Blood – a fluid tissue that circulates throughout the body, via the arteries and veins, providing a vehicle

by which an immense variety of different substances are transported between the various organs and
tissue. It composed of cells which are suspended in a liquid medium (plasma)

Blood is a body fluid in humans and other animals that delivers necessary substances such as nutrients
and oxygen to the cells and transports metabolic waste products away from those same cells. In
vertebrates, it is composed of blood cells suspended in blood plasma.

Blood is essential to life. Blood circulates through our body and delivers essential substances like oxygen
and nutrients to the body’s cells. It also transports metabolic waste products away from those same
cells. There is no substitute for blood. It cannot be made or manufactured. Generous blood donors are
the only source of blood for patients in need of a blood transfusion.

Functions of Blood

Blood is pumped by the heart through blood vessels, which extend throughout the body. Blood helps to
maintain homeostasis in several ways.

1. Transport of gases, nutrients, and waste products. Oxygen enters blood in the lungs and is
carried to cell. Carbon dioxide, produced by cells, is carried in the blood to the lungs, from which
it is expelled. Ingested nutrients, ions and water are transported by the blood from the digestive
tract to cells, and the waste products of the cells are transported to the kidney for elimination
2. Transport of processed molecules- many substances are produced in one part of the body and
transported in the blood to another part, where they are modified.
3. Transport of regulatory molecules- many of the hormones and enzymes that regulate body
processes are carried from one part of the body to another within the blood.
4. Regulation of pH and osmosis- buffers which help keep the bloods pH within its normal limits of
7.35- 7.45, are found in the blood. The osmotic composition of blood is also critical for
maintaining normal fluid and ion balance.
 5. Maintenance of body temperature- blood is involved with body temperature regulation because
warm blood is transported from the interior to the surface of the body, where heat is released
from the blood.
6. Protection against foreign substances- cells and chemical of the blood constitute an important
part of the immune system, protecting against foreign substances such as microorganisms and
toxins.
7. Clot formation- blood clotting provides protection against excessive blood loss when blood
vessels are damaged. When tissues are damaged, the blood clot that forms is also the first step
in tissue repair and the restoration of normal function.

Composition of Blood

Blood is a type of connective tissue that consists of cells and cell fragments surrounding by
a liquid matrix. The cells and cell fragments are the formed elements, and the liquid is the plasma. The
total blood volume in the average adult is about 4-5 liters in females and 5-6 liters in males. Blood
makes up about 8% of the total body weight.

Plasma- is the liquid component of blood which is the most abundant substances in blood.it contains
antibodies which will attack certain antigens if they are present. Plasma is a pale yellow fluid that
consists of about 91% water, 7% proteins, and 2% other substances, such as ions, nutrients, gases and
waste products. Plasma proteins include albumin, globulins and fibrinogen.

 Albumin (White or egg)- makes up 58% of the plasma proteins. The water balance between
blood and tissues is determined by the movement of water into and out of the blood by
osmosis.
 Globulins- account for 38% of the plasma protein. Some globulins, such as antibodies and
complement, are part of the immune system. Other globulins and albumin function as transport
molecules because they bind to molecules such as hormones and carry them in the blood
throughout the body.
 Fibrinogen- constitutes 4% of plasma proteins and is responsible for the formation of blood
clots.

Formed Elements

About 95% of the volume of the formed elements consists of Red blood cells (RBC) or
erythrocytes. Remaining 5% of the volume of the formed elements consists of White blood Cells (WBC)
or Leukocytes and cell fragments called Platelets, thrombocytes. Red blood cells are 700 times more
numerous than white blood cells and 17 times more numerous than platelets.

Preventing Blood loss

When a blood vessel is damaged, blood can leak into other tissues and interfere with normal
tissue function, or blood can be lost from the body. A small amount of blood loss from the body can be
tolerated, and new blood is produced to replace it. If a large amount of blood is lost, death can occur.

 Vascular spasm- is an immediate but temporary constriction of a blood vessel resulting from
contraction of smooth muscle within the wall of the vessel.
  Platelets plugs- is an accumulation of platelets that can seal up a small break in a break in a
blood vessel. Platelet plug formation is very important in maintaining the integrity of the
circulatory system because small tears occurs in the smallest vessels and capillaries many times
each day, and platelet plug formation quickly closes them.

Blood clotting

Blood vessel constriction and platelet plugs alone are not sufficient to close large tears or cuts in
blood vessels. When a blood vessel is severely damaged, blood clotting or coagulation results in the
formation of a clot. A clot is a network of threadlike protein fibers called fibrin that traps blood cells,
platelets, and fluid.

Three main stages of Blood clotting

1. The chemical reactions can be started in two ways;

a) The contact of inactive clotting factors with exposed connective tissue can result in their
activation.
b) Chemicals such as thromboplastin, released from injured tissues can cause activation of
clotting factors. A series of reactions results in which each clotting factor activates the next
in the series until the clotting factor prothrombinase is formed.

2. Prothrombinase acts on an inactive clotting factor called prothrombin to convert it to its active
form called thrombin.

3. Thrombin converts the inactive clotting factor fibrinogen into its active form, fibrin a thread like
protein. A clot is a network of fibrin that traps blood cells, platelet and fluid.
Blood Grouping

ABO blood group system is used to categorize human blood. ABO antigens appear on the
surface of the Red blood cells. Type A blood has type A- antigens, type B blood has type B
antigens, type AB blood has both types of antigens, and type O blood has neither A nor B
antigens.

A donor is a person who gives blood, and a Recipient is a person who receives blood.
Usually a recipient can receive blood from a donor if they both have the same blood type.
People with Type O have been called Universal donors because they usually can give blood
to the other ABO blood types without causing an ABO transfusion reaction. Their red blood cells
have no ABO surface antigens and therefore do not react with the recipient’s anti A or anti B
antibodies.

Example:
If Type O blood is given to a person with Type A blood, the Type O red blood cells do
not react with the anti-B antibodies in the recipient’s blood.
In similar fashion, if Type O blood is given to a person with Type B blood, there would
be no reaction with the recipient’s anti A antibodies.
 Four major Blood Groups
 If you have Type A antigens on the surface of your RBC, you also have anti-B antibodies
in your plasma.
 If you have Type B antigens on the surface of your RBC, you have anti-A antibodies in
your plasma.
 If you have Type A and Type B antigens on the surface of your RBC, you do not have
antibodies to A or B antigens in your plasma.
 If you have neither Type A nor Type B antigens on the surface of your RBC, you have
anti-A and anti B antibodies in your plasma.
 Group O has neither A or B antigens on RBC but both A and B antibody are in the
plasma.

There are very specific ways in which blood types must be matched for a safe
transfusion.

Group O- can donate RBC to anybody. It is the universal donor.

Group A- can donate RBC to A’s and AB’s
Group B- can donate RBC to B’s and AB”s
Group AB- can donate to other AB’s, but can receive from all others.

RH Blood group

Another important blood group is the Rh blood group, so named because it was first studied in
the rhesus monkey. People are Rh positive if they have certain Rh antigens on the surface of their red
blood cells, and they are Rh negative if they do not have these Rh antigens. The ABO blood type and the
Rh blood type usually are designated together. ABO and Rhesus are both types of antigens found on the
surface of RBC.
Production of Formed Elements

Red Blood Cells

Normal red blood cells are disk shaped cells with edges that are thicker than the center of the
cell. The biconcave shape increases the surface area of the red blood cell compared with a flat disk of
the same size. The greater surface area makes it easier for gases to move into and out of the red blood
cell.

Function;

The primary functions of the RBC are to transport oxygen from the lungs to the various tissues
of the body and to assist in the transport of carbon dioxide from the tissues to the lungs.

Oxygen transport is accomplished by hemoglobin, which consist of four protein chains and
four heme groups. Each protein called a globin is bound to one heme, a red- pigmented molecule. Each
heme contains one iron atom, which is necessary for the normal function of hemoglobin.

All the circulating RBC in an adult originates in the red bone marrow.

White Blood Cells

WBC or Leukocytes are spherical cells that are whitish in color because they lack hemoglobin.
They are larger than RBC, and each has a nucleus. Although WBC is components of the blood, the blood
serves primarily as a means to transport these cells to other tissues of the body.
Functions of WBC

 To protect the body against invading microorganisms.

 To remove dead cells and debris from the tissues by phagocytosis.

White blood cells are named according to their appearance

a. Granulocytes- those containing large cytoplasmic granules.

b. Agranulocytes- those with very small granules that cannot be easily seen with the light
microscope.

There are three kinds of Granulocytes

 Neutrophils- the most common type of WBC, have small cytoplasmic granules that stain with
both acidic and basic dyes. Dead neutrophils, cell debris and fluid can accumulate as pus at sites
of infection.
 Basophils- the least common of all white blood cells; contain large cytoplasmic granules that
stain blue or purple with basic dyes. Basophil release histamine and other chemicals that
promote inflammation. They also release heparin, which prevents the formation of clots.
 Eosinophils- contain cytoplasmic granules that stain bright red with eosin, an acidic stain.
Eosinophils release chemicals that reduce inflammation. Chemicals from eosinophils are
involved with the destruction of certain worm parasites.

There are two kinds of Agranulocytes

 Lymphocytes- are the smallest of the WBC. The lymphocytes cytoplasm consists of only a thin,
sometimes imperceptible ring around the nucleus. Their diverse activities involve the production
of antibodies and the chemicals that destroy microorganisms, contribute to allergic reactions,
reject grafts, control tumors, and regulate the immune system.
  Monocytes- are the largest of the phagocytic WBC’s. After they leave the blood and enter
tissues, monocytes enlarge become macrophages, which phagocytize bacteria, dead cells, cell
fragments and any other debris within the tissues. Macrophages can break down phagocytized
foreign substances and present the processed substances to lymphocytes, which results in
activation of the lymphocytes.

Platelets

Platelets or thrombocytes are minute’s fragments of cells, each consisting of a small amount of
cytoplasm surrounded by a cell membrane. They are produced in the red bone marrow from
megakaryocytes, which are large cells. Small fragments of these cells break off and enter the blood as
platelets, which play an important role in preventing blood loss.

This prevention is accomplished in two ways:

 The formation of platelet plugs, which seals holes in small vessels.

 The formation of clots, which help seal off larger wounds in the vessels.

The function of platelets is to assist in the process called hemostasis.

Sources of Vitamin K

Humans rely on two sources of Vitamin K. About half comes from the diet and half from
bacteria within the large intestine. Antibiotics taken to fight bacterial infections sometimes kill these
intestinal bacteria, reducing Vitamin K levels and resulting in bleeding problems. Vitamin K supplements
maybe necessary for patients on prolonged antibiotic therapy. Newborns lack these intestinal bacteria,
and a Vitamin K injection is routinely given to infants at birth. Infants can also obtain Vitamin K from
food such as milk. Because cow’s milk contains more Vitamin K than does human milk, breast-fed infants
are more susceptible to bleeding than bottle-fed infants. Vitamin K is also needed for the formation of
clotting factors.