BLOOD

Circulatory System
BLOOD

respiration: O2 CO2 nutrition: GIT tissues excretion: waste lungs, kidneys acid-base regulation body fluid regulation regulation of body temperature distribution of hormones essential body protection: WBC, monocytes

55%

8% body weight sp gr 1.05 1.06 5-6x more viscous than water 55% Plasma Proteins: albumin, globulin, fibrin Water solutes 45% formed elements RBC Platelets WBC: neutrophil, lymphocytes, monocytes, eosinophil, basophil

Blood
ANTICOAGULANT

PLASMA RBC

SERUM RBC CLOT

ANTIGENS
SITES: RBC, WBC, platelets, spermatocytes, bone cells, skin cells. TIME: prenatal peak time: 30 years MECHANISM: genetically determined

ANTIBODIES
SITES: Tears, saliva, milk, ascitic fluid, cervical secretions, plasma TIME: post natal peak time: 5-10 years MECHANISM: genetically determined TYPE: ABO: IgM Rh: IgG (cross placenta)

Blood typing
TYPE A B AB O
ANTIGEN

ANTIBODY

anti-B
GENOTYPE:

anti-A BB, BO

none AB

anti-A anti-B OO

AA, AO

Rhesus System
5 antigen system C D E c e inherit a set of 3 out of 5 Rh (+) if D antigen present Rh (+): CDE, cDE ANTIGEN SITE RBC only TIME pre natal MECHANISM genetically determined TYPE

ANTIBODIES plasma, fluid post natal sensitization IgG

Sensitization
exposure of an antigen where an immune response is generated antibody formation

Transfusion of Rh (+) blood to an Rh (-) person Rh (-) mother pregnant with an Rh (+) fetus HEMOLYSIS anemia hemolytic disease of the newborn Erythroblastosis fetalis

MOTHER

+ +

- - + ++
FETUS

+ +

+ ++ + + + + + +

Blood

FORMED ELEMENTS

RBC Platelets WBC

GRANULAR
Neutrophil Eosinophil Basophil

AGRANULAR
Lymphocytes Monocytes

RBC
99% formed elements Anucleated, biconcave disc Lack mitochondria generate ATP anaerobically Contains hemoglobin red color Highly specialized in oxygen transport Lifespan: 120 days

RBC FORMATION AND DESTRUCTION

Leukocytes (WBC)
nucleated no hemoglobin combats microbes by

Phagocytosis Antibody formation

number increases in infection lifespan: days (hours during infection) years (lymphocytes)

Leukocytes

NEUTROPHILS/ MONOCYTES

actively phagocytic neutrophils responds first to bacterial infection monocytes arrive much later but in higher number and greater activity

Leukocytes
EOSINOPHIL

involved in allergic response release histamine mediate inflammation effective against parasitic infection phagocytize Ag-Ab complexes

Leukocytes
BASOPHIL

MAST CELLS involve in inflammation and allergic responses leaves vessels tissue liberates substances that intensifies inflammatory reactions

Heparin Histamine Serotonin

Leukocytes
LYMPHOCYTES

B cells

Humoral immunity Destroying bacteria and its toxins Cellular immunity Destroys virus, fungi, transplanted cells, cancer cells Non-T, non-B lymphocyte 1st line against viruses Kills without prior sensitization

T cells

natural killer cells

Platelets
disc shaped structures anucleated cytoplasm contains granules role in blood clotting lifespan: 5-9 days N= 150,000-400,000/mm3
megakaryoblasts megakaryocytes platelets

Blood
PLASMA

straw-colored fluid components

91.5% water

8.5% solutes plasma proteins nutrients gases electrolytes waste products enzymes

Blood

PLASMA PROTEINS

ALBUMIN

55% synthesized by liver Maintains water balance/ blood volume 38% synthesized by lymphatic tissues Functions in immunity

GLOBULIN

FIBRINOGEN

7% synthesized by liver Functions in blood clotting mechanism

CBC

COMPLETE BLOOD COUNT

Hemoglobin
Male 120 mg/dl Female 120-140 mg/dl

WBC
5-10 x 10 9 /mm3

Hematocrit
Male Female

Differential count %
Neutrophil 60-70 Lymphocytes Basophils Eosinophils 2-4 Monocytes 3-8

40-54% 38-46%

Reticulocyte count

20-25 0.5-1

Indicates rate of erythropoeisis Indicates bone marrow response to anemia

Platelet count
150-450 x 109

Hemostasis
Control of bleeding prevent hemorrhage Necessity to keep blood inside the vessels fluid BODYS RESPONSE TO INJURY

Vasoconstriction Platelet plug formation Blood Coagulation Fibrinolysis

Hemostasis

VASOCONSTRICTION

minimize blood flow to affected site keep coagulation factors at the site of injury

PLATELET PLUG FOMATION

Hemostasis

Platelet adhesion

Platelet release reaction

Factos that modify platelet sensitivity: platelet cAMP PGI2 PGD2 alteration in membrane lipids release of arachidonic acid ASA inhibit cyclooxygenase

Platelet aggregation

Hemostasis
COAGULATION

formation of the hemostatic plug FIBRIN PROTHROMBIN

THROMBIN

FIBRINOGEN

FIBRIN

Coagulation
CLOTTING FACTORS

I fibrinogen II- prothrombin III tissue factor IV Ca V proaccelerin VII- proconvertin VIII- anti-hemophilic factor A

IX anti hemophilic B X stuart factor XI anti-hemophilic C XII hageman factor XIII fibrin stabilizing factor

Coagulation

PATHWAY ACTIVATION

Extrinsic pathway Trauma TF VII VIIa X Xa V Va

Intrinsic pathway Damage Endothelium XII XIIa XI XIa IX IXa

VII, Ca

PROTHROMBINASE

Xa

PROTHROMBIN

THROMBIN

Coagulation
COMMON PATHWAY
Thrombin fibrinogen FIBRIN

Cross-linked FIBRIN

Coagulation
CLOTTING FACTORS

Vitamin K dependent factors

II VII IX X

Liver derangement Diarrhea Prolonged antibiotic

Normally produced by bacteria that inhabit GIT

Prostaglandins
eicosanoids derived from arachidonic acid phospholipase A modulates human platelet action TxA2 PGI2
Vasoconstrictor Platelet aggregatio Vasodilator Platelet aggregation

Prostaglandin
ARACHIDONIC ACID Phospholipase A2

CYCLOOXYGENASE

LIPOOXYGENASE

PROSTAGLANDINS PGE2 PGI2 TxA2

LEUKOTRIENES

Hemostasis
FIBRINOLYSIS

PLASMINOGEN PLASMIN

Dissolution of a clot Activated as soon as coagulation is started Checking system as balance to clotting

Thrombolytic agents Streptokinase Tissue plasminogen factor (tPA)

Hemostasis
SCREENING TEST

Bleeding time Clotting time Clot retraction time

Platelet count
200-400 x 109

Prothrombin time(PT)

Checks extrinsic pathway

Activated partial thromboplastin time (APTT)

Checks instrinsic pathway

Hematological Condition
RBC

Anemia Polycythemia Leukocytosis Leukopenia Leukemia Thrombocytopenia

WBC

Thrombosis DIC Liver cirrhosis

Platelets