WHAT IS THIS?

BLOOD

¡ Blood is considered as
connective tissue.
¡ It is composed of blood cells and
platelets suspended in plasma.

5
¡Which one is heavier?
¡Which one is more viscous?

Blood 4×3 Hs

¡ Blood is heavier and

about four times
heavier and more
viscous that water.
¡ The PH of blood is
between 7.35 to 7.45.
7
 CRITICAL THINKING

IS BLOOD VOLUME CONSTANT

AMONG HUMAN BEINGS?

¡ The blood volume varies

with the size of the
individual.
¡ It averages 5 to 6 liters
in males and 4 to 5 liters
in females.
¡ Blood is 8% of the body
weight. 9
RED BLOOD CELLS

Tiny biconcave disks that

transport oxygen to body
cells and carbon dioxide
from body cells.
Why the biconcave
shape?

10

RED BLOOD CELLS

The biconcave shape

exposes maximal Mature erythrocytes lack
surface area of the cell the nucleus. However, the
for the diffusion of these nucleus is present in the
gases through the plasma immature RBCs.
membrane.
11
 Abnormal 12

RED BLOOD CELLS

WHAT IS THE RED PIGMENT

THAT GIVES THE RED
COLOR TO THE BLOOD?

13
RBC
¡ Hemoglobin is the red pigment that gives the red color to the
blood.
¡ About 33% of each RBC is consist of hemoglobin.
1-
¡ Hemoglobin consists of heme, the red pigment that contains
2-
iron atom and globin, a protein.
¡ Hemoglobin combines reversibly to oxygen and transports Unc .

oxygen by RBC.
14

¡ Can Hb also transport carbon dioxide?

RBC

¡ When blood flows through the lungs, oxygen diffuses from air spaces in
the lungs into the blood.

p,ᵈ
Body
¡ Oxygen enters RBCs and combines with Hb to form oxyhemoglobin, cell
which gives a bright red color to the blood.
deoxy
(cool
¡ After the release of oxygen from oxyhemoglobin to body cells.
Lung
¡ the resultant deoxyhemoglobin carries a small amount of CO2 from ( remove
body cells to the lungs for removal. Red Blood Cells
• Oxyhemoglobin: oxygenated blood (bright red)
15
¡ What color is deoxyhemoglobin? • Deoxyhemoglobin: deoxygenated blood (dark red)
 16

CONCENTRATION OF RBC.

¡ Erythrocytes are the most abundant blood cells because they are
vital in oxygen transport.
¡ Routine red blood cell count test is used to determine the
number of RBCs in cubic millimeter.
⑤ -67
¡ Normal range in males is 4.5-6.2 million RBCs per mm3.
¡ Normal range in females is 4.2-5.4 million RBCs per mm3.
Blood is 8% of the body weight. (4-51)
17
 CRITICAL THINKING

WHY THE RBC RANGE IN MEN IS HIGHER

THAN THAT OF WOMEN? 18

¡ The higher count in males results because males have

a higher metabolic rate than females thus a greater
concentration of RBCs is required to provide needed
oxygen for the rapidly metabolizing cells.
19
 20

02 ↓
↑
RBC
↑
High alt
-

In high altitudes, the concentration of oxygen in the air is less. Hence

the RBC is able to take up less oxygen only.
Therefore the RBC count increases in people living in high altitude.

HOMEWORK ASSIGNMENT
JUSTIFY WHY THE CONCENTRATION OF RBCS IS HIGHER IN
PEOPLE LIVING AT A HIGH ALTITUDE.
RBC PRODUCTION

¡ Prior to birth RBCs are largely produced by the

liver and spleen.
¡ After birth production occurs only in the
red bone marrow.
¡ Erythrocyte production varies with the oxygen
concentration of the blood in a negative feedback
mechanism. 22

RBC PRODUCTION

¡ Erythrocyte production varies with the oxygen

concentration of the blood in a negative feedback
control mechanism.
¡ What is hypoxia??
¡ What happens in case of hypoxia??? 23
 24

RBC PRODUCTION

¡ If blood oxygen concentration is low(hypoxia) such as after

hemorrhage, the kidney and liver release erythropoietin.
¡ Erythropoietin a hormone that stimulate red bone marrow to
produce more RBCs.
¡ When the new RBCs are added to the blood and the oxygen
concentration rises to normal levels, production of
erythropoietin declines, causing a decrease in RBC production.
25
 26

Iron, folic acid, and vitamin B, are

required for the RBC production.

Iron is required for Hb synthesis. Explain

RBC PRODUCTION why? to carry oxygen to every part of your body.

Folic acid and vitamin B are required for

DNA synthesis during early stages or RBC
production.

27
 RBC PRODUCTION

¡ All blood cells including erythrocytes develop from stem cells

called hymocytoblasts in red bone marrow.
¡ Hymocytoblasts divide to form myeloid stem cells and lymphoid
stem cells. to B

¡ Erythrocytes lose their nuclei and other organelles as they mature.

( Lack )
28

29
 RBC LIFE SPAN
AND
DESTRUCTION

30

RBC LIFE SPAN AND DESTRUCTION

¡ The life span of RBCs is about 120 days and billions of

RBCs are destroyed and produced each day.
¡ The plasma membrane of the newly formed cells are
flexible which allows them to change shape as they pass
through the blood capillaries.
¡ Is that the same case scenario with older RBCs? 31
 RBC LIFE SPAN AND DESTRUCTION

¡ Worn out RBCs are removed from the circulation in the

liver and spleen by phagocytic cells called macrophages.
¡ Macrophages engulf and digest old and damaged
erythrocytes in phagocytic vesicles.
¡ What happens to the iron portion of the RBC?
32

RBC LIFE SPAN AND DESTRUCTION

¡ The heme portion of the Hb is broken down into an iron

containing compound and a yellow pigment called
Amybilirubin. B

to ¡ The iron containing compound may be temporarily stored

in the liver and spleen before being recycled to the red
bone marrow and used to form more Hb.
¡ What is bilirubin fate?
33
 RBC LIFE SPAN AND DESTRUCTION

B
¡ Bilirubin or the bile pigment is secreted by the
liver in bile, which is carried by the bile duct into
the small intestine for disposal.

34

IBRA

CHECK YOUR UNDERSTANDING

Hemoglobin is the protein that carries oxygen and exists within each red blood cell. If
your red blood cell was a vehicle, hemoglobin is in the driver's seat, picking up oxygen
at the lungs and transporting it to the tissues throughout your body.
1.How does Hb contribute to the function of
erythrocytes?
2.How is erythrocyte production regulated?
The rate of production of erythrocytes is controlled by the hormone
erythropoietin, which is produced largely in the kidneys.
35
WHITE BLOOD CELLS (WBC)

¡ Leukocytes or white blood cells are derived from

hemocytoblasts.
¡ WBCs retain their nuclei.
¡ The production of a particular type of WBC increases when the
cells encounter disease.
¡ These disease stimuluses cause the involved leukocytes to
secrete a hormone that is carried to red bone marrow, where it
stimulates the production of that certain needed leukocytes. 36

WBC FUNCTION

¡ Leukocytes provide defense against disease organisms.

¡ Most of the functions of the WBCs are performed in tissues
-
rather than in blood vessels.
¡ WBCs have the ability to move through capillary walls into
tissues in response to chemicals released by damage tissues.

37
 WBC MECHANISM OF ACTION

¡ Some WBCs destroy pathogens and cellular debris by

: phagocytosis.
¡ others release chemicals that clump pathogens to help
in phagocytosis.
C ¡ WBCs can also release chemicals that kill pathogens.
38

39
 PLATELETS

¡ Thrombocytes or platelets are cytoplasmic fragments of

megakaryocytes, large cells that develop from hemocytoblasts in red
bone marrow.
¡ There are 150,00 to 400,0000 thrombocytes per mm3 of blood.
¡ Thrombocytes clump together to plug breaks in blood vessels and
start the clotting process. 40

PLASMA

¡ Plasma is the colored portion of the blood that consist of

90% of water and 10% of different solutes.

I ¡ Examples of plasma solutes are nutrients, enzymes,

hormones, antibodies, wastes, electrolytes, and respiratory
gases.
¡ Plasma solutes stay at a maintained balanced to keep 41

homeostasis.
n
 Plasma Proteins

Blood

clot
Albumin Globulin Fibrinogen Sol
to
60 % 36 % 4% 9ns .

d &,
PH Rosspress .
→ in
Lymphoid tiss .

Alpha Beta Gamma in imm .

42

Forms 60% of plasma proteins.

PLASMA PROTEINS- Buffers that act on keeping the

ALBUMIN blood PH within narrow limits.

Play a role in maintaining

osmotic pressure. HOW???

43
 PLASMA PROTEINS-
ALBUMIN

¡ Osmotic pressure is the

water balance between
the blood and the body
cells.

44

f Bp
/ OSSP ↳sqB
.
v

BEE
Edema When osmotic pressure
water → Tiss .

declines, water moves into the

body tissues and causes edema.
PLASMA PROTEINS-
ALBUMIN
This also decrease blood
volume and in severe cases may
decrease blood pressure as well.

45
-B%sp -0-9-7=13V & Bp
Fss
When osmotic pressure increases,
1µg Water in .

body
cells .

water moves into the blood causing

an increase in blood volume and in
blood pressure.
PLASMA PROTEINS-
ALBUMIN
It will also reduce the amount of
water available in body cells.

46

Form about 36% of plasma proteins.

Three types: alpha, beta, and gamma globulins.

PLASMA PROTEINS-
GLOBULIN
Alpha and beta carry fats and lipid soluble vitamins
in blood.

Gamma globulins are produced in lymphoid tissues

and consist of antibodies that are involved in
47
immunity.
 Form 4% of plasma proteins.

PLASMA PROTEINS- Play a vital role in blood clotting

FIBRINOGEN
process.

It is a soluble protein that is converted

to insoluble fibrin to form blood clots.
48

NON-PROTEIN NITROGEN SUBSTANCES NPN

¡ These substances include amino acids, urea, and uric acid.

¡ Amino acids are nutrients that are formed by digestion
of proteins in the intestines and are absorbed into the
blood.
¡ Urea and uric acid are waste products of protein
breakdown that are carried by the blood to the kidney
for excretion in the urine. 49
ELECTROLYTES

¡ Most of the plasma electrolytes are ions that are

absorbed from the intestine of released from body cells.
¡ Examples are Na+, K+, Ca++, Cl-, HCO3-, Po4---.
¡ They maintain the PH and the osmotic pressure of the
plasma.
50

CRITICAL THINKING
HOW DOES THE BODY REACT IN CASE OF A RUPTURED BLOOD
VESSEL (HEMORRHAGE)?
51
HEMOSTASIS

¡ Whenever blood vessels are ruptured, several

homeostatic processes are implemented to prevent
excessive blood loss.
¡ The stoppage of bleeding is called hemostasis.
¡ Hemostasis involve three interrelated processes.

52

HEMOSTASIS STEPS

id
:@

Vascular Platelet Plug

Spasm Formation Coagulation

53

a
 54

HEMOSTASIS-VASCULAR SPASM

¡ Constriction or spasm is the first response to blood

vessel rupture.
¡ This spasm prevents more blood loss from the damaged
vessel and it lasts for several minutes.
¡ That time is enough for the formation of the platelet
plug and clotting.
55
 HEMOSTASIS-PLATELET PLUG FORMATION

¡ Platelets normally DO NOT stick to each other or to the

blood vessel wall because they get repelled by the positively
charged vessel wall.
¡ In case of blood vessel rupture, the underlaying connective
tissue is exposed so the platelets adhere to the negatively
charged connective tissue.
¡ The result of this will be a cluster of platelets accumulated
to plug the break. 56

HEMOSTASIS-PLATELET PLUG FORMATION

¡ As platelets accumulate at the site of the damage, they

secrete serotonin.
¡ Serotonin helps in keeping the smooth muscle contraction
in the damaged vessel.
57
HEMOSTASIS-COAGULATION

¡ Coagulation or clot formation is the third and most effective

process in hemostasis.
¡ Blood contains both procoagulants and anticoagulants. What is
the difference?
¡ Normally, anticoagulants predominate so that blood does not
clot.
¡ In case of vessel rupture, procoagulants increase their activity
58

so that clotting process starts.

HEMOSTASIS-COAGULATION

¡ Clotting process is a complex process but it is

completed within 4-6 minutes after blood vessel has
been damaged.
¡ The clot is restricted to the site of damage because that
is the site where procoagulants outnumber the
anticoagulants.
59
HEMOSTASIS-COAGULATION

¡ the aggregated platelets release platelet factors.

¡ Platelet factors react with clotting factors in the
plasma to produce prothrombin activator.

60

61
Subsequently,
fibroblasts migrate
into the clot and
form fibrous
connective tissue that
repairs the damaged
area.
62

POST-HEALING
→ breakdown fibrin
plasmin
#-) Idiss - blood clot .

→
¡ As healing occurs, tissue plasminogen activator t-PA
converts plasminogen an inactive enzyme in blood
plasma, into plasmin, the active form.
¡ Plasmin breaks down fibrin and dissolves the blood
clot. 63
HUMAN BLOOD TYPES

¡ ABO blood group

¡ Blood types are determined by specific antigens,
special proteins located on the plasma membranes
of erythrocytes.
64

65
 66

CRITICAL THINKING

What happens if a person

receives different blood
group than their own
blood group?

67
 ¡ Whenever RBCs with one type of antigen are
introduced into the blood of a person whose RBCs
possess a different antigen, the introduced antigens are
recognized as foreign bodies.
¡ They will be attacked by antibodies present in
the recipient's plasma. 68

¡ Antibodies are substances in the plasma that react with

foreign proteins in various ways to protect the body from
foreign substances and pathogens.
¡ In this case the antibodies bind to the foreign antigens,
causing the foreign RBCs to clump together.
¡ The clumping of foreign RBCs is called agglutination. 69
RH BLOOD TYPE

¡ Blood typing also routinely tests

for the presence of Rh antigen.
¡ If the Rh antigen is present on the
red blood cells, the blood is typed
as Rh+
¡ If the Rh antigen is absent, the
blood is Rh-

70

RH BLOOD TYPE

¡ The Rh blood type is determined by adding serum

containing anti-Rh antibodies to a drop of blood
on a glass slide.
¡ If agglutination occurs, the blood is Rh+
¡ If agglutination doesn’t occur, the blood is Rh-
71
RH BLOOD TYPE

¡ Anti-Rh antibodies are not normally present in the plasma of

Rh-people.
¡ They are formed only when Rh+ RBCs are introduced into an
_

Rh- blood.
¡ The first time there is no clumping reaction but the anti-Rh
antibodies will be produced.
¡ This will sensitize the person to future introduction of Rh- 72

antigens.

CASE SCENARIO

¡ If a person with Rh- has been introduced to Rh+ in the

past and receives another Rh+ transfusion, the anti-Rh
antibodies that have been produced from the first
exposure will this tie initiate agglutination of the recent
transfused Rh+ RBCs.
¡ This reaction usually has serious fetal outcomes.
73
 74

•
 75

CRITICAL THINKING

How do you link jaundice

to erythroblastosis fetalis?
The severity of erythroblastosis fetalis varies
depending on the degree of hemolysis.
Symptoms include jaundice, resulting from a
buildup of bilirubin.
76