UNIT 13: BLOOD

OUTLINE Blood is the fluid of health, transporting disease

I. Blood fighting substances to the tissue and waste to the
II. Functions of the Blood kidneys.
III. Characteristics of the Blood
IV. Components of the Blood II. Functions of the Blood
V. Blood Cells
VI. Blood Coagulation
1. To transport the products of digestion
VII. Blood Clotting
VIII. Blood Tests (from the intestine to the different
IX. Blood Types tissues for utilization)
X. Common Blood Disorders 2. To transport waste products of tissue
metabolism (e.g., urea, uric acid,
creatinine to the kidneys and other
I. Blood excretory organs for elimination)
3. To transport oxygen (in the form of
Blood is the circulating tissue of the body. It is the unstable oxyhemoglobin from the lungs
principal medium by which the biochemical to the tissues for oxidation of food and
homeostasis by our cells and interstitial fluid is production of energy)
maintained. 4. To transport endocrine secretions
(hormones from the pituitary, thyroid,
In spite of endogenous and exogenous influences, pancreas, etc. to the tissues)
its regulation is brought about by the capacity to 5. To regulate the acid base balance
perform different functions in our body. (through its efficient buffer system)
6. To regulate the fluid balance between
It is a special type of fluid connective tissue
the blood and the tissues
derived from mesoderm.
7. To regulate the body temperature (the
In biochemistry, we will discuss its composition, high specific heat of water allows the
characteristics, and the common tests conducted circulating blood to be sufficient in
on blood. maintaining the body temperature
between 36.5 ° C - 37 °C)
The branch of science that is concerned with the
8. To prevent hemorrhage (It has the
study of blood, blood clotting tissues, and
capacity to coagulate and seal of the
disorders associated to blood, is HEMATOLOGY,
leakage in the injured blood vessel)
where hema – blood, logy(logus) – study.
The blood also prevents infections due to the
presence of phagocytic leukocytes (WBCs) with
Blood is the fluid of life, transporting oxygen from the capacity to engulf/invade organisms and the
the lungs to body tissue and carbon dioxide from property to produce antibodies like agglutinins
body tissue to the lungs. that cause the clumping of bacteria, and
hemolysin & cytolysin, which causes the
Blood is the fluid of growth, transporting
hemolysis of tissues, and precipitins that
nourishment from digestion and hormones from
precipitate the antigenic protein and anti-toxins
glands throughout the body.
that counteract the toxins of certain pathogenic
bacteria like tetanus toxin.

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NPA I BSMT 2F
 III. Characteristics of the Blood
The general characteristics of blood includes the
study of its quantity, color, reactions, specific
gravity, and viscosity.
A. Blood Volume
• 6 to 8% or about 1/13 of the total body
weight
• Higher for men than women (subject to
individual variations)
• Volume in adult male 5-6 L (75 mL/kg)
• Volume in adult female 4-5 L (66 mLkg)
• Typically makes up 6-8% of body weight
• Much more dense than pure water
• Slightly warmer than body temperature
100.4 °F
• pH slightly alkaline 7.4 to 7.45 (varies due
to difference in diet and climatic
conditions)
• Salty taste
B. Color
Arterial blood – bright red, due to the
abundance of oxyhemoglobin.
Venous blood – dull purplish red, due to the
predominance of reduced hemoglobin.
C. Specific Gravity
1.045 to 1.075 – varies depending on the
gender, where men have slightly higher sp.gr.
than in women.
D. Viscosity
4.4 to 4.7 – the blood is 3-4 times more viscous
than water.
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IV. Components of the Blood
The blood is made up of the liquid portion
(plasma and cellular elements, RBC, WBC,
platelets)
Is the liquid component of blood, consisting of
around half of the total blood volume.
Plasma itself is around 90% water, with the 10%
remainder including proteins, minerals, waste
products, clotting factors, hormones, and
immunoglobins.
Without plasma, RBCs would have no medium to
travel on as they moved through the body, and
plasma also performs a number of other useful
functions in the body.
A. Plasma
As a liquid, it absorbs, transports, and releases
heat. The proteins such as the albumin are part of
osmotic balance, the globulin for defense
mechanism, fibrinogen for blood clotting, while
the electrolytic ions are responsible for the
buffering in the blood.
• 50-60% volume in the blood
• 90-92% water/8-10% solids
• 1.026 specific gravity
• 1.7-2 viscosity
• 7.4-7.45 pH
• Pale yellow colored liquid component of
the blood that holds cellular elements in
suspension.
• Nutrients (plasma proteins)
• Waste product metabolism (nitrogenous
waste products, lactic acid, ketone
bodies)
• Inorganic acids (K, Na, Ca, Cl, HCO3)
• Enzymes (also hormones, and vitamins)
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Plasma - liquid portion of the unclotted. Sulfhemoglobin is formed from the action of
Serum - liquid portion of the clotted blood. hydrogen sulfide.

WBC (Leukocytes)
B. Cellular Elements
• Larger than RBC
40 – 45% of the volume
• 5,000-10,000 per/cu. Mm of blood
RBC (Erythrocytes) • Chemical composition resembles other
tissue cells
• Biconcave disks
• Has 2 types: agranulocytes (no granules)
• Devoid of nucleus
and granulocytes (have granules).
• 4.5-5mil per/cu.mm
• Predominated by proteins, the
Exhibit no synthetic activity for proteins
nucleoproteins are the chief proteins.
fats carbs
• Most important constituent is Agranulocytes
hemoglobin (31-33%), the chief agent
• Monocytes 30%
for the transport of CO2 and O2.
• Lymphocytes 5.3%
• 6-9 micra (size)
• Sp.gr. 1.09 Granulocytes
• 55% water, 32% solids, remaining 3% is
made up of proteins and lipids that form • Neutrophil 62%
the cell membrane and the stroma • Basophil 2-3.4%
where the hemoglobin is held. • Eosinophil (acidophils) 2.3%

The hemoglobin is a conjugated protein with a Platelets

molecular weight of 68,000. It has one globin
where four Heme is attached to it, this is
responsible for its specificity, buffering property,
and capability to carry CO2
Due to differences in the globin portion, there are
variations of human hemoglobin and in
electrophoretic mobility.
For adults we have hemoglobin A, hemoglobin F
is fatal, hemoglobin S is sickle cell anemia, etc.
It can form various compounds with other
substances.
The oxyhemoglobin is the combination of O2 and
hemoglobin, it is unstable as it stays in a ferrous
state. Carbamino compound is the combination of
CO2 and hemoglobin, it is also unstable, making
it compatible for facilitating the gas exchange.
The carboxyhemoglobin is the combination of
carbon monoxide and hemoglobin.
• 200,000-400,000 per/cu.mm of blood
• They contain proteins that have a large
number of phospholipids, and take part
in blood coagulation
V. Blood Cells
Are formed in the bone marrow. All blood cells
arise from the same bone marrow stem cells.
Stem cells are immortal, meaning they never die
(at least not until you do).
Stem cells are also undifferentiated, meaning
they have not yet developed into a particular cell
type.
Furthermore, stem cells are pluripotent, meaning
they have the potential to become any type of
blood cell. These immortal, undifferentiated,
pluripotent stem cells give rise to erythrocytes,
leukocytes and platelets.

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NPA I BSMT 2F
 Red Blood Cells (Erythrocytes)
Are shaped as slightly indented, flattened disks.
RBCs contain the iron-rich protein hemoglobin.
Blood gets its bright red color when hemoglobin
picks up oxygen in the lungs. As the blood travels
through the body, the hemoglobin releases
oxygen to the tissues.
The body contains more RBCs than any other type
of cell, and each has a life span of about 4 months
(120 days). Each day, the body produces new
RBCs to replace those that die or are lost from the
body.
• Erythropoiesis – production of RBC
• Polycythemia – increase in RBC
• Erythropenia – decrease in RBC
White Blood Cells (Leukocytes)
Are a key part of the body's system for defending
itself against infection.
They can move in and out of the bloodstream to
reach affected tissues.
Blood contains far fewer WBCs than red blood
cells, although the body can increase WBC
production to fight infection.
Colorless and translucent.
• Leukopoiesis – production of WBC
• Leukocytosis – increase of WBC
• Leukopenia – decrease of WBC
• Leukemia – pathological increase of WBC
Platelets (Thrombocytes)
Are tiny oval-shaped cells made in the bone
marrow. (Circular, biconvex, non-nucleated)
They help in the clotting process. When a blood
vessel breaks, platelets gather in the area and
help seal off the leak.
Platelets survive only about 5-9 days in the
bloodstream and are constantly being replaced
by new cells.
NPA I BSMT 2F
• Thrombopoiesis – production of platelets
• Thrombocytosis – increase of platelets
• Thrombocytopenia – decrease of
platelets.
VI. Blood Coagulation
One of the nature’s defense mechanism
against possible hemorrhage whenever the
blood vessel wall gives way for injuries.
The precise detail of the platelets reaction
that initiates the process of coagulation
remains controversial.
There are various terminologies and factors to
consider, and one of them is blood
coagulation time.
Blood clotting is the process wherein the
blood loses its fluidity to become a jelly like
mass for a few minutes before it is shed out.
Coagulation Time
A diagnostic test to determine some
abnormalities in the blood. It is the time which
the blood takes to clot after it has been shed.
The time is influenced by temperature, size of the
drop, the cleanliness of the instrument.
It is more rapid when the blood is squeezed from
the site of puncture compared to when it flows
freely owing to the mixture of tissue fluids.
It is never possible to estimate the amount of
such a mixture when the blood is obtained by
puncturing the skin.
• Takes place in 2-6 mins after the blood
leaves the vessels (via puncture of skin)
• Normal coagulation time (20 minutes)
• Prolonged coagulation time may be due
to thromboplastin, prothrombin and
fibrinogen
• Hemophilia (one to several hours)
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Two types of Coagulation Time
Capillary Method
The use of fine capillary tube filled with blood,
and at a 15 second interval, is broken down little
by little until the appearance of a fine thread at
the end of the broken sections of the tube.
Drop Method
Placing a drop of blood on a clean slide and
using a needle to draw it through the blood in a
15 sec interval until the fibrin clings to the
needle and it is dragged along the needle.
Bleeding time
• The time required for a small cut to
cease bleeding.
• Usually from 1 – 3 minutes
• Acute leukemia/Aplastic anemia –
prolonged bleeding time (10-90 mins)
The interval from the onset of the bleeding up to
the disappearance of the spot.
It is determined by touching the bleeding
puncture with a piece of filter paper with an
interval of 15 seconds. The time is noted as soon
as the spot of blood disappears.
It does not parallel to the coagulation time of the
blood as it is highly reliant on the deficiencies of
the tissue fluid, elasticity of blood vessel walls,
and chemical/mechanical action of platelets.
VII. Blood Clotting
Is an important mechanism to help the body
repair injured blood vessels.
The medical term for a blood clot is a thrombus
(plural= thrombi).
When a thrombus is formed as part of a normal
repair process of the body, there is little
consequence. Unfortunately, there are times
when a thrombus (blood clot) will form when it is
not needed, and this can have potentially
significant consequences.
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VIII. Blood Tests
Blood tests are an essential diagnostic tool to
determine any characteristics, abnormalities in
the blood and body.
Blood is made up of different kinds of cells and
contains other compounds, including various
salts and certain proteins.
Blood tests reveal details about these blood cells
and, blood compounds, salts and proteins.
Complete Blood Count (CBC)
The CBC is one of the most common blood tests.
It's often done as part of a routine checkup.
The CBC can help detect blood diseases and
disorders, such as anemia, infections, clotting
problems, blood cancers, and immune system
disorders. This test measures many different
parts of your blood.
Hematocrit
Is a measure of how much space red blood cells
take up in your blood.
• High hematocrit level - dehydrated.
• Low hematocrit - anemia.
• Abnormal hematocrit levels – sign of a
blood or bone marrow disorder.
The blood sample is collected with a capillary
tube and is then centrifuged by a machine that
measures the pack of the RBC, then the range of
whether or not it is high is considered.
Blood Chemistry Test/Basic Metabolic
Panel
The basic metabolic panel (BMP) is a group of
tests that measures different chemicals in the
blood. These tests usually are done on the fluid
(plasma) part of blood.
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The tests can give doctors information about your
muscles (including the heart), bones, and organs,
such as the kidneys and liver.
The BMP includes blood glucose, calcium, and
electrolyte tests, as well as blood tests that
measure kidney function.
Some of these tests require you to fast (not eat
any food) before the test, and others don't. Your
doctor will tell you how to prepare for the test(s)
you're having.
Blood Tests to Assess Heart Disease Risk
A lipoprotein panel is a blood test that can help
show whether you're at risk for coronary heart
disease (CHD). This test looks at substances in
your blood that carry cholesterol.
Most people will need to fast for 9 to 12 hours
before a lipoprotein panel.
IX. Blood Types
There are four major blood groups determined by
the presence or absence of two antigens - A and
B - on the surface of red blood cells:
Group A - has only the A antigen on red cells (and
B antibody in the plasma)
Group B - has only the B antigen on red cells (and
A antibody in the plasma)
Group AB - has both A and B antigens on red cells
(but neither A nor B antibody in the plasma)
Group O - has neither A nor B antigens on red
cells (but both A and B antibody are in the
plasma)
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Using blood sera, antisera A, antisera B, and
antisera D. After collecting the blood, and three
drops are placed on a clean glass slide and a drop
of each antisera is added to the blood.
An agglutination is what determines the blood
type.
RH Blood Group System (Rhesus Factor)
An antigen, or more specifically a protein, that
exists on the surface of red blood cells.
There are four general categories of blood: A, B,
O, and AB. Each blood type is further labeled as
positive or negative, which is a reference to the
Rhesus factor of the blood.
People with the Rhesus factor, that is, people
with the antigen present in their blood, are Rh-
positive.
So a person who has a blood type of A and has
the Rhesus factor is said to have A-positive, or A+,
blood.
More than 85% of people are Rh-positive. People
without the Rhesus factor, that is, people that
don't have the antigen in their blood, are Rh-
negative
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 Blood Type Compatibility
X. Common Blood Disorders
Thrombocytopenia
A lower-than-normal number of platelets, is
usually diagnosed because a person has
abnormal bruising or bleeding.
Thrombocytopenia can happen when someone
takes certain drugs or develops infections or
leukemia or when the body uses up too many
platelets.
Idiopathic thrombocytopenic purpura (ITP) is a
condition in which the immune system attacks
and destroys platelets.
Sepsis
Also known as gram-negative bacteremia and
gram- positive bacteremia,
Sepsis is an overwhelming and life-threatening
bacterial infection of the Blood and body organs
caused by bacteria that has entered body tissue,
most often through a wound or incision, that
leads to the formation of pus, and/or to the
spread of the sepsis bacteria throughout the
Blood stream.
Sepsis is often caused by organisms that are
resistant to most standard antibiotics and more
often than not, is found in people with a
weakened immune system.
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Sickle Cell Disease
A hereditary Blood disease resulting from a
single amino acid mutation of the red Blood cells.
A Blood condition of anemia. People with sickle
cell disease have red Blood cells that contain
mostly hemoglobin S, an abnormal type of
hemoglobin.
Sometimes these red Blood cells become
crescent shaped "sickle shaped" and have
difficulty passing through small Blood vessels.
There is currently no universal cure for Blood
borne sickle cell disease.
Leukemia
Are cancers of the cells that produce WBCs.
These cancers include acute myeloid leukemia
(AML), chronic myeloid leukemia (CML), acute
lymphocytic leukemia (ALL), and chronic
lymphocytic leukemia (CLL).
The most common types of leukemia affecting
kids are ALL and AML. In the past 25 years,
scientists have made great advances in treating
several types of childhood leukemia, most
notably certain types of ALL.
Polycythemia Vera
With this Blood disorder, patients not only have
more red cells, that is, hematocrits can almost
double in some cases, but there is also a slow,
steady buildup of white cells and platelets.
Thalassemia
A group of fatal genetic Blood disorders. The
WHO recognizes Thalassemia as the most
prevalent inherited genetic Blood disorder in the
world
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 Thrombosis
Thrombosis forms a plug. When the platelets try
to patch up an injury within a small Blood vessel
and completely plug it up instead. This plug
obstructs the normal flow of Blood and can result
in a heart attack or stroke.
Hemophilia
(also Haemophilia) A genetic Blood disease that
causes the Blood to be unable to form a firm clot
normally and quickly.
High Blood Pressure
The most common risk factor for heart and
kidney diseases and stroke. High Blood pressure,
or hypertension, is defined in an adult as a
systolic pressure (top number) of 140 mm Hg or
higher and/or a diastolic pressure (bottom
number) of 90 mm Hg or higher. Blood pressure
is measured and noted in millimeters of mercury
(mm Hg).
HIV/AIDS
A Blood-borne disease of the human immune
system that is characterized cytologically
especially by a reduction in the numbers of CD4-
bearing helper T cells, to 20% or less of normal,
rendering the subject highly vulnerable to life-
threatening conditions, such as pneumonia.
Hemochromatosis
A most often hereditary Blood disorder that
causes body tissue to absorb and store too much
iron.
Hemochromatosis is not "caught."
The disease (which is actually many diseases) has
also been known to develop as a result of dietary
iron intake in sufficient quantity.
NPA I BSMT 2F
Its worst effects are preventable, by early
diagnosis and treatment, but, if the patient is not
found in time, it is crippling and potentially fatal.
Lymphatic Filariasis
Is a debilitating Blood disease caused by
nematode worms of the genera Wucheria and
Brugia. Larval worms circulate in the Bloodstream
of infected persons, and adult worms live in the
lymphatic vessels.
Lymphatic filariasis is not life threatening, but it
does cause extreme discomfort, swelling of the
limbs and genitals, damage to the kidneys and
lymphatic system, impairment of the body's
ability to fight infection, and general malaise.
Blood Cholesterol
An important attribute in deciding a person's risk
of getting coronary heart disease. When you have
too much cholesterol in your Blood, the excess
builds up on the walls of the arteries that carry
Blood to the heart.
This buildup is called "atherosclerosis" or
"hardening of the arteries." It narrows the
arteries and can slow down or block Blood flow to
the heart. With less Blood, the heart gets less
oxygen.
With not enough oxygen to the heart, there may
be chest pain, heart attack, or even death.
Cholesterol buildup is the most common cause of
heart disease, and it happens so slowly that you
are not even aware of it. The higher your Blood
cholesterol, the greater your chance of this build-
up.
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 Anemia
A common Blood disorder condition that is
caused by an acquired or inhered abnormality of
red Blood cells to provide adequate oxygen
supplies to body tissues.

Anemia may, in some cases, be a manifestation of

an non- hematologic disorder.

The condition may be due to decreased number

of red Blood cells, decreased amount of
substance in red Blood cells which transports
oxygen hemoglobin, or decreased volume of red
Blood cells. There are several diseases properly
known as Anemia.

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NPA I BSMT 2F