chapter 19
DESCRIPTION
Chapter 19. Blood. Blood Overview. spin blood separate into 2 parts (3). liquid cells (formed elements). WBC’s. RBC’s. Blood. chapter outline:. Overview Plasma Formed elements RBC’s WBC’s platlets (fragments) hemostasis. Blood Overview. fluid CT - PowerPoint PPT PresentationTRANSCRIPT
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Chapter 19
Blood
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Blood Overview
WBC’s
RBC’s
liquid
cells(formed
elements)
spin blood
separate into 2 parts (3)
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Blood
OverviewPlasmaFormed elements
RBC’sWBC’splatlets (fragments)
hemostasis
chapter outline:
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Blood Overview
fluid CTpart of the cardiovascular system
(heart, vessels)
provide nutrients, O2, chemical messagesremoves wastesprovide protection
to/from/for all the cells of the body
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Blood Overview
•transport:dissolved gasesnutrientshormoneswastes
•regulate:ionic composition and pH of body fluids
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Blood Overview
•restrict fluid lose at injury
•stabilize body temperature
•defend against toxins and pathogens
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Blood Overview
•restrict fluid lose at injury
•stabilize body temperature
•defend against toxins and pathogens
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Blood Overview
plasma
~55% of blood
H2O 92%plasma proteins 7%ionsnutirentswasteshormones
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Blood Overview
formed elements
produced through hemopoiesis
99.9% RBC’s0.1 % WBC’s and platlets
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Blood Overview
whole blood
•38˚ C•5x more viscous than H2O
(sticky, thick)
•slightly alkalaipH 7.35 - 7.45
5-6 L in average adult male (165)4-5 L in average adult female (125)
(7% of body weight)
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Clinical Note
blood donations
median cubital veinvenipuncture
easy to findthin walls than arterieslower bp than arteries
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Clinical Note
capillary blood
finger tipearlobetoe / heel (infant)
small quantity (drops)
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Clinical Note
arterial blood
radial or brachial artery
check blood gases
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Stop here 3/21Lec #29
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Blood plasma
body fluids
ICFECF
interstitial fluidblood plasma
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Blood plasma
similar in composition to interstitial fluid (ECF) (different than ICF)
but different than ECF in:
dissolved gases (O2, CO2)(always being used by
cells)
dissolved proteins(don’t cross capillary
walls)
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Blood plasma
7.6 g% (5x ICF)7.6 grams / 100 ml plasma
large size and globular shapeprevents them from leaving vessels
three classes of proteins:albuminsglobulinsfibrinogen
proteins:
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Blood plasma
proteins:
albumins
60% of plasma proteinsmade in livertransport:
fatty acidshormonesother stuff
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Blood plasma
proteins:
globulins35% of plasma proteinstwo typesimmunoglobulins
transport globulinsaka., antibodies (Ab)
hormone-binding (thyroid H)
metalloaproteins (iron)
apolipoproteins (lipids)
steroid-binding (testosterone)
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Blood plasma
proteins:
fibrinogen4% of plasma proteinsblood clotting
converted to fibrin (strings)(framework for clot)
plasma without clotting stuff= serum
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Blood plasma
proteins:
other plasma proteinsvarious
hormones
origins of proteinsliver makes 90%
plasma cells make antibodies (Ab)
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100 keys pg. 643
“Your total blood volume, in liters, is roughly equal to 7% of your body weight (in kilograms). Approximately half the volume of whole blood consists of cells and cell products. Plasma resembles interstitial fluid, but it contains a unique mixture of proteins not found in other extracellular fluids.”
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Clinical Note
Plasma expanders
used to increase blood volume
(buy time to determine blood type)
isotonic (normal) saline solutionsshort-lived diffuse into interstitial fluid and
cells
Ringer’s solution has lactate (slows diffusion)
Dextran in saline
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Clinical Note
Plasma expanders
temporarily replace blood volume
don’t help increase O2 carried
need to give or make new RBC’s
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Formed elements
RBC’saka., red blood cells
erythocytes
contain pigment molecule hemoglobin
Hb + O2 HbO2
(dark) (bright red)
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RBC’s
Quantity
# RBC’s in one µl (microliter)(1 mm3)
about 5,000,000 cells / µlx 5 L of blood
25,000,000,000 RBC’s in adult
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RBC’s
Quantity
percentage of whole blood occupied by RBC’s
hematocrit
average is about 45 males42 females
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RBC’s
Quantity
What factors may affect the hematocrit ?
increase
decrease
dehydrationEPO stimulation
bleedingproblems with RBC production
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RBC’s
Structure
unusual cellslack most organelles
(nucleus, mitochondria, etc)except cytoskeleton
biconcave discs
fig. 19-2c
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fig. 19-2d
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RBC’s
Structure
shape
large surface area to volume ratio
absorption and release of O2
form stacks to go through vessels
can bend and flex to get through narrow capillaries
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RBC’s
Structure
lack of organelles
cannot dividecannot synthesize proteinscannot repair itself
short life-span (120 days)replace ~1% each day
low energy demands
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RBC’s
Structure
What do they have inside ?
95% of proteins inside the cell is
hemoglobin (Hb)14 g%
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RBC’s
Structure of Hemoglobin
complex structure4 polypeptide chains
2 alpha () chains2 beta () chains
(amino acids)
each chain has a hemepigment moleucleFe2+
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fig. 19-3
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RBC’s
Structure of Hemoglobin
280 million Hb molecules/RBC
one RBC can carry over a billion O2
O2 bound depends on [O2]if [CO2] is high
bind to Hbcarbaminohemoglobin
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RBC’s
Structure of Hemoglobin
low hematocritlow Hb
reduced O2-carrying capacity
= anemia many forms
reduced flow of O2 to tissues
weakness, lethargy, confusion
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RBC’s
Formation / Turnover
exposed to severe mechanical stresscannot repair themselves
macrophagesengulf old/damaged cellsengulf cell parts after hemolysis
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RBC’s
Formation / Turnover
hemolysis
releases Hb from cells
if phagocytosed - recycledif not, eliminated by kidney
hemoglobinuria
red or brown urinelots of Hb in urine
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RBC’s
Formation / Turnover
hemolysis
hemoglobinuria
hematuria
intact RBC’s in urinemeans kidney damage or
blood vessel damage
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RBC’s
Formation / Turnover
recycling (by macrophages)
globin proteinsamino acids
reused
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RBC’s
Formation / Turnover
recycling (by macrophages)
heme (without Fe2+)
bilverdin (greenish) (bruise)
bilirubin (yellowish)(jaundice)
excretion (urine, feces)
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RBC’s
Formation / Turnover
recycling
Fe2+ (if free, is toxic to cells)
transported to bone marrowby transferrin
used to make new RBC’sneed 26 mg/day
1-2 mg is usually enoughmost is recycled
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RBC’s
Formation / Turnover
recycling
too little Fe2+
reduction of RBC production
dietary deficiencyiron absorption
iron-deficiency anemia
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RBC’s
Formation / Turnover
recycling
too much Fe2+
excessive buildup in heartlinked to heart disease
excessive buildup in liver
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fig. 19-4
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to here 3/23lec # 30
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100 Keys (pg. 649)
“Red blood cells (RBC’s) are the most numerous cells in the body. They remain in circulation for approximately 4 months before being recycled; several million are produced each second. The hemoglobin inside RBCs transports oxygen from the lungs to the peripheral tissues; it also carries carbon dioxide from the tissues to the lungs.”
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RBC’s
Production
embryo yolk sacfetus liver, spleenadults red bone marrow
(aka., myeloid tissue)
erythropoiesis
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RBC’s
Production
hemocytoblast myeloid stem cell proerythroblasts - - - normoblasts (sheds nucleus)
reticulocyte (enter blood)
mature RBC
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RBC’s
Production
fig. 19-5
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RBC’s
Regulation of Production
requirements:
amino acidsironvitamins
B6
folic acidB12 meat/dairy products
absorption requiresintrinsic factor
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RBC’s
Regulation of Production
requirements:
B12
if not enough eatenor absorbed
pernicious anemia
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RBC’s
Regulation of Production
stimulated by EPOerytropoietinerythropoiesis stimulating
hor.
made by peripheral tissues especially kidney when exposed to low oxygen levels
hypoxia
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RBC’s
Regulation of Production
what might trigger kidneyto release EPO?
anemiareduced blood flow to kidneylow O2 in lungs
(disease or high altitude)lung damage
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RBC’s
Regulation of Production
effects of EPO
stimulates cell division inerythroblasts and stem
cells
stimulates Hb synthesis and maturation of RBC’s
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RBC’s
Regulation of Production
effects of EPO
RBC production canincrease from
3,000,000 cells/second to
30,000,000 cells/second
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RBC’s
Regulation of Production
effects of EPO
important following blood loss
given to healthy person(Olympic endurance athletes)blood can carry more O2
but, hematocrit rises (65+)blood get thickerstrain on heart
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RBC’s
Regulation of Production
effects of EPO
same applies to blood doping
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RBC’s
Blood testing
table 19-1
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table 19-1
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100 Keys (pg. 649)
“Red blood cells (RBC’s) are the most numerous cells in the body. They remain in circulation for approximately 4 months before being recycled; several million are produced each second. The hemoglobin inside RBCs transports oxygen from the lungs to the peripheral tissues; it also carries carbon dioxide from the tissues to the lungs.”
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Blood typing
antigens“foreign” moleculescan trigger immune response
cells (including RBC’s) haveproteins on their surface
your immune system “ignores” the molecules on the surface of your cells because they are “self”
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Blood typing
your body makes antibodies (Ab)(aka., immunoglobulins)
to attack and destroy antigens
There are three (of 50) important “antigens” used for blood typing
ABRh
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Blood typing
if your cells normally have A on surface
(A is “self”)
your immune system will ignore it, but has antibodies to attack B
(anti-B antibodies)
You have type A blood
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Blood typing
if your cells normally have B on surface
(B is “self”)
your immune system will ignore it, but has antibodies to attack A
(anti-A antibodies)
You have type B blood
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Blood typing
if your cells have A & B on surface(both are “self”)
your immune system will ignore them
You have type AB blood
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Blood typing
if your cells have neither on surface(neither are “self”)(both are foreign)
your immune system has antibodies to attack both
You have type O blood
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fig. 19-6
agglutination
hemolysis
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Genetics of blood groupings:
ABO system
three alleles
IA
IB
i
IA IA
IA iIB IB
IB iIA IB
i i
AABBABO
DOMINANTrecessive
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Other blood groupings:
ABO system
Rh system
C, D, E: close on same chromosome
Dominant/recessive
C, D, or E Rh positive
ccddee Rh negative
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Blood typing
if your cells have Rh factor on surface(Rh is “self”)
your immune system will ignore it
You have type Rh+ (positive) blood
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Blood typing
if your cells lack Rh factor on surface(Rh is “foreign”)
your immune system will make antibodies to attack it
You have type Rh- (negative) blood
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table 19-2
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Blood typing
cross reaction
Ab + RBC agglutinationand hemolysis
blood transfusiontest for
compatability
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Blood typing
standard test
determine donor’s and recipient’s blood type using ABO and Rh systems
mix drops of blood withanti-Aanti-Banti-Rh
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fig. 19-7
A+
B+
AB+
O-
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universaldonor
fig. 19-7
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Blood typing
standard test
just tested 3 of 50+ possible antigens
if time and facilities allow:cross-match testing
mix donor and recipient bloodand look for problems
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Blood typing
HDN
Hemolytic disease of the newborn
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Blood typing
HDN
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