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Chapter 18 The Circulatory System: Blood. Blood Functions and properties Blood cell production Erythrocytes (RBC) Leukocytes (WBC) Hemostasis Blood types. Functions and Properties of Blood. Function: Helps cells get nutrition, gets rid of waste Two types of fluid: Blood and Interstitial

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chapter 18 the circulatory system blood
Chapter 18The Circulatory System: Blood
  • Blood Functions and properties
  • Blood cell production
  • Erythrocytes (RBC)
  • Leukocytes (WBC)
  • Hemostasis
  • Blood types
functions and properties of blood
Functions and Properties of Blood
  • Function: Helps cells get nutrition, gets rid of waste
  • Two types of fluid: Blood and Interstitial
    • Blood is the transported
    • Interstitial fluid is the diffuser
hematology
Hematology
  • The study of blood
    • (Hemo = blood, -ology = study)
  • Blood is as unique as your fingerprints
  • Most cells cannot move around to get oxygen and nutrients and get rid of waste, the blood system does this for them.
  • INTO the BLOOD- Oxygen from the lungs, nutrients from the small intestines
  • OUT OF the BLOOD- Waste goes out the kidneys, skin and large intestine
two functions of blood
Two Functions of Blood
  • 1. Transport- oxygen, nutrients, waste
  • 2. Protection- clotting, immunity = white blood cells (WBC), interferon, complement
physical characteristic of blood
Physical Characteristic of Blood
  • Alkaline: 7.4 pH avg.
  • 8 % of body weight (if you weighted 100 pounds, and lost all your blood you would lose 8 pounds)
  • Blood volume: 1.2 gallon female, 1.5 gallon male
  • Temperature of the blood is a little higher then body temperature, WHY? ______________
components of blood
Components of Blood
  • If Blood is spun down (centrifuged), we see two parts:
    • 1. Plasma- liquid
      • If this is allowed to clot what remains is called “serum”
    • 2. Cells- bottom of tube
      • Cells of the blood are mostly red blood cells (RBCs). The rest, only 1%, is basically platelets and white blood cells (WBCs)
centrifuging blood
Centrifuging Blood
  • Centrifuging blood forces cells to separate from plasma
  • Hematocrit is the % of total volume of cells
  • Normal crit = females 42 avg., males 47 avg.
hematocrit tells us
Hematocrit Tells Us…
  • Hematocrit of 40 means that 40 % of the blood is __ __ __s
    • Does a doctor do a hematocrit to determine the amount of WBCs or platelets? YES NO
    • Then what is in the buffy coat? ________
  • Abnormal:
    • Low crit =Anemia, decreased ________
    • High crit = Polycythemia
polycythemia
Polycythemia
  • Polycythemia is an excess of RBC
    • primary polycythemia is due to cancer of erythropoietic cell line in the red bone marrow
      • Hematocrit of 80%
    • secondary polycythemia from dehydration, emphysema, high altitude, or physical conditioning
  • Dangers of polycythemia
    • increased blood volume, pressure and viscosity can lead to embolism, stroke or heart failure
plasma proteins
Plasma Proteins
  • 3 major categories of plasma proteins
    • Albumins are most abundant plasma protein
    • Globulins (antibodies) provide immune system defenses
      • alpha, beta and gamma globulins
    • Fibrinogen creates fibrin threads that causes blood to clot
formation of blood cells
Formation of Blood Cells
  • Hemopoiesis- Blood making
    • Lymphoid hemopoiesis occurs in widely distributed lymphoid tissues (thymus, tonsils, lymph nodes, spleen & peyers patches in intestines)
    • red bone marrow produces RBCs, WBCs and platelets
    • SEQUENCE:
      • 1.) Stem cells
      • 2.) Committed cells
      • 3.) Precursor Cells
      • 4.) Final blood cells
hypoxia an important concept
Hypoxia: An important concept
  • Cellular oxygen deficiency is hypoxia (hypo= under, ox= oxygen)
    • Ischemia is a from of hypoxia due to obstruction of blood flow (as by the narrowing of arteries by spasm or disease)
  • This can cause cell death (necrosis)
  • Occurs in many situations:
    • High altitude
    • Anemia
    • Iron or B12 deficiency resulting in anemia
    • Circulatory problems
erythrocyte homeostasis
Erythrocyte Homeostasis
  • Classic negative feedback control
    • drop in RBC count causes hypoxemia to kidneys
    • stimulation of bone marrow
    • RBC count  in 3-4 days
  • Stimulus for erythropoiesis
    • Hypoxia is a stimulus for blood production such as:
      • low levels of atmospheric O2 (high altitude)
      • increase in exercise
      • Circulatory problems
      • Anemia from Iron or B12 deficiency
lab test for rbc creation
Lab Test for RBC creation
  • Reticulocyte count (“Tic”) measures the rate of erythropoiesis and so can give an indication of RBC creation.
  • Normal= avg. 1 %--- because about 1% of RBCs are replaced in a day therefore about 1% of the blood is reticulocytes
    • Low tic count = red bone marrow not working. Cause = nutritional deficiency or leukemia
    • High tic count = usually good sign, response to iron therapy
red blood cells rbcs
Red Blood Cells (RBCs)
  • RBCs are called erythrocytes (red, cells)
  • Oxygen-carrying cells
  • Contains oxygen-carrying protein called hemoglobin
  • Anatomy- 7.5 microns, biconcave disc- can get into small places
    • large surface area helps diffusion of gases
  • No nucleus or organelles so ample space for oxygen
  • Gets energy anaerobically
    • So it doesn’t need the oxygen that it’s carrying
leukocyte production leukopoiesis
Leukocyte Production (Leukopoiesis)
  • Some lymphocytes leave bone marrow unfinished
    • go to thymus to complete their development (T cells)
  • Circulating WBCs do not stay in bloodstream
    • granulocytes leave in 8 hours
    • monocytes leave and transform into macrophages
    • WBCs provide long-term immunity lasting decades
platelet production
Platelet Production
  • Cells called megakaryocyte create platelets
  • Cytoplasm of the cell splits off creating cell fragments that enter the bloodstream as platelets (live for 10 days)
    • some stored in spleen & released as needed
  • Platelets are important for _________
erythrocytes and hemoglobin tests
Erythrocytes and Hemoglobin Tests
  • RBC count & hemoglobin concentration indicate the amount of oxygen the blood can carry
    • hemoglobin concentration of whole blood
      • men avg. 15; women avg. 14
    • RBC count
      • men 5.5 million avg.; women 5 million avg.
erythrocyte death disposal
Erythrocyte Death & Disposal
  • RBCs live for 120 days
    • membrane fragility -- lysis in narrow channels in the spleen through a process called ____________
  • Macrophages in spleen
    • remove iron from heme
    • convert heme to bilirubin (yellow pigment)
  • Why can’t RBCs repair themselves?
  • Bilirubin is converted to urobilogen in the intestine by bacteria giving fecal matter it’s brown color
anemia
Anemia
  • Causes of anemia
    • Decreased RBCs or hemoglobin
      • inadequate dietary vitamin B12
      • Or lack of intrinsic factor in the stomach (pernicious anemia)
      • iron-deficiency anemia
        • If in males and post-menopausal females check for hemorrhage
      • aplastic anemia can be drug induced marrow destruction
    • Anemia (normocytic): causes ABCD:Acute blood lossBone marrow failureChronic dietary deficiencyDestruction (hemolysis)
anemia1
Anemia
  • Effects of anemia
    • FATigue
    • Heart races
    • Edema
    • Low blood pressure
    • Pallor
    • Shortness of breath
    • (Fat HELPS)
sickle cell disease
Sickle-Cell Disease
  • Sickle-Cell is hereditary Hemoglobin defect of African Americans
    • sickle-cell disease individual has shortened life
      • cell stickiness causes agglutination and blocked vessels
      • intense pain, kidney and heart failure, paralysis, and stroke
  • Sickle cell Disease-codominant genetic disorder, resistant to malaria. Why?
    • Because sickle cells hemoglobin is indigestible to malaria parasites
blood types
Blood Types
  • The surface of RBCs contain genetically determined antigens (antibody generator) these determine the blood types
  • Major blood types are: ABO and Rh
  • ABO blood group are based on people that have blood antigens A or B
  • If you have A antigen on your RBCs you are type A, if you have B antigens you are type B, and type AB has both antigens but if you don’t have any A or B antigens you are type O.
  • Remember: This applies to incoming blood
blood type diet theory
Blood Type Diet Theory
  • Type O is said to be the Original blood type, no antigens. These were the hunters. Diet is meat based. Native Americans are 79% type Os.
  • Type A is the Agrarian blood type. These are the farmers. Diet is vegetarian.
abo blood typing
ABO Blood Typing
  • Agglutination is the term for blood clumping
  • For example: type A has agglutination on the left which tells us this blood reacted with anti-A
  • Type AB has agglutination to both ____ and ______
blood swapping
Blood Swapping
  • Type AB- universal ABceptor, person can be infused with any type of blood
  • Type O- universal dOnor, can give their blood to anyone
  • Caveat: Remember that blood contains other antigens and antibodies than ABO, so specific typing should always be done to avoid Agglutination (clumping)
  • Agglutination is massive clumping which is distinct from normal clotting (like from a cut)
the rh group
The Rh Group
  • Rh or D agglutinogens discovered in Rhesus monkey
    • If you have the Rh antigen you are Rh+
    • If you don’t have the Rh antigen you are Rh-
  • Anti-D agglutinins are not normally present in blood
    • formed only in individuals exposed to Rh+ blood
      • Rh- pregnant woman carrying an Rh+ fetus
      • no problems result with the first pregnancy
      • hemolytic disease of the newborn (erythroblastosis fetalis) occurs if mother has formed antibodies & is pregnant with 2nd Rh+ child
    • RhoGAM is given to pregnant woman to prevent antibody formation and prevent any future problems
  • Relate disease: Peanut butter should be avoided in ____ peanut butter cup syndrome
hemolytic disease of newborn
Hemolytic Disease of Newborn
  • Mother’s antibodies attack fetal blood causing toxic brain syndrome from excessive bilirubin in blood from hemolysis
    • treatment is phototherapy to degrade bilirubin or complete exchange transfusion to replace all the infant’s blood
    • http://nobelprize.org/educational_games/medicine/landsteiner/
slide33
GRANULAR

Neutrophils

Eosinophils

Basophiles

AGRANULAR

Lymphocytes

Monocytes

White Blood Cells (WBCs)WBC are also called Leukocytes (leuko= white, cyte= old cell)-Have nucleus but no hemoglobin_____________________________________

granular leukocyte wbcs
Granular Leukocyte (WBCs)
  • Granulocytes- when stained these show granules under the microscope
    • basophils – non-abundant, dark violet granules (<1%)
      • large U- to S-shaped nucleus hidden by granules
    • eosinophils - pink-orange granules & bilobed nucleus (2-4%)
    • neutrophils - multilobed nucleus (60-70%)
      • fine reddish to violet granules in cytoplasm
      • Older neutrophils are called polymorphonuclear (PMN) leukocytes or “POLYS”
    • BEN
granulocyte functions
Granulocyte Functions
  • Neutrophils ( in bacterial infections)
    • phagocytosis of bacteria
    • releases antimicrobial chemicals
  • Eosinophils ( in parasitic infections or allergies)
    • phagocytosis of antigen-antibody complexes, allergens & inflammatory chemicals
    • release enzymes destroy parasites such as worms
  • Basophils ( in chicken pox, sinusitis, diabetes)
    • secrete histamine (vasodilator)
    • secrete heparin (anticoagulant)
agranular leukocyte wbcs
Agranular Leukocyte (WBCs)
  • These cells do contain granules but do not stainand are small
  • Monocytes- the cops of the body
  • The blood is a transport system (cop car) for monocytes as they fight infection in tissues
    • They go into tissue and become macrophages (macro= big, phage= eater)
  • Lymphocytes- cytoplasm stains and forms a blue rim around the cell
    • B cells, T cells and Killer cells
agranulocyte functions
Agranulocyte Functions
  • Lymphocytes ( in diverse infections & immune responses)
    • destroy cancer & foreign cells & virally infected cells
    • coordinate actions of other immune cells
    • secrete antibodies & provide immune memory
  • Monocytes ( in viral infections & inflammation)
    • differentiate into macrophages
    • phagocytize pathogens and debris
lymphocytes
LYMPHOCYTES
  • Major types are B cells, T cells, and natural killer cells which are major warriors in the immune response
  • B cells- from Bone marrow
    • Good at destroying Bacteria
  • T cells- Formed in bone marrow but matures in the Thymus gland
    • Good at attacking virus, fungi, cancer cells and Transplanted organs
  • Killer cells- kill microbes and tumor cells
increased and decreased wbcs
INCREASED

Neutrophils- bacteria

Lymphocytes- virus

Monocytes-virus, fungus

Eosinophils-allergy, parasites

Basophils- allergy, cancer

DECREASED

Neutrophils- radiation, drugs, nutrition deficiency

Lymphocytes- chronic illness

Monocytes-bone marrow depression

Eosinophils-drugs, stress

Basophils- pregnancy, stress

Increased and Decreased WBCs
wbc pathology
WBC Pathology
  • Leukocytosis- increased WBCs
    • usually normal
    • Due to stresses such as microbes and strenuous exercise
  • Leukopenia- decreased WBCs
    • Abnormal
    • due to shock or drug reactions or disease
wbc pathology leukemia
WBC pathology- Leukemia
  • Leukemia = cancer of hemopoietic tissue
    • Uncontrolled WBC production
    • Subject to opportunistic infection, anemia
  • Acute Leukemia- = immature WBC
  • Chronic Leukemia- = too many WBCs
    • Remission (disappearing) and exacerbation (occurrence) common
normal and leukemia blood smears
Normal and Leukemia Blood Smears
  • Normal blood ratio = 700 RBCs to 1 WBC
the action of wbcs
The Action of WBCs
  • WBCs leave the bloodstream by emigration
  • Phagocytosis- the process of the WBC eating an invader, a bacteria
  • Chemotaxis- the process of attracting phagocytes, caused by toxins that are produced by microbes destroying tissue
  • Lysozymes- enzymes that the phagocytes use to destroy bacteria
  • A Differential WBC count (Diff) is counting of the different WBC, determining the percentage of each type of WBC helps in the diagnosis
of thrombosis and embolism
Of Thrombosis and Embolism
  • Unwanted coagulation
    • Thrombosis = the formation of a clot of blood within a blood vessel
      • Thrombosis can create a thrombus
    • Thrombus = a clot of blood formed within a blood vessel and remaining attached to its place of origin
      • most likely to occur in leg veins of inactive people
      • the thrombus may break off causing an embolus
    • An embolus is an abnormal particle circulating in the blood
      • An embolus could travel from veins to lungs producing pulmonary embolism
      • death from hypoxia may occur
out damned clot
Out, Damned Clot!

After four days, a fibrin clot (red) is on its way out of a microvessel (green) in a mouse's brain.

Tiny blood vessels in the brains of mice have a novel way of dealing with clots — they pack them up and shove them out, right through the vessel wall. Does this happen in Humans?

necrosis
Necrosis
  • Necrosis = Tissue death
  • Infarct = an area of necrosis in a tissue or organ resulting from obstruction of the local circulation
  • Infarction is the process of forming an infarct
    • may occur if an embolus or thrombus blocks blood supply to an organ (MI or stroke)
    • 650,000 Americans die annually of thromboembolism
coagulation blood cotting blood has the ability to clot together this is good and bad depending
GOOD

Hemostatis- the process of stopping the bleeding process

BAD

Thrombosis- blood clotting in vessels forming BLOOD CLOTS

Embolism- a blood clot, or air bubble or fat, that blocks a vessel causing Ischemia

Hemorrhage- blood loss. Can be from drugs like Celebrex, anticoagulants, or vessel tear

COAGULATION(BLOOD COTTING)Blood has the ability to clot together. This is good and bad, depending.
anticoagulant drugs
Anticoagulant Drugs
  • Warfarin or Coumadin (rat poison) may be given to people who have a tendency to produce blood clots, like in atrial fibrillation
    • “Poisons and medicine are oftentimes the same substance given with different intents.”
          • -Peter Mere Latham, MD (1789-1875)
    • Their blood must be monitored for possible hemorrhage
    • These drugs are antagonists to vitamin K
  • Streptokinase- produced from streptococcal bacteria is a thrombolytic agent, it dissolves blood clots both good and bad. Used in stroke patients.
hemophilia
Hemophilia
  • Genetic lack of any clotting factor affecting the patient’s blood coagulation
  • Sex-linked recessive in males (inherit from mother)
  • Physical exertion causes bleeding & excruciating pain
hemostasis the control of bleeding
Hemostasis - The Control of Bleeding
  • Platelet plug is formed by pseudopods that adhere to the vessels and contract drawing the vessel together
  • Fibrin, a sticky protein, comes from the plasma to trap blood cells
formed elements of blood
Formed Elements of Blood
  • Never Let Monkeys Eat Bananas- quantities of WBCs
nutritional needs for erythropoiesis
Nutritional Needs for Erythropoiesis
  • B12 & folic acid (for rapid cell division) and vitamin C & copper synthesizing RBCs
  • Iron is key nutritional requirement for erythropoiesis
    • lost daily through urine, feces, and bleeding
    • low absorption rate requires consumption of 5-20 mg/day
      • Maintain supplement for six months to replace liver storage
    • dietary iron in 2 forms: ferric (Fe+3) & ferrous (Fe+2)
    • ferrous is the form of iron used by the body (For US two)
      • stomach acid converts Fe+3 to absorbable Fe+2
iron blood tests
Iron Blood Tests
  • Transferrin blood test determines how much iron is bound to the protein that carries iron in the blood (Trans-port)
  • Serum ferritin test shows the level of iron in the liver (FerritIN the liver)
cbc blood test
CBC Blood Test
  • Complete Blood Count (CBC) is a composite of blood tests that measures certain components of the blood.
  • RBCs, WBCs and platelets are counted
  • ______= the total blood volume of RBCs is measured
  • A “diff” (differential of WBCs) is included
  • Hemoglobin content is included- which measures the amount of the oxygen carrying protein found in the RBCs