Blood

Chapter 18
 Functions
• Transport
– Gases, nutrients, hormones, wastes, heat
• Regulation
– pH, ion concentration, osmolarity
• Clotting to prevent fluid loss
• Immune system
– White blood cells, antibodies, inflammation
 Whole Blood
• Plasma
– Hormones, ions,
glucose, lipids,
clotting proteins,
etc.
• Formed Elements
(Cells)
– Erythrocytes
(RBCs)
– Leukocytes
(WBCs)
– Platelets
• Red blood cells (RBCs) Blood Cells and Platelets
aka erythrocytes
• White blood cells
(WBCs) aka leukocytes
– Lymphocytes
(T & B cells)
– Granulocytes (granules)
• Eosinophil (orange-pink)
• Basophil (blue)
• Neutrophil (clear)
– Monocytes (largest)
• Platelets (cell
fragments for clotting)
 Characteristics
• More viscous than water
(thicker & stickier than water)
• Alkaline (slightly), 7.35-7.45 pH
• Males: ~5-6 liters
• Females: ~4-5 liters
• Male hematocrits (%RBCs) are generally higher than female
 Plasma Composition
• Water (92%) + Proteins
• Proteins
– Albumins(~60% of proteins)
– Globulins (~35%)
• Antibodies or immunoglobulins
• Transport proteins – hormones (binding proteins),
metals (metalloproteins), lipids
(apolipoproteins/lipoproteins)
– Fibrinogen(~4%)
– Additional proteins including hormones,
cytokines, some waste products, etc.
– Salts, sugars and other nutrients
 Red Blood Cells
• Most abundant cell in blood (37-54%)
• Measured many ways
– Hematocrit (% of whole blood volume)
– RBC count (concentration of RBCs/vol.)
• Biconcave disc
– Large surface to volume ratio
– Allows cells to “stack”
– Allows cells to bend & flex
• Lose organelles except cytoskeleton
– No protein synthesis
– No aerobic cell respiration
 Structure and
Shape of Red Blood
Cells
 Hemoglobin
• Structure
– 4 subunits –
2 pair identical
subunits (a & b)
– Heme group @ center
w. iron (Fe)
• Function
– Oxyhemoglobin (O2)
– Deoxyhemoglobin (H+)
– Carbaminohemoglobin (CO2)
 Oxygen Carrying Capacity
Method of Measurement Females Males

Hematocrit (packed cell 37-48% 42-52%

volume)

RBC counts/μl 4.2-5.4 million 4.6-6.2 million

Hemoglobin (iron) 12-16 g/dL 13 to 18 g/dL

Overview of Erythropoiesis & Leukopoiesis in
Bone Marrow
Hematopoietic Stem Cells (HSCs)

Myeloid Stem Cells Lymphoid Stem Cells

RBCs Monocytes

Megakaryocytes Granulocytes T cells B cells NK cells

Helper T Cytotoxic T
Eosinophils Basophils Neutrophils cells (TH) cells (TC)
(in thymus) (in thymus)
 Erythropoiesis
• Red marrow • Requires:
• Timing – Amino acids
– ~8 weeks (total) – Iron (Fe)
– ~3-5 d. (ECFU to – B12, B6 & folic acid
reticulocyte) • Erythopoietin
– ~2 d. (reticulocyte to RBC)
• Hemocytoblast to myeloid stem cell to erythroblast
Regulation and
Role of
Erythropoietin
(EPO)
Iron Metabolism
 RBC Breakdown
• Trapping in spleen & liver
• Hemolysis & phagocytosis
• Proteins lysed & recycled
• Heme unit broken down
into Fe++ & biliverdin
• Biliverdin converted to bilirubin
• Bilirubin transported to liver & excreted in bile.
• Skin, whites of eyes & mucous membranes can all
turn yellow during jaundice
Review of RBC Life Cycle
• Nutrition required
– Protein
– Iron
– Folic Acid
– Vitamin B12
• Produced in red marrow
• Degraded in spleen &
liver
– Iron recycled
– Bile excreted
 Anemia
• Inadequate hemoglobin content of blood
• Proximal causes:
– Low hematocrit
– Low hemoglobin/
erythrocyte
• Ultimate causes:
– Blood loss
– Diet
– Bone marrow (cancer/chemotherapy)
– Disease (e.g. sickle cell anemia/thalassemia/pernicious anemia)
 Basis of ABO Blood Types
• Molecules on surface of RBC =
blood type
• For ABO – sugars on glycolipids
in membrane
• Determined by enzymes (genes)
• Locus = blood group
• 2 possible alleles/person
 Blood Types
• Glycolipids of ABO blood group
– A version (antigenic)
– B version (antigenic)
– O version (not antigenic)
• Proteins in Rh blood group
– D (antigenic)
• Type indicates sugars or proteins on RBC
• Transfusion rule:
– Don’t give anyone an antigen they don’t have
Agglutination &
Blood Typing
Hemolytic Disease of the Newborn
 Leukocytes
• White Blood Cells – immunity
– Agranulocytes
• Monocytes – become macrophages
• Lymphocytes – antibody production or killer cells
– Granulocytes – chemical defense & some phagocytosis
• Eosinophils
• Basophils
• Neutrophils
Types of White Blood Cells
Overview of Erythropoiesis & Leukopoiesis in
Bone Marrow
Hematopoietic Stem Cells (HSCs)

Myeloid Stem Cells Lymphoid Stem Cells

RBCs Monocytes

Megakaryocytes Granulocytes T cells B cells NK cells

Helper T Cytotoxic T
Eosinophils Basophils Neutrophils cells (TH) cells (TC)
(in thymus) (in thymus)
 Leukopoiesis –
Production of
White Blood Cells
Platelet Function - Clotting
Clotting
• Release of
– Vasoconstrictors
– Clotting factors
– Chemical messengers that attract
Thrombocytopoiesis
neutrophils & macrophages as well • Making platelets
as growth factors • Regulated by
• Formation of platelet plug – Thrombopoietin
• Active contraction to shrink clot – Cytokines, particularly IL-6
 Production of
Platelets by
Megakaryocytes
 Hemostasis
• Vascular spasm • Platelet plug formation
– Endothelin – Adhesion to collagen fibers
– Serotonin – Aggregation & degranulation
– Thromboxane A2 – Plug formation and shrinkage
• Coagulation – clot formation
Coagulation Pathways
• Extrinsic mechanism
– Starts with release of
thromboplastin from
damaged cells
• Intrinic mechanism
– Starts with activation of
factor XII by platelets
• Final Common Pathway –
– Factor X to fibrin formation
• Extrinsic triggers intrinsic
through positive feedback
Coagulation
Cascade
Illustrating
Amplification
of Response
Diagram of
Fibrinolysis
Pathway