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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 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) 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.