Transcript Rh Blood Group

Blood!!
Blood
• The fluid portion of cardiovascular system
• Connective Tissue
• Serves the body’s 75 Trillion Cells!!
WOW!
Blood
• Blood is a sticky opaque fluid with a
characteristic metallic taste.
• Blood has a pH of 7.3-7.4
• Oxygen rich blood is more scarlet in color
while oxygen poor blood is a dark red color.
• Average adult male has 5-6 liters of blood,
while the female is slightly less with 4-5 L.
Functions of Blood
• Transports
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Gases
Nutrients
Electrolytes
Hormones
Wastes ex: urea and uric acid
Functions of Blood
• Restricts blood loss
– Clotting
• Defends against pathogens and toxins.
– White blood cells
– Antibodies
• Distributes heat produced by cells
• Regulates interstitial fluid by exchange with
capillaries.
Blood and Blood Cells
• Whole blood is slightly heavier 3 to 4 times
more viscous than water.
• Its cell form mostly in red bone marrow,
include white and red blood cells. (Bone
marrow transplants often take place in the ilium..your hip)
• Blood also contains cellular fragments
called blood platelets.
Composition of Blood
• Whole Blood =
• Plasma + formed elements
• a solution
cells & platelets
Composition of Blood
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45% Formed elements
Platelets
Red Blood Cells
White Blood Cells
Most of the formed
elements is RBC..99%
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55% Plasma
Electrolytes
Water
Proteins- Albumins,
Globulins, Fibrinogen
• Wastes
• Gases
• Nutrients, Vitamins,
Hormones.
Blood
• If a sample of blood is
spun in a centrifuge,
the heavier formed
elements are packed
down by the
centrifugal force and
the less dense plasma
remains at the top.
Blood
• You have three
distinct layers
– Plasma –(55% of
whole blood)
– Buggy Coat(leukocytes and
platelets < 1% of
whole blood)
– Erythrocytes (45% of
whole blood)
Blood
Blood Plasma
Plasma
• (You may have to add this material to your
notes…NOT in guided reading)
• Function:
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Maintaining osmotic balance,
Buffering against pH changes
Maintain blood viscosity
Transporting materials through blood
Blood clotting.
Erythrocytes
aka Red Blood Cells
• Red Blood Cells
(erythrocytes) are tiny
flattened discs with
depressed centers.
• They have no nucleus and
have basically no
organelles.
• Essentially they are little
bags of hemoglobin (Hb)
which is the protein that
functions in gas transport.
Erythrocytes
aka Red Blood Cells
• It is its special shape
that is an adaptations
that allows it to readily
squeeze through the
narrow passages of
capillaries.
Structure of Hemoglobin
• Hemoglobin, the
protein that makes red
blood cells red, binds
easily and reversibly
with oxygen, and most
oxygen carried in
blood is bound to
hemoglobin.
Erythrocytes
aka Red Blood Cells
• The number or count
varies from individual
to individual.
• Increase in number
during strenuous
exercise, increase in
altitude
• They live approx. 120
days and travel
through the body
about 75,000 times.
• They age with time,
they become more
fragile and can be
damaged simply by
passing through
capillaries.
Erythrocytes
aka Red Blood Cells
• The production of
RBC are controlled
through Negative
Feedback and a
hormone called
erythroprotein.
• A deficiency of red
blood cells or a
reduction in the
amount of the
hemoglobin they
contain results in a
condition called
anemia.
Sickle Cell Anemia
• Sickle cell anemia (uhNEE-me-uh) is a
serious disease in
which the body makes
sickle-shaped red
blood cells. “Sickleshaped” means that the
red blood cells are
shaped like a "C."
Sickle Cell Anemia
• Sickle cells contain abnormal hemoglobin that
causes the cells to have a sickle shape. Sickleshaped cells don’t move easily through your blood
vessels. They’re stiff and sticky and tend to form
clumps and get stuck in the blood vessels. (Other
cells also may play a role in this clumping
process.)
• The clumps of sickle cells block blood flow in the
blood vessels that lead to the limbs and organs.
Blocked blood vessels can cause pain, serious
infections, and organ damage.
Sickle
Cell
Anemia
Leukocytes
aka White Blood Cell
• White Blood cells or
leukocytes protect
against disease.
• Work outside the
circulatory system.
• They are transported
in the blood to sites of
infections.
• Leukocytes can
phagocytize bacterial
cells in the body.
• Other produce
antibodies that destroy
foreign particles.
Leukocytes
aka White Blood Cell
• White Blood cell
count should range
between 5-10,000 per
cubic millimeter.
• Too many is called
leukocytosis- could
indicate acute
infections such as
appendicitis
• Too few is called
leukopenia…such a
deficiency may
accompany typhoid
fever, influenza,
measles, mumps…
Leukocytes
aka White Blood Cell
• There are five
different types of
white blood cells.
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Neutrophilis
Lymphocytes
Monocytes
Eosiniphils
Bbasophils
Blood Platelets
• Blood platelets are not complete cells, less
than half the size of a RBC.
• Help repair damaged blood vessels by
sticking to broken surfaces.
• They release serotonin, which contracts
smooth muscles in the vessel walls,
reducing blood flow.
Composition of Blood
Types of Blood Cells
Hemostasis
• Refers to the stoppage of bleeding.
• Is vitally important when smaller blood vessels are
damaged.
• Larger vessels may result in a severe hemorrhage
that requires treatment.
• Following injury, these 3 actions may prevent
blood loss:
• Blood Vessel Spasm
• Platelet Plug Formation
• Blood Coagulation
Extrinsic and Intrinsic
Clotting Mechanisms.
• Extrinsic – Triggered
when blood contacts
damaged blood vessel
walls or tissues
outside blood vessels.
• Intrinsic – Stimulated
when blood contacts
with foreign surfaces
in the absence of
tissue damage.
• All components
necessary are in blood.
Blood Vessel Spasm
• Cutting or breaking a smaller blood vessel
stimulates the smooth muscles in its wall to
contract, an event called vasospasm.
• Blood loss lessens immediately and severed vessel
may close.
• This effect results from stimulation of vessel as
well as reflexes elicited by receptors.
• Blockage called platelet plug has formed and
blood is coagulating.
Platelet Plug Formation
• Platelets stick to exposed ends of injured
blood vessels.
• They adhere to any rough surfaces.
• When in contact with collagen, shapes
change drastically.
• Platelets stick to each other forming a
platelet plug in the vascular break.
Platelet Plug Cont.
• A plug may control blood loss from a small
break, but a larger one may require a blood
clot to halt bleeding.
Blood Coagulation
• The most effective hemostatic mechanism.
• Causes formation of a blood clot by a series of
reactions, each one activating the next in a chain
reaction.
• May occur in extrinsic or intrinsic clotting
mechanism.
• Utilizes many biochemicals called clotting factors.
• Vitamin K is necessary.
Blood Coagulation Cont.
• The major event in blood clot formation is
conversion of the soluble plasma protein
fibrinogen into insoluble threads of the
protein fibrin.
• Activation of certain plasma proteins
triggers the conversion.
Blood Types
• In 1910, Physician Karl Landsteiner identified the
ABO blood antigen gene.
• Today 20 different genes are know to contribute to
the surface features of red blood cells, which
determine compatibility between blood type.
• Agglutination – Clumping of red blood cells when
testing blood compatibility or resulting from a
transfusion reaction.
Antigens and Antibodies
• Although there are many different antigenes in
humans only a few of them trigger serious
transfusion complications.
• Antigens – Red blood cell surface molecules.
• Antibodies – Proteins carried in plasma.
• Avoiding the mixture of certain kinds of antigens
and anitbodies prevents adverse transfusion
reactions.
ABO
• ABO blood group is based on the presence ( or
absence) of 2 major antigens, A and B.
• A persons antigen combination can be only A,
only B, both A and B, or neither A nor B.
• If persons antigen is –
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Only A = A blood type.
Only B = B blood type.
Both A and B = AB blood type.
Neither A nor B = Type O blood.
Permissible Transfusion!!
• You must keep in
mind that you cannot
except a blood type
that has anitbodies
against your own.
• O is often called the
universal donor
because it lacks
antigen A and B,
however it does
contain BOTH anti A
and anti B antibodies
so it can only except
blood from another
type O.
Blood Types
Blood Type
Antigen
Antibody
A
A
Anti-B
B
B
Anti-A
AB
A and B
Neither
anti-A nor
anti-B
O
Neither A
nor B
Both anti-A
and anti-B
Preferred and Permissible Blood
Types
Blood Type of
Recipient
Preferred Blood
Type of Donor
A
A
Permissible
Blood Type of
Donor
A, O
B
B
B, O
AB
AB
AB, A, B, O
O
O
O
The Rh Blood Type System
• When we are told our blood type, it is usually expressed
as a letter followed by either a positive (+) or negative
(-).
• This positive and negative indicates the Rh factor. The Rh
factor determines the presence or absence of a protein on
the surface of the RBC. If you carry this protein, you are
Rh positive. If you don't carry the protein, you are Rh
negative
• 85% of the population is Rh +.
The Rh Blood Type System
• The Rh system is actually much more complicated than
the ABO system because there are more than 30
combinations possible when inherited, however for
general usage, the Rh proteins are grouped into two
families - either positive or negative.
The Rh Blood Type System
• As with the ABO system, there is a dominant
allele which happens to be the positive
family. This means that the genetic pairs that
can exist in humans are as follows:
• Genetic makeup Blood type
++
Rh positive
+Rh positive
-Rh negative
The Rh Blood Type System
• Rh+ blood can never be given to someone with Rh - blood,
but the other way around works. For example, 0 Rh+ blood
can not be given to someone with the blood type AB Rh -.
• People with blood group 0 Rh - are called "universal
donors" and people with blood group AB Rh+ are called
"universal receivers."
Agglutination
• For a blood transfusion to be successful, AB0 and Rh blood groups
must be compatible between the donor blood and the patient blood.
• If they are not, the red blood cells from the donated blood will clump
or agglutinate. The agglutinated red cells can clog blood vessels and
stop the circulation of the blood to various parts of the body.
• The agglutinated red blood cells also crack and its contents leak out in
the body. The red blood cells contain hemoglobin which becomes
toxic when outside the cell. This can have fatal consequences for the
patient.
Can blood type effect pregnancy?
• Rh Compatibility?
• When you find out you are
pregnant one of the first
things you will have is
your blood type
tested…why??
• Any issue regarding this
primarily focuses on the
Rh protein(+,-) more than
the “typing”…like A, or
AB.
Rh Compatibility
• If you and your baby are
Rh-negative, there's no
problem, since you both
have the same Rh type.
• If the father's genes are + Rh positive, and the
mother's are + - Rh
positive, the baby can be:
+ + Rh positive
• + - Rh positive
• - - Rh negative
Rh Compatibility
• If a father's Rh factor
genes are + +, and the
mother's are - -, the
baby will have one +
from the father and
one - gene from the
mother. The baby will
be + - Rh positive.
Can blood type effect pregnancy?
• If you're Rh-negative and your baby is Rh-positive
(thanks to your husband's genes), that's fine….
until your blood mixes with your baby's blood a
bit during placental separation at birth.
• At that critical point, fetal blood cells can
accidentally combine with your system, and you
make antibodies to fight them.
Can blood type effect pregnancy?
• Your immune system is successful in vanquishing
these stray fetal blood cells in your circulation.
• This is of no consequence, because once they've
gotten rid of the baby's blood cells in your system,
they have no other job. And they can't filter back
through to your baby's blood, because delivery has
already taken place.
• The antibodies you made just remain in your
circulation waiting. For what? For your next
pregnancy. Herein lies the problem!!!
Can blood type effect pregnancy?
• In the modern world of obstetrics; they now
monitor blood typing closely…shortly before or
after delivery the Rh- mother is given a RhoGAM
shot.
• This LIMITS moms body from producing those
antibodies that would actually cross through the
placenta in a second baby and attack the babies
RBC.
Hemolytic Disease
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This means you have become sensitized and your antibodies can cross the
placenta and attack your baby’s blood.
They break down the fetus’s red blood cells and produce anemia (the blood
has a low number of red blood cells).
This condition is called hemolytic disease or hemolytic anemia.
It can become severe enough to cause serious illness, brain damage, or even
death in the fetus or newborn.
Hemolytic Disease
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Sensitization can occur any time the fetus’s blood mixes with the mother’s
blood. It can occur if an Rh-negative woman has had:
A miscarriage
An induced abortion or menstrual extraction
An ectopic pregnancy
Chorionic villus sampling
A blood transfusion
• http://www.youtube.com/watch?v=t0pyd_uJvg
• http://www.youtube.com/watch?v=CRh_dA
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