CHAPTER 10: BLOOD PHYSICAL CHARACTERISTICS AND VOLUME

BLOOD BLOOD CHARACTERISTICS

− Transports everything that must be carried from one ▪ Sticky, opaque fluid
place to another through blood vessels, such as: ▪ Heavier and thicker than water
▪ Nutrients ▪ Color range
▪ Wastes − Oxygen-rich blood is scarlet red
▪ Hormones − Oxygen-poor blood is dull red or purple
▪ Body heat ▪ Metallic, salty taste
− Blood is the only fluid tissue, a type of connective ▪ Blood pH is slightly alkaline, between 7.35 and 7.45
tissue consisting cells (WBCs & RBCs) and ▪ Blood temperature is slightly higher than body
fragments (platelets), in the human body temperature, at 38°C or 100.4°F
− Contribute 8% of total body weight
BLOOD VOLUME
− 5x thicker than water
− About 5-6 liters, or about 6 quarts, of blood are found
COMPONENTS OF BLOOD in a healthy adult
− Blood makes up 8 percent of body weight
COMPONENTS OF BLOOD
− Formed elements (living cells) – 45% Blood volume 4-6 Liters
▪ RBC (95%) Average 5 Liters
▪ WBC (4-5%) Female 5-6 Liters
▪ Platelets (≤ 1%) Male 4-5 Liters
− Plasma (nonliving fluid matrix) – 55% Red Blood Cell Count
▪ H2O (91%) Male 5.2 – 6.5 millions / 𝑚𝑚3
▪ Proteins (7%) Female 4.5 – 5.5 millions / 𝑚𝑚3
▪ Albumin (58%)
▪ Globulin (38%) Hematocrit (hct) Count
▪ Fibrinogen (4%) − Percentage of RBC in the blood
− Other substance (2%) Male 42 – 52 %
▪ Waste Female 37 – 47 %
▪ Ions Hemoglobin (hgb) Count
▪ Nutrients Male 13 – 18 g/dl (16)
▪ Gases Female 12 – 16 g/dl (14)

FUNCTIONS OF BLOOD White Blood Cell Count 5,000 – 10,000 / 𝑚𝑚3

▪ Balances Acid and Base Platelets 150,000 – 450,000 / 𝑚𝑚3
Bleeding Time 1 – 6 minutes
▪ Levels temperature
Clotting Time 6 – 10 minutes
▪ Oxygen transport
▪ Osmosis
▪ Delivers nutrients PLASMA
▪ Protection
▪ Hormonal transportation PLASMA
▪ 90 percent water
POWER HYDROGEN (PH) ▪ Straw-colored fluid
▪ Helps distribute body heat
− Normal is 7.35 – 7.45
▪ Includes many dissolved substances
−  PH = acidosis (too acid)
− Nutrients
−  PH = alkalosis (too basic)
− Salts (electrolytes)
WHEN BLOOD IS SEPARATED: − Respiratory gases
− Plasma rises to the top (55 percent of blood) − Hormones
− Erythrocytes, or red blood cells, sink to the bottom − Plasma proteins
percent of blood, a percentage known as the − Waste products
hematocrit)
− Buffy coat contains leukocytes, or white blood cells FIBRINOGEN
and platelets (less than 1 percent of blood) − Clotting factor for platelet formation to prevent
− Buffy coat is a thin, whitish layer between the bleeding or coagulation
erythrocytes and plasma
GLOBULIN – For immunity
ALBUMIN
− Most abundant plasma protein, responsible for
transportation of molecules and proteins
− Contributes to the osmosis to keep H2O in the blood
stream
PLASMA PROTEINS
− Most abundant solutes in plasma
− Most are made by the liver
− Include:
▪ Albumin - an important blood buffer and
contributes to osmotic pressure
▪ Clotting proteins - help to stem blood loss when
a blood vessel is injured
▪ Antibodies - help protect the body from
pathogens
BLOOD COMPOSITION
− Varies as cells exchange substances with the blood
− Liver makes more proteins when levels drop
− Respiratory and urinary systems restore blood pH to
normal when blood becomes too acidic (acidosis) or
alkaline (alkalosis)
FORMED ELEMENTS
FORMED ELEMENTS
▪ Erythrocytes
− Red blood cells (RBCs)
▪ Leukocytes
− White blood cells (WBCs)
▪ Platelets
− Cell fragments
ERYTHROCYTES (RED BLOOD CELLS, OR RBCS)
ERYTHROCYTES (RED BLOOD CELLS, OR RBCS)
− Main function is to carry oxygen
− RBCs differ from other blood cells
▪ Anucleate (no nucleus)
▪ Contain few organelles; lack mitochondria
▪ Make ATP by anaerobic means
▪ Essentially "bags" of hemoglobin (Hb)
▪ Shaped like biconcave discs
− Normal count is 5 million RBCs per cubic millimeter
(mm3) of blood
CHARACTERISTICS OF RBC
▪ Biconcave disc (height 7.2 µm) (width 2.5 µm)
▪ Anucleate = no nucleus & mitochondria, few
organelles
▪ Contains hemoglobin
▪ Pliable = RBC can bent / fold around its thin
center allowing it to pass move easily
HEMOGLOBIN – ERYTHROCYTES
− Is an iron-bearing protein
− Binds oxygen
− Each hemoglobin molecule can bind 4 oxygen
molecules
− Each erythrocyte has 250 million hemoglobin
molecules
− Normal blood contains 12-18 g of hemoglobin per 100
milliliters (ml) of blood
HOMEOSTATIC IMBALANCE OF RBCs:
ANEMIA
− Is a decrease in the oxygen-carrying ability of the
blood due to:
▪ Lower-than-normal number of RBs
▪ Abnormal or deficient hemoglobin content in the
RBCs
− HYPOXIA =  oxygen in the tissue
− HYPOXEMIA =  oxygen in the blood
SICKLE CELL ANEMIA (SCA)
− Results from abnormally shaped hemoglobin (crescent)
− When Hgb is exposed to low concentration of O2
− Extreme pain and difficulty grasping air
POLYCYTHEMIA
− Disorder resulting from excessive or abnormal
increase of RBCs due to:
▪ Bone marrow cancer (polycythemia vera)
▪ Life at higher altitudes (secondary polycythemia)
− Increase in RBCs slows blood flow and increases
blood viscosity
LEUKOCYTES (WHITE BLOOD CELLS, OR WBCS)
LEUKOCYTES (WHITE BLOOD CELLS, OR WBCS)
− Crucial in body's defense against disease
− Respond to inflammation & infection
− Complete cells, with nucleus and organelles
− Able to move into and out of blood vessels
(diapedesis)
− Respond to chemicals released by damaged tissues
(known as positive chemotaxis)
− Move by amoeboid motion by forming cytoplasmic
extensions to help them move
− 4,800 to 10,800 WBCs per mm3 of blood
HOMEOSTATIC IMBALANCE OF WBCs:
LEUKOCYTOSIS
− Normal response to an infection but excessive
production of abnormal WBCs during infectious
mononucleosis or leukemia is pathological
LEUKOPENIA
− Abnormally low WBC count
− Commonly caused by certain drugs, such as
corticosteroids and anticancer agents
LEUKEMIA AGRANULOCYTES
− Bone marrow becomes cancerous
− Numerous & mutation immature WBC are produced LYMPHOCYTES
− Bone pain, thrombocytopenia ( platelets, bleeding − Large, dark purple nucleus, slightly larger than RBCs
disorder, fever infections − Reside in lymphatic tissues
− Play a role in immune response
LEUKOCYTOSIS = abnormal  of WBC >10000 − 1,500-3,000 lymphocytes per mm3 of blood
− (20-45 percent WBCs)
LEUKOPENIA = abnormal  of WBC <5000 /MM3 MONOCYTES
− Largest of the white blood cells
TYPES OF LEUKOCYTES (WBC) − Distinctive U- or kidney-shaped dark purple nucleus
− Function as macrophages when they migrate into the
GRANULOCYTES
tissues
− Granules in their cytoplasm can be stained
− Important in fighting chronic infection
− Possess lobed nuclei
− 100-700 monocytes per mm3 of blood (4-8 percent of
− Include neutrophils, eosinophils, and basophils
WBCs)
AGRANULOCYTES
AMEOBOID MOTION
− Lack visible cytoplasmic granules
− Migration of neutrophils to the tissue space
− Nuclei are spherical, oval, or kidney-shaped
− Include lymphoctes and monocytes DIAPEDESIS
LIST OF WBCS, FROM MOST TO LEAST ABUNDANT − WBC in & out of blood vessels
− Squeezing of neutrophils to the B.V wall
▪ Neutrophils
▪ Lymphocytes PLATELETS
▪ Monocytes
PLATELETS a.k.a “THROMBOCYTES”
▪ Eosinophils
− Fragments of megakaryocytes (multinucleate cells)
▪ Basophils
− Needed for the clotting process
GRANULOCYTES − Normal platelet count is 300,000 per mm3 of blood
− Lifespan is 18-10 days
NEUTROPHILS − Function: clot formation to prevent bleeding
− Most numerous WBC and Multilobed nucleus
− Cytoplasm stains pink and contains fine granules CHARACTERISTICS OF PLATELETS
− Function as phagocytes at active sites of infection 1. Sticky – presence of glycoproteins
− Numbers increase during infection 2. Fatty – lipids
− 3,000-7,000 neutrophils per mm3 of blood (40-70 3. Contractile – actin & myosin
percent of WBCs)
PLATELET FORMATION – Stimulus: vessel wall injury
EOSINOPHILS 1. Vascular spasm – vasoconstriction –  blood flow
− Nucleus stains blue-red 2. Platelet Plug Formation
− Brick-red cytoplasmic granules − Collagen of damaged tissue
− Function is to kill parasitic worms; play a role in allergy − Chemicals → formation of “plug”
attacks. Responsible for Parasitic infection 3. Blood Coagulation
− 100-400 eosinophils per mm3 of blood (1-4 percent of − Prothrombin activating factor – convert
WBCs) prothrombin to thrombin

BASOPHILS HEMATOPOIESIS (BLOOD CELL FORMATION)

− Rarest of the WBCs, responsible for allergic reaction
HEMATOPOIESIS
− Large histamine-containing granules that stain dark
− Is the process of blood cell formation
blue to purple
− Occurs in red bone marrow (myeloid tissue)
− Contain heparin (anticoagulant)
− All blood cells are derived from a common stem cell
− 20-50 basophils per mm3 of blood (0-1 percent of
(hemocytoblast)
WBCs)
− Hemocytoblasts form two types of descendants
▪ Lymphoid stem cell, which produces lymphocytes
▪ Myeloid stem cell, which can produce all other
formed elements
 FORMATION OF RED BLOOD CELLS FORMATION OF WHITE BLOOD CELLS & PLATELETS

RED BLOOD CELLS (RBCs)
− Since RBCs are anucleate, they are unable to divide,
grow, or synthesize proteins
− RBCs wear out in 100 to 120 days
− When worn out, RBCs are eliminated by phagocytes
in the spleen (main graveyard) or liver
− Lost cells are replaced by division of hemocytoblasts
in the red bone marrow
− Reticulocytes are young RBCs which enter the
blood to become oxygen-transporting erythrocytes
− Rate of RBC production is controlled by a hormone
called erythropoietin
− Kidneys produce most erythropoietin as a response
to reduced oxygen levels in the blood
− Homeostasis is maintained by negative feedback
from blood oxygen levels
ERYTHROPOIESIS (RBC FORMATION)
− Stimulus: Erythropoietin which is the principal
stimulus for the formation of RBC in the bone marrow
− Erythropoietin (90% from kidney) (10% from liver)
− WBC & platelet production is controlled by hormones
− Colony stimulating factors (CSs) and interleukins
prompt bone marrow to generate leukocytes
− Thrombopoietin stimulates production of platelets
from megakaryocytes
HEMOSTASIS
HEMOSTASIS
− Is the process of stopping the bleeding that results
from a break in a blood vessel
− Hemostasis involves three phases
1. Vascular spasms
2. Platelet plug formation
3. Coagulation (blood clotting)
STEP 1: VASCULAR SPASMS
▪ Immediate response to blood vessel injury
▪ Vasoconstriction causes blood vessel to spasm
▪ Spasms narrow the blood vessel, decreasing blood
loss

I. Proerythroblast STEP 2: PLATELET PLUG FORMATION

II. Basophil Erythroblast (1st gen RBC start to ▪ Collagen fibers are exposed by a break in a blood
acquire Hgb) vessel
III. Reticulocytes (ejection od nucleus “young RBC” ▪ Platelets become "sticky" and cling to fibers
IV. Erythrocytes ( “mature RBC” ) ▪ Anchored platelets release chemicals to attract more
platelets
Number of RBC produced per second = 2.5 millions/sec ▪ Platelets pile up to form a platelet plug
Number of RBC destroyed per second = 2.5 millions/sec
STEP 3: COAGULATION
▪ Inured tissues release tissue factor (TF)
FACTORS THAT AFFECT RBC FORMATION
▪ PF3 (a phospholipid) interacts with TF, blood protein
▪ Bone marrow disease
clotting factors, and calcium ions to trigger a clotting
▪ Attitude is high
cascade
▪ Tissue hypoxia
▪ Prothrombin activator converts prothrombin to
▪ Circulatory disease
thrombin (an enzyme)
▪ Hemorrhage
STEP 3: COAGULATION
VITAMIN FOR RBC FOPRMATION ▪ Thrombin joins fibrinogen proteins into hairlike
VITAMIN B12 “Cyanocobalamin” molecules of insoluble fibrin
− Best absorbed in Ileum ▪ Fibrin forms a meshwork (the basis for a clot)
− For DNA synthesis ▪ Within the hour, serum is squeezed from the clot as
− If absent = pernicious anemia it retracts to pull edges of the blood vessel together
− serum is plasma minus clotting proteins
FOLIC ACID (VITAMIN B9) “Pteroylglutamic acid” ▪ Blood usually clots within 3 to 6 minutes
− Best absorbed in Ileum
− If absent = folic acid anemia ▪ The clot remains as endothelium regenerates
▪ The clot is broken down after tissue repair
IRON “FE”
− Best absorbed in duodenum
− Hgb synthesis
− If absent = Iron deficiency anemia
\ DISORDERS OF HEMOSTASIS
UNDESIRABLE CLOTTING:
THROMBUS
− A clot that develops persists in an unbroken blood
vessel
− Can be deadly in areas such as the lungs
EMBOLUS
− A thrombus that breaks away and floats freely in the
bloodstream
− Can later clog vessels in critical areas such as the
brain
BLEEDING DISORDERS
THROMBOCYTOPENIA
− Insufficient number of circulating platelets
− Arises from any condition that suppresses the bone
marrow
− Even normal movements can cause bleeding from
small blood vessels that require platelets for clotting
− Evidenced by petechiae (small purplish blotches on
the skin)
HEMOPHILIA
− Hereditary bleeding disorder
− Normal clotting factors are missing
− Minor tissue damage can cause life-threatening
prolonged bleeding
BLOOD GROUPS AND TRANSFUSIONS
Large losses of blood have serious consequences
PALLOR AND WEAKNESS
− Loss of 15 to 30 percent of blood
SHOCK
− Loss of over 30 percent of blood, which can be fatal
BLOOD TRANSFUSIONS
− Are given for substantial blood loss, to treat severe
anemia, or for thrombocytopenia
HUMAN BLOOD GROUPS
ANTIGENS
− Blood contains genetically determined proteins
known as antigens
− Are substances that the body recognizes as foreign
and that the immune system may attack
▪ Most antigens are foreign proteins
▪ We tolerate our own "self' antigens
ANTIBODIES
− Are the "recognizers" that bind foreign antigens
Blood is "typed" by using antibodies that will cause blood
with certain proteins to clump (agglutination) and lyse
TRANSFUSION REACTIONS
− Lysed red blood cells release hemoglobin into the
blood stream
− Freed hemoglobin may block kidney tubules, causing
kidney failure and death
− Fever, chills, nausea, and vomiting can also result
There are over 30 common red blood cell antigens
ABO AND RH BLOOD GROUP ANTIGENS
− Causes the most vigorous transfusion reactions
ABO BLOOD GROUP
− Blood types are based on the presence or absence of
two antigens
1. Туре A
2. Туре В
− Presence of both antigens A and B is called type AB
− Presence of antigen A is called type A
− Presence of antigen B is called type B
− Lack of both antigens A and B is called type O
Type AB − Can receive A, B, AB, and O blood
− Is the "universal recipient"
Type B − Can receive B and O blood
Type A − Can receive A and O blood
Type O − Can receive O blood
− Is the "universal donor"
Rh BLOOD GROUP
− Named for one of the eight Rh antigens (agglutinogen
− D) identified in Rhesus monkeys
− Most Americans are Rh+ (Rh-positive), meaning they
carry the Rh antigen
− Anti-Rh antibodies are not automatically formed in the
blood of Rh-negative individuals (unlike the
antibodies of the ABO system)
If an Rh- (Rh -negative) person receives Rh+ blood:
− The immune system becomes sensitized and begins
producing antibodies; hemolysis does not occur,
because as it takes time to produce antibodies
− Second, and subsequent, transfusions involve
antibodies attacking donor's Rh+ RBCs, and
hemolysis occurs (rupture of RBCs)
Rh-related problem during pregnancy
− Danger occurs only when the mother is Rh- ,the father
is Rh+ and the child inherits the Rh+ factor
− RhoGAM® shot can prevent buildup of anti-Rh+
antibodies in mother's blood
The mismatch of an Rh mother carrying an Rh+ baby
can cause problems for the unborn child
− The first pregnancy usually proceeds without
problems;
− the immune system is sensitized after the first
pregnancy
− In a second pregnancy, the mother's immune system
produces antibodies to attack the Rh+ blood
(hemolytic disease of the newborn)

BLOOD TYPING

BLOOD TYPING
− Blood samples are mixed with anti-A and anti-B
serum
− Agglutination or the lack of agglutination leads to
identification of blood type
− Typing for ABO and Rh factors is done in the same
manner
− Cross matching --- testing for agglutination of donor
RBCs by the recipient's serum, and vice versa

DEVELOPMENTAL ASPECTS OF BLOOD

SITES OF BLOOD CELL FORMATION

− The fetal liver and spleen are early sites of blood cell
formation
− Bone marrow takes over hematopoiesis by the
seventh month

CONGENITAL BLOOD DEFECTS

− Include various types of hemolytic anemias and
hemophilia

CYANOSIS
− Incompatibility between maternal and fetal blood can
result in fetal cyanosis, resulting from destruction of
fetal blood cells

FETAL HEMOGLOBIN
− Differs from hemoglobin produced after birth

PHYSIOLOGIC JAUNDICE
− Occurs in infants when the liver cannot rid the body of
hemoglobin breakdown products fast enough

LEUKEMIAS
− Are most common in the very young and very old
− Older adults are also at risk for anemia and clotting
disorders