dont have to name names (proerythroblasts, etc.)
Erythropoiesis Phase 2:
Late erythroblast becomes a normoblast
Hemoglobin accumulates
At a concentration of hemoglobin at 34% organelles are ejected
DIDNT talk about this slide
Erythrocytes Iron:
65% of iron is in hemoglobin
Iron is stored in cells as ferritin and hemosiderin
Iron in blood is bound to transferrin
Iron is necessary to produce RBCs/Hemoglobin
Ferritin checked if you think a pt has low iron levels
Most of iron is stored in liver and liver damage can occur if
take too much
Transferrin Almost everything in blood is carried by a transfer
molecule (like Transferrin).
Iron-binding capacity and Total iron binding capacity
o How much Iron is on Transferrin (and other binding molecules).
o They measure how many open spots are on the Transferrin.
o An increased iron binding capacity means it is DOWN (there are
empty receptors)
Erythrocytes Destruction:
Live about 120 days
Dying erythrocytes are engulfed by macrophages
Iron is salvaged Important point!
Heme becomes bilirubin
Bilirubin is picked up by liver cells and secreted into the intestine as bile
In the intestine is converted to urobilinogen
- If there is an obstruction (such as a gallstone) between the liver and
intestine the urine will be dark d/t the increase of urobilinogen in
the urine and the stool will be pasty white d/t an absence of
stercobilin.
Degraded pigment is excreted in stool as stercobilin
Hematocrit definition percentage of RBCs in plasma (blood)
Blood made in red bone marrow
If a woman doesnt take iron supplements after pregnancy it
would take 3 years to get her stores back up to normal!
Elevated bilirubin JAUNDICE (esp. in infants because their livers
after able to break down the bilirubin into products)
Leukocytes Classification:
Granulocytes
o Neutrophils
o Basophils
o Eosinophils
Agranulocytes
o Lymphocytes
o Monocytes
Granulocytes Neutrophils:
Also known as polymorphonuclear leukocytes (PMNs or polys)
Very fine granules
Lilac colored
o Absorb both acidic and basic dyes
Granulocytes Eosinophils:
Deep red nucleus
Nucleus has 2 lobes connected by a broad band
Coarse granules absorb acid (eosin) dyes
Eosinophils Function:
Elevated in:
Neoplasm
Asthma
Allergy
Connective tissue disease
Parasites
(NAACP)
Inactivates inflammatory reactants in allergic reactions
Neoplasms, Asthma, and Allergies are the zebras if Eosinophils are
raised you think PARASITES
Granulocytes Basophils:
Large coarse histamine containing granules
Deep purple U or S shaped nucleus with 2 3 constrictions
Related to mast cells (also contain histamine)
Agranulocytes Lymphocytes:
Large dark purple nucleus (almost all nucleus)
Nucleus is round and occupies most of the cell volume
Lymphocytes Functional Cell Types:
T lymphocytes or T cells
B lymphocytes
B Cells produce antibodies in an immune reaction
T Cells 2 common types: 1) Helper T cells helps B cells and
produces antibodies and 2) Cytotoxic T Cells the only cell capable of
killing another cel
Remember B & Helper T cells are part of Humoral Immunity
And Cytotoxic T cells are part of Cell Mediated Immunity (CMI)l
Lymphocytes T Cells:
Act against viruses
Acts against tumor cells
RARE to see Lymphocytes elevated in cancer, you think VIRUS
So you would expect to see Lymphocytes or Neutrophils elevated in a
pt with a fever.
In a viral infection the Neutrophils will increase before the
Lymphocytes
Lymphocytes B Cells:
Give rise to plasma cells
Release antibodies
B cell releasing antibodies are known as Plasma cells
What becomes of nave B cells? Remember from Immunology, half will
become plasma cells and the other half will become memory cells
Agranulocytes Monocytes:
Pale blue cytoplasm
Kidney shaped nucleus
Monocytes Function:
Leaves the circulatory system to become macrophages
Fights
o viruses,
o intracellular bacterial parasites,
o and chronic infections
Elevated in chronic diseases Theyre the work horse of the immune
system
Leukocytes Production:
Called leukopoiesis
Hormonally controlled
For each strain of WBC there is a different chemical signal (aka
cytokine) telling it to be released
DONT have to remember the whole thing that takes palce
Leukopoiesis Hormones:
Released by macrophages and T lymphocytes
Interleukins (numbered IL3)
Colony-stimulating factors (CSFs named e.g. granulocyte CSF)
Platelets Description:
Cell fragments not a cell
Blue staining outer segment with purple staining granules
Essential for blood clotting
Picture of cell: Only exists in the bone marrow, its too big which is why
platelets are broken down cell fragments
Platelets Formation:
Megokaryoblasts differentiate into megokarocytes
This process is regulated by thrombopoietin
Cell fragments break off and enter the blood
Platelets are filled with chemicals that are important to clotting
Hemostasis Description:
Fast, localized, controlled reaction
Has to be localized so you dont start clotting in other parts of your
body
Platelet Regulation:
Endothelial cells produce prostacyclin PGI 2
Produced by intact (healthy) endothelial cells
Prevent aggregation of platelets
Prostacyclin PGI 2 is the chemical that sends signals to platelets to
NOT clot in a healthy vessel
Coagulation Description:
Blood transformed from a liquid to a gel
Has three phases:
1) Prothrombin Activation
2) Thrombin Activation
3) Fibrin Mesh
Fibrin (like the fibers in Velcro) makes the platelets stick together
better.
BUT Fibrin needs to be INACTIVE in the blood Prothrombin and
thrombin speed up the activation of fibrin
Coagulation Prothrombin Activation:
KNOW the difference between the two pathways
Two pathways:
o Intrinsic (comes from within)
o Extrinsic (comes from outside)
Both require the presence of PF3
This is a cascade there are very few in the body
Hemophilia can occur if there is a problem with any of the clotting
factors.
o How is it treated? You give an injected of the deficient clotting factor, but it must
be given every day and immediately if they cut themselves.
o Complications bleeding in joints leads to arthritis at a young age so they
have horrible joint damage
o Older pts dont have hemophilia as much. Why? Because AIDS was in Clotting
Factor 7 & 8 so a lot of them died.
o More common in Males
Coagulation Regulation:
Limiting factors that prevent clotting in the intact blood vessel
Fibrinolysis of the clot breaking down of the clot
Regulation = localization
It HAS to be localized, therefore you have to limit where the blood
clotting will take place and thats what limiting factors are
Coagulation Fibrinolysis:
Presence of a clot causes endothelial cells secrete tissue plasminogen activator
(TPA)
TPA transformed plasminogen into plasmin
Plasmin dissolves the clot
TPA is seen when a patient has a stroke or MI
When injecting TPA (particularly for a stroke,) you want as little TPA as
possible and where the clot is, so you do a cath.