HUMAN ANATOMY WITH PATHOPHYSIOLOGY
CHAPTER 10: BLOOD
BLOOD - Shapes like biconcave disc
Blood transports everything that must be carried form one place to Normal count id 5 million RBC’s per cubic millimeter of
another, such as: blood.
Hemoglobin is an iron-bearing protein
Nutrients
Binds oxygen
Wastes
Each hemoglobin molecule can bind 4 oxygen molecules
Hormones
Each erythrocyte has 250 million hemoglobin molecules
Body heat
Normal blood contains 12–18 g of hemoglobin per 100
milliliters (ml) of blood
COMPONENTS OF BLOOD Homeostatic imbalance of RBCs
Blood is the only fluid tissue, a type of connective tissue, in the human Anemia
body. - a decrease in the oxygen-carrying ability of the blood
Components of blood: due to:
- Lower-than-normal number of RBCs
Formed elements (living cells)
- Abnormal or deficient hemoglobin content in the RBCs
Plasma (nonliving fluid matrix)
Sickle cell anemia (SCA)
When blood is separated
- results from abnormally shaped hemoglobin
Hematocrit – a percentage
Polcythemia
Erythrocytes sink to the bottom (45 percent) - excessive or abnormal increase of RBCs due to:
Buffy coat is the leukocytes and platelets (less than 1 o Bone marrow cancer (polycythemia vera)
percent)
o Life at higher altitudes (secondary
Plasma rises to the top (55 percent of blood) polycythemia)
Increase in RBCs slows blood flow and increases blood
PHYSICAL CHARACTERISTICS AND VOLUME viscosity
Blood characteristics
Leukocytes
Sticky, opaque fluid
White blood cells (WBCs)
Heavier and thicker than water
Crucial in body’s defense against disease
Color range
Complete cells, with nucleus and organelles
- Scarlet red is oxygen rich
Able to move into and out of blood vessels (diapedesis)
- Dull red or purple is oxygen poor
Respond to chemicals released by damaged tissues (known
Metallic, salty taste as positive chemotaxis)
Blood pH is slightly alkaline, between 7.35 and 7.45 Move by amoeboid motion
Blood temperature is slightly higher than body temperature, 4,800 to 10,800 WBCs per mm 3 of blood
at 38ºC or 100.4ºF.
Leukocytosis
Blood volume
WBC count above 11,000 cells per mm 3 of blood
About 5–6 liters, or about 6 quarts, of blood are found in a
healthy adult Generally, indicates an infection
Blood makes up 8 percent of body weight Leukopenia
Abnormally low WBC count
Commonly caused by certain drugs, such as corticosteroids
PLASMA
and anticancer agents
90 percent water Leukemia
Straw-colored fluid Bone marrow becomes cancerous
Includes many dissolved substances Numerous immature WBC are produced
- Nutrients
- Salts (electrolytes) Types of Leukocytes
- Respiratory gases 1. GRANULOCYTES
- Hormones Granules in their cytoplasm can be stained
- Plasma proteins
Possess lobed nuclei
- Waste products
Include neutrophils, eosinophils, and basophils
Plasma Proteins
Neutrophils
Most abundant solutes in plasma
- Most numerous WBC
Most are made by the liver
- Multilobed nucleus
Include: - Cytoplasm stains pink and contains fine granules
- Albumin— important blood buffer and contributes to - Function as phagocytes at active sites of infection
osmotic pressure
- Numbers increase during infection
- Clotting proteins— stem blood loss when a blood
vessel is injured - 3,000–7,000 neutrophils per mm 3 of blood (40–70
percent of WBCs)
- Antibodies— protect the body from pathogens
Blood composition varies as cells exchange substances with the blood
Eosinophils
Liver makes more proteins when levels drop
- Nucleus stains blue-red
Respiratory and urinary systems restore blood pH to
- Brick-red cytoplasmic granules
normal when blood becomes too acidic or alkaline
- Function is to kill parasitic worms and play a role in
Plasma helps distribute body heat.
allergy attacks
- 100–400 eosinophils per mm 3 of blood (1–4 percent of
FORMED ELEMENTS WBCs)
Basophils
Erythrocytes - Rarest of the WBCs
Red blood cells (RBCs) - Large histamine-containing granules that stain dark
blue
Main function is to carry oxygen
- Contain heparin (anticoagulant)
Differ from other blood cells
- 20–50 basophils per mm 3 of blood (0–1 percent of
- Anucleate (no nucleus) WBCs)
- Contain few organelles; lack mitochondria 2. AGRANULOCYTES
- Essentially bags of hemoglobin (Hb) Lymphocytes
HUMAN ANATOMY WITH PATHOPHYSIOLOGY
CHAPTER 10: BLOOD
- Large, dark purple nucleus Thrombin joins fibrinogen proteins into hairlike molecules of
- Slightly larger than RBCs insoluble fibrin
- Reside in lymphatic tissues Fibrin forms a meshwork (the basis for a clot)
- Play a role in immune response Within the hour, serum is squeezed from the clot as it
- 1,500–3,000 lymphocytes per mm 3 of blood (20–45 retracts
percent of WBCs) - Serum is plasma minus clotting proteins
Monocytes
- Largest of the white blood cells Blood usually clots within 3 to 6 minutes
- Distinctive U- or kidney-shaped nucleus The clot remains as endothelium regenerates
- Function as macrophages when they migrate into The clot is broken down after tissue repair
tissues
- Important in fighting chronic infection
DISORDERS OF HEMOSTASIS
- 100–700 monocytes per mm 3 of blood (4–8 percent of
WBCs) Undesirable clotting
Thrombus
- A clot in an unbroken blood vessel
PLATELETS
- Can be deadly in areas as the lungs
Fragments of megakaryocytes (multinucleate cells)
Embolus
Needed for the clotting process
- A thrombus that breaks away and floats freely in the
Normal platelet count is 300,000 platelets per mm 3 of blood bloodstream
- Can later clog vessels in critical areas such as the brain
HEMATOPOIESIS (BLOOD CELL FORMATION) Bleeding disorders
Hematopoiesis is the process of blood cell formation Thrombocytopenia
Occurs in red bone marrow (myeloid tissue) - Insufficient number of circulating platelets
All blood cells are derived from a common stem cell - Arises from any condition that suppresses the bone
(hemocytoblast) marrow
Hemocytoblasts form two types of descendants - Even normal movements can cause bleeding from
small blood vessels that require platelets for clotting
- Lymphoid stem cell: which produces lymphocytes
- Evidenced by petechiae (small purplish blotches on the
- Myeloid stem cell: which can produce all other formed
skin)
elements
Hemophilia
- Hereditary bleeding disorder
FORMATION OF RED BLOOD CELLS
- Normal clotting factors are missing
Since RBCs are anucleate, they are unable to divide, grow, - Minor tissue damage can cause life-threatening
or synthesize proteins prolonged bleeding
RBCs wear out in 100 to 120 days
When worn out, RBCs are eliminated by phagocytes in the
BLOOD GROUPS AND TRANSFUSIONS
spleen or liver
Lost cells are replaced by division of hemocytoblasts in Large losses of blood have serious consequences
the red bone marrow - Loss of 15 to 30 percent causes weakness
Rate of RBC production is controlled by a hormone called - Loss of over 30 percent causes shock, which can be
erythropoietin fatal
Kidneys are the ones who produce most erythropoietin as a Blood transfusions are given for substantial blood loss, to
response to reduced oxygen levels in the blood treat severe anemia, or for thrombocytopenia.
Homeostasis is maintained by negative feedback from blood
oxygen levels HUMAN BLOOD GROUPS
Antigens
FORMATION OF WHITE BLOOD CELLS AND PLATELETS Blood contains genetically determined proteins
WBC and platelet production is controlled by hormones Are substances that the body recognizes as foreign and that
- Colony stimulating factors (CSFs) and interleukins the immune system may attack
prompt bone marrow to generate leukocytes Most antigens are foreign proteins
- Thrombopoietin stimulates production of platelets from We tolerate our own “self” antigens
megakaryocytes Antibodies
are the “recognizers” that bind foreign antigens
HEMOSTASIS
Hemostasis is the process of stopping the bleeding that Blood is “typed” by using antibodies that will cause blood
results from a break in a blood vessel with certain proteins to clump (agglutination) and lyse
Hemostasis involves three phases There are over 30 common red blood cell antigens
1. Vascular spasms The most vigorous transfusion reactions are caused by ABO
2. Platelet plug formation and Rh blood group antigens
3. Coagulation (blood clotting) ABO blood group
Step 1: vascular spasms Blood types are based on the presence or absence of two
Immediate response to blood vessel injury antigens
- Type A
Vasoconstriction causes blood vessel to spasm
- Type B
Spasms narrow the blood vessel, decreasing blood loss
Presence of both antigens A and B is called type AB
Step 2: platelet plug formation Presence of antigen A is called type A
Collagen fibers are exposed by a break in a blood vessel Presence of antigen B is called type B
Platelets become “sticky” and cling to fibers Lack of both antigens A and B is called type O
Anchored platelets release chemicals to attract more Rh blood group
platelets
Named for the eight Rh antigens (agglutinogen D)
Platelets pile up to form a platelet plug (white thrombus) Most Americans are Rh + (Rh-positive), meaning they carry
Step 3: coagulation the Rh antigen
Injured tissues release tissue factor (TF) If an Rh – (Rh-negative) person receives Rh+ blood:
PF 3 (a phospholipid) interacts with TF, blood protein clotting - The immune system becomes sensitized and begins
factors, and calcium ions to trigger a clotting cascade producing antibodies; hemolysis does not occur,
Prothrombin activator converts prothrombin to thrombin (an because as it takes time to produce antibodies
enzyme)
HUMAN ANATOMY WITH PATHOPHYSIOLOGY
CHAPTER 10: BLOOD
- Second, and subsequent, transfusions involve
antibodies attacking donor’s Rh + RBCs, and hemolysis
occurs (rupture of RBCs)
Rh-related problem during pregnancy
Danger occurs only when the mother is Rh – , the father is
Rh + , and the child inherits the Rh + factor
RhoGAM shot can prevent buildup of anti-Rh+ antibodies in
mother’s blood.
The mismatch of an Rh – mother carrying an Rh + baby can cause
problems for the unborn child
The first pregnancy usually proceeds without problems; the
immune system is sensitized after the first pregnancy
In a second pregnancy, the mother’s immune system
produces antibodies to attack the Rh + blood (hemolytic
disease of the newborn)
BLOOD TYPING
Blood samples are mixed with anti-A and anti-B serum
Agglutination or the lack of agglutination leads to
identification of blood type
Typing for ABO and Rh factors is done in the same manner
Cross matching—testing for agglutination of donor RBCs by
the recipient’s serum, and vice versa
DEVELOPMENTAL ASPECTS OF BLOOD
Sites of blood cell formation
The fetal liver and spleen are early sites of blood cell
formation
Bone marrow takes over hematopoiesis by the seventh
month
Congenital blood defects include various types of hemolytic
anemias and hemophilia
Incompatibility between maternal and fetal blood can result
in fetal cyanosis, resulting from destruction of fetal blood
cells
Fetal hemoglobin differs from hemoglobin produced after
birth
Physiologic jaundice occurs in infants when the liver cannot
rid the body of hemoglobin breakdown products fast enough
Leukemias are most common in the very young and very old
- Older adults are also at risk for anemia and clotting
disorders
