PUM

CD

ept.

of A

nat.

His

t. &

Em

bry.

BLOOD

陈咏梅

YONG-MEI CHEN

Dept. of Anatomy, Histology & Embryology

Peking Union Medical College

PUM

CD

ept.

of A

nat.

His

t. &

Em

bry.

Composition & functions of plasma

Structure & functions of erythrocytes

Classification, structure & functions

of leukocytes

Structure & functions of platelets

Hemopoiesis

Content

PUM

CD

ept.

of A

nat.

His

t. &

Em

bry.

Blood smear

Wright & Giemsa stain (azures)

PUM

CD

ept.

of A

nat.

His

t. &

Em

bry.

Hemogram

Plasma~ 55%

Platelets(100-300)×109 /L

MonocytesAgranular ~ ~ 45%

Lymphocytes6-10×109 /LelementBasophilsLeukocytesFormed

Granular ~ EosinophilsNeutrophils

female: 3.9-5.5×1012 /LErythrocytes

male: 4.1-6 ×1012 /L

Blood

Hematocrit: 40-50% in men & 35-45% in women

PUM

CD

ept.

of A

nat.

His

t. &

Em

bry.

I. Plasma: yellowish & translucent1. Compositions:

PUM

CD

ept.

of A

nat.

His

t. &

Em

bry.

Plasma proteins: • albumin, α,β,γ-globulin • clotting protein (prothrombin, fibrinogen, etc.) • complement protein (C1-C9) • lipoproteins (chylomicrons, VLDL, LDL, HDL)2. Functions:

Transportation, regulation & defense3. Serum:

PUM

CD

ept.

of A

nat.

His

t. &

Em

bry.

II. Formed element:1. Erythrocytes (Red Blood Cell, RBC)(1) Structure:

1) biconcave disc2) d ≈ 7-8μm

sectioned slide“Histologic ruler”

PUM

CD

ept.

of A

nat.

His

t. &

Em

bry.

3) acidophilic

4) no nucleus

5) no organelles

6) rich in hemoglobin

7) deformable membrane

(1) Structure:

1) biconcave disc

2) d ≈ 7-8μm

PUM

CD

ept.

of A

nat.

His

t. &

Em

bry.

Hemoglobin (Hb):globin + iron-containing heme

HbA & HbF

PUM

CD

ept.

of A

nat.

His

t. &

Em

bry.

RBC membrane proteins:

a) Integral ~: Na+-K+ pump, Ca2+ pump, and glucose transport protein, band 3 protein, and glycophorins etc.

Blood groupABO group Rh group

hemolytictransfusion reaction

PUM

CD

ept.

of A

nat.

His

t. &

Em

bry.

b) Peripheral ~: spectrin, actin, and ankyrin etc. serving as a membrane skeleton.

RBC membrane proteins:

RBC membrane is flexible & deformable

PUM

CD

ept.

of A

nat.

His

t. &

Em

bry.

(2) Functions: O2 transport and CO2 transport

AlveoliCell in the tissue

PUM

CD

ept.

of A

nat.

His

t. &

Em

bry.

(3) Normal value of erythrocytes

female: 3.9-5.5×1012 /LErythrocytes

male: 4.1-6 ×1012 /L

Hemoglobinfemale: 105-135 g/L

male: 120-150 g/L

PUM

CD

ept.

of A

nat.

His

t. &

Em

bry.

(4) Change of RBC1) Physical adaptation:2) Pathological changes:D > 9μm: macrocytes; D < 6μm: microcytes

Anisocytosis

PUM

CD

ept.

of A

nat.

His

t. &

Em

bry.

eg: Iron-deficiency ~, Sickle cell ~, Mediterranean ~ etc.

Anemia: RBC < 3 × 1012 /L, Hb < 100g/L

PUM

CD

ept.

of A

nat.

His

t. &

Em

bry.

(5) Osmotic equilibrium between RBC and plasma

blood shadow or blood ghost

PUM

CD

ept.

of A

nat.

His

t. &

Em

bry.

(6) Reticulocyte: 0.5~1.5% of RBCanucleate, contain some organelles, e.g.: rRNAdemonstrated by brilliant cresyl blue methods

（煌焦油蓝）

PUM

CD

ept.

of A

nat.

His

t. &

Em

bry.

(7) Life span: about 120days

PUM

CD

ept.

of A

nat.

His

t. &

Em

bry.

Inactive WBC

diapedetis

Active WBC

Blood

2. Leukocytes (White Blood Cell, WBC)

PUM

CD

ept.

of A

nat.

His

t. &

Em

bry.

Monocytes 3-8% Agranular ~

Lymphocytes 20-30%6-10×109 /LBasophils < 1% Leukocytes

Granular ~ Eosinophils 0.5-3%Neutrophils 50-70% (1) Introduction:

1) Granular leukocytesa. Azurophilic granules: staining purple, lysosomesb. Specific granules:

PUM

CD

ept.

of A

nat.

His

t. &

Em

bry.

Monocytes 3-8% Agranular ~

Lymphocytes 20-30%6-10×109 /LBasophils < 1% Leukocytes

Granular ~ Eosinophils 0.5-3%Neutrophils 50-70% (1) Introduction:

2) Agranular leukocytesa. Azurophilic granules

3) Life span: variable

PUM

CD

ept.

of A

nat.

His

t. &

Em

bry.

(2) Classification:1) Neutrophils: 12-15μma. Structure:

Nucleus: band-form or multilobed, 2-5 lobes

Specific granules: neutrophilic ~: small, barely visible in LM, containing alkaline phosphatase, collagenaseand lysozyme etc.

PUM

CD

ept.

of A

nat.

His

t. &

Em

bry.

b. Functions:Chemotaxis:Phagocytosis and destruction of microorganisms, especially bacteria.

• Pus & pyocyte

PUM

CD

ept.

of A

nat.

His

t. &

Em

bry.

2) Eosinophils: 12-15μma. Structure:

Nucleus: bilobed

Specific granules:

containing major basic protein, histaminase, myeloperoxidase, etc.

Eosinophilic ~: staining orange-pink, large, elongated, crystalline core, refractile, and

PUM

CD

ept.

of A

nat.

His

t. &

Em

bry.

b. Functions:Chemotaxis:Phagocytosis of Ag-Ab-complexes and destruction of parasites.

PUM

CD

ept.

of A

nat.

His

t. &

Em

bry.

3) Basophils: 12-15μma. Structure:

Nucleus: lobed, S-shaped, or irregular, often masked by the overlying specific granules

PUM

CD

ept.

of A

nat.

His

t. &

Em

bry.

b. Functions: mediatingthe allergic reactions.

eosinophil chemotacticfactor of anaphylaxis (ECF-A). Leukotriene

Specific granules: Basophilic ~: metachromasia, staining blue purple and containing heparin, histamin,

PUM

CD

ept.

of A

nat.

His

t. &

Em

bry.

4) Lymphocytes:a. Structure:

Small lymphocytes: 6-8μm, nucleus: cytoplasm≈9:1Deeply-stained spherical nucleus, sometimes with an indentation, located eccentrically; cytoplasm is basophilic, sky-blue, contains fine azurophilic granules.

PUM

CD

ept.

of A

nat.

His

t. &

Em

bry.

Medium-sized lymphocytes: 9-12μmLarge lymphocytes: 13-18μm

b. Classification and functions: • B-Lymphocytes: 20-30%, responsible for humoral immunity• T-Lymphocytes: 70-80%, responsible for cell-mediated

immunity• Natural killer cells:

PUM

CD

ept.

of A

nat.

His

t. &

Em

bry.

5) Monocytes: 12-20μma. Structure: oval, kidney- or horseshoe-shaped nucleus,

eccentric position; cytoplasm is basophilic, bluish-gray, and contains fine azurophilic granules.

b. Functions:

Precursor cells of the mononuclear phagocyte system

PUM

CD

ept.

of A

nat.

His

t. &

Em

bry.

3. Platelets: (Thrombocytes) 2-4μm

(1) Structure: often in clumps1) anucleate, biconvex round or ovoid discs.

PUM

CD

ept.

of A

nat.

His

t. &

Em

bry.

2) Hyalomere: peripheral clear zone

• dense tubular system

• open canalicular system

• microtubules

3) Granulomere: central darker zone

• α, λ, δ granules

PUM

CD

ept.

of A

nat.

His

t. &

Em

bry.

(2) Functions: promote blood clotting & controlling hemorrhage

thrombocytopenic purpura

(3) Life span: ~ 10 days.

PUM

CD

ept.

of A

nat.

His

t. &

Em

bry.

Hemopoiesis (Blood Cell Formation)I. Hemopoietic Organ:1. Mesoblastic phase: york sac2. Hepatic phase:3. Splenic phase:4. Myeloid phase:

bone marrow

PUM

CD

ept.

of A

nat.

His

t. &

Em

bry.

Red Bone Marrow Yellow Bone Marrow

RBM YBM

PUM

CD

ept.

of A

nat.

His

t. &

Em

bry.

Structure of Red Bone Marrow:(1) Stroma: reticular tissue(2) Hemopoietic cord: hemopoietic cells & macrophages(3) Sinusoids:

PUM

CD

ept.

of A

nat.

His

t. &

Em

bry.

pluripotential hemopoietic stem cells

progenitor cells (committed stem cells)

precursor cells (blasts)

colony-forming cells (CFC) or

colony-forming units (CFU).

colony-stimulating factors (CSF), growth factors or hematopoietins, e.g.: Erythropoietin (EPO), G-CSF, GM-CSF etc

PUM

CD

ept.

of A

nat.

His

t. &

Em

bry.

Monoblast

Myeloblast

PUM

CD

ept.

of A

nat.

His

t. &

Em

bry.

PUM

CD

ept.

of A

nat.

His

t. &

Em

bry.

(1) Cell volume: ↓(2) Cytoplasm:

basophilic → acidophilic(3) Nucleus: ↓ disappear

nucleoli: disappearchromatin condensation

• Major morphological changes:

II. Erythropoiesis ~7d

PUM

CD

ept.

of A

nat.

His

t. &

Em

bry.

III. Granulopoiesis ~11d Granules

PUM

CD

ept.

of A

nat.

His

t. &

Em

bry.

IV. Thrombopoiesis

Megakaryoblast →Promegakaryocyte → Megakaryocyte→ Platelet