Transcript Document

BLOOD: FUNCTION
• Transport
▫ O2
• Protection
▫ CO2
▫ Platelets and clotting
factors
▫ Nutrients
▫ Inflammation
▫ Wastes
▫ Antibodies
▫ Hormones
▫ Leukocytes
▫ Ions
▫ Proteins
 Regulation
 Stabilizes pH
 Water balance of
tissues
 Body temperature
PHYSICAL CHARACTERISTICS
• Color
▫ Bright red when oxygenated
• pH
▫ 7.35 to 7.45
• Volume
▫ 4-5 liters in females
▫ 5-6 liters in males
• Viscosity
▫ 5 times as viscous as water
BLOOD: COMPONENTS
• Hematocrit
Plasma
•55% of whole blood
Buffy coat
•Leukocytes & platelets
•<1% of whole blood
Erythrocytes
•45% of whole blood
BLOOD: COMPONENTS
• Plasma
▫ Clear fluid matrix
• Erythrocytes
▫ Red blood cells
• Leukocytes
▫ White blood cells
• Thrombocytes
▫ Platelets
Plasma
•55% of whole blood
Buffy coat
•Leukocytes & platelets
•<1% of whole blood
Erythrocytes
•45% of whole blood
COMPOSITION OF PLASMA
• 92% water
• Proteins (8%)
▫ Albumins
▫ Globulins
▫ Clotting proteins
• Nutrients
▫ Glucose
▫ Amino acids
▫ Lipids
• Wastes
▫ Urea (amino acid
breakdown)
• Electrolytes
▫ Na+, K+, Ca2+, Cl-, HCO3-
• Gases
• Hormones
• SERUM = plasma without
the clotting proteins
PLASMA PROTEINS
• Albumins
▫ 60 % of blood proteins
▫ Produced by liver
▫ Influence:
• Globulins
▫ Alpha and beta
 Transport:
▫ Gamma
 Antibodies
▫ Fibrinogen
 Clotting mechanism
FORMED ELEMENTS: ERYTHROCYTES
• Function
▫ Production of hemoglobin
▫ Carries oxygen
▫ Carries 20% of CO2
▫ Blood viscosity
7.5 m
• Structure
▫ Biconcave shape
▫ 97% hemoglobin (excluding
H2O)
▫ 250 to 280 million
hemoglobin molecules/ RBC
2.0 m
HEMOGLOBIN
• 12 to 16 g/100 ml blood
in females
• 13 to 18 g/100 ml in
males
• Composed of:
2
1
2
1
heme
▫ Globin protein
▫ Heme pigment
• Binds oxygen
• May also bind to carbon
dioxide (CO2) or carbon
monoxide (CO)
HEMOGLOBIN
• 4 globin chains, each
bound to a heme group
 Iron atom at the center of





heme
Iron binds O2
4 O2 per hemoglobin
molecule
Forms oxyhemoglobin in
the lungs
Releases O2 in tissues to
become
deoxyhemoglobin
CO2 may bind to globin to
form
carbaminohemoglobin
2
1
2
1
heme
ERYTHROCYTE PRODUCTION(ERYTHROPOIESIS)
• In red bone marrow
• Epiphyses of femur and humerus, spongy bone of sternum
and hip
• Stimulated by erythropoietin (EPO)
• Formed elements arise from the same stem cell in the bone
marrow
ERYTHROCYTE PRODUCTION(ERYTHROPOIESIS)
 Hemocytoblast
 Committed to become an RBC
 Begins hemoglobin production
 Nucleus is ejected
 3 to 5 days
 Reticulocytes enter circulation
 Fully mature 2 days after entering circulation
 Reticulocyte counts
ERYTHROPOIESIS
• Over 2 million RBC’s produced/sec.
• Iron and B vitamins necessary
• Kidney cell hypoxia = EPO production
▫ Accelerated RBC production triggered by:
 RBC numbers
 oxygen availability
  oxygen demand by tissues
• Testosterone enhances erythropoietin
production
REGULATION OF ERYTHROPOIESIS
Start
Increases O2carrying ability
of blood
Reduces O2
levels in blood
Enhanced
erythropoiesis
increases RBC
count
Erythropoietin stimulates
re bone marrow
Stimulus:
Hypoxia due
to decreased
availability of
O2 t o blood,
or increased
tissue
demands for
O2
Kidney releases
erythropoietin
ERYTHROCYTE DESTRUCTION
• RBC lifespan:
• Old RBC’s:
▫ Cell fragments destroyed by macrophages in the
liver and spleen
▫ Hemoglobin globin and heme
▫ Globin amino acids
▫ The iron of the heme group reuse
▫ Rest becomes bilirubin (pigment)
▫ Bilirubin secreted in bile from the liver into the
small intestine
ERYTHROCYTE DISORDERS
• Anemias
▫ oxygen carrying capacity
▫ Fatigue, chills, dizziness, shortness of breath
▫ Causes:
1 Reduced number of RBC’s
 Blood loss, RBC destruction, bone marrow failure
 Three types:
▫ Hemorrhagic anemia
▫ Hemolytic anemia
▫ Aplastic anemia (abnormalities in marrow)
ERYTHROCYTE DISORDERS
• Anemias
▫ Causes of anemia (continued)
2 Decreased hemoglobin
 Iron deficiency
 Athlete’s anemia
 Pernicious anemia (B12 deficiency)
▫ Intrinsic factor
ERYTHROCYTE DISORDERS
• Anemias
▫ Causes of anemia (continued)
3 Abnormal hemoglobin
 Thalassemia
▫ Genetic- Mediterranean descent
▫ Depressed globin synthesis- reduced RBC count
Sickle cell anemia
 Genetic-
ancestors in the malaria belt
 Abnormal hemoglobin
 RBC’s collapse / sickle-shaped
ERYTHROCYTE DISORDERS
• Polycythemia vera
▫ erythrocytes
▫ Dizziness, high RBC count (hematocrit may be 80%),
viscous blood, impaired circulation
 bone marrow cancer
 blood doping or use of EPO
LEUKOCYTES
•
•
•
•
•
Complete, nucleated cells
Less than 1% of blood volume (4,000 to 11,000 / mm3)
Protect body from:
Use diapedesis
Amoeboid movement
capillary
connective tissue
leukocyte
LEUKOCYTE PERCENTAGES
Neutrophil
(40-70%)
Erythrocytes
Blood
FORMED
ELEMENTS
Granulocytes
Eosinophil
(1-4%)
Leukocytes
Basophil
(0-1%)
Lymphocyte
(20-45%)
Platelets
Agranulocytes
Monocyte
(4-8%)
GRANULOCYTES
• Neutrophils
▫ Most numerous
▫ Phagocytize bacteria
GRANULOCYTES
• Eosinophils
▫ Fight parasites
▫ Inactivation of some
inflammatory
chemicals
GRANULOCYTES
• Basophils
▫ Least numerous
▫ Histamine and heparin
release
AGRANULOCYTES
• Lymphocytes
▫ Immune response
 Direct attack
 Antibodies
AGRANULOCYTES
• Monocytes
▫ Phagocytosis
▫ Chronic infections
LEUKOCYTE DISORDERS
• Leukocytosis
▫ WBC count (over 11,000 per mm3)
 bacterial or viral invasion
 leukemia and mononucleosis
• Leukopenia
▫ WBC count
 drugs (especially glucocorticoids), chemotherapy, rheumatoid
arthritis, cirrhosis of the liver
• Leukemias
▫
▫
▫
▫
Cancer: WBC’s
Rapidly dividing WBC’s, unspecialized, nonfunctional
normal bone marrow function
Fever, weight loss, bone or organ pain, infections
LEUKOCYTE DISORDERS
• Mononucleosis
▫
▫
▫
▫
▫
Contagious viral infection
Children and young adults
Epstein-Barr virus
agranulocyte numbers
Fatigue, aches, sore throat, low grade fever
• Differential White Blood Cell Count:
THROMBOCYTES
•
•
•
•
•
Fragments of megakaryocytes
No nucleus
Temporary plug
Life span < 10 days
250,000 to 500,000 / ml blood
PLATELET PLUG FORMATION
Injury to lining of vessel
exposes collagen fibers;
platelets adhere
Fibrin clot with
trapped RBC’s
Platelet plug forms
collagen
fibers
PF3 from platelets & tissue
thromboplastin from
damaged tissue cells
fibrin
platelets
+
Ca2+ & other clotting
factors in blood
plasma
Formation of PROTHROMBIN ACTIVATOR
PROTHROMBIN
THROMBIN
FIBRINOGEN
FIBRIN
CLOTTING AND BLEEDING DISORDERS
• Hemophilia
▫ Inherited
▫ clotting time
 missing clotting factors VIII or IX
• Thrombocytopenia
▫ platelet numbers
▫ Bleeding from small vessels
• Thrombus
▫ Clot develops in unbroken vessel
 blocks circulation
• Embolus
▫ Traveling thrombus
 Trapped in smaller blood vessels
BLOOD TYPES
• Protein antigens on RBC plasma membrane:
▫ B, A or no antigens (Type O)
• Other Rh antigens
• Antibodies attack antigen not recognized by the
body
• Results in agglutination and hemolysis with
nonmatching blood type
Type A blood
of donor
Type A antibody in
Type B blood of
recipient
Antigen & antibody
match
Agglutination
ABO BLOOD GROUPS
Antigen
A
Antigen
B
Antigen
AB
Antibody
B
Antibody
A
Neither Antibody
A nor B
Antibody
A and B
TYPE A
TYPE B
TYPE AB
TYPE O
Neither Antigen
A nor B
ABO BLOOD GROUPS
• Universal Donor
▫ Neither A nor B antigens
▫ Type O blood
• Universal Recipient
▫ A and B antigens
▫ Type AB blood
ERYTHROBLASTOSIS FETALIS
• Rh+ fetus / Rh- mother
• Fetal organ damage
FIRST PREGNANCY
SECOND PREGNANCY
maternal circulation
(Rh-)
fetal circulation
(Rh+)
(RH-) antibodies develop in
the mother after delivery
Agglutination of fetal
(RH+) fetus