BLOOD

By:
Dr. Antoinette T.
Leuterio
 BLOOD
• Blood Composition
– Formed elements
• Erythrocytes
• Leukocytes
• Blood platelets
– Blood plasma
– “ haemopoiesis”
– Blood Functions
• 1) Transport oxygen
• 2) Carries hormones
– 5 liters - 7%
 BLOOD
 Hematocrit
 40 - 50 % male
 35 - 45 % female
• Methods used to study blood and bone marrow:
– Romanowsky-type as Giemsa, Wright of Leishman
– 4 distinctive staining characteristics:
• 1) basophilia- methylene blue
• 2) azurophilia
• 3) eosinophilia
• 4) neutrophilia
 BLOOD
• ERYTHROCYTE
– rubricytes or erytroplastids
– most prevalent cells
– 5.4 million men
– 4.8 million women
• Hemoglobin
• Agglutination
• Erythron
 Structure of erythrocytes:

• 7.5 um in diameter
– erythrocyte ghost(blood shadow or blood
ghosts)
– Crenation
– Rouleaux formation
– Reticulocyte count
– Hemoglobin A
 Ultrastructure of
Erythrocytes:

– Lipid bilayer
– Membrane skeleton
– Spectrin
– Actin
– 120 day
– Glucose
 Chemical composition of
hemoglobin:

• hematin & globin

• bilirubin- bile
• oxyhemoglobin; carbaminohemoglobin
– carboxyhemoglobin
– Human DNA
• Polypeptide chains ;alpha, beta, gamma,
and delta
– Functions of erythrocytes:
– Transport oxygen
Abnormalities of erythrocytes:
– Anemia
– Anisocytosis
– Poikilocytosis
– Macrocytic (>9um), normocytic,microcytic
– Hyperchromic, normochromic, hypochromic
– Thalassemia
– Polycythemia or erythrocytosis
Surface Antigens & Blood
groups

– Antigens
– ABO blood group system:
– TYPE A-B,AB,O
– Antibodies
– Cross-matching
– Hemolytic disease of newborn
 Clinical Considerations:

• Erythrocyte Disorders
• HEREDITARY SPHEROCYTOSIS
• IRON-DEFICIENCY ANEMIA
• PERNICIOUS ANEMIA
• SICKLE CELL DISEASE
• Bleeding Disorders
• THROMBOCYTOPENIA

• Coagulation Disorders
• FACTOR VIII DEFICIENCY(HEMOPHILIA A)
• VON WILLEBRANDS DISEASE
 BLOOD PLATELETS
(thromboplastids)

• Structure & distribution

– Thrombocytes _ anucleate corpuscles
– 150,000-350,000 per cubic millimeter
– Megakaryocytes
– two zones
• hyalomere
• granulomere
– alpha granules - platelet factor IV
– beta granules - serotonin
–Functions of PLATELETS
»blood clotting
PLATELET ABNORMALITIES

–hemophilia
–thrombocytopenia
–thrombocytopathia
 LEUKOCYTES

• Classified into two:

 granulocytes - neutrophils, eosinophils, basophils
 agranulocytes - lymphocytes, monocytes
 Ranges from 5000 to 9000 per cubic millimeter
• differential leukocyte count
 neutrophils-55-60%;eosinophils-1-3%;basophils-0-
0.7%
 lymphocytes-25-33%;monocytes-3-7%
 leukocytosis - above (12T)
 leukopenia- below (5T)
 NEUTROPHILS
(polymorphonuclear leukocytes or
segmenters)

 Distibution:
 -most abundant &most active of granular leukocytes
 -3000-6000 per milliliter
 Structure:
 -nucleus consists of two or more lobes
 -band forms or stabs
 Ultrastructure of neutrophils:

 cytoplasm stippled with:

 -very fine specific granules - lysozyme
 -larger azurophilic granules - myeloperoxidase
 Functions of neutrophils:
 primary function is phagocytosis
 body’s first line of defense
 -opsonisation
 -phagosome
 -pus cells
 -complement components ( C5a)
 -Neutrophilia
 -lymphocytosis
 EOSINOPHILS

 Distribution:
 - 1-3% of blood leukocytes
 - diurnal variation
 Structure of eosinophils:
 - eosinophilic granules
 - nucleus is bilobed
 - specific granules
 Functions of Eosinophils

• -contains lysosomal hydrolase, aryl

sulfatase, acid phospatase, histaminase.
 - all have receptors for IgE
 - Eosinophilia
 allergic & parasitic conditions
 BASOPHILS

 Distribution:
 - 0.5% of white blood cells
 - rarest leukocyte
 Structure of basophils:
 - nucleus is U- or J- shaped
 - metachromasia
 - contain histamine, serotonin & heparin
 - basophils & mast cells with similar structure
 & function
 Functions of Basophils:

 Mediate inflammmatory response

 - eosinophil chemotactic factor
 - stimulate the formation of
immunoglobulin E(IgE)
 - anaphylactic shock
 - Cutaneous basophil hypersensitivity
 LYMPHOCYTES

 Distribution:
 -second most numerous class of leukocytes
 - smallest cells in the white cells series
 - exist in connective tissues lamina propia,
lymph nodes, the spleen & tonsils, & bone
marrow
 Structure of Lymphocytes:

 - no specific granules
 -deeply staining slightly indented nucleus & a thin
rim of clear blue cytoplasm
 described as:(Lymphocytes)
 - large
 - medium
 - small (most common)
 - two major categories: B- lymphocytes & T-
lymphocytes
 - null cells
 Functions of Lymphocytes:
 - principal agents of the body’s immune
responses
 B- lymphocytes- “memory cells”
 - Helper T- lymphocytes
- Suppresor T- lymphocytes
 - Humoral immune response
 - Cell mediated immunity
 - Cytotoxic T- lymphocytes
 MONOCYTES
 Distribution:
 - 0-8% of the circulating leukocytes
 Structure of monocytes:
 - largest leukocytes(9-12 um)
 Larger and more cytoplasm than lymphocytes
 - nucleus is eccentric and round
 - chromatin stains less intensely than lymphocytes
 - Precursors of macrophages
 - lead to functional unit- monocyte- macrophage
system
 - Multinuclate gaint cells
 Monocyte Function:

 - monocytes response to the presence of

necrotic material, invading microorganisms,
and inflammation by migration into the tissues
and differentiation into microphages.
 - great capacity for phagocytosis
 - some functions form part of immunological
mechanisms
 BLOOD PLASMA

 - comprise 55% of whole blood

 fluid matrix in w/c blood cells are suspended and
contains proteins
 - Plasma protien:albumin, globulins, fibrinogen, &
complement
blood serum
 - Albumin:
 - smallest and most abundant plasma protein
 - Globulins:
 - immunoglobulins
 - Fibrinogen:
 - fibrin ,final step of coagulation
 BLOOD
 - complement system:
 - group of 12 serum proteins
 Plasma lipoproteins;

 - Very low-density lipoproteins (VLDL)
 - Low-density lipoproteins (LDL)
 LYMPH
 BONE MARROW & BLOOD CELL
FORMATION

 Structural organization of bone marrow

 Hemopoiesis(Hematopoiesis)
 - Prenatal Hematopoiesis
 - Postnatal Hematopoiesis
 - Development of Myeloid elements
 - The Stem Cell:Hemocytoblast
 Erythropoiesis
 Granulopoiesis
 - Neutrophilic myelocytes
 - Eosinophilic myelocytes
 - Basophilic myelocytes

 BONE MARROW & BLOOD CELL
FORMATION

 Agranulopoiesis
 Monopoiesis
 Lymphopoiesis
 Thrombopoiesis
 - Megakaryocytes development
(Megakaryocytopoiesis)

 BONE MARROW & BLOOD CELL
FORMATION

 Hematopoietic growth factors

 Intrauterine hemapoiesis
 Regulation of hemopoiesis
 - hemopoietic environment
 - Humoral regulation of hemopoiesis
 Clinical correlations
 BONE MARROW & BLOOD CELL
FORMATION
 BONE MARROW
 - Red marrow
 - Yellow marrow
 HEMOPOIESIS
 Formed from two types of tissues:
 - Myeloid tissues
 - Lymphoid tissues
 Extramedullary hemopoiesis
 Theories of Hemopoiesis:

 1). Unitarian or monophyletic theory- hemocytoblat

 2). Dualistic or diphyletic theory- myeloblast &
 lymphoblast
 Prenatal Hemopoiesis
 stages:
 1. Mesoblastic
 2. Hepatic and Splenic
 3. Bone marrow
 Postnatal hemopoiesis

 3 classes of cells:
 1. Stem cells
 2. Progenitor cells
 3. Precursor cells
 Initial steps in blood formation
 1. Pluripotential hematopoietic stem cells(PHSCs)
 2. Mulipotentials
 2 types;
 1. CFU-S
 2. CFU-Ly

 ERYTHROPOIESIS
 Erythrocyte series
 1. Proerythroblast(rubriblast)
 2. Basophilic erythroblast (prorubricyte)
 3. Polychromatophilic erythroblast(rubricyte)
 4. Normoblast(orthochromatophilic)
 5. Reticulocytes
 Erythroid progenitor cells
 1. BFU-E
 2. CFU-E

 GRANULOPOIESIS
 Stages:
 1. Myeloblast
 2. Promyelocyte
 3. Myelocyte
 4. Metamyelocyte
 5. Stabs cells or brand forms
 Granulocyte progenitor cells
 1. CFU-Eo
 2. CFU-Ba
 3. CFU-Nm
 4. CFU-N
 5. CFU-M
 GRANULOPOIESIS
 Compartments

 1. Medullary formation
 -mitotic and maturation
 2. Medullary storage
 3. Circulating
 4. Marginating(diapedisis)
 AGRANULOPOIESIS
 Monocyte formation
 CFU-M - CFU-Nm
 2 precursor cells
 1. Monoblast
 2. Promonocytes
 Lymphocyte formation
 CFU-Ly
 2 progenitor cells
 1. CFU-LyB
 2. CFU-LyT
 THROMBOPOIESIS

 Platelet formation
 CFU-Meg - CFU-S

 Megakaryocyte divide into 3 zones
 1. Perinuclear zone
 2. Intermediate
 3. Marginal
 THROMBOCYTOPENIC PURPURA
 BLOOD COAGULATION -
 EXTRINSIC & INTRINSIC PATHWAY (FACTORS)