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HEMATOPOIESIS Blood cell formation Occurs in red bone marrow Adult red marrow is found in ribs, vertebrae, sternum, pelvis, proximal humeri, and proximal femurs. HEMATOPOIESIS All blood cells are derived from a common stem cell (hemocytoblast) Hemocytoblast differentiation Lymphoid stem lymphocytes Myeloid stem cell all other formed elements Figure 10.4 FORMATION OF ERYTHROCYTES Mature RBC are anucleate= NO NUCLEUS. Therefore, Unable to divide, grow, or synthesize proteins 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 CONTROL OF ERYTHROCYTE PRODUCTION Stimulus: Decreased RBC count, decreased availability of O2 to blood, or increased Normal blood oxygen levels tissue demands for O 2 Rate is controlled by a hormone (erythropoietin) Kidneys produce most erythropoietin as a response to reduced oxygen levels in the blood Homeostasis is maintained by negative feedback from blood oxygen levels Increased O2- carrying ability of blood Reduced O2 levels in blood More RBCs Enhanced Erythropoietin erythropoiesis Red bone stimulates marrow Kidney releases erythropoietin Figure 10.5 CONTROL OF ERYTHROCYTE PRODUCTION Normal blood oxygen levels Figure 10.5, step 1 CONTROL OF ERYTHROCYTE PRODUCTION Normal blood oxygen levels Stimulus: Decreased RBC count, decreased availability of O2 to blood, or increased tissue demands for O2 Figure 10.5, step 2 CONTROL OF ERYTHROCYTE PRODUCTION Normal blood oxygen levels Stimulus: Decreased RBC count, decreased availability of O2 to blood, or increased tissue demands for O2 Reduced O2 levels in blood Figure 10.5, step 3 CONTROL OF ERYTHROCYTE PRODUCTION Normal blood oxygen levels Stimulus: Decreased RBC count, decreased availability of O2 to blood, or increased tissue demands for O2 Reduced O2 levels in blood Kidney releases erythropoietin Figure 10.5, step 4 CONTROL OF ERYTHROCYTE PRODUCTION Normal blood oxygen levels Stimulus: Decreased RBC count, decreased availability of O2 to blood, or increased tissue demands for O2 Reduced O2 levels in blood Kidney releases erythropoietin Erythropoietin stimulates Red bone marrow Figure 10.5, step 5 CONTROL OF ERYTHROCYTE PRODUCTION Normal blood oxygen levels Stimulus: Decreased RBC count, decreased availability of O2 to blood, or increased tissue demands for O2 Reduced O2 levels in blood More RBCs Kidney releases erythropoietin Enhanced erythropoiesis Erythropoietin stimulates Red bone marrow Figure 10.5, step 6 CONTROL OF ERYTHROCYTE PRODUCTION Normal blood oxygen levels Stimulus: Decreased RBC count, decreased availability of O2 to blood, or increased tissue demands for O2 Increased O2- carrying ability of blood Reduced O2 levels in blood More RBCs Kidney releases erythropoietin Enhanced erythropoiesis Erythropoietin stimulates Red bone marrow Figure 10.5, step 7 CONTROL OF ERYTHROCYTE PRODUCTION Normal blood oxygen levels Stimulus: Decreased RBC count, decreased availability of O2 to blood, or increased tissue demands for O2 Increased O2- carrying ability of blood Reduced O2 levels in blood More RBCs Kidney releases erythropoietin Enhanced erythropoiesis Erythropoietin stimulates Red bone marrow Figure 10.5, step 8 FORMATION OF WHITE BLOOD CELLS Colony stimulating factors (CSFs) and interleukins prompt bone marrow to generate leukocytes FORMATION OF PLATELETS The stem cell (megakaryocyte) undergoes mitosis without cytokinesis many times, forming a large, multinuclear cell, which then fragments into platelets. HEMOSTASIS Stoppage of bleeding resulting from a break in a blood vessel Hemostasis involves three phases 1. Vascular spasms 2. Platelet plug formation 3. Coagulation (blood clotting) HEMOSTASIS Figure 10.6 HEMOSTASIS- STEP 1 Vascular spasms Vasoconstriction causes blood vessel to spasm Spasms narrow the blood vessel, decreasing blood loss Step 1: Vascular Spasms Figure 10.6, step 1 HEMOSTASIS- STEP 2 Step 1: Vascular Spasms Platelet plug formation Collagen fibers are exposed by a break in a blood vessel Platelets become “sticky” and cling to fibers Anchored platelets release chemicals to attract more platelets Platelets pile up to form a platelet plug Step 2: Platelet Plug Formation Injury to lining of vessel exposes collagen fibers; platelets adhere Collagen fibers Figure 10.6, step 2 HEMOSTASIS – STEP 3 Coagulation Injured tissues release tissue factor (TF) PF3 (a phospholipid) interacts with TF, blood protein clotting factors, and calcium ions to trigger a clotting cascade Prothrombin activator converts prothrombin to thrombin (an enzyme) Step 1: Vascular Spasms Step 2: Platelet Plug Formation Injury to lining Platelet of vessel exposes plug collagen fibers; forms platelets adhere Collagen Platelets fibers Platelets release chemicals that attract more platelets to the site and make nearby platelets sticky PF3 from platelets + Calcium and other clotting factors in blood plasma Tissue factor in damaged tissue Figure 10.6, step 4 HEMOSTASIS – COAGULATION CONTINUED Thrombin joins fibrinogen proteins into hair-like molecules of insoluble fibrin Fibrin forms a meshwork (the basis for a clot) Platelets release chemicals that attract more platelets to the site and make nearby platelets sticky PF3 from platelets + Tissue factor in damaged tissue Phases of coagulation (clotting cascade) Prothrombin Fibrinogen (soluble) Calcium and other clotting factors in blood plasma Formation of prothrombin activator Thrombin Fibrin Figure 10.6, step 7 (insoluble) HEMOSTASIS Blood usually clots within 3 to 6 minutes The clot remains as endothelium regenerates The clot is broken down after tissue repair Figure 10.7 SUMMARY OF HEMOSTASIS Hemostasis is initiated by a break in the blood vessel wall (or lining), initiating vascular spasms and causing platelets to cling to the damaged site. Once attached, the platelets release serotonin, which enhances vasoconstriction. Injured tissue cells release tissue factor, which interacts with platelet phospholipids (PF3), Ca2+ and plasma clotting factors to form prothrombin activator. Prothrombin activator converts prothrombin to thrombin. Thrombin, an enzyme, then converts soluble fibrinogen molecules into long fibrin threads, which form the basis of the clot and then traps erythrocytes flowing by in the blood. UNDESIRABLE CLOTTING Thrombus A clot in an unbroken blood vessel Can be deadly in areas like the heart Embolus A thrombus that breaks away and floats freely in the bloodstream Can later clog vessels in critical areas such as the brain Coagulation can be promoted by: i. Roughened vessel lining, which attracts/activates platelets. ii. Pooling of blood within vessels can result in the activation of clotting factors and the initiation of the coagulation process. BLEEDING DISORDERS Thrombocytopenia Platelet deficiency Even normal movements can cause bleeding from small blood vessels that require platelets for clotting The liver is the source of fibrinogen and several other factors that are necessary for clotting. When the liver is damaged and dysfunctional, it becomes unable to synthesize the usual amounts of clotting factors. When this situation happens, abnormal and often severe bleeding episodes can occur Hemophilia Hereditary bleeding disorder Normal clotting factors are missing http://www.sciencecases.org/hemo/hemo.asp THE ROYAL DISEASE REVIEW QUESTIONS #1 1. What is the name of the stem cell that gives rise to all other formed elements? 2. Name the formed elements that arise from myeloid stem cells. Name those arising from lymphoid stem cells. 3. What property of RBCs dooms them to a limited life span of only 120 days? 4. What WBC type resides primarily in the tissues of the body? 5. How is the production of platelets different from that of all other formed elements? 6. Describe the process of hemostasis. Indicate what starts the process. 7. What factors enhance the risk of thrombus formation in intact blood vessels? 8. How can liver dysfunction cause bleeding disorders? 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 the only way to replace blood quickly Transfused blood must be of the same blood group HUMAN BLOOD GROUPS Blood contains genetically determined proteins Antigens (a substance the body recognizes as foreign) may be attacked by the immune system Antibodies are the “recognizers” Blood is “typed” by using antibodies that will cause blood with certain proteins to clump (agglutination) HUMAN BLOOD GROUPS There are over 30 common red blood cell antigens The most vigorous transfusion reactions are caused by ABO and Rh blood group antigens ABO BLOOD GROUPS Based on the presence or absence of two antigens Type A Type B The lack of these antigens is called type O ABO BLOOD GROUPS The presence of both antigens A and B is called type AB The presence of antigen A is called type A The presence of antigen B is called type B The lack of both antigens A and B is called type O 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 ABO BLOOD GROUPS Table 10.3 RH BLOOD GROUPS Named because of the presence or absence of one of eight Rh antigens (agglutinogen D) that was originally defined in Rhesus monkeys Most Americans are Rh+ (Rh positive) Problems can occur in mixing Rh+ blood into a body with Rh– (Rh negative) blood Percentage of Population with Each Blood Type Rh+ Rh- O 38.5% 6.5% A 34.3% 5.7% B 8.6% 1.4% AB 4.3% 0.7% RH DANGERS DURING PREGNANCY Danger occurs only when the mother is Rh – and the father is Rh+, and the child inherits the Rh+ factor RhoGAM shot can prevent buildup of anti-Rh+ antibodies in mother’s blood RH DANGERS DURING PREGNANCY 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) BLOOD TYPING Blood samples are mixed with antiA and anti-B serum Coagulation or no coagulation leads to determining blood type Typing for ABO and Rh factors is done in the same manner Cross matching—testing for agglutination of donor RBCs by the recipient’s serum, and vice versa Figure 10.8 REVIEW QUESTIONS #2 9. What are the classes of human blood groups based on? 10. What are agglutinins? 11. Name the four ABO blood groups. 12. What is a transfusion reaction? Why does it happen? 10. What is the probable result from infusion of mismatched blood? 11. Cary is bleeding profusely after being hit by a truck as he was pedaling his bike home. At the hospital, the nurse asked him whether he knew his blood type. He told her he “had the same blood as most other people.” What is his ABO blood type? 12. What is the difference between an antigen and an antibody? 13. Explain why a Rh- person does not have a transfusion reaction on the first exposure to Rh+ blood? Why is there a transfusion reaction the second time he or she receives the Rh+ blood?