1. CHAPTER 9 Blood and Lymphatic Systems

2. Blood System Overview • Blood transports oxygen and nutrients to body cells • Blood removes carbon dioxide and other waste products from body cells for elimination

3. Composition of Blood • Plasma • 90 percent water = liquid portion of blood • Transports cellular elements of blood throughout circulatory system • Remaining portion = solutes • Electrolytes, proteins, fats, glucose, bilirubin, and gases • Most abundant solutes are plasma proteins: albumins, globulins, and fibrinogen

4. Composition of Blood • Solid components • Formed elements = cells + cell fragments • Erythrocytes, leukocytes, thrombocytes

5. Plasma Proteins • Albumins • Constitute about 60 percent of the plasma proteins • Help maintain normal blood volume and blood pressure • Help to maintain balance between fluid in the blood and fluid in the interstitial tissues

6. Plasma Proteins • Globulins • Constitute approximately 36 percent of plasma proteins • Alpha and beta globulins transport lipids (fats) and fat-soluble vitamins in blood • Gamma globulins are antibodies and function in immunity

7. Plasma Proteins • Fibrinogen • Constitutes approximately 4 percent of plasma proteins • Largest of plasma proteins • Essential in process of blood clotting

8. Question True or False: The blood has 2 main components: plasma and proteins.

9. Blood Cells • Erythrocytes • Known as red blood cells (RBC) • Tiny biconcave-shaped disks • Thinner in center than around edges • No nucleus in mature red blood cell • Average life span = approximately 120 days • Main component = hemoglobin • Primary function = transport oxygen to cells of body

10. Blood Cells • Leukocytes • Known as white blood cells (WBC) • Larger than erythrocytes, but fewer in number • Mature WBC has a nucleus; does not have hemoglobin • Two categories = granulocytes + agranulocytes • Granulocytes have granules in their cytoplasm • Agranulocytes have no granules in their cytoplasm • Five different types of leukocytes within the categories

11. Granulocytes • Neutrophils • Constitute approximately 60 to 70 percent of all WBCs • Have multi-lobed nuclei • Phagocytic in nature • Do not absorb acid or base dye well • Remain fairly neutral color

12. Granulocytes • Eosinophils • Constitute approximately 2 to 4 percent of all WBCs • Have a nucleus with two lobes • Increase in number in response to allergic reactions • Stain a red, rosy color with an acid dye

13. Granulocytes • Basophils • Constitute less than 1 percent of all WBCs • Have a nucleus with two lobes • Secrete histamine during allergic reactions • Secrete heparin, a natural anticoagulant • Stain a dark blue with a base dye

14. Agranulocytes • Monocytes • Constitute approximately 3 to 8 percent of all WBCs • Largest of all white blood cells • Have a kidney bean-shaped nucleus • Phagocytic in nature

15. Agranulocytes • Lymphocytes • Constitute approximately 20 to 25 percent of all WBCs • Have a large spherical-shaped nucleus • Play important role in immune process • Some lymphocytes are phagocytic • Other lymphocytes produce antibodies

16. Cell Fragments • Thrombocytes • Small, disc-shaped fragments of very large cells called megakaryocytes • Also known as platelets • Contain no hemoglobin • Essential for normal clotting of blood

17. Question Why would an erythrocyte not have a nucleus? • It is still an immature cell. • It needs maximum room to carry oxygen to the body's cells. • It is a rare mutation but otherwise is present. • Hemoglobin already has one.

18. Blood Types • Blood Type A • Has A-antigen present on RBC • Has Anti-B antibody present in plasma • Blood Type B • Has B-antigen present on RBC • Has Anti-A antibody present in plasma

19. Blood Types • Blood Type AB • Has AB-antigens present on RBC • Has no antibodies present in plasma • Blood Type O • Has no antigens present on RBC • Has both Anti-A and Anti-B antibodies present in plasma

20. Terms Related to Blood Transfusions • Donor • Person who gives blood • Recipient • Person who receives blood

21. Terms Related to Blood Transfusions • Universal donor blood • Type O • No A antigens or B antigens present on its RBCs • Universal recipient blood • Type AB • No Anti-A or Anti-B antigens present in its plasma

22. Rh Factor • Rh positive (Rh+) • Rh antigen is present on the RBC • Rh negative (Rh-) • Rh antigen not present on the RBC • Concern: Rh- blood being exposed to Rh+ blood via transfusion • Concern: Rh- mother giving birth to Rh+ baby and blood mixes during birth process

23. Blood Clotting • Clotting of blood = coagulation • Injury to blood vessel creates roughened area in vessel • Platelets come in contact with rough spot and disintegrate • Release substance called thromboplastin • Thromboplastin converts prothrombin into thrombin • In presence of calcium ions and other clotting factors • Thrombin converts fibrinogen into fibrin • Fibrin threads form a mesh that forms the clot

24. Question The Red Cross loves to call a person with this blood type: • A • B • AB • O

25. PATHOLOGICAL CONDITIONS The Blood

26. Anemia • Pronounced • (an-NEE-mee-ah) • Defined • Deficiency of oxygen being delivered to cells due to decrease in quantity of hemoglobin or red blood cells

27. Anemia • Similarities in all types of anemia • Fatigue • Paleness of skin • Headache • Fainting

28. Anemia • Similarities in all types of anemia • Tingling sensations and numbness • Loss of appetite • Swelling in lower extremities • Difficulty breathing

29. Aplastic Anemia • Pronounced • (ah-PLAST-ik an-NEE-mee-ah) • Defined • Form of anemia characterized by pancytopenia, an inadequacy of all the formed blood elements (RBCs, WBCs, platelets) • Also known as “bone marrow depression anemia”

30. Hemolytic Anemia • Pronounced • (he-moh-LIT-ik an-NEE-mee-ah) • Defined • Form of anemia characterized by the extreme reduction in circulating RBCs due to their destruction

31. Iron Deficiency Anemia • Pronounced • (EYE-urn dee-FIH-shen-see an-NEE-mee-ah) • Defined • Anemia that is characterized by deficiency of hemoglobin level due to a lack of iron in the body

32. Pernicious Anemia • Pronounced • (per-NISH-us an-NEE-mee-ah) • Defined • Form of anemia resulting from a deficiency of mature RBCs and the formation and circulation of megaloblasts, with marked poikilocytosis and anisocytosis • Distorted RBCs due to lack of vitamin B12 absorption necessary for maturation of RBCs

33. Sickle Cell Anemia • Pronounced • (SIKLSELL an-NEE-mee-ah) • Defined • Chronic hereditary form of hemolytic anemia in which RBCs become crescent-shaped in presence of low oxygen concentration • Crescent-shaped RBCs clump together forming thromboses which occlude small blood vessels, causing much pain for the individual

34. Question True or False: The breakdown of anemia is an = without, -emia = blood condition (noun form).

35. Granulocytosis • Pronounced • (gran-yew-loh-sigh-TOH-sis) • Defined • Abnormally elevated number of granulocytes in the circulating blood as a reaction to any variety of inflammation or infection

36. Hemochromatosis • Pronounced • (hee-moh-kroh-mah-TOH-sis) • Defined • Rare iron metabolism disease characterized by iron deposits throughout the body • Usually as a complication of one of the hemolytic anemias

37. Hemophilia • Pronounced • (hee-moh-FILL-ee-ah) • Defined • Hereditary inadequacies of coagulation factors resulting in prolonged bleeding times

38. Hemophilia • Hemophilia A • Also called classic hemophilia • Result of a deficiency or absence of antihemophilic factor VIII • Deficiency results in traumatic or spontaneous bleeding • Characterized by bleeding in joints, gums, or mouth • Hematuria is a common characteristic

39. Hemophilia • Hemophilia B • Also called Christmas disease • Result of deficiency of a coagulation factor called factor IX • Only distinguishable from hemophilia A through laboratory differentiation of factor deficiencies

40. Leukemia • Pronounced • (loo-KEE-mee-ah) • Defined • Excessive uncontrolled increase of immature WBCs in the blood, eventually leading to infection, anemia, and thrombocytopenia • Course of leukemia is subclassified as acute or chronic

41. Leukemia • Acute leukemia • Rapid onset • Swiftly progresses to severe thrombocytopenia, progressive anemia, infective lesions in throat and mouth, high fever, and severe infection • Chronic leukemia • Gradual onset • Progression slower than with acute form

42. Leukemia • Classifications of leukemia • AML • Acute myelogenous leukemia • ALL • Acute lymphocytic leukemia

43. Leukemia • Classifications of leukemia • CML • Chronic myelogenous leukemia • CLL • Chronic lymphocytic leukemia

44. Question True or False: Granulocytosis is an overreaction by the WBCs with granules to inflammation and infection.

45. Multiple Myeloma (Plasma Cell Myeloma) • Pronounced • (MULL-tih-pl my-eh-LOH-mah) • Defined • Malignant plasma cell neoplasm causing an increase in the number of both mature and immature plasma cells • Often entirely replaces the bone marrow and destroys the skeletal structure

46. Polycythemia Vera • Pronounced • (pol-ee-sigh-THEE-mee-ah VAIR-ah) • Defined • Abnormal increase in the number of RBCs, granulocytes, and thrombocytes leading to an increase in blood volume and viscosity

47. Purpura • Pronounced • (PURR-pew-rah) • Defined • Collection of blood beneath the skin in the form of pinpoint hemorrhages appearing as red-purple skin discolorations • Idiopathic thrombocytopenic purpura = antibodies formed by the individual that destroy his/her own platelets

48. Thalassemia • Pronounced • (thal-ah-SEE-mee-ah) • Defined • Hereditary form of hemolytic anemia in which the production of hemoglobin is deficient, creating hypochromic microcytic RBCs • Alpha or beta hemoglobin chains are defective

49. DIAGNOSTIC TECHNIQUES, TREATMENTS, AND PROCEDURES The Blood

50. Diagnostic Techniques, Treatments, and Procedures • Direct antiglobulin test (Coomb’s test) • Blood test used to discover the presence of antierythrocyte antibodies present in the blood of an Rh-negative woman • Production of these antibodies is associated with an Rh incompatibility between a pregnant Rh-negative woman and her Rh-positive fetus