Chapter 13 The Blood

Transcription

1 Chapter 13 The Blood Copyright 2015 Wolters Kluwer Health Lippincott Williams & Wilkins

2 Overview

3 Key Terms agglutination erythrocyte lymphocyte albumin fibrin megakaryocyte anemia hematocrit monocyte antigen hematopoietic neutrophil antiserum hemoglobin plasma basophil hemolysis platelet (thrombocyte) centrifuge hemorrhage serum coagulation hemostasis thrombin cryoprecipitate leukemia thrombocytopenia eosinophil leukocyte transfusion

4 Blood Important in maintaining homeostasis Classified as a connective tissue Accounts for 8% of total body weight

5 Functions of the Blood Learning Objective 1. List the functions of the blood.

6 Blood Constituents Learning Objectives 2. Identify the main components of plasma. 3. Describe the formation of blood cells. 4. Name and describe the three types of formed elements in the blood, and give the functions of each. 5. Characterize the five types of leukocytes.

7 Hemostasis and Coagulation Learning Objectives 6. Define hemostasis, and cite three steps in hemostasis. 7. Briefly describe the steps in blood clotting.

8 Blood Types Learning Objectives 8. Define blood type, and explain the relation between blood type and transfusions. 9. Explain the basis of Rh incompatibility and its possible consequences.

9 Use of Blood and Blood Components Learning Objective 10. List four possible reasons for transfusions of whole blood and blood components.

10 Blood Disorders Learning Objectives 11. Define anemia, and list six causes of anemia. 12. Define leukemia, and name the two types of leukemia. 13. Describe four forms of clotting disorders.

11 Blood Studies Learning Objective 14. Identify six types of tests used to study blood.

12 Case Study Learning Objective 15. Referring to the case study, discuss the adverse effects of bone marrow damage.

13 Word Anatomy Learning Objective 16. Show how word parts are used to build words related to the blood.

14 Functions of the Blood Transportation Regulation Protection Gases Nutrients Wastes ph Fluid balance Heat Disease Blood loss

15 Functions of the Blood (cont.) Checkpoints 13-1 What are four types of substances transported in the blood? 13-2 What is the ph range of the blood?

16 Blood Constituents Learning Objectives 2. Identify the main components of plasma. 3. Describe the formation of blood cells. 4. Name and describe the three types of formed elements in the blood, and give the functions of each. 5. Characterize the five types of leukocytes.

17 Blood Constituents (cont.) Plasma Liquid portion Formed elements Cellular portion

18 Blood Constituents (cont.) Figure 13-1 Composition of whole blood.

19 Blood Constituents (cont.) Figure 13-2 Blood cells as viewed under the microscope. Which cells are the most numerous in the blood?

20 Blood Constituents (cont.) Blood Plasma Plasma is 55% of blood. Components Water Protein Albumin Clotting factors Antibodies Complement

21 Blood Constituents (cont.) Formed Elements Produced in red bone marrow from hematopoietic cells Erythrocytes Leukocytes Neutrophils Eosinophils Basophils Lymphocytes Monocytes Platelets

22 Blood Constituents (cont.) Erythrocytes Red blood cells (RBCs) most numerous Biconcave shape Mature cells anuclear Contain hemoglobin Binds to oxygen for transport Carries hydrogen ions for buffering Carries carbon dioxide for elimination

23 Blood Constituents (cont.) Figure 13-3 Red blood cells as seen under a scanning electron microscope. Why are these cells described as biconcave?

24 Blood Constituents (cont.) Checkpoints 13-3 What are the two main components of blood? 13-4 Next to water, what is the most abundant type of substance in plasma? 13-5 Where do blood cells form? 13-6 What type of cell gives rise to all blood cells? 13-7 What is the main function of hemoglobin?

25 Blood Constituents (cont.) Leukocytes White blood cells (WBCs) colorless, round, with prominent nuclei Granulocytes Neutrophils (polymorphs) Eosinophils Basophils Agranulocytes Lymphocytes Monocytes Clear body of foreign material, cellular debris, pathogens

26 Blood Constituents (cont.) Figure 13-4 Stages in neutrophil development.

27 Blood Constituents (cont.) Figure 13-5 Phagocytosis. What type of epithelium makes up the capillary wall?

28 Blood Constituents (cont.) Platelets (Thrombocytes) Smallest formed element Not cells no nuclei or DNA Fragments release from megakaryocytes Essential for blood coagulation (clotting)

29 Blood Constituents (cont.) Figure 13-6 Platelets (thrombocytes).

30 Blood Constituents (cont.) Checkpoints 13-8 What are the three types of granular leukocytes? What are the two types of agranular leukocytes? 13-9 What is the most important function of leukocytes? What is the function of blood platelets?

31 Hemostasis and Coagulation Learning Objectives 6. Define hemostasis, and cite three steps in hemostasis. 7. Briefly describe the steps in blood clotting.

32 Hemostasis and Coagulation (cont.) Prevents blood loss when blood vessel ruptures Events include: Contraction of smooth muscle in the damaged blood vessel wall Formation of a platelet plug Formation of a blood clot Formation of prothrombinase Conversion of prothrombin into thrombin (by prothrombinase) Conversion of fibrinogen into fibrin (via thrombin)

33 Hemostasis and Coagulation (cont.) Figure 13-7 Blood clotting (coagulation). What part of the word prothrombinase indicates that it is an enzyme? What part of the word prothrombin indicates that it is a precursor?

34 Hemostasis and Coagulation (cont.) Checkpoints What is the general term for the process that stops blood loss? What substance in the blood forms a clot? How does serum differ from blood plasma?

35 Blood Types Learning Objectives 8. Define blood type, and explain the relation between blood type and transfusions. 9. Explain the basis of Rh incompatibility and its possible consequences.

36 Blood Types (cont.) Blood types must be compatible for blood transfusion from donor to patient. Proteins (antigens or agglutinogens) on red cells cause incompatibility. A and B antigens Rh factor

37 Blood Types (cont.) The ABO Blood Type Group Blood Type Red Blood Cell Antigen Reacts with Anti- Serum Plasma Antibodies Can Take from Can Donate to A A Anti-A Anti-B A, O A, AB B B Anti-B Anti-A B, O B, AB AB A, B Anti-A, Anti-B O None None Anti-A, Anti-B None AB, A, B, O O, A, B, AB

38 Blood Types (cont.) Figure 13-8 Blood typing. Can you tell from these reactions whether these cells are Rh-positive or Rhnegative?

39 Blood Types (cont.) ABO Blood Type Compatibility Safest transfusion is with same blood type. Type O blood can be given to any ABO type. Type AB blood can receive any ABO type.

40 Blood Types (cont.) Rh Factor Red cell antigen group Rh (D antigen) Rh-positive blood has antigen. Rh-negative blood lacks antigen. Rh incompatibility can lead to hemolytic disease of newborn (HDN).

41 Blood Types (cont.) Figure 13-9 Rh incompatibility.

42 Blood Types (cont.) Checkpoints What is the term for any substance that activates an immune response? What are the four ABO blood types? What blood factor is associated with incompatibility during pregnancy?

43 Use of Blood and Blood Components Learning Objective 10. List four possible reasons for transfusions of whole blood and blood components.

44 Use of Blood and Blood Components (cont.) Blood stored in blood banks up to 35 days Anticlotting solution added Expiration date added Blood donated before elective surgery (autologous blood)

45 Use of Blood and Blood Components (cont.) Whole-Blood Transfusions Used for loss of large volume of blood Massive hemorrhage from serious injuries During internal bleeding During or after an operation Blood replacement in treatment of HDN

46 Use of Blood and Blood Components (cont.) Blood Components Centrifuge separates plasma from formed elements. Hemapheresis keeps desired elements and returns remainder to donor. Plasmapheresis keeps plasma and returns formed elements to donor.

47 Use of Blood and Blood Components (cont.) Use of Plasma Replace blood volume Treat circulatory failure (shock) Treat plasma protein deficiency Replace clotting factors Provide needed antibodies

48 Use of Blood and Blood Components (cont.) Checkpoint How is blood commonly separated into its component parts?

49 Blood Disorders Learning Objectives 11. Define anemia, and list six causes of anemia. 12. Define leukemia, and name the two types of leukemia. 13. Describe four forms of clotting disorders.

50 Blood Disorders (cont.) Blood abnormalities Anemia (low level of hemoglobin or red cells) Leukemia (increase in white cells) Clotting disorders (abnormal tendency to bleed)

51 Blood Disorders (cont.) Anemia Excessive loss or destruction of red cells Hemorrhagic anemia Hemolytic anemia Sickle cell anemia Impaired production of red cells or hemoglobin Nutritional anemia Pernicious anemia Thalassemia Bone marrow suppression

52 Blood Disorders (cont.) Figure A blood smear in sickle cell anemia. What kind of microscope was used to take this picture?

53 Blood Disorders (cont.) Leukemia Characterized by enormous increase in white cells Myelogenous leukemia from bone marrow Lymphocytic leukemia from lymphoid tissue Bone marrow transplants sometimes successful in restoring blood-producing stem cells lost after leukemia treatment

54 Blood Disorders (cont.) Figure Leukemia.

55 Blood Disorders (cont.) Clotting Disorders Abnormal bleeding through disruption of coagulation process Hemophilia von Willebrand disease Thrombocytopenia Disseminated intravascular coagulation (DIC)

56 Blood Disorders (cont.) Checkpoints What is anemia? What is leukemia? What blood components are low in cases of thrombocytopenia?

57 Blood Studies Learning Objective 14. Identify six types of tests used to study blood.

58 Blood Studies (cont.) Some blood tests are a standard part of a routine physical examination. Machines can perform several tests simultaneously.

59 Blood Studies (cont.) Hematocrit ml of red cells per 100 ml of whole blood Performed in centrifuge Adult range for men: 42% to 54% Adult range women: 36% to 46%

60 Blood Studies (cont.) Figure Hematocrit.

61 Blood Studies (cont.) Hemoglobin Tests g of hemoglobin per 100 ml of whole blood Performed by electrophoresis Adult range for men: 14 to 17 g/dl Adult range for women: 12 to 15 g/dl

62 Blood Studies (cont.) Blood Cell Counts Red cell counts Range: 4.5 to 5.5 million cells per microliter (mcl) White cell counts Range: 5,000 to 10,000 cells per microliter (mcl) Platelet counts Range: 150,000 to 450,000 per microliter (mcl)

63 Blood Studies (cont.) Blood Slide (Smear) Complete blood count (CBC) performed on stained blood smear Red cells examined Platelets examined Parasites may be found Differential white count performed

64 Blood Studies (cont.) Blood Chemistry Tests Electrolytes Blood glucose Nitrogenous waste products (creatine) Enzymes Lipids Plasma proteins Hormones Vitamins Antibodies Drug levels

65 Blood Studies (cont.) Coagulation Studies Performed before surgery and during treatment of certain diseases Amounts of clotting factors Bleeding time Clotting time Capillary strength Platelet function

66 Blood Studies (cont.) Bone Marrow Biopsy Sample of red marrow through needle from sternum, sacrum, or iliac crest Used in diagnosing bone marrow disorders Leukemia Some types of anemia

67 Blood Studies (cont.) Checkpoints What test measures the relative volume of red cells in blood? What are two ways of expressing hemoglobin level?

68 Case Study Learning Objective 15. Referring to the case study, discuss the adverse effects of bone marrow damage.

69 Case Study (cont.) All of the blood s formed elements are produced in the red bone marrow. Continuous cell replacement is essential to life. Eleanor, losing the protective functions of the blood cells due to her bone marrow damage, exhibited the following symptoms: Pallor and fatigue due to low red cells and hemoglobin Hemorrhage due to platelet loss Eleanor acquired: An infection due to diminished leukocytes Strain on her heart and an increased heart rate to compensate for low hemoglobin

70 Word Anatomy Learning Objective 16. Show how word parts are used to build words related to the blood.

71 Word Anatomy (cont.) Word Part Meaning Example Blood Constituents erythr/o red, red blood cell An erythrocyte is a red blood cell. hemat/o blood Hematopoietic stem cells form (-poiesis) all of the blood cells. hemo blood Hemoglobin is a protein that carries oxygen in the blood. kary/o nucleus A megakaryocyte has a very large nucleus. leuk/o white, colorless A leukocyte is a white blood cell. lymph/o lymph, lymphatic system Lymphocytes are white blood cells that circulate in the lymphatic system.

72 Word Anatomy (cont.) Word Part Meaning Example Blood Constituents (cont.) macr/o large A macrophage takes in large amounts of foreign matter by phagocytosis. mon/o single, one A monocyte has a single, unsegmented nucleus. morph/o shape The nuclei of polymorphs have many shapes. phag/o eat, ingest Certain leukocytes take in foreign matter by the process of phagocytosis. thromb/o blood clot A thrombocyte is a cell fragment that is active in blood clotting.

73 Word Anatomy (cont.) Word Part Meaning Example Hemostasis and Coagulation -gen producing, originating Fibrinogen converts to fibrin in the formation of a blood clot. pro- before, in front of Prothrombinase is an enzyme (-ase) that converts prothrombin to thrombin. Blood Types -lysis loosening, dissolving, separating A recipient s antibodies to donated red cells can cause hemolysis of the cells.

74 Word Anatomy (cont.) Word Part Meaning Example Uses of Blood and Blood Components cry/o cold Cryoprecipitate forms when blood plasma is frozen and then thawed. Blood Disorders emia (from hemia) blood Anemia is a lack (an-) of red cells or hemoglobin. -penia lack of Leukopenia is a lack of white cells.