BIOS222 Pathology and Clinical Science 2 · PDF fileo Revise and review anatomy and physiology...

BIOS222

Pathology and Clinical Science 2

www.endeavour.edu.au

Session 3

Lymphatic and

Haematological Disorders 1

Bioscience Department

© Endeavour College of Natural Health www.endeavour.edu.au 2

Session Learning Outcomes

At the end of this session, you should be able to

o Revise and review anatomy and physiology of blood and lymphatic system

o Identify and define the conditions affecting various blood cells.

o Suggest appropriate assessment and interpretations for haematological disorders.

o Define and describe causes for increase or decrease in RBC, WBC and Platelets.

o Describe causes of lymphadenopathy and splenomegaly.


Session Plan

o Anatomy and physiology of blood and lymphatic system• Composition and function of blood and blood cells

• Components of lymphatic system

• Lymph formation and function

o Examination and investigation of haematological system

o Presenting problems in haematological disease• Anaemia and high haemoglobin

• Leucopenia and Leucocytosis

• Thrombocytopenia and thrombocytosis

• Venous thrombosis

• Pancytopenia and Bleeding


Anatomy and Physiology of Blood

and Lymphatic System


Composition of Blood

o Blood is a liquid connective tissue composed of extra

cellular matrix called blood plasma that dissolves and

suspends various cells and cell fragments.

Tortora, GJ & Derrickson, B 2014, Principles of anatomy and physiology,

14th edn, John Wiley & Sons, Hoboken, NJ


Function of Blood

o Transport:

• oxygen, carbon dioxide, other wastes

o Regulation:

• pH, Temperature, Body fluid

o Protection:

• Blood loss and infection


Formation of Blood cells

Tortora, GJ & Derrickson, B 2014, Principles of anatomy and physiology, 14th edn,

John Wiley & Sons, Hoboken, NJ


Blood Cells - RBCs




Destruction and Recycling of RBC




Blood Cells - WBCs




Blood Cells - Platelets

Blood Clot with Platelets and Fibrin

threads from www.sciencephoto.comTortora, GJ & Derrickson, B 2014, Principles of anatomy and physiology, 14th edn,




http://www.sciencephoto.com/


Lymphatic System

o The lymphatic

system consists of:

• Lymph

• Lymphatic

vessels

• Lymphatic tissues

and organs

• Red bone marrow


Flow of Lymph


Lymph Node

o Located along

lymphatic vessels

o About 600 bean-

shaped structure

o Superficial and deep

o Usually occur in

groups

o Function as a filter


Lymphatic Tissues and Organs

o Spleen

o Thymus

o Lymphatic nodules:

• Tonsils

• Peyer’s patches

• MALT (mucosa-

associated lymphoid

tissue)


Examination and Investigation of

Haematological system


Investigation of Haematological

Systemo Full blood count

• Haemoglobin

• RBC count and Blood indices (MCH,MCV,MCHC,PCV)

• Total WBC count (TC)

• Differential count of WBC (DC)

• Platelet count

o ESR

o Blood film examination

o Bone marrow examination

o Screening tests for bleeding disorders

o Investigation of possible thrombophilia


Screening tests: Bleeding

Disorders

Walker, BR, Colledge, NR, Ralston, SH, & Penman, ID (eds) 2014, Davidson’s principles and

practice of medicine, 22nd edn, Churchill Livingstone Elsevier, Edinburgh.


Investigation of Possible

Thrombophilia




Presenting Problems in

Haematological Disease


Presenting problems in

haematological diseaseo Anaemia: Low haemoglobin level in the blood





Haematological Diseaseo Erythrocytosis: Persistently raised PCV






o Leucopenia: A reduction in the total numbers of

circulating white blood cells.

• Neutropenia (low neutrophil counts)

• Lymphopenia (low lymphocyte counts)

o Leucocytosis: An increase in the total numbers

of circulating white blood cells

• Neutrophilia (high neutrophil counts)

• Lymphocytosis (high lymphocyte counts)




o Thrombocytopenia (Low Platelets)

• Causes of thrombocytopenia

–Decreased production due to Marrow

disorders

– Increased consumption of platelets

o Thrombocytosis (High Platelets)

• Causes of raised platelet count

Reactive thrombocytosis

Malignant thrombocytosis




o Pancytopenia: refers to the combination of

anaemia, leucopenia and thrombocytopenia.





Haematological Diseaseo Infection: occurs as a complication of

haematological disorders.

• Due to immunological deficit caused by the

disease or its treatment with chemotherapy

and/or immunotherapy.

o Bleeding:

• Abnormal vessels rupture

• Defect in haemostasis:– Deficiency or dysfunction of platelets or coagulation factors,

– Excessive fibrinolysis



Haematological Diseaseo Venous thrombosis:

• Predisposing haematological disorders

–Polycythaemia rubra vera

–Essential thrombocythaemia

–Deficiency of anticoagulants

–Paroxysmal nocturnal haemoglobinuria

–Prothrombotic mutations

–Myelofibrosis




o Lymphadenopathy: Enlarged lymph glands





Haematological Diseaseo Splenomegaly: Enlargement of spleen.

• Causes of splenomegaly:

–Haematological diseases

–Other causes:

Congestive diseases

Infective diseases

Inflammatory / granulomatous disorders

Other malignancy

Storage disease

Miscellaneous


Reading and Resourceso Crowley LV, 2012, An Introduction to Human Diseases – Pathology and

Pathophysiology Correlations, 9th edn, Jones and Bartlett Learning

o Grossman SC & Porth CM 2014, Porth’s Pathophysiology- Concepts of

Altered Health States, 9th edn. Wolters Kluwer Health - Lippincott, Williams

& Wilkins

o Hinson, J, Raven, P & Chew, S 2010, The endocrine system: basic science

and clinical conditions, 2nd edn, Churchill Livingstone Elsevier, Edinburgh

o Jamison, JR 2006, Differential diagnosis for primary care: a handbook for

health care practitioners, 2nd edn, Churchill Livingstone Elsevier,

Edinburgh.

o Jarvis, C, 2012 Physical Examination & Health Assessment, 6th ed.,

Elsevier Saunders, Philadelphia.

o Kumar, P & Clark, M 2012, Kumar and Clark’s clinical medicine, 8th edn,

Saunders Elsevier, Edinburgh.

o Kumar, V, Abbas, AK & Aster, JC 2015, Robbins & Cotran pathologic basis

of disease, 9th edn, Elsevier Saunders, Philadelphia.


Reading and Resourceso Lee, G & Bishop, P 2009, Microbiology and infection control for health

professionals, 4th edn, Pearson Education, Frenchs Forest, NSW.

o McCance, KL, Heuther, SE, & Brashers, VL 2014, Pathophysiology: the

biologic basis for disease in adults and children, 7th edn, Elsevier.

o Michael-Titus, A, Revest, P & Shortland, P 2010, The nervous system: basic

science and clinical conditions, 2nd edn, Churchill Livingstone Elsevier,

Edinburgh

o Mosby’s dictionary of medicine, nursing and health professions 2013, 9th

edn, Elsevier, St. Louis, MO.

o Tortora, GJ & Derrickson, B 2014, Principles of anatomy and physiology,

14th edn, John Wiley & Sons, Hoboken, NJ.

o VanMeter, KC & Hubert, RJ 2014, Gould's pathophysiology for the health

professions, 5th edn, Elsevier, St Louis, MO.

o Walker, BR, Colledge, NR, Ralston, SH, & Penman, ID (eds) 2014,

Davidson’s principles and practice of medicine, 22nd edn, Churchill

Livingstone Elsevier, Edinburgh.


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