Download RBC hypotonic burst + haemolysis Haemolytic anaemia

Blood
Consists of formed elements (cells) and extra cellular matrix
(plasma)
Functions:
1- Provide tissue + cells with nutrients and 02
2- Carrying waste products C02
3- Transport hormones
4- Carrying drugs, elements and cells that protect body
From injection, foreign a body and proteins
5- Having a homeostatic role based on its
thermoregulatory and buffering capacity.
Microscopic examination of blood, differential count of “WBC,
CBC” is all valuable in clinical examination.
The formed elements of the blood (blood cells)
1- red blood cells = erythrocytes = - male 5*106/ mm3
- female 4.5* 106 / mm3
2- white blood cells = leukocytes = 6-9 * 103 / mm3
3- platelets 200.000 / mm3 - 400.000/ mm3
 Homework: The, volume of the formed elements.'
Cells about 45% of total blood volume.
Plasma(55%)
Buffy coat
RBC(45%)
1% WBC
Plasma
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It's a specific protein rich matrix.
Its volume 55 % of total blood volume.
Constitution
Water
90 - 92 %
Protein (e. g) albumin, immunoglobulins,
Solutes electrolytes (Na, K, ca, mg, etc…..)
Non-protein nitrogen: (uric acid urea, creatine..)
Nutrients (glucose, lipid, amino acids and fatty
acids)
 Blood gases.
 Regulatory substances (hormones, enzymes)
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RBC = Erythrocyte
 They are non-nucleated cells shaped like biconcave disk
 With 8 x 2 Um in two dimension, average diameter 7-5Um in
diameter
 Life span = 120 days
 The shape of the RBC
a- provided more surface area for gas exchange
b- They are highly elastic and deform readily and
provide flexibility to pass through small blood
vessels.
 Spectrin (intermediate filaments) binds to RBC inner side of
plasma membrane.
 Contain carbonic anhydrous C02
( www.herbs-hands-healing.co.uk/Superfoodnew/nu)
Function
1- Maintains its shape + provide flexibility
2- RBC stain uniformly
3- RBC filled with conjugating protein = Hemoglobin
which responsible for O2 carrying. Thus render the
cell esinophil
Hemoglobin (Hb)
1- oxyhaemoglobin
O2
2- carboxyhaemoglobin
C02
Consists of 4 polypeptide chains each bound to iron containing
heme group. There are 3 types of Hb: HbA1, HbA2 & Hbf. In
adult hemoglobin is about 96% HbA1 2% HbA2 and 2% Hbf.
Clinical note
In sickle cell anemia = hemoglobin chains altered cause
deformation (Hbs) + rigidity of RBC and lead to haemolysis they
block small capillaries
crises of pain due to ischaemia
RBC
They are sensitive to change of osmotic environment.
RBC hypertonic
RBC lose water + shrink
solution
RBC hypotonic
burst + haemolysis
Haemolytic anaemia
(Jaundice)
RBC incompatability (antibodies attack RBC)
Lead to
haemolysis e.g. erythroblastosis fetalis
Sickle Red Blood Cell
Normal Red Blood Cell
(http://www.blc.arizona.edu/courses/181gh/rick/human_genetics/diseases.html)
)www.answers.com/topic/sickle-cell-disease)
White Blood Cells (Leucocytes)
1- Granular (contain specific granules and “azaurphilic granules”
a- Neutrophils
b- Eosinophils
c- Basophils
Derived from myeloblast.
2- Non-granular (non specific granules = “azurphilic granules”
= lysosome)
a- Monocytes
b- Lymphocytes: - small
- Large
* They constitute about 1 % of total blood count.
* They are connective tissue cells that play important role in
Inflammation.
Neutrophils
% of total leukocytes = 60 - 80 %
Cell diameter = 10 - 12 Mm.
Nucleus = Multilobulated called polymorph nuclear 3-5 lobes
Each lobes connected by chromatin strands
EM: heterochromatin condensed on the periphery euochromatin
Are chiefly at the center.
Cytoplasmic granules: there are 2 types:
1- Small specific" 80 %"
 Appear as tiny pink granules
 Contain bactericidal and bacteriostatic and
other substances such as lysozyme, lactoferrin
, cobalamine
Binding protein, alkaline phosphates
2- Azurophilic (less numerous) = non specific granules =
they contain lysosomal enzymes such as peroxidase,
hydrolase, acid phosphates (light blue or violet)
Function:
1-They increase in acute inflammation. They attracted to site
of inflammation by chemotactic factors.
2- Ospsinins = plasma protein enhance the engulfment of
bacteria by neutrophil
3- They phagocytes bacterial and other damage cells, tissue
debris. During this processes die and accumulate with dead
bacteria -7 pus = thick yellow exudates
4- They form leukolrimes inflammatory process.
Clinical notes:
Clinical condition
Neutrophilia no. of neutrophils
bacterial infection appendicitis, tonsillitis
Neutropenia
no. of neutriphil, occure in typhoid
fever and viral influenza.
Basophil
% of total leukocytes = 0.5 - 1 %, rare in blood film.
Cell diameter = 8 - 10 Um
Nucleus = bilobed or U-shaped, S-shaped
Cytoplasmic granules: large specific granules
LM: basophilic or metachromatic 1Um. It may obscure the
bilobed nucleus
EM: They are large electron dense granules, variable in size
resemble myelin, contain: slow reacting substance (SRS)
of anaphylaxis, glycosamineglycane, histamine, heparin
sulfate.
Histamine + SRS
vasodilatation of small blood vassals
Histamine
responsible for basophilic of the granules and
Permeability of blood vessels
(Note the local change in the skin when there is allergy).
Function:
1- Resemble mast cell in function and structure but not
identical to it.
2- They bind to lmmunogobulin B (IgB) in allergic reaction
Release its vasoactive substance.
3- They attract other leucocyte and cause sever local swelling
Or in sever cases
anaphylactic shock
Eosinophilia
% of total leucocytes = 1 - 4 %
Diameter = 10 - 12 Um same size of neutrophil
Nucleus: 1- it is typically bilobed
(di Fiore,s – Atlas of histology)
hetrochromatin condescend at the periphery and euochromatin
Concentrated at the center of the nucleus.
Cytoplasmic granules
Numerous large (uniform in size) orange - red granules
(esinophilic) = acidophilic contain hydrolytic enzymes
and peroxides, histamines arylsulfatase.
Histaminase = neutralizes the action of histamine
arylsulfatase = neutralizes activity of SRS.
EM:
Center of granules contain an electron dense crystalloid
core
 Esinophilia thus regulate the allergic responses by
neutralizing the action of basophilia. ( degredate
histamine, SRS )
 It engages the antigen - antibody complexes in
allergic
Condition.
 It control certain parasitic infections (e.g
schistosomiasis)
esinophila contain major basic protein ( MBP ) in the
Crystalloid core of the granules. MBP released in to
the surface of the that parasite and promotes
antibody dependent specific for that parasite to
attract it.
NB: Hydrocortisone cause demobilization of esinophilia from
the bone marrow and the depress allergic immune
reaction.