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Blood • Cells in the body are fixed within tissues and must have nutrients and oxygen brought to them and waste removed. • The blood is classified as a fluid matrix connective tissue – The cells and cell fragments are the formed elements and the matrix of the blood is fluid (plasma). – Formed elements make up about 45% and plasma 55% of the total blood volume. – Blood volume: 4-5 L in females, 5-6 L in males. Blood Functions • Distribution and transportation – Respiration – Nutritive – Excretory – Negative Aspects • Regulation and Maintenance – Hormonal regulation – Thermoregulation – pH / acid-base balance – Fluid volume • Protection – Clotting – Immunity Major Components of the Circulatory System • Two divisions: Cardiovascular and lymphatic systems. – Cardiovascular: Heart, blood vessels • Heart • Vessels – Lymphatic: lymphatic vessels and lymphoid tissues in spleen, thymus, tonsils, and lymph nodes. • The fluid portion of the blood (plasma) passes through the capillary walls under hydrostatic pressure (interstitial fluid). • Some interstitial fluid returns to the blood and some enters the lymphatic system – Lymphatic vessels carry interstitial fluid now called lymph back to the venous blood. – Lymph nodes along the way filter and cleanse the blood before it is returned. Erythrocytes • Structure – Biconcave, anucleate – 4.8 million/mm3 in women. – 5.4 million/mm3 in men. – 7.5 um in diameter • Components – Hemoglobin – Lipids, ATP, carbonic anhydrase • Function – Transport oxygen from lungs to tissues and carbon dioxide from tissues to lungs Hemoglobin • Consists of: – 4 globin molecules: 2 alpha and 2 beta chains • 280 million per RBC. • Transport carbon dioxide (carbonic anhydrase involved), nitric oxide. – 4 heme molecules: Transport oxygen • Iron is required for oxygen transport Erythropoiesis • Production of red blood cells – Stem cells proerythroblasts early erythroblasts intermediate late reticulocytes • Erythropoietin: Hormone to stimulate RBC production Hemolytic Anemia Anemias • Result of either a decrease in hemoglobin / RBC or in the number of RBCs. • Symptoms: pale, lethargic, shortness of breath, tired. • Aplastic anemia: inability of red bone marrow to produce RBCs • caused by: damage to Red bone marrow, Iron of Folate deficiency • Pernicious anemia - Vitman B12 deficiency • Hemorhagic anemia - results from loss of blood • Hemolytic anemia - erythrocytes rupture or are destroyed at an increased rate. • Thalasemia - defective hemoglobin production Malaria Sickle cell anemia Formed Elements • Red blood cells (erythrocytes) • White blood cells (leukocytes) – Granulocytes • Neutrophils • Eosinophils • Basophils – Agranulocytes • Lymphocytes • Monocytes • Platelets (thrombocytes) Production of Formed Elements • Hematopoiesis or hemopoiesis: Process of blood cell production • Stem cells: All formed elements derived from single population – Proerythroblasts: Develop into red blood cells – Myeloblasts: Develop into basophils, neutrophils, eosinophils – Lymphoblasts: Develop into lymphocytes – Monoblasts: Develop into monocytes – Megakaryoblasts: Develop into platelets Hematopoiesis Neutrophil • Appearance – 2-5 lobes – 10-12 um – 54-62% of white cells • Characteristics – Fights bacterial and fungal infections – Contains peroxidases and defensins – Numbers increase with meningitis and appendicitis Eosinophil • Appearance – Bilobed nucleus – Red granules – 11-14 um – 1-3% of white blood cells • Characteristics – Fights parasitic infections. – Releases antiinflammatory chemicals. – Secretes enzymes that break down clots. Basophils Basophil Eosinophil • Appearance – Two indistinct lobes – Blue-purple granules – 10-12 um – Less than 1% of WBC • Characteristics – Release histamine – Chemoattractant for other WBCs – Releases heparin to prevent clots. Monocyte • Apearance – Nucleus round, kidney or horseshoe shaped – 12-20 um – 3-9 % of WBC • Characteristics – Transforms into macrophages Lymphocyte • Appearance – Round nucleus – 6-14 um – 25-33% of WBC • Characteristics – Found in lymphoid tissue – Provides specific immune response • T - lymphocytes • B - lymphocytes Leukocytes Hemostasis • Arrest of bleeding • Events preventing excessive blood loss – Vascular spasm: Vasoconstriction of damaged blood vessels – Platelet plug formation – Coagulation or blood clotting Thrombocytes • Cell fragments pinched off from megakaryocytes in red bone marrow • Important in preventing blood loss – Platelet plugs – Promoting formation and contraction of clots Platelet Plug Formation Coagulation • Stages – Activation of prothrombinase – Conversion of prothrombin to thrombin – Conversion of fibrinogen to fibrin • Pathways – Extrinsic – Intrinsic Clot Formation Fibrinolysis • Clot dissolved by activity of plasmin, an enzyme which hydrolyzes fibrin Blood Grouping • Determined by antigens (agglutinogens) on surface of RBCs • Antibodies (agglutinins) can bind to RBC antigens, resulting in agglutination (clumping) or hemolysis (rupture) of RBCs • Groups – ABO and Rh ABO Blood Groups Agglutination Reaction Rh Blood Group • First studied in rhesus monkeys • Types – Rh positive: Have these antigens present on surface of RBCs – Rh negative: Do not have these antigens present • Hemolytic disease of the newborn (HDN) – Mother produces anti-Rh antibodies that cross placenta and cause agglutination and hemolysis of fetal RBCs Erythroblastosis Fetalis Diagnostic Blood Tests • Type and crossmatch • Complete blood count – Red blood count – Hemoglobin measurement – Hematocrit measurement • White blood count • Differential white blood count • Clotting Blood Disorders • Erythrocytosis: RBC overabundance • Anemia: Deficiency of hemoglobin – Iron-deficiency – Pernicious – Hemorrhagic – Hemolytic – Sickle-cell • • • • • • • Hemophilia Thrombocytopenia Leukemia Septicemia Malaria Infectious mononucleosis Hepatitis