The Blood Chapter 13

Objectives List functions of blood List main ingredients in plasma Describe formation of blood Name 3 elements and give function Characterize the 5 types of leukocytes Define hemostasis and 3 steps involved Describe steps in blood clotting Define blood type and explain relation between this and transfusions 9. List possible reasons for transfusions Define anemia and leukemia. Know the causes and types Name several clotting disorders 12. Clarify tests used to study blood

Blood. Blood. Blood. Circulating blood is vital and Life sustaining!!! Classified as connective tissue. Average adult has approx. 5 liters

Functions of the Blood Transportation Regulation Protection

Blood Constituents (what’s in it!!) Formed Elements Erythrocytes Leukocytes Platelets Plasma Albumin Clotting factors Antibodies Complement

Formation of Blood Cells Come from blood forming stem cells. These can be any of the blood cell types. Blood cells are short lived, so normal bone marrow activity is crucial! Formation of Blood Cells

Erythrocytes Disk-shaped and biconcave No nucleus Carries oxygen that is bound to hemoglobin Serves as a buffer Measured by hematocrit Normal value : 4.5 - 5 Most numerous of blood cells Live 120 days RBC production stimulated by erythropoietin Need certain nutrients to maintain production

Leukocytes Round, colorless with prominent nuclei Function to fight and destroy pathogens Identified by their size, shape, nucleus and the presence of granules Normal value: 5,000 – 10,000 Classified as Granulocytes or Agranulocytes Neutrophils Eosinophils Basophils Lymphocytes Monocytes

WBC’s Granulocytes Neutrophils : Phagocytosis Eosinophils : Allergic reaction / parasitic Basophils : allergic rxn / inflammatory Agranulocytes Lymphocytes : immunity (t and b cells) phagocytosis

Platelets Smallest of formed elements Normal range : 150,000 – 450,000 Not cells, but fragments No nuclei, but have enzymes and mitochondria Essential for clotting First form plug, then release chemicals

Hemostasis Process that prevents blood loss from circulation when a blood vessel is ruptured by an injury. Involves: Contraction Formation of plug Formation of clot

Blood Clotting Procoagulants promote clotting Anticoagulants prevent clotting Controlled process – 12 factors Complicated Occurs in response to an injury Serum is the fluid after clotting factors have been removed

Blood Types A – Have A antigen B - Have B antigen AB – Have both RBC’s that contain specific antigens (proteins) Very important to monitor for transfusion reactions A – Have A antigen B - Have B antigen AB – Have both O – Has neither Rh factor ( D antigen) AB is the Universal Recipient O is the Universal Donor

Rh Factor Rh compatibility is very important in pregnant women!! Rh - mother can produce antibodies to Rh + fetus (received Rh + from father) Not problem then, but if has another Rh + fetus, mother’s antibodies can attack and cause HDN. RhoGAM

WHY WOULD SOMEONE NEED A TRANSFUSION??? Massive Hemorrhage Blood Loss from Internal bleeding During or after Surgery Blood replacement for Hemolytic Disease of the Newborn WHY WOULD SOMEONE NEED A TRANSFUSION???

Plasma Can be given alone in an emergency to replace blood volume and prevent shock Can be given to anyone (no RBC’s present) Can be frozen and given later Increase’s osmotic pressure (brings fluid back into circulation)

Results from a loss of RBC’s ANEMIA Results from a loss of RBC’s Types: Hemorrhagic Hemolytic Iron-deficiency Pernicious Thalassemia

SICKLE-CELL TRAIT AND DISEASE Inherited disease that is a type of anemia. RBC’s are sickle- shaped Fragile and break easily Swelling, pain and abd pain SICKLE-CELL TRAIT AND DISEASE

Leukemia Neoplastic disease of blood-forming tissue Enormous increase in WBC’s Exhibit general symptoms of anemia No known cause Treatments include chemo and bone marrow transplant Two types: - Myelogenous (cancer of the bone marrow) - Lymphocytic (cancer in lymphoid tissue)

Clotting Disorders Hemophilia – hereditary bleeding disorder (Factor VIII) Von Willebrand disease – hereditary clotting disorder Thrombocytopenia – most common and is deficiency of circulating platelets DIC – widespread clotting disorder involving excessive coagulation

Blood Studies Hematocrit Hemoglobin women 12-15 - volume % of RBC’s in whole blood - Normals : men 42-54% women 36-46% *Low values can indicate anemia and bone marrow problems Hemoglobin measures amount of Hb in RBC’s Normals : men 14-17 women 12-15 *Can signify anemia, but useful in diagnosing sickle cell anemia specifically

Blood Studies Cont……. RBC’s – (4.5 – 5) increase is called polycythemia WBC’s – (5,000 – 10,000) low count is called leukopenia. Leukocytosis is high count over 10,000. Platelets – (150,000 – 450,000) platelet loss is thrombocytopenia Chemistry – tests for electrolytes, glucose, nitrogenous waste, BUN, creatinine, cardiac enzymes, lipids Coagulation – PT/PTT

Review : Functions of blood Parts of blood Hemostasis Blood types Blood disorders Blood studies