4Hematophobia = fear of blood Blood transports substances and maintains homeostasis in the bodyHematophobia = fear of blood
5Blood and Blood Cells Blood is a type of CONNECTIVE TISSUE It has two basic components:CELLS (rbc, wbc, platelets) = 45%Plasma (water, proteins, amino acids..etc) = 55%What is hematology? (study of blood)Is blood a fluid tissue (yes)
6Hematocrit - volume of blood cells in a sample, should be 45% Hematocrit - volume of blood cells in a sample, should be 45%. The remaining fluid is plasma (55%). To determine the percentages, blood is placed in a centrifugeWhat is the difference between blood plasma and blood serum? (Plasma contains clotting factors , serum does not)
7Three Types of Blood Cells RBC – millionWBC – 5-10,000Platelets – 250,000Three Types of Blood Cellsred blood cells (erythrocytes) white blood cells (leukocytes) platelets (thrombocytes)
8BLOODRBC live about 4 months before going to the liver Granular leukocytes live only a few days Non-granular leukocyte 6 months or more
10HEMATOPOEISIS – formation of blood cells (bone marrow) Biconcave discs5 million per cubic millimeterLack nucleiWhat is myeloid tissue better known as : Red bone marrow – sternum, ribs, and hip bonesHEMATOPOEISIS – formation of blood cells (bone marrow)Liver & Spleen - phagocytosis
11Main Functions of RBCs Transports oxygen, picks up carbon dioxide HEMOGLOBIN - molecule that combines with O2IRON is critical to synthesize hemoglobinDisk shape without nucleiBecause of their large number and their unique shape their total surface area is enormous , if laid out their total surface area is bigger than a football field
12Oxygen Levels Oxyhemoglobin = plenty of oxygen; bright red Deoxyhemoglobin = low in O2, “bluish red”
13Elements Critical to RBC Production Folic AcidVitamin B12IronToo few RBC = anemia
14WHITE BLOOD CELLS (Leukocytes) General function is to protect the body against diseaseThere are FIVE different kinds of WBCsGranulocytes (granular cytoplasm) Neutrophils, Eosinophils, BasophilsAgranulocytes (lacking granular cytoplasm) Monocytes, Lymphocytes
26Platelets (thrombocytes) Blood clots and vessel repair
27Platelets Platelets and blood clotting Platelets play an essential role in blood clottingBlood clot formationClotting factors released at the injury site produce prothrombin activatorProthrombin activator and calcium convert prothrombin to thrombinThrombin triggers formation of fibrin, which traps RBC to form a clotWhat does thrombin combine with to form fibrin? (fibrinogen)When does clotting become dangerous? (Clots are dangerous when they occlude normal blood flow.)What is an embolism? (This is a clot that has moved from the site of formation.)What is a thrombus? (This is a stationary clot.)
29PLASMA The liquid portion of blood is 92% water Also contains nutrients, gases, vitamins (etc) and plasma proteinsPlasma – blood minus its cellsComposition – water containing many dissolved substances (food, salts, and hormones)Amount of blood varies with person’s size – 4-6 liters (7-9% of body weight)
30Fibrinogen converted to FIBRIN Plasma ProteinsAlbumins – blood pressureGlobulins (alpha, beta, gamma) – transport lipids and antibodies for immunityFibrinogen – important for blood clottingMAJOR EVENT IN BLOOD CLOTTING =Fibrinogen converted to FIBRIN
34HEMOSTASIS The process of stopping bleeding Involves the coagulation and clotting of the blood to seal the site of damage
35THREE EVENTS IN HEMOSTASIS 1. Blood Vessel Spasm Seratonin = vasoconstrictor2. Platelet plug formation3. Blood coagulationconversion of fibrinogen to fibrin*thrombin is an enzyme that causes the conversion
41On a cold day in 1667, a renegade physician named Jean Denis transfused calf's blood into one of Paris's most notorious madmen. In doing so, Denis angered not only the elite scientists who had hoped to perform the first animal-to-human transfusions themselves, but also a host of powerful conservatives who believed that the doctor was toying with forces of nature that he did not understand. Just days after the experiment, the madman was dead, and Denis was framed for murder. From: Blood Work: A Tale of Medicine and Murder in the Scientific Revolution
42Even animals have blood types Austrian Karl Landsteiner discovered human blood groupsEven animals have blood types
43Blood Type is Controlled by 3 Alleles 4 Possible Blood TypesAlleles: A, B, OA & B are codominantO is recessive
44Rh factor antigen present in RBCs Rh-negative blood Rh systemRh-positive bloodRh factor antigen present in RBCsRh-negative bloodNo Rh factor present in RBCsNo anti-Rh antibodies present naturally in plasmaAnti-Rh antibodies appear in the plasma of Rh-negative people if Rh-positive RBCs have been introduced into their bodiesWhere did the term “Rh” come from? (Rh was discovered in a rhesus monkey, thus its name.)What is an antigen in blood typing? What is an antibody? (An antigen is a substance that can activate the immune system. An antibody is the substance made in response to the stimulation of an antigen.)What happens when many antibodies react with their antigens? (Agglutination can occur and lead to death. Cross matching of blood is essential to avoid agglutination.)
45GenotypesWhat are antigens and antibodies, and how do they relate to each other? (Antigens are substances that can react with antibodies. Antibodies are substances which can react with antigens which are labeled as “foreign” to the body.)What can happen if a patient receives a blood transfusion with a blood type not compatible with her own? (illness and/or death)Which type is known as the universal donor? (type O blood)What is the universal recipient? (type AB blood)
46Consider Both ParentsType A (genotype AA) x Type O (genotype OO)
48Blood that has antibodies on it that is not recognized by the body will be attacked by your immune systemAB is the Universal AcceptorO is the Universal Donor
49Rh FactorA person can either be Rh + or Rh –(positive is dominant)
50Rh Factor and Pregnancy *Problem: When a fetus is Rh+ and the mother is Rh-, this can cause the mother’s immune system to attack the fetus. There are drugs that will suppress this reaction.Rh systemErythroblastosis fetalis: May occur when Rh-negative mother carries a second Rh-positive fetus; caused by mother’s Rh antibodies reacting with baby’s Rh-positive cells
51What is the trade name of the protein usually given to all Rh-negative mothers who carry an Rh-positive baby? (RhoGAM)What does this protein do? (It stops the mother’s body from forming anti-Rh antibodies.)Discuss Research, Issues & Trends: Artificial Blood.
53Blood Safety EXAMPLES OF BLOODBORNE PATHOGENS HEPATITIS B (HBV) HEPATITIS C (HCV)Other NON A, NON B HEPATITISHUMAN IMMUNODEFICIENCY VIRUS (HIV)MALARIAOTHER POTENTIALLY INFECTIOUS MATERIALS
54TRANSMISSIONHIV, hepatitis B virus, and hepatitis C virus are the viruses most likely to be transmitted via the following routes in an occupational setting:needle stick / sharps injuries skin or eye contact mucous membrane and non-intact skin exposure to contaminated blood or other potentially infectious materials ( scratches, cuts, bites, or wounds )
55Avoid Contact With Blood Wear glovesDispose of items that have been contaminated (tissues, needles, bandaids) in biohazard containersDo not “horse around”Treat every person as if they may be carrying an infectious disease
57Carbon Monoxide Poisoning CO binds to your hemoglobin, prevents oxygen from binding. Can be fatal. It is a "silent killer" as people often die in their sleep when a heater fails.Carbon monoxide deaths are more likely to occur in winter Article from 2010, St Clair County
59ANEMIA Iron-Deficiency Anemia (most common) Aplastic Anemia – bone marrow does not produce enough RBCHemorrhagic anemia – due to extreme blood lossPernicious anemia – B12 deficiencySickle Cell Anemia (genetic) - blood cells abnormally shapedPolycythemia – too many RBC
60SICKLE CELL ANEMIA Genetic Disorder Abnormally shaped blood cells Parents can be carriers (asymptomatic)
61ComplicationsPainLethargyLifelong anemia (low red blood count)Organ failureStroke
62Leukemia Type of cancer Overproduction of immature white blood cells They take the place of RBCsTreatable with bone marrow transplants, chemothemotherapy, radiation
63Leukemia Leukopenia - Abnormally low WBC Leukocytosis – Abnormally high WBC countLeukemia – Elevated WBC, but they do not function properly – immature
66St. Jude HospitalLeukemia is one of the most common childhood cancers. It occurs when large numbers of abnormal white blood cells fill the bone marrow and sometimes enter the bloodstream.Because these abnormal blood cells are defective, they don't help protect the body against infection the way normal white blood cells do. And because they grow uncontrollably, they take over the bone marrow and interfere with the body's production of other important types of cells in the bloodstream, like red blood cells (which carry oxygen) and platelets (which help blood to clot).
67Infectious mononucleosis sometimes called "mono" or "the kissing disease," is an infection usually caused by the Epstein-Barr virus (EBV). The designation "mononucleosis" refers to an increase in one type of white blood cells (lymphocytes) in the bloodstream relative to the other blood components as a result of the EBV infection. EBV is very common, and many people have been exposed to the virus at some time in childhood. Article at Medicinenet
68Blood poisoning - Septicemia An infection enters the blood streamCan be deadlyTreated with antibiotics
69Thrombocytopenia Low production of Platelets Causing bleeding or bruisingA bruise is caused when tiny blood vessels are damaged or broken as the result of a blow to the skin (be it bumping against something or hitting yourself with a hammer). The raised area of a bump or bruise results from blood leaking from these injured blood vessels into the tissues as well as from the body's response to the injury.
70Hemophilia - inability or reduced ability of the blood to clot; genetic disorder (more on this later)von Willebrand Disease - also a clotting disorder, but not as severe, excessive bruising occurs
71HEMOPHILIA This disorder causes a failure of the blood to clot Patients can be treated with blood transfusions that include clotting agents.
75Quick Genetics ReviewA gene consists of 2 alleles (represented by letters)One allele is usually dominant over the otherExample:Genotype PhenotypePP widow’s peakPp widow’s peakpp straight hairline
76A person with a widow's peak (Pp) is married to a person with a straight hairline (pp), what percentage of their children will have a straight hairline?
77Two people who are both heterozygous for the widow's peak trait are married. What percentage of their children will have a straight hairline?
78Sickle Cell Anemia is actually codominant AA = normalAa = sickle cell trait (few symptoms) aa = sickle cell anemia
79If both parents are carriers, child has a ¼ chance of having the disease
80A female has sickle cell anemia and is married to a man who appears normal. A doctor tests the man and determines that he does NOT have sickle cell trait. What is the chance that this couple will have a child with sickle cell anemia?
81What happens when a female who is a carrier marries man with sickle cell anemia?
82Hemophilia is carried on the X chromosome Females X H X H normalX H X h carrierX h X h hemophiliacMales X H Y normalX h Y hemophiliac
83What happens when a female who is a carrier marries a normal man?
84What happens when a female who is normal marries a man who has hemophilia?