Blood - Chapter 11 PDF

BLOOD NIKKO RYAN C’ZARE A. ABALOS RN, MD MEMBER, PHILIPPINE SOCIETY OF ANATOMISTS INC. LPU-BATANGAS  Functions of Blood Transport of gases, nutrients and waste products Transport of processed molecules Transport of regulatory molecules Regulation of pH and osmosis Maintenance of bod...

BLOOD NIKKO RYAN C’ZARE A. ABALOS RN, MD MEMBER, PHILIPPINE SOCIETY OF ANATOMISTS INC. LPU-BATANGAS  Functions of Blood Transport of gases, nutrients and waste products Transport of processed molecules Transport of regulatory molecules Regulation of pH and osmosis Maintenance of body temperature Protection against foreign substances Clot formation 2 Copyright © McGraw-Hill Education. Permission required for reproduction or display.  Characteristics of Blood Type of connective tissue Sticky Heavier than water O2 content determines color Temp. slightly higher than rest of body Males (5-6 L), females (4-5 L) 3 Copyright © McGraw-Hill Education. Permission required for reproduction or display.  Copyright © McGraw-Hill Education. Permission required for reproduction or display. Plasma (percentage by weight) Albumins 58% Proteins 7% Globulins 38% Percentage by volume Fibrinogen Percentage by 4% body weight Water 91% Ions Nutrients Other solutes 2% Waste products Plasma 55% Gases Buffy Formed elements Regulatory coat (number per cubic mm) substances Platelets 250–400 thousand White blood cells Formed elements White blood cells Neutrophils 45% 5–10 thousand 60%–70% Lymphocytes 20%–25% Monocytes 3%–8% Red blood cells Eosinophils 4.2–6.2million 2%–4% Basophils 0.5%–1% (left): © liquidlibrary/PictureQuest RF Copyright © McGraw-Hill Education. Permission required for reproduction or display.  Composition of Blood Plasma: - 55% of total blood - pale, yellow liquid that surrounds cells - 91% water, 7% proteins, and 2% other Formed Elements: - 45% of total blood - cells and cell fragments - erythrocytes, leukocytes, thrombocytes 5 Copyright © McGraw-Hill Education. Permission required for reproduction or display.  Plasma Proteins Albumin: - 58% of plasma proteins - helps maintain water balance Globulins: - 38% of plasma proteins - helps immune system Fibrinogen: - 4% of plasma proteins - aids in clot formation 6 Copyright © McGraw-Hill Education. Permission required for reproduction or display.  Erythrocytes Red blood cells (RBC) Disk-shaped with thick edges Nucleus is lost during development Live for 120 days Function: transport O2 to tissues 7 Copyright © McGraw-Hill Education. Permission required for reproduction or display.  Hemoglobin Main component of erythrocytes Transports O2 Each globin protein is attached to a heme molecule Each heme contains one iron atom O2 binds to iron Oxyhemoglobin: hemoglobin with an O2 attached 8 Copyright © McGraw-Hill Education. Permission required for reproduction or display.  9 Copyright © McGraw-Hill Education. Permission required for reproduction or display.  Production of Erythrocytes 1. Decreased blood O2 levels cause kidneys to increase production of erythropoietin. 2. Erythropoietin stimulates red bone marrow to produce more erythrocytes. 3. Increased erythrocytes cause an increase in blood O2 levels. 10 Copyright © McGraw-Hill Education. Permission required for reproduction or display.  11 Copyright © McGraw-Hill Education. Permission required for reproduction or display. Fate of Old Erythrocytes and Hemoglobin Old rbc’s are removed from blood by macrophages in spleen and liver Hemoglobin is broken down Globin is broken down into amino acids Hemoglobin’s iron is recycled Heme is converted to bilirubin Bilirubin is taken up by liver and released into small intestine as part of bile 12 Copyright © McGraw-Hill Education. Permission required for reproduction or display. Copyright © McGraw-Hill Education. Permission required for reproduction or display.  Leukocytes White blood cells (WBC) Lack hemoglobin Larger than erythrocytes Contain a nucleus Functions: - fight infections - remove dead cells and debris by phagocytosis 14 Copyright © McGraw-Hill Education. Permission required for reproduction or display.  15 Copyright © McGraw-Hill Education. Permission required for reproduction or display.  16 Copyright © McGraw-Hill Education. Permission required for reproduction or display.  Types of Leukocytes Granulocytes contain granules 1. Neutrophils: - most common - remain in blood for 10-12 hours then move to tissues - phagocytes 17 Copyright © McGraw-Hill Education. Permission required for reproduction or display. 2. Eosinophils: reduce inflammation 3. Basophils: - least common - release histamine and heparin 18 Copyright © McGraw-Hill Education. Permission required for reproduction or display.  Agranulocytes no granules 1. Monocytes : - largest - produce macrophages 2. Lymphocytes: - immune response - several different types (T cells and B cells) - lead to production of antibodies 19 Copyright © McGraw-Hill Education. Permission required for reproduction or display.  20 Copyright © McGraw-Hill Education. Permission required for reproduction or display.  Platelets What are they? - blood clotting cells - produced in red bone marrow 21 Copyright © McGraw-Hill Education. Permission required for reproduction or display.  Hematopoiesis What is it? process of blood cell formation In an infant, occurs in liver, thymus gland, spleen, lymph nodes, and red bone marrow. Adults occurs mainly in red bone marrow. Stem cell: original cell line Copyright © McGraw-Hill Education. Permission required for reproduction or display. 22  23 Copyright © McGraw-Hill Education. Permission required for reproduction or display.  Blood Loss When blood vessels are damaged, blood can leak into other tissues and disrupt normal function. Blood that is lost must be replaced by production of new blood or by a transfusion. 24 Copyright © McGraw-Hill Education. Permission required for reproduction or display.  Preventing Blood Loss 1. Vascular spasm: temporary constriction of blood vessel 2. Platelet plugs: can seal up small breaks in blood vessels 3. Blood clotting (coagulation) 25 Copyright © McGraw-Hill Education. Permission required for reproduction or display.  Blood Clotting Blood can be transformed from a liquid to a gel Clot: - network of thread-like proteins called fibrin that trap blood cells and fluid - depends on clotting factors Clotting factors: - proteins in plasma - only activated following injury - made in liver - require vitamin K 26 Copyright © McGraw-Hill Education. Permission required for reproduction or display.  27 Copyright © McGraw-Hill Education. Permission required for reproduction or display.  Steps in Clot Formation 1. Injury to a blood vessel causes inactive clotting factors to become activated due to exposed conn. tissue or release of thromboplastin 2. Prothrombinase (clotting factor) is formed and acts upon prothrombin 3. Prothrombin is switched to its active form thrombin 4. Thrombin activates fibrinogen into its active form fibrin 5. Fibrin forms a network that traps blood (clots) 28 Copyright © McGraw-Hill Education. Permission required for reproduction or display. Copyright © McGraw-Hill Education. Permission required for reproduction or display.  Control of Clot Formation Clots need to be controlled so they don’t spread throughout the body Anticoagulants: - prevent clots from forming - Ex. Heparin and antithrombin Injury causes enough clotting factors to be activated that anticoagulants can’t work in that particular area of the body 30 Copyright © McGraw-Hill Education. Permission required for reproduction or display.  Clot Retraction and Fibrinolysis Clot retraction: - condensing of clot - serum in plasma is squeezed out of clot - helps enhance healing Fibrinolysis: - process of dissolving clot - plasminogen (plasma protein) breaks down clot (fibrin) 31 Copyright © McGraw-Hill Education. Permission required for reproduction or display.  32 Copyright © McGraw-Hill Education. Permission required for reproduction or display.  Blood Reactions Injury or surgery can lead to a blood transfusion Transfusion reactions/Aggulination: clumping of blood cells (bad) Antigens: molecules on surface of erythrocytes Antibodies: proteins in plasma Blood groups: named according to antigen (ABO) 33 Copyright © McGraw-Hill Education. Permission required for reproduction or display.  ABO Blood Groups Type A B AB O Antigen A B A&B None Antibodies Anti-B Anti-A None Anti- A&B Common 2nd 3rd 4th 1st 34 Copyright © McGraw-Hill Education. Permission required for reproduction or display.  35 Copyright © McGraw-Hill Education. Permission required for reproduction or display.  36 Copyright © McGraw-Hill Education. Permission required for reproduction or display.  O are universal donors because they have no antigens Type A can receive A and O blood Type B can receive B and O blood Type AB can receive A, B, AB blood Type O can only receive O blood 37 Copyright © McGraw-Hill Education. Permission required for reproduction or display.  Rh Blood Group Rh positive means you have Rh antigens 85-95% of the population is Rh+ Antibodies only develop if an Rh- person is exposed to Rh+ blood by transfusion or from mother to fetus 38 Copyright © McGraw-Hill Education. Permission required for reproduction or display.  Example of Rh Reaction If mother is Rh- and fetus is Rh+ the mother can be exposed to Rh+ blood if fetal blood leaks through placenta and mixes with mother’s blood. First time this occurs mother’s blood produces antibodies against antigens. Any repeated mixing of blood causes a reaction. 39 Copyright © McGraw-Hill Education. Permission required for reproduction or display.  Hemolytic Disease of Newborn What is it? - occurs when mother produces anti-Rh antibodies that cross placenta and agglutination and hemolysis of fetal erythrocytes occurs - can be fatal to fetus - prevented if mother is treated with RhoGAM which contains antibodies against Rh antigens 40 Copyright © McGraw-Hill Education. Permission required for reproduction or display.  Figure 11.13 Copyright © McGraw-Hill Education. Permission required for reproduction or display.  Diagnostic Blood Tests Complete blood count: provides information such as RBC count, hemoglobin, hematocrit, and WBC count Hematocrit: % of total blood volume composed of RBC Hemoglobin: - determines amount of hemoglobin - indicate anemia 42 Copyright © McGraw-Hill Education. Permission required for reproduction or display.  43 Copyright © McGraw-Hill Education. Permission required for reproduction or display.  Prothrombin time: time it takes for blood to begin clotting (9-12 sec.) White blood cell count: total number of wbc White blood cell differential count: - Determines the % of each 5 kinds of leukocytes - neutrophils: 60-70% - lymphocytes: 20-25% - monocytes: 3-8% - eosinophils: 2-4% - basophils: 0.5-1% 44 Copyright © McGraw-Hill Education. Permission required for reproduction or display.  White Blood Cell Disorders Leukopenia: - low wbc count - caused by radiation, chemotherapy drugs, tumors, viral infections Leukocytosis: - high wbc count - caused by infections and leukemia 45 Copyright © McGraw-Hill Education. Permission required for reproduction or display.  46 Copyright © McGraw-Hill Education. Permission required for reproduction or display.  47 Copyright © McGraw-Hill Education. Permission required for reproduction or display.  48 Copyright © McGraw-Hill Education. Permission required for reproduction or display.  49 Copyright © McGraw-Hill Education. Permission required for reproduction or display.