Physiology 1 Pharmacy

(Hematology 2)

Fatima Daoud, MD, PhD

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The required references for this lecture are
*Chapter 27 Fluid, Electrolyte, and Acid–Base Homeostasis
*Chapter 19, The Cardiovascular System: The Blood

Principles of ANATOMY & PHYSIOLOGY

15th Edition
GERARD J. TORTORA
Bergen Community College
BRYAN DERRICKSON
Valencia College
Question
• Hemoglobin A1C (HbA1C) test is a blood test that shows what your
average blood glucose level. As your blood glucose level increases,
more of your hemoglobin will be coated with glucose. How frequent
would you repeat the test?
A) Every 3 months.
B) Every 6 months.
C) Once a year.
D) Once in life.
Principle roles of the blood

• Gases, nutrients, hormones, waste

Transportation products.

• pH, body temperature, water content

Regulation (osmotic pressure)

Protection • Clotting, white blood cells,antibodies

Red Blood Cells/ Erythrocytes
• Contain oxygen-carrying protein hemoglobin
• Production = destruction with at least 2 million new RBCs per second
• Biconcave disc
• Strong, flexible plasma membrane
• Lack nucleus and other organelles
• No mitochondria – doesn’t use oxygen
• Glycolipids in plasma membrane responsible for ABO and Rh blood groups
• Average number of red blood 5,200,000/ mm3 (±300,000) in men; and in
women, it is 4,700,000/ mm3 (±300,000).
 Hemoglobin

• The main protein in RBCs that responsible for carrying O2

• Hemoglobon = (4) heme molecules + (4) globin (long polypeptide
chain).

Osmosis (you tube)

 Hemoglobin
• The different types of chains are designated alpha chains, beta chains,
gamma chains, and delta chains.
• The most common form of hemoglobin in the adult human
being, hemoglobin A, is a combination of two alpha chains and two
beta chains.
• Iron ion can combine reversibly with one oxygen molecule
• Also transports 23% of total carbon dioxide (Combines with amino
acids of globin)
 Hemoglobin
• Normal blood hemoglobin content is ~14.0 g/dL in the adult female
and ~15.5 g/dL in the adult male.

Anemia polycythemia
 Circulation for about
120 days

3 7

Amino Reused for

protein synthesis Fe3+ Transferrin
acids
Globin

4 6
5
Fe3+
2 Heme Ferritin Fe3+

Transferrin +
Bilirubin Globin
9 +
Biliverdin Bilirubin Liver Vitamin B12
1 Red blood cell 11
10 +
death and
Small Erythopoietin
phagocytosis
intestine
Kidney Erythropoiesis in
Bilirubin
8
13 red bone marrow
12
Urobilin
Macrophage in Urobilinogen Bacteria Key:
spleen, liver, or
red bone marrow in blood
Stercobilin
Large 14
intestine in bile

Urine Feces

Copyright 2009, John Wiley & Sons, Inc.

RBC life cycle
• Live only about 120 days
• Cannot synthesize new components – no nucleus
• Ruptured red blood cells removed from circulation and
destroyed by fixed phagocytic macrophages in spleen and
liver
• Breakdown products recycled
• Globin’s amino acids reused
• Iron reused
• Non-iron heme ends as yellow pigment urobilin in urine or
brown pigment stercobilin in feces
Erythropoiesis
• Starts in red bone marrow with
proerythroblast
• Cell near the end of
development ejects nucleus
and becomes a reticulocyte
• Develop into mature RBC
within 1-2 days
• Negative feedback balances
production with destruction Nucleus
exocytosis
Erythropoietin (EPO)
• Is a glycoprotein that normally formed in the
kidneys.
• It is essential to stimulate the production of
erythroblasts from hematopoietic stem cells
in the bone marrow.
• Hypoxia causes a marked increase in
erythropoietin production.
• With renal failure, EPO release slows and RBC
production is inadequate. This leads to a
decreased hematocrit.
White Blood Cells (WBCs)
Leukocyte
LEUKOCYTES CLASSIFICATION
Neutrophils (62%)

WHITE BLOOD CELLS

Granulocytes
Eosinophils (2.3%)
(65%)
LEUKOCYTES
Basophils (0.4%)

Monocyte (5%)
Agranulocytes
Lymphocytes (30%)
 LEUKOCYTES CLASSIFICATION
Granulocytes Agranulocytes
Neutrophils Monocytes
Eosinophils Lymphocytes
Basophils

N E L

B M

Boron Medical Physiology

Functions of WBCs
• Usually live a few days
• Except for lymphocytes – live for months or years
• Far less numerous than RBCs (4000-1100/μl)
• General function to combat invaders by phagocytosis or
immune responses
• Leukocytosis is a normal protective response to invaders,
strenuous exercise, anesthesia and surgery
• Leukopenia is never beneficial
Emigration sticking

emigration

• Many WBCs leave the

bloodstream
• Roll along endothelium
• Stick to endothelial cells
• squeeze between
endothelial cells
(Emigration/ diapedesis)
• Precise signals vary for
different types of WBCs
WBCs (Neutrophils and macrophages)
• Neutrophils and macrophages are active phagocytes
• Attracted by chemotaxis
• Neutrophils respond most quickly to tissue damage by bacteria
• Uses lysozymes, strong oxidants, defensins
• Monocytes take longer to arrive but arrive in larger numbers and
destroy more microbes
• Enlarge and differentiate into macrophages
WBCs (Basophils & Eosinophils)
• Basophils leave capillaries and release granules containing heparin,
histamine and serotonin, at sites of inflammation
• Intensify inflammatory reaction
• Involved in hypersensitivity reactions (allergies)
• Eosinophils leave capillaries and enter tissue fluid
• Release histaminase, phagocytize antigen-antibody complexes and effective
against certain parasitic worms
WBC (Lymphocytes)
• Lymphocytes are the major soldiers of the immune system
• B cells – destroying bacteria, inactivating their toxins, and producing
antibodies (plasma cell)
• T cells – attack viruses, fungi, transplanted cells, cancer cells and some
bacteria
• Natural Killer (NK) cells – attack a wide variety of infectious microbes and
certain tumor cells