CLINICAL I Human body

Anatomy and physiology, 3.

The blood
Ian Peate, Head of School, School of Health Studies, Gibraltar

as erythrocytes, are the most abundant

Abstract
of the blood cells. They are bi-concave
Although the primary function of blood is to deliver oxygen and nutrients to—and remove waste discs (Figure 3) and contain oxygen-
from—body cells, the blood also performs a number of other functions. The specific functions carrying protein called haemoglobin
of blood include defence against disease and distribution of heat, as well as maintenance of (McGuiness, 2010). The bi-concave shape
homeostasis. This article provides an overview of this life-saving fluid. It emphasises the need for is maintained by a network of proteins;
the healthcare assistant and assistant practitioner (HCA and AP) to develop an understanding this network permits the red blood cells
of blood and its various functions in illness and health. Understanding the function of blood can to change shape as they are transported
help the HCA and AP to offer people care that is safe, effective and informed. through the blood vessels. The RBCs can
The article considers the components of blood. The various functions of blood, including its bend easily to squeeze through narrow
role in transportation, regulation and protection, are described. The article offers a glossary of blood vessels. Young red blood cells
terms that can help the HCA and AP in understanding some of the terms that have been used. contain a nucleus; however, the nucleus
A short quiz is provided to help reinforce the learning. is absent in a mature red blood cell, thus
Keywords increasing the oxygen-carrying capacity
Blood Transportation of the red blood cell. As RBCs have no
Regulation Protection nucleus, they are incapable of dividing
and reproducing; they are also unable to
be repaired.

T
he blood is an essential body fluid.
It is vital for life—without blood,
the cells and tissues will die. Blood
is, as the proverb says, thicker than
water (it is viscous) and feels sticky. The
temperature of blood in the body is 38°C;
this is about one degree higher than
body temperature. The volume of blood
a person has in their body will depend
mostly on size, weight and gender.
The average person has around 4.5 to
5.5 litres of blood: blood accounts for
about 4.5 to 5.5 kg. A new-born baby
weighing 2.3 to 3.6 kg has about 0.2 litres
of blood in their body.
By the time a child is 5 or 6 years of
age, they have about the same amount of
blood as an adult.
Components of blood
Blood is the only fluid connective tissue.
It is circulated throughout the body by
the pumping action of the heart, through
the veins and arteries (circulatory
system) (see Figure 1), nourishing every
of plasma and the RBCs, WBCs and
platelets make up the remaining 45%
(Boore et al, 2017).
Plasma
This is a light yellow liquid (straw-
coloured) that makes up over half the
volume of blood (55%). More than 90% of
blood plasma is water, while less than 10%
are dissolved and suspended substances,
mainly proteins (Boore et al, 2017; Waugh
and Grant, 2014). Blood plasma also
contains electrolytes, vitamins, glucose and
amino acids. Among other roles, blood
plasma proteins help to maintain blood
osmotic pressure, which is an important
consideration in fluid exchange.
Red blood cells
The red blood cells (RBCs), also known
“The red blood cells (RBCs), also known as erythrocytes,
are the most abundant of the blood cells. They are
bi-concave discs and contain oxygen-carrying protein
There are more than 4-5 million red
blood cells in every cubic millimetre
of blood in the body; this number is
called the red blood cell count. RBCs
include the iron-containing pigment
called haemoglobin (Hb); haemoglobin
is responsible for the carriage of oxygen
transported in the blood. It is the red
blood cells that give the blood its red
colour. When the red blood cell with
oxygen attached to it reaches the tissues
where it is needed, it gives the oxygen
(O2) up and then picks up carbon dioxide
(CO2). The carbon dioxide is then
transported back to the lungs. When
a person is deficient of haemoglobin,
this is known as anaemia. RBCs live for
about 120 days and when they die or are
damaged, they are broken by the spleen,
liver or bone marrow; these are part
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cell. Blood contains formed elements,

for example, red blood cells (RBCs),
white blood cells (WBCs), platelets (see
Figure 2) and a fluid component called
plasma: 55% of blood is composed
474
called haemoglobin. As RBCs have no nucleus, they are
incapable of dividing and reproducing; they are also
unable to be repaired”
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 Human body I CLINICAL

of the reticuloendothelial system (also for the clotting of blood, as well as is haematopoiesis. All blood cells

Adobe Stock/pixelcaos
known as the mononuclear phagocytic controlling bleeding (haemostasis). are developed from one type of
system (MPS)). The haemostatic blood-clotting cell and this is called the ‘stem
These cells are destroyed by function can be described as the cell’. In the adult, blood stem
macrophages of the reticulo endothelium formation of a haemostatic plug. cells are usually found in the
system that is part of bone, liver, lymph The cells clump together red bone marrow of the
nodes and spleen. The iron from the if bleeding happens and bones (see Figure 7).
haemoglobin is recycled and stored and chemicals are released into the Blood cell production
reused at a later stage. blood stream; this also helps begins during fetal
in promoting haemostasis. development; when
White blood cells There are around 150 000 the fetus reaches
The white blood cells (WBCs) are also to 440 000 platelets per 6-7 months,
known as leucocytes. There are several cubic millimetre. Platelets production of blood
types of WBCs in the blood in varying are oval, non-nucleated cells begins in the
amounts and each of them has a role structures that contain bone marrow.
to play in the immune response, which vital elements such as:
is the response of the body to fight Potassium Conclusion
infection or anything else that the body Calcium Blood is
recognises as strange or unfamiliar. The Several clotting a type of
WBCs are key concerning body defence; factors connective
they destroy micro-organisms and Adrenaline tissue.
foreign particles. Enzymes Each cell in the body
There are fewer WBCs than RBCs. Platelets live for about 8-12 days gets its nutrients from
The ‘normal’ WBC count is between and old platelets are destroyed blood; without blood, the
4000 and 11 000 per cubic millimetre of by the spleen. An increase in the cells and tissues will die.
blood. WBCs also differ from RBCs; for production of these cells occurs Haematopoiesis is the
example, they have a nucleus and they after tissue trauma, destruction term used to describe the
are larger in size. There are five types of and hypoxeamia (abnormally production of blood cells.
leucocyte (see Table 1 and Figure 4). low concentration of oxygen in All blood cells are derived
WBCs have a short life span; some of the blood). from one type of cell, which
them will only live for a few hours and is termed the ‘stem cell’ and is
others survive for a few days. The body How blood cells
produces them very quickly in response are produced
to inflammation and infection. When The term used for the Figure 1. The veins and arteries
in circulation, they pass into the tissues production of blood cells (circulatory system)
and are lost to the exterior in faeces
and respiratory secretions; or if they

Adobe Stock/Balint Radu

die in the tissues, they are surrounded
by macrophages and this is called
phagocytosis (see Figure 5).

Platelets
Platelet cells are also called thrombocytes.
These are smallest in number of formed
blood components. They also look
like small discs, as do the RBCs (see
Figure 6). The platelets are responsible

“The white blood cells

(WBCs), also known
as leucocytes, are key
concerning body defence;
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they destroy micro-

organisms and any
foreign particles” Figure 2. Components of blood.

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 CLINICAL I Human body

important for modern research, although

Dennis Kunkel Microscopy/Science Photo Library

there is controversy over the use of stem

cells for this. Blood stem cells in the adult
are usually found in the red bone marrow
of the bones. An understanding of blood
can help the HCA and AP offer care and
support to others.
There are two components in the
blood, a cellular component and a fluid
component. Platelets are the cellular parts
of blood that have a responsibility for
clotting; they clump together to form a
plug if bleeding occurs and simultaneously
release chemicals into the blood stream
that assist in helping the blood form a
clot and the blood vessel to be repaired.
Clotting or haemostasis is complex and
involves a complicated chain of events that
involve clotting factors.
The RBCs contain haemoglobin, which
is vital for the transportation of oxygen
to the tissues of the body. A reduction
in haemoglobin, due to a decrease (i.e.
Figure 3. The biconcave red blood cell. haemorrhage) or dysfunction of the
RBCs, can cause anaemia.
Adobe Stock/apple1

There are a number of types of WBCs.

They are also known as leucocytes and

White blood cells they are essential in defending the body

from infection and in providing immunity.
These cells are made very quickly by the
body. Some WBCs only live for a few
hours and others for a few days. BJHCA

Acknowledgement
I would like to thank Mrs Frances Cohen
for her help and support.

References
Boore J, Cook N, Shepherd A (2017) Essential of
Anatomy and Physiology for Nursing Practice.
neutrophil eosinophil basophil monocyte lymphocyte Sage, London
McGuiness H (2010) Anatomy and Physiology.
The Therapy Basics. 4th edn. Hodder, London
Figure 4. The white blood cells. Nair M (2017) Circulatory system. In: Peate I,
Nair M, eds. Fundamentals of Anatomy and
Table 1. The white blood cells Physiology for Nursing and Healthcare Students.
2nd edn. Wiley, Oxford
Type of WBC Key characteristics
Waugh A, Grant A (2014) Ross and Wilson
Granulocytes – Granulocytes account for about 70% of the total white cell count Anatomy and Physiology. 12th edn. Churchill
divided into: Livingstone, Edinburgh
Neutrophils 2000–7500 per cubic millimetre. They may only live for a few hours
Eosinophils 40–400 per cubic millimetre. These cells participate in allergic reactions
Basophils 0-100 per cubic millimetre. They are involved in hypersensitivity,
anaphylactic and inflammatory reactions Test
1. The main function of a red blood cell
Lymphocytes 1300–4000 per cubic millimetre. These cells are responsible for
© 2017 MA Healthcare Ltd

(RBC) is to:
producing antibodies
a. Fight infection
Monocytes 200-800 per cubic millimetre. These are the largest WBCs. They circulate b. Provide support to the veins
in the blood for only 10-12 hours
c. Act as a transport system
(Source: adapted Nair, 2017; Boore et al; 2017; Waugh and Grant, 2014)
d. Destroy viruses, but not bacteria

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 Adobe Stock/designua Human body I CLINICAL

Jacopin BSIP/Science Photo Library

Figure 5. Phagocytosis.

Adobe Stock/royaltystockphoto

Figure 7. Haematopoiesis usually occurs in these

coloured bones.

c. Act as a transport system

d. Assist with haemostasis

4. The plasma is:

a. A light yellow liquid and makes up just
over half the volume of blood (55%)
b. Only present in people with anaemia
Figure 6. Platelet: key in the process of blood clotting. c. A dark red liquid making up just over
half the volume of blood (55%)
© 2017 MA Healthcare Ltd

2. The main function of a white blood d. Destroy viruses, but not bacteria d. A light yellow (straw-coloured) liquid,
cell (WBC) is to: it makes up less than the 45% of
a. Fight infection 3. The main function of platelets is to: blood volume
b. Provide support to the veins a. Fight infection
c. Act as a transport system b. Provide support to the veins 5. The correct term for the formation of

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CLINICAL I Human body
blood cells is:
a. Haemoglobin
b. Haemorrhage
c. Haematopoiesis
d. Haematocrit
Test answers below
Key points
The HCA and AP need to have an
understanding of the blood in order to
provide people with safe and effective care
Every cell in the body receives its nutrients
from blood; without blood, cells and tissues
will die
Blood is comprised of a fluid called plasma,
accounting for 55% of blood; the remaining
45% is made up of the blood cells
RBCs are also called erythrocytes with oxygen
attached to them, which is then carried via
the circulatory system to the tissues
WBCs are also called leucocytes; their key
function is to fight infection, but they also
play a part in immunity
Platelets, also called thrombocytes, play a
key role with regards to blood clotting
Answer: 1C, Answer: 2A, Answer: 3D,
Answer: 4A, Answer: 5C
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478
Glossary of terms
Amino acids They are the basic building blocks of the body
Anaphylactic A severe and possibly life-threatening reaction to a trigger, for
example, an allergy. It is also known as anaphylactic shock
Electrolyte These are salts and minerals found in the blood, for example,
sodium, potassium, chloride and bicarbonate. They can conduct
electrical impulses in the body
Haemorrhage Bleeding; can be internal or external—an escape of blood from a
blood vessel
Homeostasis Maintenance of a constant internal environment in the body
Hypoxaemia Low oxygen in the blood stream
Immunity The capability to resist harmful microorganisms: the body’s defence
system being able to recognise a specific type of infection and the
cells of the body being prepared to fight it
Organism An individual form of life
Phagocytosis The process that the body uses to get rid of unwanted organisms, for
example, harmful bacteria, foreign bodies and dead cells
Reticulo endothelial Range of specialised cells that are capable of phagocytosis
system
Viscous Viscosity is a measure of a fluid’s thickness or resistance to flow
Reflective questions for your continuing professional development (CPD)
Name 6 components of blood and three of the functions of blood
How does an understanding ofblood help you as an HCA or AP to care for people better?
Prepare with a colleague a talk for fellow support staff on the importance of blood
Tweet us
@HCAssistants
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