1

HPHS221W1
Lecture 1
BLOOD )

N. MKHWANAZI
MKHWANAZI@UKZN.AC.ZA
EXT: 4072

ROOM 212 DDMRI MEDICAL SCHOOL

 Spots Facts 2

One drop of blood contains 1 billion A women’s body contains between

red blood cells and 2 million white 4 and 5 liters of blood; a man
blood cells ‘s has 5 to 6 liters

Your heart is about the

Your heart beats
size of your clenched fist. about 40 million
An average heart weighs times every year. The
around 300g heart of young baby
beats up to 120 times
every minutes
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LEARNING OUTCOMES

 Characteristics of the blood.

 Major components of blood.
 Different types of blood cells
 Major functions of blood.
 To understand the process of erythropoiesis.
 Regulation of Erythrocyte production.
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Blood
 Is the fluid confined to the interconnected tubes called blood vessels
 Is a mixture of cellular component suspended in a fluid called plasma

 Delivery of nutrients
◦ Oxygen
◦ Food
◦ Vitamins
 Removal of wastes
◦ Carbon dioxide
◦ Nitrogenous wastes
◦ Cellular toxins
 Protection versus invading microorganisms
 Multiple cellular & acellular elements
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Components, characteristics of
blood

 Major components of blood

 Clear/ yellowish Plasma
 Thin/whitish buffy coat (leukocytes and
platelets)
 Reddish mass- erythrocytes.
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Components of blood

 Plasma
 Transport mechanism
Plasma Components
 90-92% water.
 6-7% proteins Water
90%

 2-3%
 Fats
 Carbohydrates (glucose)
 Electrolytes
Other Protein
 Gases (O2, CO2) 3% 7%

 Chemical messengers
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General characteristics of the
plasma

 Plasma makes up 55% of normal blood by

volume
 Water is 90% of the plasma by volume
 Many different solute in the plasma
 Albumin-pH buffer and osmotic pressure
 Globulins-binding proteins and antibodies
 Clotting proteins- prothrombin and
fibrinogen
 Other proteins-enzymes, hormones, others
 Nutrients-glucose, fatty acids, amino acids,
cholesterol, vitamins
 Electrolytes
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Plasma proteins

 Exerts an osmotic pressure that favours the

absorption of extracellular fluid into capillaries.
 Classified into three broad groups:
 Albumins

 Globulins

 Fibrinogen

 Albumins and globulins

 Synthesized in the liver
 provide nonpenetrating solutes of plasma
 Bind and transport other plasma constituents
(lipids,hormones, vitamins,metals etc).
 Fibrinogen function in clotting
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The Blood cells

 Formed elements- the actual cellular components of blood

 Erythrocytes- red blood cells
 Leukocytes- white blood cells
 Platelets- cell fragments for clotting
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Characteristics of Blood

 Bright red (oxygenated)

 Dark red/purplish (unoxygenated)
 Much more dense than pure water
 pH (7.35-7.45)
 Slightly warmer than body temperature
 5-6 litres male adult
 4-5litres female adult
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3 Type of blood vessels

 Arteries-brings blood from the heart to

the organs.
 Capillaries-very fine that branches into
a network
 Veins- brings bloods back hearts
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Major Functions of Blood

1.Distribution and Transport

 Oxygen from lungs to body cells
 Carbon dioxide from body cells to lungs
 Nutrients from GI tract to body cells
 Nitrogenous wastes from body cells to kidneys
 Hormones from glands to body cells

2. Regulation (maintenance of homeostasis)

 Normal body pH (blood proteins (albumin) and bicarbonate
 Circulatory/interstitial fluid
 temperature

3. Protection
 Platelets and proteins seal vessel damage
 Protection from foreign material and infections
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Erythrocytes

 Carry oxygen taken in by lung and carbon dioxide

produced by the cells.
 It consist of large amount of protein called
hemoglobin
 Oxygen binds to iron atom in the hemoglobin
molecules.
 Concentration Hb in women 14g/100ml and
16g/100ml in men
Erythrocytes- Red blood cells 14

 Produced in bone marrow

 7.5 micron diameter;2.0 micron
thick
 Biconcave disk shape; ideal for gas
exchange; with heamoglobin
 No nucleus
 Very few organelles; mainly a
hemoglobin carrier.
 No mitochondria; only anaerobic
respiration.
 Ratio
erythrocytes:leukocytes=800:1.
 No DNA nor RNA (no division
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Haemoglobin
 Pigmented protein complex.
 Globin 4 subunits, 2 alpha and 2 beta.
 Iron containing Heme unit.
 Each heme molecules bind one oxygen
molecules
 States of haemoglobin
 Oxy-heamoglobin- when oxygen is
bound to IRON
 Deoxy-heamoglobin- no oxygen bound
to IRON
 Carbamino-heamoglobin- when
carbon dioxide bound (to polypeptide
chain
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Iron

 Is the element to which oxygen binds on a haemoglobin molecules within an

erythrocytes.

 Iron balance must be maintained by ingesting of iron containing foods.

 Food that rich in iron are: meat, liver, shellfish, egg yolk, beans, nuts and
cereal.

 Iron deficiency leads to inadequate haemoglobin.

 Hemochromatosis- is the excess of iron in the body; it is a serious toxic effect.

 Ferritin- is the protein that bound iron that is stored in the liver; serves as a
buffer against iron deficiency.

 Transferrin- is the protein that bound iron that is release in the plasma; delivers
all this iron into the bone marrow to be incorporated into the new
erythrocytes.
 Folic acid and Vitamin B12 17

 Folic acid- Necessary for DNA replication, thus cell proliferation.

 Vitamin B12- Necessary for DNA replication, thus cell proliferation.

 Few erythrocytes are produced when folic acid deficiency

 Vit B12 (cobalamin) is required for the action of folic acid

 Intrinsic factor is required in absorption of Vit B12

 Lack of intrinsic factor causes Vit B12 deficiency.

 This results to erythrocytes deficiency known as pernicious anaemia

 Erythropoiesis 18

 The process of maturation, development and production of erythrocytes- erythropoiesis.

 RBC are synthesized in bone marrow, specifically red bone marrow.

 Erythrocytes precursor produce haemoglobin- they lose their nucleus and organelles.

 They have short life span and only last about 120 days and they must be replaced
everyday.

 Dying erythrocytes normally occurs in the spleen and in the liver.

 Bilirubin is the major breakdown of haemoglobin which give the plasma yellowish colour.

 Erythropoietin (hormone from kidneys) triggers differentiation of stem cells to erythrocytes.

 Production of Erythrocytes 19

• Vitamins, folic acid and vitamin B12 are essential for production of
erythrocytes
• A hemocytoblast is transformed into a committed cell called proerythroblast

• Proerythroblast develop into early erythroblast.

• The developmental pathway consists of three phases

• Phase 1> > ribosome synthesis
• Phase2>>hemoglobin accumulation
• Phase 3>> ejection of nucleus from normablast

• Reticulocytes then become mature erythrocytes

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Regulation of Erythropoiesis

 Hormonal controls- erythropoietin is the hormone that stimulates RBC

production.

 Decreased oxygen level in blood causes kidneys to increase release of

erythropoietin
 Less RBCs from bleeding
 Less RBCs from excess RBC destruction
 Low oxygen levels (high altitude, illness)
 Increased oxygen demand exercise

 Testosterone can also mildly stimulate production of RBC in humans.

 Iron- essential for haemoglobin in carry oxygen.

 B-complex Vitamins- vitamin B12 and Folic acid essential for DNA synthesis in
early mitotic divisions leading to erythrocytes.
 Regulation and Requirements for 21
Erythropoiesis

 Circulating erythrocytes – the number remains

constant and reflects a balance between RBC
production and destruction
 Too few red blood cells leads to tissue hypoxia
 Too many red blood cells causes undesirable blood
viscosity
 Erythropoiesis is hormonally controlled and depends
on adequate supplies of iron, amino acids, and B
vitamins
RBC Production
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Fig. 12-69
 Erythropoietin Mechanism 23

Start
Normal blood oxygen levels Stimulus: Hypoxia due to
decreased RBC count,
decreased availability of O2
to blood, or increased
Increases tissue demands for O2
O2-carrying
ability of blood

Reduces O2
levels in blood

Erythropoietin
Kidney (and liver to a
Enhanced stimulates red
smaller extent) releases
erythropoiesis bone marrow
erythropoietin
increases RBC
count

Figure 17.6
 Filtering and Destruction of 24
Erythrocytes
• The spleen filters and removes old
erythrocytes, and the liver metabolizes
byproducts from breakdown of
erythrocytes.

• Iron is recycled for the synthesis of new

hemoglobin.

• Iron is transported in the blood bound to

transferrin to the red bone marrow.

• Iron is stored bound to ferritin in the liver,

spleen and small intestines.
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Dietary Requirements of Erythropoiesis

 Erythropoiesis requires:
 Proteins, lipids, and carbohydrates
 Iron, vitamin B12, and folic acid

 The body stores iron in Hb (65%), the liver, spleen, and

bone marrow

 Intracellular iron is stored in protein-iron complexes such

as ferritin and hemosiderin

 Circulating iron is loosely bound to the transport protein

transferrin
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Erythrocytes Disorders (Anaemia
and Polycythemias)
1. Anaemias- a symptom that results when blood has lower than normal ability to
carry oxygen.
a) Insufficient erythrocyte count
i. Hemorrhagic anaemia-loss of blood from bleeding (wound, ulcer etc0
ii. Haemolytic anaemia-erythrocytes rupture (haemoglobin/transfusion problem, infection)
iii. Aplastic anaemia- red marrow problems (cancer treatment, marrow disease etc).

b) Decrease in Haemoglobin
i. Iron-deficiency anaemia-low Iron levels (diet; absorption, bleeding etc)
ii. Pernicious anaemia- low Vitamin b12 (diet, intrinsic factor for Vit B12 absorption.

c) Abnormal haemoglobin (usually genetics)

i. Thalassemia- easily ruptured RBCs
ii. Sickle-cell anemia-sickle-shaped RBC

2. Polycythemia-excess RBC count, causes thick blood

i. Polycythemia vera –bone marrow problem; hematocrit may jump to 80%
ii. Secondary polycythemia- high altitude(normal); or too much erythropoietin release
iii. Blood doping in athletes- RBCs previously withdrawn are transfused before an event; more RBCs, more
oxygen delivery to the body
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Major causes of anaemia

1. Dietary deficiency of iron (iron deficiency anaemia).

2. Bone marrow failure due to toxic drugs or cancer.
3. Blood loss from the body (haemorrhage) leading to iron
deficiency
4. Inadequate secretion of erythropoietin in kidney disease
5. Excessive destruction of erythrocytes (e.g sickle-cell
anaemia).

 Sickle-cell anaemia –is due to a genetic mutation that alters

one amino acid in the haemoglobin chain
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THANK YOU
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