1. Sarmishtha Ghosh Physiology
CAL-session
Peripheral Smear
Sarmishtha Ghosh
Physiology

2. CBC TOTAL RBC COUNT TOTAL WBC COUNT PERIPHERAL SMEAR
SHAPE, SIZE & COLOR OF RBCs
DIFFERENTIAL WBC COUNT
PLATELET COUNT
HEMOGLOBIN CONCENTRATION
BLOOD INDICES – MCH, MCV, MCHC

4. 1 2 3 4

6. Normal RBC distribution

7. TAIL- TOO THIN, MACROCYTIC & FLAT
HEAD- TOO THICK, SMALL & HYPOCHROMIC

16. SHAPE

20. HEMOGLOBIN CONTENT & DISTRIBUTION

25. WHITE BLOOD CELLS- LEUCOCYTES

27. NEUTROPHIL

28. EOSINOPHIL

29. BASOPHIL

30. LYMPHOCYTE

31. MONOCYTE

32. Hemocytometer

35. Blood Indices
The relationships between the hematocrit, the hemoglobin level, and the RBC are converted to red blood cell indices through mathematical formulas.
These formulas were worked out and first applied to the classification of anemias by Maxwell Wintrobe in 1934.
The indices include these measurements: mean corpuscular volume (MCV); mean corpuscular hemoglobin (MCH); mean corpuscular hemoglobin concentration (MCHC); and red cell distribution width (RDW). They are usually calculated by an automated instrument as part of a complete blood count (CBC).

36. Mean corpuscular volume (MCV)
MCV is the index most often used.
It measures the average volume of a red blood cell by dividing the hematocrit by the red blood cell count.
The MCV categorizes red blood cells by size.
Cells of normal size are called normocytic, smaller cells are microcytic, and larger cells are macrocytic. Following formula is used to calculate MCV

37. Mean corpuscular hemoglobin concentration (MCHC)
measures the average concentration of hemoglobin in a red blood cell.
This index is calculated by dividing the hemoglobin by the hematocrit. The MCHC categorizes red blood cells according to their concentration of hemoglobin.
Cells with a normal concentration of hemoglobin are called normochromic;
cells with a lower than normal concentration are called hypochromic.
Because there is a physical limit to the amount of hemoglobin that can fit in a cell, there is no hyperchromic category.
Anemias are categorized as hypochromic or normochromic according to the MCHC index.

38. Mean corpuscular hemoglobin (MCH)
The average weight of hemoglobin in a red blood cell is measured by the MCH.
Anemias are categorized as hypochromic or normochromic or hyperchromic according to MCH index.
MCH is most useful in diagnosis of severely anemic patients. Among those with lesser degrees of anemia, it is less useful because the measurement has a potential for a relatively wide range of error.
MCH (in pg) = hemoglobin (in g/dL) x 10 ÷ RBC count (in millions/mm3)

39. Normal results for red blood cell indices are as follows:
MCV 82 to 98 fl (femtoliters)
MCHC 31 to 37 g/dl (or %)
MCH 26 to 34 pg (picograms)

40. References cellbio.utmb.edu/microanatomy/Blood.htm
MBBS
2012
LAB EXERCISES
Constructed by:
Dr. Sarmishtha Ghosh
References cellbio.utmb.edu/microanatomy/Blood.htm

41. IDENTIFY WITH JUSTIFICATION : a,b,c,d1
IDENTIFY WITH JUSTIFICATION : a,b,c,d

42. e f 2 a d b c

43. 3 1) What is the advantage of the biconcave shape of RBCs?
2) Why is the absence of a nucleus an advantage?
R- Red Blood Cell
N- Neutrophil
E- Eosinophil

44. 4 1) What is the function of N & E respectively?
2) The eosinophil count of a patient is 7%. What might be the probable indications?
R- Red Blood Cell
N- Neutrophil
E- Eosinophil

45. 5 Identify “X”. What is it composed of?
What is its function in the body? X

46. 6 The photograph shows a Monocyte
What made you identify it to be a Monocyte?
Where would you expect monocytes to be in an infection?
What is their function?

47. 7 These cells in the are 25-33% of white blood cells.
What is it and what is its function?

48. 8
Identify Cell # 1
Identify Cell # 2
Identify Cell # 3

49. 9 This is a Lymphocyte. State the Identifying features
Is this a T lymphocyte or a B- lymphocyte

50. 10 A B C
Comment on RBCs in the three slides A,B and C.