RED BLOOD CELLS

Red blood cells

White blood
cells
Platelets
RED BLOOD CELLS
◼ Non-nucleated, circular, biconcave disks
containing hemoglobin
◼ Diameter -7.2-7.5 μm; thickness -1-2 μm
◼ Average life span -120 days
important part!!!!!
biconcave disk allow the RBC to move
squeeze through the capillaries.
others can become sickle cells, stuck in the
capillaries
Red blood cells as seen in a stained blood smear
Red blood cell as seen in side view; looks
biconcave

1
2

7.5 
Surface view of a red blood cell; looks circular;
flattened at the central (central pallor)
the view under microscope

7.5 
Advantages of biconcave shape
◼ Last longer in circulation; Spherical cells have
shorter lifespan. (do not lyse easily in
hypotonic medium)
◼ Increases surface area for gas exchange
◼ Facilitates movement through narrow
capillaries (aided by their deformability)
 Capillary endothelium RBC

Red cells assume a parachute-like shape while

squeezing through a capillary
pushing forward movement due to pressure
Variation in size & shape of red cells

◼ Poikilocytosis- Excessive variation in shape

of red cells
◼ Anisocytosis- Excessive variation in red cell
size
Rouleaux formation
◼ Tendency of red cells to align themselves
side-by-side to form stacks towards the end
◼ Reversible; occurs on cessation of blood flow
◼ Due to removal of negative charges on red
cells on stagnation
◼ Plasma proteins (Fibrinogen) responsible
◼ Rouleaux formation hastens erythrocyte
sedimentation→ increases ESR
Rouleaux formation
 Red blood cell (RBC) count
◼ The number of RBCs in 1 cu.mm(μL) of blood
◼ Adult male: 5.2 millions
◼ Adult female: 4.8 millions
◼ sNew born infants: 6-8 millions per cu.mm (count
rapidly decreases in the first 2 weeks after birth)
◼ Reaches a value that is lower than adult value at
the end of one year
◼ Count rises again towards the adult value
 RBC count at different ages

I.U life Weeks Months Years Decades

Adult values

5.2
Male

4.8
Female
the difference is because of the
hormonal interphase

0 2 4 1 10 20 40 60 80
Variations in count
◼ Decrease in count (oligocythemia) leads to
anemia→ decreased oxygen carrying capacity
of blood
◼ Increase in count is polycythemia; e.g. Hypoxia
(Malignant form called Polycythemia vera)
◼ Polycythemia increases blood viscosity →
increased resistance to flow → stagnant
hypoxia →Increased O2 extraction by tissues
due to sluggish flow → cyanosis
blueish discoloration on skin
Red cell membrane
◼ Lipid bilayer
◼ Integral proteins- Act as anion-exchangers
(Cl- HCO3-); antigens
◼ Membrane skeleton-for stability, shape &
flexibility provided by proteins, ANKYRIN &
SPECTRIN
◼ Abnormalities (mutations) in membrane
skeleton proteins cause hereditary
spherocytosis
 Red cell metabolism
◼ Red cells have no nuclei, no mitochondria, no
ribosomes, no ER
◼ Glucose is the primary metabolic fuel (Insulin
not needed for glucose transport)
◼ Glycolytic enzymes present; no Kreb’s cycle
◼ HMP shunt provides NADPH (needed for
membrane integrity)
Red cell fragility (Osmotic fragility)
◼ A measure of the ability of the red cells to
withstand the tendency to breakdown when
suspended in hypotonic solution
◼ 0.9% NaCl solution is isotonic with plasma
◼ At normal osmotic fragility, red cells begin to
hemolyze when suspended in 0.5% saline;
50% lysis occurs in 0.42-0.45% saline;
undergo complete lysis in 0.35% saline.
Osmotic fragility (iso,hypo,hyper)
◼ Fragility increases in hereditary
spherocytosis, since spherical red cells are
more prone for damage as they pass through
splenic sinusoids & have less life-span
◼ Spherocytosis causes hemolytic anemia
◼ Fragility is also increased by G6PD
deficiency (G6PD generates NADPH, which is
needed for membrane integrity)

google the function and why they do menitor diffusion

Conditions of

Decreased fragility Increased fragility

◼ Iron deficiency anemia ◼ Hereditary
◼ Sickle cell anemia spherocytosis
◼ After splenectomy ◼ Macroctic anemia
◼ G-6 PD deficiency
DO RESEARCH FOR ANEMIA ON:
-definition
-classification
-causes
-signs and symptom
Hemoglobin
◼ Red, oxygen-carrying pigment in the RBC
◼ 4 subunits; each with HEME conjugated to
GLOBIN (2 pairs)
◼ Heme contains IRON (in ferrous form); is a
porphyrin ring
◼ Adult HbA(α2β2) & fetal HbF(α2γ2)
◼ 250 molecules in each red cell
Advantages of carrying Hb within red
cells
Inclusion of hemoglobin within red cell
prevents
◼ Urinary excretion & rapid catabolism
◼ Minimizes osmotic effects
◼ Prevents marked increase in viscosity
Packed cell volume (Hematocrit)
◼ Represents the fractional volume of blood that
the red cells occupy.
◼ Is the % volume of packed blood cells
following adequate centrifugation of a sample
of blood
Before
centrifugation 10
After
centrifugation
Centrifuged
blood sample
in Wintrobe’s
Plasma (55%)
tube showing
Packed cells
5 &
Buffy coat
supernatant
Packed red cells (45%) Plasma

0
 Hematocrit (PCV)
◼ Normal values:
Adult male: 46%
Adult female: 42%
◼ Values change with
◼ Changes in red cell mass or with
◼ Changes in plasma volume (e.g.Hemo-concentration
due to dehydration, causes a relative increase in red
cell mass & increases PCV & hemodilution causes a
fall in PCV)
45% 30% 70%

10

A B C Hematocrit
under various
conditions
5 A. NORMAL
B. Anemia (or hemodilution)
C. Polycythemia
(or hemoconcentration)

0
Calculation of blood indices
MCV (Mean corpuscular volume)

Hct x 10
= -------------
RBC (in millions)

Normal value 87 fL(μm³)

Calculation of blood indices
MCH (Mean corpuscular hemoglobin)

Hb% x 10
= ---------------
RBC (in millions)

Normal value 29 pg
Calculation of blood indices
MCHC (Mean corpuscular hemoglobin
concentration)

Hb% x 100
= -----------------
Hct

Normal value 34% (g/dL)

Erythrocyte Sedimentation
◼ When blood treated with an anticoagulant is made to
stand in a long vertical tube, red cells settle down
gradually, leaving a clear supernatant plasma at the
top of the tube
◼ The rate at which red cells settle down in a tube of
standard dimensions (2.5 mm inner diameter; 200 mm
height) is called Erythrocyte Sedimentation Rate (ESR)
◼ Rouleaux formation causes/determines the rate of
settling & ESR
Erythrocyte Sedimentation Rate (ESR)
◼ Increase in plasma proteins (globulins & fibrinogen)
increases rouleaux formation & ESR
◼ ESR increased in most inflammatory conditions (e.g.
tuberculosis)
◼ Of prognostic importance; not much use in diagnosis
◼ Decreased ESR occurs when cells are non-uniform
in shape/size