BLOOD

-Highly complex suspension of cells in a viscous fluid medium Physical Characteristics account for approximately 8% of body weight Volume in healthy Adult males: (5 6 L) Adult females: (4 5 L) pH - slightly alkaline : 7.35 - 7.45 Viscosity : 5x more viscous than water because of the formed elements Color - scarlet ( oxygen rich ) --- arterial blood dark red ( oxygen poor ) --- venous blood Sticky ,opaque fluid w/ characteristic salty taste FUNCTIONS: A. DISTRIBUTION FUNCTIONS : 1. Delivery of oxygen from the lungs & of nutrients from the digestive tract to all body cells 2. Transport of metabolic waste products from cells to elimination sites ( to the lungs for CO2 elimination, and to the kidneys for eliminations of nitrogenous wastes in urine ) 3. Transport of hormones from the endocrine glands to their target organs 4. Maintenance of body temperature thru absorption & distribution of body heat B. PROTECTION FUNCTIONS : 1. Maintenance of normal pH in body tissues 2. Maintenance of an adequate fluid volume in the circulatory system 3. Prevention of blood loss 4. Prevention of infection COMPOSITION of BLOOD 1. Formed elements or Cellular elements =45% volume a) Red Blood Cells normal rbc are biconcave discs , about 8 microns in diameter & a thickness of 2 microns at the thickest point & I micron or less at the center Major function is to transport hemoglobin which in turn carries oxygen from the lungs to the tissues Mature rbcs are non- nucleated Concentration of RBC in the blood : Normal males - 5.2 M/cu.mm +/- 300,000 Normal females - 4.7 M/cu.mm +/- 300,000

Production of RBC : Hematopoietic Tissues

Areas in the body that produce RBC (embryonic, fetal) 1. Yolk sac - produces primitive nucleated RBC in the early few weeks of embryonic life 2. Liver - main organ for production during the middle trimester of gestation. At the same time ,reasonable quantity of RBC is produced by the spleen & lymph nodes. 3. Bone marrow - during the latter part of gestation & after birth POSTNATAL HEMATOPOIESIS: the bone marrow of all bones produces RBCs until 5 years.The marrow of long bones becomes fatty & no longer produce rbc after 5 yrs of age. GENESIS of BLOOD CELLS: In the BM are cells called pluripotential hemopoietic stem cells (PHSC), from which all cells in the circulating blood are derived. PHSC reproduce continously throughout the life of the person, but a portion remain exactly like the original pluripotential cells & are retained in the BM to maintain a supply, though their numbers decrease with age. Committed Stem Cells - the larger portion of the reproduced stem cells differentiates to form other cells. These early offspring still cant be recognized as different from the PHSC , even though they have already committed to a particular line of cells..these are called Committed stem cells .

CFU E = committed stem cell that produces RBCs CFU GM= colony forming units that form granulocytes & monocytes INDUCERS : multiple proteins that controls growth & reproduction of different stem cells E.g. Interleukin 3 : promotes growth & reproduction of virtually all the different types of stem cells DIFFERENTIATION INDUCERS: another set of inducers responsible for the differentiation of cells. Formation of growth inducers & differentiation inducers is itself controlled by factors outside the bone marrow. RBC exposure of body to low oxygen for long period WBC infectious diseases cause growth & differentiation & eventual formation of the specific types of WBC needed to combat infection.\

STAGES of DIFFERENTIATION ( RBC ) Proeryhtroblast Basophilic erythroblast Polychromatophilic eryhtroblast Orthochromatic erythroblast Diffusely Basophilic erythrocyte Erythrocyte Pronormoblast Basophilic normoblast Polychromatophilic normoblast Orthochromatic normoblast Reticulocyte Normocyte/ Discocyte

Anemia - as a result of haemorrhage, or any other condition, where the BM immediately begins to produce rbcs. Destruction of major portions of the BM High altitudes Various diseases of the circulation that decrease blood flow to peripheral vessels & decreases oxygen absorption, also increases rbc production. ERYTHROCYTE DISORDERS POLYCYTHEMIA: excessive or abnormal increase in the number of erythrocytes. This increases the viscosity of the blood causing it to flow sluggishly. Polycythemia vera - often as a result of BM cancer ANEMIA : a deficiency of red blood cells , which may be due either by too rapid loss or too slow production of RBC ANEMIA : a deficiency of red blood cells , which may be due either by too rapid loss or too slow production of RBC Examples : A. Anemia of blood loss: maybe acute or chronic B. Aplastic anemia : BM not functioning C. Megaloblastic anemia : Vit B12, folate def D. Hemolytic anemia : normal production of RBC, but life span is shortened different abnormalities of RBC that makes the RBC fragile & make them rupture easily. Effect of Anemia on Circulatory System Severe Anemia decreased blood viscosity decreased resistance to blood flow in the peripheral vessels increased blood flow thru the tissues increased blood returned to the heart Morover , hypoxia due to diminished transport of oxygen by the blood causes the peripheral vessels to dilate ,allowing still further increase in return of blood in the heart, increasing cardiac output to a still higher level . Thus, one of the major effects of anemia is greatly increase workload on the heart.

Regulation of RBC Production Tissue Oxygenation : basic regulator of RBC production any condition that causes the quantity of oxygen transported to the tissues to decrease , usually increases the rate of RBC production. Erythropoietin principal factor that stimulates rbc prod.

BLOOD 2-The White Blood Cells White Blood Cells Mobile units of the bodys protective system Acting together , these cells provide the body with powerful defenses against tumors , viral infections and parasitic infections N value : 4000 - 11000 / cu.mm Types of WBC : Granulocytes neutrophil eosinophil basophil Agranulocytes lymphocytes monocytes Life Span of WBCs : A. Granulocytes -once released from the BM, the life span is 4 8 hours circulating in the blood and another 4 5 days in the tissues . B. The life span will be shortened through in infection. They ingest/phagocytise the invading organisms and in the process are themselves destroyed. Production & Life Span of WBCs : A. Like erythropoiesis, leukopoiesis is hormonally stimulated. These hematopoietic hormones are called CSFs ( colony stimulating factors ) , not only prompt the WBC precursors to divide & mature but also enhance the protective potency of mature leukocytes. B. WBCs are able to slip into and out of the blood vessels by Diapedesis. Types of WBCs: A. NEUTROPHILS: for phagocytosis Most numerous of the WBC Exhibit phenomenon of chemotaxis Neutrophilia & neutrophil invasion of the inflamed area 2nd line of defense against infection B. EOSINOPHILS : slightly phagocytic Plays part in detoxification, also in disintegration & removal of proteins Increase in number in parasitic infections & allegy

C. BASOPHILS : exhibit local anticoagulation in cases of inflammation & this ability is due to its elaboration of heparin like substance. Least numerous of WBCs D. LYMPHOCYTE : formation of gamma globulin( antibody) Lymphocytes remain in the blood for few hours , the pass by diapedesis into tissues, then re-enter the Lymph & return to blood again Life span varies from 100 - 300 days ,or in some ,even years depending on the bodys need. E. MONOCYTES: phagocytosis They are mobilized along with neutrophils as part of inflammatory response & constitute a 1st line of defense against bacterial infection. Have short transit time in the blood wandering through the capillary membrane into the tissues. Once in tissues they swell to much larger size to become tissue macrophage , can live for months or even years , unless destroyed by performing phagocytic function. Tissue Macrophage System 1. Provides a 1st line of defense in the tissues against infection . 2. Examples : Histiocytes - tissue macrophages in the skin & subcutaneous tissues ; Tissue macrophages of lymph nodes Alveolar macrophages - lungs Kupffer cells - liver Microglia The Process of Inflammation When tissue injury occurs , whether it be caused by bacteria ,trauma, chemicals , heat or other phenomenon , multiple substances that cause dramatic secondary changes in the tissues are released by the injured tissues. These secondary changes are called INFLAMMATION

 INFLAMMATION : CHARACTERIZED BY : 1. Vasodilation of the local blood vessels 2. Increased permeability of capillaries with leakage of large quantities of fluid unto the interstitial spaces. 3. Often clotting of the fluid in these spaces because of excessive amounts of fibrinogen & other proteins. 4. Swelling of the cells WALLING OFF effect of Inflammation : One of the 1st results of inflammation is to wall off the area of injury from the remaining tissues. This delays the spread of bacteria or other toxic products. Pus mixture of necrotic ,dead neutrophils & dead macrophages Disorders of White Blood Cells AGRANULOCYTOSIS - clinical condition where the BM stops producing WBC , leaving the body unprotected against bacteria & other agents that might invade tissues. LEUKEMIAS uncontrolled production of WBC caused by cancerous mutation of a myelogenous or lymphogenous cell Characterized by greatly increased numbers of abnormal white blood cells in the circulating blood Leukemic cells, esp. the undifferentiated cells are non-functional, so that they cannot provide the usual protection associated with WBCs. TYPES of LEUKEMIA Lymphogenous leukemia : caused by cancerous production of lymphoid cells, beginning first in a lymph node or either lymphogenous tissue , then spreading to other areas of the body. Myelogenous leukemia : begins by cancerous production of young myelogenous cells in the BM & then spread throughout the body so that WBCs are produced in many extra medullary organs. Effects of Leukemia on the Body 1st effect is metabolic growth of leukemic cells in abnormal areas of the body. The leukemic cells in the BM may reproduce so greatly that they invade the surrounding bone , causing pain & tendency to fracture. They utilize the metabolic elements of the tissues & cause tissue destruction.

Very common effect : infections, severe anemia, & bleeding tendency Most important effect : excessive use of metabolic substrates by growing cancerous cells : Tremendous demands on body fluids for foodstuffs, especially amino acids & vitamins After metabolic starvation has continued long enough (leukemic tissues grow while other tissues are debilitated ) DEATH