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Lesson # 3. (Chapter 19). Blood-1. Objectives:. 1- To describe the general characteristics of blood and its major functions. 2- To describe the types of blood cells. 3- To describe the functions of red blood cells.

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slide1

Lesson # 3

(Chapter 19)

Blood-1

Objectives:

1- To describe the general characteristics of blood and its major functions.2- To describe the types of blood cells.

3- To describe the functions of red blood cells.

4- To list the blood types and explain the importance and basis of blood typing.

5- To discuss the reaction sequences responsible of blood clotting.

slide2

Introduction to the Cardiovascular System

  • Heart

The muscular pump that makes blood to circulate through the blood vessels.

The Cardiovascular System

Blood vessels

The plumbing that ensure the proper routing of blood to its destination.

It transports substances from place to place in the body.

Blood

It is the liquid medium in which these substance travel.

slide3

Blood

  • Blood is specialized fluid of connective tissue, which contains cells suspended in a fluid matrix.

Functions of Blood

1- Transport of dissolved substances

  • Oxygen and carbon dioxide, nutrients, hormones, immune system components , waste products.

2- Regulation of pH and ions

Blood eliminates deficiencies or excesses of ions. It also absorbs and neutralizes acids generated by active tissues.

3- Restriction of fluid losses at injury sites

Blood contains enzymes and other substances that initiate the process of clotting.

4- Defense against toxins and pathogens

Blood transports white blood cells that migrate into other tissues to fight infections and to remove debris. Blood also contains and delivers the antibodies.

6- Stabilization of body temperature

Blood absorbs the heat generated by active skeletal muscles and distributes it to other tissues. If body temperature increases, the heat is lost through the skin blood vessels. If body temperature is too low, the warm blood is directed to the brain and other temperature-sensitive organs.

slide4

Composition of Whole Blood

Plasma (46-63%)

Formed elements (37-54%)

slide5

They are made in the liver.

Functions: Major contributors to osmotic pressure of plasma. Transport lipids and steroids hormones.

It is also made in the liver.

Functions:Essential component of clotting system.

They are produce by white blood cells (lymphocytes) and by the liver.

Functions: Antibodies. Transport ions, hormones and lipids.

The Composition of Plasma

Plasma is 92% water in which are dissolved proteins and a mixture of other materials (hormones, nutrients, wastes and electrolytes).

Albumins (60%)

Globulins (35%)

PLASMA PROTEINS

(7%)

Fibrinogen (4%)

Regulatory proteins (< 1%)

Enzymes, proenzymes and hormones.

slide6

Electrolytes

They are ions produce by the dissociation of salts in water: Na+, K+, Ca2+, Mg2+, Cl-, HCO3-, HPO4-, SO42-

Functions:

A normal ion composition is essential for vital cellular activities.

Ions contribute to osmotic pressure of body fluids.

Organic Nutrients

OTHER SOLUTES

(1%)

Lipids (fatty acids, cholesterol, glycerides), carbohy-drates (glucose), and aminoacids.

Functions:

They are used for ATP production, growth and cell maintenance.

Organic waste

They are carried to sites of breakdown or excretion.

Ex: Urea, uric acid, creatinine, bilirubin, ammonium ions.

slide7

The Cardiovascular System

GasExchange

Systemic

Pulmonary

Circuit

Circuit

Capillary

Lung

Venule

Arteriole

Pulmonary arteries

Pulmonary veins

O2 poor,

CO2 rich blood

O2 rich,

CO2 poor blood

Wastes

Nutrients

O2

CO2

CO2

O2

Venae cavae

Aorta

Capillary

Tissue

Venule

Arteriole

slide8

BHP

BOP

BOP > BHP

BHP > BOP

Venule

Arteriole

Wastes

Nutrients

CO2

1- Blood Hydrostatic Pressure (BHP) pushes water outside the blood vessels

O2

Tissue

2- Blood Osmotic Pressure (BOP) pulls water back to the blood vessels

Blood Osmotic Pressure of the blood depends on:

1- Electrolytes ( mainly sodium ions)

2- Proteins (mainly albumin)

3- Erythrocytes

slide9

If the osmolarity of the blood is too high, the blood stream absorbs too much water, the blood volume raises, and blood pressure increases.

Ex: Patients with high blood pressure must reduce the intake of salt in the diet.

If the osmolarity of blood drops too low, too much water remains in the tissues and they become swollen (edematous).

  • Kwashiorkor
    • Children with severe protein deficiency.
slide10

Formed Elements of Blood

Monocyte

Small

lymphocyte

Neutrophil

Platelets

Eosinophil

Small

lymphocyte

Erythrocyte

Neutrophil

Monocyte

Large

lymphocyte

Neutrophil

Basophil

slide11

Red Blood Cells or Erythrocytes

Red blood cells constitute 99.9% of all the formed cell in blood.

  • Number of RBCs in 1 microliter of whole blood:
    • Male: 4.5–6.3 million
    • Female: 4.2–5.5 million
  • Packed cell volume (PCV) or Hematocrit). It is the percentage of RBCs in centrifuged whole blood:
    • Male: 40–54%
    • Female: 37–47%

Erythrocytes lack of nucleus and other organelles and live only an average of 120 days.

They are biconcave discs, thick in the outer edges and thin in the center.

They contain the hemoglobin, which transport O2 and CO2.

slide12

Hemoglobin

Hemoglobin is a protein that gives the RBCs their color and name. Each RBC contains about 280 million molecules of hemoglobin (33% of the cytoplasm).

  • Normal hemoglobin (adult male): 14–18 g/dL whole blood
  • Normal hemoglobin (adult female): 12–16 g/dL, whole blood
slide13

Fe2+

  • Hemoglobin has a complex quaternary structure consisting of four globular protein subunits.
  • Each chain contains one molecule or group heme.
  • Each heme contains one iron ion, which associates easily with oxygen (oxyhemoglobin) OR dissociate easily from oxygen (deoxyhemoglobin).

Hb + O2

4

HbO2

Deoxyhemoglobin

Oxyhemoglobin

Each RBC contains about 280 million molecules of hemoglobin.

Each RBC potentially can carry more than a billion molecules of O2 (280 x 4)

slide14

Hemoglobin Conservation and Recycling

Macrophage in spleen, liver, bone marrow

BONE MARROW

Fe2+ is transported in circulation by transferrin

Fe2+

RBC formation

Amino- acids

120 days average life span (90%)

Heme

Bilirubin-derived products

Bilirubin-derived products

Urobilins, Stercobilins

Bilirubin

Bilirubin

Biliverdin

Bilirubin

Bilirubin

Indirect or unconjugated bilirubin. It increases in accelerated erythrocyte hemolysis (erythroblastosis fetalis, hemolytic anemia), and hepatocellular disease

10% Hemolysis

+ Albumin

BLOOD PLASMA

KIDNEYS

LIVER

Hb

Excreted in bile

Absorbed into the circulation

If is called hemoglobinuria

Direct or conjugated bilirubin.

It increases in obstruction of the biliary ducts (cancer of pancreas’ head), gallstones or hepatocellular diseases such as cirrhosis or hepatitis.

Eliminated in urine

LARGE INTESTINE

SMALL INTESTINE

Eliminated in feces

slide15

Iron Metabolism

When iron is released into the blood stream, it binds to transferrin, a plasma protein

Excess transferrins, are removed in the liver and spleen and the iron is stored in two special proteins-iron complex: ferritin and hemosiderin.

Transferrin

Iron

Plasma protein that transports iron

Ferritin

Protein-iron complex that stores iron

Hemosiderin

Protein-iron complex that stores iron

slide16

RBC Production

Erythrocytes have no repair mechanisms because they lack of nucleus and other organelles. They live only an average of 120 days.

  • About 1% of circulating RBCs are replaced everyday.
  • In this process, about 3 million new RBCs enter the blood stream each second.

Erythrocyte production is called erythropoiesis, which normally takes 3 to 5 days.

White blood cells (leucopoiesis)

Myeloid stem cell

Pro- erythroblast

Erythroblast

Reticulocyte

Erythropoiesis takes place in the red bone marrow.

Normoblast

Mature Red Blood Cell

Day 1

Day 3

Day 4

Day 5-7

Circulation

Nucleus

Synthesis of hemoglobin (80%).

Erythropoiesis requires:

Erythropoiesis is stimulated by:

  • Aminoacids
  • Iron
  • Vitamins B12, B6, and folic acid
  • Erythropoietin
  • Thyroxine
  • Androgens
  • Growth hormone
slide17

Blood Types

Blood types and transfusion compatibility are a matter of interaction between antigens and antibodies.

Antigens

They are foreign substances that are able to trigger an immune response. Most of antigens are proteins.

Antibodies

They are proteins produced by cells of the immune system, which are able to recognize an interact with the corresponding antigens.

Y

Y

Y

Y

Y

Y

Plasma cell

Y

Antigens

Y

Y

Y

Y

slide18

Antigen-antibody reaction is specific, meaning that the antibodies can recognize only the corresponding antigens.

Y

Y

Y

Y

Y

Y

Antigens

Plasma cell

Plasma cell

Y

Antigens

Y

Y

Y

Y

C

C

C

C

C

C

C

C

C

C

Antigens

Plasma cell

slide19

The plasma membrane of the cells contains glycoproteins (surface markers) on the outer surface that can act as antigens. That means that they can trigger an immune response and can interact with the corresponding antibodies.

Surface markers are genetically determined and are different in every person. They are responsible for transplant rejection.

C

C

C

C

C

Transplant rejection is a process in which a transplant recipient's immune system attacks the transplanted organ or tissue.

slide20

Blood types and transfusion compatibility are a matter of interaction between plasma antibodies and surface antigens in the erythrocytes.

The plasma membrane of the erythrocytes contains glycoproteins on the outer surface that can act as antigens. That means that they can interact with the corresponding antibodies.

ABO Blood Group

Type A

Type B

Type A B

Type O

slide21

Blood Types are Genetically Determined

Genotype

Blood Type (Phenotype)

Genotype

Blood Type (Phenotype)

A

A

A A

A i

B

B

B B

B i

O

A B

A B

i i

slide22

Plasma contains antibodies against surface antigens that are not present on self cells. That is why foreign tissues are rejected by the immune system.

Plasma contains antibodies against surface antigens that are not present on self red blood cells.

Neither anti-A nor anti-B antibodies

Anti-A and anti-B antibodies

Anti-B antibodies

Anti-A antibodies

slide23

When antibodies attack, the foreign cells agglutinate (clump together). This process is called agglutination.

+ Ab

The antigens that determine the blood types are called agglutinogens, and the corresponding antibodies are called agglutinins

slide24

ABO Blood Typing

Control

Blood Type

A

B

AB

O

slide25

Rh Blood Group

The Rh blood group is named for the rhesus monkey, the animal in which the Rh antigens were discovered in 1940.

D

D

D

D

D

D

D

D

This group include numerous antigens (C, D, E). Antigen D is by far the most reactive and it is used for Rh typing.

Genotypes DD or Dd

Genotype dd

Rh +

Rh -

No anti-D antibodies

No anti-D antibodies

slide26

ABO and Rh Blood Typing

Control

Anti-A

Anti-B

Anti-D

Control

Anti-A

Anti-B

Anti-D

A-

AB-

AB+

A+

B-

O-

B+

O+

slide27

Transfusion Reaction

The agglutinated RBCs lodge in smaller blood vessels and cut of the blood flow to vital organs.

Blood from

type A donor

Free hemoglobin can block the kidney tubules and produce death from acute renal failure within a week or so.

Type B

(anti-A)

recipient

Donor RBCs

agglutinated by

recipient plasma

Agglutinated RBCs

block small vessels

slide28

Hemolytic Disease of Newborn

leaves

Rh- mother

Rh

antigen

Second

Rh+ fetus

Rh+ fetus

Uterus

Anti-D

antibody

Amniotic sac

and chorion

Placenta

(a) First pregnancy

(b) Between pregnancies

(c) Second pregnancy

Rh antibodies attack fetal blood causing severe anemia and toxic brain syndrome (Hemolytic Disease of the New Born).