Ch10.pdf

Chapter 10 Blood © 2012 Pearson Education, Inc.  Blood Blood transports everything that must be carried from one place to another, such as: Nutrients Wastes Hormones Body heat © 2012 Pearson Education, Inc.  Components of Blood Blood is the onl...

Chapter 10 Blood © 2012 Pearson Education, Inc.  Blood Blood transports everything that must be carried from one place to another, such as: Nutrients Wastes Hormones Body heat © 2012 Pearson Education, Inc.  Components of Blood Blood is the only fluid tissue, a type of connective tissue, in the human body Components of blood Formed elements (living cells) Plasma (nonliving fluid matrix) © 2012 Pearson Education, Inc.  Components of Blood When blood is separated: Erythrocytes sink to the bottom (45 percent of blood, a percentage known as the hematocrit) Buffy coat contains leukocytes and platelets (less than 1 percent of blood) Buffy coat is a thin, whitish layer between the erythrocytes and plasma Plasma rises to the top (55 percent of blood) © 2012 Pearson Education, Inc.  Physical Characteristics and Volume Blood characteristics Sticky, opaque fluid Heavier and thicker than water Color range Oxygen-rich blood is scarlet red Oxygen-poor blood is dull red or purple Metallic, salty taste Blood pH is slightly alkaline, between 7.35 and 7.45 © 2012 Pearson Education, Inc.  Physical Characteristics of Blood Blood temperature(38ºC or 100.4ºF) is slightly higher than body temperature, because of the friction produced as blood flows through the vessels. In a healthy man, blood volume is about 5–6 liters. Blood makes up ~8% of body weight  Blood Plasma Composed of ~90% water, and rest are solutes. It is straw coloured liquid part of the blood. Transportation of substances across body. It helps to distribute body heat evenly throughout the body. Includes many dissolved substances Nutrients Salts (electrolytes) Respiratory gases Hormones Plasma proteins Waste products  Blood Plasma Plasma proteins Most abundant solutes in plasma Most plasma proteins are made by liver except antibodies and protein based hormones. The composition of plasma varies as cells exchange substances with the blood. Liver makes more proteins when the level drops.  Blood Plasma Various plasma proteins include:- Albumin — It regulates osmotic pressure of blood, thus maintaining volume ( keeps water in blood stream). It acts as carrier through circulation(lipid hormones). Important blood buffer (PH). Clotting proteins (fibrinogen) —help to stem blood loss when a blood vessel is injured. Antibodies (globulins) —help protect the body from pathogens. Help in lipid, hormone transport. © 2012 Pearson Education, Inc.  Blood Plasma Acidosis Blood pH becomes too acidic Alkalosis Blood pH becomes too basic In each scenario, the respiratory system and kidneys(urinary system) help restore blood pH to normal. ©©2012 2015 Pearson Education,Inc. Pearson Education, Inc.  Formed Elements Erythrocytes Red blood cells (RBCs) Leukocytes White blood cells (WBCs) Platelets Cell fragments  Erythrocyte Structure Erythrocytes (RBC) Main function is to carry oxygen. RBCs differ from other blood cells Anucleate (no nucleus) Contain few organelles; no mitochondria Essentially bags of haemoglobin (Hb) Shaped like biconcave discs 5 million RBCs per cubic millimetre (mm3) of blood is the normal count.  Hemoglobin: Iron-containing protein which gives red colour to blood. Binds strongly, but reversibly, to oxygen A single RBC contains contains 250 million hemoglobin molecules. Each haemoglobin molecule has four oxygen binding sites. Each RBC carry = 1 billion molecules of oxygen. A globular protein with tertiary structure Normal blood contains 12–18 g of haemoglobin per 100 mL of blood. Men= 13 - 18g : Female= 12 - 16g © 2012 Pearson Education, Inc. © 2012 Pearson Education, Inc.  Homeostatic imbalance of RBCs Anemia is a decrease in the oxygen-carrying ability of the blood due to: Lower-than-normal number of RBCs Abnormal or deficient hemoglobin content in the RBCs Sickle cell anemia (SCA) results from abnormally shaped haemoglobin Polycythemia is an excessive or abnormal increase in the number of RBCs. Figure 10.3  Sickle-cell Anemia Common in Central African descent. Hemoglobin cannot carry oxygen efficiently, the RBCs become distorted, rupture easily and obstruct the capillaries. Normal hemoglobin has a jelly-like consistency, allowing RBCs to squeeze easily through the narrowest blood vessels. Sickle-shaped red blood cells tend to clump together and block the blood vessels. The sickle-shaped cells cannot carry as much oxygen as normal RBCs. Weakness, abdominal pain, kidney failure, heart failure, stroke. © 2012 Pearson Education, Inc.  Sickle cell Anaemia Sickle Cell Trait(SCT) : People carrying one sickling gene. Individuals with sickle cell gene have better chance of survival in Malaria prone areas. RBC infected with the malaria causing parasite stick to capillary wall and loose potassium, preventing it from multiplying within their blood. Individuals with sickle cell gene have a better chance of surviving where Malaria is prevalent. ©©2012 2015 Pearson Education,Inc. Pearson Education, Inc. © 2012 Pearson Education, Inc.  Formed Elements Polycythemia: Disorder resulting from excessive or abnormal increase of RBCs. May be caused by bone marrow cancer (polycythemia vera). May be a normal homeostatic response to life at higher altitudes (secondary polycythemia). Increase in RBCs slows blood flow and increases blood viscosity and impairs circulation. © 2012 Pearson Education, Inc.  Leukocytes (WBCs) ©©2012 2015 Pearson Education,Inc. Pearson Education, Inc.  Formed Elements Leukocytes (white blood cells, or WBCs) Crucial in body’s defense against bacteria, virus, parasites, and tumour cells and dispose of dead cells. Complete cells, with nucleus and organelles. Cytoplasmic Granules: Lysosomes and secretory vesicles. © 2012 Pearson Education, Inc.  Formed Elements Leukocytes (white blood cells, or WBCs) Able to move into and out of blood vessels- process called diapedesis. Respond to chemicals released by damaged tissues known as positive chemotaxis. Move by amoeboid motion through tissue spaces. 4,800 to 10,800 WBCs per mm3 of blood © 2012 Pearson Education, Inc.  Whenever WBCs mobilize for action, the body speeds up their production, and as many as twice the normal number of WBCs may appear in the blood within few hours. Abnormal numbers of leukocytes  Formed Elements Abnormal numbers of leukocytes Leukocytosis WBC count above 11,000 cells/mm3. Generally indicates an infection. It is a normal response to infection. Leukopenia Abnormally low leukocyte level (WBCs) Commonly caused by certain drugs, such as corticosteroids and anticancer agents. Leukemia Excessive production of abnormal WBCs. Bone marrow becomes cancerous; turns out excess WBCs. © 2012 Pearson Education, Inc.  Review Questions 1) Excess numbers of these cells cause leukocytosis 2) Alternate name for white blood cell 3) Type of cell that contains a nucleus and organelles 4) Type of cell that transports carbon dioxide 5) Type of cell produced in response to erythropoietin © 2012 Pearson Education, Inc.  Types of leukocytes WBCs are classified into two major groups: I. Granulocytes Granules in their cytoplasm can be stained Possess lobed nuclei All of them are phagocytic Include neutrophils, eosinophils, and basophils. II. Agranulocytes Lack visible cytoplasmic granules Nuclei are spherical, oval, or kidney-shaped Include lymphocytes and monocytes  Formed Elements List of the WBCs, from Easy way to most to least abundant remember this list Neutrophils Never Lymphocytes Let Monocytes Monkeys Eosinophils Eat Basophils Bananas © 2012 Pearson Education, Inc. Types of Granulocytes  I. Types of granulocytes: 1.Neutrophils: First to reach infection site. Cytoplasm stains pale pink and contains fine (small) granules. ▪ Deep purple nucleus contains three to seven lobes. ▪ They particularly destroy bacteria and fungi by phagocytosis at active sites of infection. ▪ 3,000 –7,000 neutrophils in a cubic millimetre of blood. ▪ Numbers increase during infection. ▪ Numerous type (40 –70 percent of WBCs) © 2012 Pearson Education, Inc.  Types of granulocytes: 2. Eosinophils Brick red, coarse cytoplasmic granules. Bilobed nucleus stains blue-red. Functions to kill parasitic worms by releasing digestive enzymes from their cytoplasmic granules onto parasitic surface, digesting it. Their no. increases rapidly during parasitic infection. 100 – 400 eosinophils in a cubic millimeter of blood (1– 4 percent of WBCs) © 2012 Pearson Education, Inc. Types of granulocytes 3. Basophils: Rarest WBCs. Have large histamine containing granules which stain dark blue. U- or S -shaped nucleus stains dark blue. Release histamine (vasodilator, inflammatory chemical that makes blood vessels leaky) at sites of inflammation. 20 – 50 basophils in a cubic millimeter of blood (0 –1 percent of WBCs) © 2012 Pearson Education, Inc.  II. Types of agranulocytes: 1. Lymphocytes Slightly larger than RBCs. Cytoplasm is pale blue. Dark purple-blue nucleus. ▪ Functions as part of the immune response: ▪ B lymphocytes produce antibodies. ▪ T lymphocytes are involved in graft rejection, fighting tumors and viruses. ▪ Reside in lymphatic tissues, such as tonsils. ▪ 1,500 – 3,000 lymphocytes in a cubic millimeter of blood. ▪ They are the second most numerous leukocytes in blood (20 – 45 percent of WBCs). © 2012 Pearson Education, Inc.  Types of agranulocytes: 2. Monocytes: Largest of the white blood cells. Grey-blue cytoplasm. Dark blue-purple nucleus is often kidney or U- shaped. ▪ Function as macrophages when they migrate into tissues. ▪ Activate lymphocytes during Immune response. ▪ Important in fighting chronic infection like tuberculosis. ▪ 100–700 monocytes per cubic millimeter of blood (4 – 8% of WBCs) © 2012 Pearson Education, Inc.  Formed Elements Platelets: fragments of cells. Derived from ruptured multinucleate cells called megakaryocytes in the bone marrow. Appear as irregular bodies. Needed for the clotting process (platelets plug). Platelet count ranges from 150,000 to 400,000 per cubic millimeter of blood 300,000 is considered a normal number of platelets per cubic millimeter of blood © 2012 Pearson Education, Inc. © 2012 Pearson Education, Inc. © 2012 Pearson Education, Inc. © 2012 Pearson Education, Inc.  Hematopoiesis - Blood Cell formation Hematopoiesis is the process of blood cell formation. Occurs in red bone marrow or myeloid tissue. Young children: All the bone marrow is red BM. In Adults: Red BM remains between trabeculae of spongy bone of Flat bones of skull, ribs, sternum, vertebrae, pelvis, proximal epiphyses of the humerus and femur. © 2012 Pearson Education, Inc.  Hematopoiesis - Blood Cell formation All formed elements are derived from a common stem cell residing in bone marrow, hemocytoblast. Hemocytoblast differentiation Lymphoid stem cell produces lymphocytes. Myeloid stem cell produces all other formed elements. © 2012 Pearson Education, Inc.  Hemocytoblast stem cells Lymphoid Myeloid stem cells stem cells Secondary stem cells Basophils Erythrocytes Platelets Eosinophils Lymphocytes Monocytes Neutrophils © 2012 Pearson Education, Inc.  Red Blood Cells Since RBCs are anucleate, they are unable to divide, grow, or synthesize proteins. RBCs (age) wear out in 100 to 120 days When worn out, RBCs are eliminated by phagocytes in the spleen or liver. Lost cells are replaced by division of hemocytoblasts in the red bone marrow © 2012 Pearson Education, Inc.  Destruction of Red Blood Cells When worn out, RBCs are eliminated by phagocytes in the spleen or liver. Globin is broken down to amino acids, which are released into the circulation. Iron is bound to protein as ferritin. Heme group is degraded to bilirubin. Bilirubin is secreted into the intestines (in Bile) by liver cells. There it becomes a brown pigment called stercobilin, that leaves the body in feces. © 2012 Pearson Education, Inc.  Formation of Mature RBCs Developing RBCs divide many times and then begin synthesizing huge amounts of hemoglobin. When enough haemoglobin has been accumulated, the nucleus and most organelles are ejected. The young RBC formed are called a reticulocyte (because it still contains some rough endoplasmic reticulum).  The reticulocytes enter the bloodstream to transport oxygen. Ejected any remaining ER within 2 days of release. Become fully functioning mature RBC. The entire developmental process from hemocytoblast to mature RBC takes 3 to 5 days.  Control of Red Blood Cells Production Rate of RBC production is controlled by a hormone called erythropoietin Kidneys produce most erythropoietin (liver also produce some) as a response to reduced oxygen levels in the blood. Erythropoietin targets the bone marrow. Small amount of hormone circulates in the blood all time. Homeostasis is maintained by negative feedback from blood oxygen levels. © 2012 Pearson Education, Inc.  Homeostasis: Normal blood oxygen levels 1 Stimulus 5 O2−carrying Low blood O2−carrying ability ability of blood due to increases. Decreased RBC count Decreased amount of hemoglobin Decreased availability of O2 4 Enhanced erythropoiesis 2 Kidney (and liver increases RBC count. to a smaller extent) releases erythropoietin 3 Erythropoietin stimulates red bone marrow. Figure 10.5, step 5  Formation of White Blood Cells & Platelets WBC and platelet production is controlled by hormones Colony stimulating factors (CSFs) and interleukins prompt bone marrow to generate leukocytes and also enhance the ability of mature leukocytes to protect the body. These hormones are released in response to specific chemical signals in the environment, such as inflammatory chemicals and certain bacteria or their toxins. Thrombopoietin stimulates production of platelets from megakaryocytes.  Bone Marrow Biopsy ▪ When bone marrow problem or a disease condition such as leukemia is suspected. ▪Small sample of Red Bone Marrow is withdrawn from one of the flat bones (ilium or sternum) close to the body surface for microscopic examination. © 2012 Pearson Education, Inc.  Hemostasis (Blood Clotting) Hemostasis is the process of stopping the bleeding that results from a break in a blood vessel Hemostasis involves three phases 1. Vascular spasms 2. Platelet plug formation 3. Coagulation (blood clotting) Blood loss at the site is permanently prevented when fibrous tissue grows into the clot and seals the hole in the blood vessel. Hemostasis prevents blood loss from damaged vessels  Phases of Hemostasis Step 1. Vascular spasms: Decrease blood flow and pressure within the vessel temporarily. The immediate response to blood vessel injury is vasoconstriction, which causes that blood vessel to go into spasms. The spasms narrow the blood vessel, decreasing blood loss until clotting. Vessel spasms are also caused by direct injury to smooth muscle cells, release of serotonin by anchored platelets.  Step 2. Platelet plug formation: Temporary blockage of break by a platelet plug. Platelets are repelled by intact endothelium. Underlying collagen fibers are exposed by a break in a blood vessel. Platelets become “sticky” and cling to damage site (fibers). Anchored platelets release chemicals to attract more platelets (platelet aggression). Platelets pile up to form a platelet plug or white thrombus.  Step 3. Coagulation Coagulation is the formation of the clot that seals the hole until tissues are repaired It involves formation of a fibrin protein mesh that stabilizes the platelet plug to form a clot. © 2012 Pearson Education, Inc. ©©2012 2015 Pearson Education,Inc. Pearson Education, Inc.  Step 3. Coagulation events occur Injured tissues release tissue factor (TF). Tissue factor (TF) interacts with platelet factor, PF3, (phospholipid coating platelets). This complex interacts to other protein clotting factors, and Ca2+ to form the prothrombin activator that converts prothrombin to thrombin (enzyme). Thrombin converts soluble fibrinogen into insoluble hairlike molecules called fibrin.  Step 3: coagulation Fibrin forms a meshwork (forming the clot) that traps the RBCs and platelets. Within the hour, serum is squeezed from the clot/mass as it retracts pulling the ruptured edges of the blood vessel closer together. Serum is plasma minus clotting proteins © 2012 Pearson Education, Inc.  Slide 4 Events of hemostasis. Step 3 Coagulation events occur. Clotting factors present in plasma and released by injured tissue cells interact with Ca2+ to form thrombin, the enzyme that catalyzes joining of Fibrin fibrinogen molecules in plasma to fibrin. Fibrin forms a mesh that traps red blood cells and platelets, forming the clot. © 2012 Pearson Education, Inc. Hemostasis Blood usually clots within 3 to 6 minutes The clot remains until endothelium regenerates The clot is broken down after tissue repair  Review Questions: 1) Cell fragments that from the rupture of a megakaryocyte 2) Immature form of this cell is called a reticulocyte 3) Type of cell that contains hemoglobin for gas transport © 2012 Pearson Education, Inc.  Undesirable Clotting Thrombus A clot in an unbroken blood vessel is called thrombus. Can be deadly in areas such as the heart (Coronary thrombosis) and lungs. Embolus A thrombus that breaks away and floats freely in the bloodstream is called Embolus. Can later clog vessels in critical areas such as the brain ( Cerebral embolus may cause stroke). Rough endothelium due to fat deposition, immobilised patients. Treatment for Thrombus prone patients (clot inhibitors): Anticoagulants like aspirin, heparin, coumadin and dicumarol. © 2012 Pearson Education, Inc.  Bleeding Disorders Hemophilia Hereditary bleeding disorder. Normal clotting factors are missing. Minor tissue trauma can be life threatening. Treatment: Transfusion of fresh plasma or clotting factor injections. © 2012 Pearson Education, Inc.  Bleeding Disorders Thrombocytopenia ▪Caused due to low number of blood platelet. Even normal movements can cause bleeding from small blood vessels that require platelets for clotting. Evidenced by petechiae (small purplish blotches on the skin). Arise from any condition that cause suppression of bone marrow such as bone marrow cancer, radiation, and some drug. Liver disorders, vitamin K deficiency.  Blood Groups and Transfusions Large losses of blood have serious consequences Loss of 15 – 30% causes weakness Loss of over 30% causes shock, which can be fatal Transfusions are given for substantial blood loss, to treat severe anemia, or for thrombocytopenia (low platelets).  Human Blood Groups (ABO blood group) © 2012 Pearson Education, Inc.  Human Blood Groups Blood contains genetically determined proteins known as antigens. Antigens are substances that the body recognizes as foreign and stimulates the immune system to produce antibodies. Most antigens are foreign proteins We tolerate our own “self” antigens Antibodies are the “recognizers” present in the plasma and bind with the foreign antigens (Eg. RBC bearing surface antigens). © 2012 Pearson Education, Inc.  Human Blood Groups Plasma membrane of RBCs contains genetically determined proteins called as antigens. Each of us tolerates our own cellular (self) antigens, One person’s RBC antigens are recognised as foreign if transfused into another person with different RBC antigens. There are over 30 common red blood cell antigens. The most vigorous transfusion reactions are caused by ABO and Rh blood group antigens. © 2012 Pearson Education, Inc.  Antigens on Red Blood Cells (ABO blood group) Presence of both antigens A and B is called Type AB. Presence of antigen A is called Type A. Presence of antigen B is called Type B. The lack of both antigens A and B is called Type O. © 2012 Pearson Education, Inc. © 2012 Pearson Education, Inc.  Agglutination Binding of antibodies causes the foreign RBCs to clump, called as Agglutination. Antigens also called as agglutinogens. Antibodies are also called as agglutinins. It leads to the clogging of the small blood vessels throughout the body. Foreign RBCs are ruptured (Hemolysis) and hemoglobin is released into blood. Freed haemoglobin block kidney tubules (kidney failures) and death. © 2012 Pearson Education, Inc.  Agglutination © 2012 Pearson Education, Inc.  Donor- Recipient Compatibility © 2012 Pearson Education, Inc. 76  ABO Blood Groups Blood type AB can receive A, B, AB, and O blood (Universal recipient) Blood type B can receive B and O blood Blood type A can receive A and O blood Blood type O can receive O blood (Universal donor) © 2012 Pearson Education, Inc.  The ABO blood system Blood antigens are inherited from one’s parents. Blood type is controlled by Tri- allelic gene.The alleles control the production of antigens on the surface of the red blood cells. Allele ‘O’ is recessive to the allele ‘A’ and ‘B’. Type “ AB” blood is an example of Co-dominance ALLELE CODES FOR PRODUCES ANTIGEN IA Type ‘A’ Antigen A IB Type ‘B’ Antigen B i Type ‘O’ No antigen © 2012 Pearson Education, Inc.  The ABO blood system The three different alleles of Blood group, IA (Group A), IB (Group B) and i (O Group) can be combined in different ways following Mendel's Laws of Inheritance. S.No. POSSIBILITIES RESULTING PHENOTYPE (Genotypes) ( Blood Type) 1 IAIA Type A 2 IAi Type A 3 IBIB Type B 4 IBi Type B 5 IAIB Type AB 6 ii Type O So there are : 6 different Genotypes © 2012 Pearson Education, Inc. 4 different Phenotypes 79 © 2012 Pearson Education, Inc. © 2012 Pearson Education, Inc.  Rh Blood Groups Rh antigen present on RBC membrane (Rh+). Rh blood groups are named because one of the eight Rh antigens (agglutinogen D) that was originally identified in Rhesus monkeys. Later same antigen was discovered in humans. Most Americans are Rh+ (Rh-positive). People who lack Rh factor (Rh – negative) can become sensitized to Rh antigen if exposed, so only people who are Rh+ should be given Rh+ blood. © 2012 Pearson Education, Inc. © 2012 Pearson Education, Inc.  People with Type O blood is called Universal donor because they can give blood to others without causing any ABO transfusion reaction. Type AB is called as Universal recipient. People with blood group O negative can receive blood from only O negative people. O negative and AB positive are the least common blood types. © 2012 Pearson Education, Inc.  Rh Incompatibility Problems can occur in mixing Rh+ blood into a body with Rh– (Rh-negative) blood. Antibodies to Rh antigen are produced only after an initial exposure to Rh antigen, called sensitization. Thus Hemolysis does not occur with first transfusion, because it takes time to make antibodies. Second, and subsequent, transfusions involve antibodies attacking donor’s Rh+ RBCs and hemolysis occurs (rupture of RBCs) © 2012 Pearson Education, Inc. Rh Dangers During Pregnancy Hemolytic disease of New born (HDN) or Erythroblastosis fetalis The mismatch of an Rh– mother carrying an Rh+ baby can cause problems for the unborn child. The first pregnancy usually proceeds without problems. The immune system is sensitized after the first pregnancy. In a second pregnancy, the mother’s immune system produces antibodies to attack the Rh+ blood (hemolytic disease of the newborn). © 2012 Pearson Education, Inc.  Rh Dangers During Pregnancy – Hemolytic disease of new born Danger occurs only when the mother is Rh– and the father is Rh+, and the child inherits the Rh+ factor (Baby is Rh +). RhoGAM shot can prevent buildup of anti-Rh+ antibodies in mother’s blood. © 2012 Pearson Education, Inc.  Rh factor and pregnancy © 2012 Pearson Education, Inc.  RhoGAM RhoGAM is an artificial immunoglobulin used to prevent hemolytic disease of the newborn. During childbirth of the first Rh+ baby to an Rh- mother, RhoGAM is injected to prevent sensitization and production of anti-Rh antibodies. Then, during the second pregnancy with an Rh+ baby, there are no anti-Rh antibodies to cross the placenta and harm the fetus. © 2012 Pearson Education, Inc.  Difference between Rh antigens and ABO antigens Rh antigens are similar to AB antigens in that they are all present on the cell surfaces of RBC. Rh antigens are different from AB antigens because antibodies against Rh are NOT automatically made but anti-A and anti-B antibodies are automatically made in body. © 2012 Pearson Education, Inc.  ABO Blood group In ABO blood group, antibodies are formed during infancy against the ABO antigens. ©©2012 2015 Pearson Education,Inc. Pearson Education, Inc.  Blood Typing Blood samples are mixed with anti-A and anti-B serum. Agglutination or the lack of agglutination leads to identification of blood type. Both Blood typing and cross matching are used to check agglutination and compatibility. ©©2012 2015 Pearson Education,Inc. Pearson Education, Inc.  Blood being tested Serum Anti-A Anti-B Type AB (contains antigens A and B; agglutinates with both sera) Agglutinated RBCs Type B (contains antigen B; agglutinates with anti-B serum) Type A (contains antigen A; agglutinates with anti-A serum) Type O (contains no antigens; does not agglutinate with either serum) © 2012 Pearson Education, Inc.  Cross Matching International society of blood transfusion recognised 29 important blood groups including ABO and Rh antigen. Because any of the group can cause transfusion reaction, a cross match is performed. Cross matching — testing for agglutination of : 1. Donor RBCs are mixed with the recipient’s serum. 2. Donor serum are mixed with recipient RBC cells. Serum: fluid portion of plasma minus clotting proteins. © 2012 Pearson Education, Inc.  KEY POINTS: Blood contains a liquid portion, plasma, and two types of formed elements, blood cells and platelets that perform many crucial tasks from transporting nutrients and waste, and fighting infection. Hemoglobin is a protein found inside RBCs; it binds to oxygen, transporting it throughout circulatory system. Neutrophils are a type WBC that are the first to arrive at the site of an injury; they ingulf microorganisms, helping prevent the spread of infection. © 2012 Pearson Education, Inc.  KEY POINTS: Monocytes are another type of WBC that helps clean up injuries by phagocytizing dead cells and invading microorganisms. Two types of lymphocyte are found in the body; they help provide immune protection, another means of protecting the body from foreign organisms like bacteria and viruses. Leukemia is a cancer of WBCs; cancerous WBCs fill the bone marrow, reducing RBC and platelet formation, potentially leading to anemia and internal bleeding. Platelets are elements of blood that help form blood clots needed to repair damaged blood vessels. © 2012 Pearson Education, Inc.  KEY POINTS: Hemophilia is a potentially life-threatening clotting disorder caused by a genetic defect. Blood types are determined by the presence of specific glycoproteins found in the cell membranes of RBCs. Blood from one person can be used to supply another but the bloods must match genetically with respect to blood type and Rh factors for a successful transfusion. © 2012 Pearson Education, Inc.  Solve using Punnett Square 1. A woman with Type “O” blood and a man who is Type “AB” are expecting a child. What are the possible blood types of the kid? © 2012 Pearson Education, Inc.  Solve using Punnett Square 2. A woman with Type “O” blood and a man who is heterozygous Type “A” are expecting a child. What are the possible blood types of the kid? © 2012 Pearson Education, Inc.  Solve using Punnett Square 3. A woman with Type “AB” blood and a man who is Type “B” are expecting a child. What are the possible blood types of the kid? © 2012 Pearson Education, Inc.