BIOS222 Pathology and Clinical Science 2 Session 3 Lymphatic and Haematological Disorders 1 Bioscience Department www.endeavour.edu.au
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 www.endeavour.edu.au 2
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 www.endeavour.edu.au 3
Anatomy and Physiology of Blood and Lymphatic System Endeavour College of Natural Health www.endeavour.edu.au 4
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 www.endeavour.edu.au 5
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 www.endeavour.edu.au 6
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 www.endeavour.edu.au 7
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 www.endeavour.edu.au 8
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 www.endeavour.edu.au 9
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 www.endeavour.edu.au 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 www.endeavour.edu.au 11
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 www.sciencephoto.com Tortora, GJ & Derrickson, B 2014, Principles of anatomy and physiology, 14th edn, John Wiley & Sons, Hoboken, NJ Endeavour College of Natural Health www.endeavour.edu.au 12
Lymphatic System o The lymphatic system consists of: Lymph Lymphatic vessels Lymphatic tissues and organs Red bone marrow Endeavour College of Natural Health www.endeavour.edu.au 13
Flow of Lymph Endeavour College of Natural Health www.endeavour.edu.au 14
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 www.endeavour.edu.au 15
Lymphatic Tissues and Organs o Spleen o Thymus o Lymphatic nodules: Tonsils Peyer s patches MALT (mucosaassociated lymphoid tissue) Endeavour College of Natural Health www.endeavour.edu.au 16
Examination and Investigation of Haematological system Endeavour College of Natural Health www.endeavour.edu.au 17
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 www.endeavour.edu.au 18
Endeavour College of Natural Health www.endeavour.edu.au 19
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 www.endeavour.edu.au 20
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 www.endeavour.edu.au 21
Presenting Problems in Haematological Disease Endeavour College of Natural Health www.endeavour.edu.au 22
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 www.endeavour.edu.au 23
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 www.endeavour.edu.au 24
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 www.endeavour.edu.au 25
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 www.endeavour.edu.au 26
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 www.endeavour.edu.au 27
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 www.endeavour.edu.au 28
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 www.endeavour.edu.au 29
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 www.endeavour.edu.au 30
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 www.endeavour.edu.au 31
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 www.endeavour.edu.au 32
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 www.endeavour.edu.au 33
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 www.endeavour.edu.au 34
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