Blood, Lymph, and Lymph Nodes Presenter: Dr. Jim Hurrell
A Warm Welcome from My Faculty TEAM and Me!!! Copyright Penn Foster 2017 2
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Course Orientation Animal Anatomy & Physiology 2 P R E S E N T E R : D R. J I M H U R R E L L 12
A Little Bit about Me Married, 2 daughters, 8 grandchildren Graduated from Michigan State University College of Veterinary Medicine Owned small animal practice for 7 years Program Director at 3 AVMA-accredited Veterinary Technician Programs over 30+ years Have seen over 1,400 students graduate as Veterinary Technicians at these 3 Programs Have taught online last 18+ years for 5 colleges in Michigan, Florida, Louisiana, Arkansas, Pennsylvania 13
I LOVE Teaching My Students! 14
Courses I Teach in the Program Orientation to Veterinary Technology Animal Anatomy & Physiology 1 & 2 Veterinary Office Management and Skill with People Radiography for Veterinary Technicians 15
Penn Foster Values VISION MISSION PROMISE CULTURE CODE 16
Our Vision, Mission, Promise VISION To create a better world through knowledge and skill. MISSION To help students achieve their academic goals and unlock their career potential. PROMISE To empower youth and adult learners with knowledge, skills and confidence to improve their employability and workplace effectiveness. 17
Our Culture Code for All Employees 18
Veterinary Technician Program Mission Statement TO DEVELOP PENN FOSTER VETERINARY TECHNICIANS THAT HAVE BOTH EXCELLENT PEOPLE SKILLS AS WELL AS EXCELLENT CLINICAL SKILLS. 19
So What Is Animal Anatomy & Physiology? MOST IMPORTANT foundational courses for learning your clinical skills Study of the structure and function of an animal s body and its parts Emphasis on dogs, cats, horses, cattle Blending Anatomy with Medical Terminology 20
Is It Like Human Anatomy & Physiology? 21
Course Set-up 3 Lessons (Recorded Lectures & live Webinars) Webinar attendance is not mandatory, but STRONGLY recommended! 3 Lesson Exams All multiple choice exams Optional Activities (also strongly recommended!) Study Groups and Course Spaces in the Community Final Proctored Exam Short answer/essay exam 22
Are You Using the Course Spaces in the Veterinary Technician Space in the Community? 23
High Tech? Or High Touch? CONNECTION Is So Important! Connect with fellow students and my Awesome Award- Winning Faculty TEAM in the Community https://community.pennfoster.edu/ community/academicgroups/working-withanimals/veterinary-technician Animal A&P 2 Course Space in the Community 24
Vet Tech Terminology Challenge http://lessons.pennfoster.com/terminologychallenge/terminology/#/home/vt 25
Question! Are Your Pets Helping You with A&P? 26
Riley! 27
Nalla! 28
And My FAVE Duck Elly! 29
My Advice for a Good Grade Save a copy of the Chapter PowerPoint Slides Take Notes and Study the Notes from: Recorded Lectures for each Chapter Many Webinars Study Guide Objectives Chapter Objectives READ and highlight textbook Perform the Self-Checks in the Study Guide Don t forget to study the pictures and charts, as well as read the Clinical Applications and answer the Test Yourself Questions in the textbook 30
How Much Should I Study in This 4-Credit Course? Brick and mortar college 64 hours of classroom time (16 week semester), with a recommended 128 hours of study at home 64 + 128 = 192 hours This online course at least 250 hours (See Syllabus) of independent study, including the following: Listening to and taking notes during Recorded Lectures and Webinars Completing Required Readings, Study Guide Self- Checks, and textbook Test Yourself Questions 31
My Final Thoughts for You! Learn as much as you can in this course! Don t blow through this course just to get a grade! The more you comprehend in this Animal Anatomy & Physiology 2 course, the easier the remainder of VET courses will be And the more you will understand on Clinical Externships and on your current or future jobs in veterinary practices 32
And a Few Last Things! Take good notes on the Recorded Lectures and Webinars! Read! Read! Read all of the assigned readings in the textbook. Highlight your textbook! And then study your highlights thoroughly! And study your notes thoroughly for Lesson Exams and the Proctor Exam! Good luck on your journey through this course! WELCOME ABOARD!!! 33
The 8 Secrets of Life! 1. Balance is the key! 2. We are all walking salt water aquariums! 3. The solution to pollution is dilution! 4. Use it or lose it! 5. Get tough or die! 6. It s not polite to fool Mother Nature! 7. Recycle resources! 8. Thoughts are things! 34
Blood, Lymph, and Lymph Nodes Presenter: Dr. Jim Hurrell
Blood, Lymph, and Lymph Nodes 37
Learning Objectives 38
Internal Medicine 39
Blood Composition 40
a fluid connective tissue Blood whole blood blood contained in cardiovascular system peripheral blood whole blood circulating in blood vessels carries oxygen, nutrients, waste materials plasma clear liquid in which cellular components are suspended 41
Blood a living tissue even after it is taken from an animal RBCs utilize plasma glucose for energy glucose cannot be replenished in a tube after RBCs use it functions transport oxygen to tissues (hemoglobin) transport carbon dioxide to lungs maintain cell shape and deformability 42
erythrocytes leukocytes neutrophils eosinophils basophils lymphocytes monocytes platelets Cellular Components of Blood From Thibodeau GA, Patton KT: Anatomy & physiology, ed 5, St Louis, 2003, Mosby. 43
Functions of Blood transportation oxygen, nutrients, waste products, hormones, platelets regulation body temperature, tissue fluid content, blood ph defense system white cell phagocytosis, platelets 44
Hematopoiesis ERYTHROPOIESIS THROMBOPOIESIS LEUKOPOIESIS 45
Hematopoiesis production of all blood cells continuous process throughout animal s life occurs primarily in red bone marrow adult sites: skull, ribs, sternum, vertebral column, pelvis, proximal ends of the femurs less-active bone marrow = yellow bone marrow occurs in liver and spleen in times of great need 46
Hematopoiesis Blood Cell Formation 47
Erythropoiesis process of creating red blood cells multiple maturation steps rate controlled by hormones erythropoietin (EPO) released from cells in kidney in response to hypoxia 48
Thrombopoiesis production of platelets (thrombocytes) unipotential stem cell in bone marrow differentiates into a megakaryocyte pieces of cytoplasm from megakaryocytes are released into peripheral blood as platelets multi-nucleated megakaryocyte never leaves marrow 49
Leukopoiesis general term for formation of white blood cells 3 types of white blood cell production granulopoiesis lymphopoiesis monopoiesis 50
Diagnostic Blood Tests ROUTINELY PERFORMED ON SICK ANIMALS WHOLE BLOOD OR CLOTTED BLOOD SAMPLES COMMONLY OBTAINED 51
Liquid portion: Plasma Cellular portion: Red blood cells (erythrocytes) White blood cells (leukocytes) Platelets (thrombocytes) Blood = Plasma + Cells 52
Plasma versus Serum Both liquids appear identical to the naked eye Serum the liquid part of blood AFTER coagulation Fibrinogen is not found in serum Plasma protein Assists in the blood clotting process Leaves plasma to help clot blood 53
Plasma versus Serum 54
Plasma versus Serum Blood to which an anticoagulant has been added will not clot Whole Blood Clotted Blood 55
Complete Blood Count (CBC) 56
Complete Blood Count = Hemogram = CBC one of the most useful clinical evaluations plasma proteins red blood cells white blood cells platelets health status of animal is reflected in results 57
Packed Cell Volume (PCV) = Hematocrit (Hct) volume of packed RBCs measured and expressed as a percent of total volume of blood 3 layers: plasma buffy coat red blood cells 58
Stained Blood Smears 59
Cellular Components of Blood RED BLOOD CELLS (ERYTHROCYTES) WHITE BLOOD CELLS (LEUKOCYTES) PLATELETS (THROMBOCYTES) 61
Red Blood Cells STRUCTURE FUNCTION LIFE SPAN AND DESTRUCTION 62
Red Blood Cell = Erythrocyte = RBC highly specialized cell mature cell lacks a nucleus, mitochondria, ribosomes appearance non-nucleated biconcave disks with thinner central zone stain red 63
Krispy Kremes Anyone? 64
How Small Are They? They are soooooooooooo small. 65
Bird and Reptile RBC s Bird RBC s Reptile RBC s 66
Life Span of Blood Cells normal life span varies with species from mice (20-30 days) to cats (68 days) to dogs (120 days) to horses and sheep (150 days) to cows (160 days) process of aging = senescence enzyme activity decreases cell membrane loses deformability about 1% of cells removed from circulation daily destruction: extravascular or intravascular 67
Platelets STRUCTURE FUNCTION LIFE SPAN AND DESTRUCTION 68
Platelets = Thrombocytes not complete cells pieces of cytoplasm from giant multinucleated bone marrow cells appearance on blood smear: non-nucleated round to oval in shape clear cytoplasm small blue to purple granules in cytoplasm size varies by species generally smaller than RBCs macroplatelets are occasionally seen 69
Function of Platelets most important for normal hemostasis formation of platelet plug stabilization of the plug clotting process: platelet adhesion platelet aggression thrombin is formed converts fibrinogen to strands of fibrin fibrin attaches to platelet surface 70
Platelets absence of platelets can result in bleeding disorders petechiae = small hemorrhages on the skin life span = 5-7 days liver produces thrombopoietin to regulate number of circulating platelets macrophages remove old or damaged platelets from circulation 71
White Blood Cells FUNCTIONS GRANULOCYTES AGRANULOCYTES 72
White Blood Cell = Leukocyte = WBC mature WBC generally larger than mature RBC 5 types normally present in circulating blood granulocytes basophils, neutrophils, and eosinophils agranulocytes lymphocytes and monocytes From Thibodeau GA, Patton KT: Anatomy & physiology, ed 5, St Louis, 2003, Mosby. 73
Function of White Blood Cells provide defense for the body against foreign invaders phagocytosis immunity produced in bone marrow use peripheral blood to travel to site of activity each type has its own role 74
Granulocytes prominent granules appear in their cytoplasm when viewed on a stained blood smear eosinophils granules pick up acidic stain and appear red basophils granules pick up basic stain and appear blue neutrophils don t pick up either stain well appear colorless or faintly violet From Thibodeau GA, Patton KT: Anatomy & physiology, ed 5, St Louis, 2003, Mosby. 75
Neutrophil Characteristics 40-75% of circulating leukocytes most abundant cell type in blood of dogs, cats, horses mature cells = polymorphonuclear (PMN) leukocytes 2-5 nuclear segments larger than RBCs smaller than monocytes 76
Life Span of Neutrophils neutrophil spends about 10 hours in bloodstream before it enters the tissue doesn t return to blood all circulating neutrophils are replaced about two and a half times a day replaced by mature neutrophils in bone marrow 77
Neutrophil Function involved in early stages of inflammatory response diapedesis process used by neutrophils to go from circulation into tissue spaces chemotaxis process that attracts neutrophils to inflammatory chemicals at site of infection 78
Neutrophil Function opsonization coating process that makes microorganism more recognizable allows neutrophil to begin phagocytosis encapsulated microorganism is coated with a plasma protein a specific antibody = opsonin 79
phagocytosis Neutrophil Function microorganisms are engulfed and enclosed in phagosome cytoplasmic granules move close to edge of phagosome granules release lysosomal enzymes which help kill the microorganisms 80
Lysosomal Enzymes of the Neutrophil hydrogen peroxide myeloperoxidase lysozyme 81
Eosinophil Characteristics named for red granules of mature cells when viewed on a stained blood smear segmented nucleus usually 2 lobes slightly larger than neutrophils produced in bone marrow stay in blood circulation for 3-8 hours before migrating to tissue, where they remain From Thibodeau GA, Patton KT: Anatomy & physiology, ed 5, St Louis, 2003, Mosby. changes in number of circulating eosinophils eosinophilia and eosinopenia 82
Eosinophil Functions inflammatory response immunity phagocytosis 83
Basophil Characteristics named for the blue granules of mature cells when viewed on a stained blood smear multi-lobed nuclei similar in size to neutrophils changes in number of circulating basophils basophilia and basopenia From Thibodeau GA, Patton KT: Anatomy & physiology, ed 5, St Louis, 2003, Mosby. 84
Basophil Functions least phagocytic of the granulocytes contents of granules histamine heparin share some characteristics with tissue mast cells both contain Immunoglobulin E 85
Agranulocytes WBCs that don t contain specific staining granules in their cytoplasm include lymphocytes and monocytes From Thibodeau GA, Patton KT: Anatomy & physiology, ed 5, St Louis, 2003, Mosby. 86
Lymphocyte Characteristics easily recognized by round or oval nucleus minimal, clear, almost colorless cytoplasm most live in lymphoid tissue and circulate between these tissues and blood changes in number of circulating lymphocytes lymphocytosis and lymphocytopenia From Thibodeau GA, Patton KT: Anatomy & physiology, ed 5, St Louis, 2003, Mosby. 87
Lymphocyte Functions 3 different types of lymphocytes with individual functions that regulate the immune system T lymphocytes (T cells) B lymphocytes (B cells) natural killer (NK) cells 88
T Lymphocytes = T Cells most lymphocytes in peripheral blood are T cells processed in thymus before going to peripheral lymphoid tissue responsible for cell-mediated immunity responsible for activating B cells 89
B Lymphocytes = B Cells inactive B cells travel through lymph nodes, spleen, and other lymphoid tissue rarely in peripheral blood responsible for antibody production each B cell produces only one antibody type against one specific antigen surface receptors are shaped to fit only one antigen shape (epitope) 90
Humoral (Antibody) Immunity process when B cells recognize an antigen and transform into plasma cells antigen-antibody complex is formed when B cell and a specific antigen are joined all other B cells are unaffected plasma cells produce, store, and release antibodies plasma cells found in any body tissue most numerous in tissues engaged in antibody formation 91
Natural Killer (NK) Cells granular lymphocytes found in blood and lymph have ability to identify and kill virus-infected cells bind to cell and induce cellular changes that lead to cellular death = apoptosis do not ingest the target cell 2 types of receptors killer-activating receptor (KAR) killer-inhibitory receptor (KIR) 92
Memory Cells both T cells and B cells can become memory cells clones of an original lymphocyte wait in lymphoid tissue for second exposure to same antigen quicker and stronger response than initial immune response 93
Monocyte Characteristics largest WBC in circulation nuclei can be of many different shapes round to pseudo-lobed abundant cytoplasm stains gray may contain vacuoles changes in number of circulating monocytes monocytosis and monocytopenia From Thibodeau GA, Patton KT: Anatomy & physiology, ed 5, St Louis, 2003, Mosby. 94
Monocyte Functions participates in inflammatory response known as macrophage when it enters tissues lives in tissues for 100+ days tissue macrophages and monocytes constitute mononuclear phagocyte system (MPS) clean up cellular debris after an infection/inflammation clears up can also ingest antigens 95
Macrophage Engulfing Bacteria https://66.media.tumblr.com/44d4115e5bc4b49db07f8f3d238b1e95/tumblr_o1i34hjdtu1ryueyco1_400.gif 96
Hematopoiesis Blood Cell Formation 97
Summary of White Blood Cells 98
The Lymphatic System STRUCTURE & FUNCTION LYMPH FORMATION LYMPHOID ORGANS AND TISSUES 100
Lymphatic System Overview Trace a Drop of Lymph 101
Lymph Capillaries Run with Blood Capillaries 102
Lymphatic System 2 separate parts of animal s immune system system of ducts and fluid lymph system picks up fluid leaked from capillaries lymph ducts carry lymph to blood vessels near heart lymph is put back into bloodstream system of lymphoid organs and tissues lymph nodes, spleen, thymus, tonsils, and gut associated lymph tissue (GALT) 103
Lymphatic System Functions removal of excess tissue fluid inadequate lymph drainage can result in edema waste material transport filtration of lymph lymph passes through lymph nodes protein transport 104
Lymph Formation lymph starts out as excessive tissue fluid capillaries in tissue join to form larger vessels to propel lymph toward the heart lymph eventually joins bloodstream 105
Lymph Circulation excessive interstitial fluid picked up by small lymph capillaries fluid enters/leaves tissue spaces due to blood pressure and osmotic pressure lymph capillaries join together to form larger and larger lymph vessels utilization of one-way valves and body movements to propel lymph toward the heart lymph passes through at least one lymph node and picks up lymphocytes (continued) 106
Lymph Circulation macrophages in lymph node remove microorganisms lymph is emptied into vena cava just before large vein enters the heart lymph has come full circle originated in plasma has returned to plasma 107
Lymph Characteristics transparent or translucent liquid contains varying numbers of cells primarily lymphocytes different from plasma more water, sugar, and electrolytes fewer of the larger proteins found in plasma lymph from digestive system = chyle postprandial lipemia 108
2 classifications primary thymus bursa of Fabricius Peyer s patches secondary spleen lymph nodes tonsils Lymphoid Organs 109
thymus Lymphoid Organs located in cranial thoracic region most prominent in young animals atrophies with age produces mature T-cells from precursors sent from the bone marrow cells leave thymus and travel to secondary lymphoid tissue important in stimulating cell-mediated immune response 110
Thymus 111
Lymphoid Organs bursa of Fabricius found only in birds round sac located above the cloaca similar in structure and function to the thymus Peyer s patches located in wall of small intestine (GALT) structure and functions vary among species activate B cells to produce antibodies 112
Secondary Lymphoid Organs include spleen, lymph nodes, and tonsils enlarge in response to antigenic stimulation main function trap and process antigens and mature lymphocytes that mediate immune responses 113
Spleen Largest lymphoid organ Storage of blood Lymphocyte cloning Removal of old RBC s (Secret of Life!) 114
The Spleen tongue-shaped organ located on the left side of the abdomen near stomach in simple-stomached animals near the rumen in ruminants covered with capsule of fibrous connective tissue and smooth muscle trabeculae from capsule go into soft tissue of spleen smooth muscle cells contract and squeeze blood out of spleen and back into circulation 115
The Spleen interior divided into 2 areas: white pulp and red pulp 116
The Spleen acts as a reservoir for blood when animal is at rest spleen gets larger when storage spaces are filled with blood when body needs excess blood cells: trabeculae contract blood is squeezed back into circulation spleen gets smaller not essential for life 117
Lymph Nodes in the Dog 118
Lymph Nodes small, kidney bean-shaped filters located along lymphatic vessels trap antigens and other foreign materials in lymph 2 sections cortex lymph nodules medulla tissue macrophages 119
Lymph Nodes found throughout the body drain organs in their associated locations can give clue to health of an animal nodes more easily palpated when enlarged in response to antigenic stimulation Fine Needle Aspirate (FNA) and cytology for evaluation for abnormalities 120
Canine Tonsils 121
The Tonsils nodules of lymphoid tissue that are not covered with a capsule found in epithelial surfaces all over the body most familiar in pharyngeal region others in larynx, intestine, prepuce, vagina function to prevent spread of infection into respiratory and digestive systems 122
Tonsils vs. Lymph Nodes tonsils found close to moist epithelial surfaces found at beginning of lymph drainage system no capsule lymph nodes found along lymph vessels have a capsule 123
Transfusions 124
Transfusion Therapy used to replace fluid or blood that has been lost or destroyed involves taking blood or blood component from donor animal and injecting it into recipient animal indications for a transfusion rapid blood loss severe anemia coagulation factor deficiency lower than normal plasma protein thrombocytopenia 125
Key Terms agranulocyte anemia antibody anticoagulant antigen B cell (B lymphocyte) basophil basopenia basophilia chemotaxis deoxyhemoglobin diapedesis edema eosinopenia eosinophilia eosinophil erythrocyte erythropoiesis erythropoietin (EPO) extravascular hemolysis fibrin fibrinogen fibrinolysis granulocyte 126
Key Terms granulopoiesis gut associated lymph tissue (GALT) haptoglobin hematocrit hematopoiesis hemoglobin hemoglobinemia hemoglobinuria hemostasis hypoxia intravascular hemolysis leukocyte leukocytosis leukopenia leukopoiesis lymph lymphocyte lymphocytosis lymphopenia lymphopoiesis macrophage mast cell megakaryocyte monocyte 127
Key Terms monocytopenia monocytosis monopoiesis mononuclear phagocyte system (MPS) natural killer cell (NK cell) neutropenia neutrophil neutrophilia opsonin opsonization oxyhemoglobin packed cell volume (PCV) peripheral blood petechiae phagocytosis phagosome plasma plasma cell platelet pluripotential stem cell (PPSC) polycythemia polymorphonuclear postprandial lipemia red bone marrow 128
Key Terms red pulp senescence serum thrombocyte thrombocytopenia thrombocytosis thrombopoiesis thymus T cell (T lymphocyte) vacuole white pulp whole blood yellow bone marrow 129