1. Chapter 11 Blood

2. Elsevier items and derived items © 2008, 2004 by Mosby, Inc., an affiliate of Elsevier Inc. Slide 2 BLOOD COMPOSITION (Table 11-1)  Blood plasma  Definition—blood minus its cells  Composition—water containing many dissolved substances (e.g., foods, salts, and hormones)  Amount of blood—varies with size and sex; 4 to 6 L about average; about 7% to 9% of body weight

3. Elsevier items and derived items © 2008, 2004 by Mosby, Inc., an affiliate of Elsevier Inc. Slide 3 BLOOD COMPOSITION  Formed elements  Types RBCs (erythrocytes) RBCs (erythrocytes) WBCs (leukocytes) WBCs (leukocytes)  Granular leukocytes—neutrophils, eosinophils, and basophils  Nongranular leukocytes—lymphocytes and monocytes Platelets, or thrombocytes Platelets, or thrombocytes  Count RBCs—4.5 to 5 million per mm 3 of blood RBCs—4.5 to 5 million per mm 3 of blood WBCs—5000 to 10,000 per mm 3 of blood WBCs—5000 to 10,000 per mm 3 of blood Platelets—300,000 per mm 3 of blood Platelets—300,000 per mm 3 of blood  Formation—red bone marrow (myeloid tissue) forms all blood cells except some lymphocytes and monocytes, which are formed by lymphatic tissue in the lymph nodes, thymus, and spleen

4. Elsevier items and derived items © 2008, 2004 by Mosby, Inc., an affiliate of Elsevier Inc. Slide 4 BLOOD COMPOSITION  RBCs  Structure—disk-shaped, without nuclei  Functions—transport oxygen and carbon dioxide  Anemia—inability of blood to carry adequate oxygen to tissues; caused, for example, by: Inadequate RBC numbers Inadequate RBC numbers Deficiency of hemoglobin Deficiency of hemoglobin Pernicious anemia—deficiency of vitamin B12 Pernicious anemia—deficiency of vitamin B12  Polycythemia—abnormally high RBC count  Hematocrit test—medical test in which a centrifuge is used to separate whole blood into formed elements and liquid fraction (Figure 11-3) Buffy coat is WBC and platelet fraction Buffy coat is WBC and platelet fraction Normal RBC level is about 45% Normal RBC level is about 45% Erroneous test result can be caused by dehydration Erroneous test result can be caused by dehydration

5. Elsevier items and derived items © 2008, 2004 by Mosby, Inc., an affiliate of Elsevier Inc. Slide 5

6. Elsevier items and derived items © 2008, 2004 by Mosby, Inc., an affiliate of Elsevier Inc. Slide 6

7. Elsevier items and derived items © 2008, 2004 by Mosby, Inc., an affiliate of Elsevier Inc. Slide 7 BLOOD COMPOSITION  WBCs (leukocytes)  General function—defense  WBC count Differential WBC count reveals proportions of each type of WBC Differential WBC count reveals proportions of each type of WBC Leukopenia—abnormally low WBC count Leukopenia—abnormally low WBC count Leukocytosis—abnormally high WBC count Leukocytosis—abnormally high WBC count  Neutrophils and monocytes carry out phagocytosis  Lymphocytes produce antibodies (B-lymphocytes) or directly attack foreign cells (T-lymphocytes)  Eosinophils protect against parasitic irritants that cause allergies  Basophils produce heparin, which inhibits clotting

8. Elsevier items and derived items © 2008, 2004 by Mosby, Inc., an affiliate of Elsevier Inc. Slide 8 BLOOD COMPOSITION  WBC disorders  Leukemia—cancer Elevated WBC count Elevated WBC count Cells do not function properly Cells do not function properly  Type identified by how quickly symptoms appear and cell type involved Acute lymphocytic leukemia (ALL) Acute lymphocytic leukemia (ALL) Acute myeloid leukemia (AML) Acute myeloid leukemia (AML) Chronic lymphocytic leukemia (CLL) Chronic lymphocytic leukemia (CLL) Chronic myeloid leukemia (CML) Chronic myeloid leukemia (CML)

9. Elsevier items and derived items © 2008, 2004 by Mosby, Inc., an affiliate of Elsevier Inc. Slide 9 BLOOD COMPOSITION  Platelets and blood clotting (Figure 11-6)  Platelets play an essential role in blood clotting  Blot clot formation Clotting factors released at the injury site produce prothrombin activator Clotting factors released at the injury site produce prothrombin activator Prothrombin activator and calcium convert prothrombin to thrombin Prothrombin activator and calcium convert prothrombin to thrombin Thrombin triggers formation of fibrin, which traps RBCs to form a clot Thrombin triggers formation of fibrin, which traps RBCs to form a clot

10. Elsevier items and derived items © 2008, 2004 by Mosby, Inc., an affiliate of Elsevier Inc. Slide 10

11. Elsevier items and derived items © 2008, 2004 by Mosby, Inc., an affiliate of Elsevier Inc. Slide 11

12. Elsevier items and derived items © 2008, 2004 by Mosby, Inc., an affiliate of Elsevier Inc. Slide 12 BLOOD TYPES  ABO system (Figure 11-7)  Antigen—substance that can activate immune system  Antibody—substance made by body in response to stimulation by an antigen  Blood types Type A blood—type A self-antigens in RBCs; anti-B type antibodies in plasma Type A blood—type A self-antigens in RBCs; anti-B type antibodies in plasma Type B blood—type B self-antigens in RBCs; anti-A type antibodies in plasma Type B blood—type B self-antigens in RBCs; anti-A type antibodies in plasma Type AB blood—type A and type B self-antigens in RBCs; no anti-A or anti-B antibodies in plasma Type AB blood—type A and type B self-antigens in RBCs; no anti-A or anti-B antibodies in plasma Type O blood—no type A or type B self-antigens in RBCs; both anti-A and anti-B antibodies in plasma Type O blood—no type A or type B self-antigens in RBCs; both anti-A and anti-B antibodies in plasma

13. Elsevier items and derived items © 2008, 2004 by Mosby, Inc., an affiliate of Elsevier Inc. Slide 13

14. Elsevier items and derived items © 2008, 2004 by Mosby, Inc., an affiliate of Elsevier Inc. Slide 14 BLOOD TYPES  Rh system  Rh-positive blood—Rh factor antigen present in RBCs  Rh-negative blood—no Rh factor present in RBCs; no anti-Rh antibodies present naturally in plasma; anti-Rh antibodies, however, appear in the plasma of Rh-negative persons if Rh- positive RBCs have been introduced into their bodies

15. Elsevier items and derived items © 2008, 2004 by Mosby, Inc., an affiliate of Elsevier Inc. Slide 15 BLOOD TYPES  Universal donor and universal recipient blood  Type O  —universal donor blood  Type AB + —universal recipient blood  Erythroblastosis 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

16. Elsevier items and derived items © 2008, 2004 by Mosby, Inc., an affiliate of Elsevier Inc.  What is the liquid portion of the blood? a. Thrombocytes b. Cellulose c. Hemoglobin d. Plasma Slide 16

17. Elsevier items and derived items © 2008, 2004 by Mosby, Inc., an affiliate of Elsevier Inc.  What is another name for the red blood cell a. Leukocyte b. Thrombocyte c. Plasma d. Both A and B Slide 17

18. Elsevier items and derived items © 2008, 2004 by Mosby, Inc., an affiliate of Elsevier Inc.  What is another name for the white blood cell a. Leukocyte b. Thrombocyte c. Plasma d. Both A and B Slide 18

19. Elsevier items and derived items © 2008, 2004 by Mosby, Inc., an affiliate of Elsevier Inc.  What is  What is an inability of the blood to carry sufficient oxygen to the tissues called? a. Leukocyte b. Thrombocyte c. Plasma d. Anemia Slide 19

20. Elsevier items and derived items © 2008, 2004 by Mosby, Inc., an affiliate of Elsevier Inc.  What is  What is the platelet involved in blood clotting a. Leukocyte b. Thrombocyte c. Plasma d. Anemia Slide 20

21. Elsevier items and derived items © 2008, 2004 by Mosby, Inc., an affiliate of Elsevier Inc.  What is  What is a laboratory test to determine the total volume of the red blood cells called? a. Prothrombin Time b. CBC c. Hemoglobin (HgB d. Hematocrit (Hct) Slide 21

22. Elsevier items and derived items © 2008, 2004 by Mosby, Inc., an affiliate of Elsevier Inc.  What is  What is used to determine the types of “antigens” located on the red blood cell to facilitate blood transfusions called? a. Typing b. Crossing c. CBC d. Blood Typing Slide 22

23. Elsevier items and derived items © 2008, 2004 by Mosby, Inc., an affiliate of Elsevier Inc. Questions Slide 23