1.07 THE BLOOD Dr. Ma. Luisa Crisostomo || October 2022 ANPH111 ‘The thickness or stickiness OUTLINE: wiscoely) of blood BLOOD FUNCTIONS OF BLOOD Loop COMPONENTS OF BLOOD ‘A specializes connective tissue HEMATOPOIESIS Plays an imporiant rte in maintaining homeostasis in HEMOSTASIS a iving organism BLOOD GROUPS AND TRANSFUSIONS Blood transports everything that must be carrie from DEVELOPMENTAL ASPECTS OF BLOOD ane place to another, such as: + Nutrients TERMINOLOGIES 2 Wostes aaa ‘A delcieny of red blood + Hormones cells ornemogiobin + Body heat aia The fewest of he WECS and Physical characteristics of he blood secretes heparin Sticky, opaque fuid Coagulation Blood coting Heavier and ticker than water Wie blood ces that protect © Colorrange against parastes anc also ‘+ Orygen-tch blood is scarlet red aoe involved in allergic = Oxygen-poor blood is dull red or Teections purple Enpthrocytes Red blood calls + Metalic, say taste Hormone secreted by the * Blood pH is slightly alkaline, between 7.35 Erythropoietin Kidneys that stimulates the and 7.45 production of RBCS + Blod temperature is sight higher than Tnsclble protein bers body temperature, a 38°C or 100 °F Fibrin Invoted in trming a biood + Average adult = 7.9% of oa body weight clot t Male = 5 ters Process of asschtion of + Female = 4.6 ters ibis load cot + Red color of arterial blood is ave to The percentage of ea bo0d oxygenated hemoglobin (Hb) coy cells in a sample of blood a “3 " iron-ontaning pigment of II, FUNCTIONS OF BLOOD Hemoglobin ted blood cel tht carries Transport oxygen Protection The destucton of red Bood Regulation Homolysis, a Hemopotesis The preucton of blood I; COMPONENTS OF BLOOD Hemostasis ‘An arrest of beeding ‘Components of lod includes the folowing: Leukocytes White bood calls A Plane Leukocytosis Bievatscl white blood ced) b.1 Red Blood Cells. a et ee ba wte ood cals moray ow wi 63 Platelet Eeukopent cell count ‘Second most numerous of ‘A. PLASMA Lymphocytes the WBCs: responsible for Liquid portion long-term immunity Straw-colored fis a es ies any dase subtrees moe Te oN en shagoeytic © Reepeatony gettes Most abundant of the white & Hormones penine pols blood cells; highly mobile ° paanne ee © Waste products Pieoma | T*cemrentaceiar rar Fee iis dela wd transpor of nutents Blood et raqments tat @ ers Platolots play @ key role in stopping ‘= Most abundant solutes in plasma bleeding = Most are made by the liver Tr immature form ofan +” Albumin — Promotes water Reticulocyte fray iteton oman end aa Plasma without te CoRing Yalan and proses proteins molecule to transport liquid 1 s[ANPH114] 1.07 THE BLOOD ~ Dr. Ma. Luisa Crisostomo and fat soluble vitamin in the biood — used as ‘antibodies — immunoglobulins ‘+ Fibrinogen - blood clotting ‘+ Antibodies - hep protect the body from pathogens © Cations — positively charged like Na+. Ke. Cat, Mgt ‘Anions ~ chloride, phosphate, iodide + Nutrients and Waste products ‘© Nutrients - Glucose, amino acid, phospholipid, triglyceride, free fatty acid, cholesterol © Metabolic Wastes — Lactic acid, ritrogenous waste (urea) © Gases and Buffers ‘= Oxygen, Nitrogen, and Carbon Dioxide ~ principal gases cissolved in plasma __L ERYTHROCYTES (RED BLOOD CELLS/RBCs) ‘Main function is to carry ha yeroone* RE oxygen ‘+ Ae the most numerous blood cell are about one thousand times more numerous than white blood cells 7 to 8 um in diameter 5.5 million/cu, Mm for male 4.9 milion/cu, Mm for female RBCs differ from other blood cells ‘© Anucleate (no nucleus) — © Contain few organelles; lack mitochondria © Essentially bags of hemoglobin (Hb) ‘© Shaped like biconcave discs © Absence of cytoplasmic organelles ‘+ Normal count is § millon RBCs per cubic millimeter (mm) of blood ‘+ Hemogiobin is an iror-bearing protein © Binds oxygen ‘© Each hemoglobin molecule can bind 4 oxygen molecules © Each erythrocyte has 250 million hemoglobin molecules © Normal blood contains 12-18 g of hemoglobin per 100 milters (ml) of blood © Male fas higher Hgb because testosterone is found more in male RBC Clinical Correlation ‘= Homeostatic imbalance of RECs ‘© Anemia is a decrease in the oxygen-carrying ability of the blood due to: * Lower-than-normal number of RBCs = Abnormal or deficient hemoglobin Content in the RBCs © Sickle cell anemia (SCA) results from abnormally shaped hemoglobin 2 Polycythemia + Disorder resulting rom excessive or ‘abnormal increase of RBCs due to: ‘+ Bone marrow cancer (polycythemia vera) ‘+ Life at higher altitudes (secondary polycythemia) + Increase in RBCs slows blood flow and increases. blood viscosity ‘Inthe lungs oxygen binds with heme iron portion to form oxyhemoglobin, when blood reaches the body tissue capillaries, hemoglobin releases oxygen first into interstitial fuid and then to cel for its cellular metabolism * Carbon dioxide, a waste product of cellular ‘metabolism from the tissue, will bind with globin to {form carbaminchemogiobin. As blood flows to the lungs carbon dioxide is released by hemoglobin and then exhaled, + Erythropoiesis ~ Production of RBC ‘© Site of production: Red bone marrow of certain bones + Hypoxia stimulates the kidney to produce hormone erythropoietin which in turn stimulates the red bone marrow to produce RBC ‘© Reticulocyte - Immature RBC © Erythrocyte ~ mature RBC ‘ edie oe a ~ feabone wT + Het— Hematocrit to separate) © Percentage of volume of biood sample ‘occupied by red cel's ‘© Supernatant plasma, buffy coat, and packed RBCs ‘© Number of RBG in whole blood + Male: 45 ~ 52% + Female: 37-48% ty cont 4 4 tae.IANPH111] 1.07 THE BLOOD ~ Dr. Ma Luisa Crisostomo Crucial in body's defense against disease + Complete celis, with nucleus and organelles © No hemoglobin © Less numerous and larger than RBC + Able to move into and out of biood vesse's (Giapedesis) + Most ive in few days except lymphocytes can lve for several months or years + Respond to chemicals released by damaged tissues (known as positive chemotaxis) + Move by amoeboid motion * Combats pathogen by phagocytosis and immune response + 4,800 to 10,800 W8Cs per mms3 of blood * Chemotaxis ~ process by which neutrophil and other WBC are attached to the chemicals released by microorganisms atthe site of infection or injury + Diapedesis — process by which WEC leaves the bloodstream by being able to deform, elongate squeeze through pores of capillaries to reach injured tissue Ciinical Correlation = Leukocytosis ‘© WBC count above 11,000 cells per mm3 of blood © Generally indicates an infection + Leukopenia ‘© Abnormally low WBC count ‘© Commonly caused by certain drugs, such as corticosteroids and anticancer agents = Leukemia ‘© Bone marrow becomes cancerous © Numerous immature WBC are produced = Types of Leukocytes © Granulocytes + Granules in their cytoplasm can be stained + Possess lobed nuclei * Include neutrophils, eosinophils, and basophils © Agranulocytes * Lack visible cytoplasmic granules * Nuclei are spherical, oval, or kidney- shaped + Include lymphocytes and monocyte Multiobed nucleus (3-5 lobes) hare hatin ag Cytoplasm stains pink and contains fine granuies Function as phagocytes at actve sites of infection 3,000-7,000 neutrophils per mm3 of blood (40-70% of 2, Os a. NEUTROPHILS ‘= Most numerous WBC og First line of defense © Responds quickly to aga ‘bacterial infection © Numbers increase during infection + BARR Body — inactive X chromosome 2 EOSINOPHILS, ‘+ Nucleus stains biue-red Stains pink in acidic dyes ‘+ Brick-red cytoplasmic granules ‘Function isto kill parasitic worms and piay a role in allergy attacks © Combat effects of histamine in allergic feaction by releasing histaminase + Phagooytize Ag-Ab complexes + 100-400 eosinophils per mm3 of blood (1-4 percent of wacs) 4.3 BASOPHILS + Rarest of the WBCs Sy eye + Coarse large granules which Zz shaped nucieus } + Contain heparin (anticoagulant) a. slow reacting substance of P + 20-50 basophils per mms of biood (0-1 percent of Wwacs) = re stain dark blue obscuring S- anaphylaxis SRSA fa) bt LYMPHOCYTES Large, dark purple nucleus Slightly larger than RBCs Reside in lymphatic tissues Play a role in immune response 41,500-3,000 lymphocytes per mms of blood (20-45% of WBCs) + Types af Lymphocytes ° B=cel 2 T-cell © NKcells b, 2 MONOCYTES + Largest of the white blood cells + Distinctive U- or kidney-shaped nucleus + Function as macrophages when they migrate into tissues * Stays in the bloodstream only for 3days ++ Important in fighting chronic infection + Capable of phagocytosis as it transforms to ‘macrophages 100-700 monocytes per mm3 of blood (4-8 percent of Wacs) > aD, « tay + Fragments of megakaryocytes (multinucieate cells) + Anucleated + Needed for the clotting process + Normal platelet count is 300,000 platelets per mm? of opi blood Fane + Ate shed from the surface of megakaryocytes in red bone marrow + Usually described as having a biconvex discoidal shape + Approximately 2 to 4 ym in diameter and often appear in clumps 1. They prevent ioss of blood by clotting 2. Platelets also have an incompletely understood role in maintaining the integnty of the endothelial lining. 3, Platelets react to abnormal surfaces such as might be ‘encountered in a bleeding wound. Such platelets are activated, ‘Mass of platelets increases called thrombus. 4. They release factors that participate in the clotting cascade in fin formation. rue[ANPH111] 1.07 THE BLOOD ~ Dr. Ma, Luisa Crisostomo, Hematopoiesis isthe process of biood cell formation ‘Occurs in red bone marrow (myeloid tissue) Al blood cells are derived from a common stem cell (hemocytobiast) Hemocytoblasts form two types of descendants ‘+ Lymphoid stem cell, which produces lymphocytes ‘+ Myeloid stem cell, which can produce all other formed elements Since RBCs are anucleate, they are unable to divide, ‘grow, or synthesize proteins RBCs wear out in 100 to 120 days ‘When worn out, RBCs are eliminated by phagocytes in the spleen or liver Lost cells are replaced by division of hemocytoblasts inthe red bone marrow Formation of Red Biood Cells ‘© Rate of RBC production is controlied by a hormone called erythropoietin © Kidneys produce most erythropoietin as a response to reduced oxygen levels in the blood Homeostasis is maintained by negative feedback from blood oxygen levels WBC and platelet production is controlled by hormones. © Colony stimulating factors (CSFs) and intorloukins prompt bone marrow to generate leukocytes © Thrombopoietin stimulates production of platelets from megakaryocytes Hemostasis isthe process of stopping the bleeding that results from a break in a blood vessel Blood usually clots within 3 to 6 minutes The clot remains as endothelium regenerates ‘The clot is broken down after tissue repair Hemostasis involves three phases © Vascular spasms © Platelet plug formation ‘© Coagulation (blood ciotting) ‘Stop 1: Vascular Spasms ‘+ Immediate response to blood vessel injury ‘* Vasoconstriction causes blood vessel to spasm ‘+ Spasms narrow the blood vessel, decreasing blood loss ‘Stop 2: Platelet Plug Formation ‘+ Collagen fibers are exposed by a break ina blood vessel Platelets become “sticky” and cling to fibers ‘Anchored platelets release chemicals to attract more platelets ‘+ Platelets pile up to form a platelet plug (white thrombus) ‘Stop 3: Coagulation ‘+ Injured tissues release tissue factor (TF) ‘+ PF3 (a phospholipid) interacts with TF, blood protein clotting factors, and calcium ions to trigger a cloting cascade ‘+ Prothrombin activator converts prothrombin to thrombin (an enzyme) ‘+ Thrombin joins fbxinogen proteins into haike molecules of insoluble fibrin ‘+ Fibrin forms a meshwork (the basis fora cit) ‘+ Within the hour, serum is squeezed from the clot as itretracts Serums plasma minus clotting proteinsIANPH111] 1.07 THE BLOOD - Dr. Ma. Luisa Crisostomo | A DISORDERS OF HEMOSTASIS) UNDESIRABLE CLOTTING a. THROMBOCYTOPENIA ‘Insufficient number of circulating platelets ‘= rises from any condition that suppresses the bone + Even normal movements can cause bleeding from ‘small blood vessels that require platelets for clotting ‘+ Evidenced by petechiae (small purplish blotches on the skin) b, HEMOPHILIA + Hereditary bleeding disorder + Normal clotting factors are missing Minor tissue damage can cause life-threatening prolonged bleeding -MEBLOOD GROUPS ANDTRANSFUSIONS Large losses of blood have serious consequences ‘+ Loss of 15 to 30 percent causes weakness ‘+ Loss of over 30 percent causes shock, which can be fatal © Blood transfusions are given for substantial blood loss, to treat severe anemia, oF for thrombocytopenia ANTIGENS. ‘© Blood contains genetically determined proteins known as antigens ‘= Antigens are substances that the body recognizes as foreign and that the immune system may attack > Mostantigens are foreign proteins > We tolerate our own “self antigens ANTIBODIES ‘© Antibodies are the “recognizers” that bind foreign antigens Blood is “typed” by using antibodies that will cause blood with certain proteins to clump (agglutination) and lyse + There are over 30 common red blood cell antigens + The most vigorous transfusion reactions are caused by ABO and Rh blood group antigens - LABOBLOODGROUP ‘= Blood types are based on the presence or absence of ‘two antigens o Type A Type 8 Presence of both antigens A and B is called type AB. Presence of antigen A is called tyoe A Presence of antigen B is called type B Lack of both antigens A and B is called type O Rh BLOODGROUP + Named for the eight Rh antigens (agglutinagen D) + Most individuals are Rh+ (Rh-positive), meaning they carry the Rh antigen nical Correlation + fan Rh- (Rh-negative) person receives Rh¢ blood ‘The immune system becomes sensitized and begins producing antibodies; hemolysis does not occur, because as it takes time to ‘produce antibodies ‘Second, and subsequent, transfusions Involve antibodies attacking donor's Rit RBCs, an hemolysis occurs (rupture of RBCs) + Rh-related problem during pregnancy = Danger occurs enly when the mother Is Rh-, the father is Rh¢, and the child inherits the Rhe factor © RhoGAM shot can prevent buildup of anti- Rh+ antibodies in mother's blood 2 The mismatch of an Rh- mother carrying an hs baby can cause problems for the unborn chile + The fist pregnancy usually proceeds without problems; the immune system is sensitized after the frst pregnancy + Ina second pregnancy, the mother's, Immune system produces antibodies to attack the Rh+ blood (hemolytic disease of the newbom) cecal: BLOOD TYPING Blood samples are mixed with anti-A and antl-6 serum ‘+ Agglutination or the lack of agglutination leads to identification of blood type + Typing for ABO and Rh factors is done in the same ‘manner + Cross matching—testing for agglutination of donor RBCs by the recipient's serum, and vice versa 2 Siles of blood cell formation + The fetal liver and spleen are early sites of blood cell formation + Bone marrow takes over hematopoiesis by the seventh month © Developmental Aspects of Blood © Cangenital blood defects include various types of hemolytic anemias anc hemophilia © Incompatibility between maternal and fetal blood can result in fetal cyanosis, resulting from destruction of fetal blood cells 2 Fetal hemoglobin difers from hemoglobin produced after birth © Physiologic jaundice oceurs in infants when the liver ‘cannot rid the body of hemoglobin breakdown products fast enough 2 Developmental Aspects of Blood © Leukerias are most common in the very young and very old > Older adults are also at risk for anemia and clatting disorders, raed