BIOS222 Pathology and Clinical Science 2
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1 BIOS222 Pathology and Clinical Science 2 Session 3 Lymphatic and Haematological Disorders 1 Bioscience Department
2 Session Learning Outcomes At the end of this session, you should be able to o Revise and review anatomy and physiology of blood and lymphatic system o Identify and define the conditions affecting various blood cells. o Suggest appropriate assessment and interpretations for haematological disorders. o Define and describe causes for increase or decrease in RBC, WBC and Platelets. o Describe causes of lymphadenopathy and splenomegaly. Endeavour College of Natural Health 2
3 Session Plan o Anatomy and physiology of blood and lymphatic system Composition and function of blood and blood cells Components of lymphatic system Lymph formation and function o Examination and investigation of haematological system o Presenting problems in haematological disease Anaemia and high haemoglobin Leucopenia and Leucocytosis Thrombocytopenia and thrombocytosis Venous thrombosis Pancytopenia and Bleeding Endeavour College of Natural Health 3
4 Anatomy and Physiology of Blood and Lymphatic System Endeavour College of Natural Health 4
5 Composition of Blood o Blood is a liquid connective tissue composed of extra cellular matrix called blood plasma that dissolves and suspends various cells and cell fragments. Tortora, GJ & Derrickson, B 2014, Principles of anatomy and physiology, 14th edn, John Wiley & Sons, Hoboken, NJ Endeavour College of Natural Health 5
6 Function of Blood o Transport: oxygen, carbon dioxide, other wastes o Regulation: ph, Temperature, Body fluid o Protection: Blood loss and infection Endeavour College of Natural Health 6
7 Formation of Blood cells Tortora, GJ & Derrickson, B 2014, Principles of anatomy and physiology, 14th edn, John Wiley & Sons, Hoboken, NJ Endeavour College of Natural Health 7
8 Blood Cells - RBCs Tortora, GJ & Derrickson, B 2014, Principles of anatomy and physiology, 14th edn, John Wiley & Sons, Hoboken, NJ Endeavour College of Natural Health 8
9 Destruction and Recycling of RBC Tortora, GJ & Derrickson, B 2014, Principles of anatomy and physiology, 14th edn, John Wiley & Sons, Hoboken, NJ Endeavour College of Natural Health 9
10 Blood Cells - WBCs Tortora, GJ & Derrickson, B 2014, Principles of anatomy and physiology, 14th edn, John Wiley & Sons, Hoboken, NJ Endeavour College of Natural Health 10
11 Blood Cells - WBCs Tortora, GJ & Derrickson, B 2014, Principles of anatomy and physiology, 14th edn, John Wiley & Sons, Hoboken, NJ Endeavour College of Natural Health 11
12 Blood Cells - Platelets Tortora, GJ & Derrickson, B 2014, Principles of anatomy and physiology, 14th edn, John Wiley & Sons, Hoboken, NJ Blood Clot with Platelets and Fibrin threads from Tortora, GJ & Derrickson, B 2014, Principles of anatomy and physiology, 14th edn, John Wiley & Sons, Hoboken, NJ Endeavour College of Natural Health 12
13 Lymphatic System o The lymphatic system consists of: Lymph Lymphatic vessels Lymphatic tissues and organs Red bone marrow Endeavour College of Natural Health 13
14 Flow of Lymph Endeavour College of Natural Health 14
15 Lymph Node o Located along lymphatic vessels o About 600 beanshaped structure o Superficial and deep o Usually occur in groups o Function as a filter Endeavour College of Natural Health 15
16 Lymphatic Tissues and Organs o Spleen o Thymus o Lymphatic nodules: Tonsils Peyer s patches MALT (mucosaassociated lymphoid tissue) Endeavour College of Natural Health 16
17 Examination and Investigation of Haematological system Endeavour College of Natural Health 17
18 Investigation of Haematological o Full blood count System Haemoglobin RBC count and Blood indices (MCH,MCV,MCHC,PCV) Total WBC count (TC) Differential count of WBC (DC) Platelet count o ESR o Blood film examination o Bone marrow examination o Screening tests for bleeding disorders o Investigation of possible thrombophilia Endeavour College of Natural Health 18
19 Endeavour College of Natural Health 19
20 Screening tests: Bleeding Disorders Walker, BR, Colledge, NR, Ralston, SH, & Penman, ID (eds) 2014, Davidson s principles and practice of medicine, 22nd edn, Churchill Livingstone Elsevier, Edinburgh. Endeavour College of Natural Health 20
21 Investigation of Possible Thrombophilia Walker, BR, Colledge, NR, Ralston, SH, & Penman, ID (eds) 2014, Davidson s principles and practice of medicine, 22nd edn, Churchill Livingstone Elsevier, Edinburgh. Endeavour College of Natural Health 21
22 Presenting Problems in Haematological Disease Endeavour College of Natural Health 22
23 Presenting problems in haematological disease o Anaemia: Low haemoglobin level in the blood Walker, BR, Colledge, NR, Ralston, SH, & Penman, ID (eds) 2014, Davidson s principles and practice of medicine, 22nd edn, Churchill Livingstone Elsevier, Edinburgh. Endeavour College of Natural Health 23
24 Presenting Problems in Haematological Disease o Erythrocytosis: Persistently raised PCV Walker, BR, Colledge, NR, Ralston, SH, & Penman, ID (eds) 2014, Davidson s principles and practice of medicine, 22nd edn, Churchill Livingstone Elsevier, Edinburgh. Endeavour College of Natural Health 24
25 Presenting Problems in Haematological Disease o Leucopenia: A reduction in the total numbers of circulating white blood cells. Neutropenia (low neutrophil counts) Lymphopenia (low lymphocyte counts) o Leucocytosis: An increase in the total numbers of circulating white blood cells Neutrophilia (high neutrophil counts) Lymphocytosis (high lymphocyte counts) Endeavour College of Natural Health 25
26 Presenting Problems in Haematological Disease Tortora, GJ & Derrickson, B 2014, Principles of anatomy and physiology, 14th edn, John Wiley & Sons, Hoboken, NJ Endeavour College of Natural Health 26
27 Presenting Problems in Haematological Disease o Thrombocytopenia (Low Platelets) Causes of thrombocytopenia Decreased production due to Marrow disorders Increased consumption of platelets o Thrombocytosis (High Platelets) Causes of raised platelet count Reactive thrombocytosis Malignant thrombocytosis Endeavour College of Natural Health 27
28 Presenting Problems in Haematological Disease o Pancytopenia: refers to the combination of anaemia, leucopenia and thrombocytopenia. Walker, BR, Colledge, NR, Ralston, SH, & Penman, ID (eds) 2014, Davidson s principles and practice of medicine, 22nd edn, Churchill Livingstone Elsevier, Edinburgh. Endeavour College of Natural Health 28
29 Presenting Problems in Haematological Disease o Infection: occurs as a complication of haematological disorders. Due to immunological deficit caused by the disease or its treatment with chemotherapy and/or immunotherapy. o Bleeding: Abnormal vessels rupture Defect in haemostasis: Deficiency or dysfunction of platelets or coagulation factors, Excessive fibrinolysis Endeavour College of Natural Health 29
30 Presenting Problems in Haematological Disease o Venous thrombosis: Predisposing haematological disorders Polycythaemia rubra vera Essential thrombocythaemia Deficiency of anticoagulants Paroxysmal nocturnal haemoglobinuria Prothrombotic mutations Myelofibrosis Endeavour College of Natural Health 30
31 Presenting Problems in Haematological Disease o Lymphadenopathy: Enlarged lymph glands Walker, BR, Colledge, NR, Ralston, SH, & Penman, ID (eds) 2014, Davidson s principles and practice of medicine, 22nd edn, Churchill Livingstone Elsevier, Edinburgh. Endeavour College of Natural Health 31
32 Presenting Problems in Haematological Disease o Splenomegaly: Enlargement of spleen. Causes of splenomegaly: Haematological diseases Other causes: Congestive diseases Infective diseases Inflammatory / granulomatous disorders Other malignancy Storage disease Miscellaneous Endeavour College of Natural Health 32
33 Reading and Resources o o o o o o o Crowley LV, 2012, An Introduction to Human Diseases Pathology and Pathophysiology Correlations, 9th edn, Jones and Bartlett Learning Grossman SC & Porth CM 2014, Porth s Pathophysiology- Concepts of Altered Health States, 9th edn. Wolters Kluwer Health - Lippincott, Williams & Wilkins Hinson, J, Raven, P & Chew, S 2010, The endocrine system: basic science and clinical conditions, 2nd edn, Churchill Livingstone Elsevier, Edinburgh Jamison, JR 2006, Differential diagnosis for primary care: a handbook for health care practitioners, 2nd edn, Churchill Livingstone Elsevier, Edinburgh. Jarvis, C, 2012 Physical Examination & Health Assessment, 6th ed., Elsevier Saunders, Philadelphia. Kumar, P & Clark, M 2012, Kumar and Clark s clinical medicine, 8th edn, Saunders Elsevier, Edinburgh. Kumar, V, Abbas, AK & Aster, JC 2015, Robbins & Cotran pathologic basis of disease, 9th edn, Elsevier Saunders, Philadelphia. Endeavour College of Natural Health 33
34 o o o o o o Reading and Resources Lee, G & Bishop, P 2009, Microbiology and infection control for health professionals, 4th edn, Pearson Education, Frenchs Forest, NSW. McCance, KL, Heuther, SE, & Brashers, VL 2014, Pathophysiology: the biologic basis for disease in adults and children, 7th edn, Elsevier. Michael-Titus, A, Revest, P & Shortland, P 2010, The nervous system: basic science and clinical conditions, 2nd edn, Churchill Livingstone Elsevier, Edinburgh Mosby s dictionary of medicine, nursing and health professions 2013, 9th edn, Elsevier, St. Louis, MO. Tortora, GJ & Derrickson, B 2014, Principles of anatomy and physiology, 14th edn, John Wiley & Sons, Hoboken, NJ. VanMeter, KC & Hubert, RJ 2014, Gould's pathophysiology for the health professions, 5th edn, Elsevier, St Louis, MO. o Walker, BR, Colledge, NR, Ralston, SH, & Penman, ID (eds) 2014, Davidson s principles and practice of medicine, 22nd edn, Churchill Livingstone Elsevier, Edinburgh. Endeavour College of Natural Health 34
35 COMMONWEALTH OF AUSTRALIA Copyright Regulations 1969 WARNING This material has been reproduced and communicated to you by or on behalf of the Endeavour College of Natural Health pursuant to Part VB of the Copyright Act 1968 (the Act). The material in this communication may be subject to copyright under the Act. Any further reproduction or communication of this material by you may be the subject of copyright protection under the Act. Do not remove this notice. Endeavour College of Natural Health 35
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