HUMAN ANATOMY AND PHYSIOLOGY II CHAPTER 14: BLOOD. MARY CATHERINE FLATH, Ph.D.

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HUMAN ANATOMY AND PHYSIOLOGY II CHAPTER 14: BLOOD MARY CATHERINE FLATH, Ph.D.

BLOOD A connective tissue Average volume of 5 liters (70 kg male) 45% solid cells or formed elements (hematocrit [HCT] quantitation) Erythrocytes Leukocytes Thrombocytes 55% liquid plasma Water Plasma proteins Much more

Blood Composition

BLOOD SMEAR Wright s stain is used to differentially stain blood cells for identification

BLOOD SMEAR ~HIGH~

ALL BLOOD CELLS COME FROM A LARGE PRIMITIVE CELL CALLED A HEMOCYTOBLAST

BLOOD CELLS ERYTHROCYTES LEUKOCYTES THROMBOCYTES

Red blood cells ERYTHROCYTES 4-6 million per mm 3 blood (in a healthy individual) Biconcave shape 7.5 microns in diameter Anucleate (live approximately 120 days) Carry hemoglobin Transport oxygen

BLOOD SMEAR ~OIL~ ERYTHROCYTES (abundant pale pink discs)

Co 14 Copyright The McGraw-Hill Companies, Inc. Permission required for reproduction or display. Image Source

Red blood cells ERYTHROCYTES 4-6 million per mm 3 blood (in a healthy individual) Biconcave shape 7.5 microns in diameter Anucleate (live approximately 120 days) Carry hemoglobin Transport oxygen

SEM of erythrocytes moving into a capillary

Red blood cells ERYTHROCYTES 4-6 million per mm 3 blood (in a healthy individual) Biconcave shape 7.5 microns in diameter Anucleate (live approximately 120 days) Carry hemoglobin Transport oxygen

LIFE CYCLE OF AN ERYTHROCYTE 120 DAYS

Life Cycle of an Erythrocyte

Red blood cells ERYTHROCYTES 4-6 million per mm 3 blood (in a healthy individual) Biconcave shape 7.5 microns in diameter Anucleate (live approximately 120 days) Carry hemoglobin Transport oxygen

ERYTHROCYTE PRODUCTION ERYTHROPOIESIS

Erythropoiesis

Normal Erythrocytes vs. Hypochromic Anemia

Normal versus sickled erythrocyte

BLOOD CELLS ERYTHROCYTES LEUKOCYTES THROMBOCYTES

LEUKOCYTES White blood cells 5-10,000 per mm 3 blood (in a healthy individual) Control Disease Divided into: Granulocytes (with cytoplasmic granules) Neutrophils, Eosinophils, Basophils Agranulocytes (lack cytoplasmic granules) Monocytes and Lymphocytes

GRANULOCYTES NEUTROPHILS EOSINOPHILS BASOPHILS

NEUTROPHILS Most abundant leukocyte 54-62% Polymorphonucleocytes 2-6 nuclear lobes Phagocytosis of foreign particles (disease organisms and debris) Increased during bacterial infections

Fig. 14.10 Copyright The McGraw-Hill Companies, Inc. Permission required for reproduction or display. Ed Reschke

NEUTROPHIL

EOSINOPHILS 1-3% of total leukocytes Kill parasites and are involved in allergic reactions Increased during parasitic infections and allergic reactions Tapeworm and hookworm Release granules of histamine

Fig. 14.11 Copyright The McGraw-Hill Companies, Inc. Permission required for reproduction or display. Ed Reschke

EOSINOPHIL

BASOPHILS Less than 1% of total leukocytes Granules of: Histamine (vasodilator) Heparin (inhibits blood clotting) Increase during inflammatory reactions May leave blood stream and develop into mast cells Antibodies attach and cause mast cells to burst, releasing allergy mediators

Fig. 14.12 Copyright The McGraw-Hill Companies, Inc. Permission required for reproduction or display. Ed Reschke

BASOPHIL

AGRANULOCYTES LYMPHOCYTES MONOCYTES

LYMPHOCYTES 25-33% of total leukocytes Live for months to years Range in size from 10-14µ to small 6-9µ Function in immunity T cells in cell mediated immunity B cells in antibody mediated immunity Increased during viral infections (TB, whooping cough), and tumors Decreased in immune disorders

Fig. 14.14 Copyright The McGraw-Hill Companies, Inc. Permission required for reproduction or display. Ed Reschke

LYMPHOCYTE

MONOCYTES 3-9% of total leukocytes Phagocytosis Largest leukocyte (12-20u) In blood, phagocyte In tissues, macrophage Increased in viral and fungal infections (typhoid fever, malaria, mononucleosis) and chronic disease

Fig. 14.13 Copyright The McGraw-Hill Companies, Inc. Permission required for reproduction or display. R. Kessel/Visuals Unlimited

MONOCYTE

LEUKOCYTES Neutrophil: 54-62% Eosinophil: 1-3% Basophil: <1% Lymphocyte: 25-33% Monocyte: 3-9%

Leukocyte Type Normal Differential Percentage High Count May Indicate Low Count May Indicate Neutrophils Lymphocytes Monocytes Eosinophils Basophils

Leukocyte Type Normal Differential Percentage High Count May Indicate Low Count May Indicate Neutrophils 54-62% Bacterial infection, burns, stress, inflammation Lymphocytes 25-33% Viral Infections, Some leukemias Monocytes 3-9% Viral or fungal infections, TB, some leukemias, other chronic diseases Radiation exposure, drug toxicity, B12 deficiency, SLE Prolonged illness, immunosuppression, cortisol treatment Bone marrow depression, cortisol treatment Eosinophils 1-3% Allergic reactions, parasitic infections, autoimmune disease Drug toxicity, stress Basophils <1% Allergic reactions, leukemias, cancers, hypothyroidism Pregnancy, ovulation, stress, hyperthyroidism

LEUKOCYTES (continued) DIAPEDESIS The process by which a leukocyte moves through a capillary wall to enter tissues.

Which leukocytes do this? Neutrophils, Basophils, Monocytes

Leukocytes fight infection

LEUKEMIA ABNORMAL (UNCONTROLLED) PRODUCTION OF A SPECIFIC TYPE OF IMMATURE LEUKOCYTE

Normal versus leukemia (granulocytic leukemia a type of myeloid leukemia)

Fig. 14A THE DRUG Gleevec has treated her leukemia. Copyright The McGraw-Hill Companies, Inc. Permission for reproduction or display. Bone marrow biopsies are required at regular intervals 2005 Basil Childers

BLOOD CELLS ERYTHROCYTES LEUKOCYTES THROMBOCYTES

THROMBOCYTES Platelets 150-450,000 per mm 3 blood Fragments of megakaryocytes Function in blood clotting Fibrinogen fibrin Calcium and vitamin K required

All blood cells come from a primitive cell called a HEMOCYTOBLAST

Major Blood Cell Type Scientific Name Circulating Concentration/ mm 3 blood General Function Key Characteristics

Major Blood Cell Type red blood cell white blood cell platelet Scientific Name erythrocyte leukocyte thrombocyte Circulating Concentration/ mm 3 blood 4-6 million/ mm 3 blood 5-10,000/ mm 3 blood 150,000-450,000/ mm 3 blood General Function transportation of oxygen fight infection/ control disease blood clotting Key Characteristic see outline page 3 see outline pages 4-5 are fragments of giant megakaryocyte; See outline page 5 & 8

Blood Composition

BLOOD PLASMA WATER (91.5%) PROTEINS (7%; albumin, fibrinogen, globulin) NUTRIENTS (amino acids, monosaccharides, lipoproteins) WASTES (urea, uric acid, creatine, creatinine, bilirubin) GASES (Nitrogen, O 2 and CO 2 ) ELECTROLYTES (Na +, Cl -, Ca ++, K -, HCO 3-, etc) REGULATORY MECHANISMS (enzymes, hormones)

HEMOSTASIS

Platelet Plug Formation

SEM

Fibrinolytic Mechanisms (prevent spontaneous blood clot formation)

Preventing Deep Vein Thromboses (DVT)

FIBRINOLYTIC SYSTEM

PHARMACOLOGIC AGENTS TISSUE PLASMINOGEN ACTIVATOR (TPA) INJECTED POST-MI HEPARIN EXTRACTED FROM LUNG TISSUE USED DURING HEMODYALYSIS AND HEART/LUNG PERFUSION WARFARIN COUMADIN SLOWER ACTING THAN HEPARIN INDICATED IN PATIENTS PRONE TO CLOTTING

MEDICINAL USES OF THE LEECH

BLOOD TYPING

BLOOD TYPING BLOOD TYPE IS DETERMINED BY ANTIGENS PRESENT ON THE CELL MEMBRANES OF ERYTHROCYTES ANTIGENS ARE INHERITED THE TWO ANTIGENS DETERMINE FOUR BLOOD TYPES A, B, AB, O

AB ANTIBODIES IN PLASMA ANTIBODIES ARE PRODUCED AGAINST NON- SELF ANTIGENS PERSONS WITH TYPE A BLOOD, PRODUCE B-ANTIBODIES PERSONS WITH TYPE B BLOOD, PRODUCE A-ANTIBODIES PERSONS WITH TYPE AB BLOOD, DO NOT PRODUCE EITHER A OR B-ANTIBODIES PERSONS WITH TYPE O BLOOD, PRODUCE BOTH A- AND B-ANTIBODIES

TRANSFUSION REACTIONS TRANSFUSION REACTIONS OCCUR WHEN THE ANTIBODIES IN THE RECIPIENT S PLASMA REACT WITH THE ANTIGENS ON DONATED CELLS I.E. ANTIBODY-B IN RECEIPIENTS PLASMA REACTS WITH B-ANTIGEN ON DONATED CELLS AN IMMUNE RESPONSE OCCURS WHICH CAUSES CLUMPING AND HEMOLYSIS OF THE DONATED CELLS.

AgA-AbA = Agglutination :--(; AgB-AbB = Agglutination :--(

Blood type Antigens on rbc s Antibodies in plasma Compatible donors Incompatible donors

Blood type A B AB O Antigens on rbc s A B A AND B NEITHER A OR B Antibodies in plasma ANTI -B ANTI -A NEITHER ANTI-A OR -B BOTH ANTI-A AND B Compatible donors A,O B, O AB, A, B, O O Incompatible donors B, AB A, AB A, B, AB

BLOOD DONORS AND RECIPIENTS UNIVERSAL DONOR: TYPE O UNIVERSAL RECIPIENT: TYPE AB

Rh Factor Rh FACTOR IS AN INHERITED GROUP OF PROTEINS PRESENT ON SURFACE OF ERYTHROCYTES Rh ANTIBODIES DO NOT SPONTANEOUSLY DEVELOP ANTIBODIES DO DEVELOP UPON EXPOSURE TO Rh ANTIGEN SIGNIFICANCE: Rh NEGATIVE MOTHERS WHO IS PREGNANT (WITH Rh POSITIVE FETUS) HEMOLYTIC DISEASE OF THE NEWBORN RHOGAM is administered to mother between weeks 28-30 and after birth.

Bloodgen is a consortium of European blood banks and universities investigating the use of DNA microarrays (chips) to type blood. Their logo is pictured at left