BLOOD

ADEQUATE BLOOD VOLUME

Blood volume, blood pressure, blood flow
If blood volume decreases the blood pressure and flow also decreases and vice versa
Low blood volume = hypovolemia
Hypo = decrease
Hypovolemia – because of bleeding/dehydration/severe vomiting/severe burns/ and some
medication used to treat hypertension
Asymptomatic – 10-20% blood loss
Hypovolemic shock – blood circulating is not enough for the body/ loss around 750ml to
1500ml of blood
High increase of blood volume = hypervolemia
Hypervolemia = retention of water and sodium (hindi lumalabas). Can be seen in ppl with renal
disease and heart disease(?)
*Sodium attracts water
APPROPRIATE PRESSURE GRADIENT
Fluids flow from area of high pressure to low pressure
BP = force needed to move blood from the arterial system to the venous system then back to
the heart
Pressure gradient – start of arterial system between the aorta and
In order for blood to flow through a vessel or heart valve, there must be a force = difference in
blood pressure
Flow rate – resistance to that flow
FLOW IN ONE DIRECTION
Heart has 2 types of valves
Atrioventricular valve/cuspid – between the atria and ventricles
Base of the large vessels leaving the ventricles – semilunar valves
Semilunar valves – aortic and pulmonic valves
SERIES OF UNOBSTRUCTED TUBES
BLOOD
Blood is a liquid connective tissue consists of cells surrounded by a liquid (extracellular matrix =
blood plasma)
Characteristics of blood
COLOR
- dark red = venous blood (given its oxygen in tissues), unoxygenated/deoxygenated
- bright red = arterial blood, oxygenated/ saturated with oxygen
TEMPERATURE
- 38 degrees Celsius / 100-degree Fahrenheit
pH
- Power of hydrogen
- Measure of how acidic
- pH of blood is slightly alkaline or basic
- below .35 = acidic
- 7.35-7.45 pH to ensure proper functioning of metabolic processes and delivery of
oxygen to tissues
VISCOSITY
- 3 to 4 times more viscous than water
- Viscous = thicker
VOLUME
- 5 to 6 liters in average-sized adult male
- 4 to 5 liters in average-sized adult female

FUNCTIONS OF THE BLOOD

TRANSPORTATION
- Transport oxygen from the lungs to the cells of the body and CO2 from the cells to lungs
for exhalation
» Oxygen passes across the thin linings of the air sacs and into the blood vessels –
diffusion (lungs to cells)
» Oxygen passes through the blood stream then CO2 leaves it
- Carries nutrients from the GIT to the body cells and hormones from endocrine glands to
other body cells
 » Walls of small intestine absorbs the digested nutrients to the bloodstream
» Insulin is used for glucose to enter in the cell
- Transports heart and waste products to various organs for elimination from the body
» Blood helps adjust body temp through the heat absorbing and coolant properties
in blood plasma
» Blood brings waste products to the kidneys and liver that remove and process
them for elimination
REGULATION
- Circulating blood helps maintain homeostasis of all body fluids
» Stabilizing pH, body temp, and osmotic pressure
» Regulate fluid electrolyte balance
- Helps regulate pH through the use of buffers (chemicals that convert strong acids or
bases into weak ones)
- Helps adjust body temperature through the heat-absorbing and coolant properties of
the water in blood plasma
» Blood vessels expand or contract when responding to changes
- Blood osmotic pressure influences the water content of cells, mainly through
interactions of dissolves ions and proteins
» Osmotic pressure – pressure applied to prevent the flow of water to semi-
permeable membrane
» Hypertonic – cell size shrinks
» Hypotonic – cell size swell
» Blood maintains an isotonic environment

PROTECTION
- Blood can clot (gel-like), which protects against its excessive loss from the cardiovascular
system after an injury
- WBC protect against disease by carrying on phagocytosis
» Phagocytosis – process of a certain living cells tries to engulf other cells or
particles (cell eating)
» Protection against pathogens
- Several types of blood proteins, including antibodies interferons, and complement, help
protect against disease in a variety of ways.

COMPONENTS OF THE BLOOD

- Plasma and formed elements (RBC, WBC, and Platelets)
 - Plasma = watery liquid
- Formed elements = cells and cell fragments
» Plasma = 55%
» WBC and platelets = <1%
» RBC = 45%

PLASMA
- Liquid matrix
- 91.5% water and 8.5% solutes (primarily proteins)
- Plasma proteins = maintain proper blood osmotic pressure
» Important in the exchange of fluid in capillary walls
- Hepatocytes synthesize most plasma proteins (7%)
» Hepatocytes = liver cells
» Albumins (54%), fibrinogen (7%), antibodies/globulins (38%)
- Other solutes: electrolytes, nutrients, enzymes, hormones, gases, and waste products
- Complex fluid of clear amber color which contains a great variety of substances
- Specific gravity = 1.026 (ratio of density of a substance compared to the density of
water)
- pH = 7.4
- Viscosity is 5 to 6 times greater than water
Components of Plasma:
- Water = 91.5 – 92%
- Gases – O2 and CO2
- Electrolytes – sodium, PO4, calcium
- Nutrients – glucose, amino acids, lipids, vitamins, minerals
- Hormones & enzymes
- Metabolic wastes – urea, uric acid, creatinine, ammonia and bilirubin
- Clotting factors
- Antibodies
- Plasma proteins
» Serum Albumin – most abundant and smallest plasma protein, serves as
transport proteins for steroid hormones and fatty acids
» Serum Globulin (38%) - helps attacks viruses and bacteria, produced by liver
plasma cells
» Fibrinogen (7%) – produced by the liver, essential role in blood clotting

Functions of plasma proteins

1. Exerts intravascular osmotic pressure
- Colloid nature of albumin keeps the fluid within the blood vessels
 2. Blood coagulation
- Blood plasma contains fibrinogen (large molecular weight soluble protein) and the
conversion to insoluble fibrin then cross linking will produce a tangles mesh of filaments
that comprises the blood clot.
3. Production of antibodies
- Can only produce a single class of antibodies
4. Promotes growth and repair of tissues
- Proteins = building blocks of the body
» Critical to the growth and repair of cells
» Use as an energy source
5. Viscosity of blood
- Addition of formed elements into plasma further the increases of viscosity
- Effect of a protein in viscosity depends on its molecular weight and structure the less
spheroid shape= higher molecular wight, higher pH sensitivity or temp = higher plasma
viscosity
6. Reservoir of amino acids
- Reservoir = fluid that collects
- Amino acids are carried by RBC and plasma
FORMED ELEMENTS
- RBC/erythrocytes
» 4.5 to 5.5 million/cu.mm
» Gas transport
» Life span: 120 days
» Biconcave disk
- WBC/leukocytes
» 5000 to 10,000 per cu.mm
» Control infection
» Life span: Few hours – 200 days
» Circular
- Platelets/thrombocytes
» 150,000 to 300,000 per cu.mm
» Blood clotting
» Life span: 6-18 days
» Oval

Formation of Blood Cells

Hemopoiesis or Hematopoiesis
 - Hemopoiesis before birth first occurs in the yolk sac of embryo then later in the liver,
spleen, thymus, and lymph nodes of a fetus
Liver = upper right of the abdominal cavity just beneath the diaphragm
Spleen = upper left
Thymus = upper anterior of the chest/ behind the sternum and between the lungs
Lymph nodes
- Abundance of WBC is based on response to invading pathogens or foreign antigens

Red bone marrow = primary site for the last 3 months before birth and continues after birth
and throughout life
» .05 to 0.1 of RBC stem cells derived from mesenchyme and called pluripotent stem cells
or hemocytoblasts. Have the capacity to develop in different type of cells. As an
individual grows and in adulthood, the rate of blood cells formation decreases; the red
bone marrow in the medullary cavity of long bones becomes inactive and is replaced by
yellow bone marrow.
» Pluripotent = biological generation. Describes a cell where it is capable of generating
tissue.
Negative feedback mechanisms
» Regulate the total numbers of RBC
- Stem cells in bone marrow
» Reproduce themselves
» Proliferate and differentiate
- Formed elements don’t divide once they leave the bone marrow

Pluripotent stem cells produce:

- Myeloid stem cells
» Development of RBC, Platelets, monocytes, eosinophils etc.
» Progenitor cells = can’t reproduce
» Progenitor cells – CFU-E, CFU-Meg, CFU-GM
» CFU-E- RBC
» CFU-Meg – megakaryocytes
» CFU-GM – granulocyte
- Lymphoid stem cells
» Completes its development in tissues
» Develop directly into pre-cursor cells
» Give rise to lymphocytes
Red Blood Cells/erythrocytes
- Circular disk
- Without nuclei
- Biconcave
- 5.4 million = male, 4.8= female
- To maintain normal numbers RBC new mature cells must enter the circulation at the
astonishing rate of at least 2 million per second, a pace that balances the equally high
rate of RBC destruction
- 7.5 micrometer (diameter)
- Has a strong and flexible plasma membrane
- Composition: Stroma and Hemoglobin
Stroma
- Connective tissue that provides the framework of an organ
- Fluid filled interior of chloroplast containing enzymes needed for photosynthesis
- Blood group A, B, & Rh are located
- Composed of CHON and lipid
Hemoglobin
- Once RBC – contains several million molecules of Hgb (280 million)
- Body produces 6.25 gm Hgb per day
- Gives blood its red color
- Can bind with other molecules other than oxgen: CO2 and carbon monoxide
- If saturated with oxygen = oxyhemoglobin
- Carboxyhemoglobin = carbon monoxide and hemoglobin
- Normal Hgb concentration = 14-16%
- Hgb molecule consists of a protein called urglobin
- Heme and Globin
- Nitric Oxide binds to hemoglobin (causes vasodilation to improve blood flow and oxygen
delivery)
Heme
- Oxygen has affinity for Hgb
- 4 molecules of oxygen and 1 molecule of hemoglobin
- Ring-like non protein pigment
- Has an iron ion in the center
» Combine reversibly one oxygen molecules (4 oxygen)

Affinity – strength of binding/attraction

Globin
- Composed of 4 polypeptide chains
» 2 alpha chain and 2 beta chains
» Each has a heme

Page 590 (masadot akon)

27% of CO2 is transported back to the lungs by RBC

PRODUCTION SITE
Embryo – first blood cells arise from mesenchymal cells of the yolk sac
2nd month – liver, spleen, thymus, and lymph nodes
7-9 months – red bone marrow
After birth – red bone marrow only
Infancy and childhood – all bones produce RBC but when growth process of bones is completed
RMB of the cancellous and flat bones, vertebrae, and proximal ends of long bones.
REGULATION OF ERYTHROPOEISIS
Proteins, folic acid, copper, cobalt, iron, cyanocobalamin
Erythropoiesis – production of RBC’s
Factors that stimulate erythropoiesis:
1. Increase destruction
2. Result in RBC which result in hypoxemia
3. Injury of RBC-forming tissues
4. Altitude
5. Increase body temp = increase the number of RBC
6. After puberty men have higher hematocrit than women
7. Time of day (RBC count is highest in early evening)
Hypoxia – too little oxygen in the tissue
Hypoxemia – low oxygen levels in blood
NEGATIVE FEEDBACK SYSTEM
 Hypoxia
Release of kidney enzyme erythrogenin (REF) renal erythropoietic factor
Activates erythropoietin (hormone)
Stimulation RBM to produce hemocytoblasts
Matures into erythrocytes
Released into the blood stream
If there is abrupt demand for RBC production, reticulocytes may be released
Plasma membrane becomes more fragile as we age
Life cycle and destruction of RBC: PAGE 11-12 IN INSTRUCTIONAL MATERIAL
WHITE BLOOD CELLS
- Have nuclei and organelles
- No hemoglobin
- Classifies as: granular or agranular
- Translucent
Classification of WBC’s
- Neutrophil (granu)
» 60-70%
- Eosinophil (granu)
» 2-4%
- Basophil (granu)
» 0.5-1%
- Monocyte (agranu)
»
- Lymphocyte (agranu)

Neutrophil
- Most abundant
- Form the puss we see in the site of infections
Eosinophil
- Parasitic worms
- High counts – parasitic infection or allergic reaction
- Release enzymes (histaminase) to combat effect inflammation during allergic reactions
Basophil
- Less common
- Release heparin (prevent abnormal blood clotting)
- Also release histamine

Monocyte
- Largest WBC
- Becomes macrophage once it leaves the blood
- Phagocytize: bacteria, waste products, engulfs phagocytize foreign substances
Lymphocytes
- Smallest WBC
- Major soldiers
- Responsible for rejecting transplanted organs
- Types: B cells, T cells, NK (natural-killers) cells
- B cells – antibodies, inactivating toxins
- T cells – attacks fungi, cancer cells, virus, bacteria
- NK – attack a wide variety of microbes

SITE OF PRODUCTION
Granulocyte – red bone marrow
Lymphocytes – RBM and lymphoid tissue
Monocytes – RBM

PAGE 588
Production
1. Stimuli – infection, hemorrhage, tissue destruction
2. Elements – protein, vitamins
3. Drugs that depress leukopoiesis – sulfonamides, gold,
Characteristics
1. Diapedesis – leaving the bloodstream (emigration). They roll along the endothelium,
stick to it and squeeze between the endothelial cells
 Adhesion molecules – selectins (stick to carbohydrates on the surface of neutrophils) and
integrins
2. Mobility – ability to move because of the adhesion molecule (integrins)
3. Chemotaxis - Several different chemicals released by microbes and inflamed tissues
attract phagocytes

Functions:
1. Phagocytosis
2. Production of immune globulins
3. Ingestion of cellular debris at the site of inflammation
4. A role as macrophage to become part of the reticuloendothelial system

PLATELETS
- Fragments or megakaryocytes
- 2-4 um in diameter
- Controls the cessation of bleeding
Functions:
1. Initiate blood clotting process – disintegrate and release of thromboplastin
2. Reduce blood loss – release of serotonin and epinephrine resulting in vessel
vasoconstriction
Hemostasis – sequence of response that stops bleeding
Reducing blood minutes
1. Vascular spasm – arteries are damaged, the circulatory arranged smooth muscle in their
wall constricts immediately
The spasm is probably caused by the damaged to the smooth muscles
Reduces blood loss for several minutes or hours
2. Platelet plug formation
- Clotting factors in platelet (ADP, ATP, Ca2 and serotonin)
- Enzymes produces thromboxane a2
- Fibrin-stabilizing factor – helps strengthen blood clot
- Lysosome
- Mitochondria
- Glycogen
 - PDGF - hormone that can cause proliferation of vascular endothelial cells, vascular smooth
muscle fibers, and fibroblasts to help repair damaged blood vessel walls.

PAGE 18-19 LM
BLOOD TYPES
Agglutinogens – surface of RBCs contains genetically determined assortment of antigens
(glycolipids, glycoproteins)
Blood groups – base on presence or absence of various antigens
- At least 24 blood groups and more than 100 antigens
ANTIGENS AND ANTIBODIES OF ABO BLOOD TYPE
- Based on 2 glycolipid antigens (A and B)
A antigen – type A
B antigen – type B
A and B antigen – type AB
No antigen – type O
Anti A antibody – reacts with antigen A
Anti B antibody – reacts with antigen B
Neither antibody – antigen AB
Both anti A and B – reacts with antigen O
BLOOD TYPING
- Need single drop of blood mixed with different antisera
- Agglutination with an antisera indicates the presence of that antigen on the RBCR
RhoGAM = a drug taken by a pregnant mother. Will keep the mothers body from forming
antibodies that may attack the baby’s blood when both bloods are mixed.