Far Eastern University-Dr.

Nicanor Reyes Medical Foundation

Blood and Lymph by Dr. Grace Bardelosa (7.17.2014)

Blood Serum
 Specialized connective tissue  Liquid portion of clotted blood
 Cells suspended in PLASMA  Contains growth factors and other proteins
 5 L move unidirectionally in a closed circulatory system  released from platelets
 Biologically different from plasma
Functions of Blood
 A distributing vehicle (O2, CO2, metabolites, hormones and
other substances)
 Regulation of body temperature
 Maintenance of acid-base and osmotic balance
Composition of Plasma
 An aqueous solution
 pH 7.4
 Dissolved compounds are mostly proteins
 Nutrients
 Respiratory gases
Formed Elements  Nitrogenous waste products
 Erythrocytes  Hormones
 Leukocytes  Inorganic ions aka electrolytes
  Platelets  Albumun
Plasma o Most abundant; maintains osmotic pressure of blood
 Straw-colored, translucent o α-Globulins and β-globulins
 Slightly viscous supernatant o Transport lipids, metal ions, iron ions in bloodstream
 55% at top of a centrifuged tube  γ-Globulins
Hematocrit o Immunoglobulins
 Unclotted blood  Fibrinogen
 Erythrocytes that are sedimented o Participates in blood coagulation, precursor of fibrin
 45% in healthy adults  Complement proteins
Buffy Coat o Important in inflammation & destruction of organisms
 Thin gray-white layer between plasma and hematocrit
 1%
 Leukocytes and platelets

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Far Eastern University-Dr. Nicanor Reyes Medical Foundation
Blood and Lymph by Dr. Grace Bardelosa (7.17.2014)

Erythrocytes  NV males: 4.1 to 6.0 million/ uL

 Flexible
 Cuplike shape
 Rouleaux: RBC’s adhere to one another loosely in
 stacks.
 Lacks all organelles
 Filled with hemoglobin
 Tetrameric O2 carrying protein
 Oxyhemoglobin (O2) Binds reversibly via
 Carbaminohemoglobin (CO2) diffusion
 Hemoglobin + CO
 Rely on anaerobic glycolysis for minimal energy
 needs (No mitochondria)
 Cannot replace defective proteins
 120 days normal life span
o Removed in circulation by macrophages (spleen,
liver and bone marrow)

Plasmalemma (strongest in RBCs)

40% lipid, 10% carbohydrate, 50% protein
 Mostly integral membrane proteins
 Non nucleated (removed in orthochromatophilc erythrocyte o Ion channels
stage) o Band 3 protein (anion transporter)
 Reticulocytes: earliest in blood; 3 days before remnants o Glycophorin A
disappear o Glycosylated extracellular domains include antigenic
 Completely filled with hemoglobin sites
 Biconcave discs – provides surface-to-volume ratio,  Basis for ABO blood typing system
facilitates gas exchange  Peripheral proteins
 7.5 um diameter o Spectrin: forms lattice with actin filaments  
  2.6 um thick at rim o Ankyrin: anchors lattice to glycophorins and band 3
 0.75 um thick at center Erythrocytes proteins
 NV females: 3.9 to 5.5 million/ uL o Stabilizes the membrane

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Far Eastern University-Dr. Nicanor Reyes Medical Foundation
Blood and Lymph by Dr. Grace Bardelosa (7.17.2014)

o  Maintains cell shape

o Provides cell elasticity Leukocytes
Anemia  Granulocytes
 Condition where concentration of RBC’s are below the  Azurophilic granules
normal range  Specific granules
 S/Sx: lethargy, shortness of breath, fatigue, skin pallor,  Bind neutral, basic, or acidic stains
cardiac palpitations  Have specific functions
 Causes:  Polymorphic nuclei (Mononucleated but multilobulated)
o Insufficient RBC production o  Neutrophils, Eosinophils, & Basophils
o Blood loss Erythrocytosis  Agranulocytes
Polycythemia o No specific granules
 Increased concentration of RBC’s o Azurophillic granules
 Physiologic o Nuclei indented but not lobulated
o Areas with high altitudes o Lymphocytes & Monocytes Leukocytes
o O2 tension is low  Defense against invading microorganisms
o Increase in hematocrit  Repair of injures tissues

Neutrophils
 12-15 um
 54% to 62%
 Nuclei: 2 to 5 lobes linked by
thin nuclear extensions
 Females: drumstick-like
appendage
 Inactive and spherical when
inactive
 Amoeboid during diapedesis
 Active phagocytes of bacteria
 Usually first to arrive at sites of
infection
 Azurophilic primary granules
 Role in killing and degrading

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Far Eastern University-Dr. Nicanor Reyes Medical Foundation
Blood and Lymph by Dr. Grace Bardelosa (7.17.2014)

engulfed
 microorganisms Basophils
o Myeloperoxidase (Hypochlorite)  12 to 15 um
o Lysozyme  Less than 1%
o Defensins  Nucleus is divide into two irregular
 Specific secondary granules lobes
o Secretion of ECM-degrading enzymes such as  Large specific granules stain purple
collagenases o Heparin and sulfated GAG’s
 Delivery of additional bactericidal proteins to the o Histamine
phagolysosomes o Platelet activating factor
 Insertion of new cell membrane components o Eosinophil chemotactic factor
 Role in inflammatory response o Phospholipase A
 Restore normal tissue microenvironment  Supplement function of mast cells
 First line of defense against invasion by pathogenic bacteria o Contain heparin and histamine
 Short-lived o Receptors for IgE
 Half-life of 6 to 8 hours o Secrete components in response to certain Ag’s and
 Life span of 4 days in connective tissue allergens

Eosinophils Lymphocytes
 1% to 3%   B lymphocytes
 Bilobed nucleus  T lymphocytes
 Abundance of large acidiphilic specific o Helper (CD4+)
granules stain pink or red o Cytotoxic (CD8+)
 Major basic protein (MBP)  Natural killer cells (NK cells)
 50% of total granule protein  Immune defense against
 Kill parasitic worms and helminths invading microorganisms,
 Modulate inflammatory responses parasites, abnormal cells
triggered by allergies Types (in reference to RBC size)
 Remove antigen-antibody complexes from interstitial fluid by  Small – similar to RBC’s
phagocytosis o Spherical nuclei
 Found in Intestinal lining, lung tissues o Highly condensed chromatin
o Scanty cytoplasm

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Far Eastern University-Dr. Nicanor Reyes Medical Foundation
Blood and Lymph by Dr. Grace Bardelosa (7.17.2014)

 Medium and Large (activated lymphocytes or NK cells)  Life span of 10 days

 9 to 18 um  Clumps
 Slightly indented nuclei  Discoid
 More cytoplasm  Hyalomere
 Few azurophilic granules Monocytes o Lightly stained peripheral zone
 Precursor cells of macrophages, osteoclasts, microglia and  Granulomere
other cells of the mononuclear phagocyte system o Dark-staining central zone containing granules
 Antigen-presenting cells Thrombocytopenia
 Immune defense  Lack of circulating platelets
 Leads to a bleeding tendency
Monocytes Thrombocytosis
 12 to 18 um  Excess of platelets
 Nucleus: indented or C-  Leads to risk of inappropriate blood clotting (thrombosis)
shaped
 Cytoplasm: basophilic Normal Plasma
 Azurophilic granules:  Normal plasma is said to be isoosmotic or
bluish-gray distributed  isotonic.
through the cytoplasm  Isotonic solutions maybe prepared for the study
 of corpuscles outside the body
Platelets  0.85% solution of sodium chloride is approximately isotonic
 Thrombocytes for the blood
 Non-nucleated cell Crenation
fragments  “Scalloped” or “notched”
 2 to 4 um  The formation of an abnormal notching around the edge of
 From an erythrocyte
megakaryocytes  Shrinkage after suspension in a hypertonic solution
 Promote blood Echinocytes or burr cells
clotting  Hypertonic solution is added to blood
 Repair of minor  Erythrocytes become shrunken and irregular in surface
tears or leaks in contour
small BV’s Platelets  Cockle-Burr appearance
 150,000 to 400,000/uL (mm3)  The process is called crenation

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Far Eastern University-Dr. Nicanor Reyes Medical Foundation
Blood and Lymph by Dr. Grace Bardelosa (7.17.2014)

Hemolysis  Lymphoma
 Breakage of the RBC’s membrane o Neoplastic proliferation of lymphocytes
 Release of hemoglobin and other internal components into o Failure of lymphocytes to undergo apoptosis
surrounding fluid o All are considered malignant Lymph
 Pink to red tinge in serum  Filariasis
 May compromise laboratory’s test parameters o A parasitic disease caused by microscopic, thread-
 Hypotonic solution: RBC’s become spheroidal : swelling of like worms
cells o Adult worms only live in human lymphatic system
 Two causes o Spread from person to person by mosquitoes
o In vivo: Pathological causes
o Autoimmune hemolytic anemia
o Transfusion reaction
 In vitro: Improper specimen collection, processing, transport

Lymph
 Excess interstitial fluid from tissue spaces
 Does not contain RBC’s
 Lymphocytes may be present
 Rich in proteins
 Greater hydrostatic pressure of blood at arterial ends of
capillaries
 Opposite at venous end
 Osmotic pressure of plasma
 Increased rate of tissue fluid formation at arterial end
 Lesser reuptake of fluid at venous end
Excess fluid Lymph
Chylothorax
 A type of pleural effusion
 Lymphatic fluid accumulating in the pleural cavity
 Causes
o Lymphoma
o Trauma Lymph

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