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Blood Composition: Plasma, RBCs, WBCs, Platelets, Hemopoiesis, Examination, Quantitative Exam, Morphologic Exam

Explore the composition of blood including plasma, red blood cells, white blood cells, platelets, and the process of hemopoiesis. Learn about the quantitative and morphologic examination of blood components.

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Blood Composition: Plasma, RBCs, WBCs, Platelets, Hemopoiesis, Examination, Quantitative Exam, Morphologic Exam

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  1. بسم الله الرحمن الرحيم

  2. BLOOD

  3. Composition: suspension of cells in a complex liquid (plasma) Plasma:* H2O + organic molecules + mineral salls * After coagulation (- Fibrinogen) = serum Blood Cells: * R.B. C * W. B. C. * platelets. Origin: Site: *In the embryo (Liver, Spleen, Bone marrow) * After birth (only in the Bone marrow) * Lymmphoid tissues (B.M., L.N., Spleen, Payer's patches)

  4. HEMOPOIESIS • 1-Erythropoiesis: • The erythroblastic line represents 10 -30% of the bone marrow cells. • 2-Steps of maturation: It take 7 days under normal condition. • 1- Erythroblast (pronormoblast) • 2-Basophilic Normoblast • 3- Polychromatic normoblast. • 4-Orthochromatic normoblast. • 5-Reticulocyte • 6- R. B. C

  5. 4-In Cases or Urgent Blood Loss: E.g.: - after haemolytic attack - after Hge 1- Hypersecretion of erythropoietin 2- Augmentation of no. of erythroblasts in B. M. resulting in: 3- Acceleration of Hb. synthesis normal corpuscular conc. or Hb. occurs early decrease the number of cell divisions between stage of erythroblast and reticulocytes -- reduction of duration of erythropoiesis to 3-4 days. N.B as a result of Hyper secretion of the erythropoietin and acceleration of Hb. synthesis. Hypererythropoiesis occurs.

  6. HYPERERYTHROPOIESIS a- Increase in number or reticulocytes in the peripheral blood b- presence of immature R.B.CS (polvchromatophilia ) c- Macrocytosis. (duo to reduction of number of mitoses between proerthroblasts and Reticulocytes) d- Some orthochromatic normoblasts may be found in the peripheral Blood

  7. 5-Exogenous Factors necessary for Erythropoiesis: 1-Iron 2-Folic acid and Vitamin B12

  8. EXAMINATION OF THE BLOOD: COMPLETE BLOOD PICTURE (C.B.C.) A-QUANTITATIVE EXAMINATION: 1-Quantitative Exam. of the RBCS with its constituents: a- R.B.Cs no./mm3: Male 4.5 – 6.2 x 106 Female & Child: 4 – 5.4 x 106 Infant 3.6 – 5 x 106 at Birth 5 – 6 x 106

  9. b-Hematocrite: (relative volume of R.B.CS in the blood) - By centrifugation of a small column of blood in a standard tube: Male40 - 54 % Female35 - 47 %

  10. c- Hb. Content of 100 cc blood: Male13 - 18 gm/100cc Female & Child: 12 - 16 gm/100cc Infant 12 - 16 gm/100cc at Birth 14 - 20 gm/100cc

  11. f- Reticulocytic count: - Normal life span of RBCs = 120 days - Reticulocytes are the newly fabricated RBCs within the 1st 24 hours (still containing cytoplasmic organelles) i.e. --- by special stain --- counting the no. of RBCs containing such organells among 1000 RBCs in %. - Absolute no. of reticutocytes: = RBCs count X reticulocytic %. * normal 25.000 ----- 100.000/mm3 (l-2 %) For Hb content within the normal range. * with anaemia increase in no. of the reticulocytes , if there is a normal ability of the B.M. to synthesis RBCs i.e., If Hb <= 8 gm in regenerative anaemia (e.g., haemolytic or post Hgic) -- reticulocytic count must be > 100.000 . If < 100.000 this means aregnerative, i.e., ( hypoplastic or aplastic ) anaemia.

  12. 2 - Quantitative Exam. of WBCS: Normal 4.000 --- 10.000/mm3 in adults Infants 1st year 5.000 - 20.000 /mm3 2nd year 6.000 – 17.000 / mm3 10 years 5.000 --- 13.000/mm3 N.B. In adult. * > 11.000 indicates leucocytosis­ * < 4.000 indicates leucopenia.

  13. 3-QUANTITATIVE ESTIMATION OF PLATELETS: Normal l50.000 - 450. 000/mm3 < 150,000 indicates thrombocytopenia. >450.000 indicates thrombocytosis

  14. B- MORPHOLOGIC EXAMINATION: RBCs Morphological exam. of RBCs. WBCS Differential white cell count. I- Morphologic Examination of RBCs: Normally : RBCs are of * same form * same colour * same diameter. Any abnormality Pathological condition: * in size : anisocytosis * in form: poikilocytosis

  15. II- Differential white cell Count: -The absolute no. more important than the %

  16. Polymorphonuclear Neutrophils: * 40 – 70% of WBCS (1700 - 7000) * Function: The main Function is phagocytosis of foreign bodies esp. Bacteria

  17. Granulopoiesis: It takes 10 days under normal conditions 50 -70 % of B. M. cells - Myeloblasts 2.3 % - Promyelocytes 4-8% - Myelocytes 10-15% - Metamyelocytes15-20% - Polynuclearcells20-30% * Life span: in the circulation is very short within 12 hours . 50% of formed neutrophils leave the blood to the tissues and don't turn back again.

  18. In cases of excess demand: Rapid passage of neutrophils to the blood from the marrow resulting in the release of band forms, even metamyelocytes and myelocytes.

  19. Polymorphonuclear leucocytosis: Due to increase polymorphonuclear neut. i.e.> 7000/ mm3 1- Reactional: a- physiologic: - Neonates - Severe exercise - Menestruation - Pregnancy

  20. b- Pathologic: - Bacterial infections - Inflammatory diseases : (Arthritis - Allergic ) - Tissue necrosis e.g., rnyocardial Infraction, pancreatitis - Heavy smokers. - Acute hemorrhage or hemolysis - Intoxication (radiation, benzene) - Start of chronic myeloid leukemia - Without cause

  21. 2- Myeloproliferative disorders: as Chronic Myeloid 1eukemia Neutropenia: means that Neutrophils < 1700 / mm3, It is due to either: 1- Insufficient production (central): A- As a part of Pancytopenia: e.g., aleukemic leukemia or aplastic amenia B- Isolated: 1- Hereditary form. 2- Allergy to certain drugs 3- Direct central inhibition e.g., henothiazine 4- Constitutional agranulocytosis.

  22. 2- Hyperdestruction (peripheral): - Auto immunisation - Lupus Erythromatosis . Usually with thrombocytopenia - Felty's syndrome # But espe. in moderate cases (i.e. 800- 1700) we must exclude : -Some parasitic infections (kala Azar) - Some bacterial infections (typhoid, Brucellosis) - Some viral infections (Viral hepatitis) - May be normal esp. in black races.

  23. Eosinophiles: * Functions: (not exactly known) - phagocytosis : Ag- Ab complex - Transport the plasminogen - Play a role in destruction of certain larvae - Has a role in allergy

  24. Eosinophilia: means eosinophils > 300/mm3 but more significant if > 500/mm3 causes: 1- Allergic conditions: - Asthma, - Allergy to certain drugs as penicillin's. 2- parasitic infections: Filariasis, Ascaris, Oxyuris, Taeniasis. 3- Polyarteritis nodosa 4- Dermatosis­ 5- Malignancy: - H.D - certain cancers (Liver, Ovary)

  25. Basophils: * Function: - Unknown. - Rich in histamine and heparin - Play a role in delayed hypersensitivity reaction If >1 % = pathologic conditions: 1- Myeloproliferative syndromes esp. C.M.L 2-Severe hyperlipidaemia 3- Hypothyroidism

  26. Monocytes: - The largest circulatory blood cells, have: * characteristic Nuclear shape, * Longer life span than other WBCs (2-3 days) Function: 1- phagocytosis : Play a role in defence mechanism In tissues --- Macrophages 2- Play a role in immunologic reactions

  27. Monocytosis: means monocytes > 1000 /mm3: 1- reactional: - infections: (bacteria, virus parasites) - At the recovery of agranulocytosis 2- Acute monocytic leukemia, chronic myelomonocytic leukemia 3- Isolated chronic Monocytosis : ­rare as in refractory anaemias at the start of acute monocytic Leukemia, and chronic myelomonocytic eukemia.

  28. Lymphocytosis: • Means increased number of lymphocytes above the upper limit of normal (> 4000 – 4500/cumm in adults , > 6000- 7000 , cu mm in neonates and infants. • Causes: • Viral infections : hepatitis, measles, infective mononucleosis • Bacterial infections : brucellosis , T.B., whooping cough. • Malignant lymphocytosis : Chronic lymphatic leukemia and Waldestron’s macroglobulinemia.

  29. Thank you

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