Exercise 29

BLOODPhoto: http://www.cti.dtu.dk/~berco/pix/art/2000/red_blood_cells.jpg

• Two major components of blood, average Two major components of blood, average %%

• Plasma--composition, functional Plasma--composition, functional importanceimportance

• Formed elements—cell types, %, Formed elements—cell types, %, functionsfunctions

• Cellular composition of blood, sickle cell Cellular composition of blood, sickle cell anemia, leukemiaanemia, leukemia

• ABO, Rh blood groups—donors, recipientsABO, Rh blood groups—donors, recipients

• Hematology testsHematology tests

• Anemia, polycythemia, leukopenia, Anemia, polycythemia, leukopenia, leukocytosis, leukemialeukocytosis, leukemia

ObjectivesObjectives

•Connective tissue—fibers apparent only Connective tissue—fibers apparent only when clottingwhen clotting

•Two major components Two major components

–Plasma (nonliving fluid matrix)Plasma (nonliving fluid matrix)•55%55%

–Living cells (formed elements) Living cells (formed elements) •45%45%

What is Blood?What is Blood?

•Composition variesComposition varies

•>90% water>90% water

•Salts & Electrolytes (Na, K, Ca, Mg, Cl, Salts & Electrolytes (Na, K, Ca, Mg, Cl, HCOHCO33))

•Proteins (albumin, fibrinogen, globulin)Proteins (albumin, fibrinogen, globulin)

•Transported in the blood:Transported in the blood:–Nutrients (glucose, fatty acids, amino acids, Nutrients (glucose, fatty acids, amino acids, vitamins)vitamins)

–Metabolic waste (urea, uric acid)Metabolic waste (urea, uric acid)

–Respiratory gases (ORespiratory gases (O22, CO, CO22))

–HormonesHormones

What is Plasma?What is Plasma?

•Transport all of those componentsTransport all of those components

•Regulate pH & ion composition of Regulate pH & ion composition of fluidsfluids

•Clotting proteins—injuriesClotting proteins—injuries

•Antibodies (immunoglobulins)Antibodies (immunoglobulins)

•Stabilization of body temperature Stabilization of body temperature (absorbs heat from active muscles, (absorbs heat from active muscles, redistributes or releases through redistributes or releases through skin)skin)

Why is it important?Why is it important?

Fig. 19-1

•Living cellsLiving cells

•Three typesThree types–Erythrocytes (red blood cells—RBCs)Erythrocytes (red blood cells—RBCs)

–Leukocytes (white blood cells—WBCs)Leukocytes (white blood cells—WBCs)

–Platelets Platelets

What are formed elements?What are formed elements?

0.10.1%%

99.999.9%%

Fig. 19-1

Erythrocytes (red blood cells—Erythrocytes (red blood cells—RBCs)RBCs)

•99.9% of formed 99.9% of formed elementselements

•Anucleate when Anucleate when maturemature

•Contain Contain hemoglobin (Hb--red hemoglobin (Hb--red pigment)pigment)

•Transport OTransport O22 and and COCO22

Fig. 19-2Fig. 19-2

Leukocytes (white blood cells—Leukocytes (white blood cells—WBCs)WBCs)

•<0.01% of formed elements<0.01% of formed elements

•Have nuclei, no HbHave nuclei, no Hb

•Defense against pathogensDefense against pathogens

•Remove toxins, wastes, damaged Remove toxins, wastes, damaged cellscells

•Several typesSeveral types–Granulocytes, AgranulocytesGranulocytes, Agranulocytes

GranulocytesGranulocytesFig. 19-2Fig. 19-2

•NeutrophilsNeutrophils50-70% of WBCs50-70% of WBCsGranules are Granules are “neutral”—hard to “neutral”—hard to stainstainMultiple lobes in Multiple lobes in nucleusnucleus

Nonspecific defensesNonspecific defenses11stst on site of injury on site of injurySpecialize in Specialize in phagocytizing marked phagocytizing marked bacteria (antibodies, bacteria (antibodies, complement proteins)complement proteins)

GranulocytesGranulocytesFig. 19-2Fig. 19-2 •EosinophilsEosinophils

2-4% of WBCs2-4% of WBCsGranules stain dark Granules stain dark with “eosin”with “eosin”Bilobed nucleusBilobed nucleus

Nonspecific defensesNonspecific defensesAttack objects w/ABs, Attack objects w/ABs, parasites, allergensparasites, allergensAlso reduce Also reduce inflammation at injury inflammation at injury sitessites

GranulocytesGranulocytesFig. 19-2Fig. 19-2 •BasophilsBasophils

<1% of WBCs<1% of WBCsGranules stain Granules stain purple/bluepurple/blueSmaller cells (neut/eosin)Smaller cells (neut/eosin)

Nonspecific defensesNonspecific defensesContain histamine & Contain histamine & heparinheparinRelease of these Release of these increases inflammation increases inflammation Attracts more basophils Attracts more basophils (& eosinophils) to area(& eosinophils) to area

AgranulocytesAgranulocytesFig. 19-2Fig. 19-2 •MonocytesMonocytes

<2-8% of WBCs<2-8% of WBCs~2x size of RBC~2x size of RBCnucleus oval-kidney nucleus oval-kidney shapedshaped

Nonspecific defensesNonspecific defensesPhagocytosis--Phagocytosis--macrophages in tissuesmacrophages in tissuesRelease chemicals to Release chemicals to attract neutrophils, attract neutrophils, monocytes, other monocytes, other phagocytic cells, phagocytic cells, fibroblasts (scar tissue)fibroblasts (scar tissue)

AgranulocytesAgranulocytesFig. 19-2Fig. 19-2

•LymphocytesLymphocytes<20-30% of WBCs<20-30% of WBCsLarge, round nucleus Large, round nucleus

SPECIFICSPECIFIC defenses defensesImmune response—direct Immune response—direct cell attack or antibodiescell attack or antibodiesT CellsT CellsB CellsB CellsNK (Natural Killer) CellsNK (Natural Killer) Cells

PlateletsPlatelets

Fig. 19-2Fig. 19-2

•Irregularly shaped, Irregularly shaped, smallsmallcell fragments in cell fragments in mammalsmammals

ClottingClotting

Anemia = low hematocrit or low Anemia = low hematocrit or low Hb levelHb level

• Hematocrit = % cells in whole Hematocrit = % cells in whole blood (normal 42-46%)blood (normal 42-46%)– Centrifuge the blood tubeCentrifuge the blood tube– PCV “packed cell volume”PCV “packed cell volume”– ↓ ↓ if dehydrated, internal if dehydrated, internal

bleeding, RBC problems…bleeding, RBC problems…

• Polycythemia= elevated Polycythemia= elevated hematocrithematocrit– Many types, often treatable but Many types, often treatable but

not curablenot curable– Can be bone marrow cancerCan be bone marrow cancer

Sickle-Cell AnemiaSickle-Cell Anemia

• Specific type of anemiaSpecific type of anemia• Caused by single genetic (amino acid) Caused by single genetic (amino acid)

mutation of Hb molecule (chains) mutation of Hb molecule (chains) shapeshape

• Defective Hb gives up some bound Defective Hb gives up some bound oxygenoxygen

• Causes cell to become stiff and Causes cell to become stiff and curved—sickled curved—sickled

• Makes RBC fragile, can get stuck in Makes RBC fragile, can get stuck in capillariescapillariesblockageblockageno oxygenno oxygen

Fig. 19-4

Sickle-Cell AnemiaSickle-Cell Anemia

• Leukopenia = inadequate #s of WBCsLeukopenia = inadequate #s of WBCs– Can be measles, typhoid fever, cirrhosis, TBCan be measles, typhoid fever, cirrhosis, TB

• Leukocytosis = excessive #s of WBCsLeukocytosis = excessive #s of WBCs– Slight is normal during bacterial or viral Slight is normal during bacterial or viral

infectioninfection– Can be metabolic disease, hemorrhage, Can be metabolic disease, hemorrhage,

poisoningpoisoning– Extreme usually indicates LEUKEMIAExtreme usually indicates LEUKEMIA

• Malignant disorder of lymphoid tissuesMalignant disorder of lymphoid tissues• Many types, treatment helps, often fatalMany types, treatment helps, often fatal

APPLICATIONS MANUAL HAS DETAILS OF EACHAPPLICATIONS MANUAL HAS DETAILS OF EACH

BLOOD TYPINGBLOOD TYPING

• ABO Blood typesABO Blood types– surface antigens surface antigens (can trigger (can trigger

immune response)immune response) on RBCs on RBCs

Type A has “A” antigensType A has “A” antigens

Type B has “B” antigensType B has “B” antigens

Type AB has bothType AB has both

Type O has neither Type O has neither

BLOOD TYPINGBLOOD TYPING

• Rh FactorsRh Factors– Rh surface antigens Rh surface antigens (can trigger (can trigger

immune response)immune response) on RBCs on RBCs

Rh positive has the surface Rh positive has the surface antigens antigens

Rh negative does notRh negative does not

• Combine the two:Combine the two:AA++ or A or A-- B B++ or B or B--

ABAB++ or AB or AB- - OO++ or O or O--

Fig. 19-8

Donors and RecipientsDonors and Recipients

• Your antibodies will attack Your antibodies will attack other blood types other blood types (transfusions)(transfusions)

• You’re Type A—you have You’re Type A—you have Antibodies against Type B Antibodies against Type B “anti-B antibodies”“anti-B antibodies”

• Type O—anti-A and anti-B Type O—anti-A and anti-B

Donors and RecipientsDonors and Recipients

• Rh negative person will Rh negative person will onlyonly have anti-Rh antibodies if have anti-Rh antibodies if previously exposedpreviously exposed– Transfusion, pregnancyTransfusion, pregnancy

Donors and RecipientsDonors and Recipients

• Test for cross-Test for cross-reactivity to reactivity to “type” the “type” the bloodblood

• Clumps if the Clumps if the sample has sample has those those antigensantigens

Sample Anti-A Anti-B Anti-Rh

A+

B+

AB+

O-

Fig. 19-8

Donors and RecipientsDonors and Recipients• Universal DonorUniversal Donor

Type OType O• Universal RecipientUniversal Recipient

Type ABType AB

WEBSITE:WEBSITE:http://

nobelprize.org/medicine/educational/landsteiner/

Hematology TestsHematology Tests

• Total WBC countTotal WBC count– TOTAL # cells per unit volume of TOTAL # cells per unit volume of

bloodblood• Differential “DIFF” WBC countDifferential “DIFF” WBC count

– Count the first 100, categorize into Count the first 100, categorize into types, %types, %

• Total RBC countTotal RBC count– TOTAL # cells per unit volume of TOTAL # cells per unit volume of

bloodblood

Hematology TestsHematology Tests

• Hematocrit/PCV Hematocrit/PCV – (centrifuge, % cells)(centrifuge, % cells)

• Hemoglobin: can be anemic with Hemoglobin: can be anemic with normal Hctnormal Hct– RBCs carry oxygen in blood from RBCs carry oxygen in blood from

lungs to tissueslungs to tissues– Measures oxygen carrying-capacityMeasures oxygen carrying-capacity