What is Blood

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What is Blood?
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Characteristics of Blood

• Complex mixture of cells, cell fragments, and
  dissolved biochemicals
• Transports nutrients, oxygen, wastes, and
  hormones
• Helps maintain interstitial fluid and distributes
  heat
• Links the bodys internal and external
  environments
• Plays a vital role in homeostasis

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What is it?

• Blood is a type of connective tissue
• Cells are suspended in a liquid
• Major component of the cardiovascular system
  along with the heart and blood vessels

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Blood and Blood Cells

• Blood is heavier and 3 4 times more viscous
  than water.
• Most blood cells are formed in bone marrow
• Blood platelets cell fragments

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Blood Volume

• Factors that affect Blood volume
• body size
• changes in fluid intake
• electrolyte concentration
• amount of adipose tissue
• An average adult has about 5.3 liters of blood in
  their body

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Blood Composition

• Blood is usually about 45 cells
• Most blood cells are red
• Small number of white cells and platelets
• The remaining 55 is a clear straw-colored liquid
  called plasma
• Plasma is a mixture of water, amino acids,
  proteins, carbohydrates, lipids, vitamins,
  hormones, electrolytes and cellular waste

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Red Blood Cells

• Erythrocytes Red Blood Cells
• Shape biconcave discs
• Shape allows for increased surface area through
  which gases can diffuse

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Red Blood Cells Cont.

• Red blood cells contain hemoglobin which carries
  the oxygen in the blood
• Hemoglobin is a protein and is responsible for
  the red color of blood
• Oxyhemoglobin oxygen combined with hemoglobin
  bright red
• De-oxyhemoglobin hemoglobin after oxygen is
  released darker red

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Red Blood Cells Cont.

• Red blood cells have nuclei during early stages
  of development but get rid of them as they mature
  to make room for hemoglobin

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Question

• Describe the limitations of red blood cells given
  that they dont have a nucleus?

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Red Blood Cells
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Red Blood Cell Counts

• Red Blood Cell Count of RBCs in a cubic
  millimeter of blood
• Typical range for adult
• Females 4,200,000 5,400,000 cells per cubic
  mm
• Males 4,600,000 6,200,000 cells per cubic mm

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Red Blood Cells Cont.

• The more RBCs the greater the bloods oxygen
  carrying capacity
• Changes in the number of RBCs may affect health
• RBC counts are routinely conducted to help
  diagnose and evaluate disease

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Control of RBC Production

• Formation of RBC hemopoiesis
• RBC are produced in the red bone marrow
• The average life span of a red blood cell is 120
  days
• ? What type of mechanism could control
  production of RBCs?

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RBC Production

• Homeostatic control of RBC production
• Negative feedback mechanism
• Controlled by hormone erythropoietin
• Hormone produced in the liver and kidneys due to
  prolonged oxygen deficiency.
• ? What physiological stresses could cause
• prolonged oxygen deficiency?

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RBC Production Cont.

• 1. Decrease on blood oxygen
• 2. Release of erythropoietin from liver and
  kidneys
• 3. Erythropoietin travels via blood to red bone
  marrow
• 4. Stimulates RBC production

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RBC Production Cont.

• Takes a few days for new RBC to appear in the
  circulating blood
• Production of new RBCs continues until the
  number of erythrocytes in circulation is
  sufficient to supply tissues with oxygen
  requirements.
• ? Recall the issue of oxygen debt in the muscular
  system. Why might the liver produce the hormone
  to stimulate RBC production?

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Question 1

• Which of the following is a function of blood?
• A. Prevents fluid loss
• B. Involved in regulation of body
  temperature
• C. Carries oxygen to cells
• D. All of the above

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Question 2

• Erythrocytes
• A. Are the least numerous formed element in
  blood
• B. Are cylindrically shaped cells
• C. Are produced in yellow bone marrow
• D. Do not have a nucleus

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Question 3

• Erythropoietin
• A. Is produced mainly by red bone marrow
• B. Inhibits the production of erythrocytes
• C. Production increases when blood oxygen
  levels decrease
• D. All of the above

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Question 4

• The composition of blood is
• A. 55 plasma, 45 formed elements
• B. 45 plasma, 55 formed elements
• C. 50 plasma, 50 formed elements
• D. none of the above

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Question 5

• Which of the following formed elements carry
  oxygen?
• A. Leukocytes
• B. Erythrocytes
• C. Thrombocytes
• D. Monocytes

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Question 6

• The structure of red blood cells is that of
• A. A disk that is convex on one side and
  concave on the other
• B. Irregularly shaped fragments without a
  nucleus
• C. Relative large cells with multiple nuclei
  that stain blue
• D. Biconcave disks that carry hemoglobin

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Question 7

• Erythropoietin is released by the kidney in
  direct response to
• A. A decrease in the number of red blood
  cells
• B. An increase in circulating biliverdin
• C. Stimuli originating in the lungs
• D. A decrease in circulating oxygen
  concentration

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Dietary Factors Affecting RBC Production

• B-complex vitamins (B12 and folic acid)
  significantly influence RBC production
• These vitamins are essential to DNA synthesis
• Iron
• Required for hemoglobin synthesis and RBC
  production
• Iron can be reused by the body after cell
  decomposition or RBCs
• Too few RBCs or not enough iron causes anemia

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Sickle Cell Disease

• Read Blue box on pg 309.
• What causes the disease?
• How does the disease affect a persons ability to
  carry oxygen? How?
• What are the symptoms of the disease?
• What treatments exist?

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Destruction of Red Blood Cells

• Macrophages phagocytize and destroy damaged red
  blood cells
• Hemoglobin molecules are broken down into
  subunits
• Heme iron-containing portion
• Decomposes into iron and greenish pigment called
  biliverdin
• Iron can be reused in red bone marrow to make new
  hemoglobin
• Or it can be stored in the liver where it is
  converted into an orange pigment called bilirubin
• Both biliverdin and bilirubin are excreted in the
  liver as bile
• Globin protein

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Jaundice

• Read Blue Box pg 311
• What is jaundice?
• What causes jaundice?
• How is it treated?

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Question 8

• The diagnostic blood test that detects anemia is
• A. Type and cross match
• B. Hemoglobin measurement
• C. White blood cell count
• D. Prothrombin time

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Question 9

• Sickle Cell anemia is a genetic disease which
  causes hemoglobin in red blood cells to
  crystallize is response to
• A. Low iron content in blood
• B. High oxygen levels in blood
• C. Low oxygen levels in blood
• D. High lipoprotein content

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Question 10

• As red blood cells are broken down, the iron
  decomposes into two sub-units of
• A. Biliverdin and bilirubin
• B. Heme and globin
• C. Iron and biliverdin
• D. Protein and bilirubin

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White Blood Cells and Platelets
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White Blood Cells

• White Blood Cell Leukocyte
• Function protect against disease
• Develop from hemocytoblasts (stem cell)
• Blood transports white blood cells to sites of
  infection
• White blood cells have the ability to leave the
  blood stream

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Types of White Blood Cells

• Granulocytes develop in red bone marrow, short
  life span (12 hrs)
• Neutrophils
• Eosinophils
• Basophils
• Agranulocytes develop in red bone marrow and
  lymphatic system, long life span (months to
  years)
• Monocytes
• Lymphocytes

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White Blood Cell Function

• Protection against infection
• Phagocytize bacterial cells
• Produce proteins (anitbodies) that destroy or
  disable foreign particles
• Some can leave the circulation
• Inhibition of blood clotting
• Heparin prevents intravascular blood clot
  formation
• Histamine Increases blood fowl to injured tissue

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White Blood Cell Counts

• The number of WBCs in a cubic millimeter
• A WBCC normally contains 5,000 10,000 cells
• Changes in response to abnormal conditions (ex.
  infection)
• Leukocytosis - acute infection with more than
  10,000 WBCs per mm3 (ex. appendicitis)
• Leukophenia WBCC below 5,000 per mm3 (typhoid
  fever, influenza, measles, mumps, chicken pox,
  AIDS)

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White Blood Cell Counts Cont.

• Differential white blood cell count
• of each type of WBC
• Neutrophils increase during bacterial infection
• Eosinophils increase during parasitic infections
  or allergic reactions
• Lymphocyted decrease sharply in individuals with
  AIDS

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Blood Platelets

• Platelets Thrombocytes
• Cell fragment
• Help close breaks in damaged blood vessels, begin
  clot formation
• Formed from megakaryocytes cells in the red bone
  marrow
• Larger fragments shrink and become platelets
• Develop from hemocytoblasts (stem cells) in
  response to hormone thrombopoietin

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Blood Plasma and Hemostasis
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Blood Plasma

• Clear straw-colored liquid portion of the blood
  in which cells and platelets are suspended
• It is composed of 92 water
• Contains a mixture of organic and inorganic
  biochemicals

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Function of Blood Plasma

• Transports nutrients, gases and vitamins
• Helps regulate fluid and electrolyte balance and
  maintains an appropriate pH

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Plasma Proteins

• Most abundant dissolved substance in plasma
• Remain in the blood and interstitial fluid and
  are not used as an energy source

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Three Types of Plasma Proteins

• Albumins
• Account for 60 of plasma proteins
• Important in regulation of osmotic pressure in
  the plasma which translates to blood volume which
  is directly related to blood pressure
• Smallest plasma protein
• Globulins
• Accounts for 36 of the plasma proteins
• Can be divided into alpha, beta and gamma
  globulins
• Beta globulins transport lipids and fat-soluble
  vitamins
• Gamma globulins are a type of antibody
• Fibrinogen
• Accounts for 4 of the plasma proteins
• Functions in blood coagulation
• Largest of the plasma proteins

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Blood Gases

• The most important blood gases are oxygen and
  carbon dioxide
• Plasma also contains a significant amount of
  nitrogen

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Blood Nutrients

• Include amino acids, simple sugars, nucleotides
  and lipids
• Plasma lipids include fats (triglycerides),
  phospholipids, and cholesterol

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Lipoproteins

• Fats combine with proteins in the plasma to form
  lipoprotein complexes
• Lipoproteins are classified on the basis of their
  density which reflects their concentration of fat
• VLDL (Very low-density lipoproteins) have a high
  concentration of triglycerides
• LDL (Low-density lipoproteins) have a relatively
  high concentration of cholesterol and are the
  major cholesterol-carrying lipoproteins
• HDL (High-density lipoproteins) have a high
  concentration of protein and a lower
  concentration of lipids

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Other Components of Plasma

• Nonprotein Nitrogenous Substances molecules
  that contain nitrogen atoms but are not proteins
• Includes amino acids, urea, and uric acid
• Plasma Electrolytes absorbed from the intestine
  or released as by-products of metabolism
• Includes sodium chloride ions and bicarbonate ions

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Hemostasis

• The stoppage of bleeding to damaged blood vessels
• Includes the following processes
• Blood vessel spasm
• platelet plug formation
• Blood coagulation

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Blood Vessel Spasm

• Cutting or breaking of blood vessels stimulates
  the smooth muscles in its walls to contract, and
  blood loss lessens almost immediately
• Allows time for platelet plug to form
• Platelets release serotonin which contracts walls
  of blood vessel walls helping to reduce further
  blood loss

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Platelet Plug Formation

• Platelets stick to any rough surface
• When a blood vessel breaks, platelets adhere to
  the collagen lining of the blood vessels
• Platelets also stick to each other forming a
  platelet plug
• Platelet plugs control blood loss only from small
  breaks. Larger breaks require a blood clot

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Blood Coagulation

• Causes the formation of a blood clot
• Blood coagulation is complex and utilizes many
  biochemicals called clotting factors
• Some factors promote coagulation and others
  inhibit it
• Whether or not blood coagulates depends on the
  balance between the two groups
• Abnormal clot formations
• Antherosclerosis accumulation of fatty deposits
  that change the arterial linings
• Coronary thrombosis blood clot forming in the
  vessels that supply the heart
• Cerbral thrombosis blood clot forming in the
  vessels that supply the brain
• Infarction when tissue is killed due to clot
• Empolism that travels and then blocks a vessel
  that supplies a vital organ (pulmonary embolism)

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Blood Clot Formtation
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Question 11

• Which of the following is not a component of
  plasma?
• A. Albumin
• B. Globulin
• C. Fibrinogen
• D. Platelets

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Question 12

• Platelet plug begins to form when platelets are
• A. Exposed to air
• B. Exposed to a rough surface
• C. Exposed to calcium
• D. Crushed

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Question 13

• Lipoproteins are categorized by their
• A. Size
• B. Density
• C. Solubility
• D. Shape

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Blood Groups and Transfusions
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Antigens and Antibodies

• Agglutination clumping of red blood cells
  following a transfusion reaction
• Due to reaction between red blood cell surface
  molecules (antigens) and protein (antibodies)
  carried in plasma
• Mismatched blood transfusion quickly produces
  signs of agglutination
• Anxiety, difficulty breathing, facial flushing,
  jaundice and ultimately kidney failure

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ABO Blood Group

• The ABO blood group is based on the presence (or
  absence) of two major antigens on red blood cell
  membranes
• Antigen A
• Antigen B
• A person has one of four antigen combinations on
  their erythrocytes
• Only A A Blood Type
• Only B B Blood Type
• Both A and B AB Blood Type
• Neither A nor B O Blood Type

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ABO Blood Types
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Antibodies

• Antibodies are synthesized in the plasma
• When antigen A is absent, anti-A (antibody) is
  produced
• Persons with type B blood have anti-A in their
  plasma
• When antigen B is absent, anti-B is produced
• Persons with type A blood have antibody anti-B in
  their plasma
• When both antigen A and B are present, neither
  antibody is produced
• When neither antigen is present, both antibodies
  are produced

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Blood Types

• In the U.S.
• Type O (47) and Type A (41) are the most
  common, Type B (9) and AB (3) are rarer

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Blood Types Cont.

• A person with type A blood cannot receive blood
  type B or AB, either would clump in the presence
  of anti-B
• A person with type O blood must not receive type
  A, B or AB blood
• Persons with AB blood can receive any type of
  blood (Universal recipient)
• Type A blood, type B blood and type O blood still
  contain antibodies that could agglutinate type AB
  cells if transfused rapidly. For this reason, AB
  recipients usually receive AB blood
• Persons with O blood can donate to any other
  blood type (Universal donor)
• Same issues as with type AB blood, must be
  transfused slowly.

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Rh Blood groups

• Rh blood group was named after the rhesus monkey
  in which it was first studied.
• This group includes several Rh antigens (factors)
• If any of the factors are present on the RBC
  membrane, the blood is said to be Rh positive.
• If the RBC lacks Rh antigens, the blood is Rh
  negative

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Question 14

• Type AB blood
• A. Has type A antigens
• B. Has type B antibodies
• C. Will not cause a transfusion reaction if
  given to a person with type O blood
• D. All of the above

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Question 15

• A person with antibody A in his or her plasma
  would have which blood type?
• A. Type A
• B. Type B
• C. Type AB
• D. Type O

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Question 16

• People with type O blood are considered to be
  universal donors because their blood contains
• A. Neither A or B antigens on their RBCs
• B. Both A and B antigens in their blood
  plasma
• C. The Rh antigen on their RBCs
• D. None of the above

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Question 17

• The only people who can ever have anit-Rh
  antibodies in their plasma are
• A. Rh-negative men who have been transfused
  with Rh positive blood
• B. Rh-negative women who have been
  transfused with Rh positive blood
• C. Rh-negative women who have carried an
  Rh-positive fetus
• D. All of the above