Chapter 015

The Human Body in Health and Illness, 4th edition

Barbara Herlihy

Chapter 15:Blood

Lesson 15-1 Objectives

• Describe the three functions of blood.• Describe the composition of blood.• Describe the three types of blood cells:

erythrocytes, leukocytes, and thrombocytes.• Explain the formation of blood cells.• Explain the breakdown of red blood cells and

the formation of bilirubin.

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Three General Functions of Blood

• Transportation– Oxygen, nutrients, waste

• Regulation– Temperature, acid-base, fluid-electrolyte balance

• Protection– Against infection and bleeding

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Hematocrit• Plasma

– 55% of total– Clear yellowish liquid

• Formed elements – 45% of total – Erythrocytes (RBCs)– Leukocytes (WBCs)– Thrombocytes

Other Characteristics of Blood

• Whole blood– Viscosity (three to five times thicker than H2O)

– pH (7.35 to 7.45)

• Plasma– Water, electrolytes, ions, and waste– Plasma proteins: Albumin, clotting factors, gamma

globulins– Serum: Plasma minus clotting factors

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Hemopoiesis

• Process of blood cell production

• Two locations of hemopoiesis– Myeloid hemopoiesis in red

bone marrow– Lymphoid hemopoiesis in

lymphoid tissue

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Hemopoiesis (cont’d.)

• Origin: Stem cell• Three paths

– Erythropoiesis– Leukopoiesis– Thrombopoiesis

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Bone Marrow Depression

• Occurs if bone marrow cannot produce enough blood cells.– Also called myelosuppression

• Results– Aplastic anemia: RBC deficiency– Leukopenia: WBC deficiency– Thrombocytopenia: Platelet deficiency– Pancytopenia: Depression of all blood cells

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Overactive Bone Marrow

• Overactive bone marrow leads to excess RBC production.– Called polycythemia (vera or secondary)

• Polycythemia vera– Burdens the heart– Overwhelms clotting system– Causes beet-red face and palms

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Red Blood Cells: Oxygen Carriers

• Large, disc-shaped• Bendable• Contain

hemoglobin• Globin shapes RBC• Heme carries iron• Iron carries O2

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Why Blood Changes Its Color

• Oxyhemoglobin– O2 binds loosely with iron (Fe)

– Makes blood bright red– Lack of O2 makes blood bluish red

• Carbaminohemoglobin– CO2 binds with globin

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Conditions for Healthy RBCs

• Correct genetic code for hemoglobin• Healthy bone marrow• Iron• Vitamin B12 and intrinsic factor

• Folic acid• Healthy kidneys and erythropoietin• Absence of bleeding and hemolysis

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Shape of Red Blood Cells

• Large disc, thick rim• RBC bends, fits

through tiny vessels to deliver O2

• Sickle cell anemia: RBC does not bend, blocks vessel, fails to deliver O2

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Regulating RBC Production• Low O2 level in blood

• Kidney secretes erythropoietin (EPO)

• EPO stimulates bone marrow to produce RBCs

• RBCs increase, thus increasing O2

Dismantling a Red Blood Cell

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Jaundice

Hemolytic JaundiceRapid breakdown of RBCs

Hyperbilirubinemia

Yellow stained tissue

Obstructive JaundiceNormal rate of RBC

breakdown but diminished excretion of

bilirubin in bile

Yellow, stained tissue

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Anemia: Insufficient RBCs

• RBC production falters if conditions are disordered or necessary substances are missing.

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White Blood Cells (WBCs)• Protect the body against

infection and inflammation • Phagocytes

– Neutrophils – Monocytes

• Can leave the blood vessels– To site of infection or

Classification of WBCsTypes Major Functions

GranulocytesNeutrophilsEosinophilsBasophils

AgranulocytesLymphocytesMonocytes

PhagocytosisResponse to parasitic infection; allergiesRelease of heparin

ImmunityPhagocytosis

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Remembering Types of WBCs

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Platelets or Thrombocytes

• Tiny structures– Fragments of megakaryocytes– Produced in red bone marrow

• Life span of 5 to 9 days• Function to prevent blood loss

– Key role in hemostasis

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Lesson 15-2 Objectives

• Identify the steps of hemostasis.• Describe the four blood types.• Describe the Rh factor.

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Hemostasis: Stopping Bleeding

• Vascular spasm• Platelet plug• Coagulation

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Formation of a Blood Clot1. Injury produces

PTA. 2. PTA activates

prothrombin to form thrombin.

3. Thrombin activates fibrinogen to form fibrin fibers (clot).

4. Clot retraction

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Fibrinolysis: Clot Breakdown

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Drugs that Affect Clotting

• Antiplatelet drugs– Aspirin, NSAIDs, clopidogrel

• Anticoagulants– Heparin (antithrombin)– Coumadin (prevents formation of prothrombin)

• Fibrinolytic or “clot buster” drugs– Tissue plasminogen activator (TPA)

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Four Types of Blood• Type A

A antigen on RBC Anti-B antibodies in plasma

• Type B B antigen on RBC Anti-A antibodies in plasma

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Four Types of Blood (cont’d.)

• Type AB Both A and B antigens on RBC Neither anti-A nor anti-B antibodies in plasma

• Type O Neither A nor B antigen on RBC Both anti-A and anti-B antibodies in plasma

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Agglutination: Clumping of RBCs

• Blood clumps in response to interactions between antigens and antibodies.

• Example of a mismatched transfusion– Type A recipient has A antigens on RBC and anti-B

antibodies in plasma Type B donor has B antigen on RBC Result: Anti-B antibodies of recipient attack Bantigen of donor’s blood, causing agglutination and hemolysis.

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Type O: “Universal” Blood Donor

• Type O blood has no antigens on RBCs.• Anti-A and anti-B antibodies of all other blood

types have no antigen to attack.• So, type O blood can be safely donated to all

recipients.

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Type AB: “Universal” Recipient

• Type AB has neither anti-A nor anti-B antibodies in the plasma.

• Type AB has no antibodies to attack antigens in any blood type—A, B, AB, or O.

• So, type AB can safely receive blood of any type.

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Rh Factor: An Additional Antigen • People with Rh factor are Rh

positive (+). Types A(+), B(+), AB(+), and O(+)

• Those without Rh factor are Rh() Types A(), B(), AB(), and O()

• Rh() persons initially have no anti-Rh antibodies in their blood, but develop them after exposure to the Rh factor.

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Rh Factor: Two Considerations

• Blood transfusions Rh() blood can be donated to Rh(+) recipients Rh(+) blood cannot be donated to Rh() recipients

o The true universal donor is O().o The true universal recipient is AB(+).

• Rh incompatibility during pregnancy causes erythroblastosis fetalis.

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Rh Incompatibility in Pregnancy

• Condition: Mother is Rh() and baby is Rh(+).• In late pregnancy, Rh(+) blood moves from

baby to mother.• Mother develops anti-Rh antibodies.• Mother’s anti-Rh antibodies move into baby,

causing agglutination and hemolysis.

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Erythroblastosis Fetalis

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