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BLOOD-LIQUID CONNECTIVE TISSUECELLS EXTRACELLULAR MATRIX(suspended) (45%) PLASMA (55%)Physical properties of blood1.Colour: opaque fluid, red in colour2.Volume: 5-6 ltrs in adult M, 4-5 ltrs in F3.pH: slightly alkaline, ph 7.44.Specific Gravity:1.052 to 1.0625.Viscosity: 5 times more viscous than water6.Temperature: 38 o C / 102.4 o F

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PLASMA

WATER 91-92% SOLUTES 8-9%

PROTEINS OTHER SOLUTESAlbumin ElectrolytesGlobulin NutrientsFibrinogen Gases Enzymes Hormones Waste products

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CELLS

RED BLOOD WHITE BLOOD PLATELETS

CELLS CELLS/Leukocytes Thrombocytes

Erythrocytes

GRANULOCYTES AGRANULOCYTES

1.Neutrophils 1. Monocytes

2.Eosinophils 2. Lymphocytes

3.Basophils

SERUM= PLASMA-FIBRINOGEN

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BLOOD PLASMA• Yellow coloured liquid contains dissolved

substancesWATER:• Liquid portion of blood• Act as solvent & suspending medium for

components of bloodPLASMA PROTEINS:1. ALBUMINS: smallest & most numerous(54%) Transport proteins for steroid hoemones &

fatty acids

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2.GLOBULINS(38%): defense mechanism, transport iron, lipids & fat soluble vitamins

3.FIBRINOGEN (8%):Essential clotting of blood

OTHER SOLUTES:1.ELECTROLYTES: cations- Na+, K+, Ca++, Mg++ anions- Cl-, HPO4--, SO4--, HCO3-2.NUTRIENTS: glucose, amino acids, fatty acids, vitamins,

minerals3.GASES: Oxygen, Carbon dioxide4.ENZYMES: amylase, carbonic unhydrase, alkaline

phophatase, acid phophatase, lipase, esterase, protease, transminase

5.HORMONES: all produced by endocrine glands6.WASTE PRODUCTS: urea, uric acid, creatine, creatinine,

ammonia, bilirubin

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RED BLOOD CELLS• Normal value: adult male:5-5.5 million/µL adult female: 4.5-5 million/µL• Anatomy: Biconcave disc -diameter:7-8µ, thickness:2.2µ, surface area:120µ -Nucleus & other cell organelles absent-280 million Hemoglobin molecules/RBC• Functions:-Transport O2 from lungs to tissues

-Transport CO2 from tissues to lungs-Act as buffer by action of hemoglobin-Help in determination of blood groups

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ERYTHROPOIESIS• Process by which the origin, development &

maturation of erythrocytes occur• Site of erythrpoeisis: ends (RBM) of long bones &

membranous bones. During disorder of bones-spleen• The process of development of red blood cells from

pluripotent stem cells takes about 7 days • Pluripotent stem cells Proerythroblast Early

Normoblast Intermediate Normoblast Late Normoblast Reticulocyte Erythyrocyte

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1. PROERYTHROBLAST (Megaloblast)• First cell derived from Stem Cell• Size of cell is large:Dia-20-25µ• Nucleus is large, occupies the cell• Does not contain hemoglobin• It multiplies several times and forms next

stage2. EARLY NORMOBLAST• Slightly smaller , diameter of about 15µ• Nucleoli disappear• Condensation of chromatin network

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3.INTERMEDIATE NORMOBLAST:• Small than previous cell, dia of about 10-12µ• Nucleus still present• Further condensation of chromatin• Hemoglobin starts appearing4.LATE NORMOBLAST:• Further reduction in cell size, dia 8-10 µ• Ink spot nucleus• Increase hemoglobin quantity• Disintegration of nucleus & disappears

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5.RETICULOCYTE:• Slightly larger than matured RBC• Cytoplasm contains reticulum formed by

remnants of disintegrated organelles• Below 1% of RBC• Cells enter capillaries

6.MATURED ERYTHROCYTE:• Reticulum starts disappearing• Biconcave & smaller in size-7.2µ• With hemoglobin & without nucleus

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WHITE BLOOD CELLS/LEUKOCYTES• Normal value:4000-11000/mm3

• WBCs have nucleus and of various sizes• Account for about 1% of the blood volume WHITE BLOOD CELLS/LEUKOCYTES GRANULOCYTES AGRANULOCYTES 1.Neutrophils 1. Monocytes 2.Eosinophils 2. Lymphocytes 3.Basophils

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GRANULOCYTES• Neutrophils: 10-12µ diameter, nucleus has 2-

5 lobes connected by thin strands of chromatin, cytoplasm has very fine violet granules

• Function-Phagocytosis: destruction of bacteria

• Eosinophils:10-12µ diameter, nucleus has 2 lobes, large red-orange granules, almost cover nucleus

• Function-phagocytize antigen-antibody complex, parasitic invasion; overcomes effects of histamine involved in inflammation during allergic reactions

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•Basophils:8-10µ in diameter, nucleus has 2 lobes, deep blue granules• Function-liberate heparin, histamine &

sertotonin at inflammation site in allergic reactions, that intensify overall inflammatory response

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AGRANULOCYTES

• Lymphocytes: Small 6-9µ in diameter, large 10-14µ in diameter, nucleus is round or slightly indented, cytoplasm forms a rim around the nucleus, sky blue colour. Larger the cell, more cytoplasm is visible

• Function: These develop into plasma cells which secret antibodies

• Monocytes:12-20µ diameter, nucleus is kidney shaped, cytoplasm is blue-grey

• Function: Phagocytosis

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SIGNIFICANCE OF LEUKOCYTE COUNTTYPE OF

WBC

NORMAL RANGE (%)

HIGH COUNTINDICATIONS

LOW COUNTINDICATIONS

Neutrophil 50 - 70 Bacterial infection, Burns, Stress, Inflammation

Radiation exposure, Drug toxicity, Vit B12 deficiency, SLE

Eosinophil 1 - 6 Allergic reactions, Parasitic infections, Autoimmune disease

Drug toxicity, Stress

Basophil Less than 1 Allergic reactions, Leukemia, Hypothyroidism

Pregnancy, Stress, Hyperthyroidism

Monocytes 2 - 10 Viral, Fungal infections, TB, Chronic diseases

Bone marrow suppression, treatment with cortisol

Lymphocytes 20 - 30 Viral infections, Leukemia

Prolonged illness, immunosuppression

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PLATELETS/THROMBOCYTES• Normal Value:1.5-4.0 lacks/µL. • Disc shaped, 2-4µ in diameter, has many

vesicles but no nucleus• Function: help stop blood loss from damaged

vessels by forming platelet plug. Platelet release chemicals that provide vascular spasm and blood clotting.

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Functions of Blood• TransportationBlood transports oxygen from lungs to

cells of body and co2 from body cells to lungs

Carries nutrients from GIT to body cellsTransport enzymes and hormones to

other body cellsTransports waste products to various

organs for elimination from body

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Regulation•Blood helps regulate pH through use of buffers•Helps adjust body temperature through heat absorbing and cooling properties of water in plasma•Blood regulates water balance between intracellular & extra-cellular fluid

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Protection•Blood protects excessive loss of blood by formation of clot after injury•WBC protect against disease by carrying phagocytosis•Several types of blood proteins, interferons help protect against disease various ways

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BLOOD GROUPS• The surfaces of erythrocytes contain a

genetically determined collections of antigens. These are composed of glycoproteins & glycolipids.

• Based on the presence or absence of various antigens, blood is categorized into different blood groups.

• Within a blood group there may be two or more different blood types.

• Two blood group systems:-ABO and Rh

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ABO Blood Group System

Blood Type

Type A Type B Type AB (universal recipient)

Type O (universal donor)

Antigen on surface of RBC

A- antigen

B-antigen Both A & B- antigen

Neither A nor B- antigen

Antibody in Plasma

Anti-B antibody

Anti-A antibody

Neither antibody

Both anti-A, anti-B

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Rh Blood Group

• Antigen Rh was discovered in the

blood of Rhesus

Monkey

Blood Type

Rh + (positive)

Rh – (negative)

Antigen Rh antigen

No Rh antigen

Antibody No antibody

No antibody

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BLOOD CLOTTING

• Clotting or process of gel formation is a series of chemical reaction that ends in formation of fibrin threads.

• Clotting factors: Calcium ions, several inactive enzymes and various molecules associated with platelets or released by damaged tissues

• Clotting is a complex cascade of enzymatic reactions in which each clotting factor activates next factor in a fixed sequence. Finally, large quantity of product (Fibrin) is formed.

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Clotting- 3 Stages

1. Formation of Prothrombinase, either by extrinsic pathway or intrinsic pathway

Next 2 stages are same-Common pathway

2. Conversion of Prothrombin into Thrombin

3. Conversion of soluble fibrinogen into insoluble fibrin

Fibrin + Cells Clot

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Extrinsic Pathway

• Surface of damaged cells release a tissue protein called Tissue Factor (TF) i.e. Thromboplastin in blood (outside the blood)

• In the presence of Ca++, TF begins a sequence of reactions that activates clotting factor X. This factor combines with factor V in presence of Ca++ forms active enzyme Prothrombinase

Intrinsic Pathway• Damaged blood vessels activates clotting factor XII, which

begins a sequence of reactions that activates factor X• Factor X combines with factor V and forms enzyme

Prothrombinase

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Common Pathway

• Prothrombinase and Ca++ catalyze conversion of prothrombin into thrombin• In last stage, thrombin in presence of Ca+

+, converts soluble fibrinogen into loose fibrin threads, fibrin• Thrombin also activates factor XIII which

strengthens and stabilizes fibrin threads into clot.

Blood Transfusion

• Indications:• Transfusion of whole blood from one

individual to another is indicated for two main reasons: firstly, when the volume of blood within the circulation system of the patient is less than that required to sustain life and, secondly, when the red blood cells are deficient either in quantity or quality.

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Indications• Anaemia• Major Surgical Operation• Accidents resulting in considerable blood loss• Cancer patients requiring therapy• Women in childbirth and newborn babies in

certain cases• Patients of hereditary disorders like

Haemophilia and Thalassaemia• Severe burn victims

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BLOOD DISORDERS• Anemia-a condition in which oxygen carrying

capacity of blood is reduced• Classification of Anemia

1. Impaired erythrocyte production– Iron deficiency– Megaloblastic – Hypoplastic

2. Increased erythrocyte loss– Hemolytic anemia– Normocytic anemia

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• Polycythemia-abnormally large number of erythrocytes in the blood

• Leukopenia- In this condition, total blood leukocyte count is less than 4000/mm3

• Granulocytopenia-abnormal reduction in numbers of circulating granulocytes

• Leukocytosis-In this condition, total blood leukocyte count more than 11000/mm3

• Leukemia-Uncontrolled increase in production of leukocytes/ or their precursors

• Thrombocytopenia-In this condition blood platelet count is below 150000/mm3