PRINCIPLES OF MEDICAL LABORATORY IN SCIENCE 2 WEEK 2: JAN 23, 2023

MT1B - DURAN, MA. ANDREA NICOLE B.

CIRCULATORY SYSTEM b) Lymphocytes
transports oxygenated blood from the heart and - T-Cells – cell-mediated immunity
lungs all throughout the body - B-cells – produce antibodies
Helps in the coagulation process, regulates the - Increased in
body temperature and assists the body in = Viral Infections
fighting diseases.
Two main components
 the Cardiovascular system
 The Lymphatic system
ARTERIAL SYSTEM
Carry oxygen-rich blood away from the heart
Pulmonary arteries carry oxygen-poor blood
Paired – left and right artery of the same name
VENOUS SYSTEM
Carries oxygen-poor blood toward the heart
Except pulmonary veins
Most large veins have the same names as the
arteries they are next to
HEPATIC PORTAL SYSTEM 3. THROMBOCYTES: platelets
Collection of veins carrying blood to the liver 4. PLASMA
BLOOD  91% water
SPECIALIZED CONNECTIVE TISSUE  7% Plasma proteins
Plasma: fluid part (55%)  58% Albumin
Formed elements (45%)  38% Globulin
 Erythrocytes  4% Fibrinogen
 Leukocytes  2% Plasma solutes
 Thrombocytes
 Ions, nutrients, waste products, gases,
CELLULAR COMPONENTS
enzymes, hormones
1. ERYTHROCYTES (RBCs)
FUNCTIONS:
 95% of the volume of blood cells
Transports: O2, CO2, nutrients, waste,
 Contains Hemoglobin (Heme + Iron) which hormones
carries O
Regulates: body pH, body temperature
2. LEUKOCYTES (WBCs)
Clotting mechanism
 Transported primarily by the lymphatic system
Protection against foreign microbes and toxins
to increase encounter with foreign materials
and elicit immune response Osmosis
 Granulocytes: neutrophils, eosinophils, In vivo, is in fluid form; in vitro, it coagulates in 5-
basophils 10 mins.
a) Neutrophils Thick & viscous; 3.5-4.5 times thicker than water
- most abundant in circulation Makes up 7 to 8% of the total body component
- Increased in bacterial infections or 75 to 85mL of blood per kilogram body weight
b) Eosinophils Approximately 20 grams solid per 100mL blood
- Increased in Type I Hypersensitivity Total Blood Volume (TBV)
reactions such as those caused by  Adult Male 5-6 L
Urticaria, Food Allergy, Hay Fever,  Adult Female 4-5 L
Allergic Rhinitis, and Anaphylaxis.  Newborns 250-350mL
c) Basophils Color
- Increased in Malignancies  Arterial: bright red (Hb is saturated with O2;
 Agranulocytes: monocytes, lymphocytes sat. Hb O2)
a) Monocytes  Venous: dark purplish red (Hb is NOT
- Increased in tuberculosis, fungal saturated with O2)
infections, and recovery from acute  IN PULMONARY ARTERIES & VEINS:
infections reverse is true
 PRINCIPLES OF MEDICAL LABORATORY IN SCIENCE 2 WEEK 2: JAN 23, 2023
MT1B - DURAN, MA. ANDREA NICOLE B.
Blood pH: 7.35 to 7.45 (Average of 7.40) agglutinate the red blood cells. When a doctor
 Venous 7.35 mentions blood type, he is referring to your or
 Arterial 7.45 ABO system or Rhesus (RH) factor.
Blood specific gravity: # of solutes dissolved in
bld
 Whole blood 1.045 – 1.066
 Serum 1.024 – 1.028
 Plasma 1.025 – 1.029
BLOOD DISORDERS
1. Anemia
2. Leukemia
3. Leukocytosis
4. Leukopenia
5. Polycythemia rubra vera
6. Thrombocytosis
7. Thrombocytopenia
DIAGNOSTIC TEST FOR BLOOD DISORDERS
Complete Blood Count (CBC) / Hemogram
 RBC Count
 WBC Count
 Hematocrit (Hct)
 Hemoglobin (Hb or Hgb)
 RBC Indices (MCH, MCV, MCHC)
 Platelet Count
 WBC Differential (diff) count
Bone marrow examination
Reticulocyte (retic) count
Erythrocyte sedimentation rate (ESR)
Ferritin and Iron (Fe) Status
Total iron-binding capacity (TIBC)
DISORDERS OF THE LYMPHATIC SYSTEM
1. Lymphangitis
2. Lymphadenitis
3. Lymphadenopathy
4. Splenomegaly
5. Hodgkin's disease
6. Lymphosarcoma BLOOD ANTIGEN ANTIBODY BLOOD THAT CAN
TYPE PRESENT PRESENT BE RECEIVED
7. Lymphoma
A A Anti-B A and O
DIAGNOSTIC TEST FOR THE LYMPHATIC B B Anti-A B and O
SYSTEM DISORDER AB AB None A, B, AB, and O
1. Bone Marrow Biopsy O None Anti-A and O
2. Complete Blood Count Anti-B
3. Culture & Sensitivity
4. Lymph node biopsy DISORDERS ASSOCIATED WITH BLOOD TYPE
5. Mononucleosis test Transfusion Reactions
BLOOD TYPE Autoantibodies against Blood Antigens
The human blood type is inherited and Weak Expression of Blood Antigens
determined by the antigens on the surface of the DIAGNOSTIC TEST FOR BLOOD TYPE
red blood cells. ABO & RH typing
The blood contains or can develop antibodies Weak D typing
directed at the opposite blood type. AHG Testing / Coomb’s Test
Blood type match is important especially during Cross-matching
blood transfusion because the wrong type could
 PRINCIPLES OF MEDICAL LABORATORY IN SCIENCE 2 WEEK 2: JAN 23, 2023
MT1B - DURAN, MA. ANDREA NICOLE B.
DISORDERS OF COAGULATION PROTEINS HEMOSTASIS
Hemophilia A Arresting of bleeding
Factor Deficiencies Achieved through
Bleeding Tendencies  Vasoconstriction and Platelet Plug
DIAGNOSTIC TESTS Formation (Primary Hemostasis)
Prothrombin Time  Clotting (Secondary Hemostasis or
Activated Partial Thromboplastin Time Thrombosis)
Specific Factor Assays 4 Components
Mixing Studies  Vascular system
DISORDERS OF ANTICLOTTING FACTORS  Thrombocytes
Anticlotting Factor Deficiencies  Coagulation Factors
Hypercoagulable State  Fibrinolytic System
Thromboembolism
DIAGNOSTIC TESTS
Anticlotting Factor Assays
Antihthrombin C
Protein C

FIBRINOLYSIS
Final stage of hemostatic activation
Systematic, accelerating hydrolysis of fibrin by
plasmin
Excessive fibrinolysis predisposes a person to
uncontrolled bleeding
DISORDERS OF FIBRINOLYSIS
Deep Venous Thrombosis (Deficiencies)
Slow or Failure to form Clot (Excess)
 Bleeding
DIAGNOSTIC TESTS
DIFFERENTIATION OF THE LIQUID PORTION OF D-Dimers
BLOOD
SERUM PLASMA
Fibrin Degradation Products (FDP)
Liquid portion of CLOTTED Liquid portion of Plasminogen
BLOOD UNCLOTTED/ANTICOAGU PERIPHERAL CIRCULATORY SYSTEM
LATED BLOOD FUNCTIONS:
Pale yellow; clear & Pale yellow or straw colored 1. Carry blood
transparent but slightly hazy
NO FI (Fibrinogen) Has FI (Fibrinogen); has 2. Exchange nutrients, waste products, and gases
complete set of 3. Transport of hormones, components of the
unconsumed PCF that’s immune system, molecules required for
why it’s slightly hazy coagulation, enzymes, nutrients, gases, waste
Has FI, FV, FVIII:C, FXIII –
products, etc.
completely
Has FI, FV, FVIII:C, FXIII – NO FI (Fibrinogen) 4. Regulate blood pressure
completey consumed in the 5. Direct blood flow
coagulation process; forms TYPES OF BLOOD VESSELS
as part of the clot Arteries: thicker wall but smaller lumen diameter
FII (Prothrombin) – not
completely consumed
than veins
•>80% is consumed  Elastic
•<20% remains in serum and  Muscular
is called  Arterioles
RESIDUAL PROTHROMBIN
 PRINCIPLES OF MEDICAL LABORATORY IN SCIENCE 2
MT1B - DURAN, MA. ANDREA NICOLE B.
Capillaries: site of exchange with tissues
 Capillary wall consists of endothelial cells
(simple squamous epithelium), basement
membrane and a delicate layer of loose C.T.
- Scattered pericapillary cells that are
fibroblasts, macrophages or
undifferentiated smooth muscle cells.
 Substances move through capillaries by
diffusion through:
- Lipid-soluble and small water-soluble
molecules through plasma membrane
- Larger water-soluble molecules pass
through fenestrae or gaps between
endothelial cells.
Veins: thinner walls than arteries, contain less
elastic tissue and fewer smooth muscle cells
 Venules
 Small veins
 Medium or large veins
CAPILLARY NETWORK
Blood flows from arterioles through
metarterioles, then through capillary network
Flow through thoroughfare channel fairly
consistent while flow through arterial capillaries
is intermittent
Smooth muscle in arterioles, metarterioles,
precapillary sphincters regulates blood flow
STRUCTURE OF ARTERIES & VEINS
1. Tunica Intima
 Endothelium
 Basement membrane
 Lamina propria (C.T. layer)
 Internal elastic membrane. Fenestrated
layer of elastic fibers.
WEEK 2: JAN 23, 2023
2. Tunica Media: smooth muscle cells arranged
circularly around the blood vessel.
 Vasoconstriction: smooth muscles
contract, decrease in blood flow
 Vasodilation: smooth muscles relax,
increase in blood flow
3. Tunica Externa (adventitia)
 Connective tissue, varies from dense
regular near the vessel to loose that
merges with the surrounding C.T.
BLOOD VESSELS: Arteries & Arterioles
Strongest of the blood vessels
Carry blood away from the heart
Under high pressure
Arterioles: small branches of arteries
 Transport blood from small arteries to
capillaries
 Smallest arteries where the three tunics can
be differentiated
 Like small arteries, capable of
vasoconstriction and dilation
Aorta: takes blood from the heart to the body
Coronary arteries: supply blood to heart muscle
AGING OF THE ARTERIES
Arteriosclerosis: general term for degeneration
changes in arteries making them less elastic
Atherosclerosis: deposition of plaque on walls
Tests
 Lipid Profile
BLOOD VESSELS: Veins & Venules
Blood under no pressure in veins
 Does not move very easily
 Skeletal muscle contractions help move
blood
 Sympathetic nervous system also
influences pressure
Valves prevent backflow
Venules
 Small vessels formed when capillaries
merge
Superior and inferior vena cava
 Largest veins
 Carry blood into right atrium
 PRINCIPLES OF MEDICAL LABORATORY IN SCIENCE 2 WEEK 2: JAN 23, 2023
MT1B - DURAN, MA. ANDREA NICOLE B.
DISORDERS OF THE VASCULAR SYSTEM STRUCTURES OF THE HEART VALVES
1. Aneurysm Atrioventricular valves (AV valves). Each
2. Arteriosclerosis valve has leaf-like cusps that are attached to
3. Atherosclerosis cone-shaped papillary muscles by tendons
4. Embolism (chordae tendineae).
5. Hemorrhoids  Right has three cusps (tricuspid). Left has
6. Phlebitis two cusps (bicuspid, mitral). When valve is
7. Thrombophlebitis open, canal is atrioventricular canal.
8. Thrombus Semilunar valves. Right (pulmonary); left
9. Varicose veins (atrial). Each cusp is shaped like a cup. When
Diagnostic Test of Primary Hemostatic System cusps are filled, valve is closed; when cusps are
and the Vasculature empty, valve is open.
Bleeding Time HEART VALVES
Platelet Aggregation Studies Three layers of tissue
Clot Retraction Time  Epicardium: Serous membrane; smooth
Lipid Profile outer surface of heart
 Lipoproteins (HDL, LDL, VLDL)  Myocardium: Middle layer composed of
 Triglycerides cardiac muscle cell and responsibility for
 Cholesterol heart contracting
THE HEART  Endocardium: Smooth inner surface of
ANATOMY & PHYSIOLOGY heart chambers
Generating blood pressure Pectinate muscles: muscular ridges in auricles
Routing blood: separates pulmonary and and right atrial wall
systemic circulations Trabeculae carnae: muscular ridges and
Ensuring one-way blood flow: valves columns on inside walls of ventricles
Regulating blood supply
 Changes in contraction rate and force match
blood delivery to changing metabolic needs
HEART CHAMBERS
Atria
Right atrium: three major
openings to receive blood
returning from the body
(superior vena cava, inferior
vena cava, coronary sinus)
Left atrium: four openings
that receive blood from
pulmonary veins
Interatrial septum: wall
between the atria. Contains a
depression, the foramen ovale, a remnant of
the fetal opening between the atria
Ventricles
Atrioventricular canals:
CIRCULATION
openings between atria and
Pulmonary circuit
respective ventricles
Right ventricle opens to right atrium  right ventricle  pulmonary artery
pulmonary trunk trunk  pulmonary arteries  lungs  pulmonary
Left ventricle opens to aorta veins  heart (left atrium)
Interventricular septum Systemic circuit
between the two. left atrium  left ventricle  aorta  arteries 
arterioles  capillaries  venules  veins  vena
cava  heart (right atrium)
 PRINCIPLES OF MEDICAL LABORATORY IN SCIENCE 2 WEEK 2: JAN 23, 2023
MT1B - DURAN, MA. ANDREA NICOLE B.
HEART & HOMEOSTASIS LIST OF DIAGNOSTIC TESTS FOR HEART
Conducting System of the Heart DISORDERS:
SA node: sinoatrial node. The pacemaker. Arterial Blood Gases (ABG)
Specialized cardiac muscle cells. Cardiac Enzymes
 Generate spontaneous action potentials.  Aspartate aminotransferase (AST) or Serum
 Action potentials pass to atrial muscle cells glutamic-oxaloacetic transaminase (SGOT)
and to the AV node  Creatine kinase (CK)
AV node: atrioventricular node. Action potentials  Creatine Kinase (CK)-MB
conducted more slowly here than in any other  Lactate Dehydrogenase
part of system. Myoglobin
 Ensures ventricles receive signal to contract Troponin T (TnT)
after atria have contracted Cholesterol & Triglycerides
AV bundle: passes through hole in cardiac Potassium (K)
skeleton to reach interventricular septum  High  Bradycardia (Slow), cause sudden
Right and left bundle branches: extend death
beneath endocardium to apices of right and left  Low  Arrythmias (Ventricular Tachycardia,
ventricles  Sinus Bradycardia)
Purkinje fibers: Large diameter cardiac muscle
cells with few myofibrils. Many gap junctions.
 Conduct action potential to ventricular
muscle cells
Effect of blood pressure
 Baroreceptors monitor blood pressure; in
walls of internal carotids and aorta. This
sensory information goes to centers in the
medulla oblongata
Effect of pH, carbon dioxide, oxygen
 Receptors that measure pH and carbon
dioxide levels found in hypothalamus
 Chemoreceptors monitoring oxygen levels
found in aorta and internal carotids.
Prolonged lowered oxygen levels causes
increased heart rate, which increases blood
pressure and can thus deliver more oxygen
to the tissues.
Effect of extracellular ion concentration
 Increase or decrease in extracellular K +
decreases heart rate
Effect of body temperature
 Heart rate increases when body
temperature increases, heart rate
decreases when body temperature
decreases
DISORDERS OF THE HEART
1. Angina pectoris
2. Aortic stenosis
3. Bacterial endocarditis
4. Congestive heart failure
5. Myocardial infarction
6. Pericarditis