chapter 11 blood - faribaultmail.faribault.k12.mn.us/~laura_childs/s01b3e075.13... · i. functions:...

Chapter 11 Blood

I. Functions:

A. Transport – material exchange

B. Regulatory –homeostasis

Temp, pH,

C. Prevention – defense, clotting

II. Characteristics:

A. Red body fluid (atrial redder than venous)

B. 100.4 F core temp

C. pH 7.35 – 7.45

D. 8% total body wt

E. Ave man: 5 – 6 L/woman 4-5 L

III. Plasma: liquid portion (55%)

A. Water 91%

B. Protein 7%

Albumin 58% - osmotic pressure

Globulins 38% - immunity

Fibrinogen 4% - clotting factor

Serum – plasma w/out clotting factor

C. Other 2% (ions, nutrients, waste, gases)

IV. Formed elements: cells/fragments (45%)

A. Hematopoiesis – blood cell production 1. Stem cells (hemocytoblast): produce all others

a) Fetus: organs, lymph & red bone marrow

b) Adult: red marrow (long bones)/lymph only

B. Erythrocytes – red blood cells (RBC’s) Biconcave disks (↑ SA=>gas exchange)

No nucleus/can’t reproduce

Life span: males-120 days/females-110 days

1. Function:

a) Hemoglobin: 33% of cell (99% O2 transport)

– 4 heme grps: pigment w/Fe-carries O2 (98.5%=>redder)

– 4 globins: protein-carries CO2 (23%/7% plasma)

b) 70% CO2 w/carbonic anhydrase to H++HCO3-

c) CO binds Fe 210x more than O2 (irreversible-flush)

2. Life History

a) Production: from proerythroblasts

1) ~ 5 mil/cubic mm (build ~ 2.5 mil/sec)

2) Need B12, Folate (DNA)/Fe in diet to make

3) Lo O2/hi alt/endurance exer: kidneys release erythropoietin = RBC production (marrow)

b) Breakdown of old/damaged RBC’s

1) Removed by spleen/liver WBC (macrophages)

2) Fe back to bone marrow/globin AA recycled

3) Liver-heme to bilirubin (yellow pigmt)/added to bile/SI; some reabsorbed urine

4) Circulates w/liver problems-jaundice

C. Leucocytes – white blood cells (WBC’s)

1. General Characteristics:

a) Nucleus w/no hemoglobin

b) 5 – 9 thousand/cubic mm

c) Protect from infection

d) Cytoplasmic granules - dig enzymes

e) Phagocytic: engulf dead cells/debris

f) Ameboid movement (to tissues)

2. Granulocytes: large granules (red marrow) a) Neutrophils (65%): phagocytic; w/bac infect.

b) Eosinophils (3%): inflam (brkdwn histamn);w/parasite

c) Basophils (1%): inflam (hist); clot (heparin)

3. Agranulocytes: small granules (marrw/lymph) a) Lymphocytes (25%): AB, virus, cancer/graft reax

b) Monocytes-bld/macrophages-tiss (5%): chronic infec

WHITE BLOOD CELLS

Granulocytes

D. Thrombocytes (platelets): cell fragments

1. prevent bld loss (plugs/internal clot-thrombus)

2. 250 – 400 thou/cubic mm

V. Preventing Blood Loss

A. Vessel constrictn (spasm): NS controls smooth musc

(platelet thromoxanes=same effect)

B. Platelet plug: platelets accumulate (sticky)

1. von Willebrand’s factor: bind platelets to BV wall collagen

2. Platelet Releasing Factor: thromboxane activates ↑ platelets

3. Fibrinogen: binds platelet together

4. Aspirin: inhibits thromboxane prod= ↓ platelet activation

C. Blood clotting (w/lg cut)=coagulation

1. thrombin converts fibrinogen to threadlike fibrin=

traps RBC/platelets

2. Vitamin K needed (diet/LI bacteria)

D. Clot Control: anticoagulants (heparin) present w/normal conditions (injury overwhelms)

E. Clot Retraction: plateletactin/myosin contract (squeeze out serum)=seals vessels (healing)

F. Fibrinolysis (clot dissolves): plasminogen to plasmin=breaks down clot over time

1. Streptokinase (genetically engineered bacterial enzyme): w/heart attack inject to activate plasmin

VI. Blood Grouping:

A. General Principals

1. Transfusion (tranfer of blood) Reax:

a) Caused by antigen (RBC surface) & antibodies (plasma)

b) Agglutination (Ab bind RBC’s Ag) and hemolysis (burst)

B. ABO Blood Group

1. Surface proteins: Antigens A or B (plasma Ab) a) Type O (00) (no Ag): 47% (A & B Ab)-universal donor

b) Type A (AA, A0): 41% (B Ab)

c) Type B: (BB, B0) 9% (A Ab)

d) Type AB: 3% (no A or B Ab)-universal receiver

C. Rh Blood Grouping (CO2 channel):

1. Incompatibility:Rh+ : have surface antigens/Rh- does not

Genotype

Which 2 alleles are

present in the cell?

What Rhesus antigen

is present on the

surface of the red

cell?

Phenotype

(Rh blood group)

DD D Rhesus positive

Dd D Rhesus positive

dd none Rhesus negative

Rh Positive Rh Negative

0+ 37% 0- 6%

A+ 34% A- 6%

B+ 10% B- 2%

AB+ 4% AB- 1%

85% positive 15% negative

Rh proteins act as gas channels that help speed the transfer of carbon dioxide (CO2) in and out of red blood cells.CO2 can also pass through the cell membrane unaided (above right), but not quickly enough, said UC Berkeley researchers. (Image by Barbara Alonso)

2. Hemolytic Disease of Newborn (HDN): Rh- mom w/Rh+ fetus; mom makes Rh Ab w/2nd preg->HND; give mom anti-Rh Ab’s (bind-inactivate fetal Rh Ag)

VII. Diagnostic Blood Tests:

A. Cross match (serum-ABO-Rh) w/transfsn

B. Complete bld count: 1. RBC’s=~5mil/mm3 (=erythrocytosis)

2. Hemoglobin=~14 g/100ml (=anemia)

3. Hematocrit=%RBC’s/bld vol~50% ( Fe=smaller RBC)

4. WBC=5-9000/mm3 (= leucopoenia w/viral infct, folate/

B12; =leukocytosis w/bac infct, cancer=leukemia)

5. Differentiated WBC: # & type (help diagnose)

6. Clotting

a) Platelet count=250-400,000/mm3 ( = thrombocytopenia)

b) Prothrombin time measurement=9-12 seconds

C. Blood Chemistry

1. Glucose: insulin from pancreas

2. Blood urea N (BUN): kidney function

3. Bilirubin: liver dysfunction

4. Cholesterol: cardiovascular disease

VIII. Diseases and Blood Disorders: p 308-9 A. Iron-deficient anemia: iron

B. Pernicious anemia: B12

C. Hemolytic anemia: RBC’s burst (Ebola, venom)

D. Sickle-cell anemia: abnormal hemoglobn (genetics)

E. Hemophilia: abnormal clotting (genetics)

F. Septicemia: blood poisoning

G. Infectious Mononucleosis: Epstein-Barr virus (lymphocytes)

H. Malaria: protozoan ruptures RBC

I. AIDS: virus destroys lymphocytes