BloodBlood

Made of Made of – Plasma 55%– liquid part of blood (water, Plasma 55%– liquid part of blood (water,

proteins)proteins)– Formed elements 45%– rbc’s, wbc’s, Formed elements 45%– rbc’s, wbc’s,

plateletsplatelets– Buffy coat – wbc and plateletsBuffy coat – wbc and platelets

Average person 4-6LAverage person 4-6L 7.4 pH, acidosis if falls below 7.357.4 pH, acidosis if falls below 7.35

Blood typesBlood types

Antigen – substance that stimulates Antigen – substance that stimulates the body to make antibodies, almost the body to make antibodies, almost always foreign substances that always foreign substances that entered from outside the bodyentered from outside the body

Antibody – made by the body to help Antibody – made by the body to help agglutinate (clump) the antigensagglutinate (clump) the antigens

Blood typesBlood types

AA, AO, BB, BO, AB, OOAA, AO, BB, BO, AB, OO ““A” blood type means that it contains A” blood type means that it contains

a certain antigen on plasma a certain antigen on plasma membrane of rbc, present from birth, membrane of rbc, present from birth, therefore body does not build therefore body does not build antibodies against them.antibodies against them.

Antibodies for B are present in plasma Antibodies for B are present in plasma and there from birth, unknown whyand there from birth, unknown why

Rh SystemRh System

Rh positive – rbc contains antigen for Rh Rh positive – rbc contains antigen for Rh factorfactor

Rh negative – no antigen on rbcRh negative – no antigen on rbc Erythroblastosis fetalisErythroblastosis fetalis – Rh – mom – Rh – mom

and Rh+ dad, baby is Rh+, can and Rh+ dad, baby is Rh+, can introduce anti Rh antigens into moms introduce anti Rh antigens into moms body, causing concern in next body, causing concern in next pregnancypregnancy

RhoGAMRhoGAM – protein that prevents mom’s – protein that prevents mom’s body from producing anti Rh antibodiesbody from producing anti Rh antibodies

Blood PlasmaBlood Plasma

Salts, foods, oxygen, carbon dioxide Salts, foods, oxygen, carbon dioxide and plasma proteinsand plasma proteins

Plasma proteins – Plasma proteins – – Albumins – thicken bloodAlbumins – thicken blood– Globulins – includes antibodies that Globulins – includes antibodies that

protect from infectionsprotect from infections– fibrinogen and prothrombin – clottingfibrinogen and prothrombin – clotting

Serum – plasma minus the clotting Serum – plasma minus the clotting factorsfactors

Formed elements Formed elements

Erythrocytes – rbc, 5 million in 1 drop of Erythrocytes – rbc, 5 million in 1 drop of bloodblood

Leukocytes – wbc, 7500Leukocytes – wbc, 7500– GranularGranular

NeutrophilsNeutrophils EosinophilsEosinophils BasophilsBasophils

– Non-granularNon-granular LymphocytesLymphocytes monocytesmonocytes

Thrombocytes - Platelets – 300,000Thrombocytes - Platelets – 300,000

Hematopoiesis - Blood Hematopoiesis - Blood formationformation

Myeloid tissue – Red bone marrowMyeloid tissue – Red bone marrow– Sternum, ribs, hip bonesSternum, ribs, hip bones

lymphatic tissue – forms most lymphatic tissue – forms most lymphocytes and monocyteslymphocytes and monocytes– Found in lymph nodes, thymus and Found in lymph nodes, thymus and

spleenspleen Hemoglobin – red pigment, carries Hemoglobin – red pigment, carries

oxygenoxygen

Blood testsBlood tests

CBC – complete blood cell count, CBC – complete blood cell count, values of each type of cell count, values of each type of cell count, rangesranges

Hematocrit – information on the Hematocrit – information on the volume of rbc’s in a blood sample volume of rbc’s in a blood sample using a centrifugeusing a centrifuge

Red Blood cell disordersRed Blood cell disorders

PolycythemiaPolycythemia – overproduction of – overproduction of RBC’sRBC’s– Increase viscosityIncrease viscosity– Slows blood flowSlows blood flow– Can lead to hypertension, coagulation Can lead to hypertension, coagulation

problems, hemorrhages….problems, hemorrhages….– Treatment – blood removal, irradiation of Treatment – blood removal, irradiation of

bone marrow, chemotherapy treatment bone marrow, chemotherapy treatment to suppress production of RBC’sto suppress production of RBC’s

AnemiaAnemia low oxygen carrying capacity of blood (low #’s of low oxygen carrying capacity of blood (low #’s of

RBC’s or problems with hemoglobin)RBC’s or problems with hemoglobin)– HemorrhagicHemorrhagic – due to hemorrhage or bleeding, – due to hemorrhage or bleeding,

acute or chronicacute or chronic– AplasticAplastic – destruction of bone marrow, – destruction of bone marrow,

exposure to toxinsexposure to toxins– PerniciousPernicious – vit. B deficiency, or intrinsic factor – vit. B deficiency, or intrinsic factor

(allows vit B to be absorbed)(allows vit B to be absorbed)– Iron deficiencyIron deficiency – iron is required to make – iron is required to make

hemoglobinhemoglobin– HemolyticHemolytic – decreased RBC life span due to – decreased RBC life span due to

increase rate of destruction, sickle cell anemia, increase rate of destruction, sickle cell anemia, ThalassemiaThalassemia

White Blood Cells - White Blood Cells - LeukocytesLeukocytes

GranularGranular– NeutrophilsNeutrophils – phagocytes – phagocytes– EosinophilsEosinophils – protection against parasite – protection against parasite

infections, allergic reactionsinfections, allergic reactions– BasophilsBasophils – react in inflammatory reactions – react in inflammatory reactions

AgranularAgranular– LymphocytesLymphocytes – protection, immune – protection, immune

mechanism, B (antibodies) and T (attack mechanism, B (antibodies) and T (attack bacteria)bacteria)

– MonocytesMonocytes – largest, phagocytes – largest, phagocytes

White Blood Cell disordersWhite Blood Cell disorders

Multiple myeloma – cancer of B Multiple myeloma – cancer of B lymphocyteslymphocytes

Leukemia – blood cancers affecting the Leukemia – blood cancers affecting the WBCs, elevated WBC levels, WBCs, elevated WBC levels, – Chronic lymphocytic leukemia (CLL), adultChronic lymphocytic leukemia (CLL), adult– Acute lymphocytic leukemia (ALL), childrenAcute lymphocytic leukemia (ALL), children– Chronic myeloid leukemia (CML), adultsChronic myeloid leukemia (CML), adults– Acute myeloid leukemia (AML)Acute myeloid leukemia (AML)

Infectious Mononucleosis – young Infectious Mononucleosis – young adults, viral, kissing diseaseadults, viral, kissing disease

Platelets and blood clottingPlatelets and blood clotting

Blood clot Blood clot injury to vessel injury to vessel clotting factor released clotting factor released form form prothrombin activator prothrombin activator – Platelets become sticky at point of injury Platelets become sticky at point of injury

and form a platelet plug.and form a platelet plug.– Platelets release clotting factorsPlatelets release clotting factors– ProthrombinProthrombin is converted to is converted to thrombinthrombin– ThrombinThrombin reacts with fibrogen to reacts with fibrogen to

change into change into fibrinfibrin..

Clotting Clotting

Vitamin K stimulates liver to produce Vitamin K stimulates liver to produce more prothrombin more prothrombin faster clot faster clot

Coumadin – anticoagulant, inhibit Coumadin – anticoagulant, inhibit synthesis of prothrombinsynthesis of prothrombin

Heparin – inhibits conversion of Heparin – inhibits conversion of prothrombin to thrombinprothrombin to thrombin

Clotting disordersClotting disorders

ThrombusThrombus- clot stays stationary, - clot stays stationary, throbosisthrobosis

EmbolusEmbolus – clot travels, embolism – clot travels, embolism HemophiliaHemophilia – X-linked disorder, – X-linked disorder,

failure to produce clotting factorsfailure to produce clotting factors ThrombocytopeniaThrombocytopenia – decrease in – decrease in

platelet count usually caused by platelet count usually caused by bone marrow destruction due to bone marrow destruction due to radiation, drugs, cancerradiation, drugs, cancer

WBC CountWBC Count

Leukopenia – abnormally low WBC Leukopenia – abnormally low WBC countcount

Leukocytosis – abnormally high WBC Leukocytosis – abnormally high WBC countcount

Differential WBC count – each type Differential WBC count – each type reported as % of total countreported as % of total count