Hematology

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Hematology

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Objectives

• Explain the structure of the blood.
• Analyze the function of the blood
• Discuss characteristics and treatments of common
  blood disorders

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Structure of Blood

• Average adult 8-10 pints of blood
• Composition
• PLASMA liquid portion of blood without cellular
  components
• SERUM plasma after a blood clot is formed
• CELLULAR COMPONENTS (elements are red cells,
  white cells and platelets)

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PLASMA

• Straw colored, contains
• Water
• Blood proteins
• Plasma proteins
• FIBRONOGEN necessary for blood clotting,
  synthesized in the liver
• ALBUMIN from the liver, helps maintain bloods
  osmotic pressure and volume
• PROTHROMBIN a globulin which helps blood
  coagulate. Vitamin K necessary for prothrombin
  synthesis.
• Nutrients
• Electrolytes
• Hormones, vitamins, enzymes
• Metabolic waster products

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ERYTHROCYTES
Shape biconcave disc donut-shaped
HEMOGLOBIN gives red color, heme is iron and
globin is protein. Function transports oxygen
to tissues and carbon dioxide away from
cells Normal men 14-18 gm, women 12-16 gm
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Function of Hemoglobin

• Red cells travel through the lungs where
• O2 is carried to tissues and released
• CO2 picked up and carried back to lungs for
  exchange
• Arterial blood lots of oxygen bright red
• Venous blood lots of CO2 dark crimson What is
  carbon monoxide poisoning?

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What is carbon monoxide
poisoning?
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• ERYTHROPOIESIS
• Manufacture of red blood cells
• Occurs in bone marrow
• Red cells live 120 days
• Old cells broken down by the spleen and liver
• HEMOLYSIS rupture or bursting of erythrocyte,
  can be from a blood transfusion or disease.

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LEUKOCYTES

• White Blood Cells LEUKOCYTES
• Larger than erythrocytes
• 5 types
• Normal leukocyte count 3,200 9,800

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• Types of White Cells
• Neutrophils
• Eosinophils
• Basophils
• Lymphocytes
• Monocytes

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• PHAGOCYTOSIS process when white cells surround,
  engulf, and digest harmful bacteria

Basophils produce HEPARIN an
anticoagulant DIAPEDESIS when white cells move
through capillary wall into neighboring tissue.
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INFLAMMATION

• Bodys reaction to chemical or physical trauma
• PATHOGENIC disease producing microorganisms can
  cause inflammation
• Symptoms redness, local heat, swelling and pain
• Why? Bacterial toxins, increased blood flow,
  collection of plasma in tissues (edema)
• HISTAMINE increases the blood flow to the injured
  area
• PUS produced a combination of dead tissue, dead
  and living bacteria, dead leukocytes and plasma
• ABSCESS pus-filled cavity below the epidermis
• PYREXIA increase in body temperature by the
  hypothalamus in response to pathogenic invasion

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LEUKOCYTOSIS increase in the number of white
cells in response to infection LEUKOPENIA
decrease in number of white cells due to
chemotherapy or radiation
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THROMBOCYTES (Platelets)

• Smallest of solid components of blood
• Synthesized in red marrow
• Not cells fragments of megakaryocytes
• Necessary for the initiation of the blood
  clotting process COAGULATION

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COAGULATION

• Cut or injury ? platelets and injured tissue
  release THROMBOPLASTIN ? act on PROTHROMBIN in
  plasma ? Calcium ions converts to THROMBIN ?
  the thrombin acts as an enzyme and changes
  FIBRINOGEN ? FIBRIN creating a mesh that traps
  red blood cells, platelets and plasma creating a
  blood clot.
• ANTICOAGULANTS prevent blood clotting
• HEPARIN antiprothrombin
• PROTHROMBIN dependent on Vitamin K

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Function of the Blood

• Four main functions
• 1.Transport oxygen, nutrients, cellular waste
  products and hormones
• 2. Aids in distribution of heat
• 3. Regulates acid-base balance
• 4. Helps protect against infection

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BLOOD TYPES

• Four major types of blood- A, B, AB and O
• Inherited from parents
• Determined by presence or absence of an ANTIGEN
  on the surface of the red blood cell

A
O
AB
AB
B
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• ANTIBODY a protein in the plasma that will
  inactivate a foreign substance that enters the
  body.
• Someone with type A blood has b antibodies
• Someone with type B blood has a antibodies
• Someone with type AB blood has no antibodies
• Someone with type O blood has a and b antibodies

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• UNIVERSAL DONOR O
• UNIVERSAL RECIPIENT AB
• Red cells also may contain Rh factor
• If you have it, youre Rh
• If you dont, youre Rh

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DISORDERS OF THE BLOOD

• ANEMIA
• IRON-DEFICIENCY ANEMIA
• APLASTIC ANEMIA
• SICKLE CELL ANEMIA
• POLYCYTHEMIA
• EMBOLISM
• THROMBOSIS
• HEMATOMA

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DISORDERS OF THE BLOOD

• HEMOPHILIA
• THROMBOCYTOPENIA
• LEUKEMIA

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IRON-DEFICIENCY ANEMIA

• Usually in women, children and adolescents
• Deficiency of iron in the diet causing
  insufficient hemoglobin synthesis
• Treat with iron supplements and green, leafy
  vegetables

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APLASTIC ANEMIA

• Bone marrow does not produce enough red and white
  blood cells
• Caused by drugs or radiation therapy

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SICKLE CELL ANEMIA

• Chronic blood disease inherited from both parents
• Causes the red cells to form in abnormal sickle
  shape
• Sickle cells break easily and carry less oxygen
• Occurs primarily in blacks
• Treatment blood transfusions

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POLYCYTHEMIA

• Too many red blood cells are formed
• May be a temporary condition that occurs at high
  altitude

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EMBOLISM

• Air, blood clot, cancer cells, fat, etc. that is
  carried by the bloodstream until it reaches an
  artery too small for passage
• Also known as a moving blood clot

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THROMBOSIS

• The formation of a blood clot in a blood vessel
• The blood clot is a THROMBUS

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HEMATOMA

• Localized clotted mass of blood found in an
  organ, tissue or space.
• Caused by an injury that can cause a blood vessel
  to rupture

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HEMOPHILIA

• Hereditary
• Missing clotting factor
• Blood clots slow or abnormally
• Sex-linked transmitted genetically from mothers
  to sons
• Treatment with missing clotting factor, avoid
  trauma

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THROMBOCYTOPENIA

• Not enough platelets
• Blood will not clot properly

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LEUKEMIA

• Malignant condition
• Overproduction of immature white blood cells
• Hinders synthesis of red cells
• Treatment Research on cord blood