67 terms

Davis: A and P: Hematology

Composition of Blood, Blood clotting, Blood disorders and complications, blood typing
liquid medium that carries out the functions of the circulatory system.
Functions of Blood
a. Gas exchange: distributes O2 to tissues and picks up CO2 from tissues
b. Primary internal transport medium - chemically and cellularly - WBC
c. Strong Defense Mechanism
d. Heat Distribution
f. Primary Fluid Reservoir - water can be added or removed as needed
g. Manages pH - buffers in bloodstream
h. Blood clotting - mechanism for preventing blood loss
Blood Transports what types of Chemical mediums?
1. Electrolytes
2. Urea and ammonia - metabolites
3. Nutrients from digestion
4. Hormones
How is Blood a strong defense mechanism?
i. Delivers Antibodies
ii. Delivers White Blood Cells (WBC)
iii. Delivers Chemicals responsible for fever and inflammation
iv. Provides nutrients to wounds
How is heat distributed through blood? What biological characteristic does blood maintain?
i. Heat is distributed by water in Blood for healing or increased activity
e. Chemical Regulator for Homeostasis
Composition of Blood
a. Composed of CT - variety of cells in a fluid matrix
b. 4-6L in a normal human body - accounts for 8% of body weight
c. 80-85uL/kg of tissue required for normal healthy function
d. pH 7.4
e. Two Parts
i. Plasma - matrix
iii. Formed Elements
Composition of Blood Plasma
1. 58% of Blood
2. Clear to pale yellow fluid
3. Water - bulk
4. Nutrients from digestion
5. Hormones from 1 part to the other
6. Non-dissolved gases - ie) N2
7. Nitrogenous Wastes - Urea
8. Electrolytes - Na+
9. Blood Serum - Plasma with elements centrifuged out
10. Proteins (may wear out and replaced regularly)
11. Fibrinogen
12. Nutrients Absorbed in Plasma
Proteins in Plasma
1. Albumin
2. Globulins
(65%) slippery clear, like egg whites, thickens blood, regulates osmolarity, buffers, transports dissolved nutrients
3 Types of Globulins
i. a-Globulin:
ii. b-Globulin:
iii. Y-Globulin:
transports vitamins, lipids, hormones, and Copper, and promotes blood clotting
transports lipids and iron, destroys toxins, and combats microorganisms
forms into antibodies
pre-cursor protein - only activates when injured and turns into Fibrin - blood clotter.
Types of Nutrients Absorbed in Plasma
a. Glucose
b. Amino acids
c. Fatty acids
d. Phospholipids
e. Cholesterol
f. Small amounts of dissolves gases
g. Vitamins and minerals
h. Miscellaneous chemicals, ie) caffeine or alcohol
i. Nitrogen bi-products
Complications in Blood Plasma
1. ↓ protein and RBC will cause the blood to thin out and move faster
a. Results in High Blood pressure
2. Conversely ↑ protein and ↑ RBC contributes to viscosity that will not allow the blood to move at an effective rate
3. Osmolarity of blood determines rate in which nutrients exchange with tissue
a. ↑ osmolarity = ↑ BP
b. ↓ osmolarity = edema - tissue swelling
Formed Elements
1. Located within plasma
2. Cells wear out and need to be replaced.
a. made by Hemopoiesis with Hemocytoblasts:
1. Daily Production
a. 10 billion - Leukocytes
b. 200 billion - RBC
c. 400 Billion Platelets
3. Erythrocytes (RBC)
4. Leukocytes - WBC
5. Platelets
- synthesizes new blood cells in Hemopoietic Tissue like
Types of Hemopoietic Tissues
1. bone marrow (Myeloid Hemopoiesis) - makes all cells
2. lymphatic tissues (Lymphoid Hemopoeisis)- makes lymphocytes
cells that make blood cells (type of stem cell)
most common about 45%
a. Disc-like shape: doughnut
b. Carries O₂
c. RBC count in Female: 4.2-5.4 million/uL, and Male: 4.6-6.2 million/uL
f. Contains no organelles
g. Lack nuclei - removed during hemopoiesis
i. Lack protein synthesis
ii. Non-mitotic
h. Lack mitochondria - relies entirely on anaerobic respiration
j. Cytoplasm contains Hemoglobin (30%)
Function of RBC
- Gas Exchange
i. Collects O₂from lungs and delivers to tissues
ii. Simultaneously picking up CO2 and delivered to lungs for diffusion out.
iii. Shape allows for moving through capillaries carrying O₂
- break down of RBC
i. Break down quickly - lasts 120 days
1. Releases yellow-green pigment called Bilirubin - jaundice
a. Gets absorbed by the liver and excreted into the gallbladder
b. Mixes with bile salts and turns into bile
c. Bile digests lipids
2. Releases hemoglobin and absorbed by a-Globulin
O₂ and CO₂ binding pigment (O₂ - bright red color, CO₂ - maroon color) on the surface of the cell.
Formed from Hemes - rich in Fe
- abnormally high RBC
1. Primary - indicator of Bone Marrow Cancer
2. Secondary - insufficient amount of O2
3. Causes
a. Emphazema
b. Chronic bronchitis
c. Or any lung related diseases
d. Smoking
e. Dehydration
f. People who live in urban populated areas
g. Sometimes is a condition of adaptations
i. Athletes
ii. People who live in high altitude areas
Pernicious Anemia
lacks intrinsic factor: necessary for the absorption of B-12
Hypoplastic/Aplastic Anemia
loss of hemopoietic tissue
a. Results from kidney failure
b. Viruses like HIV - destroy hemopoietic tissue
c. Radiation
d. Toxins like Benzene, arsenic, mustard gas
e. Can also be an autoimmune deficiency
Sickle Cell Anemia
- inherited recessive disorder
1. Malformation of RBC - defective hemoglobin protein
2. Binds O2 poorly
3. RBC have a tendency to stick together in clumps - blocking off capillaries
4. Symptoms:
a. Anemia
b. Intense pain in extremities
c. Chronic fatigue
d. Bouts of weakness
e. Kidney or heart failure
f. Paralysis
g. Death
5. Can also prevent malaria - trait is common in areas of world where malaria is prevalent
decreased RBC count (symptom)
1. Blood loss (Hemorrhagic anemia)
2. Inadequate Hemopoiesis
a. Low dietary iron
b. Protein deficiency
c. Insufficient folic acid
d. Insufficient vitamins
a. Less than 1% in blood stream
b. 5-10k/uL
c. Contains nuclei, organelles
d. Large in size
e. Circulate in the blood but mostly found in tissues for invaders
f. 5 Types
3 Types of Granulocytes
granules with lysosomes, they circulate 4-8 hours then move to tissue for 4-5 days
1. Neutrophils
2. Eosinophils
3. Basophils
(polymorphonuclear leukocytes) (60-70%) - phagocytize bacteria and release antimicrobial chemicals
2. Eosinophils (2-4%) - fluctuate with day/night cycle, seasons, and female menstrual cycle
a. Phagocytize antigen-antibody complexes, consume allergens and inflammatory molecules
(<1%) - release histamine (vasodilator) and Heparin (anticoagulant)
a. Increase blood flow to tissue to initiate inflammation
2 Types of Agranulocytes
1. Monocytes
2. Lymphocytes
(3-8%) - largest WBC
a. Lives in blood for 10-20 hours than turns into a macrophage when moved to tissue where it will live for a few yrs.
(25-33%) - coordinates immune response, produce antibodies, and attacks immune cells.
a. Transferred to blood via lymphatic tissue and can live for weeks to decades
b. Functions: immune defenders and memory
: increased WBC count (symptom)
1. Indicator of allergy or Disease
2. Can occur due to dehydration, stress
decreased WBC count
1. Low immune response
2. Cause:
a. Poor nutrition
b. Poisons - heavy metal poisoning
c. Radiation sickness
d. Cortico-steroids
e. Anti-cancer drugs
f. Immunosuppressant
g. Typhoid, measles, mumps, and Polio
h. Chicken pox and flu
i. HIV
cancer of Hemopoietic Tissue
1. Occurs in lymphatic tissue or bone marrow
2. Common in children
3. Large numbers of dysfunctional leukocytes
4. Acute form: rapid onset, and deadly, occurs in elderly adults
5. Chronic form: slow developing up to 3 yrs. and can be treatable id caught early.
a. Smallest of Formed Elements
b. Fragments of megakaryocytes (bone marrow cells)
c. Functions
i. Hemostasis

ii. Fibrinolysis
dissolves clots
1. Releases chemicals to attract inflamed tissue
2. Contains growth factors - stimulate growth of new BV.
prevents blood loss
1. Secrete vasoconstrictors
2. Severe clotting factors (proteins)
a. Platelets cluster to form platelet plugs which seal off broken BV
ABO Blood Gouping
a. ABO Blood Groups: Antigens found in the membranes of RBCs that allow your blood to identify the right markers
i. 4 Types
Type A
contains Antigen A which makes Antibody Anti-B, and accepts A and O donor types
Type B
contains Antigen B which makes Anti- A, and accepts B and O donor types
Type O
contains no antigens and has both Anti-A and Anti-B, and accepts only O donor types (universal donors)
Type AB
contains both antigens but makes no Antibodies, and accepts all blood types (universal receivers)
Rh Blood Grouping
b. Rh group typing: named after Rhesus Monkeys, contains the presence of D-antigen
i. 2 Types
Rh Positive
contains Antigen D which makes no antibodies, accepts both Rh group donors
a. Dominant genetic trait
Rh Negative
contains no Antigen-D and produces Anti-D, accepts only Rh- donor types.
Erythroblastis Fetalis
Rh- woman becomes pregnant with Rh+ baby will eventually develop the Anti-D to reject baby.
i. Usually occurs after the 2nd pregnancy.
ii. 1st pregnancy, mother's immune will react like it's fighting off a virus.
Hemolytic Newborn Disease (HDN)
resulted from Erythroblastis Fetalis causing a miscarriage, death with birth, or mental illness which eventually leads to death.
Rh Immune Globulin
drug that depresses part of immune system to allow the mother to carry Rh+ baby to term
Process of Hemostasis
a. Vascular Spasm
b. Platelet Plug Formation
c. Coagulation
Vascular Spasm
BV constricts to limit Blood loss
i. Stop Gap - immediate response
Platelet Plug Formation
platelets connect to the collagen under endothelium
i. Plugs up the site of injury
ii. Platelets contract to close injury
iii. Stops minor bleeding
: plugs up injury to heal wound
i. Chemical pathways for immediate trauma
ii. Pre-coagulants: clotting factors (usually inactive) that activate in sequence- Reaction Cascade
Reaction Cascades
a. 2 steps occurring simultaneously converging onto a 3rd step
b. Extrinsic Mechanism
c. Intrinsic Mechanism
d. Common Pathway
Extrinsic Mechanism
- clot factors are released by damage to BV and perivascular tissue begins immediately and lasts 15 sec.
- Steps
i. Damage to BV in perivascular tissue has Factor III (tissue Factor or Tissue Thromboplastin) that exposed blood...
ii. Factor III and Factor VII combine to form III -VII Complex...
iii. III-VII Complex activates Factor X in presence of Ca2+...
Intrinsic Mechanism
- found in blood, occur shortly after extrinsic and lasts 3-6 min.
i. Platelets release Factor XII (Hegemen Factor)...
ii. Factor XII activates Factor XI....
iii. Factor XI (with Ca2+) activates Factor IX...
iv. Factor IX combines with Ca2+ and Factor VIII (antihemophilic factor)...
v. Factor IX and Factor VIII complex in presence of Ca2+ activates Factor X
Common Pathway
- action of coagulation (final pathway)
i. Factor X (with Ca2+) combines with Factor V...
ii. Factor X and Factor V complex (prothrombin activator) activates Factor II (prothrombin), forming Thrombin (3 jobs - activates Factor V and....)
iii. Thrombin acts on Factor I (fibrinogen) to accelerate action forming fibrin which accumulates forming adhesive proteins
iv. Thrombin also activates Factor XIII....
v. Factor XIII (with Ca2+) weaves fibrin fibers with covalent cross links within Fibrin Polymer: stabilizes clots
vi. Platelets and WBC will build up on Fibrin Polymer which will form the blood clot within 30 min.
vii. Clot Retraction will occur which pulls the edges of the wound together until it is healed.
: formation of blood clot - usually in veins (which contains less pressure)
1. Antithrombin: blocks formation of blood clots
clotting more than usual
1. Results from:
a. Autoimmune disease
b. Cancers
c. Pregnancy
d. Estrogen- therapy due to menopause
e. Obesity
f. Genetics
g. Anything disturbing natural flow
h. Atrial fibrillation
i. Heart disease
j. Circulatory shock
k. Long term immobility
Trauma to Endothelium
1. Results from infection, surgery, natural injuries, and hypertension
clot that breaks loose and circulates in the blood stream
a. Can be dissolved by anti-coagulants
b. Lodged somewhere causing - myocardial infarction, problems in kidneys, lungs, heart, or brain: Thromboembolism
i. Results in heart attacks, kidney failure, strokes, and sudden death
1. There are 650,000 death ea. Yr related to Thromboembolisms
2. Caused by surgical complication
a. Typically given blood thinners after surgery to prevents clot formation