chapter 10 blood power point

Chapter 10: BloodChapter 10:
Chapter Objectives
Name the three types of plasma proteins and roles of each.
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List three physical characteristics of red blood cells and explain the functional implications of each characteristic.
Describe the structure and function of hemoglobin.
Describe the life cycle of a red blood cell.
Discuss the diagnosis and possible causes of anemia.
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Chapter Objectives (cont’d)
Use flowcharts to illustrate the tissue factor pathway, contact activation pathway, and common pathway of blood clotting, and explain how two different anticoagulants work.
List three differences between coagulation and thrombosis.
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Determine which blood group can be transfused into patients with A, B, O, or AB blood, and explain why aggultination reactions occur.
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Overview of Blood (to know for test)
Blood is classified as connective tissue, but it has properties that make it different from other tissues.
Blood cells are in continuous motion.
Life span is a few hours to a few months
Blood is red if well oxgenated and reddish-blue when it needs reoxygenated,
Blood is thicker than water
Back to chapter objectives
Overview of Blood (cont’d) (to know)
Properties of blood
Accounts for about 7% of body weight
Blood has five main functions
Transport
Overview of Blood (cont’d) ( to know )
Blood is Composed of Plasma and Cellular Elements
Whole blood is the extracellular matrix called plasma and the solid cellular elements
What you see in a centrifuge (from top to bottom):
Plasma – the liquid part of blood that accounts for 55% of blood volume.
Buffy coat – contains white blood cells and platelets
Red blood cells – about 45% of blood volume, referred to as the hematocrit
Overview of Blood (cont’d) (to know )
Plasma Contains Water and Solutes
Plasma is about 90% water and 9% specialized proteins.
Three types of plasma proteins
Albumin – about 55% of all plasma proteins; holds water in the blood and draws water across the blood vessel wall from tissues into the bloodstream; also acts as a binding protein.
Fibrinogen – about 5%; involved in blood clotting
Globulins – specialized binding (transport proteins), enzymes, protein hormones, and clotting factors
Transfering (to look in book)
Gama Globulins (look in the book)
Overview of Blood (cont’d) (to know for test)
Plasma Solutes
Calcium, iron, sodium, potassium, and other minerals
Metabolic wastes
Overview of Blood (cont’d)
Blood Components
Overview of Blood (cont’d) (to know)
Cellular Elements are Produced in the Bone Marrow
Generation of blood cells is called hematopoiesis
All blood cells arise from pluripotent hematopoietic stem cell; gives rise to two other specialized stem cells
Lymphoid stem cells
Myeloid stem cells
About 25% of bone marrow is composed of developing red cells; the remaining 75% consists of developing white cells.
Overview of Blood (cont’d)
Hematopoiesis
Overview of Blood (Review)
True or false: Blood, like cartilage, is classified as connective tissue.
Overview of Blood (Review)
Leukocytes Inflammation and Immunity (to know)
Introduction
Leukocytes defend the body against infections, airborne particulate matter, and newly hatched tumor cells.
Also clean up dead cells, and debris, and assist with repair
Have amoeba-like movement that is called diapedsis
Only formed elements that are complete cells
Leukocytes, Inflammation, and Immunity (cont’d) (to know page 383)
Cellular Elements of Blood
Leukocytes, Inflammation, and Immunity (cont’d)
Leukocyte production (leukopoesis) depends on cell-to-cell signaling by cytokines
WBC-to-WBC cytokines are called interleukins.
Three types of leukocytes
Granulocytes
Have irregularly-shaped nucleus and abundant cytoplasm containing large cytoplasmic granules
Actively mobile cells that defend the body against bacteria and other threats.
Further classified according to color of cytoplasmic granules
Neutrophils – phagocytize and digest bacteria
Eosinophils –release packets of enzymes that destroy parasites and neutralize offending agents in allergic reactions
Lymphocytes
Defend against external threats
Leukocytes, Inflammation, and Immunity (cont’d) (to know for test)
Leukocytes are Involved in Inflammation
Inflammation is the body’s collective cellular and vascular response to injury.
Acute inflammation
Result of short-term, intense injury; persists for hours or days.
Chronic inflammation
The result of longer-term, less intense injury; can persist for weeks or years
Intermediate inflammation
Leukocytes, Inflammation, and Immunity (cont’d) (to know for test)
Infection is a Risk with Low Numbers of Leukocytes
Low leukocyte count is called leukopenia
Neutropenia is a low neutrophil count
Example of disease marked by low lymphocyte count is AIDS.
Leukemia is malignant growth of any type of leukocyte, including lymphocytes, in which malignant leukocytes are present in the blood.
Lymphoma is malignant growth of lymphocytes when no malignant cells are detectable in the blood
Leukocytes, Inflammation, and Immunity (Review)
Rank the following leukocytes from the most abundant to the least abundant: basophils, eosinophils, lymphocytes, neutrophils, monocytes.
Leukocytes, Inflammation, and Immunity (Review)
Answer: neutrophils, lymphocytes, monocytes, eosinophils, basophils
Erythrocytes and Oxygen Transport (to know)
Introduction
Erythrocytes are workhorse transportation cells – their major task is to transport oxygen from the lungs to the tissues and carbon dioxide from the tissues to the lungs.
Most abundant cellular element in blood
A microliter of blood contains 5 million RBCs (called the RBC count)
Erythrocyte Form Contributes to Function
No nuclei
Flexible
Erythrocytes and Osygen Transport (cont’d)
Physical Characteristics of RBCs
Oxygen is Bound to Hemoglobin
Effectiveness of oxygen transport is directly proportional to the number of erythrocytes and the amount of hemoglobin they contain.
Hemoglobin is a large iron-containing molecule that binds oxygen and carbon dioxide and completely fills the RBC’s cytoplasm.
Each molecule of hemoglobin contains four folded chains of globin and four molecules of heme, each of which contains an iron ion.
To know type of hemoglobin page 388 last paragraph.
The Erythrocyte Life Cycle Spans 120 Days
RBC building blocks are absorbed from food.
Reticulocytes are released from bone marrow into the blood and mature into erythrocytes.
RBCs survive about 120 days in the bloodstream
Macrophages in spleen, liver, an bone marrow phagocytize old RBCs
Transferrin transports iron from heme to storage sites in the bone marrow. The rest is converted into bilirubin
The liver excretes bilirubin in bile, to be expelled in feces.
To know page 388 (The erythrocyte life cycle spans 120 days)
Erythrocytes and Oxygen Transport (cont’d)
Erythrocyte Life Cycle
Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins
McConnell and Hull: Human Form and Human Function
Erythrocytes and Oxygen Transport (cont’d) ( to know for test) page 389
Erythropoietin Stimulates Erythropoiesis
Erythropoietin (EPO) is a protein hormone produced by the kidneys.
EPO is not stored; its production is regulated in a classic negative feedback loop based on the availability of oxygen.
People who live at high altitude have higher RBC counts than those who live at lower altitudes.
Erythropoietin Stimulates Erythropoiesis
Erythrocytes and Oxygen Transport (cont’d) (to know for test)
Anemia is Too Little Hemoglobin in the Blood
Anemia is the manifestation of three basic conditions:
Too few erythrocytes in the blood
Size of the erythrocyte is too small
Concentration of hemoglobin in the erythrocyte is too low
Erythrocytes and Oxygen Transport (cont’d) (to know for test) page 390
Anemia is not a disease; it is a sign.
Hemolytic anemia – abnormally rapid destruction of RBCs
Examples: sickle cell anemia, malaria
Hemorrhagic anemia – bleeding
Example: undetected intestinal bleeding
Production failure anemia – impaired production of new RBCs or failure to produce enough hemoglobin in them
Example: iron deficiency anemia
Polycythemia is Too Many RBCs
Most common cause is dehydration; dehydration reduces plasma volume, resulting in a high hematocrit.
Some people who live at high altitudes have absolute polycythemia, which is a normal adaptation to their living conditions.
Polycythemia vera is an uncontrolled malignant proliferation of primitive erythrocyte precursor cells in the bone marrow.
Hematocrit Disorders
Erythrocytes and Oxygen Transport (Review)
What is the difference between a reticulocyte and an erythrocyte?
Erythrocytes and Oxygen Transport (Review)
Answer: Reticulocytes are immature erythrocytes that have some cytoplasmic RNA and ribosomes.
Platelets (to know 392)
Have no nuclei
A microliter of blood contains 200,000 – 500,000 platelets.
Production of platelets (thrombopoiesis) is governed by the hormone thrombopoietin (TPO), which is manufactured by the liver and kidneys.
Live for about a week
Abnormally low number of platelets is called thrombocytopenia
Platelets (cont’d)
Platelets (Review)
Name two cellular components of blood that do not have DNA.
Platelets (Review)
Hemostasis (to know, page 393)
Collective name for a group of activities that together prevent or stop bleeding
Sudden blood loss has two ill effects
Loss of RBCs results in reduced oxygen transport capacity
Loss of blood volume results in low blood flow to tissues.
Gradual blood loss is less dramatic because plasma can replace some lost blood volume in less than a day.
Hemostasis (cont’d) (to know)
Hemostasis has three components:
Vasoconstriction
When blood vessel is broken, damaged endothelial cells release chemical signals (paracrine factors).
Paracrine factors, along with reflex autonomic nerve signals stimulate smooth muscle contraction in the vessel wall.
Hemostasis (cont’d)
Formation of platelet plug
When blood vessel is broken, blood cells and plasma leave the vascular space and come into contact with collagen in connective tissue surrounding the blood vessel.
Platelets stick to the collagen and aggregate to form a platelet plug.
Platelets in the plug release signals that stimulate further blood vessel contraction, attract additional platelets, and accelerate coagulation.
Hemostasis (cont’d) (to know, page 395)
Coagulation
Coagulation is a chain of events that produces a clot.
A clot is a gel-like semi-solid web of fibrin filaments, platelets, and trapped blood cells.
Fibrin is a long filamentous protein created by polymerization of fibrinogen.
Steps of Hemostasis
Coagulation
Coagulation is the result of interactions among 50 blood coagulation factors, most of which circulate in plasma.
Most coagulation factors are proteins made by the liver.
Most coagulation factors interact in pathways
Tissue factor pathway
Contact activation pathway
Tissue factor pathway
Initiated when extravascular tissue or fluid are exposed to plasma.
Cell membrane of extravascular cells contains a protein called tissue factor, which initiates clotting when it comes into contact with plasma.
Tissue factor activates factor VII, which activates the common pathway
Contact activation pathway
Most often initiated by contact with foreign material
Initiated when plasma factor XII comes into contact with a foreign substance
Some chemical reactions require calcium, which also acts as a clotting factor (factor VII).
This pathway takes a few minutes to produce a clot.
Common pathway
Begins with activation of thrombokinase (factor X), an enzyme that converts prothrombin (factor II) into thrombin.
Thrombin acts on fibrinogen (factor I) to convert it into a weave of fibrin that forms the clot.
Clotting is a rapid homeostatic process that normally occurs outside the vascular space.
In some pathological circumstances, blood clots inside vessels even when no hemorrhage is occurring.
Hemostasis (cont’d) (to know, page 395)
Plasmin Dissolves Clots
As the body regenerates new tissue or scar tissue, the clot slowly dissolves.
Plasmin is a blood protein that digests the fibrin holding the clot together.
Thrombin promotes clot dissolution by stimulating plasmin production.
As clot contracts, a fluid called serum is expressed.
Hemostasis (cont’d) (page 397)
Anticoagulants Prevent Coagulation
Normally, circulating coagulants prevent clot formation.
When an injury occurs, natural anticoagulants are released at the site that restrict clotting to the locality of the injury and hemorrhage.
Some pharmaceutical anticoagulants are frequently administered as therapeutic drugs.
Warfarin (Coumadin™)
Hemostasis (cont’d) ( to know)
Coagulation and Thrombosis Differ
A thrombus is an abnormal, localized intravascular collection of platelets and blood cells, but it is not a clot.
A thrombus forms inside a blood vessel at a point where the vessel lining is injured; platelets begin to stick to the site, then WBCs start to stick, etc.
A thrombus has a visible internal architecture that is different from a blood clot.
Hemostasis (Review)
Hemostasis (Review)
Answer: calcium
Blood Groups and Transfusion (to know, page 400)
Transfusion traits are due to antigens and antibodies.
An antigen is a molecule capable of provoking a defensive reaction by the immune system.
An antibody is a specialized blood protein generated specifically to mount an attack against an antigen.
Persons possessing a certain RBC antigen are said to belong to a certain blood group (or blood type).
WBCs and platelets also have surface antigens, but they are of little importance in most blood transfusions.
Rh group
Named after its discovery in rhesus monkeys
Eight antigens; only antigen D is important
80% of Americans have Rh D on their RBCs and are said to be Rh-positive.
Those without the antigen are said to be Rh-negative
Blood Groups and Transfusion (cont’d)
Every person in early life develops antibodies against the A and B antigens not present in their own blood:
Plasma of type A blood contains anti-B antibodies
Plasma of type B blood contains anti-A antibodies
Plasma of type O blood contains both anti-A and anti-B antibodies
Plasma of type AB blood has neither anti-A nor anti-B antibodies
Agglutination Reveals Blood Types
In the presence of antigens they are designed to attack, antibodies attach to the antigens on the surface of RBCs and bind them together.
This is called agglutination.
This is very serious when it happens in a person’s bloodstream, but this is also how blood typing is performed on blood samples.
Common Blood Groups
Cross Matching
Blood Groups and Transfusion (Review)
If a person has anti-A antibodies and Rh antibodies, what is his or her blood group?
Blood Groups and Transfusion (Review)
Answer: B negative
Bone Marrow Failure: The Case of Eleanor B.
Eleanor died of bone marrow failure – breast cancer spread to her bones and replaced most of her bone marrow.
At the time of her death, every one of her major cell lines was affected.
Leukocytes – total white blood cell count was very low.
From the time of her initial emergency room visit until her death, she required treatment for pneumonia, skin infections, and recurrent diarrhea.
Bone Marrow Failure: The Case of Eleanor B. (cont’d)
Platelets – during initial hospitalization, she had a severe nosebleed and tiny skin hemorrhages (petechiae).
On final admission, thrombocytopenia and bleeding esophageal ulcer combined to produce an acute esophageal hemorrhage.
Erythrocytes – severely anemic on first hospitalization, reflecting the failure of marrow production even before the nosebleed occurred.
Bone Marrow Failure: The Case of Eleanor B. (cont’d)
Bone Marrow Failure: The Case of Eleanor B. (Review)
Eleanor is confused because her brain is not getting enough oxygen. In addition to her low blood pressure, can you think of a second reason?
Bone Marrow Failure: The Case of Eleanor B. (Review)
Answer: Because she is anemic, she lacks enough oxygen to supply her brain with sufficient oxygen to function normally.

chapter 10 blood power point

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