1. Practical Hematology Manual

2. Components of Normal Adult Blood

3. How to collect blood sample to do the Complete blood count (CBC)
When blood come in contact to external surfaces (tube), it will
Normally clot as follow
We need to prevent this blood clotting to be able to proceed through the intended CBC,
To do this we have to add anti-coagulants (chemicals that prevents the blood clotting

5. Separation of Components
Plasma = Less Dense
Platelets / WBC’s
Hematocrit
“Packed Cells”
More Dense

6. Hemacytometer Hemo: blood Cyto: cell Meter: measurement/counter
Thus, it is an instrument used to count the blood cells.
The hemacytometer counting chamber is used for cell counting.
It is constructed so that the distance between the bottom of the coverslip and the surface of the counting area of the chamber is 0.1 mm.
The surface of the chamber contains two square ruled areas separated by an H-shaped moat.

7. It includes:
Neubauer’s slide
Cover slip
RBC pipette
WBC pipette

8. haemocytometer chamber
Thoma white pipette
Rubber sucking tube

9. Hemacytometer

10. Each scale is 3mm wide and 3mm long.
The whole scale is divided into 9 big squares.
Each primary square is 1mm long and 1mm width
Each primary square is further divided into 16 secondary square (central 25 secondary square )
Each secondary square is further subdivided into 16 tertiary square

12. Principle of WBCs count
Free-flowing capillary or well-mixed anticoagulated venous blood is added to a diluent) at a specific volume in the diluting pipette.
The diluent lyses the erythrocytes but preserves leukocytes and platelets. The diluted blood is added to the hemacytometer chamber.
Sample:
EDTA- anticoagulated blood or capillary blood is preferred.
WBCs count diluting fluid :
May be one of the following:
Acetic acid 1% (v/v) in distilled water.
HCL 1% (v/v) in distilled water.
Turks' solution which is formed of:
Glacial acetic acid 1 ml
Crystal violet 1 ml
100 ml distilled water.

13. Equipment White blood cells count diluting fluid WBCs pipette
Hemacytometer and coverslip
Microscope
Lint-free wipe
Alcohol pads
For WBC counting
0.5 part of blood is mixed in 10 parts of fluid
So, 1 part of blood is in 20 parts of fluid
Thus, dilution factor for WBC counting is 20.

15. Procedure
Carefully charge hemacytometer with diluted blood by gently squeezing sides of reservoir to expel contents until chamber is properly filled.

16. FOCUSING 4X to see the general formation of slide.
10X for WBC counting
40X for RBC counting

17. Adjust the microscopic objective lens 40X for RBC counting

20. Counting Rule Cont RBCs in the L shape method
Do not count cells touching
Top line
Right line
This is to avoid double counting.

21. Normal Values: 4500 -11000/mm3 or µL
WBC COUNTING Total no. of WBCs in 4 Primary squares = X Mean No. of WBCs in Primary squares (1 mm2) = X/4 (diluted) X/4 x20 = No. of WBCs in 1 mm2 of undiluted blood X/4 x20 x 10= No. of WBCs in 1 mm3 of undiluted blood No. of WBCs in 1mm³ = 1 µl = X x 50/mm³ While X is the No of WBCs counted in the 4 primary square
Normal Values:
/mm3 or µL

22. Disturbance of Leukocytes Number)
Leucopenia :WBCs < 4000
Leukocytosis : WBCs >11000
Neutrophilia:
Lyphoctosis
Leukemia. Uncontrolled production of WBCs can be caused by cancerous growth . Leukemia, is characterized by WBCs > 30000/ul