chapter030

Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins

Timby/Smith: Introductory Medical-Surgical Nursing, 10/e

Timby/Smith: Introductory Medical-Surgical Nursing, 10/e

Chapter 30: Introduction to the Hematopoietic and Lymphatic Systems


Hematopoietic SystemHematopoietic System• Hematopoiesis: The Manufacture and Development

of Blood Cells

Hematopoietic System

Bone Marrow

Lymphatic System

Thymus Gland

SpleenRed

Marrow Yellow

Marrow


QuestionQuestion

Is the following statement true or false?

The lymphatic system is involved in hematopoiesis.


AnswerAnswer

True.

The lymphatic system and bone marrow have roles in hematopoiesis.


Hematopoietic SystemHematopoietic System

Figure 30-2 Hematopoiesis

● Bone Marrow– Soft tissue in long bones, spongy bones– Manufactures blood cells– Red marrow

• Ribs; Sternum; Skull; Clavicle; Vertebrae; etc.• Blood cells; Hgb

– Yellow marrow• Fat cells; Connective tissue• Non-manufacture of blood cells; Certain conditions


Anatomy and Physiology: HematopoieticAnatomy and Physiology: Hematopoietic

• Blood: Cells Suspended in Plasma

– Pluripotential stem cells

– Myeloid stem cell conversion

• Erythrocytes; Leukocytes: Several types

• Platelets

– Lymphoid stem cell conversion

• Lymphocytes (WBCs with immune functions)


QuestionQuestion


Red blood cells are the liquid component of blood.


AnswerAnswer

False.

Plasma is the liquid component of blood, red blood cells are the solid component.


Anatomy and Physiology: HematopoieticAnatomy and Physiology: Hematopoietic• Erythrocytes

– Transport O2; Remove CO2

– Erythropoiesis: Production of erythrocytes

• Erythropoietin: Regulates production rate

– Require iron; B vitamins for proper maturation

– Normal number

• Varies with age, gender, and altitude

• Between 3.6 and 5.4 million/μL


Anatomy and Physiology: Hematopoietic Anatomy and Physiology: Hematopoietic • Erythrocytes (Cont’d)

– Hemoglobin

• Red color: Iron containing pigment

• Binds with oxygen to form oxyhemoglobin

• Carries oxygen to the cells of the body

• Normal amount: 12 to 17.4 g/dL

– Circulate circa 120 days

– Removed by spleen and liver


Anatomy and Physiology: Hematopoietic Anatomy and Physiology: Hematopoietic

• Leukocytes

– Protective function

– Normal count: 5,000 to 10,000/mm3

– Leukocytosis; Leukopenia

– Life span: 1 to 2 days

• Continuous production demand

• Need even greater if infection present

– Granulocytes; Agranulocytes



Leukocytes

Granulocytes Agranulocytes

Lymphocytes MonocytesNeutrophils Basophils

B Lymphocytes

T Lymphocytes

Eosinophils



Figure 30-4: Phagocytosis. The cell membrane of the neutrophil surrounds and pinches off the bacteria or dead tissue. Enzymes

within the cell destroy the foreign material.


Anatomy and Physiology: Hematopoietic Anatomy and Physiology: Hematopoietic • Platelets (Thrombocytes)

– Manufactured in red bone marrow

– Contribute to hemostasis

– Glycoprotein IIb/IIIa helps in blood clotting

• Plasma

– Serum; 90% water and 10% proteins

– Contains and transports

• Blood cells; Proteins; Clotting factors



• Plasma (Cont’d)

– Plasma proteins

• Albumin: Maintains osmotic pressure; Most abundant

• Globulins: Alpha; Beta; Gamma

• Gamma globulins (AKA immunoglobulins); Immunologic agents

• Fibrinogen: Transforms into fibrin; Helps in blood clotting


QuestionQuestion


Plasma contains approximately 10% proteins.


AnswerAnswer

True.

Plasma contains approximately 90% water, 10% proteins.


Anatomy and Physiology: Hematopoietic Anatomy and Physiology: Hematopoietic • Blood Groups

– Four blood types: A, B, AB, O; Determined by heredity

– Ascertained by antigen on RBC membranes

– Antibodies react with incompatible RBC antigens

– Universal donors and recipients

– Rh factor: Specific protein on the RBC membrane

– Crossmatching: Hemolysis; Rh factor


Anatomy and Physiology: LymphaticAnatomy and Physiology: Lymphatic


Anatomy and Physiology: Lymphatic Anatomy and Physiology: Lymphatic • Thymus Gland

– Undifferentiated stem cells released from bone marrow

– Stem cells develop into T lymphocytes upon migration

• Spleen

– Largest lymphatic structure

– Reservoir of blood

– Contains phagocytes


Anatomy and Physiology: Lymphatic Anatomy and Physiology: Lymphatic



• Lymph Nodes: Glandular Tissue

– Clustered in the axilla, groin, neck, and large vessels of the thorax and abdomen

– Contain both T and B lymphocytes

• Lymph Fluid: Similar to Plasma in Composition

– Contraction of skeletal muscles

– Lymph ducts: Afferent; Efferent

– Macrophages attack and engulf foreign substances


AssessmentAssessment• History: Signs and Symptoms

– Bleeding; fatigue; chills; infections

– Discomfort in the axilla, groin, or neck

– Difficulty swallowing

– Lymph node removal or splenectomy

– Treatment for cancer and renal failure

– Prescribed and nonprescribed medications

– Dietary history; Foreign travel

– Exposure to industrial or environmental toxins


AssessmentAssessment• Physical Examination

– Inspection: Skin; Vital signs

– Lymph nodes; Tonsils; Extremities

• Diagnostic Tests

– Lab tests: CBC; Coagulation tests

– Bone marrow aspiration: Blood cell formation

– Lymph node biopsy; Radiography

– Ultrasound; CT; Bone scan; MRI


Nursing ManagementNursing Management• Data Collection

• Client Teaching for Tests

– Preparations; Procedures; After-test care

• Specimen Collection and Handling

• Monitoring for adverse effects during and after diagnostic procedures

• Prompt Reporting

– Changes in client condition; Test results


End of Presentation

chapter030

Documents

andlippincott williams

blood clotting copyright

red blood cells

hematopoiesis copyright

hematopoietic blood

phagocytes copyright

factors copyright

liver copyright