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Unit G: Hematology Explain the structure of the blood. Analyze the function of the blood. Discuss characteristics and treatments of common blood disorders Assignment • Find in your packet the page titled Blood Anticipation Guide. Read the instructions carefully! Complete. Bell/Payday! • List the functions of the Blood! • Goals: Explain structures of the blood »Analyze the functions of the blood »Discuss characteristics and treatment of common blood disorders • Average adult = 8-10 pints of blood • Functions: • Transports nutrients, oxygen, cellular waste products, and hormones • Aids in distribution of heat • Regulates acid-base balance • Helps protect against infection Ha! Ha! • Why did the blonde nurse take a red magic marker to work? So she could draw blood! I just had to tell you that one I heard the other day. Funny, even if I am blonde( sometimes)!! • PLASMA – liquid portion of blood without cellular components • Serum – plasma after a blood clot is formed • Cellular elements are red cells, white cells, and platelets PLASMA • Straw colored, contains – • Water • Blood proteins • • • • • • • Plasma proteins: FIBRONOGEN – necessary for blood clotting, synthesized in the liver ALBUMIN – from the liver, helps maintain blood’s osmotic pressure and volume PROTHROMBIN – a globulin which helps blood coagulate. Vitamin K necessary for prothrombin synthesis. Nutrients Electrolytes Hormones, vitamins, enzymes Bell • Complete the 2nd ½ of Blood anticipation guide • List all functions of blood • …when you finish come show me your work! Read page 243 • The first person to write down and show me ( in medical/scientific terms) what do smarties and RBC’s have in common wins a prize! Bell • What % of blood is Plasma? • What % of blood is formed ? • What is in formed? ERYTHROCYTES • Shape = biconcave discs • HEMOGLOBIN – gives red color, heme is iron and globin is protein. • Function = transports oxygen to tissues and carbon dioxide away from cells • Normal – men =14-18 gm, women = 12-16 gm Function of Hemoglobin • Red cells travel through the lungs where • O2 is carried to tissues and released • CO2 picked up and carried back to lungs for exchange Arterial blood – lots of oxygen = bright red Oxyhemiglobin-bright red color Venous blood – lots of CO2 = dark crimson Carbiminohemiglobin-crimson blue What is carbon monoxide poisoning? Hemoglobin readily accepts carbon monoxide - even over the life giving oxygen atoms (as much as 200 times as readily as oxygen) forming a toxic compound known as carboxyhemoglobin (COHb). By replacing oxygen with carbon monoxide in our blood, our bodies poison themselves by cutting off the needed oxygen to our organs and cells, causing various amounts of damage depending on exposure. red blood cells……….. • ERYTHROPOIESIS – Manufacture of red blood cells – Occurs in bone marrow • Red cells live 120 days • Old cells broken down by the spleen and liver • HEMOLYSIS – rupture or bursting of erythrocyte, can be from a blood transfusion or disease. • Page 148 workbook A. 1, 2, 3, 4, 5 Bell • Complete “b” from page 153-154…”I Am the Red Blood Cell” This has been copied and is in your packets! Bell • Page 148-149 workbook A. 1, 2, 3, 4, 5 Bell…. • Define the function of a Leukocyte Leukocytes-Defends body from injury and disease Larger than erythrocytes 5 types Normal leukocyte count = 3,200 – 9,800 Types of White Cells Neutrophils Eosinophils Basophils Lymphocytes Monocytes http://science.howstuffworks.com/immune-system10.htm Leukocytes are divided into two classes: • Granulocytes - grainules • Agrainulocytes without grainules • Classification is due to the presence of cytoplasmic grainules & a reaction of a Wright Stain 1/2/4 discussion…45 second time limit • • • • • • • Granulocytes Agrainulocytes Neutrophils Eosinophils Basophils Lymphocytes Monocytes - Granulocytes make up 50% to 60% of all leukocytes. Granulocytes are themselves divided into three classes: neutrophils, eosinophils and basophils. Granulocytes get their name because they contain 30% to 40% of all leukocytes. Lymphocytes come in two classes: B cells (those that mature in bone marrow) and T cells (those that mature in the thymus). Neutraphils-Immune defense (phagocytosos Eosinophils- Defense against parasites Basophils- Inflamatory response. Histamine. Produce HEPARIN – an anticoagulant Agranulocytes 2 divisions Monocyte – Formed in the bone marrow and spleen, Monocytes protect against blood-borne pathogens. Assist in phagocytosis. Move quickly to sites of infection in the tissues. http://science.howstuffworks.com/immune-system10.htm Lymphocyte - Lymphocytes make up up 7% or so of all leukocytes. A lymphocyte is a type of white blood cell involved in the human body's immune system. T-lymphocyte from thymus B-lymphocyte formed in bone marrow. Classes of Blood Cells • Erythrocytes-Oxygen and carbon Dioxide trandsport • Neutraphils-Immune defense (phagocytosos) • Eosinophils- Defense against parasites • Basophils- Inflamatory response. Histamine. Produce HEPARIN – an anticoagulant • B-lymphocytesAntibody production • T- lymphocytes Cellular Immune response • Monocytes-Immune defense (phagocytosos) • Platelets-Blood clotting Bell • Define phagocytosis PHAGOCYTOSIS • – process when white cells surround, engulf, and digest harmful bacteria. .All leukocytes except Lymphocytes can….. • DIAPEDESIS • – when white cells LEUKOCYTES move through capillary wall into neighboring tissue. Leukocytes are divided into two classes: • Granulocytes - grainules (Megablasts)-origin Red Bone Marrow • Neutraphils-Immune defense (phagocytosos) Eosinophils- Defense against parasites, increase with alergic reactions .(phagocytosos) • Basophils- Inflamatory response. Histamine. Produce HEPARIN – an anticoagulant Agranulocytes 2 divisions 1) Monocyte – Formed in the bone marrow and spleen, Monocytes protect against blood-borne pathogens. Assist in phagocytosis. Move quickly to sites of infection in the tissues. • 2) Lymphocyte Lymphocytes make up up 7% or so of all leukocytes. A lymphocyte is a type of white blood cell involved in the human body's immune system. – T-lymphocyte from thymus – B-lymphocyte formed in bone marrow. • Body’s reaction to chemical or physical trauma • PATHOGENIC – disease producing microorganisms can cause inflammation • Symptoms – redness, local heat, swelling and pain • Why? Bacterial toxins, increased blood flow, collection of plasma in tissues (edema) • HISTAMINE increases the blood flow to the injured area Why do we need LEUKOCYTES?? Define @ top of 3rd pg of outline • PUS produced – a combination of dead tissue, dead and living bacteria, dead leukocytes and plasma • ABSCESS – pus-filled cavity below the epidermis • • • • • PYREXIA – increase in body temperature by the hypothalamus – in response to pathogenic invasion LEUKOCYTOSIS – increase in the number of white cells in response to infection LEUKOPENIA – decrease in number of white cells due to chemotherapy or radiation Workbook page 153-154 E,F,G(ck pkt) Worksheet Top ½ “The Blood” Bell/payday • If you missed any portion of class yesterday, see me! • Complete…..Workbook G page 156already copied in pkt! • Workbook E, F Career exploration (Name of career, Area of speculation, work environment, Academic requirements, Salary range, Educational programs ) • Choose One… • Clinical Laboratory Scientist ( medical technologist ) • Clinical Laboratory Technician ( Med. Lab. Tech) • Phlebotomist • Hematologist • Biomedical Scientist • Any other ideas?? Bell • Workbook 149 answer 7 and 8 THROMBOCYTES (Platelets) Smallest of solid components of blood Synthesized in red marrow Not cells – fragments of megakaryocytes Necessary for the initiation of the blood clotting process 250,000 to 450,000 per ml. COAGULATION • Cut or injury platelets and injured tissue release THROMBOPLASTIN act on PROTHROMBIN in plasma + Calcium ions converts to THROMBIN the thrombin acts as an enzyme and changes FIBRINOGEN FIBRIN creating a mesh that traps red blood cells, platelets and plasma creating a blood clot. • See Transparency Clotting…. ANTICOAGULANTS – prevent blood clotting HEPARIN = antiprothrombin PROTHROMBIN – dependent on Vitamin K W/B H (already in Pkt) Word bank pg 154 Complete (worksheet) Functions of Blood Cells • Quick review… • Plasma-Straw colored, contains: Water, Blood proteins • Erythrocytes-Function = transports oxygen to tissues and carbon dioxide away from cells • Leukocytes-Defends body from injury and disease • Platelets- initiation of the blood clotting process Bell • Name the 4 blood types Are you my type? • Four major types of blood- A, B, AB and O • Inherited from parents • Determined by presence or absence of an ANTIGEN on the surface of the red blood cell Example-Type A blood has antigen A • Type O has neither Antigen A or B BLOOD TYPES • ANTIBODY – a protein in the plasma that will inactivate a foreign substance that enters the body. • Someone with type A blood has b antibodies • Someone with type B blood has a antibodies • Someone with type AB blood has no antibodies • Someone with type O blood has a and b antibodies • UNIVERSAL DONOR – O • UNIVERSAL RECIPIENT – AB • See poster Blood Simulated Transfusion Compatibility Blood Type of Patient Donor Person receiving blood Group A Group A Group B Group AB Group O Donor Group B Donor Group AB Donor Group O Step 1: Label paper cups with Group A, Group B, Group AB, Group O. Label Step 6: Rinse the Patient cup. Add liquid from Group B to the Patient cup. The empty cup patient. Step 2:: Fill four cups about 2/3 full with water. Leave the fifth cup empty Step 3: Add red color to cup A, blue to cup B, Step 7: Repeat step 5 using “blood” from the Group B cup. Step 8: Repeat step 6 and equal amounts of red and blue to cup AB; do not add food coloring to cup O Step 9: Repeat step 5 using “blood” from the Group AB cup. Step 4: Pour a small amount of liquid from cup B into Step 10: Repeat step 6 Patient cup. Patient now has that type of blood. Step 5: Using a medicine dropper, transfer “blood” from Group A to Patient cup. Did the color change in patient cup? Record your findings as either safe or unsafe. Step 11: Repeat step 5 using liquid from the Group O cup Step 12: Which “blood” groups can safely give blood to the patient who had Group B blood? Key..next slideAs Long as liquid does NOT change color=safe! As long as the liquid in the patient cup does not change color the transfussion is safe! Blood Type of Patient Recipient Group A Group B Group AB Group O Donor Group A safe unsafe safe unsafe Donor Group B unsafe safe safe unsafe Donor Group AB unsafe unsafe safe unsafe Donor Group O safe/emerg safe/emerg safe safe Classwork/homework • Blood typing study guide Erythroblastosis fetalis Determining a person's blood type is very important if she becomes pregnant. Blood cells from the unborn baby (fetal red blood cells) can cross over into the mother's bloodstream, especially at delivery. If the mother and her baby have compatible blood types, the crossover does not present any danger. However, if the blood types are incompatible, the mother's immune system manufactures antibodies against the baby's blood. Usually, this incompatibility is not a factor in a first pregnancy, because few fetal blood cells reach the mother's bloodstream until delivery. The antibodies that form after delivery cannot affect the first child. In later pregnancies, fetuses and babies may be in grave danger. The danger arises from the possibility that the mother's antibodies will attack the fetal red blood cells. If this happens, the fetus or baby can suffer severe health effects and may die. Are you positive??? • • Red cells also may contain Rh factor • If you have it, you’re Rh + • If you don’t, you’re Rh – • Another blood typing system, discovered in 1939, is called the Rh blood group. The Rh comes from Rhesus monkeys on which the tests were first run. About 85% of our population is positive for the Rh factor, and the remainder is Rhnegative. • RHO gam given to RH neg . mothers BBLOOD TYPE REVIEW QUESTIONS 1. Mrs. Payne’s blood type is O positive. Her husband’s type is O negative. Her newborn baby’s blood type is O negative. Is there any need for concern with this combination? 2. You hear that your friend has been in a car accident and needs a blood transfusion; you want to donate blood. Your friend has type O+ blood and you have A+ blood. Can yourblood be given to your friend? Explain the reason for your answer. 3. Ms. Pratt is claiming the Mr. X is the father of her child. Ms. Pratt’s blood type is O negative. Her baby boy has type A positive blood. Mr. X’s blood is typed and found to be B positive. Could he be the father of her child? _______ If not, what blood type would the father be expected to have? 4. A patient comes to the doctor’s office. She is pregnant and states she is Rh negative and her husband is Rh positive. She has heard that there may be a problem with the baby. Explain to her about the Rh factor and how this situation is taken care of today. Bottom 1?2 “The Blood” BLOOD TYPING STUDY GUIDE 1. 2. Define antigen. Define antibody. ABO Blood System 1. Name and differentiate the four main blood types. 2. Describe the reaction that occurs when the body is exposed 3. What two reactions will occur if a person receives a 4. 5. 6. 7. What test must be done before anyone can receive a transfusion? Define donor and recipient. What are universal donors? How did the Rh factor get its name? to antigens that are not in their blood. transfusion of blood with antigens that do not match. 8. Describe the reactions that occurs when an Rh negative person receives Rh negative blood. 9. How can the Rh factor be dangerous in pregnancies. Complete Bottom ½ The Blood” Bell/Pay Day • You have approximately 10 index cards… • Write the name of the disorder (see your outline) on one side & description on the other • Complete L & M in workbook, page 157 • When you have done all….see me for a copy of the test to study! Cord Blood • Umbilical cord blood from a newborn is important in research because…. • Cord blood has immunity producing stem cells, is easy to transplant and does on cause rejection DISORDERS OF THE BLOOD • ANEMIA • Deficiency in number or % of red cells • IRON-DEFICIENCY ANEMIA • Usually in women, children and adolescents • Deficiency of iron in the diet causing insufficient hemoglobin synthesis • Treat with iron supplements and green, leafy vegetables • APLASTIC ANEMIA • Bone marrow does not produce enough red and white blood cells • Caused by drugs or radiation therapy SICKLE CELL ANEMIA • Chronic blood disease inherited from both parents • Causes the red cells to form in abnormal sickle shape • Sickle cells break easily and carry less oxygen • Occurs primarily in blacks • Treatment – blood transfusions DISORDERS OF THE BLOOD • • • • • • • • • • • • • POLYCYTHEMIA Too many red blood cells are formed May be a temporary condition that occurs at high altitude EMBOLISM Air, blood clot, cancer cells, fat, etc. that is carried by the bloodstream until it reaches an artery too small for passage Also known as a “moving blood clot” THROMBOSIS The formation of a blood clot in a blood vessel The blood clot is a THROMBUS HEMATOMA Localized clotted mass of blood found in an organ, tissue or space. Caused by an injury that can cause a blood vessel to rupture DISORDERS OF THE BLOOD • • • • • • HEMOPHILIA Hereditary Missing clotting factor Blood clots slow or abnormally Sex-linked – transmitted genetically from mothers to sons Treat with missing clotting factor, avoid trauma • • • THROMBOCYTOPENIA Not enough platelets Blood will not clot properly • • • • LEUKEMIA Malignant condition Overproduction of immature white blood cells Hinders synthesis of red cells • http://www.cbsnews.com/sections/sunday/main3445 .shtml?source=vanityurl/ Create Questions to play Jeopardy Jepardy Groups 1) Anemia-Sink side 2) Embolisms-Podium Row 3) Hemophilia-Middle tables 4) Leukemia-Clock row 5) Thrombocytopenia-computer row Create 5 questions from your topic. One side write topic other side write question AND ANSWER! On the end rank question by difficulty: 100-500 bell • Workbook 157 L 8.Platelets are cell fragments that function in coagulation. 9. The enzyme that activates fibrin during clotting is called thrombin. 10. Albumin is a plasma protein that carries bilirubin. 11. Capillary exchange at the arterial end is driven by blood pressure. 12. Capillary exchange at the venous end is driven by osmosis. 13. A foreign substance that stimulates the immune system to react is called a/an antigen. 14. In the ABO blood typing system, the universal blood donor is type O. 15. The color of deoxyhemoglobin is dark blue/purple. 16. Erythropoietin is a hormone produced by the kidneys in response to decreased arterial oxygen levels. Short Answer. 16. Name 3 functions of blood. 1. Transport - nutrients, wastes, hormones 2. Protection - fluid loss & disease 3. Regulation - fluid, ion, and pH balance & heat distribution 17. If a person suffers from carbon monoxide poisoning, why is removing the person from the source of carbon monoxide not sufficient to revive them? Carbon monoxide binds to hemoglobin 200X more tightly than oxygen, and will remain bound for many hours which renders those red blood cells useless in carrying oxygen. 18. Name 4 general differences between erythrocytes and leukocytes. 1. Mature erythrocytes do not have a nucleus, leukocytes do. 2. Erythrocytes have hemoglobin, leukocytes do not. 3. Leukocytes are much bigger than erythrocytes. 4. Erythrocytes are normally confined to the blood vessels, leukocytes are highly mobile and move out into the tissues. 19. Name the two types of lymphocytes and their functions. 1. B lymphocytes - produce antibodies 2. T lymphocytes - directly destroy antigens 20. Name three types of plasma proteins and their functions. 1. Albumin - carries bilirubin 2. Lipoproteins - carry cholesterol 3. Globulins - fight infection 21. What is the function of lymphatic capillaries? To collect excess tissue fluid remaining after capillary exchange and return it to the circulatory system - helps maintain normal blood volume and blood pressure. 22. In the ABO blood-typing system, what blood type is considered the universal recipient? Why? Type AB, because an individual with type AB blood would not have antibodies to either A or B antigens as it carries both types of antigens. Therefore, none of the other blood types would be recognized as foreign. 23. Name two organs that remove aged red blood cells from circulation. What happens to the hemoglobin in these cells? Liver and spleen. Hemoglobin is broken down into heme and globin. Globin is further broken down into its component amino acids, which are recycled by the body. Heme is broken down and excreted as the bile pigments, bilirubin and biliverdin. (The Billy Brothers!) Extra Credit: If an Rh negative mother is pregnant with an Rh positive baby, how can hemolytic disease of the baby be prevented? If an Rh positive mother is pregnant with an Rh negative baby, how can hemolytic disease be prevented? To Be Continued Bell • Answer review questions on page 255/256(new) 235/236(OLD)