1. Allied Health Sciences I Instructor: Melissa Lewis
Hematology
Allied Health Sciences I
Instructor: Melissa Lewis

2. How much blood does an average adult have in their body?
Eight to Ten pints (8-10)
Four to Five Quarts (4-5)

3. Functions of the Blood:
Transporting fluid of the body
Carries nutrients from digestive tract to cells
Carries waste products from cells to excretory organs
Carries hormones and other chemical substances that control proper functioning

4. Functions of the Blood Cont:
Controls body temperature by circulating excess heat to body surfaces and to lungs, through which it is lost.
Circulates antibodies and defensive cells throughout body to combat infection and disease.

5. Objective 1H07. 01: Explain the structure of the blood
Blood composition: Blood is made up of plasma, which is the liquid portion of the blood without the cellular elements and the celluar elements which are: 1. Erythrocytes (RBC’s) 2. Leukocytes (WBC’s) 3. Thrombocytes (platelets)

6. Plasma:
Liquid portion of the blood
Makes up 55% of the blood volume

7. Plasma Contains the following Substances:
1. Water which is 92%of the total volume of plasma.
2. Blood proteins-hemoglobin is a protien found in red blood cells.
3. Nutrients- also part of the blood plasma are the nutrient molecules such as glucose, fatty acids, cholesterol, and amino acids that are absorbed from the digestive tract

8. Cont…
4. Electrolytes- Sodium Chloride (NaCl) and potassium (K) are the most abundant electrolytes
5. Hormones, Vitamins, and enzymes help the body with it’s chemical reactions and are found in very small amounts in the blood plasma.
6. Metabolic waste products- these are carried by the blood plasma to the various excretory organs.

9. Cont…
7. Plasma proteins- Fibrinogen, serum albumin, and serum globulin are the three most abundant proteins in plasma.
A. Fibrinogen- is the protein synthesized by the liver than is necessary for blood clotting
B. Albumin- is the protein also synthesized by the liver that maintains the blood’s osmotic pressure and volume. It is the most abundant of the plasma proteins.
C. Globulin- formed in the liver and lymphatic system. It has two parts- Gamma globulin is necessary for the synthesis of antibodies to fight organisms. Prothrombin is the other part that is formed continuously in the liver, which helps bloods to coagulate. Vitamin K helps in the synthesis of prothrombin.

10. Cont…
7. Plasma proteins- Fibrinogen, serum albumin, and serum globulin are the three most abundant proteins in plasma.
A. Fibrinogen- is the protein synthesized by the liver than is necessary for blood clotting
B. Albumin- is the protein also synthesized by the liver that maintains the blood’s osmotic pressure and volume. It is the most abundant of the plasma proteins.
C. Globulin- formed in the liver and lymphatic system. It has two parts- Gamma globulin is necessary for the synthesis of antibodies to fight organisms. Prothrombin is the other part that is formed continuously in the liver, which helps bloods to coagulate. Vitamin K helps in the synthesis of prothrombin.

11. Red Blood Cells (RBC’s):
Called erythrocytes
Biconcave
Disc-shaped cells
Look like donuts
Thin in the middle & thicker on the outer edges

12. Hemoglobin: Red pigment of erythrocyte
Composed of a protein molecule called globin and an iron compound called heme.
Transports oxygen to tissues and carbon dioxide from tissues
Normal Hemoglobin Levels for men =14-18 grams per 100 cc, women = grams/100cc

13. Hemoglobin cont:
The RBC’s pick up oxygen from capillaries in lungs as we inhale. The oxygen chemically combines with hemoglobin forming compound oxyhemoglobin. The RBC’s carry the oxyhemoglobin to capillaries of body tissues and releases the oxygen. The carbon dioxide that is formed is picked up by plasma and the RBC’s circulate back to lungs to give up the carbon dioxide and absorb more oxygen. We exhale the carbon dioxide.

14. Hemoglobin cont:
The blood cells of the arteries (except pulmonary artery) carry oxyhemoglobin. This gives blood it’s bright red color.
The blood cells of the veins (except pulmonary veins) contain carbominohemoglobin, which is responsible for the dark, crimson-blue color characteristic of venous blood.

15. Carbon Monoxide Poisoning:
Is a serious and sometimes fatal condition. It is an odorless gas present in the exhaust of gasoline engines. Carbon monoxide rapidly combines with hemoglobin; and it binds at the same site on the hemoglobin molecule as oxygen. It crowds the oxygen out.
Symptoms are headache, dizziness, drowsiness, and unconiousness.Death can occur.

16. Carbon monoxide poisoning cont…
One should remember that the gas is odorless. It is also present in gas furnaces and gas or oil-fired space heaters. Always allow plenty of ventilation. There are commercial carbon monoxide detectors available to measure for carbon monoxide.

17. Erythropoiesis:
Erythropoiesis is the manufacture of RBC’s. Until adolescence RBC’s are formed in the red marrow of the bones. After adolescence RBC’s are formed in the short and flat bones.
RBC’s come from stem cells in the red bone marrow called hemocytoblasts. As it matures into an erythrocyte, it loses it’s nucleus and cytoplasmic organelles. The hemocytoblasts gains hemoglobin and develops into the biconcave shape and enters into the bloodstream.

18. Cont…
Erythrocytes only live 120 days. At the cells age they deteriorate. They are broken down by the spleen and liver. Hemoglobin breaks down into the globin and heme and the iron content of heme is used to make new red blood cells
Normal RBC count for men=4.5 to 6.2
Normal RBC count for women=4.2 to 5.4

19. White blood cells (Leukocytes):
Granular or agranular, translucent, and ameboid in shape.
Much larger than RBC’s
Two major groups: granulocytes and agranulocytes
Granulocytes are formed in the red marrow from cells called myeoblasts. Their life span is usually only a few days but does vary.

20. Three types of Granulocytes:
Neutrophils: Phagocytize (surround, engulf, and digest harmful bacteria) bacteria with lysosomal enzymes
Eosinophils: Phagocytize antibody-antigen reactions. Also increase allergic conditions.
Basophils: Phagocytize. Their count increases during chronic inflammation and during healing of an infection. They produce histamine, which is a vasodilator, and heparin, an anticoagulant.

21. Agranulocytes:
Divided into lymphocytes and monocytes

22. Lymphocytes:
Lymphocytes are divided into B-lymphocytes and T-lymphocytes
Life span ranges from few days to several years
Synthesize & release antibody molecules
Protect against formation of cancer cells

23. Monocytes: Assist with phagocytosis
Able to leave the bloodstream to attach themselves to tissues
When they attach themselves to tissues they become macrophages/histiocytes
Macrophages/histiocytes help wall off an infected area

24. Inflammation: Process of our body that protects us
Occurs when we have 1. chemical or physical tissue damage or 2. invasion from a microorganism
Pathogen= a microorganism that is capable of causing disease

25. Symptoms of Inflammation:
Redness
Local heat
Swelling
Pain

26. Inflammation Cont…
Histamine is released by basophils & this increases blood flow to the area
Capillary permeability is increased
Neutrophils move through the capillary walls by diapedesis and begin phagocytizing the microorganism

27. Inflammation Cont…
Result equals combination of dead tissue, dead & living bacteria, dead leukocytes, & plasma
This all looks like a cream-colored liquid (called pus)
If damaged area is below the epidermis an abscess (pus filled cavity) forms
If damaged area is on skin or mucosal surface it is called an ulcer

28. Inflammation Cont…
Sometimes during inflammation process pyrogens are formed & they travel to the hypothalamus
In the hypothalamus, these pyrogens affect the temperature control center which raises the body temperature causing a fever or pyrexia

29. Blood Clotting: Thrombocytes are blood platelets
Thrombocytes are the smallest of the solid components of the blood
Normal platelet count is 250,000 to 450,000 per cubic millimeter of blood

30. Blood Clotting Process:
1. Platelets come in contact with vessel’s collagen fibers
2. This stimulates the platelets to produce sticky projecting structures, allowing them to stick
3. A platelet plug forms to stop bleeding
4. Platelets secrete a chemical called serotonin
5. Serotonin causes blood vessel spasm which decreases blood flow
6. Clot is formed

31. Coagulation: Means blood clotting
When blood vessel is injured platelets & injured tissue release thromboplastin
Thromboplastin is a complex substance that can only allow cause coagulation if calcium ions & prothrombin are present
Prothrombin is a plasma protein that is synthesized in the liver

32. Coagulation cont…
The thromboplastin & calcium ions act as enzymes in a reaction that converts prothrombin into thrombin
This occurs when there is bleeding
Thrombin acts as an enzyme and changes fibrinogen into fibrin
The fibrin threads layer themselves over the cut forming a network
This network traps RBC’s, platelets, & plasma
This creates a blood clot
Serum oozes from the cut forming a scab over the fibrin threads & completes the clotting process

33. Coagulation cont…
There are 2 anticoagulants that must be neutralized before clotting can occur
They are antithromboplastin & antiprothrombin (heparin)
Both of these are neutralized by thromboplastin

34. Coagulation cont…
Prothrombin & fibrinogen are plasma proteins that are made in the liver
If liver disease present, the blood clotting process will be affected
Prothrombin can not be made without Vitamin K
Vit K is manufactured from a type of bacteria found in the intestines

35. Clotting Time: Time is takes for the blood to clot
Normal clotting times for humans is 5-15 minutes
A person clotting time should be known prior to doing surgery

36. Blood Types:
There are four major blood types A B AB O

37. Blood Types Cont…
Blood type is determined by presence or absence of blood protein called agglutinogen or antigen that is on the surface of the RBC
Type A blood has B antibodies
Type B blood has A antibodies
Type O blood has A & B antibodies
Type AB contains no antibodies

38. Universal Donor: O blood because it has no A or B antigens
O blood could be given to anyone

39. Universal Recipient: Type AB because has no antibodies
Someone with Type AB blood could receive any of the four blood types

40. Rh Factor: RBC contain Rh antigen
This is the Rh factor since it was found in the Rhesus monkey
It is found on the surface of the RBC
If it is present a person is said to be Rh positive
If it is not present a person is said to be Rh negative
Most Americans are Rh positive

41. Rh Factor cont…
If a Rh negative person receives a transfusion of Rh positive blood, he or she will develop antibodies to it (takes 2 weeks to acquire new antibodies)
Usually there is no problem the first transfusion
If a second transfusion occurs with Rh positive blood, the new antibodies will clump with the antigens

42. Rh Factor & Pregnancy:
This same problem can occur with a Rh negative mother who is carrying a Rh positive fetus
The problem would occur with the second pregnancy
The second baby’s RBC’s would clump & the baby would be born with erythroblastosis fetalis

43. Rh Factor & Pregnancy cont…
Erythroblastosis fetalis is rare today because of a drug call RHO Gam
RHO Gam is an immune globulin
This injection is given to Rh negative mothers within 72 hours after delivery
The antibodies in the RHO Gam will destroy any Rh positive cells of the baby’s which have entered the mother’s blood stream
Therefore the mother will not produce antibodies

44. Disorders of the Blood:
Anemia: deficiency of RBC’s & the amount of hemoglobin in the blood
Iron deficiency anemia: Caused by inadequate amounts of iron in diet
Pernicious anemia: Caused by deficiency of Vit B12 (Vit B12 & Folic acid are necessary for development of RBC’s

45. Disorders of the Blood cont…
Aplastic anemia: Occurs when the bone marrow does not produce enough RBC or WBC (usually occurs in chemo or radition treatment patients)
Sickle Cell Anemia: Chronic disease that is inherited from both parents
RBC’s are a crescent shape (abnormal)
They carry less oxygen & break easily

46. Disorders of the Blood cont…
Cooley’s anemia: Caused by a defect in hemoglobin formation (also called thalassemia)
Polycytemia: Condition of too many RBC’s are formed
Embolism: Condition where a blood clot or embolus is carried by the blood stream until it reaches an artery that is too small for its passage
Embolus could be made of air, cancer cells, blood clot, bacterial clumps, needle or bullet

47. Disorders of the Blood cont…
Thrombosis: formation of a blood clot in a blood vessel
Hematoma: Localized clotted mass of blood found in an organ, tissue, or space
Hemophilia: Hereditary disease in which the blood clots slowly or abnormally

48. Disorders of the Blood cont…
Thrombocytopenia: Blood disease which there is a decrease in the number of platelets
Leukemia: Cancerous or malignant condition in which there is a great increase in the number of the WBC’s

49. Umbilical Stem Cells:
There are immunity-producing stem cells found in the umbilical cord that are the same as the immunity-producing stem cells in the bone marrow
Umbilical cells are easier to transplant
Stem cells are young & the brand new donor has not yet developed antibodies that turn against the recipient
These transplants are highly experimental & have been used mainly in children
They aid in the treatment of leukemia, anemia, & Hodgkin’s disease

50. THE END