The Blood

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27

• The Blood

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Learning Outcomes (cont.)

• 27.1 Describe the components of blood, giving
  the function of each component listed.
• 27.2 Explain how bleeding is controlled.
• 27.3 Explain the differences among blood types
  A, B, AB, and O including in the discussion
  which blood types are compatible.

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Learning Outcomes (cont.)

• 27.4 Explain the difference between Rh- positive
  blood and Rh-negative blood.
• 27.5 Describe the causes, signs and symptoms,
  and treatments of various diseases and disorders
  of the blood.

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Introduction

• Blood
• 4-6 liters per adult 8 of body weight
• Essential functions
• Carries oxygen and nutrients
• Removes carbon dioxide and wastes
• Transport mechanism for hormones
• Regulation of body temperature

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Components of Blood

• Red blood cells erythrocytes
• Small biconcave-shaped cells
• Small enough to pass through capillaries

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Blood Components (cont.)

• Hematocrit
• The percentage of red blood cells
• Normally about 45
• White cells and platelets 1
• Plasma 55

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Blood Components (cont.)

• Hemoglobin
• Oxyhemoglobin carries oxygen
• Deoxyhemoglobin carries carbon dioxide
• RBC count
• Normally between 4 million and 6.5 million RBC/ml
• Anemia

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Blood Components (cont.)

• RBCs
• Produced in the red bone marrow
• Life span 120 days
• Erythropoietin
• Produced by kidneys
• Stimulates bone marrow
• Released when oxygen concentrations are low

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Blood Components (cont.)

• RBC production
• Iron
• Vitamin B12
• Folic acid

• Aging RBCs
• Destroyed by macrophages in liver and spleen
• Biliverdin released and converted to bilirubin by
  the liver

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White Blood Cells

• Leukocytes - WBCs
• Granulocytes
• Neutrophils 55
• Eosinophils 3
• Basophils lt 1

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White Blood Cells

• Agranulocytes
• Monocytes 8 destroy bacteria, viruses, and
  toxins in blood
• Lymphocytes 33 provide immunity for the body

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White Blood Cells (cont.)

• WBC count
• normally 5000 to 10,000 WBCs per cubic millimeter
• Leukocytosis high
• Leukopenia low
• Diapedesis

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Blood Platelets

• Also called thrombocytes
• Fragments of cells
• Needed for the clotting process
• Normal count 130,000 to 360,000 platelets per
  cubic millimeter of blood  

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Blood Plasma

• Water
• Proteins
• Albumins help to maintain blood pressure
• Globulins transport lipids and fat-soluble
  vitamins
• Fibrinogen needed for blood clotting
• Serum

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Blood Plasma (cont.)

• Nutrients
• Amino acids
• Glucose
• Nucleotides
• Lipids

• Gases
• Oxygen
• Carbon dioxide
• Nitrogen

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Blood Plasma (cont.)

• Electrolytes
• Non-protein nitrogenous substances
• Waste products

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Apply Your Knowledge
True or False __ Hematocrit is the percentage of
WBCs in the blood. __ Neutrophils destroy
bacteria, viruses, and toxins in the
bloodstream. __ Platelets are important to the
clotting process. __ Albumin is a small plasma
protein that pushes water out of the
bloodstream. RBCs are biconcave-shaped cells
and have hemoglobin rather than a nucleus.
ANSWER
RBCs
F
T
T
pulls water into
F
T
Bloody Great!
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Bleeding Control

• Hemostasis the control of bleeding
• Three processes of hemostasis
• Blood vessel spasm
• Platelet plug formation
• Blood coagulation

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Bleeding Control (cont.)
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Bleeding Control (cont.)

• Coagulation
• Fibrinogen converts to fibrin
• Fibrin sticks to damaged area
• Fibrin meshwork traps blood cells and platelets
• Blood clot stops bleeding

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Bleeding Control (cont.)

• Thrombus clot in a vessel with no known injury
• Embolus
• Thrombus that breaks off and moves through blood
  stream
• Danger of blocking artery
• Pulmonary embolism
• Myocardial infarction
• CVA

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Apply Your Knowledge
Explain what happens when a blood vessel is
injured?
ARTERIES Hemostasis occurs to control bleeding.
First the blood vessel spasms, then a platelet
plug forms, and lastly, the blood coagulates
forming a blood clot.
YIPPEE!
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ABO Blood Types

• Blood types are distinguished by antigens and
  antibodies
• Agglutination
• Clumping of red blood cells
• Antigens on surface of RBCs bind to antibodies
  in plasma

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Blood Types (cont.)
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Blood Types (cont.)
Blood Type Antigen on RBC Antibody in Plasma Blood That Can Be Received
A A B A and O
B B A B and O
AB A and B None A, B, AB, and O
O None A and B O
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Apply Your Knowledge

• Identify the blood type

ANSWER
1
2
3
4
Truly Terrific!
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Rh Factor

• Rh antigen
• Rh-positive
• Rh-negative
• Transfused blood
• Match for Rh factor
• 1st unmatched transfusion antibodies develop
• 2nd time agglutination

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Rh Factor

• Erythroblastosis fetalis
• Mother developed antibodies to the Rh antigen in
  prior pregnancy
• Antibodies attack fetus blood
• Infant severe anemia

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Rh Factor (cont.)
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Apply Your Knowledge
What is the difference between Rh-positive and
Rh-negative blood and why is it important to
know whether a person is RH-positive or negative
before transfusing blood?
ANSWER Rh-positive blood contains the Rh
antigen while Rh-negative blood does not. If a
person with Rh-negative blood receives a
transfusion of Rh-positive blood, he will develop
antibodies to the Rh antigen. If he receives any
subsequent transfusions of Rh-positive,
agglutination will occur.
Bravo!
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Diseases and Disorders of the Blood System
Disease Description
Anemia The blood does not have enough RBCs or hemoglobin to carry an adequate amount of oxygen to the bodys cells
Leukemia Bone marrow produces a large number of abnormal WBCs
Sickle cell anemia Abnormal hemoglobin causes RBCs to change to a sickle shape abnormal cells stick in capillaries
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Diseases and Disorders of the Blood System
(cont.)
Disease Description
Polycythemia vera Disease of the bone marrow that results in an abnormally high number of blood cells, especially RBCs, causing the blood to thicken
Thalassemia Inherited form of anemia defective hemoglobin chain causes, small, pale, and short-lived RBCs
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Apply Your Knowledge
The doctor has told your patient she has anemia.
How would you explain this to her?
ANSWER Anemia is a condition in which a person
does not have enough red blood cells or
hemoglobin in the blood to carry an adequate
amount of oxygen to body cells.
Way to go!
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In Summary

• 27.1. The formed elements in blood include red
  blood cells that are responsible for oxygen and
  carbon dioxide transport white blood cells that
  are responsible for working with the immune
  system by fighting infection and platelets,
  which assist in blood clotting.
• The liquid component of blood is called plasma
  and when all clotting factors and formed
  elements are spun out of plasma, the remaining
  liquid is called serum.

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In Summary (cont.)

• 27.2 Hemostasis refers to the control of
  bleeding. Three basic processes occur during
  hemostasis
• 1. blood vessel spasm
• 2. platelet plug formation and
• 3. blood coagulation.
• Clot formation is coagulation. It involves
  fibrinogen converting to fibrin, which sticks
  to the damaged area of the blood vessel,
  creating a meshwork that entraps blood cells and
  platelets

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In Summary (cont.)

• 27.3 The four blood types are A, B, AB and O.
• The antibodies attached to each type (except
  AB, which has no antibodies) require that each
  blood type receive only its specific antigen
  type during transfusions.
• So, A receives A or O B receives B or O AB as
  the universal receiver can receive any blood
  type and O, although the universal donor, may
  receive only type O blood.

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In Summary (cont.)

• 27.4 Rh factor is an antigen that may be
  attached to any blood type.
• Its importance arises during transfusions
  (Rh- negative blood cannot receive Rh-positive
  blood) and also during pregnancy if the mother
  is Rh- negative but the fetus received the
  Rh-positive antigen from the father.
• The effect on the first fetus will be little,
  but unless treated, any subsequent Rh-positive
  fetus will suffer effects of erythroblastosis
  fetalis, as the mothers blood developed
  antibodies against the Rh-positive factor during
  the initial pregnancy.

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In Summary (cont.)

• 27.5 There are many different types of blood
  diseases described within this chapter.
• The signs, symptoms, and treatments are as
  varied as the diseases themselves.
• The Common Diseases and Disorders for the Blood
  System section of this chapter outlines the most
  common of these diseases, their signs and
  symptoms, as well as their treatments.

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End of Chapter 27

• The bond that links your true family is not one
  of blood, but of respect and joy in each others
  life.
• Richard Bach