1. 4 Fluids and Transport Fundamentals of Anatomy & Physiology Unit
Frederic H. Martini
PowerPoint® Lecture Slides prepared by Professor Albia Dugger, Miami–Dade College, Miami, FL
Professor Robert R. Speed, Ph.D., Wallace Community College, Dothan, AL
Copyright © 2005 Pearson Education, Inc., publishing as Benjamin Cummings

2. Chapter 19: Blood

3. What are the components of the cardiovascular system, and their major functions?

4. The Cardiovascular System
A circulating transport system:
a pump (the heart)
a conducting system (blood vessels)
a fluid medium (blood)

5. Functions of the Cardiovascular System
To transport materials to and from cells:
oxygen and carbon dioxide
nutrients
hormones
immune system components
waste products

6. What are the important components and major functions of blood?

7. Blood Is specialized fluid of connective tissue
Contains cells suspended in a fluid matrix

8. 5 Functions of Blood Transport of dissolved substances
Regulation of pH and ions

9. 5 Functions of Blood Restriction of fluid losses at injury sites
Defense against toxins and pathogens
Stabilization of body temperature

10. Whole Blood
Figure 19–1a

11. Whole Blood
Plasma:
fluid
Formed elements:
all cells and solids

12. Plasma
Water
Dissolved plasma proteins
Other solutes

13. Plasma Is similar to, and exchanges fluids with, interstitial fluid
Is matrix of formed elements

14. 3 Types of Formed Elements
Red blood cells (RBCs) or erythrocytes:
transport oxygen
White blood cells (WBCs) or leukocytes:
part of the immune system
Platelets:
cell fragments involved in clotting

15. Hemopoiesis Process of producing formed elements
By myeloid and lymphoid stem cells

16. Fractionation Process of separating whole blood for clinical analysis:
into plasma and formed elements

17. 3 General Characteristics of Blood
38°C (100.4°F) is normal temperature
High viscosity
Slightly alkaline pH (7.35–7.45)

18. Blood Volume Blood volume (liters) = 7% of body weight (kilograms):
adult male: 5 to 6 liters
adult female: 4 to 5 liters

19. What is the composition and function of plasma?

20. Plasma
Figure 19–1b

21. Plasma Makes up 50–60% of blood volume
More than 90% of plasma is water

22. Extracellular Fluids Interstitial fluid (IF) and plasma
Materials plasma and IF exchange across capillary walls:
water
ions
small solutes

23. Differences between Plasma and IF
Levels of O2 and CO2
Dissolved proteins:
plasma proteins do not pass through capillary walls

24. 3 Classes of Plasma Proteins
Albumins (60%)
Globulins (35%)
Fibrinogen (4%)

25. Albumins Transport substances: fatty acids thyroid hormones
steroid hormones

26. Globulins Antibodies, also called immunoglobulins
Transport globulins (small molecules):
hormone-binding proteins
metalloproteins
apolipoproteins (lipoproteins)
steroid-binding proteins

27. Fibrinogen Molecules form clots
Produce long, insoluble strands of fibrin

28. Serum Liquid part of a blood sample:
in which dissolved fibrinogen has converted to solid fibrin

29. Other Plasma Proteins 1% of plasma:
changing quantities of specialized plasma proteins
enzymes, hormones, and prohormones

30. Origins of Plasma Proteins
90% made in liver
Antibodies made by plasma cells
Peptide hormones made by endocrine organs

31. KEY CONCEPT (1 of 3)
Total blood volume (liters) = 7% of body weight (kilograms)

32. KEY CONCEPT (2 of 3)
About 1/2 the volume of whole blood is cells and cell products

33. KEY CONCEPT (3 of 3)
Plasma resembles interstitial fluid, but contains a unique mixture of proteins not found in other extracellular fluids

34. What are the characteristics and functions of red blood cells?

35. Red Blood Cells
Red blood cells (RBCs) make up 99.9% of blood’s formed elements

36. Measuring RBCs Red blood cell count:
reports the number of RBCs in 1 microliter whole blood
Hematocrit (packed cell volume, PCV):
percentage of RBCs in centrifuged whole blood

37. Normal Blood Counts RBC: Hematocrit: male: 4.5–6.3 million
female: 4.–5.5 million
Hematocrit:
male: 4–52
female: 3–47

38. RBC Structure Small and highly specialized disc
Thin in middle and thicker at edge
Figure 19–2d

39. Importance of RBC Shape and Size
High surface-to-volume ratio:
quickly absorbs and releases oxygen
Discs form stacks:
smoothes flow through narrow blood vessels
Discs bend and flex entering small capillaries:
7.8 µm RBC passes through 4 µm capillary

40. Lifespan of RBCs Lack nuclei, mitochondria, and ribosomes
Live about 120 days

41. What is the structure and function of hemoglobin?

42. Hemoglobin (Hb) Protein molecule, transports respiratory gases
Normal hemoglobin (adult male):
14–18 g/dl whole blood

43. Hemoglobin Structure
Complex quaternary structure
Figure 19–3

44. Hemoglobin Structure 4 globular protein subunits: Iron ions easily:
each with 1 molecule of heme
each heme contains 1 iron ion
Iron ions easily:
associate with oxygen (oxyhemoglobin)
or dissociate from oxygen (deoxyhemoglobin)

45. Fetal Hemoglobin Strong form of hemoglobin found in embryos
Takes oxygen from mother’s hemoglobin

46. Carbaminohemoglobin With low oxygen (peripheral capillaries):
hemoglobin releases oxygen
binds carbon dioxide and carries it to lungs

47. Anemia Hematocrit or hemoglobin levels are below normal
Is caused by several conditions

48. How are the components of old or damaged red blood cells recycled?

49. Recycling RBCs
Figure 19–4

50. Recycling RBCs 1% of circulating RBCs wear out per day:
about 3 million RBCs per second
Macrophages of liver, spleen, and bone marrow:
monitor RBCs
engulf RBCs before membranes rupture (hemolyze)

51. Diagnosing Disorders Hemoglobinuria: Hematuria:
hemoglobin breakdown products in urine due to excess hemolysis in blood stream
Hematuria:
whole red blood cells in urine due to kidney or tissue damage

52. Hemoglobin Recycling Phagocytes break hemoglobin into components:
globular proteins to amino acids
heme to biliverdin
iron

53. Iron Recycling To transport proteins (transferrin)
To storage proteins (feritin and hemosiderin)

54. Breakdown of Biliverdin
Biliverdin (green) is converted to bilirubin (yellow)
Bilirubin is:
excreted by liver (bile)
jaundice is caused by bilirubin buildup
converted by intestinal bacteria to urobilins and stercobilins which account for the yellow brown to brown color of stool.

55. What is erythropoiesis
What is erythropoiesis? What are the stages of red blood cell maturation, and how is red blood cell production regulated?

56. RBC Maturation
Figure 19–5

57. Erythropoiesis Red blood cell formation
Occurs only in red bone marrow (myeloid tissue)
Stem cells mature to become RBCs

58. Hemocytoblasts Stem cells in bone marrow divide to produce:
myeloid stem cells:
become RBCs, some WBCs
lymphoid stem cells:
become lymphocytes

59. Stages of RBC Maturation
Myeloid stem cell
Proerythroblast
Erythroblasts
Reticulocyte
Mature RBC

60. Components Building red blood cells requires: amino acids iron
vitamins B12, B6, and folic acid

61. Pernicious Anemia Low RBC production
Due to unavailability of vitamin B12 (remember the intrinsic factor produced by the parietal cells in the gastric glands of the stomach, which is needed to absorb vitamin B12)

62. Stimulating Hormones Erythropoietin (EPO)
Also called erythropoiesis-stimulating hormone:
secreted when oxygen in peripheral tissues is low (hypoxia)
due to disease or high altitude

63. RBC Tests
Table 19–1

64. KEY CONCEPT (1 of 3)
Red blood cells (RBCs) are the most numerous cells in the body

65. KEY CONCEPT (2 of 3)
RBCs circulate for approximately 4 months before recycling
Several million are produced each second

66. KEY CONCEPT (3 of 3) Hemoglobin in RBCs transports:
oxygen from lungs to peripheral tissues
carbon dioxide from tissues to lungs

67. What is blood typing, and why is it important
What is blood typing, and why is it important? What is the basis for ABO and Rh incompatibilities?

68. Surface Antigens
Are cell surface proteins that identify cells to immune system
Normal cells are ignored and foreign cells attacked

69. Blood Types Are genetically determined
By presence or absence of RBC surface antigens A, B, Rh

70. 4 Basic Blood Types
Figure 19–6a

71. 4 Basic Blood Types A (surface antigen A) B (surface antigen B)
AB (antigens A and B)
O (neither A nor B)

72. Agglutinogens Antigens on surface of RBCs Screened by immune system
Plasma antibodies attack (agglutinate) foreign antigens

73. Blood Plasma Antibodies
Type A:
type B antibodies
Type B:
type A antibodies
Type O:
both A and B antibodies
Type AB:
neither A nor B

74. The Rh Factor Also called D antigen
Either Rh positive (Rh+) or Rh negative (Rh—)
Only sensitized Rh— blood has anti-Rh antibodies

75. Cross-Reaction
Figure 19–6b

76. Cross-Reaction Also called transfusion reaction
Plasma antibody meets its specific surface antigen
Blood will agglutinate and hemolyze
If donor and recipient blood types not compatible

77. Blood Type Test
Determines blood type and compatibility
Figure 19–7

78. Cross-Match Test
Performed on donor and recipient blood for compatibility
Without cross-match, type O— is universal donor

79. Based on structures and functions, what are the types of white blood cells, and what factors regulate the production of each type?

80. White Blood Cells (WBCs)
Also called leukocytes
Do not have hemoglobin
Have nuclei and other organelles

81. WBC Functions Defend against pathogens Remove toxins and wastes
Attack abnormal cells

82. WBC Movement Most WBCs in: Small numbers in blood:
connective tissue proper
lymphatic system organs
Small numbers in blood:
6000 to 9000 per microliter

83. Circulating WBCs Migrate out of bloodstream Have amoeboid movement
Attracted to chemical stimuli (positive chemotaxis)
Some are phagocytic:
neutrophils, eosinophils, and monocytes

84. Types of WBCs
Figure 19–9

85. 5 Types of WBCs Neutrophils Eosinophils Basophils Monocytes
Lymphocytes

86. Neutrophils Also called polymorphonuclear leukocytes
50–70% of circulating WBCs
Pale cytoplasm granules with:
lysosomal enzymes
bactericides (hydrogen peroxide and superoxide)

87. Neutrophil Action Very active, first to attack bacteria
Engulf pathogens
Digest pathogens
Release prostaglandins and leukotrienes
Form pus

88. Degranulation Removing granules from cytoplasm Defensins:
peptides from lysosomes
attack pathogen membranes

89. Eosinophils Also called acidophils 2–4% of circulating WBCs
Attack large parasites
Excrete toxic compounds:
nitric oxide
cytotoxic enzymes

90. Eosinophil Actions Are sensitive to allergens
Control inflammation with enzymes that counteract inflammatory effects of neutrophils and mast cells

91. Basophils Are less than 1% of circulating WBCs Are small
Accumulate in damaged tissue

92. Basophil Actions Release histamine: Release heparin:
dilates blood vessels
Release heparin:
prevents blood clotting

93. Monocytes 2–8% of circulating WBCs Are large and spherical
Enter peripheral tissues and become macrophages

94. Macrophage Actions Engulf large particles and pathogens
Secrete substances that attract immune system cells and fibroblasts to injured area

95. Lymphocytes 20–30% of circulating WBCs Are larger than RBCs
Migrate in and out of blood
Mostly in connective tissues and lymphatic organs

96. Lymphocyte Actions
Are part of the body’s specific defense system

97. 3 Classes of Lymphocytes
T cells
B cells
Natural killer (NK) cells

98. T cells
Cell-mediated immunity
Attack foreign cells directly

99. B cells Humoral immunity
Differentiate into plasma cells (activated B cells that secrete antibodies).
Synthesize antibodies

100. Natural Killer Cells (NK)
Detect and destroy abnormal tissue cells (cancers)

101. The Differential Count of Circulating WBCs
Detects changes in WBC populations
Infections, inflammation, and allergic reactions

102. WBC Disorders Leukopenia: Leukocytosis: Leukemia:
abnormally low WBC count
Leukocytosis:
abnormally high WBC count
Leukemia:
extremely high WBC count

103. KEY CONCEPT RBCs outnumber WBCs 1000:1
WBCs defend against infection, foreign cells, or toxins
WBCs clean up and repair damaged tissues

104. KEY CONCEPT The most numerous WBCs: neutrophils lymphocytes
engulf bacteria
lymphocytes
are responsible for specific defenses of immune response

105. WBC Production Origins and Differentiation of Formed Elements PLAY
Figure 19–10

106. WBC Production All blood cells originate from hemocytoblasts:
which produce myeloid stem cells and lymphoid stem cells

107. Myeloid Stem Cells Differentiate into progenitor cells:
which produce all WBCs except lymphocytes

108. Lymphocytes Are produced by lymphoid stem cells Lymphopoiesis:
the production of lymphocytes

109. WBC Development WBCs, except monocytes: Monocytes:
develop fully in bone marrow
Monocytes:
develop into macrophages in peripheral tissues

110. Other Lymphopoiesis
Some lymphoid stem cells migrate to peripheral lymphoid tissues (thymus, spleen, lymph nodes)
Also produce lymphocytes

111. 4 Colony-Stimulating Factors (CSFs)
Hormones that regulate blood cell populations:
1. M-CSF:
stimulates monocyte production
2. G-CSF:
stimulates granulocyte production
neutrophils, eosinophils, and basophils

112. 4 Colony-Stimulating Factors (CSFs)
3. GM-CSF:
stimulates granulocyte and monocyte production
4. Multi-CSF:
accelerates production of granulocytes, monocytes, platelets, and RBCs

113. Summary: Formed Elements of Blood
Table 19–3

115. What is the structure and function of platelets, and how are they produced?

116. Platelets Cell fragments involved in human clotting system
Nonmammalian vertebrates have thrombocytes (nucleated cells)

117. Platelet Circulation Circulates for 9–12 days Are removed by spleen
2/3 are reserved for emergencies

118. Platelet Counts 150,000 to 500,000 per microliter Thrombocytopenia:
abnormally low platelet count
Thrombocytosis:
abnormally high platelet count

119. 3 Functions of Platelets
Release important clotting chemicals
Temporarily patch damaged vessel walls
Actively contract tissue after clot formation

120. Platelet Production Also called thrombocytopoiesis:
occurs in bone marrow

121. Megakaryocytes
Giant cells
Manufacture platelets from cytoplasm

122. Hormonal Controls
Thrombopoietin (TPO)
Inteleukin-6 (IL-6)
Multi-CSF

123. What mechanisms control blood loss after injury, and what is the reaction sequence in blood clotting?

124. Hemostasis The cessation of bleeding: vascular phase platelet phase
coagulation phase

125. The Vascular Phase A cut triggers vascular spasm 30-minute contraction
Figure 19–11a

126. 3 Steps of the Vascular Phase
Endothelial cells contract:
expose basal lamina to bloodstream

127. 3 Steps of the Vascular Phase
Endothelial cells release:
chemical factors:
ADP, tissue factor, and prostacyclin
local hormones:
endothelins
stimulate smooth muscle contraction and cell division

128. 3 Steps of the Vascular Phase
Endothelial cell membranes become “sticky”:
seal off blood flow

129. The Platelet Phase
Begins within 15 seconds after injury
Figure 19–11b

130. The Platelet Phase (1 of 2)
Platelet adhesion (attachment):
to sticky endothelial surfaces
to basal laminae
to exposed collagen fibers

131. The Platelet Phase (2 of 2)
Platelet aggregation (stick together):
forms platelet plug
closes small breaks

132. Activated Platelets Release Clotting Compounds
Adenosine diphosphate (ADP)
Thromboxane A2 and serotonin
Clotting factors
Platelet-derived growth factor (PDGF)
Calcium ions

133. Platelet Plug: Size Restriction (1 of 2)
Prostacyclin:
released by endothelial cells
inhibits platelet aggregation
Inhibitory compounds:
released by other white blood cells

134. The Coagulation Phase Begins 30 seconds or more after the injury
Figure 19–12a

135. The Coagulation Phase Blood clotting (coagulation):
Involves a series of steps
converts circulating fibrinogen into insoluble fibrin

136. Blood Clot Fibrin network Covers platelet plug Traps blood cells
Seals off area

137. Clotting Factors Also called procoagulants Proteins or ions in plasma
Required for normal clotting

138. Plasma Clotting Factors
Table 19–4

139. Cascade Reactions During coagulation phase
Chain reactions of enzymes and proenzymes
Form 3 pathways

140. 3 Coagulation Pathways Extrinsic pathway: Intrinsic pathway:
begins in the vessel wall
outside blood stream
Intrinsic pathway:
begins with circulating proenzymes
within bloodstream

141. 3 Coagulation Pathways Common pathway:
where intrinsic and extrinsic pathways converge

142. The Extrinsic Pathway Damaged cells release tissue factor (TF)
TF + other compounds = enzyme complex
Activates Factor X

143. The Intrinsic Pathway Activation of enzymes by collagen
Platelets release factors (e.g., PF–3)
Series of reactions activate Factor X

144. The Common Pathway Enzymes activate Factor X
Forms enzyme prothrombinase
Converts prothrombin to thrombin
Thrombin converts fibrinogen to fibrin

145. Functions of Thrombin Stimulates formation of tissue factor
stimulates release of PF-3 (platelet factor)
forms positive feedback loop (intrinsic and extrinsic):
accelerates clotting

146. Bleeding Time
Normally, a small puncture wound stops bleeding in 1–4 minutes

147. Clotting: Area Restriction
Anticoagulants (plasma proteins):
antithrombin-III
alpha-2-macroglobulin
Heparin
Protein C –stimulates plasmin formation an enzyme that breaks down fibrin strands (Protein C is activated by thrombomodulin)
Prostacyclin also inhibits platelet aggregation.

148. Other Factors
Calcium ions (Ca2+) and vitamin K are both essential to the clotting process

149. Clot Retraction After clot has formed: Takes 30–60 minutes
Platelets contract and pull torn area together
Takes 30–60 minutes

150. Fibrinolysis Slow process of dissolving clot:
thrombin and tissue plasminogen activator (t-PA):
activate plasminogen
Plasminogen produces plasmin:
digests fibrin strands

151. KEY CONCEPT (1 of 3)
Platelets are involved in coordination of hemostasis (blood clotting)

152. KEY CONCEPT (2 of 3)
Platelets, activated by abnormal changes in local environment, release clotting factors and other chemicals

153. KEY CONCEPT (3 of 3)
Hemostasis is a complex cascade that builds a fibrous patch that can be remodeled and removed as the damaged area is repaired

154. SUMMARY (1 of 8) Functions of cardiovascular system
5 functions of blood
Structure of whole blood:
plasma and formed elements

155. SUMMARY (2 of 8) Process of blood cell formation (hemopoiesis)
3 classes of plasma proteins:
albumins
globulins
fibrinogen

156. SUMMARY (3 of 8) RBC structure and function
Hemoglobin structure and function

157. SUMMARY (4 of 8)
RBC production and recycling
Blood types:
ABO and Rh

158. SUMMARY (5 of 8) WBC structure and function 5 types of WBCs:
neutrophils
eosinophils
basophils
monocytes
lymphocytes

159. SUMMARY (6 of 8)
Differential WBC counts and disease
WBC production

160. SUMMARY (7 of 8)
Platelet structure and function
Platelet production

161. SUMMARY (8 of 8) 3 phases of hemostasis: Fibrinolysis vascular
platelet
coagulation
Fibrinolysis