1. Copyright © 2012 by Mosby, an imprint of Elsevier Inc. BLOOD, BLOOD-FORMING ORGANS, AND THE IMMUNE MECHANISM Chapter Eight

2. 2 Copyright © 2012 by Mosby, an imprint of Elsevier Inc. Functions of the Blood and Immune Systems Homeostasis Functions of the blood  Transportation  Regulation  Protection from infection  Protection from blood loss

3. 3 Copyright © 2012 by Mosby, an imprint of Elsevier Inc. Functions of the Lymphatic System Cleansing Returning Providing a pathway Defending

4. 4 Copyright © 2012 by Mosby, an imprint of Elsevier Inc. Function of the Immune System Defending

5. 5 Copyright © 2012 by Mosby, an imprint of Elsevier Inc. Relationship of Lymphatic Vessels to the Circulatory System

6. 6 Copyright © 2012 by Mosby, an imprint of Elsevier Inc. Word Parts hemat/o = blood -poiesis = formation hem/o = blood cyt/o = cell -blast = embryonic, immature Hematic System Blood and vessels  Hematopoiesis  Hematopoietic stem cell (HSC)  Hemocytoblast

7. 7 Copyright © 2012 by Mosby, an imprint of Elsevier Inc. Hematic System

8. 8 Copyright © 2012 by Mosby, an imprint of Elsevier Inc. Word Parts erythr/o = red -cyte = cell leuk/o = white thromb/o = clotting, clot Blood Composition Blood cells (formed elements)  Erythrocytes  Leukocytes  Thrombocytes (platelets) Plasma

9. 9 Copyright © 2012 by Mosby, an imprint of Elsevier Inc. Word Parts hem/o, hemat/o = blood erythr/o = red -cyte = cell -globin = protein myel/o = bone marrow -siderin = iron substance -poietin = forming substance -lysis = breaking down morph/o = shape, form -logy = study of Components of Blood/Red Blood Cells Erythrocytes  Hemoglobin  RBC life cycle  Erythropoietin  Hemosiderin  Hemolysis  Morphology Erythrocytes From Thibodeau and Patton: Anatomy and physiology, ed 6, Mosby

10. 10 Copyright © 2012 by Mosby, an imprint of Elsevier Inc. Be Careful! Hgb, HB, Hb, and HG are all abbreviations for hemoglobin. Hg is the abbreviation for mercury.

11. 11 Copyright © 2012 by Mosby, an imprint of Elsevier Inc. Word Parts leuk/o = white -cyte = cell granul/o = little grain a- = no, not, without poly- = many morph/o = shape, form nucle/o = nucleus eosin/o = rosy-colored -phil = attraction neutr/o = neutral phag/o = eat, wallow bas/o = base Components of Blood/White Blood Cells Leukocytes (granulocytes and agranulocytes)  Granulocytes/polymorphonucleocytes PMN)  Eosinophils  Neutrophils  Basophils

12. 12 Copyright © 2012 by Mosby, an imprint of Elsevier Inc. Special Note! Granulocytes are also known as polymorphonucleocytes, abbreviated PMNs or polys. However, one type of granulocyte, the neutrophil, is also commonly referred to as polymorph (PMN, poly) because it has the greatest degree of nuclear polymorphism, in addition to being the most common type of leukocyte.

13. 13 Copyright © 2012 by Mosby, an imprint of Elsevier Inc. Word Parts a- = no, not, without granul/o = little grain -cyte = cell mono- = one nucle/o = nucleus -ar = pertaining to macro- = large leuk/o = white lymph/o = lymph Components of Blood/White Blood Cells  Agranulocytes/mononuclear leukocytes  Monocytes Macrophages  Lymphocytes Antigen Antibody

14. 14 Copyright © 2012 by Mosby, an imprint of Elsevier Inc. Be Careful! Don’t confuse cyt/o, meaning cell, with cyst/o, meaning a bladder or sac.

15. 15 Copyright © 2012 by Mosby, an imprint of Elsevier Inc. Word Parts thromb/o = clot, clotting -cyte = cell pro- = before -thrombin = clotting substance fibr/o = fiber -gen = producing hem/o = blood -stasis = stopping, controlling Components of Blood/Thrombocytes (platelets) Coagulation  Agglutination  Factor X/thrombokinase  Prothrombin  thrombin  Fibrinogen  fibrin  Hemostasis Clotting process

16. 16 Copyright © 2012 by Mosby, an imprint of Elsevier Inc. Be Careful! Don’t confuse hemostasis, meaning control of blood flow, with homeostasis, meaning a steady state.

17. 17 Copyright © 2012 by Mosby, an imprint of Elsevier Inc. Review Question Thrombocytes: A. are clotting cells B. are white blood cells C. protect the body against disease D. carry hemoglobin

18. 18 Copyright © 2012 by Mosby, an imprint of Elsevier Inc. Word Parts plasm/o = plasma ser/o = serum Components of Blood /Plasma Composition Serum = plasma – clotting proteins  Serology

19. 19 Copyright © 2012 by Mosby, an imprint of Elsevier Inc. Word Parts anti - = against -gen = producing agglutin/o = clumping -in = substance hem/o = blood -lytic = pertaing to breaking down Blood Groups A, B, AB, O Antigens – agglutinogens Antibodies – agglutinins Universal donor Universal recipient Rh factor ABO blood groups

20. 20 Copyright © 2012 by Mosby, an imprint of Elsevier Inc. Review Question The universal donor of blood groups is: A. type A B. type B C. type AB D. type O

21. 21 Copyright © 2012 by Mosby, an imprint of Elsevier Inc. Word Parts immune = immun/o cyt/o = cell -kine = movement lymph/o = lymph mono- = one inter- = between -leukin = white substance Immune System Role of cytokines  Cytokines  Lymphokines  Monkines  Interleukins Levels of defense  First line/ nonspecific  Second line/ nonspecific  Third line/ specific immunity Levels of defense

22. 22 Copyright © 2012 by Mosby, an imprint of Elsevier Inc. Nonspecific Immunity  Mechanical  Physical  Chemical First Line of Defense

23. 23 Copyright © 2012 by Mosby, an imprint of Elsevier Inc. Word Parts phag/o = eat, swallow cyt/o = cell -osis = abnormal condition pyr/o = fever, fire -exia = condition Second Line of Defense Nonspecific Immunity  Phagocytosis  Inflammation  Pyrexia  Protective proteins  Interferons  Complement proteins  Natural killer (NK) cells

24. 24 Copyright © 2012 by Mosby, an imprint of Elsevier Inc. Third Line of Defense Specific immunity  Body’s identification of pathogen/antigen  Antibodies/immunoglobulins formed  Process may be:  Genetic  Acquired Active: natural or artificial Passive: natural or artificial

25. 25 Copyright © 2012 by Mosby, an imprint of Elsevier Inc. Review Question Sneezing, coughing, and vomiting are examples of which level of immune defense? A. first level B. second level C. third level D. fourth level

26. 26 Copyright © 2012 by Mosby, an imprint of Elsevier Inc. Word Parts an- = no, not, without -emia = blood condition sider/o = iron -penia = deficiency Terms Related to Nutritional Anemias (D50-D53) B12 deficiency anemia Folate deficiency anemia Pernicious anemia Sideropenia

27. 27 Copyright © 2012 by Mosby, an imprint of Elsevier Inc. Word Parts hem/o = blood -lytic = pertaining to breaking down auto- = self immune = safety, protection globin/o = protein -pathy = diseae process sphre/o = sphere -cytosis = condition of abnormal increase in cells thalass/o = sea -emia = blood condition Terms Related to Hemolytic Anemias (D55-D59) Hemolytic anemia Autoimmune acquired hemolytic anemia Nonautoimmune acquired hemolytic anemia Glucose-6-phosphate- dehydrogenase (G6PD) Hemoglobinopathy Hereditary spherocytosis Thalassemia

28. 28 Copyright © 2012 by Mosby, an imprint of Elsevier Inc. Terms Related to Hemolytic Anemias (D55-D59) Sickle-cell disorders  Sickle cell trait  Sickle cell anemia  Sickle cell crisis

29. 29 Copyright © 2012 by Mosby, an imprint of Elsevier Inc. Word Parts post- = after hem/o = blood -rrhagic = pertaining to bursting forth a- = no, not, without plast/o – formation -ic = pertaining to erythr/o = red blast/o = embryonic, immature -penia condition of deficiency myel/o = bone marrow -phthisis = wasting pan- = all cyt/o = cell Terms Related to Aplastic and Other Anemias and Other Bone Marrow Failure Syndromes (D60-D64) Acute posthemorrhagic anemia Aplastic anemia Erythroblastopenia Myelophthisis Pancytopenia Normal cellularity Hypocellularity in pancytopenia

30. 30 Copyright © 2012 by Mosby, an imprint of Elsevier Inc. Word Parts intra- = within vascul/o = vessel -ar = pertaining to coagul/o = clotting -pathy = disease process hem/o = blood -philia = condition of attraction purpur/o = purple -a = noun ending thromb/o = clot, clotting cyt/o = cell -penia = deficiency Terms Related to Coagulation Defects, Purpura, and Other Hemorrhagic Conditions (D65-D69) Disseminated intravascular coagulopathy (DIC) Hemophilia Purpura Thrombocytopenia Thrombophilia Purpura

31. 31 Copyright © 2012 by Mosby, an imprint of Elsevier Inc. Word Parts erythr/o = red -cytosis = condition of abnormal increase of cells met(a)- = change hem/o = blood globin/o = protein -emia = blood condition myel/o = bone marrow fibr/o = fiber -osis = abnormal condition plasm/o = plasma Terms Related to Other Disorders of Blood and Blood- Forming Organs (D70-D77) Erythrocytosis Methemoglobinemia Myelofibrosis Plasmacytosis Myelofibrosis

32. 32 Copyright © 2012 by Mosby, an imprint of Elsevier Inc. Word Parts leuk/o = white -penia = deficiency eosin/o = rosy-colored mono- = one cyt/o = cell lymph/o = lymph/o neutr/o = neutral band/o = bands -emia = blood condition Terms Related to Coagulation Defects, Purpura, and Other Hemorrhagic Conditions (D65-D69) Leukopenia  Eosinopenia  Monocytopenia  Lymphocytopenia  Neutropenia  Bandemia

33. 33 Copyright © 2012 by Mosby, an imprint of Elsevier Inc. Word Parts leuk/o = white -cytosis = abnormal increase of cells mono- = one bas/o = base -philia = attraction eosin/o = rosy-colored neutr/o = neutral lymph/o = lymph Terms Related to Coagulation Defects, Purpura, and Other Hemorrhagic Conditions (D65-D69) Leukocytosis  Monocytosis  Basophilia  Eosinophilia  Neutrophilia  Lymphocytosis

34. 34 Copyright © 2012 by Mosby, an imprint of Elsevier Inc. Word Parts a- = no, not, without splen/o = spleen -ia = condition hyper- = excessive -ism = condition -itis = inflammation Terms Related to Coagulation Defects, Purpura, and Other Hemorrhagic Conditions (D65-D69) Asplenia Hypersplenism Splenitis

35. 35 Copyright © 2012 by Mosby, an imprint of Elsevier Inc. Word Parts septic/o = infection -emia = blood condition sept/o = infection -ic = pertaining to Systemic Infections of the Blood Septicemia Septic shock Systemic inflammatory response syndrome (SIRS)

36. 36 Copyright © 2012 by Mosby, an imprint of Elsevier Inc. Word Parts auto- = self immun/o = safety, protection syn- together -drome = run hypo- = deficiency globulin/o = protein -emia = blood condition sarc/o = flesh -oid = like -osis = abnormal condition Certain Disorders Involving the Immune Mechanism (D80-D89) Autoimmune lymphoproliferative syndrome (ALPS) Graft-versus-host disease (GVHD) Hypogammaglobulinemia Sarcoidosis

37. 37 Copyright © 2012 by Mosby, an imprint of Elsevier Inc. Word Parts immun/o = safety, protection auto- = self Other Immune Disorders Acquired immunodeficiency syndrome (AIDS)  Human immunodeficiency virus (HIV) Autoimmune disease HIV life cycle

38. 38 Copyright © 2012 by Mosby, an imprint of Elsevier Inc. Review Question Which type of anemia is an iron deficiency? A. pernicious anemia B. sideropenia C. aplastic anemia D. thalassemia

39. 39 Copyright © 2012 by Mosby, an imprint of Elsevier Inc. Review Question What is a group of inherited bleeding disorders characterized by a deficiency of one of the factors necessary for the coagulation of blood? A. purpura B. thrombocytopenia C. hemophilia D. polycythemia vera

40. 40 Copyright © 2012 by Mosby, an imprint of Elsevier Inc. Word Parts myel/o = bone marrow dys-= abnormal -plastic = pertaining to forming poly- = many, much cyt/o = cell -(h)emia = blood condition vera = true thym/o = thymus -oma = tumor, mass Benign Neoplasms Myelodysplastic syndrome Polycythemia vera Thymoma

41. 41 Copyright © 2012 by Mosby, an imprint of Elsevier Inc. Word Parts lymph/o = lymph cyt/o = cell -ic = pertaining to leuk/o = white -emia = blood condition myel/o = bone marrow -genous = pertaing to originating from Malignant Neoplasms Acute lymphocytic leukemia (ALL) Acute myelogenous leukemia (AML) Chronic lymphocytic leukemia (CLL) Chronic myelogenous leukemia (CML) Leukemia

42. 42 Copyright © 2012 by Mosby, an imprint of Elsevier Inc. Word Parts lymph/o = lymph -oma = tumor, mass myel/o = bone marrow thym/o = thymus Malignant Neoplasms Hodgkin lymphoma Non-Hodgkin lymphoma Multiple myeloma Malignant thymoma Multiple myeloma

43. 43 Copyright © 2012 by Mosby, an imprint of Elsevier Inc. Review Question Which of the following is a cancer diagnosed by the presence of Reed-Sternberg cells? A. multiple myeloma B. Hodgkin lymphoma C. thymic carcinoma D. non-Hodgkin lymphoma

44. 44 Copyright © 2012 by Mosby, an imprint of Elsevier Inc. Laboratory Tests AIDS tests  ELISA, Western blot Allergy testing  Patch  Scratch  Intradermal Western blot test

45. 45 Copyright © 2012 by Mosby, an imprint of Elsevier Inc. Laboratory Tests Basic metabolic panel  Calcium, glucose, electrolytes, creatinine, BUN Comprehensive metabolic panel  BMP + protein, liver function, and glucose Blood cultures Blood culture

46. 46 Copyright © 2012 by Mosby, an imprint of Elsevier Inc. Word Parts anti- = against -globulin = protein substance hemat/o = blood -crit = separate hem/o = blood -globin = protein substance Laboratory Tests Complete blood cell count (CBC) Coombs antiglobulin test Diff count Erythrocyte sedimentation rate (ESR) Hematocrit (Hct)  Packed cell volume (PCV) Hemoglobin (Hgb, Hb)

47. 47 Copyright © 2012 by Mosby, an imprint of Elsevier Inc. Word Parts hem/o = blood -globin = protein substance thromb/o = clot, clotting -plastin = forming substance pro- before -thrombin = clotting substance Laboratory Tests Mean corpuscular hemoglobin (MCH) Mean corpusuclar hemoglobin concentration (MCHC) Partial thromboplastin time (PTT) Prothrombin time (PT) Schilling Test White blood cell count (WBC)

48. 48 Copyright © 2012 by Mosby, an imprint of Elsevier Inc. Word Parts -apheresis = removal leuk/o = white plasm/o = plasma platelet/o = platelet auto- = self log/o = study -ous = pertaining to trans- = across -fusion = pouring hem/o = blood -stasis = stopping, controlling Blood and Bone Marrow Procedures Apheresis  Leukapheresis  Plasmapheresis  Plateletpheresis Blood transfusion  Autologous  Autotransfusion Hemostasis Be Careful! Do not confuse -apheresis, meaning removal of blood, with -poiesis, which means formation. Autologous blood transfusion

49. 49 Copyright © 2012 by Mosby, an imprint of Elsevier Inc. Blood and Bone Marrow Procedures Bone marrow transplant (BMT)  Autologous  Homologous

50. 50 Copyright © 2012 by Mosby, an imprint of Elsevier Inc. Word Parts adenoid/o = adenoid -ectomy = cutting out bi/o = life -opsy = viewing lymphat/o = lymph -ic = pertaining to lymphaden/o = lymph gland Splen/o = spleen Lymphatic and Immune System Interventions Adenoidectomy Biopsy of lymphatic structures Lymphadenectomy Splenectomy Adenoidectomy

51. 51 Copyright © 2012 by Mosby, an imprint of Elsevier Inc. Review Question Which of the following can be used as a suffix or stand alone term to mean removal? A. apheresis B. poiesis C. fusion D. porosis

52. 52 Copyright © 2012 by Mosby, an imprint of Elsevier Inc. Suffixes and Root Operations for the Blood, Blood- Forming Organs, and Immune Mechanisms -ectomyexcision, resection

53. 53 Copyright © 2012 by Mosby, an imprint of Elsevier Inc. Sort these terms into their correct categories Terms 1. thalassemia 2. phagocytosis 3. hematocrit 4. apheresis Categories __ A+P __ Pathology __ Procedures