Blood.pdf

MC_101_: ANATOMY AND PHYSIOLOGY LECTURE LECTURE #5: BLOOD PROFESSOR: Dr. Janelle Tayo 1ST SEMESTER | A.Y 2022-2023 FUNCTIONS OF BLOOD Transport of gases, nutrients and waste - ○ Waste products nitrogenous was...

MC_101_: ANATOMY AND PHYSIOLOGY LECTURE LECTURE #5: BLOOD PROFESSOR: Dr. Janelle Tayo 1ST SEMESTER | A.Y 2022-2023 FUNCTIONS OF BLOOD Transport of gases, nutrients and waste - ○ Waste products nitrogenous waste products (ex real -. Transport processed molecules - ○ Molecules that are being released Ex. Vitamin D processed in the liver and activated in the kidney Ex. Cholesterol from liver Normal pl alkalotic Transport of regulatory molecules- 7 35 - 7 45 ↓.. ○ Enzymes or hormones acidotic ↳ such as insulin means more acidic blood Regulation of pH and osmosis the hydrogen more osmosis the process of movement of water from is dilute solute to Maintenance of body temperature 36 37 - Nat 5. -. 5 Protection against foregin substances Clot formation ○ platelets COMPOSITION OF BLOOD Processed through centrifuge Blood is a connective tissues consisting of plasma and formed elements Total blood vol in an average adult is approx 5L. Plasma (55% of total blood) Pale, yellow liquid that surrounds cells 91% water, 7% proteins, and 2% other ○ Proteins 58 % Albumins osmotic pressure transportation ; antibodies 38 Globulins % system - immune ; % Fibrinogen - for clotting ; fibrinogen fibrin 4 to ○ Water (most abundant % by weight sa Buffy Coat plasma) ○ Platelets ○ Other Solutes ○ White blood Cells Ions Hematopoiesis Neutrophils Nutrients Lymphocytes Waste products Formed Elements Gasses ○ Red blood cells Regulatory substances HEMATOPOIESIS Formed Elements: Process that produces formed elements (RBC) ○ 45% of total blood ○ Cells and cell fragments Fetus - hematopoiesis occurs in several tissues ○ Most abundant is RBC, ○ LYMPHATIC TISSUE: Liver, thymus. ○ For WBC, Spleen. Lymph nodes, red bone marrow Most abundant is neutrophils (which can found in the spongy bone) Pinaka onti is basophils After birth, hematopoiesis is combined primarily to PLASMA PROTEINS red bone marrow, but white blood cells are Albumin water balance/osmotic pressure produced in lymphatic tissue ○ 58% of plasma proteins ○ Helps maintain water balance osmotic pressure HEMOCYTOBLASTS stom cells origin roc where all rocs come from - Globulins antibodies Stem cells ○ 38% of plasma proteins ○ All formed elements of blood are derived ○ Helps immune system antibodies from this single population of cells Fibrinogen fibrin These cells differentiate to give ○ 4% of plasma proteins rise to different cell lines ○ Aids in clot formation MENESES, M., PAREDES, J., PAREDES, S., PINO, R., PLURAD, N, QUIÑONES, M., RAMOS, A., REPE, A. TABANAO, K. | 1NU02 1  The heme of hemoglobin releases iron. The heme is converted to bilirubin. Blood transports iron to the red bone marrow, where it is used to produce new hemoglobin Blood transports bilirubin to the liver Bilirubin is excreted as part of the bile into the small intestine. Some bilirubin derivatives contribute to the color of the feces (Stercobilin). Other bilirubin derivatives are reabsorbed from the intestine into the blood and excreted from the kidneys in the urine ○ Urobilin = gives color to the urine; responsible for the yellow color DEFINITION OF TERMS Macrophage ○ Found in the tissues ○ Monocytes: found in the blood Jaundice = yellow discoloration of the body ○ Happens when you have problems with the gall bladder or liver ○ occur when too much bilirubin builds up in the body. ○ This may happen when: There are too many red blood cells dying or breaking down (hemolysis) and going to the liver ERYTHROCYTES Red Blood Cells (RBC) – walang nucleus LEUKOCYTES Disk-shaped with think edges White Blood Cells (WBC) Nucleus is lost during developments Lack hemoglobin Live for 120 days 170 days for men 110 days for women Larger than erythrocytes FUNCTION: Transport O2 (Oxygen) and CO2 Contains a nucleus FUNCTIONS: HEMOGLOBIN Ba B12 ○ Fights infections Main component of erythrocytes ○ Remove dead cells and debris by Transports O2 phagocytosis HEME - GLOBIN Phagocytosis = ingest the cell Gives color to the blood Globin - protein that is attached to a heme 2 globin chain beta TYPES OF LEUKOCYTES alpha molecule Granulocytes - contains specific granules and Heme - contains one iron atom include neutrophils, eosinophils, and basophils ○ O2 binds to iron (BEN) ○ Neutrophils bacterial infection- OXYHEMOGLOBIN - Hemoglobin with an O2 Anemia Most common attached Bright Red color -- - ↓ roc First to respond when bruised · ↓ nemoglobin (Pus contains dead neutrophils) If Bilirubin is not excreted, it can causes WHO Remain in blood for 10 - 12 hours discoloration of the skin Phagocytes ○ Ex. Hepatitis, gall blood stone Sadly a anem Purple How many O2 can a single RBC carry? 3-4 lobes of nuclei ○ 4. 4 heme group Jaka may bacterial infection vs. Piron = 4 oxygen - pag mataas masyado ○ Eosinophils - 3as bind acidic dyes parasite - : RBC PRODUCTION Inflammatory response, seen in The trigger is the decrease of blood oxygen level allergic reaction and asthma ○ Ex. Decrease in hemoglobin, rbc, or lung Destroy parasites (General, but problem, heart problems, increase oxygen remember ascaris para maalala demand yung 3as) Describe to have a bilobed nuclei After, it would stimulate the kidney and release (2 lobes) erythropoietin (EPO) - tataas pag may parasite ka sa body ○ Basophils basic dyes ; allergic reaction - It would trigger the bone marrow to increase the Least common * indistinct nucleus two red blood cell production Has a thin cytoplasm Release histamine and heparin - - thrombin Inactivator Increase red blood cell production + increased - allergic reaction Y inflammation ↓ clotting oxygen levels Agranulocytes - no specific granules ○ Monocytes HEMOGLOBIN BREAKDOWN Largest white blood cells In macrophages, the globin part of the Produce macrophage (for tissue) L protein part hemoglobin is broken down to individual amino Nucleus is horse-shoe like or ingetolfactor in acids (red arrow) and metabolized or used to kidney shaped build new proteins. MENESES, M., PAREDES, J., PAREDES, S., PINO, R., PLURAD, N, QUIÑONES, M., RAMOS, A., REPE, A., TABANAO, K. | 1NU02 2  ○ Lymphocytes viral infection Constriction can close small vessels completely and Immune response : antibodies stop the flow of blood through them Several different types (T cells Stimulated by chemicals released by cells of the and B cells) ↓ cells-antibodies T cells-helpers ; natural killer cell damaged blood vessel wall and by platelets Lead to production of antibodies ○ Endothelin Has a nucleus that is round and ○ Thromboxane smaller than monocytes PLATELET PLUG FORMATION Process to make plateleg plug (AAA) ○ Adhesion - occurs first, platelets stick to the exposed collagen in the damaged blood vessel wall Von Willebrand factor is considered as the glue of the neutrophil basophils basophil platelets to adhere to exposed collagen ○ Activation - change shape and release chemicals adp and thromboxane - ○ Aggregation - fibrinogens forms bridges lymphocytes monocyte between fibrinogen receptors of numerous platelets resulting in platelet plugs A. neutrophils – 2-4 lobes of nucleus B. basophils – 2 distinct lobes; thin cytoplasm C. Eosinophils – bilobe; pink to red cytoplasm D. Lymphocytes – round nucleus, distinct, somewhat small E. Monocyte – largest; horseshoe/kidney shaped PLATELETS Minute fragments of cells consisting small amount of cytoplasm surrounded by a cell membrane Produced in the red bone marrow from large cells Vasoconstriction called megakaryocytes (parang kurot in a bread) Primary hemostasis Small fragments break off from the megakaryocytes Platelet adhesion and enter the blood as platelets Secondary hemostasis FUNCTION: create clot and prevent blood loss Thrombosis and antithrombotic events - 230 000 , - 100 , 000 Fragments Thrombocytopenia BLOOD LOSS Thrombocytosis BLOOD CLOTTING When blood vessels are damaged, blood can Can be transformed from a liquid to a gel leak into other tissues and disrupt normal Clot function ○ Network of thread-like proteins called fibrin Body can tolerate a small amount of blood loss and that trap blood cells and fluid can produce new blood to replace it ○ Depends on clotting factors Large amount of blood that is lost must be replaced Fibrinogen - I by production of new blood or by a transfusion Clot formation Fibrin Threads XII - ○ Proteins in plasma PREVENTION OFBLOOD LOSS ○ Only activated following in injury ○ Made in liver Vascular spasm ○ Require vitamin K calcium and platelets ○ Temporary constriction of blood vessel , ○ Happens immediately but temporary Injured – temporary vasoconstriction in the injury (bec of smooth muscles) to block so much blood loss ○ Unstable, temporary Platelet plugs ○ Can seal up small breaks in blood vessels ○ Temporary seal ○ Like a band-aid, very temporary ○ Lessen the blood loss ○ Not stable Blood clotting (coagulation) ○ More stable clot Note: No need to memorize. VASCULAR SPASM Immediate but temporary constriction of a blood STEPS IN CLOT FORMATION vessel that results when smooth muscle within the HEME - GLOBIN wall of the vessel contracts. MENESES, M., PAREDES, J., PAREDES, S., PINO, R., PLURAD, N, QUIÑONES, M., RAMOS, A., REPE, A., TABANAO, K. | 1NU02 3  Thrombin - activation of fibrin Phrothrombinase -o Prothrombin to Anti-coagulants TYPE A ○ Prevents clots from forming Type A antigen Heparin and antithrombin TYPE B 1. PROTHROMBINASE PRODUCTION Type B antigen Inactive clotting factors come in contact with exposed connective tissue, resulting TYPE AB in their activation Has type A and Type B antigen Chemicals such as thromboplastin are released from injured tissues, causing TYPE O activation of clotting fatcors Neither A or B antigen A series of reactions results in which each clotting factor activates the next until the Note: The types of antigens found on the surface of the clotting factor prothrombinase is formed RBCs are genetically determined 2. THROMBIN PRODUCTION Prothrombinase convert an inactive In caucasians in the US, the distribution is clotting factor called prothrombin to its ○ Type O = 47% Type O-most common ; universal donor ↳ inactive form of thromb in active form = thrombin ○ Type A = 41% 3. FIBRIN PRODUCTION ○ Type B = 9% universal recepient Thrombin converts the plasma protein ○ Type AB = 3% Type AB-most rare ; fibrinogen to fibrin Among African-Americans, the distribution is ○ Fibrin = stable clot ○ Type O = 46% ○ Type A = 27% Note: The mineral primarily responsible for clot formation is ○ Type B = 20% Calcium. Vitamin K is only required for clotting factors, but ○ Type AB = 7% during coag, the Ca2+ plays an important role in the formation of blood clots. AGGLUTINATION REACTION CLOT FORMATION CONTROL A. No agglutination reaction Clots need to be controlled so they don’t spread Type A blood donated to a type A recipient throughout the body does not cause an agglutination reaction Anticoagulants because the anti-B antibodies in the ○ Prevent clots from forming recipient do not combine with the type A ○ Ex: heparin and antithrombin antigens on the RBCs in the donated Injury causes enough clotting factors to be activated blood. that anticoags can’t work in the particular area of the body Thrombus-clot the blood vessel in Embolus - travelling thrombus B. Agglutination reaction FIBRINOLYSIS Type A blood donated to a type B recipient Fibrinolysis – breaking down of a clot causes an agglutination reaction because 1. Thrombin and an inactive plasma protein called the anti-A antibodies in the recipient + pa-tissue plasminogen plasminogen is converted to its active form activator combine with the type A antigens on the plasmin breaks down fibrin - 2. Plasmin breaks down the fibrin in a blood clot, RBCs in the donated blood resulting in clot fibrinolysis.. 3 Clot Retraction - closing of wound ; retraction of fibrin ; enhances healing BLOOD GROUPING Injury or surgery can lead to blood transfusion TRANSFUSION – transfer of blood or blood components from one individual to another INFUSION – introduction of a fluid other than blood (ex. saline) Transfusion reaction / agglutination ○ Clumping of blood cells (bad) Antigen ○ Molecules on surface of erythrocytes (RBC) BLOOD DONORS AND RECIPIENT ACCORDING TO BLOOD Antibodies TYPES ○ Proteins in plasma Type O = universal donor Blood groups ○ Because they can usually give blood to ○ Named according to antigen (ABO) other ABO blood types w/o causing ABO transfusion reaction ABO BLOOD GROUPS ○ Although, it can still cause minimal to no 2 types of antigens that may appear on the surface effect at all. of the RBC, type A and type B antigen ○ Not serious reaction because the You are born with that antibody, depending on your antibodies in the donor’s blood are ABO blood group. MENESES, M., PAREDES, J., PAREDES, S., PINO, R., PLURAD, N, QUIÑONES, M., RAMOS, A., REPE, A., TABANAO, K. | 1NU02 4  diluated in the large volume of the This condition can be fatal to the fetus recipient’s blood. But can be prevented if mother is treated with ○ Type O blood is given to a person with RhoGAM which contains antibodies against Rh another blood type only in life-or-death antigens situations. RhoGAM – medicine that stops your blood from making antibodies that attack Rh-positive blood cells. Injected 26-28 weeks before delivery or 72 hours after the delivery. Situation: Px is first time mother; history: transfusion happened. Px is B- but got transfused with B+ blood. Given this, do you think she will already have erythroblastosis fetalis? = YES. Because of the transfusion reaction. She already have antibodies because of the transfusion. DIAGNOSTIC BLOOD TESTS Complete blood count ○ Provide information such as RBC count hemoglobin, hematocrit, and WBC count. Hemotocrit ○ %of total blood volume composed of WBC Hemoglobin ○ Determine amount of hemoglobin Rherus Monkey : RI ○ Indicate anemia Indicates dehydration RH BLOOD GROUP - Ito yung mga + or - after your ABO blood group. You could also determine if you have a problem in clotting: Rh positive means you have Rh antigen Prothrombin time ○ You have an antigen, you don’t have ○ Time it takes for blood to begin clotting 9 to antibodies 12 seconds ○ 95% to 85% of the population is Rh+ ○ Is determined by adding thromboplastin to ○ Antibodies only develop if an Rh- person is whole plasma exposed to Rh+ blood by transfusion or from mother to fetus White blood cell count ○ count total number of white blood cells Rh negative means you don’t have Rh antigen ○ Wala kang antigen; wala ka ring antibody Platelet Count ○ Normal platelet count is 250,000-400,000 RH INCOMPATIBILITY IN PREGNANCY platelets per microliter of blood. If mother is Rh- and fetus is Rh+, mother can be exposed to Rh+ blood if fetal blood leaks through WHITE BLOOD CELL DISORDERS placenta and mixes with mother’s blood Leukopenia First time this occurs mother’s blood produces ○ low white blood cell count antibodies against antigens ○ caused by radiation chemotherapy drug Any repeated mixing of blood causes a reaction tumor viral infection. In the womb (during pregnancy), there is no mixing of the baby to the mother. Leukocytosis In later pregnancies, however, a problems can arise ○ high white blood cell count because the mother has been sensitized to the Rh ○ caused by infection and leukemia antigen. Consequently, if the fetus is Rh-positive and if any Leukemia fetal blood leaks into the mother’s blood, she rapidly ○ Cancer of the red marrow characterized by produces large amounts of anti-Rh antibodies, abnormal production of one or more of the which can cross the placenta to the fetus white blood cell types , can cause leuktocytosis HEMOLYTIC DISEASE OF NEWBORN Aplastic Anemia Erythroblastosis fetalis stops producing formed elements when done marrow Occurs when mother produces anti–Rh antibodies - that cross placenta and agglutination and hemolysis of fetal RBCs occurs MENESES, M., PAREDES, J., PAREDES, S., PINO, R., PLURAD, N, QUIÑONES, M., RAMOS, A., REPE, A., TABANAO, K. | 1NU02 5