Introduction to Hematology

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Etymology
2 Greek Words: Haima (blood) & Logos (study/science)

Father of Hematology- William Hewson because of his contribution in the field:

1) Showed that fibrinogen can lead to coagulation (blood is clotting because of fibrinogen)
2) Contributed the advanced knowledge in lymphatic system
3) He explored the functions of thymus and spleen (organs)

-Branch of medical science ppt

*Blood components:
1. RBC
2. WBC (White Blood Cells)
3. Platelets
*5 Blood Forming Organs:
1. Bone Marrow
2. Lymph Nodes (kulani)
3. Thymus
4. Spleen
5. Liver
*Note: Not all organs are capable of forming blood
Hematopoiesis- term for blood formation

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-Study of Quality ppt
*Quality
Studies the ff:
-Morphology (appearance or structure) of cells (kung hindi yun yung appearance ng blood, baka may
hematologic condition)
-Function (baka hindi gumagana yung cell)
*Quantity- talks about number (baka kaya may sakit si patient, it’s probably because of insufficient
number of rbc (anemia) or maraming wbc (leukemia), or bagsak ang platelets ng patient because of
dengue

3 Cellular Elements of the Blood:

1. RBC (AKA erythrocyte, discocyte or normocyte)
*Red color because of hemoglobin
*Erythro means red , Discocyte because the normal shape of rbc is biconcave discoid, Normocyte
because rbc must be normal at all times in structure or appearance.
Spleen kills rbc that is not normal in shape or appearance

2. WBC (White Blood Cells)

*AKA Leukocytes (Leuko means white) (cyte means cells) or Leukoplastids
*WBC don’t have pigments. They are naturally colorless. Med tech give color or stain to WBC.

3. Platelets
*AKA thrombocyte (thrombo, from the word thrombus means clot)- the primary function of platelet is
for clot formation
*Hemostasis- proper term for clot formation

Additional Notes:
-Main function of rbc is for gas exchange.
*2 gases: oxygen (inhale) and carbon dioxide (exhale)
-Main function of wbc serves as defense and protection

-Study of laboratory procedure (ppt)

*Commonly requested test: CBC (Complete Blood Count)

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Hematology- also the discipline that studies the development and diseases of the blood based on
Turgeon

History of Hematology
-Before 17th Century ppt
*Gross appearance- means macroscopic (seen by the naked eye)

-During 17th Century ppt

*Primitive microscope (pic in ppt)

-1657 ppt
*Worms in the blood in 1657 are actually blood parasites

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-1674
*Gave account to RBC that’s why we know its appearance and shape (biconcave disc), na may
hemoglobin, na may other names ang RBC. It’s because of Anton van Leeuwenhoek

-1891 ppt
*Combined stain/polychrome- methylene blue and eosin to make a blood stain
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-Late 1800 ppt
*Hindi pa platelet ang pangalan but petite plaques because platelets are small ranging from 2-4 um
(micrometer) and plaques kasi para lang syang dumi or proper term- parang debris. While RBC ranges
from 6-8 um (mas malaki)

-1901 ppt
*Methylene blue + eosin with centrifugation of combined methylene blue and eosin and recovered the
precipitate and dissolved the precipitate in methanol making the Leishman stain.
*Supernate- fluid portion ng na-centrifuge na napunta sa ibabaw, why ibabaw? Because mas magaan.
*Precipitate- napupunta sa ilalaim or yung napupunta sa bottom

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-1902 ppt
*Wright Stain- standard stain used in hematology developed by James Homer Wright in 1902

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-Addendum

-Before 1900 ppt

*Visual counting
*RBC Count started to assess the patient condition kasi may mga babaeng madalas nahihilo etc.
*Visual Counting- binibilang kung madami or kaunti ang rbc

-1953 ppt
*Joseph and Wallace Coulter are brothers
*Machine is used to determine cells ng blood of patient
*They developed machine called coulter counter

-1958 ppt
*Available on market the automated particle counters

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-Present ppt
*Automation is thru the use of machine

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-Clinical Hematology ppt
*Concentration is based on quality and quantity, structure and function are based on quality
*We study hematology to predict, detect ppt
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-Common prefixes (came from greek and latin)
*Source for common prefixes and suffixes used in the vocabulary of hematology came from greek and
latin words
*pic ppt (examples below)
*Example anemia, emia means blood and a or an means without or lack
*Patient has condition called anisocytosis which is the variation in rbc size (because the normal size of
rbc is 6-8 um) (example)
*Ferrous sulfate treatment for anemia (medicine) because people with anemia lack of iron
*Hypoxia- decreased in oxygen
*When you read myelo, remember it is from bone marrow but if it’s not in the choices, remember the
word white blood cells
*Pandemic- means all, or worldwide
*Phagocytosis- cell eating
*Poikilocytosis- variation in the shape of rbc (normal shape of rbc is biconcave discoid shape)

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-Common suffixes (came from greek and latin)
*Hemolysis- destruction of rbc
*Oma- common for cancer patients
*Hemoglobinopathy- disease in hemoglobin
*Poietin pertains to hormones that stimulates production

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-Blood ppt
-Circulatory fluid ppt
*Components of Cardiovascular System:
1. Heart
2. Blood
3. Blood Vessels
*Pumped from the heart ppt
*Blood in the arteries is oxygenated (blood is bright red)
*Capillaries is the tissues of the body which uses the oxygen carried by rbc to veins
*Blood in the veins is deoxygenated to heart which is oxygenated
*Heart -> Arteries (oxygenated: bright red) -> Capillaries (tissues use oxygen carried by rbc) -> Veins
(deoxygenated blood) -> Heart (need ibalik sa heart para magkaoxygen ulit)

-Transports oxygen ppt

*Lungs -> Tissues -> CO2 from tissues -> Lungs
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-General characteristic of the blood ppt
1. In Vivo, In Vitro
*In Vivo- inside the body
*In Vitro- outside the body
*Heparin (AKA: (Hard Term) Mucoitin Polysulfuric Acid)- body’s natural anticoagulant that’s why blood
in the body is in liquid form. It is the most expensive anticoagulant
*When platelets are removed in the body it will coagulate or clot that’s why when blood is removed in
the body, after 5 -10 minutes, it will clot.

2. Thickness and Viscosity

*Blood is 3.5-4.5 thicker than water ppt
*Water- one of the components of blood
*Blood is 91% Water (based on plasma component)

3. Weight of the Blood

*Blood makes up ppt
*Approximately per 100ml of blood, 20g is solid. 20g of 100ml of blood is in solid form

4. Total blood volume

*Newborns- performs skin puncture (less volume will be collected)
*Women have lower blood volume because they have menstrual cycle. Every month, they lose blood
thru menstration
*Men have higher blood volume because they are heavier than women
*Ave body weight of men is 70kg (can be seen in formula)

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Total blood volume ppt
*Average weight of female is 55kg
*Formula ppt

5. Blood PH ppt
*7 and above is alkaline
*7 is neutral
*less than 7 is acidic

6. Blood specific gravity

*specific gravity ppt
*Plasma have fibrinogen while serum doesn’t have

7. Color
*Blood is red due to ppt
-Venous Blood ppt
*Reasons ppt

-Arterial Blood ppt

8. Osmolality ppt
*mOsm- milliosmoles

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-Composition of the Blood ppt
*With anticoagulant tube- plasma
*Without anticoagulant tube- serum (pag nag clot ang blood, yung fluid sa ibabaw ay serum)
*45% formed elements & 55% either serum or plasma
*Plasma: 91% is made up of water, 7% proteins (57% albumins, 38% globulins, 4% fibrinogen (plasma),
1% prothrombin) and other solutes (ions, nutrients, waste products, gases (O2 & CO2), regulatory waste
substances)
*Formed Elements: erythrocytes (>99%), leukocytes (<1%), platelets (<1%)
**Leukocytes: 60%-70% neutrophil, 20%-25% lymphocytes, 3%-8% monocytes, 2%-4% eosinophil and
0.5%-1% basophils
*Platelets are not true blood cells according to Rodaks because platelets did not undergo any
maturation series. Thus, WBC and RBC are only the true blood cells according to Rodaks.
*Buffy Coat- middle of plasma and formed elements

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-3 layers of buffy coat ppt
*Uppermost layer: platelets (2-4um & not true blood cells)
*Middlemost layer ppt
*Lowermost layer: ppt

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-Formed elements in the blood ppt
*Monocytes- largest yet most fragile (mabilis masira) wbc

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-Serum vs Plasma ppt
*Serum no fibrinogen or factor 1 because nag clot na ang blood, nagamit na ang fibrinogen. While ang
plasma may fibrinogen dahil hindi nag clot ang blood
*Serum: transparent due to absence of factor 1 or fibrinogen
*Plasma: slightly hazy due to presence of fibrinogen
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-Functions of the blood ppt
I Metabolic Functions
1. Respiratory- RBC
2. Nutritional
3. Excretory: kidneys (urine), lungs (exhalation), skin (sweat), intestine (stool)

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-II Defense Functions- WBC
1. By production of Immunoglobulins (AKA antibodies)
2. Function as phagocytes
a. Netrophil
b. Eosinophil
c. Monocytes

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-III Regulatory Functions ppt
1. Maintaining Water Balance because 55% is plasma/serum which is 91% water
2. Body Temperature (normal body temp: 37-37.5 C/ 99.5 F) –Loss of blood can drop down body
temperature
3. Organ activity (without oxygen, cells will die)
4. Acid-base balance (normal range pH 7.35-7.45) (ave. pH 7.4 (slightly alkaline))
*venous- ave. pH 7.35
*arterial- ave. pH 7.45
*< 7.35 is termed as acidosis or academia
*> 7.35 is termed as alkalosis or alkalemia

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-Homeostasis ppt
*Hemostasis- clotting (job of platelets)
*Homeostasis- balance/equilibrium
-Is maintained by:

1. Osmotic concentration means water concentration

*Isotonic- equal water outside and inside the rbc
*To maintain equal volume of water inside and outside the cell, we use in the lab -> NSS- Normal Saline
Solution (0.85% or 0.9%)

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-Hypotonic ppt
*More H2O outside than inside
-Hypertonic
*Less water H2O outside than inside

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2. pH ppt
*Venous blood range: 7.36-7.31
*Arterial blood range: 7.38-7.44
*Average pH- vein: 7.35, arterial: 7.45 (normal blood pH: 7.35-7.45 with ave. of 7.40 (slightly alkaline))

3. Temperature
Normal body temp: 37 C/98 F to 37.5 C/99 F

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-Hematological tests ppt
*Routine test- common test (day to day basis)
*Reflex test- special test

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-Additional Term and WHO Term ppt
*Differential Count- differentiates 5 types of WBC: neutro, lympho, mono, eosi, baso

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-Reflex Test
*Special or follow up test
*1st is the routine test followed by reflex test