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BLOOD

It is a specialized connective tissue Represents 8 % of the total body wt. Components: 1) Formed elements: cellular portion (45%) 2) Plasma: fluid portion (55%) 1) Formed elements: • Red blood cells (RBCs) (erythrocytes) • White blood cells (WBCs) (leucocytes) divided into: • 1) Granulocytes: (neutrophils, eosinophils & basophils) • 2)Agranulocytes;( monocytes & lymphocytes) • Platelets (thrombocytes) • Adults have 4-6 litres of blood • pH --------------- 7.35---- 7.45

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FUNCTIONS OF BLOOD

1) TRANSPORT. •Carries o2 and CO2 b/w lungs and other organs • carries nutrients from GIT & storage depots to other organs •Carries waste products to liver and kidney for detoxification or removal •Carries hormones from endocrine glands to target tissue •Carries heat to skin for removal, thus regulates body temp.

2) PROTECTION •Plays several role in inflammation. •WBCs destroy micro organism & cancer cells. •Antibody or other proteins destroy pathogens •Platelets initiates clotting and minimize blood loss 3) REGULATION Transfers water to and from the tissues , helps stabilize water balance, buffers acids and bases thus stabilize pH

nutrients. •Liver synthesize most of the plasma proteins which includes albumin (54%).PLASMA: (straw colored) •it is the fluid portion of the blood. enzymes. •It is a complex mixture of proteins. wastes products.5 % of solutes. most of which are proteins (plasma proteins).5% of water •& 8. bacteria) and destroys them . globulins (38%)& fibrinogen (7%) •Gamma globulins or immunoglobulin's (antibodies) are produced by cells in response to foreign invaders (virus . hormones and gases •Contains 91.

FUNCTIONS OF PLASMA PROTEINS •Exert colloid osmotic pressure . which helps maintain water balance b/w blood & tissues and regulates blood volume •Albumins: functions as transport protein for several steroid hormones & fatty acids •Globulins: role in killing bacteria & viruses •Fibrinogen: plays an essential role in blood clotting. .

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4 millions /mm3 •RBC contains hemoglobin which is used for the transportation of gases. •Normal value is 4.2 micrometers •They can change their shape as they squeeze through the capillaries.• RED BLOOD CELLS (ERYTHROCYTES) •They are biconcave disc shaped non. •Provides constant amount of O2 to the tissues • Life span .8 micrometers.8 --.5.120 days •Biconcave disc shape provide a larger surface area for diffusion of O2 across the membrane . •Act as a buffer.nucleated cells with no mitochondria •Have a diameter of 7.-----------. •Thickness -------.

B.membranous bones •Role of spleen.GENESIS OF R.bone marrow.C. •Early few weeks of embryo ----.bone marrow of all bones • by the age of 20 -------. Filter that removes aged or abnormal RBCs .nucleated RBCs (yolk sac) •In mid trimester -----.marrow cavities of long bones becomes inactive except upper end of humerus & Femur •Beyond 20 --------------. •Up to 5 yrs -------------.liver (mainly) partly by spleen & lymph nodes •In last trimester & after birth --------.

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F. size large.C.Erythroblast (no Hb.E Pro. takes basic dye nucleoli absent .P. Contain nucleoli) Basophil Erythroblast (Hb appear.H.U. size smaller) .B.U.F. nucleus pre.S C.S. C.

Polychromatic erythroblast (size small. here it loses its mitochondria & assume mature RBC . nucleus small. release in blood where it stays for 24 hrs . some mitochondria & ribosome stays in bone marrow for 2-3 days . stain with both acidic & basic dye) Orthochromatic erythroblast (nucleus shrinks & than lost) Reiculocyte (no nucleus. count is 1%) .

Erythrocyte .

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.Regulation of Erythropoesis: •Any condition that decreases the O2 transport to the tissue in turn increases the erythropoesis. •A) hemorrhage •B) high altitude •C) lung diseases •D) heart diseases. For e. .g.

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000 is released mainly by the kidney & partly by the liver in response to hypoxia & increases the RBC production . •Level is decreased in chronic renal disease.Role of erythropoietin: •A hormone with a MW of 34. Role Vitamin B12 & folic acid: •Both of these are used for the final maturation of RBC •They are essential for DNA synthesis & in their absence there is failure of nuclear maturation and division •The peripheral film shows macrocytes (large size RBC) •RBC lost their biconcave disc shaped and are more fragile .

2α .HEMOGLOBIN •It is a red .450. 2β chains •Hb A2 (2. 2γ.2α . •It is a globular protein with 4 sub units •Each units contains heme combines with a polypeptide chain. •HbA1c (Hb A derivative) represent glycated Hb has a glucose attatch to Beta chain .5%) --------. •Hb F -------. •Heme is an iron containing compound •Polypeptide referred to globin portion of the HB •There are two pairs of polypeptide chain in Hb •Adult Hb (Hb A) --------. 2δ.2α . oxygen carrying pigment in the RBCs •It has a MW of 64.

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2β chains Pyrrole protoporphyrin IX heme Hb chain hemoglobin A .STEPS IN SYNTHESIS OF Hb •2 succinyl CoA + 2 glycine •4 pyrrole •protoporphyrin IX + Fe •Heme + polypeptide chain •2α .

ANEMIA •Reduced amount of Hb below normal with respect to age & sex is known as anemia CLASSIFICATION 1) Morphological classification 2) Pathophysiological classification .

•B) Microcytic Hypochromic anemia: •It produced small . e. are iron def. abnormal RBCs with reduced Hb conc.g.g. megaloblastic anemia or Pernicious anemia. •4) aplastic anemia . anemia & thalassemia •3) Normocytic Normochromic anemia: •In this RBCs are of normal size with norma Hb content but they are insfficient in number. •E.1) MORPHOLOGICAL CLASSIFICATION: •It is based in size shape & color of RBC •A) Macrocytic Normochromic anemia: •Contains large shaped cells with normal Hb concentration.

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thallassemia. .g heriditary spherocytosis A protein spectrin is deficient. sickle cell anemia.2) Pathophysiological classification: A) Blood Loss: acute: trauma ii) Chronic: ulcer i) normocytic normochromic microcytic hypochromic B) Hemolytic anemia: i) RBC membrane defect: e.g. ii) Enzyme defect: G6PD deficiency (punched out holes) ii) Hemoglobin defect: e.

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3) autoimmune : i) Drug induced: ii) Erythroblastosis fetalis ..

Effect of anemia on the body •Viscosity o the blood is decreased. •If a person starts exercising the condition even becomes more severe. • • . •This results in decrease in peripheral resistance to the blood flow & causes increase in blood flow to the heart •Hypoxia results from decrease in hemoglobin causes an increase in blood flow to the heart •All this results in increase in cardiac out put.

Polycythemia • it is a condition in which the qty of RBCs are increased. • . •Chronic disease in which the bone marrow becomes hyper excitable results in increased formation of RBCs •Males are mostly affected •The pluripotent cells becomes hyper responsive to erythropoietin & results in increased formation of RBCs. •Blood viscosity is increased. •It is of two types •1) primary Polycythemia: •Also called Polycythemia rubra Vera.

•High altitude •Smoking •Congenital heart disease. •Lung diseases . epistaxis & itching.g. •Tendency of blood clotting is increased •Management : •Therapeutic venesection or taking out some blood (500 ml) from patient gives temporary relief. blackout.•Patient usually complains of headache. Secondary Polycythemia: •It is secondary to other causes for e. •Increased erythropoietin production secondary to hypoxia.

1% is present in combination with protein tranferrin in the plasma. •65% is in the form of Hb. •1% is in the form of various heme compounds. •4% is in the form of myoglobin. •0.Iron metabolism •Total qty of iron in the body is 4-5 gms. •15-30 % is stored mainly in liver in the form of ferritin .

•When the qty of iron in the body is decreased . •The transferrin molecule binds with cell membrane of the erythroblast .Transport & storage of iron •After its absorption in blood it loosley combines with a plasma protein known as apotransferrin to form transferrin. • In the cell cytoplasm iron combines with a protein apoferritin to form fereritn •This is the stored form of iron • small qty of iron is also stores in the insoluble form as hemosiderin. where it binds with transferrin & delivers to that part of the body where it is needed. iron is removed from ferritin (stored form) . This occurs when ferritin stores are saturated. . •excess iron deposits mainly in liver & less in reticuloendothelial cells of bone marrow . where it is endocytosed & delivers iron directly to the mitochondria for heme synthesis. released in plasma .

•This complex binds with the receptor present over the intestinal epithelial cell. •Liver secrete apotransferrin in the bile which comes in the intestine. • . •This combination is known as transferrin. •Thus by the process of pinocytosis transferrin carrying its iron is absorbed in the blood. •Here it combines with iron as well as with hemoglobin & myoglobin present in meat.T. •Iron is absorbed from all part of intestine.I.ABSORPTION OF IRON FROM G.

6 mg + 1. 0.6 mg.3 mg/day .•In man •In women Daily iron loss 0.

. the red cell ruptures as it passes through the small capillaries or it passes through the spleen. •1) metabolism of glucose for ATP synthesis.R. •Once the RBC membrane becomes fragile. •2) stabilizes the cell membrane •3)keeps the iron in Fe++ (ferrous) form rather than the Fe+++ (ferric) form. it contains cytoplasmic enzymes that performs the following functions. E. •4) prevents the oxidation of proteins in the red cells. or mitochondria.B.Cs •As the mature RBCs do not contain any nucleus.FATE OF R.

it releases hemoglobin which is phagocytized by the macrophage of spleen . which transports it to the liver for erythropoesis or stored in the cell in the form of ferritin Fate of porphyrin •Protorphyrin biliverdin bilirubin .•When the red cells becomes destroyed . liver & bone marrow. • the macrophage releases iron from Hb which is taken up by the transferrin .

. liver conjugated bilirubin excreted in bile .

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