Introduction to Blood, Erythrocytes and Anemia
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Transcript of Introduction to Blood, Erythrocytes and Anemia
Introduction to Blood, Erythrocytes and Anemia
Clinical PathologyMs. Canga
Introduction to Blood, RBCs, and Anemia
Topics for discussion:
• Function of blood and various components• Composition– Fluid– Cellular (Specific to erythrocytes)
• Anemia• Staining
The Function of Blood
• Classified as a _____________________ tissue– Fun Fact: Approximately ___% of animals body wt.
is blood.
• _________________________• _________________________• _________________________
Function: Transportation
• Carries _______, nutrients, etc…– To every living cell in the body.– Carried by _______ in erythrocytes– Nutrients, etc. are dissolved and delivered via
____________
• Carries waste products of cellular metabolism– Primary waste product is ___________– Carried to disposal organs that excrete from body• __________________&____________
Transportation continued• Transports _______________________– From ______________ glands to target _________
• Transports _______________________– From _______________________ in to circulation – Final destination is the _____________ as needed
• Transports _______________________– To site of ______________ within
_________________– Clump together to prevent further escape.
Function: Defense• Leukocytes (Will be covered in more detail later) – Defense from foreign invaders
• _______________________• _______________________
• Platelets (Will be covered in more detail later)– Work along side 13 clotting factors in the blood
• Are activated when a _______________________wall is damaged.
• Very complex process in which ALL factors must be activated in ____________ and __________________ in order for clot to form.
• Each factor depends on the _____________ factor to activate it.
Function: Regulation• Regulatory system– _______________________– _______________________– _______________________
Regulation• Acid-base balance– Regulation of blood ______.– Normal range is ________________(IDEAL = _____)• Higher pH = _______________________• Lower pH = _______________________
– Required for _______________________– Assists with neutralizing acidic waste products of
cellular metabolism.• Which blood is MORE alkaline? Arterial or venous?• Why?
Regulation continued• Body temperature– Regulators located in the _____________are influenced
by temperature of the blood that passes over them.• Most dogs and cats average 101.0 – 102.5oF
• Homeostasis– Body tissue fluid is maintained as __________________
as possible.– If fluid is lost in large amounts, fluid moves from
________________________ into tissues to compensate.• Leaves less plasma in bloodstream, causing
_______________________. – If fluids are given or excessive fluids are present, fluid
moves from ______________________ into bloodstream.• Excessive fluid in bloodstream causes
_______________________.
Composition of Blood• _______________________ tissue• Composed of ____________and __________– Cellular portion is composed of:• _____________– Responsible for gas exchange• _____________– Responsible for defense and immunity• _____________– Prevent leakage of blood from vessels
– Liquid portion of whole blood is called __________• Whole Blood: Blood in cardiovascular system, OR blood
that contains plasma and all other components.• Plasma is ~90% water.
“Recipe” for an RBC• __________• __________ (for the synthesis of heme-)– __________ is also important in release of iron from
tissues into plasma• ____________________ (formation of -globin)• Essential ______________ (phospholipid bilayer)• __________________: helps form RBC• __________________: also helps in RBC
formation• ____________________: works with B12 to help
form RBC.
Formation of RBCs• Formerly known as ‘__________’• Process of formation is called
_______________.– Erythropoiesis takes place in __________________
and is initiated by the cytokine called __________________ (EPO).
– EPO: produced by __________, is released when kidney cells detect __________in blood.
– EPO acts on __________ ______and causes it to begin undergoing __________divisions, developing into several RBC precursors.
Maturation Cycle of an Erythrocyte
Morphological Changes during Maturation
• Rubriblast:– Is very large, with royal blue __________. – Contains a large purple nucleus in a loose __________
pattern.• Prorubricyte:– Is slightly smaller, with a __________ cytoplasm. – The __________ composing the nucleus is slightly
smaller and __________ and stains __________.• Rubricyte:– Is smaller still, with either a __________or slightly
__________ cytoplasm as it begins to acquire the __________molecules.
Morphological Changes during Maturation
• Metarubricyte: – Cytoplasm is similar in color to __________ RBC. – Nucleus is now considered __________ (becoming more
dense) and stains dark blue. – (____________________ may be seen here)
• Reticulocyte: – __________is “pushed out” of cell leaving behind
____________________ composed of RNA. – Cytoplasm stains slightly blue, and
____________________ may be seen if stained with Wright’s stain. (Deff-Quick is a modified Wright’s stain)
– Mature RBC is seen after all ____________________ is lost from reticulocyte.
Morphological Changes During RBC Maturation
The End Result: Erythrocytes
Erythrocytes• Mature RBC is ____________________ sac.– Contains ~ _____ % water and _____ % solids
(mainly __________)
• Canines have __________RBCs; ~__________ in diameter– μ = a micron. One micron is one millionth of a
meter (VERY TINY)
• Cats, horses, cows, sheep and goats are smaller; ~__________ in diameter.
Erythrocytes - Morphology• Membrane is “____________________”• Can change shape, but is not __________.• _______________ shape provides more
____________________ to allow for gas exchange to take place.
• Disk shape allows for shorter __________ distance in and out of cell compared to a sphere.– Animals with __________ biconcave shape usually
have __________ number of RBCs on average.
Erythrocytes & Hemoglobin
• Carry __________ to all tissues of the body.• O2 carried through hemoglobin, which binds
to the oxygen.• __________ = pigment portion– produced in __________
• __________ = protein portion– Produced by __________
Hemoglobin - structure
• For every heme group, there is one __________ molecule
• Four __________ groups attach to each globin molecule.– This means that each hemoglobin molecule can
carry __________ molecules of oxygen.
Hemoglobin molecule
Hemoglobin Types
• __________ hemoglobin (HbE)• __________ hemoglobin (HbF)• __________ hemoglobin (Hb)• Each type of hemoglobin is found during
different stages of development in the animal.
Embryonic and Fetal hemoglobin
• Embryonic hemoglobin (HbE): is found in early developing __________.
• Fetal hemoglobin (HbF): is present in fetal blood during mid to late __________. – Is also present up to a couple of months after
birth. – Highest concentration of HbF is at __________.
Adult Hemoglobin (Hb)
• Found in the RBCs of all animals beginning a couple of weeks to months after birth.
• Gradually replaces __________ as primary type being produced by the body.
• Inside normal RBCs, Hb is ___________________.
Function of (Adult) Hemoglobin
• Transports __________to the tissues• Exists in two normal physiological states.• ____________________: Carrying oxygen– One oxygen molecule is associated with each iron
molecule.– pH, temperature, and O2 and CO2 levels influence
ability of Hb to carry O2
• ____________________: Has given up oxygen.– Also known as __________ hemoglobin.– CO2 is transported directly and indirectly in the RBC
and is dissolved in the __________.
RBC Life Span and Destruction
• Average in dogs is ~____ days• Average in cats is ~____ days• As an RBC ages, they are replaced by young,
but mature RBCs from __________ in constant ______________________ cycle.
• Process of aging is called ____________________.
Senescence• The process of cellular __________• Enzyme activity __________• Cell loses ____________________ and becomes
__________ as its volume decreases.• 90% of destruction of senescent RBCs occurs
through ____________________.– Takes place __________ the cardiovascular system
via macrophage ____________________.– Macrophages of __________ are especially active in
removal of senescent RBCs
Extravascular Hemolysis• Once inside a macrophage, the
__________________ of the RBC is destroyed.• Contents are recovered from the macrophages
and ________is transported back to red bone marrow.
• Heme is eliminated from the body by being converted to ____________. Bilirubin binds to ___________ (plasma protein) and is carried to the liver.
• Because it is not ____ soluble, it is called ________________________ or free bilirubin.
Extravascular Hemolysis, cont’d.
• Once in the liver, bilirubin is _________________ to ________________________, making the combination water soluble.
• Conjugated bilirubin is excreted as a ______ pigment into the intestines.
• Some conjugated bilirubin is converted into _____________________ by bacteria and eliminated in the ____________ as urobilin.
• Other conjugated bilirubin is converted into ______________________ and excreted in the __________ as stercobilin.
Senescence• ____% of RBC destruction takes place through
_________________________ hemolysis– Takes place within _____________________________.– Results in blood cell fragmentation and/or destruction
• When RBC membrane ruptures in blood vessel, _____ is released directly into the blood. – ____________________ Hb is picked up by transport
protein called __________.– __________carries unconjugated Hb to macrophages in
the __________ for breakdown. – Once in liver, ____________________hemolysis
continues.
Senescence• When ____________________is filled with
____________________ hemoglobin, the excess unconjugated Hb has nothing to bind to.
• Excess Hb is carried to __________ for excretion in urine.– _________________ ____hemolysis results in
plasma that is pink, red, or brownish.– C/S will be ____________________.– Urine will be pink, red, or brownish in color.
Anemia• Anemia: a pathological condition resulting in
decreased oxygen-carrying capacity of the blood.• May be caused by:– Low number of circulating mature RBCs• Increased __________ (RBC parasites/radiation therapy)• Decrease __________ (Bone marrow suppression)• Inappropriate __________ (hemorrhage)
– Not enough ____________________being produced for normal RBCs present. (Iron deficiency)• Appropriate # of RBCs are present• Insufficient Hb to fill each cell.
Classifying Anemia
• Anemia may be classified as either:
–Regenerative: Usually caused by hemorrhage or hemolysis.–Non-regenerative: Involves the bone marrow
(More on Anemia in next presentation)
Polycythemia
• An __________ above normal in the number of RBCs.
• Three common types:– _______________________________________– _______________________________________– _______________________________________
Relative Polycythemia
• Seen in ____________________• Common in __________ animals due to
sensible and insensible losses such as:– Excessive __________, __________,
__________or reduced __________intake.– You will learn more about sensible and insensible
losses in Special Topics.
Treatment of Relative Polycythemia
• Correction of cause of _____________________• Use of ____________________• Managing __________ intake is critical
Compensatory Polycythemia• Also known as __________ Polycythemia• Result of __________• Bone marrow is stimulated to produce more RBCs
because tissues aren’t getting enough oxygen.• Animals living in ____________________ often
develop this type of polycythemia.• Patient in heart failure may develop this type of
polycythemia because heart isn’t pumping enough blood to tissues, resulting in __________.
Treatment of Compensatory Polycythemia
• ____________________may be required if no inappropriate physiological cause
• If there is an underlying __________, surgical correction, followed by __________ treatment is required. (phlebotomy to normalize PCV may also be required)
Polycythemia Rubra Vera
• Rare ____________________ disorder• Characterized by increased _______________
of RBCs• EPO levels are __________. Bone marrow is
producing __________ stimulation from EPO.
Treatment of Polycythemia Rubra Vera
• __________is required– ~__________mLs/kg
• Simultaneous __________therapy to maintain overall blood __________.
• Treatment with Rx: Hydroxyurea will help to suppress the production of RBCs.
Staining of Blood• Different __________ within cell stain specific
colors.• Many different hematology stains – Different names but similar staining characteristics.– Many are _________________-_________stains
(Wright’s stain, Giemsa, Leishman’s, Wright-Giemsa, and May-Grunwald are all Romanovsky-type stains)• Also called ____________________ stains because they
stain more than one color.• Combination of basic blue and acidic red dyes dissolved
in __________alcohol.• Allows ____________________ structures to stain blue• Allows ____________________ structures to stain red.
Staining Blood• Stain depends on ________ you are performing.– Each test we do in here will have specific stain
instructions.
• ____________________stain is the most widely used hematology stain. – Alkaline part is ____________________ blue– Acidic part is __________
• Modified Wright’s stains offer faster staining times but don’t stain some cellular structures as effectively.– ____________________ is a Modified Wright’s stain.
Sources• http://compepid.tuskegee.edu/syllabi/pathobio
logy/pathology/clinpath/chapter2.html• Clinical Anatomy and Physiology for Veterinary
Technicians: Colville and Bassert. Second Edition• Merckvetmanuals.com