Blood and Lymphatic Systems

1. Blood and Lymphatic Systems CHAPTER 9

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. 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

9. 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

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

11. Granulocytes • Eosinophils • Constitute approximately 2-4 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

12. 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

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

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

15. 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

16. 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

17. 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

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

19. 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

20. Rh Factor • Rh Positive (Rh+) • Rh antigen is present on the RBC • RhNegative (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

21. 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

22. PATHOLOGICALCONDITIONS TheBlood

23. 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

24. Anemia • Similarities in all types of anemia • Fatigue • Paleness of skin • Headache • Fainting • Tingling sensations and numbness • Loss of appetite • Swelling in lower extremities • Difficulty breathing

25. 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”

26. 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

27. 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

28. 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

29. Sickle Cell Anemia • Pronounced • (SIKL-SELL 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

30. 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

31. 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

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

33. 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

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

35. 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

36. 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

37. Leukemia • Classifications of leukemia • AML • Acute Myelogenous Leukemia • ALL • Acute Lymphocytic Leukemia • CML • Chronic Myelogenous Leukemia • CLL • Chronic Lymphocytic Leukemia

38. 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 replace the bone marrow and destroy the skeletal structure

39. 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

40. 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 destroys his/her own platelets

41. 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

42. DIAGNOSTIC TECHNIQUES, TREATMENTS AND PROCEDURES The Blood

43. 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

44. Diagnostic Techniques, Treatments, and Procedures • Bleeding time • Measurement of the time required for bleeding to stop • Blood transfusion • Administration of blood or a blood component to an individual to replace blood lost through surgery, trauma, or disease

45. Diagnostic Techniques, Treatments, and Procedures • Bone marrow biopsy • Microscopic exam of bone marrow tissue, which fully evaluates hematopoiesis by revealing the number, shape, and size of the RBCs, WBCs, and platelet precursors • Bone samples are obtained through aspiration or surgical removal

46. Diagnostic Techniques, Treatments, and Procedures • Bone marrow transplant • Donor’s bone marrow cells are infused intravenously into the recipient • After recipient receives an infusion of aggressive chemotherapy or total-body irradiation to destroy all malignant cells and to inactivate the immune system

47. Diagnostic Techniques, Treatments, and Procedures • Complete Blood Cell Count (CBC) • Series of tests performed on peripheral blood, that inexpensively screens for problems in the hematologic system as well as several other organ systems • CBC includes • RBC count, Hemoglobin, Hematocrit, RBC indices, WBC count, WBC differential, Blood smear, Platelet count

48. Diagnostic Techniques, Treatments, and Procedures • Erythrocyte Sedimentation Rate (ESR) • Test performed on blood, that measures the rate at which red blood cells settle out in a tube of unclotted blood • ESR is determined by measuring the settling distance of RBCs in normal saline over one hour

49. Diagnostic Techniques, Treatments, and Procedures • Hematocrit • Assessment of RBC percentage in total blood volume • Hemoglobin test • Concentration measurement of hemoglobin in peripheral blood

50. Diagnostic Techniques, Treatments, and Procedures • Lipid profile • Measurement of the lipids in the blood • Partial thromboplastin time (PTT) • Blood test used to evaluate the common pathway and system of clot formation within the blood