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Anatomy and Physiology For The First Class 2 nd Semester

Erythrocytes = Red Blood Cells (RBC)

Erythrocytes = Red Blood Cells Red blood cells are biconcave discs, they have no nucleus and cytoplasmic organelles. They contain a red coloured protein called hemoglobin. Their main function is in gas transport, mainly of O2 but they also carry some CO2. Human erythrocytes are 7.5 µm in diameter, 2.6 µm thick at the rim and 0.8 µm thick in the center. The biconcave shape increases their surface area for gas exchange, and the thinness of the central portion allows fast entry and exit of gases. The cells are flexible so they can squeeze through narrow capillaries. The normal concentration of erythrocytes in blood is approximately 3.9-5.5 million per microliter in women and 4.1-6 million per microliter in men.

Biconcave shape of RBC

Life Span and Formation of Red Blood Cells Erythrocytes are produced in red bone marrow (in the ends of long bones and in flat and irregular bones). They pass through several stages of development before entering the blood. Their life span in circulation is about 120 days. The process of RBC development from stem cells takes about 7 days and is called erythropoiesis. The immature cells are released into the blood stream as reticulocytes and then mature into erythrocytes over 1-2 days within circulation. During this time, they lose their nucleus and therefore become incapable of division. The hormone erythropoietin and substances such as iron, folic acid, and vitamin B12 are essential for the production of erythrocytes. Erythropoietin hormone is a glycoprotein hormone produced in the kidneys and stimulates the production of globin (the protein component of Hb), enhances the release reticulocytes in the circulation and enhances reticulocytes maturation to mature RBC.

Erythropoiesis

Physiological Factors influencing RBC number RBC count is very high at birth (8-10 million\mm. The count is higher in children than in adults. RBC count is raised at high altitude, in warm temperature, during excitement. In women RBC count is relatively low during pregnancy. A fall in RBC count is seen low altitude.

Hemoglobin (Hb) Hb is the most important constituent of red blood cells. It is responsible for transport of O2 from lungs to tissues and CO2 from tissues to lungs. The normal value in a normal male adult is 13-18 g\100ml and in female is 11.5-16.5 g\100ml. Molecules of hemoglobin is large and complex. They are made up of heme and globin. Heme is made up of iron (in ferrous form) and porphyrin. Globin is a protein that has 4 polypeptides chains (2 alpha and 2 beta). Each unit of Hb contains 4 units of heme that are united together by the alpha and beta chains of globin. Each unit of heme can combine with one molecule of O2. So one molecule of Hb can carry 4 molecule of O2. Each RBC carries about 280 million Hb molecules, therefore each RBC has ability to carry over a billion O2 molecules. Hb with O2 is called oxyhemoglobin, and Hb without O2 called deoxyhemoglobin.

Hb Structure

Types of Normal Hb Fetal hemoglobin Hb F (α2 and γ2): presents in the fetus during the last seven months of development in the uterus. and replaced by adult Hb within 6 month after birth. Adult hemoglobin Hb (Hb A) consists of : - HbA (α2 β2) 95% -Hb A2 (α2 δ2) 1.5-3% - Very small amounts of Hb F (α2 γ2)

Recycling RBC At the end of erythrocytes life spine, their constituents (Hb) are broken dawn (to heme and globin) and reused to form new erythrocytes. Iron released from heme is carried by transferrin protein into the blood and then to various tissues (bone marrow, liver) Porphyrin released from heme is converted into a yellow pigment called bilirubin. Bilirubin is insoluble (unconjugated form). It is taken by liver cells changed to soluble form (conjugated form) and excreted into bile. In the large intestine conjugated bilirubin is converted into stercobilinogen (by action of bacteria) and then into stercobilin which is responsible for brown color of feces Some stercobilinogen is absorbed into blood and excreated into urine which called urobilinogen exposure to air converts into urobilin.

Blood Groups The plasma membrane of erythrocytes are composed of lipids and proteins. Several types of proteins are present including A, B proteins (antigens) and Rh (D) factor responsible for person s blood group. Individuals make antibodies to these antigens but not to own type of antigen Persons of blood group A have antigen of type A on their red blood cells. Their serum contains antibodies of type B. Persons of blood group B have antigen of B on their red blood cells. Their serum contains antibodies of type A. Persons of blood group AB have antigens of both types A and B. they do not have type A or type B antibodies. Persons of blood group O have neither A nor B. antibodies of both types A and B are present. Rh factor or antigen (Rhesus factor), about 85% of people have this antigen own cell membrane of RBC.

Blood Groups

Anemia and Polycythemia Anemia means decrease in the capacity of RBC to carry O2. it occurs due to decrease RBC number or amounts of Hb. Decrease in the RBC number occurs in case: - hemorrhage, -hemolysis -defect production of red blood cells by bone marrow Diminish amounts of Hb occurs in case of nutritional deficiency like in iron deficiency, vitamin B12 deficiency.

Polycythemia An increase in the number of erythrocytes is called erythrocytosis or polycythemia. Polycythemia may be a physiologic condition like in people who live at high altitudes, were O2 tension is low.

Jaundice It is yellow pigmentation of the tissues, seen in the skin and conjunctiva, caused by excess blood bilirubin. Occurs due to: - Hemolysis - liver disease - Obstruction in the bile duct.