week 5 rbcs ppt ash.ppt
TRANSCRIPT
-
8/10/2019 WEEK 5 RBCS ppt ash.ppt
1/73
Blood and Bone Marrow
Histology Dr. ashraf
mahmoud
-
8/10/2019 WEEK 5 RBCS ppt ash.ppt
2/73
Blood is a specialized type of connective tissue.
It is composed of:
A-Blood cells 45 %which include the following:1-Red blood corpuscles (erythrocytes).
2-White blood cells (leucocytes).
3- Platelets (Thrombocytes).B-Plasma55%(fluid intercellular substance).
-In man, blood volume is about 5 liters.
-
8/10/2019 WEEK 5 RBCS ppt ash.ppt
3/73
The blood plasma-Plasma is an aqueous solution containingplasma proteins,inorganic salts and severalorganic compounds such as vitamins, aminoacids and hormones.
-Plasma is in constant exchange with the extracellular fluids of the body.
-
8/10/2019 WEEK 5 RBCS ppt ash.ppt
4/73
-Plasma proteins are of threecategories:
1-Albumins.2-Globulins.
3-Fibrinogens.
-Albumins can bind with insoluble fattyacids helping in their transport,
-globulins form antibodies of the immune
system and-fibrinogensform fibrin of the blood clot.
-
8/10/2019 WEEK 5 RBCS ppt ash.ppt
5/73
-
8/10/2019 WEEK 5 RBCS ppt ash.ppt
6/73
A- In the embryothey are:1-Yolk sac mesoderm during the first twomonths.
2-Liver and spleen from the second to the fifthmonth.
3-Bone marrow from the fifth month onwards.
B- In the adult, haemopoiesis occurs in:
1-Bone marrow ( myeloid tissue) mainly ofthe skull, ribs,sternum, vertebrae, pelvis andproximal ends of long bone.
2-Lymphoid tissue.
-
8/10/2019 WEEK 5 RBCS ppt ash.ppt
7/73
Types of bone marrow1-Red bone marrow
Red bone marrow is present in all bones ofthe foetus and in certain bones of adults
( mentioned above ).
2-Yellow bone marrow
yelloow bone marrow is present in adult
long bonesand is characterized by a high fat
content.
Yellow marrow can be changed into red one
in times of need.
-
8/10/2019 WEEK 5 RBCS ppt ash.ppt
8/73
-
8/10/2019 WEEK 5 RBCS ppt ash.ppt
9/73
-
8/10/2019 WEEK 5 RBCS ppt ash.ppt
10/73
-
8/10/2019 WEEK 5 RBCS ppt ash.ppt
11/73
Examinationof bone marrow
Can be done by:
1-Bone marrow sections.
2-Bone marrow smears.
3-Marrow films.
-
8/10/2019 WEEK 5 RBCS ppt ash.ppt
12/73
-
8/10/2019 WEEK 5 RBCS ppt ash.ppt
13/73
Structure of bone marrow
(myeloid tissue)
The myeloid tissue consists of:
I-Connective tissue stroma
II-The fixed stromal cells include:
III-Free haemopoietic cells:
f
-
8/10/2019 WEEK 5 RBCS ppt ash.ppt
14/73
Structure of bone marrow
(myeloid tissue)
The myeloid tissue consists of:
I-Connective tissue stroma: containing bloodsinusoids.
The stroma is made up of reticular networkcontaining blood sinusoids, venules and arterioles.
The blood sinusoids have fenestrated endothelialcells with occludent junctions in between these cells.
-
8/10/2019 WEEK 5 RBCS ppt ash.ppt
15/73
II-The fixed stromal cells include:
1-Reticular cells
They are branched cells with pale nucleus and palecytoplasm. They produce reticular fibres, secreting
type III collagen.Reticular cells have some phagocytic activity andmay have a role in immunological response.
2-Fibroblasts
Secretes collagen that supports the blood vessels andthe stroma.
-
8/10/2019 WEEK 5 RBCS ppt ash.ppt
16/73
3-Macrophages
They are derived from monocytes.
These macrophages have pseudopodia whichare able to extend between endothelial cells toengulf any foreign body in the blood.
4-Fat cells.
5-Osteogenic cellslining the bone trabeculae.
6-Endothelial cells lining the blood sinusoids,venules and arteriole
-
8/10/2019 WEEK 5 RBCS ppt ash.ppt
17/73
III-Free haemopoietic cells:
All types of developing blood cells are
present in the meshes of the reticular
stroma.
-
8/10/2019 WEEK 5 RBCS ppt ash.ppt
18/73
The pluripotential stem cells
-They are present in a pool and are able toproduce all types of blood cells.
These stem cells resemble lymphocytes with adiameter of 7 m and a large rounded nucleushaving prominent nucleoli. Their cytoplasm
contains many ribosomes but few mitochondriaand rER.
-
8/10/2019 WEEK 5 RBCS ppt ash.ppt
19/73
The pluripotential stem cells proliferate and form:
I-Myeloid multipotential cells:which will become:
-Erythrocytes.
- Granulocytes.-Monocytes.
-Megakaryocytes.
II-Lymphoid multipotential cells: which willbecome: -Lymphocytes.
-
8/10/2019 WEEK 5 RBCS ppt ash.ppt
20/73
-
8/10/2019 WEEK 5 RBCS ppt ash.ppt
21/73
-
8/10/2019 WEEK 5 RBCS ppt ash.ppt
22/73
II-Lymphoid multipotentialcells
which will become:
-Lymphocytes.
-These stem cells proliferate and form lesspotential cells (progenitor cell)
-Progenitor cellsare unipotential or bipotential
-Precursor cells( e.g. lymphoblasts anderythroblasts ) produce mature cells
-
8/10/2019 WEEK 5 RBCS ppt ash.ppt
23/73
-
8/10/2019 WEEK 5 RBCS ppt ash.ppt
24/73
-
8/10/2019 WEEK 5 RBCS ppt ash.ppt
25/73
-
8/10/2019 WEEK 5 RBCS ppt ash.ppt
26/73
RED BLOOD CORPUSCLES
-
8/10/2019 WEEK 5 RBCS ppt ash.ppt
27/73
RED BLOOD CORPUSCLES
RBC d Bl di Di d
-
8/10/2019 WEEK 5 RBCS ppt ash.ppt
28/73
RBC and Bleeding Disorders
NORMAL
Anatomy, histology
Development
Physiology
ANEMIAS
Blood loss: acute, chronic
Hemolytic
Diminished erythropoesis
POLYCYTHEMIA
BLEEDING DISORDERS
-
8/10/2019 WEEK 5 RBCS ppt ash.ppt
29/73
Peripheral Blood: Erythrocytes
RBCs constitute thelargest number ofcells in the blood
Biconcave discs
NO NUCLEUS
ContainHemoglobin
I RED BLOOD CORPUSCLES
http://www.jdaross.mcmail.com/images/erythrocytes.jpghttp://www.jdaross.mcmail.com/images/erythrocytes.jpg -
8/10/2019 WEEK 5 RBCS ppt ash.ppt
30/73
I-RED BLOOD CORPUSCLES(ERYTHROCYTES)
1-Shape
-It is round biconcavecorpuscle in side view, known
as a dumb bell shape bell shape.-Thebiconcave shape provides a large surface area
for gas exchanges.
-In the human it is round non-nucleated-Such corpuscles may coalesce together by their sideforming the rouleaux appearance.
-
8/10/2019 WEEK 5 RBCS ppt ash.ppt
31/73
Abnormalities in the shape
A-Crenation:-it means loss of the water contents
from the R.B.C.resulting in decreasing itssize and irregularities in its shape.
B Heamolysis:
-
8/10/2019 WEEK 5 RBCS ppt ash.ppt
32/73
B-Heamolysis:
-It means loss of the corpuscularhemoglobin as result of its rupture.
-The main causes of heamolysis are:
1-Hyponotic solutions.
2-Incompatible blood transfusion.3-Toxins.
C-Poikilocytosis:
The R.B.C takes the pear shape.D-Sickle shaped cell:
The corpuscle takes the shape of a crescent.
RBC
-
8/10/2019 WEEK 5 RBCS ppt ash.ppt
33/73
RBC
-
8/10/2019 WEEK 5 RBCS ppt ash.ppt
34/73
-
8/10/2019 WEEK 5 RBCS ppt ash.ppt
35/73
-
8/10/2019 WEEK 5 RBCS ppt ash.ppt
36/73
-
8/10/2019 WEEK 5 RBCS ppt ash.ppt
37/73
-
8/10/2019 WEEK 5 RBCS ppt ash.ppt
38/73
2-Size
-Diameter:7.5 micrometers with a rangebetween (6-8um).
-Thickness: 1.9 microns.
-
8/10/2019 WEEK 5 RBCS ppt ash.ppt
39/73
Abnormalities in the size
A-Macrocyte:The diameter is more than 8
micrometers.
B-Microcyte:
The diameter is smaller than 6micrometers.
-
8/10/2019 WEEK 5 RBCS ppt ash.ppt
40/73
C-Spherocyte:
The thickness of the corpuscle is morethan 1.9 micrometers.
D-Anisocytosis:It is variation in the size of the R.B.C. in theblood of the
same person. Such variation is detected byPrice Jones curve.
3 C t
-
8/10/2019 WEEK 5 RBCS ppt ash.ppt
41/73
3-Count
-The normal count of the red blood corpuscleis always done in one cubic millimeter of
blood.
*In the male it is about 5-5.5 million /1 ul *In the female it is about 4.5 millions /1 ul.
-The red blood cells count is done by special
apparatus called heamocytometer or by the
automated methods.
Abno malities in the co nt
-
8/10/2019 WEEK 5 RBCS ppt ash.ppt
42/73
Abnormalities in the count
A-Increase in the number
( Polycythaemia)
Causes: -Primary, without a definite cause.
-Secondary due to low oxygen tension.Muscular exercise.
Pregnancy.
High altitude.Heart disease.
Cold bath.
Heavy meals.
B-Decrease in the number
-
8/10/2019 WEEK 5 RBCS ppt ash.ppt
43/73
B-Decrease in the number(oligocythaemia)
Causes: Hemorrhage.Heamolysis.
Idiopathic.
Aplastic due to bone marrow defect.Deficiency of one of the major factors forRBCs development e.g iron or B12.
4 C l
-
8/10/2019 WEEK 5 RBCS ppt ash.ppt
44/73
4-Color-Fresh blood when spreaded appear yellowish
greenin color but thick drop of blood appearredin color due to condensation of large
number of the R.B.C. over each other.
-The color of the blood is due to the red
pigment hemoglobin which appear deeper in
the peripheral part of the corpuscle and pale inits central part due to reduced thickness of the
corpuscle.
-The normal color is called Normochromic.
-
8/10/2019 WEEK 5 RBCS ppt ash.ppt
45/73
Abnormalities in the color
A-Hypochromic:
The amount of the hemoglobin is less than the
normal concentration.B-Hyperchromic:
The amount of the hemoglobin is more than
the normal concentration.C-Stippling:
Bluish dots considered as precipitation of the
the stain.
D-Polychromasia:
-
8/10/2019 WEEK 5 RBCS ppt ash.ppt
46/73
D Polychromasia:
The corpuscle contains undiffused heam-oglobin, so double colors can be seen, the theblue color of the cytoplasm and the red color ofthe HB.
E-Cabot ring:
It is a remnant of the nuclear membrane.
F-Howel jolly bodies:
They are remnants of the chromatinof the nucleus.
-
8/10/2019 WEEK 5 RBCS ppt ash.ppt
47/73
-
8/10/2019 WEEK 5 RBCS ppt ash.ppt
48/73
5-Structure
-
8/10/2019 WEEK 5 RBCS ppt ash.ppt
49/73
5-Structure
-Erythrocytes have flexible cell membranes, which
contain lipids, proteins and carbohydrates.
-The membrane peripheral proteins (spectrins) are
responsible for the shape of the erythrocyte and help intheir flexibility on passing through capillaries.
-Erythrocytes contain haemoglobin 33%,water 66%and some enzymes needed for glucose metabolism.Haemoglobin is aconjugated protein formed of globinand haematin.
-
8/10/2019 WEEK 5 RBCS ppt ash.ppt
50/73
-By EM, erythrocytes are highly electron densedue to their iron content.
-Haemoglobin can combine with O2 oxyhaemoglobin or CO2
carbaminohaemoglobin.
These combinations are reversible.-Haemoglobin may combine with CO carboxyhaemoglobin which is irreversible.
-
8/10/2019 WEEK 5 RBCS ppt ash.ppt
51/73
6-Fate
-Normally, the life span of human erythrocytes is 120days.
- erythrocytes are removed from the circulation by
macrophages of the spleen and bone marrow.-Haemoglobinis destructed to globin and haematin.
-Haematin is furtherly broken into haemosidrin
(which is reused to form haemoglobin in the liver )and haematoidin ( bilirubin ) which is excreted in
bile.
R ti l t
-
8/10/2019 WEEK 5 RBCS ppt ash.ppt
52/73
Reticulocytes
-They are immature form of erythrocytes in theblood released from the bone marrow.
-Their normal percentage in blood is about 1 %
of the circulating red blood cells.-Microscopically, they cannot be differentiatedfrom ordinary erythrocytes in a blood film.They need special incubation (supravital
staining) by brilliant cresyl blue.
-
-
8/10/2019 WEEK 5 RBCS ppt ash.ppt
53/73
-Reticulocytes increase in cases ofincrease demand for erythrocytesformation from bone marrow as inhaemorrhages.
EM, their cytoplasm appears less electrondense due to less haemoglobin content.
-Reticulocytes show remnants ofribosomes, mitochondria and Golgi.
MATURATION OF RED BLOOD CELLS
-
8/10/2019 WEEK 5 RBCS ppt ash.ppt
54/73
MATURATION OF RED BLOOD CELLS1-pluripotential stem cell
myeloid multipotentialcells.2- erythrocyte- colony forming cells
3-Proerythroblas
4-basophilic erythroblasts ts
5-polychromatophilic erythroblasts
6-normoblasts
7-reticulocyte
8-er throc te
ERYTHROPOIESIS
-
8/10/2019 WEEK 5 RBCS ppt ash.ppt
55/73
ERYTHROPOIESISMATURATION OF RED BLOOD CELLS
1-Thepluripotential stem cellsof the bonemarrow proliferate and form myeloidmultipotentialcells.
2-These cells form the progenitor daughtercells, erythrocyte- colony forming cells
(ECFC) which differentiate intoproerythroblasts.
3-Proerythroblasts are the first recognizable
-
8/10/2019 WEEK 5 RBCS ppt ash.ppt
56/73
3 Proerythroblasts are the first recognizable
cells of the erythrocytic series.
They are large cells ( 12-15 m ) with large
moderately stained nuclei having prominent
nucleoli and their cytoplasm is basophilic.
4-Proerythroblasts differentiate into basophilic
erythroblasts which is smaller ( 10-12 m )
than proerythroblast having a smaller
condensed nucleus and basophilic cytoplasm.
-
8/10/2019 WEEK 5 RBCS ppt ash.ppt
57/73
5-Basophilic erythroblasts differentiateinto polychromatophilic erythroblasts
which is smaller than basophilic erythroblastswith a small more condensed nucleus.
The cytoplasm is polychromatophilic due tothe presence of polysomes ( basophilic ) andhaemoglobin ( acidophilic ).
Mitosis occurs in proerythroblasts,basophilicand polychroma- tophilic erythroblasts.
-
8/10/2019 WEEK 5 RBCS ppt ash.ppt
58/73
6-Polychromatophilic erythroblasts
differentiates tonormoblasts
which are smaller in diameter ( 8-10 m )having darkly stained eccentric nuclei.
The cytoplasm is acidophilic due to thepresence of haemoglobin.
-
8/10/2019 WEEK 5 RBCS ppt ash.ppt
59/73
7-The nucleus of normoblast
is extruded to the outside to be phagocytosed bymacrophages and the cell now is calledreticulocyte. Reticulocytes are slightly largerthan mature erythbrocutes. Their number is
1-2 % of blood erythroblasts.
They have blue network which is the remnants
of polysomes.They stain positively with the supravital stainbrilliant cresyl blue.
-
8/10/2019 WEEK 5 RBCS ppt ash.ppt
60/73
8-The reticulocyteloses its polyribosomes and becomes mature
erythrocytebeing a biconcave disc-shaped full ofhemoglobin. Mature erythrocytes pass through theendothelium of blood sinusoids to the generalcirculation.
-The development of erythrocytes is under the
control of erythropietin and it needs iron, folic acidand vit. B12.
-Erythropoiesis takes about 7 days to produce
mature cells.
RBC Development
-
8/10/2019 WEEK 5 RBCS ppt ash.ppt
61/73
RBC Development
Proerythroblast
-
8/10/2019 WEEK 5 RBCS ppt ash.ppt
62/73
Proerythroblast
Biggest in lineage Large central nucleus
with one or two
nucleoliBasophilic cytoplasm
b/c ribosomes
Look for Golgi ghost
Basophilic Erythroblast
-
8/10/2019 WEEK 5 RBCS ppt ash.ppt
63/73
Basophilic Erythroblast
Smaller thanproerythroblast
Checkerboardnucleus(heterochromatic)
Intense basophilia(lots of ribosomes!)
Proerythroblast vs Basophilic
-
8/10/2019 WEEK 5 RBCS ppt ash.ppt
64/73
y pErythroblast
Polychromatophilic Erythroblast
-
8/10/2019 WEEK 5 RBCS ppt ash.ppt
65/73
Polychromatophilic Erythroblast
Smaller than basophilicerythroblast
Smaller intensely
heterochromaticnucleus
Purple/lilac cytoplasm
mix of basophiliafrom ribosomes andgrowing eosinophilia
from hemoglobin
Normoblast
-
8/10/2019 WEEK 5 RBCS ppt ash.ppt
66/73
Normoblast
Smaller thanpolychromatophilicerythroblast
Small, compact,
intensely stainingnucleus that is gettingready to be extruded
Eosinophilic cytoplasm
due to abundanthemoglobin
-
8/10/2019 WEEK 5 RBCS ppt ash.ppt
67/73
Reticulocyte
Immature RBC thathas polyribosomes
Appear as polychrom-atophilic erythrocyteon blood smear
When stained with aspecial (supravital)stain Reticulocyte
Erythrocyte
-
8/10/2019 WEEK 5 RBCS ppt ash.ppt
68/73
Erythrocyte
Smallest
Eosinophilicdue tohemoglobin
NONUCLEUS!
-
8/10/2019 WEEK 5 RBCS ppt ash.ppt
69/73
-
8/10/2019 WEEK 5 RBCS ppt ash.ppt
70/73
Sickle Cell Disease
-
8/10/2019 WEEK 5 RBCS ppt ash.ppt
71/73
Sickle Cell Disease Classic hemoglobinopathy
Normal HGB is 2 2: -chain defects(Val->Glu)
Reduced hemoglobin sickles inhomozygous
8% of American blacks are heterozygous
THALASSEMIAS
-
8/10/2019 WEEK 5 RBCS ppt ash.ppt
72/73
THALASSEMIASA WIDE VARIETY of diseases involving GLOBIN
synthesis, COMPLEX genetics
Alphaor betachains deficient synthesis
involved Often termed MAJOR or MINOR, depending on
severity, silent carriers and traits are seen
HEMOLYSIS is uniformly a feature, a microcyticanemia
A crew cut skull x-ray appearance may beseen
RBC LAB
-
8/10/2019 WEEK 5 RBCS ppt ash.ppt
73/73
RBC LAB