The Structure and

Function
of Blood

Blood
The circulating fluid of the body is BLOOD,
a specialized connective tissue that
contains cells suspended in a fluid matrix
3 general functions
1.Transportation
Gases, nutrients, hormones, waste products

2.Regulation
pH, body temperature, osmotic pressure

3.Protection
Clotting, white blood cells, proteins

Components of Blood
Blood plasma water liquid extracellular matrix
91.5% water, 8.5% solutes (primarily proteins)
Hepatocytes synthesize most plasma proteins
Albumins, fibrinogen, antibodies
Other solutes include electrolytes, nutrients,
enzymes, hormones, gases and waste
products
Formed elements- cell and cell fragments
- RBCs (Red blood Cells)
- WBCs ( white blood cells)
- Platelets

 Blood and lymph are connective tissues

that contains distinctive collection of
cells in a fluid matrix. In blood, the
watery matrix is called PLASMA
Red Blood Cells, accounts for almost
half the volume of blood. RBC transport
oxygen in the blood.RBC contains
small numbers of WBC, important
components of the immune system
Platelets, cell fragments that function
in the blood clotting.

Composition of Blood
Blood is responsible for..
Transporting gases (oxygen & carbon
dioxide)
Transporting waste products
Transporting nutrients
Helping remove toxins from the body

Composition of Blood
Blood makes up 68% of our
total body weight.
Normal adult blood volume is 5 L.
Blood is made up of cellular
material in a fluid matrix
called plasma.

Composition of Blood
Blood is a circulating tissue
consisting of three types of cells.
1. Red Blood Cells Erythrocytes
2. White Blood Cells Leukocytes
3. Platelets Thrombocytes

The cells listed above are suspended in

a liquid known as plasma.

Formation of Blood
Hematopoiesis the formation and development of blood cells
In adults the cellular elements are produced in the bone marrow.
Some WBCs are produced in the lymphatic tissue and bone
marrow.
Blood cells need certain nutrients to form properly.
Examples include..
Iron
Folic acid
Vitamin B12
All blood cells formed come
from a hematopoietic stem cell.
These cells can become any
blood cell.

Composition of Blood
The blood is made up of cells
that are suspended in liquid
called plasma.
Plasma makes up 55% of the blood.
Plasma is made of 90% water and
10% proteins, lipids, carbohydrates,
amino acids, antibodies, hormones,
electrolytes, waste, salts, and ions
Blood cells make up the remaining
45% of the blood.
Red blood cells make up 99% of the blood cells.
White blood cells and platelets make up the other 1%.

Composition of Blood
Each type of blood cell performs a different function.
Red blood cells (Erythrocytes)

White blood cells (Leukocytes)

Platelets (Thrombocytes)

Composition of Blood:
Red Blood Cells
Red Blood Cells
Stain pink-tan

Center of cell is lighter

central area of pallor
Life span of about 120 days
Hemoglobin (iron protein)is
found in the RBC
Hemoglobin carries oxygen from the
lungs to the rest of the body and carbon
dioxide binds to the RBC and is taken to
the lungs to be exhaled.

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Composition of Blood:
White Blood Cells
White blood cells
Contain nuclei with DNA,
the shape depends on type of cell
Certain WBCs produce antibodies
Life span is from 24 hours to several years
Size is 8-20 micrometers in diameter
There are five different types of WBCs
1. Neutrophils
2. Eosinophils
3. Basophils
4. Lymphocytes
5. Monocytes

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Composition of Blood:
Platelets
Platelets
Involved in the clotting process
Seal wounds and prevent blood loss
Help repair damaged vessels
150,000 400,000 per microliter of blood
Platelets stain bluish with reddish or purple granules

The Blood Group Systems

Inheritance and Genetics

History of Blood Groups and Blood Transfusions

Experiments with blood transfusions

have been carried out for hundreds of
years. Many patients have died and it was
not until 1901, when the Austrian Karl
Landsteiner discovered human blood
groups, that blood transfusions became
safer.
He found that mixing blood from two
individuals can lead to blood clumping.
The clumped RBCs can crack and cause
toxic reactions. This can be fatal.

History of Blood Groups and Blood

Transfusions (Cont.)
Karl Landsteiner discovered that blood
clumping was an immunological reaction
which occurs when the receiver of a blood
transfusion has antibodies against the donor
blood cells.
Karl Landsteiner's work made it possible to
determine blood types and thus paved the
way for blood transfusions to be carried out
safely. For this discovery he was awarded the
Nobel Prize in Physiology or Medicine in
1930.

General function of Blood

Transportation
Regulation
Protection
a.) Material transported by the blood
include nutrients, waste products,
gases and hormones.
b.) The blood helps regulate fluidelectrolyte balance, acid-base
balance, and body temperature.

 PROTECTION- against pathogens is

provided by white blood cells, and
the blood clotting mechanism
prevents excessive loss of blood after
injuries

Characteristic of Blood-(Amount)
An adult human has about 46
liters of blood , depending on his
or her size.
Blood consists of several types
of cells floating around in a fluid
called plasma.
38-48% is composed of various
blood cells called formed
elements
The remaining 52 to 62% of
the blood volume is plasma, the
liquid portion of blood.

Color
Arterial blood is bright red because it
contains high level of oxygen
Venous blood has given up much of its
oxygen in tissue, and has a darker, dull
red color.
If blood is bright red, it is probably from
a several artery, and dark red blood is
probably venous blood.

pH and viscosity
pH- normal pH range of blood is 7.35-7.45
which is slightly alkaline.
Venous blood normally has a lower pH than
does arterial blood because of the presence
of more carbon dioxide.
Viscosity- thickness or resistance to flow.
blood is about 3-5 thicker than water.
Viscosity is increase by the presence of
blood cells and the plasma proteins, and
this thickness contributes to normal blood
pressure

Plasma
Is the liquid part of blood and is
approximately 91% water.
Most of the carbon dioxide produced by
cells is carried in the plasma in the form
of bicarbonate ions,
Also in the plasma are the , plasma
proteins. The clotting factors prothrombin,
fibrinogen, and others are senthesized by
the liver and circulate and activated to
form a clot in a ruptured blood vessel.

ALBUMIN- the most abundant plasma protein.

Contributes to the colloid osmotic pressure
of the blood which pulls tissue fluids into
the capilliaries, this is important to
maintain blood volume and blood pressure.
Other plasma proteins are called
globulins..Alpha and beta globulins are
synthesized by the liver.
The gamma globulin are antibodies
produced by lymphocytes.
Antibodies initiate the distruction of
pathogens and provide us with immunity

Blood cells

3 kinds of blood cells

Red blood cells
White blood cells
Platelet
Blood cells are produced from stem
cells in hemopoietic tissue, after birth
this is primarily the red bone marrow,
found in flat and irregular bone such as
the sternum , hip bone and vertebrae.

Red Blood Cells

Also called erythrocytes, red blood
cells(RBCs) are binconcave disc,
which means their centers are thinner
than the edges.
Red blood cells are the only cells
without nuclei.
Their nuclei disintegrate as the red
blood cells mature and are not needed
for normal functioning.

 Normal RBC count ranges from 4.5-6.0

million cell per microliter of blood.
Hematocrit range is just like that of the
total blood cells, 38% to 48%. Both
RBCscountand hematocrit are part of a
complete blood count.
FUNCTION:
Red blood cells contain protein hemoglobin
which givesthem the ability to carry oxygen.
Red blood cells contain approx. 300 million
hemoglobin molecules, each of which can
bond to four oxygen molecules.

 Red blood cells are formed in the

bone marrow in the flat and irregular
bones. Within red bone marrow are
precursor cells called stem cells.
The stem cell of the bone marrow
may also be calle hemocytoblast
(hemo=blood. Cyto=

What are the different blood groups?

The differences in human blood are due to the
presence or absence of certain protein molecules
called antigens and antibodies.
The antigens are located on the surface of the
RBCs and the antibodies are in the blood
plasma.
Individuals have different types and
combinations of these molecules.
The blood group you belong to depends on
what you have inherited from your parents.

What are the different blood groups?

There are more than 20 genetically determined
blood group systems known today
The AB0 and Rhesus (Rh) systems are the
most important ones used for blood transfusions.
Not all blood groups are compatible with each
other. Mixing incompatible blood groups leads to
blood clumping or agglutination, which is
dangerous for individuals.

ABO blood grouping system

According to the ABO blood
typing system there are four
different kinds of blood types:
A, B, AB or O (null).

Blood Types

http://www.bloodbook.com/world-abo.html

AB0 blood grouping system

Blood group A
If you belong to the blood
group A, you have A
antigens on the surface of
your RBCs and B
antibodies
in your
blood
Blood
group
B
plasma.
If
you belong to the blood
group B, you have B
antigens on the surface of
your RBCs and A
antibodies in your blood
plasma.

Blood group AB
If you belong to the blood group
AB, you have both A and B
antigens on the surface of your
RBCs
and group
no A orOB antibodies
Blood
at all
in your
blood
If you
belong
to plasma.
the blood group O
(null), you have neither A or B
antigens on the surface of your RBCs
but you have both A and B antibodies
in your blood plasma.

Why do individuals produce antibodies to

antigens they do not have?
The "A and "B" antigens are also produced
by some other plants and microorganisms.
Thus, individuals who do not recognize one or
more of these antigens as "self" will produce
antibodies against the plant or microbial
antigens.
These antibodies will also react with human
antigens of the same kind whether introduced
via a blood transfusion or a tissue graft.

ABO inheritance and genetics

The ABO gene is autosomal (the gene is not on either sex
chromosomes)
The ABO gene locus is located on the chromosome 9.
A and B blood groups are dominant over the O blood group
A and B group genes are co-dominant
Each person has two copies of genes coding for their ABO blood
group (one maternal and one paternal in origin)

AUTOSOMAL CHROMOSOME

Susan

The alleles for Blood

group are in the same
place on the
chromosome 9.
However the genes
have a different code
giving the different
blood group

one alleles from Pete and one

from Susan.

Pete

What do co-dominant genes mean?

This meant that if a person inherited one A group gene and one
B group gene their red cells would possess both the A and B
blood group antigens.
These alleles were termed A ( which produced the A antigen ),
B (which produced the B antigen) and O (which was "non
functional"and produced no A or B antigen)

Possible Blood group Genotypes

Parent
Allele
A
B
O

Possible Blood group Genotypes

Parent
Allele

AA

AB

AO

AB

BB

BO

AO

BO

OO

The ABO blood groups

The most important in assuring a safe blood transfusion.
The table shows the four ABO phenotypes ("blood groups") present
in the human population and the genotypes that give rise to them.
Blood Antigens
Group on RBCs
A
B
AB
O

A
B
A and B
Neither

Antibodies in Serum

Genotypes

Anti-B
Anti-A
Neither
Anti-A and anti-B

AA or AO
BB or BO
AB
OO

Why group A blood must never be

given to a group B person?
Giving someone blood from the wrong ABO
group could be fatal.

The anti-A antibodies in group B attack group

A cells and vice versa.
Blood group O negative is a different story.

The Rhesus (Rh) System

Well, it gets more complicated here, because there's
another antigen to be considered - the Rh antigen.
Some of us have it, some of us don't.
If it is present, the blood is RhD positive, if not it's RhD
negative.
So, for example, some people in group A will have it, and
will therefore be classed as A+ (or A positive).
While the ones that don't, are A- (or A negative).
And so it goes for groups B, AB and O.

The Rhesus (Rh) System (Cont.)

Rh antigens are transmembrane proteins with loops
exposed at the surface of red blood cells.
They appear to be used for the transport of carbon
dioxide and/or ammonia across the plasma membrane.
They are named for the rhesus monkey in which they
were first discovered.
RBCs that are "Rh positive" express the antigen
designated D.
85% of the population is RhD positive, the other 15% of
the population is running around with RhD negative
blood.

Rh Blood Group and Rh Incompatibility

A person with Rh- blood does not have Rh
antibodies naturally in the blood plasma

Blood
Type

Genotype

Alleles
Produced

RR

Rr

R or r

rr

Rh positive

Rh negative

Do you know which blood group you

belong to?
According to above
blood grouping systems,
you can belong to either
of following 8 blood
groups:

A person with Rh- blood can develop Rh antibodies

in the blood plasma if he or she receives blood from a
person with Rh+ blood, whose Rh antigens can trigger
the production of Rh antibodies.

A person with Rh+ blood can receive blood from a

person with Rh- blood without any problems.

Why is an Rh incompatibility so dangerous

when ABO incompatibility is not during
pregnancy?
Most anti-A or anti-B antibodies are of the IgM class
(large molecules) and these do not cross the
placenta.
In fact, an Rh/type O mother carrying an
Rh+/type A, B, or AB fetus is resistant to
sensitisation to the Rh antigen.
Her anti-A and anti-B antibodies destroy any fetal
cells that enter her blood before they can elicit antiRh antibodies in her.

Rh incompatibility during pregnancy (cont.)

This phenomenon has led to an effective
preventive measure to avoid Rh sensitisation.
Shortly after each birth of an Rh+ baby, the
mother is given an injection of anti-Rh
antibodies (or Rhogam).
These passively acquired antibodies destroy
any foetal cells that got into her circulation
before they can elicit an active immune
response in her.

The ABO Blood Group System

Laboratory Determination of the
ABO System

Several methods for testing the ABO group of an

individual exist. The most common method is:
Serology: This is a direct detection of the ABO
antigens. It is the main method used in blood
transfusion centres and hospital blood banks.
This form of testing involves two components:
a) Antibodies that are specific at detecting a
particular ABO antigen on RBCs.
b) Cells that are of a known ABO group that
are agglutinated by the naturally occurring
antibodies in the person's serum.

 Illustration of the forward and reverse

grouping reaction patterns of the ABO
groups using a blood group tile

http://www.bh.rmit.edu.au/mls/subjects/abo/resources/genetics1.htm

When RBCs carrying one or both antigens are exposed to the

corresponding antibodies, they agglutinate; that is, clump
together. People usually have antibodies against those red cell
antigens that they lack.

Human RBC before (left) and after (right) adding serum

containing anti-A antibodies. The agglutination reaction
reveals the presence of the A antigen on the surface of the
cells.

Blood transfusions who can

receive blood from
whom?
People with blood group O
are called "universal
donors" and people with
blood group AB are called
"universal receivers."

Blood
Group

AB

Antigens

Antibodies

Can give
blood to

Can
receive
blood from

Blood
Group

Antigens

Antibodies

Can give
blood to

Can
receive
blood from

AB

A and B

None

AB

AB, A, B, O

A and AB

A and O

B and AB

B and O

None

A and B

AB, A, B, O

 There are numerous signs that indicate a

transfusion reaction and these can vary
from very mild to serious lifethreatening situations. If the patient is
showing any abnormal clinical signs the
surgeon should be informed immediately
and the transfusion stopped. The usual
treatment of a blood transfusion reaction
is to administer crystalloid fluids,
antihistamines, antibiotics and
corticosteroids.

Clinical signs associated with

blood transfusion reaction
Urticaria
Hypersalivation
Muscle tremors
Tachycardia
Vomiting/nausea
Restlessness
Jaundice

Dyspnea
Hemoglobinuria
Pyrexia
Facial edema
Tachypnea
Convulsions

BLOOD PPRODUCTS FOR

TRANSFUSION
WHOLE BLOOD- Not commonly
used except for extreme cases of
acute hemorrhages. Replaces blood
volume and all blood products: RBCs
, plasma proteins, Fresh Platelets
and other clotting factors.

PACKED RED BLOOD

CELLS
Use to increase the oxygen- carrying
capacity of blood in anemias,
surgery and disorders with slow
bleeding. Use to one unit of PRBCs
has the same amount of oxygencarrying RBCs as a unit of whole
Blood. One unit increases hematocrit
by APPROX. 1%-3%.

AUTOLOGOUS RBCS
Used for blood replacement following
planned elective surgery. Client
donate blood for autologous
transfusion 4-5 weeks prior to
surgery.

PLATELET
Replace platelet to client with
bleeding disorders or platelet
deficiency. Fresh platelets are most
effective. Each unit should increase
the average adult platelet by 5000
platelet/microliter.

FRESH FROZEN PLASMA

Expands blood volume and provides
clotting factor. Does not need to be
typed and crossmatched (contained
no RBCs)each unit will increase the
level of of any clotting factor by 2%to
3% in an average adult

ALBUMIN AND PLASMA PROTEIN

FRACTION CLOTTING FACTORS
AND CRYOPRECIPITATE
Blood expanders, provides plasma
proteins, used for clients with clotting
factor deficiencies. Each provides
different factors involved in the clotting.
CLOTTING PATHWAY;
CRYOPRECIPITATE ALSO CONTAINS
FIBRINOGEN