Chapter 13: Circulation and Body Defense- The Blood

Functions of the Blood Transportation

 Gases – oxygen and CO2
 Nutrients – electrolytes, digestion
 Waste – transports to organs that expel waste products
 Hormones – travel to target organs in the blood

Functions of the Blood Regulation

 pH balance
 Fluid balance – maintain proper osmotic pressure
 Heat – generated from muscles

Functions of the Blood Protection

 Disease – carries cells and antibodies from immune system
 Blood loss – clotting mechanism

Constituents

 Plasma – fluid portion
 Formed elements
Erythrocytes erythr/o (red)
Leukocytes leuk/o (white)
Platelets AKA Thrombocytes thromb/o (clotting) -cytes (cells)

Plasma

 55% total blood volume is plasma
 91% of plasma is water
 8% is proteins (albumin, clotting factors, antibodies, and antibody complements)
 1% nutrients, electrolytes, hormones, vitamins, drugs, etc

Formed Elements

 Produced in the red bone marrow
 Hematopoietic Stem Cells – ancestors of all blood cells able to form into any of the blood cell types
 hemat/o (blood)

Erythrocytes

 RBC (Red Blood Cells)
 Anuclear
 few organelles
 must be replaced constantly
 Protein of 4 amino acid chains with an oxygen- binding heme group
 Lives approx. 120 days
 Production stimulated by erythropoietin (EPO)

Hemoglobin

 O2 carrier, and iron (Fe), and buffer
 Gives blood it’s color
 Most numerous blood cell
 Able to carry H+ ions and act as a buffer
 Able to carry CO2 to lungs for elimination
 Ability to carry O2 is blocked by CO
 Requires nutrients: electrolytes, iron, copper, Vit C

Gases, nutrients, waste, hormones

What are some substances transported in the blood?

7.35 to 7.45

What is the pH range of the blood?

Plasma and formed elements

What are the two main components of the blood?

Protein

Next to water, what is the most abundant type of substance in plasma?

Red bone marrow

Where do blood cells form?

Hematopoietic stem cells

What type of cell gives rise to all blood cells?

Carry oxygen to the tissues

What is the main function of hemoglobin?

Formed Elements Leukocytes

 Prominent nuclei of varying sizes
 Colorless
 Identified by their size and appearance of the cytoplasmic granules
 Main function is immunity

Leukocytes: Granulocytes

 Show visible granules when stained
 Segmented nuclei

Neutrophils

 Neutrophils – (55%) phagocytosis
 Nuclei have various shapes, segmented
 Polymorphs; polymorphonucle ar neutrophils (PMN’s)
 morph/o (shape)

Immature cells

have a thick curved band nucleus (Band Cell)

Eosinophils

(2%) allergic reactions; defense against parasites

Basophils

(<1%) allergic reactions; inflammatory response

Agranulocytes: Lymphocytes

 No granules
 Nuclei are not segmented
 Second most numerous of white cells
 Mature in lymph tissue
 Lymph/o (lymph)

Agranulocytes: Monocytes

 Largest in size
 Phagocytosis
 mon/o (one)

Functions of Leukocytes

Clear the body of foreign materials

Phagocytosis

eat bacteria, seek and destroy phag/o (eat, ingest) (neutrophils and monocytes)

Pus

combination of living and dead bacteria and leukocytes

Abscess

collection of pus in a localized area

Macrophages

large white cells active in disposal macr/o (large) ; born of monocytes

Platelets

 Thrombocytes
 Smallest of formed elements
 Fragments released from megakaryocytes (giant bone marrow cells) kary/o (nucleus)
 Enzymes and mitochondria, no nuclei or DNA
 Clotting and coagulation
 Life span of 10 days

Neutrophils, eosinophils, basophils

What are the three types of granular leukocytes?

Lymphocytes, monocytes

What are the two types of agranular leukocytes?

Clear the body of foreign material and cellular debris.

What is the most important function of leukocytes?

Clotting the blood

What is the function of blood platelets?

Hemostasis

prevention of blood loss hem/o (blood)

Contraction

vasoconstriction

Platelet plug

platelets become sticky and form a temporary plug

Blood clot

coagulation at the site and prevents any further bleeding

Procoagulants

promote clotting

Anticoagulants

prevent clotting

12 Factors

series of well-controlled events to start the clotting process

Fibrinogen

final step converting plasma protein (fibrinogen) into fibrin (solid threads) that forms the clot-gen (producing, originating)

Prothrombinase

enzyme that triggers final clotting mechanism pro- (before, in front of

Prothrombin

is converted into thrombin with the help of Ca++

Thrombin

converts fibrinogen into fibrin

Serum

fluid remaining after the clot formation without the clotting factors

Hemostasis

What is the general term for the process that stops blood loss?

Fibrin

What substance in the blood forms a clot?

Serum does not contain clotting factors

How does serum differ from blood plasma?

Hemorrhage

excessive bleeding

Transfusion

administering blood to one person from another

Agglutinins

antibodies that may cause the RBCs of the donor’s blood to undergo agglutination (clumping)

Hemolysis

RBC’s have ruptured due to the agglutination -lysis (loosening, dissolving, separation)

Blood Type Testing

 4 blood types: A, B, AB, and O
 Anti-A serum, Anti-B serum

Antigens

proteins that live on the surface of blood cells that stimulate antibody production

Type O

is universal DONOR

Type AB

is universal RECEIVER

Rh Factor

 Rhesus monkey
 D antigen
 Positive or negative
 Hemolytic Disease of the Newborn (HDN) (erthroblastosis fetalis) – RhoGAM
 Rh negative mother with Rh positive baby first pregnancy

Uses of Blood Components

 Treated with anticoagulant
 May be stored for up to 35 days

Autologous blood transfusion

donate own blood prior to surgery

Whole Blood Transfusions

⚫ Massive hemorrhage
⚫ Internal bleeding
⚫ During surgery or post-op
⚫ Replacement for hemolytic disease of newborn

Use of Blood Components

 Components separated by centrifuge
 Packed cells refers to RBC’s
 Platelets
 Leukocytes (T-cells and T-cell helpers)

Use of Plasma

 Used during emergencies when blood type has not been determined
 May be frozen and saved (FFP)
 When thawed, may have cryoprecipitate that is rich in fibrinogen and clotting factors cry/o (frozen)
 Increases osmotic pressure to get more fluid into circulation
 Contains all the factors for clotting
 Contains antibodies left by lymphocytes

A, B, AB, O

What are the four ABO blood type groups?

A antigen, B antigen, Rh factor (D antigen)

What are the blood antigens most often involved in incompatibility reactions?

Centrifuge

How is blood commonly separated into its component parts?

Blood Disorders

Three groups:
⚫ Anemia -emia (blood)
⚫ Leukemia
⚫ Clotting disorders

Anemia

 Results from loss of RBCs
 Impaired delivery of oxygen to tissues

Hemorrhagic anemia

sudden (acute) or gradual (chronic) loss of RBC’s due to bleeding

Hemolytic anemia

excessive destruction of RBC’s, overactive spleen, infections, parasites, HDN

Sickle Cell Anemia

 Type of hemolytic anemia
 Hemoglobin is abnormal
 Change shape after O2 is released
 Very fragile cells, become tangled masses that block vessels
 Joint swelling and pain, abdominal pain
 Sickle Cell trait – from one paren

Iron-Deficiency Anemia

not enough iron intake to meet needs, especially children and young women

Pernicious Anemia

Vitamin B-12 deficiency due to a lack of intrinsic factor; deterioration of nervous system

Thalassemia

 Hereditary condition; Mediterrean descent
 Not enough RBC’s produced, destroyed in bone marrow before matured
 Have excess iron in the blood and bone marrow; absorb too much iron from the digestive trac

Aplastic anemia

caused by chemical or physical agents such as drugs, toxic substances, x-ray, injury

Bone Marrow Suppression

 Aplastic anemia – caused by chemical or physical agents such as drugs, toxic substances, x-ray, injury
 Chronic disorders of the liver or kidney, cancer, RA
 Bone marrow will not produce red or white blood cells, leading to leukopenia -penia (lack of)

Leukemia

 Neoplastic disease, increased number of WBC’s that crowd out other cells
 Incompetent, cannot perform immune properties

Myelogenous leukemia

starts in bone marrow

Lymphocytic leukemia

arises in lymphoid tissue

Leukemia: Symptoms

 General symptoms of anemia (low RBC’s)
 Bleeds easily (low platelet count)
 Frequent infections
 Enlarged spleen and other organs possible

Leukemia: Treatments

 Chemotherapy and x-ray therapy
 Bone marrow transplant
 Long recovery
 Prognosis is poor

Clotting Disorders- Hemophilia

hereditary bleeding disorder, missing Factor VIII

Symptoms are, easily bruised
and bleeding, internal hemorrhage,
bleeding into joints causing pain

Clotting Disorders- Von Willebrand disease

missing von Willebrand factor that makes platelets sticky

Symptoms are, easily bruised
and bleeding, internal hemorrhage,
bleeding into joints causing pain

Clotting Disorders- Thrombocytopenia

deficiency of circulating platelets; hemorrhage in the skin and mucous membranes

Clotting Disorders- Disseminated intravascular coagulation

excessive coagulation; platelets are used up faster than they can reproduce; burns, trauma, infections, drugs

Decrease in RBCs that hinder O2 circulation to tissues

What is anemia?

Increase of incompetent WBCs compromising the immune system

What is leukemia?

Platelets

What blood components are low in cases of thrombocytopenia?

Standard Blood Tests- Complete Blood Count (CBC)

cells counts with differential

Standard Blood Tests- Blood Chemistries (SMA)

covers all of the systems

Hematocrit

 Percentage of RBC’s in whole blood
 % per unit volume (38%/dL)
 Men: 42 to 54%/dL
 Women: 36 to 46%/dL
 Determining if anemia exists
 Or bleeding post op

Hemoglobin

 Determine oxygen delivery to tissues
 Grams/dL or percentage of a given standard
 Men: 14 to 17g/dL
 Women: 12 to 15g/dL
 Anemia

Blood Cell Counts: RBCs

RBC – 4.5 to 5.5 million/mcL

Polycythemia

increased RBC count, high altitudes

Polycythemia Vera

bone marrow disorder

Blood Cell Counts: WBCs

WBC – 5,000 to 10,000/mcL

Leukopenia

below 5,000; depressed bone marrow or bone marrow tumor

Leukocytosis

above 10,000; infection

Blood Cell Counts: Platelets

 Normal range 150,000 to 400,000/mcL
 Very low count may cause bleeding problems, requiring platelet transfusion

Blood Slide Smears

Drop of blood spread on a slide and examined under a microscope

Reticulocytes

immature RBCs