Chapter 10 Blood (PDF)

2/2/2025 1 2/2/2025 2  Learning Objective Describe the composition and volume of whole blood and its functions. Describe the composition of plasma and discuss its importance in the body. 2/2/2025 3  Blood Flu...

2/2/2025 1 2/2/2025 2  Learning Objective Describe the composition and volume of whole blood and its functions. Describe the composition of plasma and discuss its importance in the body. 2/2/2025 3  Blood Fluid tissue – Connective type Thick and homogenous liquid The blood is made up from 1- plasma 2- Formed elements 2/2/2025 4  Blood - Component (buffy coat) Less than 1 % Leukocytes & Erythrocytes Platelets 45% ( Hematocrit) 2/2/2025 5 WBC or leukocytes ; Body protection & platelets ; stops bleedings RBC or Erythrocytes; Transport oxygen 2/2/2025 6  Blood - Component 55% (buffy coat) Less than 1 % < 1% Leukocytes Leukocytes & 45% Erythrocytes Platelets 45% Hematocrit: volume % of RBC 2/2/2025 7  Blood -Physical characteristics A sticky opaque ( not clear) with a metallic taste Color – Scarlet-O2 rich– dull red- CO2 rich Heavier than water about five times thicker, why? more viscous Slightly alkaline – pH ( 7.35 – 7.45) Temperature – slightly higher than body temperature – 38oC Weight - 8% of body weight Volume – 5 – 6 liters in healthy adults 2/2/2025 8  Plasma Water 90% Dissolved Substances transported by blood: Nutrients, Waste products, Respiratory gases , Hormones , electrolytes or salts Plasma proteins Osmotic balance, pH buffering Albumin Clotting of blood Fibrinogen Defense and lipid Globulins transport Osmotic Salts ( electrolytes) balance,regulation of Na, K, Ca, Mg, Cl, memb. permeability HCO3- 2/2/2025 pH buffering 9 Osmotic balance : the process of maintenance of salt and water balance PH Buffering : a solution that resists dramatic changes in pH 2/2/2025 10  Only for understanding not memorization 2/2/2025 11  Only for understanding not memorization 2/2/2025 12  All plasma portions produced by the liver Albumin : acts as a carrier to certain molecules blood buffer osmotic pressure of blood , acts to keep water in the bloodstream 2/2/2025 13 2/2/2025 14  Nutrients, Waste products, Respiratory gases , Hormones , electrolytes 2/2/2025 15 2/2/2025 16  Learning Objective Describe the cell types making up the formed elements and major functions of each type Erythrocytes Leukocytes Platelets 2/2/2025 17  Formed elements 2/2/2025 18  A smear of Human Blood RBC Monocyte Platelets Lymphocytes Neutrophil 2/2/2025 19  Erythrocytes (RBC) 2/2/2025 20  What is the relationship between the RBC shape and its function? 2/2/2025 21  Erythrocytes (RBC) Small cells - biconcave discs Anucleate ( do not have nucleus) Contain very few organelles (ER) Lack the Mitochondria – do not use up any of the O2 they are transporting Large surface area making them ideally suited for gas exchange. 2/2/2025 22  hemoglobin Hemoglobin is a protein in red blood cells that carries oxygen It contains iron & major function is transports O2 and small amount of CO2 Mature RBCs are sacs of hemoglobin molecules 2/2/2025 23  Erythrocytes (RBC) The more Hb molecules the RBCs contain, the more O2 they will be able to carry. Hb = 12 –18 gm /100 ml of blood Female = 12-16 g/dL Male = 13-18 g/dL 2/2/2025 24  Sickle-cell anemia (SCA)  A Genetic disorder from a change in just one of the amino acids Abnormal Hb in RBCs , becomes spiky and sharp 2/2/2025 Glu Val 25 The result of a sickled cell is: oxygen content in the blood decreases below normal. Cell rupture easily dam up small blood vessel victims gasping for air and cause extreme pain. 2/2/2025 26  polycythemia An excessive increase in the number of erythrocytes is polycythemia Causes ; 1. It may result from bone marrow cancer 2. It may be a normal physiological response (homeostatic) ; living at high altitudes, where the air is thinner, and less oxygen is available Results: 1. increased viscosity- impairs circulation 2. Organomegaly 2/2/2025 ( Large organs) 27  Leukocytes (WBC) Contains nuclei and usual organelle. Helps to defend the body against bacteria, viruses, parasites and tumor cells. 2/2/2025 28  Leukocytes (WBC) Granulocytes Agranulocytes 1-4% 0-1% 20-45% 4-8% 40-70% 3000-7000 100-400 20-50 1500-3000 100-700 Occurrence in blood (per mm3) 4000 – 11,000 2/15/2021 29  Leukocytes (WBC) Neutrophils ; 1. most numerous 2. multilobed nucleus 3. Active phagocytes 4. sites of acute infection ,or short term infection 5. particularly partial to bacteria and fungi 2/2/2025 30  Leukocytes (WBC) 1. Kill parasitic worms with 1. rarest digestive enzymes; play a 2. have histamine-containing complex; eg: tapeworms granules 2. role in allergy attacks 3. Histamine is an inflammatory chemical that makes blood vessels leaky, attracts other WBCs to the inflamed site & vasodilator. 4. Contain heparin, an anticoagulant , prevent blood clotting 31  Agranulocytes agranulocytes, lack visible granules. Nucleus is, they are spherical, oval, or kidney- shaped Monocytes ; 1. largest of the WBCs. 2. migrate into the tissues, they change into macrophages 3. important in fighting chronic infections, such as tuberculosis, 4. activating lymphocytes 2/2/2025 32  Agranulocytes Lymphocytes 1. B lymphocytes produce Large nucleus that occupies antibodies; most of the cell volume. 2. T lymphocytes are Located lymphatic tissues, such involved in graft rejection as the tonsils and in fighting tumors and second most numerous viruses via direct cell leukocytes in the blood. attack 2/2/2025 33  How to memorize the order of relative abundance of WBCs in the blood? Never let monkeys eat bananas 1. neutrophils 2. Lymphocytes 3. Monocytes 4. Eosinophils 5. basophils 2/2/2025 34  Leukocytes (WBC) Granulocytes Agranulocytes Active Kill parasitic Release B -Produce Become phagocytes worms histamine- antibodies macrophages T-Fight during short Allergy vasodilator Long term tumors & acute attack virus ,graft During chronic infection rejection, infection activates B Defend the body against bacteria, viruses, parasites & tumor cells  Leukocytes (WBC) Positive chemotaxis = WBCs can locate areas of tissue damage or infection by responding to certain chemicals that diffuse from the damaged cells Diapedesis = slip into and out the blood vessel where they needed for inflammatory or immune responses Amoeboid motion = the WBCs move through the tissue spaces by motion they form flowing cytoplasmic extensions that help move 2/2/2025 36 Leukocytosis = High WBC count – more than 11,000 – normal & desirable response to infectious threats Leukopenia = Low WBC count - less than 250.000- due to certain drugs – corticosteroids and anticancer agent Leukemia = abnormal excessive production of WBC from the bone marrow & the “newborn” WBCs are immature and incapable of carrying out their normal protective functions 2/2/2025 37  Platelets Fragments of megakarocytes normal count is about 150,000- 400,000 Needed for clotting process 2/2/2025 38  Learning Objective Describe hematopoiesis (blood cell formation) 2/2/2025 39  Hematopoiesis Hematopoiesis: process of Blood cell formation occurs in red bone marrow, or myeloid tissue In adults, in the axial skeleton, pectoral and pelvic girdles, and proximal epiphyses of the humerus and femur Produced upon stimulus All the formed elements arise stem cell, the hemocytoblast in the bone marrow 2/2/2025 40  Hematopoiesis (Blood formation cells) 2/2/2025 41  Formation of Erythrocytes Anucleate, RBCs are unable to synthesize proteins, grow, or divide As they age RBCs become more rigid and begin to fragment or fall apart in 100 –120 days Remains are eliminated by phagocytes in the spleen, liver, and other body tissues Reticulocytes are young RBCs – have some ER The entire developmental process from hemocytoblast to mature RBC takes 3 to 5 days Production is controlled by Erythropoietin hormone mainly produced by the kidney Mechanism for regulating the rate of RBC production 43  Formation of Leukocytes & Platelets Stimulated by hormones which ae ; Colony stimulating factors and interleukins Major functions: 1. prompt redbone barrow to turnout leukocytes 2. Also enhancing the ability to protect the body The hormone thrombopoietin accelerates the production of platelets 2/2/2025 30-Dec-13 44 44 When leukemia is suspected, a needle is used to withdraw sample of red marrow from flat bones (ilium or sternum) close to the body surface. This procedure for microscopic examination called a bone marrow biopsy 2/2/2025 45  Learning Objective Describe the process of hemostasis and its importance (blood –clotting process) 2/2/2025 46  Hemostasis 15 minutes activity ! 1. Open chat GPT (AI) ; type “ explain hemostasis in a simple way , provide a reference” 2. Read , understand & refer to your textbook 3. Explain what you understood to your colleague 4. One of the students will explain it to us 47 What is hemostasis ? Stopping the bleeding Vascular spasm/ narrowing Platelet plug formation Coagulation or blood clot 48  Vascular Spasm What is vascular spasm ? It is vasoconstriction Why its happening ? 49  Platelet plug forms Platelets are repelled by an intact endothelium broken vessel are exposed, the platelets become “sticky” and cling to the damaged site. platelets release chemicals that enhance the 1.vascular spasms & 2.attract more platelets to the site. As more and more platelets pile up, a platelet plug forms 50  Coagulation events occur Tissue factors , platelets factors, calcium ions are interacting to form Thrombin Thrombin, an enzyme converts soluble fibrinogen proteins into long, hairlike molecules of insoluble fibrin Fibrin forms a meshwork that traps RBCs and forms the clot Within the hour, the clot begins squeezing serum (plasma minus the clotting proteins) from the mass and pulling the reptuered edges of the blood vessel closer together 51  Red Blood Cells in Fibrin Mesh 2/2/2025 52 2/2/2025 53  Learning Objective Describe the ABO & Rh blood groups Explain the basis for blood typing and transfusion reaction 2/2/2025 54  Blood groups Losses of 15-30 % lead to pallor and weakness, which can be fatal. Loss of over 30 % causes sever shock, which can be fatal. An antigen: present on the surface of RBCs , determines the blood group , is a substance that the body recognizes as foreign , each person tolerate his own antigen An antibody: present in plasma that attach to RBCs bearing surface antigens different from those on the patient’s (recipient’s) RBCs Person’s RBC proteins will be recognized as foreign if transfused into another person with different RBC antigens Binding of the antibodies causes the RBCs to clump- agglutination Agglutination 56  Blood groups ABO system:  A  B  AB  O Rhesus (Rh) system  Rh+  Rh-  1. ABO Blood Group System 2/2/2025 58  ABO Blood 1. ABO Groups Blood Group System Ag A Ag- B Ag-A & B No Ag Conclusion: 1. Blood Group A: Ag A (RBC) + Anti- B (Plasma/serum) = Normal flow of RBC in Blood 2. Blood Group B: Ag B (RBC) + Anti-A (Plasma/serum) = Normal flow of RBC in Blood 3. Blood Group AB: Ag A&B (RBC) + No antibodies (Plasma/serum) = Normal flow of RBC in Blood 4. Blood Group O: No Ag (RBC) + Anti-A & B (Plasma/serum) = Normal flow of RBC in Blood 59  RBC Agglutination & Hemolysis Example: Anti- B Ag B Anti- B Ag B Agglutination (clumping) & Hemolysis Rules: 1. Ag A + Anti-A= Agglutination & hemolysis of RBC 2. Ag B + Anti-B= Agglutination & hemolysis of RBC 3. 2/2/2025 Ag A&B + Anti-A & Anti-B = Agglutination & hemolysis of RBC 60 2/2/2025 61  The Giver The Taker 2/2/2025 62 2/2/2025 63  2. Rh Blood Group System Conclusion: 1. Blood Group Rh +ve: Ag Rh (RBC) + No Anti- Rh antibodies (D) (Plasma/serum) = Normal flow of RBC in Blood 2. Blood Group Rh -ve: No Ag Rh (RBC) + Anti-Rh antibodies (D) (Plasma/serum) = Normal flow of RBC in Blood 64  2. Rh System 2/2/2025 65  Rh Transfusion Reaction Rh- person receives mismatched blood (Rh + ) First Time few Anti-Rh-antibodies in plasma + Rh-Antigen on RBC membrane immune system becomes sensitized, and start to produce Anti-Rh antibodies No hemolysis occurs  Rh Transfusion Reaction Rh- person receives mismatched blood (Rh + Ag) Second Time immune system becomes sensitized, and produce more antibodies in second transfusion. Rupture of RBCs -Hemolysis Rupture of Conclusion: Rh +ve + Rh-ve : flow of RBC in Blood RBCs & Ag Rh (RBC) Anti-Rh (D) (Plasma/serum) Hemolysis  First Pregnancy: Pregnant Mother Rh- Baby Rh+ X Anti-Rh antibodies Rh-Antigen Delivery & Blood mixing Rh-Antigen of baby's blood is mixed with mothers blood Start the production of Ab - Low blood agglutination in the mother & baby but more formation of Anti-Rh Antibodies against antigen in mothers blood 2/2/2025 69 Safe delivery & healthy baby Second Pregnancy: Pregnant Mother Rh- Baby Rh+ High Anti-Rh X Rh-Antigen Antibodies During Pregnancy & Delivery Anti-Rh Antibodies diffuse from mothers blood to baby's blood that contain Rh-Antigen RBCs High blood agglutination & hemolysis in the baby's blood 2/2/2025 Hemolytic disease of the newborn 70  Pregnant Rh – women who are carrying Rh + babies First pregnancy results in healthy baby Mother is sensitized Rh + antigen (baby) She will develop anti Rh+ antibodies Solution: RhoGAM: immune serum that prevents this sensitization Not treated: Destroy the baby’s RBCs (Hemolytic disease of the newborn) Hemolytic disease of the newborn Brain damage and death 2/2/2025 71  Pregnant Rh – ve Mother who are carrying Rh+ ve babies Solution: RhoGAM: immune serum that prevents this sensitization after first pregnancy (prevents formation of more Anti-Rh-antibodies in mothers blood after the first delivary) 2/2/2025 72  Blood Typing/testing & Transfusion Blood typing is a method to tell what type of blood you have. Blood typing is done so you can safely donate your blood or receive a blood transfusion. It is also done to see if you have a substance called Rh factor on the surface of your red blood cells. Before blood transfusion, determine the blood group of both the donor and the recipient(X matching sample) Test the blood by mixing it with two different types of immune serum-Figure (10.7) Testing for agglutination of donor RBCs by the recipient’s serum and of the recipient’s RBCs by the donor serum- Cross matching Typing for Rh factors is also important  Blood Typing To determine the blood group of both the donor and the recipient (cross matching sample) before blood transfusion to avoid hemolysis Test the blood by mixing it with two different types of immune serum Figure (10.7) Testing for agglutination of donor RBCs by the recipient’s serum and of the recipient’s RBCs by the donor serum- Cross matching (ABO blood group) Typing for Rh factors is also important (Rh blood group) GAYATHRIANSARI Rules: 1. Ag A + Anti-A= Agglutination & hemolysis of RBC 2. Ag B + Anti-B= Agglutination & hemo 3. lysis of RBC 4. Ag A&B + Anti-A & Anti-B = Agglutination & hemolysis of RBC Blood typing Cross match test 2/2/2025 75  Rh 2/2/2025 76 2/2/2025 77  Game for Blood Typing https://educationalgames.nobelprize.org/educa tional/medicine/bloodtypinggame/ 2/2/2025 78  Blood Compatibility 2/2/2025 79  Conclusion 1. Blood Group A: Ag A (RBC) + Anti-B antibodies (Plasma/serum) = Normal flow of RBC in Blood 2. Blood Group B: Ag B (RBC) + Anti-A antibodies (Plasma/serum) = Normal flow of RBC in Blood 3. Blood Group AB: Ag A&B (RBC) + No antibodies (Plasma/serum) = Normal flow of RBC in Blood 4. Blood Group O: No Ag (RBC) + Anti-A & B antibodies (Plasma/serum) = Normal flow of RBC in Blood 1. Blood Group Rh +ve: Ag Rh (RBC) + No Anti- Rh antibodies (D) (Plasma/serum) = Normal flow of RBC in Blood 2. Blood Group Rh -ve: No Ag Rh (RBC) + Anti-Rh antibodies (D) (Plasma/serum) = Normal flow of RBC in Blood Blood typing is a method to tell what type of blood you have. Blood typing is done so you can safely donate your blood or receive a blood transfusion. It is also done to see if you have a substance called Rh factor on the surface of your red blood cells. RhoGAM: immune serum that prevents this sensitization after first pregnancy 2/2/2025 80 2/2/2025 81  Quick Review Composition & Think volume of blood & link Composition of plasma List the formed elements Explain hematopoiesis & hemostasis 2/2/2025 82 2/2/2025 83