Blood

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Chapter 19
Blood
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Blood Overview
spin blood separate into 2 parts (3)
liquid cells (formed elements)
WBCs
RBCs
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Blood
chapter outline
Overview Plasma Formed elements RBCs WBCs platle
ts (fragments) hemostasis
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Blood Overview
fluid CT part of the cardiovascular system
(heart, vessels)
provide nutrients, O2, chemical messages removes
wastes provide protection to/from/for all the
cells of the body
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Blood Overview

• transport
• dissolved gases
• nutrients
• hormones
• wastes

• regulate
• ionic composition and pH of body fluids

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Blood Overview

• restrict fluid lose at injury

• defend against toxins and pathogens

• stabilize body temperature

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Blood Overview

• restrict fluid lose at injury

• defend against toxins and pathogens

• stabilize body temperature

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Blood Overview
plasma
55 of blood H2O 92 plasma proteins
7 ions nutirents wastes hormones
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Blood Overview
formed elements
produced through hemopoiesis 99.9 RBCs 0.1
WBCs and platlets
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Blood Overview
whole blood

• 38 C
• 5x more viscous than H2O
• (sticky, thick)
• slightly alkalai
• pH 7.35 - 7.45

5-6 L in average adult male (165) 4-5 L in
average adult female (125) (7 of body weight)
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Clinical Note
blood donations
median cubital vein venipuncture easy to
find thin walls than arteries lower bp than
arteries
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Clinical Note
capillary blood
finger tip earlobe toe / heel (infant) small
quantity (drops)
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Clinical Note
arterial blood
radial or brachial artery check blood gases
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Stop here 3/21 Lec 29
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Blood plasma
body fluids ICF ECF interstitial
fluid blood plasma
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Blood plasma
similar in composition to interstitial fluid
(ECF) (different than ICF) but different than
ECF in dissolved gases (O2, CO2) (always being
used by cells) dissolved proteins (dont cross
capillary walls)
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Blood plasma
proteins
7.6 g (5x ICF) 7.6 grams / 100 ml
plasma large size and globular shape prevents
them from leaving vessels three classes of
proteins
albumins globulins fibrinogen
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Blood plasma
proteins
albumins
60 of plasma proteins made in liver transport f
atty acids hormones other stuff
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Blood plasma
proteins
globulins
35 of plasma proteins two types immunoglobulins
transport globulins
aka., antibodies (Ab) hormone-binding (thyroid
H) metalloaproteins (iron) apolipoproteins (lipids
) steroid-binding (testosterone)
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Blood plasma
proteins
fibrinogen
4 of plasma proteins blood clotting converted
to fibrin (strings) (framework for clot) plasma
without clotting stuff serum
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Blood plasma
proteins
other plasma proteins
various hormones
origins of proteins
liver makes 90 plasma cells make antibodies (Ab)
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100 keys pg. 643
Your total blood volume, in liters, is roughly
equal to 7 of your body weight (in kilograms).
Approximately half the volume of whole blood
consists of cells and cell products. Plasma
resembles interstitial fluid, but it contains a
unique mixture of proteins not found in other
extracellular fluids.
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Clinical Note
Plasma expanders
used to increase blood volume
(buy time to determine blood type)
isotonic (normal) saline solutions short-lived
diffuse into interstitial fluid and
cells Ringers solution has lactate (slows
diffusion) Dextran in saline
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Clinical Note
Plasma expanders
temporarily replace blood volume dont help
increase O2 carried need to give or make new
RBCs
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Formed elements
RBCs aka., red blood cells erythocytes
contain pigment molecule hemoglobin Hb
O2 HbO2 (dark) (bright red)
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RBCs
Quantity
RBCs in one µl (microliter) (1 mm3)
about 5,000,000 cells / µl x 5 L of
blood 25,000,000,000 RBCs in adult
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RBCs
Quantity
percentage of whole blood occupied by RBCs
hematocrit
average is about 45 males 42 females
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RBCs
Quantity
What factors may affect the hematocrit ?
increase decrease
dehydration EPO stimulation bleeding problems
with RBC production
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RBCs
Structure
unusual cells lack most organelles (nucleus,
mitochondria, etc) except cytoskeleton biconcave
discs
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fig. 19-2d
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RBCs
Structure
shape
large surface area to volume ratio absorption and
release of O2 form stacks to go through
vessels can bend and flex to get through narrow
capillaries
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RBCs
Structure
lack of organelles
cannot divide cannot synthesize proteins cannot
repair itself short life-span (120 days) replace
1 each day low energy demands
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RBCs
Structure
What do they have inside ?
95 of proteins inside the cell is hemoglobin
(Hb) 14 g
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RBCs
Structure of Hemoglobin
complex structure 4 polypeptide chains 2 alpha
(a) chains 2 beta (b) chains (amino acids) each
chain has a heme pigment moleucle Fe2
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fig. 19-3
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RBCs
Structure of Hemoglobin
280 million Hb molecules/RBC one RBC can carry
over a billion O2 O2 bound depends on O2
if CO2 is high bind to Hb carbaminohemoglobin
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RBCs
Structure of Hemoglobin
low hematocrit low Hb
reduced O2-carrying capacity
many forms
anemia
reduced flow of O2 to tissues
weakness, lethargy, confusion
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RBCs
Formation / Turnover
exposed to severe mechanical stress cannot repair
themselves macrophages
engulf old/damaged cells engulf cell parts after
hemolysis
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RBCs
Formation / Turnover
hemolysis
releases Hb from cells
if phagocytosed - recycled if not, eliminated by
kidney
hemoglobinuria
red or brown urine lots of Hb in urine
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RBCs
Formation / Turnover
hemolysis
hemoglobinuria
hematuria
intact RBCs in urine means kidney damage
or blood vessel damage
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RBCs
Formation / Turnover
recycling (by macrophages)
globin proteins amino acids reused
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RBCs
Formation / Turnover
recycling (by macrophages)
heme (without Fe2) bilverdin (greenish)
(bruise) bilirubin (yellowish) (jaundice)
excretion (urine, feces)
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RBCs
Formation / Turnover
recycling
Fe2 (if free, is toxic to cells)
transported to bone marrow by transferrin used
to make new RBCs need 26 mg/day 1-2 mg is
usually enough most is recycled
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RBCs
Formation / Turnover
recycling
too little Fe2
reduction of RBC production
dietary deficiency iron absorption
iron-deficiency anemia
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RBCs
Formation / Turnover
recycling
too much Fe2
excessive buildup in heart linked to heart
disease excessive buildup in liver
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fig. 19-4
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to here 3/23 lec 30
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100 Keys (pg. 649) Red blood cells (RBCs) are
the most numerous cells in the body. They remain
in circulation for approximately 4 months before
being recycled several million are produced each
second. The hemoglobin inside RBCs transports
oxygen from the lungs to the peripheral tissues
it also carries carbon dioxide from the tissues
to the lungs.
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RBCs
Production
erythropoiesis
embryo yolk sac fetus liver, spleen adults red
bone marrow (aka., myeloid tissue)
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RBCs
Production
hemocytoblast myeloid stem cell
proerythroblasts - - -
normoblasts (sheds nucleus)
reticulocyte (enter blood)
mature RBC
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RBCs
Production
fig. 19-5
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RBCs
Regulation of Production
requirements
amino acids iron vitamins B6 folic
acid B12 meat/dairy products absorption
requires intrinsic factor
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RBCs
Regulation of Production
requirements
B12
if not enough eaten or absorbed
pernicious anemia
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RBCs
Regulation of Production
stimulated by EPO erytropoietin erythropoiesis
stimulating hor. made by peripheral tissues
especially kidney when exposed to low oxygen
levels hypoxia
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RBCs
Regulation of Production
what might trigger kidney to release EPO?
anemia reduced blood flow to kidney low O2 in
lungs (disease or high altitude) lung damage
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RBCs
Regulation of Production
effects of EPO
stimulates cell division in erythroblasts and
stem cells stimulates Hb synthesis and
maturation of RBCs
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RBCs
Regulation of Production
effects of EPO
RBC production can increase from 3,000,000
cells/second to 30,000,000 cells/second
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RBCs
Regulation of Production
effects of EPO
important following blood loss given to healthy
person (Olympic endurance athletes) blood can
carry more O2 but, hematocrit rises (65) blood
get thicker strain on heart
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RBCs
Regulation of Production
effects of EPO
same applies to blood doping
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RBCs
Blood testing
table 19-1
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table 19-1
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100 Keys (pg. 649) Red blood cells (RBCs) are
the most numerous cells in the body. They remain
in circulation for approximately 4 months before
being recycled several million are produced each
second. The hemoglobin inside RBCs transports
oxygen from the lungs to the peripheral tissues
it also carries carbon dioxide from the tissues
to the lungs.
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Blood typing
cells (including RBCs) have proteins on
their surface
antigens foreign molecules can trigger
immune response
your immune system ignores the molecules on the
surface of your cells because they are self
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Blood typing
your body makes antibodies (Ab) (aka.,
immunoglobulins) to attack and destroy antigens
There are three (of 50) important antigens used
for blood typing A B Rh
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Blood typing
if your cells normally have A on surface (A is
self) your immune system will ignore it, but
has antibodies to attack B (anti-B antibodies)
You have type A blood
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Blood typing
if your cells normally have B on surface (B is
self) your immune system will ignore it, but
has antibodies to attack A (anti-A antibodies)
You have type B blood
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Blood typing
if your cells have A B on surface (both are
self) your immune system will ignore them
You have type AB blood
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Blood typing
if your cells have neither on surface (neither
are self) (both are foreign) your immune
system has antibodies to attack both You have
type O blood
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agglutination
hemolysis
fig. 19-6
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Genetics of blood groupings ABO system three
alleles
0
IA IA IA i IB IB IB i IA IB i i
A A B B AB O
IA IB i
DOMINANT recessive
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Other blood groupings ABO system
0
Rh system
C, D, E close on same chromosome
Dominant/recessive
C, D, or E Rh positive
ccddee Rh negative
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Blood typing
if your cells have Rh factor on surface (Rh is
self) your immune system will ignore it You
have type Rh (positive) blood
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Blood typing
if your cells lack Rh factor on surface (Rh is
foreign) your immune system will make
antibodies to attack it You have type Rh-
(negative) blood
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table 19-2
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Blood typing
agglutination and hemolysis
Ab RBC
cross reaction
test for compatability
blood transfusion
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Blood typing
standard test
determine donors and recipients blood type
using ABO and Rh systems
mix drops of blood with anti-A anti-B anti-R
h
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A
B
AB
O-
fig. 19-7
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universal donor
fig. 19-7
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Blood typing
standard test
just tested 3 of 50 possible antigens
if time and facilities allow cross-match testing
mix donor and recipient blood and look for
problems
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Blood typing
HDN
Hemolytic disease of the newborn
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Blood typing
HDN
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