Slide 1 - Title

• Title: Blood Chapter 13

  • Introduction to the chapter focused on the functions, composition, and importance of blood in maintaining body homeostasis.

  • Overview of how blood plays a role in transporting nutrients, removing waste, and providing immunity.

Slide 2-3 - Learning Objectives (Lesson 13.1)

• Functions and Composition of Blood:

  • Blood as a specialized connective tissue responsible for transportation of nutrients, gases, hormones, and wastes.

  • Regulates body temperature, pH levels, and fluid balance to maintain homeostasis.

  • Blood's role in protecting the body through immune responses and hemostasis.

• Characteristics of Blood Tissue and Plasma:

  • Blood consists of plasma (liquid portion) and formed elements (cells and cell fragments).

  • Plasma contains water, proteins, nutrients, hormones, and waste products.

• Formed Elements of Blood:

  • Includes red blood cells (RBCs), white blood cells (WBCs), and platelets.

  • Red Blood Cells (RBCs): Transport oxygen and carbon dioxide.

  • White Blood Cells (WBCs): Protect against infections and aid in immune response.

  • Platelets: Help in blood clotting to prevent excessive bleeding.

• Mechanisms of Blood Disease:

  • Overview of disorders involving blood cells and tissues, including genetic, autoimmune, and environmental causes.

  • Examples include anemia, leukemia, and clotting disorders.

Slide 4 - Blood Composition and Volume

• Liquid Fraction (Plasma):

  • Plasma as the extracellular part of blood containing water, proteins, electrolytes, and waste products.

  • Plasma also transports hormones and nutrients throughout the body.

• Cellular Components:

  • RBCs (erythrocytes), WBCs (leukocytes), and platelets (thrombocytes).

  • Red Blood Cells (RBCs): Responsible for oxygen transport and removal of carbon dioxide.

  • White Blood Cells (WBCs): Play a role in immune defense by identifying and neutralizing pathogens.

  • Platelets: Assist in hemostasis by forming blood clots.

• Blood Volume:

  • Average volume of blood: 4 to 6 liters.

  • Plasma makes up 2.6 liters, formed elements about 2.4 liters.

  • Blood volume accounts for approximately 7% to 9% of total body weight.

  • Blood volume can vary depending on age, sex, and body size.

Slide 5 - Components of Blood

• Visual Representation:

  • Diagram illustrating the components of blood, including plasma and formed elements.

  • Plasma contains nutrients, electrolytes, proteins, hormones, and waste products.

  • Visual also shows the distribution of RBCs, WBCs, and platelets within the blood.

Slide 6 - Blood pH and Donation

• Blood pH:

  • Normal blood pH is slightly alkaline, ranging from 7.35 to 7.45.

  • Acidosis occurs when blood pH moves towards neutral (below 7.35), which can impair bodily functions.

• Blood Donation:

  • Approximately 14 million units of blood are donated annually in the U.S.

  • Plasma expanders, such as albumin, are used to temporarily maintain blood volume after major blood loss.

  • Donated blood can be stored for up to six weeks under appropriate conditions.

  • Blood donations are crucial for surgeries, trauma care, and treatment of blood disorders.

Slide 7-8 - Blood Plasma

• Definition and Composition:

  • Plasma is the liquid portion of blood, minus the formed elements.

  • Composed mainly of water (92%), with dissolved substances like nutrients, salts, hormones, enzymes, gases, and waste products.

• Plasma Proteins:

  • Albumins: Help maintain osmotic pressure and blood volume, preventing fluid leakage from blood vessels.

  • Globulins: Play roles in immune response; antibodies are a type of globulin that help fight infections.

  • Fibrinogen and Prothrombin: Essential in the clotting process to prevent excessive bleeding.

  • Plasma without clotting factors is called serum, which still contains antibodies used in immunity.

  • Serum is used in diagnostic tests and in the treatment of immune deficiencies.

Slide 9-10 - Formed Elements of Blood

• Types of Formed Elements:

  • Red Blood Cells (RBCs): Erythrocytes responsible for oxygen and carbon dioxide transport.

  • White Blood Cells (WBCs): Leukocytes involved in immune defense, classified as granulocytes or agranulocytes.

    • Granular leukocytes: Neutrophils (phagocytic cells that target bacteria), eosinophils (involved in allergic responses and parasite defense), and basophils (release histamine and heparin during inflammation).

    • Agranular leukocytes: Lymphocytes (B cells and T cells involved in adaptive immunity) and monocytes (develop into macrophages that phagocytize pathogens).

  • Platelets: Also called thrombocytes, assist in blood clotting by aggregating at injury sites.

• Formation of Blood Cells:

  • Blood cells are primarily formed in red bone marrow (myeloid tissue).

  • Lymphocytes and monocytes are also formed by lymphoid tissue in the lymph nodes, thymus, and spleen.

  • This process of blood cell formation is called hematopoiesis.

Slide 11 - Mechanisms of Blood Disease

• Causes of Blood Diseases:

  • Failure of myeloid and lymphoid tissues can lead to disorders such as anemia, leukemia, and lymphoma.

  • Factors include exposure to toxic chemicals, radiation, genetic defects, nutritional deficiencies, and infections.

  • Examples of blood diseases include sickle cell anemia (genetic disorder affecting RBC shape), hemophilia (clotting disorder), and leukemia (cancer of blood-forming tissues).

Slide 12 - Aspiration Biopsy Cytology (ABC)

• Diagnostic Use:

  • ABC involves examining bone marrow or blood-forming tissues to diagnose blood disorders such as leukemia, anemia, and multiple myeloma.

  • Used if bone marrow failure is suspected, or to evaluate abnormal blood cell counts.

  • Stem cell transplants or bone marrow transplants may replace diseased tissues and restore normal blood cell production.

  • Bone marrow aspiration is often performed from the iliac crest (hip bone).

Slide 13-14 - Red Blood Cells (Erythrocytes)

• Structure and Function:

  • RBCs are biconcave disks with a large surface area for gas exchange, which enhances their efficiency in transporting oxygen.

  • They lack a nucleus and most organelles, allowing more space for hemoglobin.

  • The lifespan of an RBC is about 120 days, after which they are removed by the spleen and liver.

  • Hemoglobin (Hb): A protein composed of four globin chains, each containing a heme group with an iron atom that binds oxygen.

  • The iron in heme is what gives blood its red color.

Slide 15 - General Functions of RBCs

• Gas Transport:

  • RBCs transport oxygen from the lungs to tissues (as oxyhemoglobin) and facilitate the removal of carbon dioxide from tissues to the lungs.

  • Oxygen binds to hemoglobin in the lungs, forming oxyhemoglobin, which releases oxygen in tissues where it is needed.

  • Carbon dioxide can be transported in three forms: dissolved in plasma, as carbaminohemoglobin, or converted to bicarbonate ions by carbonic anhydrase in RBCs.

  • RBCs help maintain acid-base balance by converting CO₂ into bicarbonate, a crucial buffer for maintaining blood pH.

Slide 16 - RBC Count (CBC)

• Complete Blood Count (CBC):

  • Laboratory test used to measure levels of RBCs, WBCs, hemoglobin, hematocrit, and platelets.

  • Provides information on overall health and can help diagnose conditions such as anemia, infection, and clotting disorders.

• Hematocrit Test:

  • Measures the percentage of blood volume made up of RBCs (typically 45%).

  • Indicates the oxygen-carrying capacity of blood and can help identify dehydration or polycythemia.

  • Low hematocrit levels may indicate anemia, while high levels could indicate dehydration or polycythemia.

Slide 17-18 - RBC Abnormalities

• RBC Size and Hemoglobin Content:

  • Normocytes: RBCs of normal size (8-9 μm in diameter).

  • Microcytic: Smaller-than-normal RBCs, often associated with iron deficiency and chronic disease.

  • Macrocytic: Larger-than-normal RBCs, can be due to vitamin B12 or folate deficiency, often seen in pernicious anemia.

• Hemoglobin Content:

  • Normochromic: Normal hemoglobin levels, indicating normal oxygen-carrying capacity.

  • Hypochromic: Low hemoglobin content, often seen in iron deficiency anemia, resulting in pale RBCs.

  • Hyperchromic: High hemoglobin content, though less common, can be seen in some types of polycythemia.

Slide 19-20 - Blood Types (ABO and Rh Systems)

• ABO System:

  • Type A: A antigens on RBCs, anti-B antibodies in plasma.

  • Type B: B antigens on RBCs, anti-A antibodies in plasma.

  • Type AB: A and B antigens, no anti-A or anti-B antibodies; universal recipient (can receive all blood types).

  • Type O: No antigens, both anti-A and anti-B antibodies; universal donor (can donate to all blood types).

• Rh Factor:

  • Rh-positive: Presence of Rh antigen on RBCs.

  • Rh-negative: Absence of Rh antigen; can develop anti-Rh antibodies upon exposure to Rh-positive blood through transfusion or pregnancy.

  • Erythroblastosis fetalis: Condition occurring when an Rh-negative mother carries an Rh-positive fetus, leading to hemolysis of fetal RBCs. Prevented with RhoGAM injections to prevent sensitization.

Slide 21-23 - Red Blood Cell Conditions

• Polycythemia:

  • Overproduction of RBCs, often caused by a cancerous transformation of bone marrow, known as polycythemia vera.

  • Symptoms: Increased blood viscosity, slow blood flow, risk of clotting, hypertension, and headache.

  • Treatment: Blood removal (phlebotomy), chemotherapy, and irradiation to reduce RBC production.

• Anemia:

  • Caused by low RBC count or hemoglobin levels, leading to reduced oxygen-carrying capacity.

  • Clinical Signs: Fatigue, pallor, weakness, increased heart and respiratory rates as compensatory mechanisms.

  • Causes: Can be due to blood loss, reduced RBC production, or increased RBC destruction.

Slide 24-28 - Types of Anemia

• Hemorrhagic Anemia:

  • Caused by blood loss; can be acute (e.g., trauma or surgery) or chronic (e.g., ulcers, gastrointestinal bleeding).

  • Leads to decreased RBC count and hemoglobin levels.

• Aplastic Anemia:

  • Low RBC count due to bone marrow failure; often caused by exposure to toxins, radiation, certain drugs, or autoimmune disorders.

  • Results in pancytopenia (reduced levels of RBCs, WBCs, and platelets).

• Deficiency Anemias:

  • Pernicious Anemia: Vitamin B12 deficiency, leading to large, immature RBCs (macrocytes). Often caused by lack of intrinsic factor needed for B12 absorption.

  • Folate Deficiency Anemia: Lack of folic acid, common in malnutrition, pregnancy, and alcoholism. Leads to macrocytic anemia.

  • Iron Deficiency Anemia: Most common type of anemia; caused by inadequate iron intake, absorption issues, or chronic blood loss. RBCs are microcytic and hypochromic.

• Hemolytic Anemias:

  • Shortened RBC lifespan due to increased destruction. Causes include autoimmune disorders, infections, or genetic conditions.

  • Sickle Cell Anemia: Genetic disorder affecting hemoglobin structure, causing RBCs to assume a sickle shape, leading to blockages in capillaries and reduced oxygen delivery.

  • Thalassemia: Inherited condition leading to abnormal hemoglobin synthesis, resulting in fragile RBCs and anemia.

Slide 29-30 - Hemolytic Disease of Newborn and Erythroblastosis Fetalis

• Cause and Treatment:

  • Occurs due to Rh incompatibility between an Rh-negative mother and an Rh-positive fetus.

  • Symptoms: Jaundice, anemia, heart failure in severe cases.

  • Treatment: In utero transfusions, administration of RhoGAM to Rh-negative mothers to prevent antibody formation.

  • Prevention: RhoGAM given at 28 weeks of pregnancy and within 72 hours after delivery.

Slide 31-32 - Learning Objectives (Lesson 13.2)

• White Blood Cells (WBCs):

  • Describe structure, function, and count of WBCs.

  • Discuss types of WBCs and their role in the immune system.

• Blood Clotting:

  • Explain the steps involved in clot formation, the role of platelets, and the importance of clotting factors.

  • Discuss common clotting disorders and their causes.

Slide 33-34 - Leukocytes or White Blood Cells (WBCs)

• Types of WBCs:

  • Granulocytes: Include neutrophils (most numerous, phagocytic cells that target bacteria), eosinophils (combat parasites, involved in allergic reactions), and basophils (release histamine and heparin, promoting inflammation).

  • Agranulocytes: Include lymphocytes (B cells produce antibodies, T cells attack infected or cancerous cells) and monocytes (differentiate into macrophages).

• Leukopenia: Abnormally low WBC count, often due to immune suppression, bone marrow failure, or certain medications.

• Leukocytosis: Elevated WBC count, seen in infections, inflammation, and leukemia.

Slide 35 - Leukocyte Types and Functions (Granulocytes)

• Neutrophils: Most numerous type of WBC, first responders to infection, and effective against bacteria through phagocytosis.

• Eosinophils: Weak phagocytes that combat multicellular parasites and are involved in allergic reactions.

• Basophils: Release histamine (promotes inflammation) and heparin (anticoagulant), similar to mast cells.

Slide 36 - Agranular Leukocytes (Monocytes and Lymphocytes)

• Monocytes: Develop into macrophages that phagocytize larger particles, including bacteria, dead cells, and other debris in tissues.

• Lymphocytes:

  • B Lymphocytes: Produce antibodies that target specific antigens; responsible for humoral immunity.

  • T Lymphocytes: Involved in cell-mediated immunity; directly attack infected or cancerous cells, including virus-infected cells.

  • Natural Killer (NK) Cells: A type of lymphocyte that can kill virus-infected cells and cancer cells without prior sensitization.

Slide 37 - White Blood Cell Conditions

• WBC Cancers (Neoplasms):

  • Lymphoid Neoplasms: Affect lymphocyte precursors, leading to conditions like lymphoma and leukemia.

  • Myeloid Neoplasms: Affect precursor cells of granulocytes, monocytes, RBCs, and platelets, resulting in conditions like myelogenous leukemia.

  • Leukemia: General term for cancers of WBCs, characterized by overproduction of abnormal WBCs.

Slide 38-40 - Multiple Myeloma

• Cancer of Plasma Cells:

  • Affects people over 65, leads to bone marrow dysfunction, anemia, and bone damage.

  • Symptoms: Anemia, bone pain, frequent fractures, recurrent infections due to abnormal antibodies.

  • Treatment: Chemotherapy, radiation therapy, stem cell transplantation, and drugs to strengthen bones and reduce symptoms.

Slide 41-43 - Leukemia Types

• Chronic Lymphocytic Leukemia (CLL):

  • Common in older adults, characterized by increased lymphocytes.

  • Symptoms: Fatigue, anemia, enlarged lymph nodes, recurrent infections.

  • Treatment: May include chemotherapy, radiation, or targeted therapies.

• Acute Lymphocytic Leukemia (ALL):

  • Affects children; symptoms include fever, bone pain, enlarged lymph nodes, and easy bruising.

  • Treatment: Chemotherapy, radiation therapy, bone marrow transplant. High cure rates in children.

• Chronic Myeloid Leukemia (CML):

  • Slow onset, involves granulocyte precursors; treated with Gleevec (targeted therapy) or bone marrow transplant.

  • Symptoms: Fatigue, weight loss, splenomegaly.

Slide 44 - Acute Myeloid Leukemia (AML)

• Features:

  • Sudden onset, rapid progression, affects adults and children.

  • Symptoms: Fatigue, joint pain, anemia, infections, bleeding gums, weight loss.

  • Prognosis is poor, but bone marrow transplants and chemotherapy can improve survival rates in some patients.

Slide 45-46 - Infectious Mononucleosis

• Viral Infection:

  • Caused by Epstein-Barr virus (EBV), spread via saliva (commonly called the "kissing disease").

  • Symptoms: Fever, sore throat, swollen lymph nodes, extreme fatigue, rash, and enlarged spleen.

  • Self-limiting, resolves within 4-6 weeks, but fatigue may last longer.

  • Complications can include splenic rupture in severe cases.

Slide 47 - Platelets and Blood Clotting

• Role of Platelets:

  • Platelets become sticky at injury sites, forming a "platelet plug" to prevent bleeding.

  • Release clotting factors that assist in forming a stable clot by triggering the clotting cascade.

  • Platelets adhere to damaged blood vessels and secrete chemicals that attract more platelets.

Slide 48-49 - Clotting Mechanism

• Steps in Clot Formation:

  • Prothrombin activator: Formed in response to injury and initiates the conversion of prothrombin to thrombin.

  • Thrombin: Converts soluble fibrinogen into insoluble fibrin threads that form the structural basis of a clot.

  • Fibrin: Fibrin threads create a mesh that traps RBCs and platelets, forming a stable clot to seal the damaged vessel.

  • Calcium ions: Essential for the activation of several clotting factors during the clotting cascade.

Slide 50 - Altering the Blood-Clotting Mechanism (Part 1)

• Methods:

  • Applying gauze: Provides a rough surface to encourage platelet aggregation and plug formation.

  • Vitamin K: Promotes synthesis of clotting factors in the liver, essential for normal clot formation.

  • Coumadin (Warfarin): Anticoagulant that inhibits the synthesis of vitamin K-dependent clotting factors, used to prevent thrombosis.

Slide 51 - Altering the Blood-Clotting Mechanism (Part 2)

• Heparin: Inhibits the conversion of prothrombin to thrombin, preventing clot formation; often used during surgery or dialysis.

• tPA (Tissue Plasminogen Activator): A medication that dissolves existing clots, used in the treatment of heart attacks and strokes to restore blood flow.

  • Aspirin: Inhibits platelet aggregation by blocking the enzyme COX, reducing thromboxane production.

Slide 52 - Prothrombin Time Test

• Use in Anticoagulant Therapy:

  • Measures how long it takes for blood to clot, specifically evaluating the extrinsic pathway of coagulation.

  • Used to regulate Coumadin dosage; results standardized using the INR system (International Normalized Ratio).

  • Helps ensure that patients taking anticoagulants maintain a therapeutic balance between preventing clots and avoiding excessive bleeding.

Slide 53 - Clotting Disorders

• Thrombus: A stationary blood clot that can obstruct blood flow, potentially leading to complications like deep vein thrombosis (DVT).

• Embolus: A dislodged clot that circulates in the bloodstream and can cause blockages in vital organs, such as a pulmonary embolism or stroke.

Slide 54 - Pulmonary Embolism

• Cause: Occurs when an embolus becomes lodged in the arteries of the lung, blocking blood flow and oxygen exchange.

• Symptoms: Shortness of breath, chest pain, rapid heart rate, coughing (may include blood).

• Risk Factors: Prolonged immobility, surgery, pregnancy, smoking, and clotting disorders.

• Treatment: Includes anticoagulants, thrombolytics, and, in severe cases, surgical intervention.

Slide 55-56 - Hemophilia

• X-linked Genetic Disorder:

  • Deficiency in Factor VIII (Hemophilia A) or Factor IX (Hemophilia B), both crucial clotting proteins.

  • Symptoms: Easy bruising, spontaneous bleeding, deep muscle and joint hemorrhages, prolonged bleeding after injuries or surgery.

  • Treatment: Regular infusions of the missing clotting factor, injury prevention, and avoiding medications like aspirin that alter the clotting mechanism.

  • Complications: Joint damage from repeated bleeding, increased risk of bleeding during surgery or trauma.

Slide 57 - Thrombocytopenia

• Low Platelet Count:

  • Causes: Bone marrow damage from conditions like leukemia, autoimmune disorders, viral infections, certain medications, or radiation.

  • Symptoms: Purpura (purple spots on skin), frequent nosebleeds, gum bleeding, heavy menstrual periods.

  • Treatment: Platelet transfusions, corticosteroids to suppress the immune system, possible splenectomy if spleen is involved in excessive platelet destruction.

  • Idiopathic Thrombocytopenic Purpura (ITP): An autoimmune disorder where the body's immune system attacks and destroys platelets.

Slide 58 - Vitamin K Deficiency

• Importance:

  • Essential for the synthesis of clotting factors II, VII, IX, and X in the liver.

  • Deficiency common in newborns due to lack of gut bacteria to produce vitamin K, increasing risk of hemorrhagic disease.

  • Vitamin K is primarily obtained from leafy green vegetables and is produced by gut bacteria in adults.

  • Treatment: Vitamin K supplementation, especially for newborns and individuals with absorption issues.

Slide 59-77 - Summary and Review Questions

• Summary:

  • Recap of the structure, function, and disorders of blood and its components.

  • Review Questions: A series of questions designed to reinforce learning objectives from both lessons (13.1 and 13.2).

  • Practice Problems: Identification of blood cells, explanation of clotting mechanisms, and case studies on blood disorders.

  • Application Exercises: Real-life scenarios involving blood diseases, transfusion compatibility, and clotting disorders to test understanding and application of knowledge.