CHAPTER 14

BLOOD

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TISSUE TYPE? CONNECTIVE

FUNCTIONS? TRANSPORTATION BETWEEN CELLS AND

ENVIRONMENT/HOMEOSTASIS FORMED ELEMENTS: CELLS,

PLATELETS LIQUID: PLASMA 8% BODY WT; 5 LITERS

HEMATOCRIT

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45% RBC; 1% WBC & PLATELETS; 55% PLASMA

BLOOD CELL FORMATION

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HEMATAPOIETIC STEM CELLS/HEMOCYTOBLASTSHEMATAPOIETIC GROWTH FACTORS

RED BLOOD CELL FORMATION

MULTIPOTENT STEM CELLS COLONY-STIMULATING FACTORS (CYTOKINES

AND/OR HORMONES) ERYTHROPOIETIN (EPO) THROMBOPOIETIN (TPO) INTERLEUKIN-7 (IL-7) GRANULOCYTE-MACROPHAGE COLONY-STIMULATING

FACTOR (GM-CSF) GRANULOCYTE COLONY STIMULATING FACTOR (G-CSF)

INTERLEUKIN-5 (IL-5) INTERLEUKIN-3 MACROPHAGE COLONY-STIMULATING FACTOR (M-CSF)

RED BLOOD CELLS

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RBC CHARACTERISTICS 7.5 µm DIAMETER BICONCAVE ? HEMOGLOBIN ??

1/3 OF TOTAL VOLUME OXYHEMOGLOBIN = BRIGHT RED ?? DEOXYHEMOGLOBIN = DARKER RED

NO NUCLEUS ?? NO RNA ?? NO REPLICATION ??

ENERGY FROM GLYCOLYSIS ONLY ??

RED BLOOD CELL

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MALE: 4.6 – 6.2 MILLION/MICROLITERFEMALE: 4.2 – 5.4 MILLION/MICROLITERCHILD: 4.5 – 5.1 MILLION/MICROLITER

INCREASE OR DECREASE AFFECTS OXYGEN CARRYING CAPACITY OF BLOOD

RED BLOOD CELL

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RED BLOOD CELL PRODUCTION VITAMIN B12 AND FOLIC ACID

DNA SYNTHESIS VITAMIN B12 DEFICIENCY: PARIETAL

CELLS (STOMACH) NOT PRODUCING INTRINSIC FACTOR (GIF); CAN’T ABSORB VITAMIN B12 IN SMALL INTESTINE

IRON MOST REUSED WHEN RBC

REPROCESSED SMALL AMOUNT ABSORBED

ANEMIA ??

RED BLOOD CELL PRODUCTION

FIRST: YOLK SAC, LIVER, SPLEEN

AFTER BIRTH: RED BONE MARROW

DESTRUCTION OF RBCs

DAMAGED RBC RUPTURE IN LIVER OR SPLEEN MACROPHAGES DESTROY DAMAGED RBC HEMOGLOBINHEMEBILIVERDINBILIRUBIN:

EXCRETED WITH BILIVERDIN AS BILE SALTS IRON BINDS TO TRANSFERRIN HEMATOPOIETIC

TISSUE HEMOGLOBIN 80% STORED AS FERRITIN IN LIVER GLOBIN AMINO ACIDS METABOLIZED BY

MACROPHAGES OR SENT TO BLOOD STREAM

NEUTROPHIL

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LYMPHOCYTE

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MONOCYTE

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EOSINOPHIL

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BASOPHIL

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DENDRITIC CELL

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DENDRITIC CELL

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WHITE BLOOD CELLS

GRANULOCYTES: GRANULAR CYTOPLASM NEUTROPHILS, EOSINOPHILS,

BASOPHILS AGRANULOCYTES

MONOCYTES, LYMPHOCYTES

WHITE BLOOD CELLS

NEUTROPHILS: FINE GRANULES, OLDER: 2-5 LOBED NUCLEUS

(PMNs), YOUNGER: C SHAPED (BANDS), FIRST AT INFECTION, 54-62% OF CIRCULATING WBCs, PHAGOCYTIZE SMALL PARTICLES: BACTERIA, FUNGI, SOME VIRUSES

EOSINOPHILS: COARSE UNIFROMLY SIZED GRANULES,

BILOBED, MODERATE ALLERGIC REACTIONS, ATTACK PARASITIC WORMS, 1-3% OF WBCs

BASOPHILS: SIMILAR TO EOSINOPHILS (SIZE AND

NUCLEI SHAPE) , FEW, IRREGULARLY SHAPED GRANULES, RELEASE HISTAMINE ? AND HEPARIN?

AGRANULOCYTES

MONOCYTES: LARGEST, NUCLEI MANY SHAPES, CAN BECOME

MACROPHAGES IN TISSUE, CONSUME: BACTERIA, DEAD CELLS AND DEBRIES, 3-9%; LIVE WEEKS TO MONTHS

LYMPHOCYTES: SMALLEST WBC, LARGE ROUND NUCLEUS, T

AND B CELLS; T: DIRECTLY ATTACK CELLS: BACTERIA, TUMOR, TRANSPLANTS; B CELLS: ANTIBODIES

DENDRITIC CELLS

PRESENT IN SURFACE TISSUES (SKIN); ACTIVATED AND GO TO LYMPH NODES TO STIMULATE T AND B CELLS; SIGNAL PHAGOCYTES;

DIFF

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DIAPEDESIS

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HISTAMINE

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CHEMOTAXIS

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CHEMOTAXIS

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WHITE BLOOD CELL COUNTS 4.5 – 10 THOUSAND PER MICROLITER

LEUKOCYTOSIS MORE THAN 10,000 ACUTE INFECTION; VIGOROUS

EXERCISE; EMOTIONAL DISTRESS; BODY FLUID LOSS;

LEUKOPENIA LESS THAN 4,500 TYPHOID FEVER; FLU; MEASLES; MUMPS;

CHICKENPOX; AIDS; POLIOMYELITUS; ANEMIA; LEAD, ARSENIC, MERCURY POISONING

DIFF

MEGAKARYOCYTES

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PLATLETS FORM FROM ?? FORM PLATLETS WHEN FRAGMENTS

TRAVEL THROUGH LUNGS SMALL PACKETS OF CYTOPLASM/ ½

SIZE OF RBC LIVE 10 DAYS; AMEBOID MEVEMENT 130,000 – 160,000 PER MICROLITER STICK TO BROKEN SURFACES FOR

REPAIR RELEASE SEROTONIN TO CONTRACT

SMOOTH MUSCLE

PLATELETS

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PLASMA

CLEAR, STRAW COLORED ~92% H2O; AND NUTRIENTS; GASES;

VITAMINS; HELP REGULATE FLUID AND ELECTROLYTE

BALANCE AND Ph; HOMEOSTASIS

ALBUMENwww.friedli.com

GLOBULIN

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PLASMA PROTEINS MOST ABUNDANT DISSOLVED

SUBSTANCES IN PLASMA ALBUMIN

60%/WEIGHT BUT SMALLEST SYNTHESIZED IN LIVER IMPORTANT FOR OSMOTIC PRESSURE ??

COLLOID OSMOTIC PRESSURE REGULATE WATER COMPOSITION

CONTROLS BLOOD VOLUME AFFECTS BLOOD PRESSURE

ALSO ACT AS CARRIERS: BIND THINGS LIKE HORMONES, BILLIVERDIN, FATTY ACIDS,

GLOBULINS 36% ALPH AND BETA GLOBULINS

SYNTHESIZED BY LIVER TRANSPORT LIPIDS, FAT-SOLUBLE

VITAMINS GAMMA PRODUCED BY LYMPHATIC

TISSUE ANTIBODIES

FIBRINOGEN 4% BLOOD CLOTTING

GASES AND NUTRIENTS

BLOOD GASES ?? OXYGEN, CARBON DIOXIDE, NITROGEN

PLASMA NUTRIENTS AMINO ACIDS, SIMPLE SUGARS,

NUCLEOTIDES, LIPIDS FROM SMALL INTESTINE

LIPIDS: TRIGLYCERIDES, PHOSPHOLIPIDS, CHOLESTEROL/ WATER SOLUBLE ????

MUST BE CARRIED BY PLASMA PROTEINS

NONPROTEIN NITROGENOUS SUBSTANCES

(NPNs) AMINO ACIDS, UREA, URIC ACID, CREATINE, CREATININE

PRODUCED BY ?? PROTEIN CATABOLISM OR ABSORPTION OF

AMINO ACIDS PROTEIN CATABOLISM NUCLEIC ACID CATABOLISM CREATINE METABOLISM FORMS CREATININEGENERALLY PROTEIN INTAKE AND EXCRETION OF NITROGENOUS WASTES IS EQUAL UNLESS KIDEYS ARE NOT WORKING CORRECTLY

PLASMA ELECTROLYTES ELECTROLYTES BECOME IONS WHEN

DISSOLVED IN H2O ABSORBED BY INTESTINES OR

FORMED DURING METABOLISM SODIUM, POTASSIUM, MAGNESIUM,

CHLORIDE, BICARBONATE, PHOSPHATE, SULFATE IONS

SODIUM AND CHLORIDE ARE MOST ABUNDANT

BICARBONATE: MAINTIANING OSMOTIC PRESSURE, AND PLAMSA pH

HEMOSTASIS

STOPPAGE OF BLEEDING BY:

BLOOD VESSEL SPASM

PLATLET PLUG CLOTTING

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BLOOD VESSEL SPASM

VASOSPASM: SMOOTH MUSCLE CONTRACTS WHY?

REFLEX A FEW SECONDS, DIRECT STIMULTATION LASTS 30 MIN

PLATELETS RELEASE SEROTONIN WHICH AGMENTS THIS REACTION

PLATELET PLUG

PLATELETS ATTACH TO COLLAGEN EXPOSED UNDER EPITHELIAL LINING

COLLAGEN CAUSES THE PRODUCTION OF MANY TINY SPINOUS PROCESSES ON PLATELETS SO STICK TOGETHER TO FORM A PLUG

ONLY WORKS ON SMALLER BLOOD VESSEL BREAKS

BLOOD COAGULATION/CLOT WOUND = EXTRINSIC FACTORS FOREIGN SURFACE (PLASTIC) =

INTRINSIC FACTORS CASCADE: A SERIES OF REACTIONS

THAT ALL STIMULATE THE NEXT REACTION.

DEPENDS ON AMOUNT OF PROCOAGULANTS AND ANTICOAGULANTS

USUALLY MORE ANTICOAGULANTS

EXTRINSIC CLOTTING MECHANISM

WOUND: RELEASES TISSUE THROMOPLASTIN (FACTOR III)

WHICH EVENTUALLY CONVERTS THROMBOPLASTIN USING CALCIUM AND FORMING PROTHROMBIN ACTIVATOR

PROTHROMBIN ACTIVATOR CHANGES PROTHROMBIN (ALPHA GLOBULIN) TO THROMBIN

THROMBIN CHANGES FIBRINOGEN TO FIBRIN

FIBRIN STICKS TO DAMAGED SURFACES, TRAPS CELLS AND PLATELETS = CLOT

POSITIVE FEEDBACK ??? GENERALLY BLOOD ONLY

COAGULATES WHERE IT IS STILL OR SLOW

BLOOD NORMALLY CARRIES THROMBIN AWAY KEEPING ITS CONCENTRATION TOO LOW FOR COAGULATION AND ANTITHROMBININ BLOOD AND ON VESSEL WALLS KEEPS THROMBIN FROM FORMING

INTRINSIC FACTOR

WHEN EXPOSED TO COLLAGEN OR GLASS IT STIMULATES HAGEMAN FACTOR (FACTOR XII); ACTIVATES FACTOR XI; ACTIVATES FACTOR IX; ALONG WITH FACTOR VIII AND PHOSPHOLIPIDS ACTIVATES FACTOR X

FACTOR X PLUS CALCIUM IONS PRODUCES PROTHROMBIN ACTIVATOR

THEN LIKE EXTRINSIC FACTOR

BLOOD CLOTS FATE DRIES AND SHRINKS PULLING EDGES IN PLATELETS RELEASE PLATELET-DERIVED

GROWTH FACTOR (PDGF) STIMULATE FIBROBLASTS AND SMOOTH MUSCLE TO REPAIR DAMAGE

FIBROBLASTS PRODUCE CONNECTIVE TISSUE FIBERS TO STRENGTHEN CLOT

PLASMINOGEN PICKED UP BY FIBERS PLASMINOGEN ACTIVATOR FROM

LYSOSOMES CAUSES PLASMINOGEN TO BECOME PLASMIN WHICH IS AN ENZYME THAT DIGESTS FIBRIN

THROMBOSSIS: ABNORMALLY FORMED BLOOD CLOT

EMBOLUS: A CLOT THAT BREAKS FREE

EMBOLISM: A BLOCKAGE DUE TO AN EMBOLUS

ATHEROSCLEROSIS: ACCUMULATION OF FATS ALONG BLOOD

VESSEL WALLS ??

PREVENTION OF CLOTS SMOOTH ENDOTHELIUM

ENDOTHELIAL CELLS SECRETE A PROSTAGLANDIN: PROSTACYCLIN

PREVENTS PLATELETS FROM STICKING THROMBIN ABSORBED BY FIBRIN THREADS SO IT

CAN’T SPREAD ANTITHROMBIN: ALPHA GLOBULIN

BINDS THROMBIN AND PREVENTS ACTION ON FIBRINOGEN

HEPARIN FROM: MAST CELLS AND BASOPHILS (ESPECIALLY

LIVER AND LUNGS) ?? INTERFERES WITH PROTHROMBIN ACTIVATOR

PRODUCTION

CLOTTING

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CLOTTING

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US BLOOD TYPES Blood Type & Rh How Many Have It

Frequency O Rh Positive 1 person in 3

37.4% O Rh Negative 1 person in 15

6.6% A Rh Positive 1 person in 3

35.7% A Rh Negative 1 person in 16

6.3% B Rh Positive 1 person in 12

8.5% B Rh Negative 1 person in 67

1.5% AB Rh Positive 1 person in 29

3.4% AB Rh Negative 1 person in 167

0.6%

BLOOD TYPES

ANTIGEN: AGGLUTINOGEN: FOREGIN PROTEIN

ANTIBODIES: AGGLUTININS: ATTACK FOREIGN PROTEINS

AGGLUTINATION: WHEN WRONG BLOOD TYPES ARE TRANSFUSED

ANTIBODIES ARE FORMED IN PLASMA 2-8 MONTHS AFTER BIRTH

BLOOD TYPES

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TRANSFUSIONS

TRANSFUSIONS OF SAME BLOOD IS BEST ??

O BLOOD HAS A AND B ANTIBODIES ??

SO SHOULD BE ADDED SLOWLY REMOVING PLASMA REMOVES

ANTIBODIES

BLOOD TRANSFUSIONS

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Rh FACTOR

ANTIGEN D, C, c, E ARE THE MOST IMPORTANT BUT ABOUT 50 PROTEINS ARE INVOLVED

+ OR – REFERS TO THE D FACTOR ONLY

ERYTHROBLASTOSIS FETALIS

WHEN MOTHER IS – AND FATHER IS POSITIVE ??

IF BABY IS POSITIVE (MOTHER -) TREAT WITH IgG anti-D ANTIBODIES

(Rho(D) Immune Globulin)

BLOOD TYPING GAME

http://nobelprize.org/medicine/educational/landsteiner/index.html

TYPE O

Type O "Hot".

TraitsConfident and Strong-Willed, Proud, Dedicated, Sociable, Energetic, Extroverted, Frank, Realist, Showy, Flighty, Generalist, Positive, Independent, Risk-Takers, Dislike taking orders, Insecure, Stubborn & Self-Centered.

Make friends easily and go with flow and grasp opportunity. Quick to start a project or chase an idea. Are good at organizing activities. May have short attention span, and expresses strong emotions. May quickly take opposite views that are deep but not always durable. Classic entrepreneurs and movers and shakers.Express their emotions but can be swayed by other blood types. Have an intrinsic elegance. Sociable and showy. May be good at adapting to circumstances. Words come easily to them. Not self conscious and will frankly reveal inner feelings. Ambitious, but may have issues with detail. 

Like to be touch and be touched by others.

TYPE A

Type A "Cool"   Population Roughly 34% of the world is A +ve and 6% A -ve.   Traits Obedient, Careful, Sympathetic, Self-Sacrificing, Polite,

Honest, Loyal,  Emotional, Introverted & Nervous. Are reserved calm and even tempered. Sensitive to public

opinion. May be Introverted, shy and nervous or ill at ease with others. May be Pessimistic. Value relationships and are loyal. Hesitant to change. Nature lovers and dislike crowds - need a private place or secret hideaway. Can be indecisive. Good at team work and obey rules.

Dislike to touch or be touched by others.

TYPE B

Type B "Active"   Population Roughly 9% of the world is B +ve and 2% B -ve.   Traits Cheerful, Optimistic, Active, Sensitive, Kind, Forgetful,

unorganized, Noisy, Egocentric  Energetic and have the drive to reach towards goals. May

be workaholics. Not the best team players and are individualistic. Do things at one's own pace. Strong personality adventurous. Likes to get one's own way. Are Sociable and enjoy entertaining. 

Like to touch or be touched by others.

TYPE AB

Type AB "Care-Free"   Population Roughly 4% of the world is AB +ve and 1% AB -ve.   Traits Social, Easy-going, Sympathetic, Diplomatic, Outgoing, Laid-back,

Creative, Unpredictable, Artistic, Flexible, Moody and Brooding.  Blend of opposites. Shy with some and bold with some. Introvert

and Extrovert. Unpredictable and may seem to have calm exterior. Strong creative strain. Good at spotting problems and skirting them. Like city environment. Get bored easily. Everything they do is compelling. Never take things for granted. Appear mysterious. Contribute harmoniously to society.

Dislike to touch or be touched by others.