Transcript Blood - My CCSD

Cardiovascular System
 Blood
 The Heart
 Blood Vessels &
Circulation
Blood
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Introduction
Functions of Blood
Blood Composition
Plasma
Formed Elements
Hemostasis
The Blood
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Introduction
• Circulatory System
Components
• Circulatory System Functions
• Functions of Blood
Learning Objectives
• Circulatory System:
 Explain how the cardiovascular
system is related to the circulatory
system
• Functions of Blood:
 List & describe five functions of
blood
Circulatory System
• Component Systems:
 Cardiovascular system
 Lymphatic system
• Functions of Circulatory
System:
 Transport
 Regulation of body fluids
 Defense against pathogens
Functions of Blood
• Transport of dissolved gases,
nutrients, hormones, & metabolic
wastes
• Regulation of pH & electrolyte
composition of interstitial fluids
• Restriction of fluid losses due to
damaged vessels or injury
• Defense against toxins & pathogens
• Temperature homeostasis
Composition of Blood
• Plasma & Formed Element
• Blood Collection & Analysis
Learning Objectives
• Blood Composition:
 Describe the important
components of the blood
• Blood Collection & Analysis:
 Describe some of the basic
physical features of blood &
explain how blood is collected
 Explain how blood volume can be
estimated
Blood Tissue
• Blood is a fluid connective
tissue
 cellular components: formed
elements
 RBCs, WBCs, platelets
 matrix: plasma
 “fibrous” portion – plasma proteins
 ground substance - serum
Blood Composition
• Plasma
 connective tissue matrix:
plasma proteins – in solution
serum – ground substance (H2O)
• Formed elements
 connective tissue cells:
erythrocytes – red blood cells (RBCs)
leukocytes – white blood cells (WBCs)
platelets – cell fragments
Blood Collection
• Venipuncture
 common sampling technique –
median cubital vein (ant. surf
elbow)
 superficial veins easy to locate
 walls of veins are thinner
 venous blood pressure is
relatively low allowing puncture
wound to seal quickly
 most blood analyses
Blood Collection
• Capillary puncture
 finger tip is most common
 blood smear technique
• Arterial puncture
 uncommon sampling technique
 gas exchange efficiency –
radial artery (wrist) or brachial
artery (elbow)
Whole Blood: Plasma &
Formed Elements
Plasma Analysis
Formed Element
Analysis
Hematocrit
Physical
Characteristics
• temperature
 38 0C (100.4 0 F)
 slightly higher than normal core
B.T.
• viscosity
 5X that of H20
 interaction btw/ proteins, formed
elements, & H20
• pH
 7.35 – 7.45
 slightly alkaline average: 7.4
Blood pH
Blood Volume
• Male
 5 – 6 liters
• Female
 4 – 5 liters
• Relative to body size
 gender differences reflect
differences in ave. body size
 calculation: 0.07 (7%) of body
weight in kg (1kg = 2.2lb)
Blood Volume
• Blood volume terms
 hypovolemic – low blood volume
 normovolemic – normal blood
volume
 hypervolemic – excessive (high)
blood volume
Plasma
• Plasma & Interstitial Fluid
• Plasma Proteins
• Serum
Learning Objectives
• Plasma:
 Discuss the composition &
functions of plasma
 Discuss the origin of plasma
proteins
Plasma -vInterstitial Fluid
• Plasma
 46-63 % whole blood: ave. 55 %
92 % H2O
8 % dissolved proteins & ions
• Interstitial fluid
 96 % H2O
 similar ion conc. as plasma
 smaller conc. of proteins &
dissolved gasses
Plasma Proteins
• Albumins
 60 % (most abundant)
 contribute to osmotic pressure
 function:
- transport of fatty acids, thyroid
hormones, some steroid
hormones, & other subst.
Plasma Proteins
• Globulins
 35 %
 immunoglobulins – a.k.a.,
antibodies
 function: attack foreign proteins &
pathogens
 transport globulins
 function: bind small ions,
hormones, etc to prevent loss at
kidneys
Plasma Proteins
• Fibrinogen
4%
 function:
- blood clotting
 form fibrin strands
 serum – blood fluid from which
clotting factors have been removed
Plasma Protein
Origins
• Liver




90 % of plasma proteins
all albumins
fibrinogen
most globulins
• Lymphocytes – immunoglobulins
• Endocrine organs – peptide
hormones
Ex: α & β cells of pancreas  insulin &
glucagon
Serum
• Watery portion of blood containing
dissolved substances
 electrolytes: Na+, K+, Ca2+, Mg+, Cl-, HCO3, etc
 organic nutrients: fatty acids, amino
acids, glucose, etc
 organic wastes: urea, ammonium ions,
etc
• W/out clotting factors or clotting
proteins
Formed Elements
• Origin & Production
• Erythrocytes (Red Blood Cells)
 structure & function
 hemoglobin
 erythropoiesis
 blood typing
• Leukocytes (White Blood Cells)
 structure & function
 leukopoiesis
• Platelets
 structure & function
Learning Objectives
• Formed Elements:
 Describe the origin & formation of
formed elements in blood
• RBCs:
 List the characteristics &
functions of red blood cells
 Describe the structure of
hemoglobin, and indicate its
functions
Learning Objectives
• RBCs: (cont.)
 Describe the recycling system for
aged or damaged RBCs
 Define erythropoiesis, identify the
stages involved in erythrocyte
maturation, & describe the
homeostatic regulation of RBC
production
Learning Objectives
• RBCs: (cont.)
 List examples of important tests &
cite the normal values for each
test
 Explain the importance of blood
typing on the basis of ABO & Rh
incompatibilities
Hemopoiesis
• Production of blood
• Stem cells
 produce daughter cells that remain
capable of division throughout life
• Hemocytoblasts
 divide to produce:
 lymphoid stem cells  lymphocyte
production
 myeloid stem cells  production of all
other: RBCs, platelets, & WBCs
Erythrocytes:
Red Blood Cells
• RBCs = 99% of formed
elements
• Contain hemoglobin
 protein
 binds O2 & CO2
• Imparts deep red color to
blood when bound to oxygen:
oxyhemoglobin
RBC Trivia
• # RBCs/μl (mm3):
 = 4.5-6.0 million for male
 = 4.2-5.5 million for female
• # RBCs in 1 drop of blood = 260
million
• total # RBCs in ave adult = 25
trillion
• RBCs account for 1/3 of the total #
of cells in the human body
Red Blood Cells
• Hematocrit
 % of whole blood occupied by
cellular components
• Adult male – 46% (40-54%)
• Adult female – 42% (37-47%)
Androgens (♂ hormones) stimulate RBC
production; estrogens (♀ hormones) do
not
Blood Smear
RBC
WBC
platelet
RBC Structure &
Function
• Structure
 biconcave disk
 no nucleus in mature, circulating
RBCs
 hemoglobin (Hb) – packs RBC
• Effect on function
 large surface area – rapid absorption
& release of O2
 formation of stacks – rouleaux
 allows easy passage through vessels
 flexibility – ability to squeeze through
capillaries
Hemoglobin
Structure
• Structure
 Quaternary shape – 4 globular
polypeptide chains
2 alpha (α) chains
2 beta (β) chains
 Each subunit has 1 heme group
containing Fe
• Sickle-cell anemia
 a.a. sequence error in structure of β
chain
 RBCs “sickle” in low O2 conditions
Pleiotropy
Normal RBCs
Hemoglobin
Function
• Oxygen transport
280 million Hb molecules/RBC
each Hb has 4 heme groups
Fe in each heme carries 1 O2
a single RBC carries > 1 billion O2
molecules
 98.5% O2 in blood carried by Hb




• Oxyhemoglobin
 HbO2
 in↑oxygen environ, Hb binds O2
 in↓oxygen environ, Hb releases O2
Hemoglobin Function
• Carbon dioxide transport
 CO2 binds to α & β chains
 23% CO2 in blood carried by Hb
- remainder carried as HCO3- or dissolved
gas
• Carbaminohemoglobin
 HbCO2
 in↑carbon dioxide environ, Hb binds CO2
 in↓carbon dioxide environ, Hb releases
CO2
RBC Life Span
& Circulation
• route from heart, to peripheral
tissues, back to heart takes 1 min –
extremely stressful collisions
• travels 700 miles in 120 days
• worn cells are phagocytized by
WBCs
• 1% replaced @ day
• 3 million new RBCs enter
circulation @ sec
Erythropoiesis
Stimulation of
erythropoiesis due to
hormone
erythropoietin (EPO)
produced by kidney
in response to
hypoxia (↓O2)
Blood Typing
• Based on surface features of RBCs
 antigens – surface features
(agglutinogens) that trigger immune
responses
 RBCs have 50 different kinds of
surface antigens
 3 are especially important: A, B, & Rh
• Affected by antibodies
 agglutinins – antibodies that attack
RBCs w/ non-self antigens
Blood Types
• Type A (40% US population)
 antigen A present on RBC
 plasma carries anti-B antibodies
• Type B (10% US population)
 antigen B present on RBC
 plasma carries anti-A antibodies
• Type AB (4% US population)
 antigens A & B present on RBC
 plasma carries no ant-A or antiB antibodies
Blood Types
• Type O (46% US population)
 no A or B antigens present on
RBC
 plasma carries both anti-A &
anti-B antibodies
universal recipient
Blood Groups
universal donor
Blood Types
• Rh factor
 antigen present – positive Rh factor
= Rh+
 antigen absent – negative Rh factor
= Rh no anti-Rh antibodies are present
in Rh- individuals unless due to
previous exposure to Rh+ blood
 “Rh” omitted in blood type
terminology
Ex: O+ or A-
Rh Factors
& Pregnancy
Erythroblastosis
fetalis
Blood Group
Genetics
• Codominance
 there are 2 dominant traits
 if inherited, both are expressed
in phenotype of offspring
 type A (IA_), type B (IB_), or type
AB (IAIB)
• Multiple alleles
 more than 2 traits (surface
features) govern a character (blood
type)
 IA & I B & i
Blood Group Genetics
• Type A genotypes
 IAIA – homozygous dominant A
 IAi – heterozygous A
• Type B genotypes
 IBIB – homozygous dominant B
 IBi – heterozygous B
• Type AB genotype
 IAIB – homozygous dominant A & B
• Type O genotype
 ii – homozygous recessive
Blood Typing
Donor Blood
Serum
Type AB blood
has NO A or B
antibodies
Recipient RBCs
Universal Donor
Universal Recipient
Type B blood
carries
antibodies
against type A
Type A blood
carries
antibodies
against type B
Type O blood
carries
antibodies for
both type A &
type B
Genetics
Problem 1
•
•
A woman who is heterozygous for
type A blood marries and a man
who is heterozygous for type B
blood.
State the probability that any
child they produce will have the
following blood types:
a)
b)
c)
d)
A
B
AB
O
♀
A
I
i
♂
B
X I i
IA
IB
A
B
I I
Type AB
i
A
I
i
Type A
25% probability
for any blood type
i
B
I
i
Type B
ii
Type O
Genetics
Problem 2
• A woman who is
heterozygous for Rh+ blood
marries and a man with Rhblood.
• State the probability that any
child they produce will have
the following blood types:
a) Rh+
b) Rh-
♂
♀
+/-
-
X
-/+
-
+/-
-/-
Rh-pos
Rh-neg
+/-
-/-
Rh-pos
Rh-neg
Genetics
Problem 3
•
•
A woman who is heterozygous for
type A and Rh+ blood marries and
a man who is heterozygous for
type B- blood.
State the probability that any
child they produce will have the
following blood types:
a)
b)
c)
d)
A+
AB+
B-
e)
f)
g)
h)
AB+
ABO+
O-
i) Rh+
j) Rh-
♂
A+
BI i X I i
♀
IB-
IA+
i
A+
BI I
BI i
Type AB pos
i
A+
I i
Type A pos
Type B neg
i- iType O neg
RBC Problems
• Anemia
 hemoglobin &/or RBC deficiency
  O2 transport
 types:
 Fe-deficiency anemia – affects proper
manufacture of hemoglobin
 pernicious anemia – vitamin B12
deficiency reducing factor necessary
for RBC maturation
 aplastic anemia – reduced
manufacture of RBCs
 sickle-cell anemia – gene mutation
resulting in abnormal hemoglobin
RBC Problems
• Thalassemia
 inherited disease involving 
hemoglobin synthesis
• Polycythemia
  production of RBCs
 types:
 Primary – natural disorder leading to
 blood volume & viscosity and to
impaired circulation
 Secondary – develops as
compensation for  O2 levels: high
altitude adaptation
Learning Objectives
• WBCs:
 Categorize the various WBCs on
the basis of their structures &
functions
 Discuss factors that regulate the
production of the various types of
WBCs
Types of
Leukocytes
• Granular leukocytes
 cytoplasm contains many visible
granules
 types:
neutrophils
eosinophils
basophils
Types of
Leukocytes
• Agranular leukocytes
 cytoplasm contains few or no
visible granules
 types:
monocytes
lymphocytes
Circulation
& Movement
• amoeboid movement
• diapedesis – can squeeze btw
adjacent endothelial cells of blood
vessels to migrate out of circulatory
system
• positive chemotaxis – attracted to
specific chemical stimuli of damaged
cells, invading pathogens, etc
• phagocytosis – neutrophils,
eosinophils, & monocytes can engulf
pathogens, cell debris, etc
Circulation
& Movement
• 6000-9000 leukocytes/μl
whole blood
• most WBCs are in connective
tissue proper or organs of the
lymphatic system
• circulating leukocytes
represent tiny fraction of total
WBC count
General Functions
of Leukocytes
• Nonspecific defenses
 activated by a variety of stimuli
 do not discriminate btw one type
of threat & another
 types:
neutrophils
eosinophils
basophils
monocytes
General Functions
of Leukocytes
• Specific immunity
 respond to attacks by specific
pathogens or toxins
 types:
lymphocytes
Neutrophil
• Structure
 polymorphonuclear – segmented nucleus
 round cell; granules do not stain easily
w/ acidic or basic dyes
 packed w/ lysosomes & bactericidal
compounds
• Function
 phagocytize bacteria, fungi, some
viruses
 release chemicals to cause inflammation
makes blood vessels permeable
attract other WBCs
Neutrophil
• 50-70% circulating WBCs
 most numerous WBC in circulation
• survive 10 hrs in bloodstream
• survive 30 min while destroying
bacteria
• produced in red bone marrow
Eosinophil
(a.k.a., acidophil)
• Structure
 bilobed nucleus
 round cell; granules stain darkly red w/
eosin, an acid-based dye
• Function
 use exocytosis to secrete toxins onto
surface of large, multicellular parasites
(flukes, tapeworms, etc)
 phagocytize objects already coated w/
antibodies: bacteria, dead cells, etc
 respond to allergens
 reduce inflammation
Eosinophil
• 2-4 % circulating WBCs
• survive minutes to days
depending on activity in tissue
• produced in red bone marrow
Basophil
• Structure
 lobed nucleus – difficult to see due to
# of granules
 round cell; granules stain dark purple
or blue w/ basic dyes
• Function
 release heparin to prevent blood
clotting
 release histamine to cause
inflammation
Basophil
• < 1 % circulating WBCs
• survival time unknown
• produced in red bone marrow
Monocyte
• Structure
 kidney bean-shaped nucleus
 very large cell; abundant, pale cytoplasm
• Function
 in circulation for 24 hrs; enter tissues to
become macrophages
 phagocytic giant cell – fusion of several
macrophages to ingest large object
Monocyte
• 2-8 % of circulating WBCs
• survive for months or longer
• most produced in red bone
marrow
Lymphocyte
• Structure
 large, round nucleus
 generally round cell; little
cytoplasm
• Function
 defense against specific
pathogens: viruses, bacteria, fungi
 3 classes of lymphocytes w/
different functions
Lymphocyte
• 20-30 % of circulating WBCs
• survive months to decades
• circulate from blood to tissues
& back
• produced in red bone marrow &
lymphoid tissues
Lymphocyte
Classes
• T cells
 cellular immunity – defense
mechanisms against invading
foreign cells and tissues
 coordination of immune responses
Lymphocyte
Classes
 types of T cells:
 cytotoxic T cells – direct destruction
of foreign cells by physical & chemical
attack
 regulatory T cells:
• helper T cells – stimulate activity of
other T cells & B cells
• suppressor T cells – inhibit the
activity of other T cells & B cells
Lymphocyte
Classes
• B cells
 humoral immunity
 production of antibody defense
against antigens on pathogens,
foreign cells, etc
 antibodies produced in one region
can destroy pathogens anywhere
in the body
Lymphocyte
Classes
• NK cells (a.k.a., “natural killer”
or large, granular lymphocytes)
 immune surveillance
 detection & destruction of
abnormal tissue cells
 important in destroying cancer
cells
Blood Cell Origin
& Differentiation
Regulation of
WBC Production
• Colony-stimulating factors
(CSFs)
 hormones
 types of CSFs:
M-CSF – stimulates
monocyte/macrophage line
G-CSF – stimulates production of
granulocytes: neutrophils, eosinophils,
& basophils
Regulation of
WBC Production
 types of CSFs: (cont)
GM-CSF – stimulates production of
both granulocytes & monocytes
Multi-CSF – accelerates production of
granulocytes, monocytes,
erythrocytes, & platelets
Learning Objectives
• Platelets:
 Describe the structure & function
of platelets
 Explain how platelets are formed
Platelets
• Structure
 flattened disks or spindle-shaped cell
fragments
 non-nucleate; cytoplasm w/ enzymes &
proenzymes
• Function
 transport of clotting chemicals
 temporary patch formation in walls of
damaged blood vessels
 active contraction following clot
formation
Platelets
• 150,000-500,000 / μl whole blood
• survival time 9-12 days
• produced in red bone marrow
Platelet
Production
• Thromobocytopoiesis
 production of platelets
 contributing factors:
thrombopoietin (TPO) – accelerates
platelet formation
interleukin-6 (Il-6) – stimulates platelet
formation
Multi-CSF – stimulates production of
megakaryocytes
Note Structure of Formed
Elements: Nuclei
Hemostasis
• Prevention of blood loss
through walls of damaged
blood vessels
• Establishment of framework for
tissue repair
Learning Objectives
• Hemostasis:
 Discuss mechanisms that control
blood loss after injury
 Describe the reaction sequences
responsible for blood clotting
Phases
of Hemostasis
• Vascular Phase
 Vascular spasm – automatic
contraction of smooth muscle following
a cut in the wall of a blood vessel
 Changes in endothelium:
 endothelial cells contract & expose
underlying basement membrane to blood
stream
 endothelial cell membranes become
sticky; in small capillaries, cells from
opposite walls may stick together to
close off passageway
Phases
of Hemostasis
• Vascular Phase
 endothelial cells release chemicals
& hormones
• ADP, tissue factor, prostacyclin
• endothelins – peptide hormones
(1) stimulate smooth muscle
contraction & vascular spasm
(2) stimulate production of new
endothelial cells, smooth muscle
cells, & fibroblasts to accelerate
repair
Phases
of Hemostasis
• Platelet Phase
 Platelet adhesion – platelets begin
to stick to endothelial cells
 Platelet adhesion – platelets begin
to stick to each other
 Platelet plug forms
Phases
of Hemostasis
• Platelet Phase
 Platelets release chemicals:
 ADP – promotes aggregation
 thromboxane A2 – promotes
aggregation & secretion; also, smooth
muscle contraction & vascular spasm
 serotonin – assists thromboxane A2
 platelet factors – promotes blood
coagulation & div. of endothelial cells
 Ca2+ - promote aggregation & clotting
Phases
of Hemostasis
• Coagulation Phase
 Blood clotting
 conversion of circulating
fibrinogen to insoluble fibrin
 forms tangle of fibers that traps
blood cells and more platelets
Blood Clot
Structure
Coagulation Phase
• Extrinsic pathway
 begins w/ damaged tissues at
injury site outside the blood
stream
 release of tissue factor (TF)
activates a series of clotting
factors which combine w/ Ca2+
to produce the enzyme
prothrombin activator
Coagulation Phase
• Intrinsic pathway
 begins w/ damaged tissues at
injury site inside the blood
stream
 activates a series of clotting
factors which combine w/ Ca2+
to produce the enzyme
prothrombin activator
Coagulation Phase
• Common pathway
 prothrombin activator from either
intrinsic or extrinsic pathway
appears in plasma
 works w/ Ca2+ :
prothrombin –prothrombin activator / Ca2+ 
thrombin
circulating globular fibrinogen –thrombin fibrin
Blood Clotting
Process
Clot Retraction
& Fibrinolysis
• Platelets contract: syneresis
 pull edges of torn vessel closer
together
• Fibrinolysis
 clot dissolves
 action of plasmin by plasminogen
plasminogen –thrombin activator or t-PA  plasmin
Blood Review
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• ASX Video plays about 20 min