hematology 1 lecture

7/25/2019 Hematology 1 Lecture

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HEMATOLOGY 1 LECTURE

BLOOD

Has volume of______ , this is 7-8 of the total !o"# $ei%ht&

Has 'H of______ (al)ali*e+&

e.ifi. %/avit# is________

0t is .omose" of lasma (23-28 of the !loo" volume+, a*" se/um&

KEY TERMS

A*ti.oa%ula*t4 a* a%e*t that /eve*ts the .lotti*% of !loo"&

E5amles a/e E6TA, Cit/ate a*" Hea/i*

Cailla/#4 small !loo" vessel that .o**e.ts a/te/ioles a*" ve*ules

Hematoma4 a su!.uta*eous mass of !loo" at a ve*iu*.tu/e site

Hemo%lo!i*4 the o5#%e* .a//#i*% mole.ule of /e" !loo" .ells

Hemol#sis4 the !/ea)"o$* of /e" !loo" .ells, $ith the /elease of hemo%lo!i* i*to

the lasma o/ se/um& Ca**ot use hemol#e" samles i* la! tests&

0.te/i.4 9au*"i.e": "a/) #ello$ se/um o/ lasma

Liemi.4 havi*% a!*o/mall# hi%h level of fat& Mil)# loo)i*% samles

'lasma4 ale #ello$ a/t of $hole !loo": .o*tai*s all .lotti*% fa.to/s

e/um4 li;ui" o/tio* of !loo" $ithout the /otei* fi!/i*o%e*, $hi.h is o*e of the

.lotti*% fa.to/s

E/#th/o.#tosis4 i*./ease" i* the !loo" .ells .ou*t&

Reti.ulo.#te4 is a ve/# #ou*% e/#th/o.#te $hi.h .o*tai*s /em*a*t of R?Cs .ou*t&

Leu)o.#tosis4 i*./ease" >?Cs .ou*t&

'a*.#toe*ia 4 $he* all th/ee .ell t#es a/e "e./ease", $hi.h ma# lea" to

a*emia&


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'ol#.#themia4 $hi.h is a* i*./ease i* the H% .o*.e*t/atio* a!ove 17&2 %@"l i*

a"ult males a*" 12&2 %@"l i* a"ult females, $ith elevate" hemato./it a*" R?C

.ou*t&

FUNCTION OF BLOOD

T/a*so/ti*% flui"s su.h as4

?C a/e /eso*si!le fo/4


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_______________= to e*%ulf a*" a!so/! $aste mate/ial a*" ha/mful

mi./oo/%a*isms i* the !loo" st/eam a*" tissues

#*thesis of a*ti!o"# mole.ules

0*flammatio* /o.ess

T#es of Leu)o.#tes

____________


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BLOOD COLLECTION" #$NDLIN% $ND PRESER&$TION OF BLOOD FOR

#EM$TOLO%IC STUDY

Th/ee %e*e/al /o.e"u/es fo/ o!tai*i*% !loo" a/e (1+_________, (+_________, a*"

(3+___________& The te.h*i;ue use" to o!tai* the !loo" se.ime* is ./iti.al i* o/"e/ to

mai*tai* its i*te%/it#& Eve* so, a/te/ial a*" ve*ous !loo" "iffe/s i* imo/ta*t /ese.ts&

A/te/ial !loo" is esse*tiall# u*ifo/m i* .omositio* th/ou%hout the !o"#&

The .omositio* of ve*ous !loo" va/ies a*" is "ee*"e*t o* meta!oli. a.tivit# of

the e/fuse" o/%a* o/ tissue&

?loo" o!tai*e" !# s)i* u*.tu/e is a* a"mi5tu/e of !loo" f/om a/te/ioles,

ve*ules, a*" .ailla/ies& 0*./ease" /essu/e i* the a/te/ioles #iel"s a se.ime*

e*/i.he" i* a/te/ial !loo"& )i* u*.tu/e !loo" also .o*tai*s i*te/stitial a*"

i*t/a.ellula/ flui"s&

Ca'(llary !loo) collect(o*

/e;ue*tl# use" $he* o*l# small ;ua*tities of !loo" a/e /e;ui/e", e&%&, fo/ hemo%lo!i*

;ua*titatio*, fo/ >?C a*" R?C .ou*ts a*" fo/ !loo" smea/ /ea/atio*&

Sites of Puncture

A"ults a*" .hil"/e*4 alma/ su/fa.e of the ti of the /i*% o/ mi""le fi*%e/ o/ f/ee

ma/%i* of the ea/ lo!e& 0*fa*ts4 la*ta/ su/fa.e of the !i% toe o/ the heel&

Note4 E"ematous, .o*%este" a*" .#a*oti. sites shoul" *ot !e u*.tu/e"& Col" sites

shoul" *ot !e u*.tu/e" as samles .olle.te" f/om .ol" sites %ive falsel# hi%h /esults of

hemo%lo!i* a*" .ell .ou*ts& ite shoul" !e massa%e" u*til it is $a/m a*" i*)&

Advantages of Capillary Blood

0t is o!tai*e" $ith ease& 0t is the /efe//e" se.ime* fo/ ma)i*% e/ihe/al !loo" films si*.e *o

a*ti.oa%ula*t is a""e" that affe.t .ell mo/holo%#&

Disadvantages of Capillary Blood

O*l# small amou*ts of !loo" .a* !e o!tai*e" a*" /eeate" e5ami*atio*s /e;ui/e

a *e$ se.ime*& 'latelet .ou*t .a**ot !e e/fo/me" o* .ailla/# !loo" si*.e some latelets a/e

u*avoi"a!l# lost !# a"he/e*.e o*to the $ou*"& '/e.isio* is oo/e/ i* .ailla/# tha* ve*ous !loo" !e.ause of va/iatio* i* !loo"

flo$ a*" "ilutio* $ith i*te/stitial flui"& ?loo" i* mi./otu!es f/e;ue*tl# hemol#ses a*" hemol#sis i*te/fe/es $ith most

la!o/ato/# tests&

&e*ous Bloo) Collect(o*

A ve*ous !loo" samle is use" fo/ most tests that /e;ui/e a*ti.oa%ulatio* o/ la/%e/

;ua*tities of !loo", lasma o/ se/um&

Sites of Puncture

The vei*s that a/e %e*e/all# use" fo/ ve*iu*.tu/e a/e those i* the fo/ea/m, $/ist

o/ a*)le&


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The th/ee mai* vei*s i* the fo/ea/m a/e the .ehali., the me"ia* .ehali., a*"

the me"ia* !asili.& 0* i*fa*ts a*" .hil"/e*, ve*iu*.tu/e /ese*ts se.ial /o!lems !e.ause of the

small sie of the vei*s a*" "iffi.ult# .o*t/olli*% the atie*t& 'u*.tu/e of the

e5te/*al 9u%ula/ vei* i* the *e.) /e%io* a*" the femo/al vei* i* the i*%ui*al a/ea

is the /o.e"u/e of .hoi.e fo/ o!tai*i*% !loo"&

Advantages of Venous Blood

?# /ovi"i*% suffi.ie*t amou*t of !loo" it allo$s va/ious tests to !e /eeate" i*

.ase of a..i"e*t o/ !/ea)a%e o/ fo/ the all-imo/ta*t .he.)i*% of a "ou!tful /esult&

0t also f/e;ue*tl# allo$s the e/fo/ma*.e of a""itio*al tests that ma# !e

su%%este" !# the /esults of those al/ea"# o/"e/e" o/ that ma# o..u/ to the

.li*i.ia* as afte/thou%hts& Ali;uots of the se.ime* (lasma a*" se/um+ ma# !e f/oe* fo/ futu/e /efe/e*.e& 0t /e"u.es the ossi!ilit# of e//o/ /esulti*% f/om "ilutio* $ith i*te/stitial flui" o/

.o*st/i.tio* of s)i* vessels !# .ol" that ma# o..u/ i* ta)i*% !loo" !# s)i*u*.tu/e&

Disadvantages of Venous Blood

0t is a !it a le*%th# /o.e"u/e that /e;ui/es mo/e /ea/atio* tha* the .ailla/#

metho"& 0t is te.h*i.all# "iffi.ult i* .hil"/e*, o!ese i*"ivi"uals a*" i* atie*ts i* sho.)& Hemol#sis must !e /eve*te" !e.ause it lea"s to lo$e/e" /e" .ell .ou*ts a*"

i*te/fe/es $ith ma*# .hemi.al tests& Hematoma (o/ !loo" .lot fo/matio* i*si"e o/ outsi"e the vei*s+ must !e

/eve*te"&

$rter(al 'u*cture

A/te/ial !loo" is use" to measu/e o5#%e* a*" .a/!o* "io5i"e te*sio*, a*" to measu/e

H (a/te/ial !loo" %ases-A?G+& A/te/ial u*.tu/es a/e te.h*i.all# mo/e "iffi.ult to

e/fo/m tha* ve*ous u*.tu/es& 0*./ease" /essu/e i* the a/te/ies ma)es it mo/e

"iffi.ult# to sto !lee"i*% $ith the u*"esi/e" "evelome*t of a hematoma& A/te/ial

sele.tio* i*.lu"es /a"ial, !/a.hial, a*" femo/al a/te/ies i* o/"e/ of .hoi.e& ites *ot to

!e sele.te" a/e i//itate", e"ematous, *ea/ a $ou*", o/ i* a* a/ea of a* a/te/iove*ous

(AB+ shu*t o/ fistula&

Prevention of Hemolysis

Ma)e su/e the s#/i*%e, *ee"le a*" test tu!es a/e "/# a*" f/ee f/om "ete/%e*t as

t/a.es of $ate/ o/ "ete/%e*t .ause hemol#sis& Use smooth, %oo" ;ualit# sha/ *ee"les& Ge*tle*ess shoul" !e the $at.h $o/"& Avoi" /ou%h ha*"li*% of !loo" at a*#

sta%e& 6o *ot e9e.t the !loo" f/om the s#/i*%e th/ou%h the *ee"le as this ma#

.ause me.ha*i.al "est/u.tio* of the .ells& T/a*sfe/ the !loo" f/om the s#/i*%e !#

%e*tl# e9e.ti*% "o$* the si"e of the tu!e& Mi5 !loo" $ith a*ti.oa%ula*t !# %e*tlei*ve/sio* *ot !# sha)i*%&

Tou/*i;uet shoul" *ot !e too ti%ht a*" shoul" !e /elease" !efo/e !loo" is

asi/ate"& 0f e5ami*atio* is to !e "ela#e" !e#o*" 1-3 h/s, "o *ot allo$ the samle to sta*"

u*seale" o/ at /oom teme/atu/e& toe/ a*" sto/e i* a /ef/i%e/ato/ at DC& ?loo"

shoul" *ot !e sto/e" i* a f/eee/ !e.ause the /e" .ells $ill hemol#se o* tha$i*%&


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Ma)e su/e that all solutio*s $ith $hi.h !loo" is to !e mi5e" o/ "ilute" a/e

.o//e.tl# /ea/e" a*" a/e isoto*i.& H#oto*i. solutio*s $ill lea" to hemol#sis& >he* o!tai*i*% !loo" !# s)i* u*.tu/e ma)e su/e the s)i* is "/# !efo/e /i.)i*%

a*" to use sha/, -3mm la*.ets that /o"u.e .lea* u*.tu/e $ou*"s& The !loo"

shoul" !e allo$e" to es.ae f/eel#&

$NTICO$%UL$NTS

A*ti.oa%ula*ts a/e .hemi.al su!sta*.es that a/e a""e" to !loo" to /eve*t .oa%ulatio*&

0* othe/ $o/"s, .e/tai* stes a/e i*volve" i* !loo" .oa%ulatio*, !ut if o*e of the fa.to/s

is /emove" o/ i*a.tivate", the .oa%ulatio* /ea.tio* $ill *ot ta)e la.e& The su!sta*.es

/eso*si!le fo/ this /emoval o/ i*a.tivatio* a/e .alle" a*ti.oa%ula*ts&

Ethyle*e)(am(*e tetraacet(c ac()

Eth#le*e"iami*e tet/aa.eti. a.i" (E6TA+ has !e.ome the sta*"a/" hematolo%#

a*ti.oa%ula*t !e.ause of its ve/# effi.ie*t a*" .omlete a*ti.oa%ulatio* a*" its la.) of

effe.t o* the sie (mo/holo%#+ o/ *um!e/ of !loo" .ells i* the se.ime*& 0ts "iso"ium

o/ t/iotassium salt a/e use"&

The a*ti.oa%ula*t /e.omme*"e" !# the 0CH is the "iotassium salt& 0t is the /efe//e"

a*ti.oa%ula*t fo/ .ell .ou*ts a*" mo/holo%i.al stu"ies& 0t is ese.iall# the a*ti.oa%ula*t

of .hoi.e fo/ latelet .ou*ts a*" latelet fu*.tio* tests si*.e it /eve*ts latelet

a%%/e%atio*& 0t e5e/ts its effe.t__________________ io*i. .al.ium thus effe.tivel#

!lo.)i*% .oa%ulatio*&

Tr(so)(um C(trate

o"ium .it/ate .om!i*es $ith .al.ium, the/e!# /eve*ti*% the .o*ve/sio* of

/oth/om!i* to th/om!i*, a*" .oa%ulatio* "oes *ot o..u/& 1-1 mmol@l t/iso"ium

.it/ate (3%@l+ is the a*ti.oa%ula*t of .hoi.e i* .oa%ulatio* stu"ies&


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_________is a te/m "es./i!i*% the fo/matio* a*" "evelome*t of !loo" .ells&

0* huma*s, o..u/s i*_________ e5.lusivel#

All .ellula/ eleme*ts a/e "e/ive" f/om_________________ (''C+

''C /etai*s a!ilit# to !oth____________ a*"_____________

T#es of "iffe/e*tiatio* "ete/mi*e" !# the i*flue*.e of va/ious_________

(e/#th/ooieti*, th/om!ooieti* a*" .olo*# stimulati*% fa.to/s (Cs+&

___________ a/e /elease" i*to the e/ihe/al !loo"&

Sites of production:

etus4 - mo*ths (____________+&

-7 mo*ths ( ___________+& 2-F mo*ths (___________+&

i*fa*ts4 !o*e ma//o$

A"ults4 !o*e ma//o$, /i!s, ste/*um, s)ull, sa./um a*" elvis

Me)ullary #emato'o(es(s

E-trame)ullary hemato'oe(s(s

E5t/ame"ulla/# hematooiesis ma# o..u/ i* fetal hematooieti. tissue (live/ a*" slee*+

i* a"ult $he* the !o*e ma//o$ .a**ot meet the h#siolo%i. *ee"s of the tissues& This

.a* lea" to heatome%al# a*"@o/ sle*ome%al# (i*./ease i* sie of the live/ o/ slee*

!e.ause of i*./ease" fu*.tio*s i* the o/%a*s+&

Derivation of blood cells

- The .ommitte"__________$ill !e i*volve" i* l#mhooiesis to /o"u.e l#mho.#tes

- The .ommitte"___________ .a* "iffe/e*tiate i*to a*# of the othe/ hematooieti. .ells

i*.lu"i*% e/#th/o.#tes, *eut/ohils, eosi*ohils, !asohils, mo*o.#tes, ma./oha%es,

a*" latelets&

Erythrocytes (RBCs)


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he*eve/ the o5#%e* level $ithi* the .#tolasm of e/#th/ooieti*-/o"u.i*%

.ells falls !elo$ a ./iti.al level, e/#th/ooieti* is s#*thesie" i* the )i"*e# a*"

se./ete" i*to the !loo"st/eam&

O*.e s#*thesie" a*" /elease" f/om the .ell, e/#th/ooieti* t/avels i* the

!loo"st/eam to the !o*e ma//o$, $he/e it !i*"s to /e.eto/s o* e/#th/oi".ells, the/e!# i*itiati*% thei/ /olife/atio* a*" "iffe/e*tiatio*&

Erytrocyte Homeostasis

Classi. *e%ative fee"!a.) .o*t/ol

H#o5emia i* )i"*e#s lea"s to i*./ease" E'O /o"u.tio*

timulatio* of !o*e ma//o$

R?C .ou*t i* 3-D "a#s

timuli fo/ e/#th/ooiesis

Lo$ levels of O

0*./ease i* e5e/.ise

Hemo//ha%i*%

RBC Precursors

1& '/o*o/mo!last o/ '/oe/#th/o!last

o/ Ru!/i!last

'/o*o/mo!last is the ea/liest mo/holo%i.all# /e.o%*

ia!le /e" .ell /e.u/so/&


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S(.e: -2m i* "iamete/&

Nucleus: la/%e, /ou*" to oval a*" .o*tai*s - li%ht !luish, i*"isti*.t *u.leoli&

The .h/omati* fo/ms a "eli.ate *et$o/) %ivi*% the *u.leus a /eti.ula/aea/a*.e&

Cyto'lasm: the/e is a *a//o$ (a!out m+ /im of "a/) !lue .#tolasm& The/e

ma# !e a e/i*u.lea/ halo& The *u.lea/@.#tolasm /atio is a!out _______&

& ?asohili. (ea/l#+ *o/mo!last

S(.e: 1I-18m i* "iamete/& Nucleus: /ou*" o/ oval a*" smalle/ tha* i* the /evious sta%e& The .h/omati*

fo/ms "eli.ate .lums so that its atte/* aea/s to !e "e*se/ a*" .oa/se/ tha*that see* i* the /o*o/mo!last&


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2& Reti.ulo.#te

Afte/ the e5ulsio* of the *u.leus a la/%e some$hat !asohili. a*u.lea/ .ell /emai*s$hi.h $he* stai*e" $ith *e$ meth#le*e !lue, is see* to .o*tai* a *et$o/) of !luish%/a*ules& This *et$o/) is /eso*si!le fo/ the *ame of the .ell a*" .o*sists of/e.iitate" /i!osomes&

As the !o*e ma//o$ /eti.ulo.#te matu/es the *et$o/) !e.omes smalle/, fi*e/, thi**e/,a*" fi*all# $ithi* 3 "a#s "isaea/s&________ of /eti.ulo.#tes e*te/ the e/ihe/al

.i/.ulatio*& S(.e: 8-1m i* "iamete/

Nucleus: the /eti.ulo.#te "oes *ot .o*tai* a *u.leus&

Cyto'lasm: fai*tl# !asohili. (!lue+

I& Matu/e Re" ?loo" Cell

S(.e: 7-8m i* "iamete/ Cyto'lasm: !i.o*.ave, o/a*%e-i*) $ith a ale stai*i*% .e*te/ o..u#i*% o*e-

thi/" of the .ell a/ea&

Erythrocyte Pro)uct(o* +Erythro'o(es(s,

E/#th/ooiesis is the fo/matio* of e/#th/o.#tes f/om .ommitte" /o%e*ito/ .ells

th/ou%h a /o.ess of mitoti. %/o$th a*" matu/atio*&

The fi/st /e.o%*ia!le e/#th#/oi" .ell i* the !o*e ma//o$ is the /oe/#th/o!last o/

/o*o/mo!last, $hi.h o* >/i%ht o/ Giemsa stai* is a la/%e .ell $ith !asohili..#tolasm a*" a* immatu/e *u.lea/ .h/omati* atte/*&

u!se;ue*t .ell "ivisio*s %ive /ise to !asohili., ol#.h/omatohili., a*" fi*all#

o/tho.h/omatohili. *o/mo!lasts, $hi.h a/e *o lo*%e/ .aa!le of mitosis&

6u/i*% this matu/atio* /o.ess a /o%/essive loss of .#tolasmi. R


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Re) Bloo) Cell +RBC, Mor'holo/y


12/28

T/auma

1& 6a./o.#teso/ Tea/"/o Cells

& e/ato.#tes

3& Mi./oshe/o.#tesa*" '#/ooi)ilo.#tes

D& .histo.#tes
https://en.wikipedia.org/wiki/Dacrocytehttps://en.wikipedia.org/wiki/Keratocytehttps://en.wikipedia.org/w/index.php?title=Microspherocyte&action=edit&redlink=1https://en.wikipedia.org/w/index.php?title=Pyropoikilocyte&action=edit&redlink=1https://en.wikipedia.org/wiki/Schistocytehttps://en.wikipedia.org/wiki/Dacrocytehttps://en.wikipedia.org/wiki/Keratocytehttps://en.wikipedia.org/w/index.php?title=Microspherocyte&action=edit&redlink=1https://en.wikipedia.org/w/index.php?title=Pyropoikilocyte&action=edit&redlink=1https://en.wikipedia.org/wiki/Schistocyte


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14/28

Re) Bloo) Cell I*clus(o*s

Leukocytes (WBCs)

G/a*ulo.#tes

eosi*ohils - -D

!asohils - N1

*eut/ohils - I-7

A%/a*ulo.#tes

L#mho.#tes (? a*" T .ells+ - 2-33

Mo*o.#tes - 3-8

%ra*ulocyte Fu*ct(o*s


15/28

'ha%o.#tosis of a*ti%e*-a*ti!o"# .omle5es, alle/%e*s i*flammato/#

.hemi.als

Release e*#mes "est/o# a/asites su.h as $o/ms

?asohils

( i* .hi.)e* o5, si*usitis, "ia!etes+

e./ete histami*e (vaso"ilato/+

e./ete hea/i* (a*ti.oa%ula*t+

$/ra*ulocyte Fu*ct(o*s

L#mho.#tes (___________________________+

6est/o# .a*.e/ fo/ei%* .ells vi/all# i*fe.te" .ells

P'/ese*tQ a*ti%e*s to a.tivate othe/ immu*e .ells

Coo/"i*ate a.tio*s of othe/ immu*e .ells

e./ete a*ti!o"ies /ovi"e immu*e memo/#

Mo*o.#tes (____________________________+

6iffe/e*tiate i*to ma./oha%es

'ha%o.#tie atho%e*s a*" "e!/is

P'/ese*tQ a*ti%e*s to a.tivate othe/ immu*e .ells (A'C+

Leuocyte Pro)uct(o* +Leuo'o(es(s,

Committed cell types-- ? a*" T /o%e*ito/ l#mho.#tes a*" %/a*ulo.#te-

ma./oha%e .olo*#-fo/mi*% u*its

'ossess /e.eto/s fo/ .olo*#-stimulati*% fa.to/s /elease" !# matu/e >?Cs i*

/eso*se to i*fe.tio*s

Re" !o*e ma//o$ sto/es a*" /eleases %/a*ulo.#tes a*" mo*o.#tes

ome l#mho.#tes leave !o*e ma//o$ u*fi*ishe" %o to th#mus to .omlete thei/

"evelome*t (T .ells+

Ci/.ulati*% >?Cs "o *ot sta# i* !loo"st/eam

G/a*ulo.#tes leave i* 8 hou/s live 2 "a#s lo*%e/

Mo*o.#tes leave i* hou/s, t/a*sfo/m i*to ma./oha%es a*" live fo/ seve/al

#ea/s

>?Cs /ovi"e lo*%-te/m immu*it#

(l#mho.#tes+ last "e.a"es


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1BC Precursors

The fi/st ste i* m#eloi" "iffe/e*tiatio* is the .ommitme*t of the lu/iote*t stem to

!e.ome the______________ (CU-GEMM, also )*o$* as CU-mi5+& The CU-

GEMM the* "iffe/e*tiates fu/the/mo/e to %ive /ise to the fi/st mo/holo%i.all# i"e*tifie"

m#eloi" .ell, the M#elo!last& /om the m#elo!last, five mo/holo%i.all# "iffe/e*t

matu/atio* fo/ms a/e /o"u.e" (*ot i*.lu"i*% the !last itself+& The/efo/e, the sta%es i*the m#eloi" "iffe/e*tiatio* a/e4 1- m#elo!last, - /om#elo.#te, 3- m#elo.#te, D-

metam#elo.#te, 2- !a*", a*" I- *eut/ohil (m*+&

These se;ue*.es also e5ist fo/ the !asohil a*" the eosi*ohil, ho$eve/, i* $/iti*%

them, the $o/"s !asohili. o/ eosi*ohili. /e.e"e the matu/atio* sta%e, e&%&,

!asohili. /om#elo.#te, o/ eosi*ohili. metam#elo.#te, et.& Mo/holo%i.all#, !lasts

a/e o*l# i"e*tifie" as ?LAT $ithout a*# se.ifi.atio* of the t#e $hethe/, %/a*uloi",

mo*o.#toi", l#mhoi", o/ else&

1& M#elo!last

- La/%e, /ou*" i//e%ula/ .ell

- Ha/" to "iffe/e*tiate f/om othe/ !last .ells

- Hi%h


17/28

& '/om#elo.#te o/ '/o%/a*ulo.#te

- La/%e *um!e/s of au/ohili. (/e""ish u/le+ /ima/# %/a*ules - mai* $a# to

i"e*tif#

- G/a*ules ma"e of l#sosomes ("i%est /otei*s+, e*#mes, a*ti!a.te/ial a%e*ts


18/28

- Has a/allel si"es

- T$ist to .o*fo/m to .#tolasm sa.e

- 0f 9oi*ti*% a/ts is mo/e tha* 1@3 of the $i"th tha* its !a*", if less, its .lassifie"

as t$o sea/ate se%me*ts

- Ho/seshoe shae" *u.leus, /ou*"e" e*"s o/ shae"

- 0*"e*tatio* %/eate/ tha* 1@3 $i"th of *u.leus is se%me*te" *eut/ohil eve* if

o*l# lo!es

- Left shift o..u/s if S of !a*" *eut/ohils a/e hi%h

- To5i.it# .ommo* i* left shifts (?C et.+

- ee* i* i*flammato/# .o*"itio*s

I&


19/28

?asohil

-

G/a*ules va/# i* *um!e/, sie a*" i*te*sit#- Ma# .ove/ *u.leus (aea/ as a va.uolate" mo*o.#te+- Has %/e#-!lue .#tolasm

Monocytic Series

- Co*sists of mo*o!lasts, /omo*o.#tes a*" mo*o.#tes

- Ha/" to "iffe/e*tiate f/om %/a*ulo.#tes - e5.et /om#elo.#tes (ma%e*ta

%/a*ules+

- Mo*o!lasts /esem!le m#elo!lasts e5.et *u.leus is /ou*" to .o*volute"

- '/omo*o.#tes - li)e m#elo.#tes a*" metam#elo.#tes

- Mo*o.#tes same i* !o*e ma//o$ as i* e/ihe/al !loo"

Mo*o.#te

- La/%e .ells

- Ba/ia!l# shae" *u.lei - )i"*e#-shae", .o*volute", !a*" o/ "ou%h*ut

- Ch/omati* mo/e "iffuse tha* *eut/ohil

- C#tolasm is t#i.all# !lue-%/a# stai*i*%, a!u*"a*t a*" ___________________

- Ha/" to "iffe/e*tiate f/om to5i. !a*" *eut/ohils: if *o left shift, the* mo*o.#te

- Co*si"e/e" immatu/e $he* i* .i/.ulatio*

- Mo*o.#tes "evelo i*to ma./oha%es $he* leave !loo" a*" e*te/ tissues

Lymphocytic Series

-

A%/a*ulo.#te- Lo$ S of l#mho!lasts a*" /ol#mho.#tes see*- 6iffi.ult to "iffe/e*tiate f/om /u!/i!lasts a*" /o/u!/i.#tes- L#mho.#tes same i* !o*e ma//o$ as i* e/ihe/al !loo"-


20/28

- Cate%o/ie" i*to small, me"ium o/ la/%e, "ee*"a*t o* amou*t of .#tolasm- Usuall# /ese*t a*" ve/# "ia%*osti. of l#mhomas- Mo*o.#tes have va.oules, !i%%e/ *u.leus $he/eas l#mho.#tes "o*t

- '/o"u.e" i* l#mh *o"es, slee*, th#mus a*" !o*e ma//o$

- L#mho.#tes see* i* e/ihe/al !loo" a/e /ima/il# f/om l#mh *o"es

- Ba/#i*% sies: la/%e l#mho.#tes ma# !e "ue to /eso*"i*% to a*ti%e*i. stimuli

- Ci/.ulati*% l#mho.#tes "e./ease $ith a%e

-


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22/28


23/28

Aue/ Ro"s

Mor'holo/y:

mall au/ohil /o"s i* the .#tolasm of m#elo!lasts

a*" /om#elo.#tes& ometimes fou*" i* matu/e

*eut/ohils

Fou*) (*:

A.ute m#elo!lasti. leu)emia

M#elo"#slasti. s#*"/omes

hift to the Left

Mor'holo/y:'/ese*.e of /e.u/so/ of %/a*ulo.#tes i* the

e/ihe/al !loo"

Fou*) (*:


24/28

Auto immu*e "isease

Thrombocytes (Platelets)

mall f/a%me*ts of me%a)a/#o.#te .#tolasm

-D m "iamete/ .o*tai*i*% P%/a*ulesQ

'seu"oo"s /ovi"e amoe!oi" moveme*t ha%o.#tosis

u*.tio*s4

e./ete .lotti*% fa.to/s, %/o$th fa.to/s fo/ e*"othelial /eai/, a*"

vaso.o*st/i.to/s i* !/o)e* vessels

o/m temo/a/# latelet lu%s

6issolve ol" !loo" .lots

'ha%o.#tie !a.te/ia

Att/a.t >?Cs to sites of i*flammatio*

Platelet Pro)uct(o* +Throm!o'o(es(s,

Hemo.#to!lasts that "evelo /e.eto/s fo/ th/om!ooieti* f/om live/ o/ )i"*e#

!e.ome me%a)a/#o!lasts

Me%a)a/#o!lasts /eeate"l# /eli.ates its 6


25/28

- S(.e: /a*%es f/om -2m i* "iamete/& 0t is la/%e/ tha* the me%a)a/#o!last a*"i* the /o.ess of matu/atio* it /ea.hes the sie of the sta%e 000 .ell&

- Nucleus: la/%e, i*"e*te" a*" ol#-lo!ulate"& The .h/omati* aea/s to have.oa/se heavil# stai*e" st/a*"s a*" ma# sho$ .lumi*%& The total *um!e/ of*u.leoli is "e./ease" a*" the# a/e mo/e "iffi.ult to see tha* i* the !last .ell& The.h/omati* is thi* a*" fi*e&

- Cyto'lasm: i*te*sel# !asohili., fille" $ith i*./easi*% *um!e/s of au/ohili.%/a*ules /a"iati*% f/om the %ol%i aa/atus to$a/" the e/ihe/# sa/i*% a thi*e/ihe/al /i*% that /emai*s !lue i* .olo/&

%ra*ular Me/aaryocyteThe ma9o/it# of the me%a)a/#o.#tes of a !o*e ma//o$ asi/ate a/e i* sta%e 000 $hi.h is.ha/a.te/ie" !#/o%/essive *u.lea/ .o*"e*satio* a*" i*"e*tatio* a*" the !e%i**i*% oflatelet fo/matio* $ithi* the .#tolasm&

- S(.e: /a*%es f/om 3-1m i* "iamete/ a*" is the la/%est .ell fou*" i* the !o*ema//o$&

- Cyto'lasm: a la/%e amou*t of ol#.h/omati. .#tolasm /o"u.es !lu*t, smooth,

seu"oo"ia-li)e /o9e.tio*s that .o*tai* a%%/e%ates of au/ohili. %/a*ulessu//ou*"e" !# ale halos& These st/u.tu/es %ive /ise to latelets at the e/ihe/#of the me%a)a/#o.#tes&

Platelets- S(.e: va/ies f/om 1-Dm i* "iamete/&- Nucleus: *o *u.leus is /ese*t&

0* >/i%ht - Giemsa stai*e" films, latelets aea/ as small, !/i%ht au/e, /ou*"e" o/elo*%ate" !o"ies $ith a "eli.atel# %/a*ula/ st/u.tu/e&

ROUTINE #EM$TOLO%Y E3$MIN$TIONS

$4 #emo/lo!(*

Mai* .omo*e*t of R?C

e/ves as vehi.le fo/ t/a*so/t of O5#%e* a*" Ca/!o* 6io5i"e

>he* full# satu/ate", 1 %/am H%! hol"s 1&3DmL of o5#%e*

3 "isti*.t H%! t#es ost*atall#

H%! A

H%! A

H%!

Em!/#o*i. hemo%lo!i*s

Go$e/ 1

Go$e/

'o/tla*" 1


26/28

Hemoglobin syntesis

Heme synthesis occurs in most cells of the body, except the matureerythrocytes, but most abundantly in the erythyroid precursors.

Globin synthesis occurs in the cytoplasm of the normoblast and reticulocyte.

&unction of emoglobin T/a*so/t of O f/om the lu*%s to the tissues a*" of CO i* the /eve/se "i/e.tio*& Assisti*% i* a.i"-!ase /e%ulatio* !# elimi*ati*% CO i* the lu*%s a*" !# the

!uffe/i*% a.tio* of hemo%lo!i*&

Determination of emoglobin concentration Hemo%lo!i* is measu/e" to "ete.t a*emia a*" its seve/it# a*" to mo*ito/ a*

a*emi. atie*ts /eso*se to t/eatme*t& The test is also e/fo/me" to .he.) thehemo%lo!i* level of a !loo" "o*o/ /io/ to "o*ati*% !loo"& Cailla/# !loo" o/E6TA a*ti.oa%ulate" ve*ous !loo" .a* !e use"&

The hemo%lo!i* .o*te*t a solutio* ma# !e estimate" !# seve/al metho"s4 !# measu/eme*t of its .olo/ its o$e/ of .om!i*i*% $ith o5#%e* o/ .a/!o*mo*o5i"e !# its i/o* .o*te*t&

Ca* !e measu/e" hotomet/i.all# the a!so/!a*.e of hemo%lo!i* i* a !loo" samle is measu/e"

ele.t/o*i.all# usi*% a filte/ .olo/imete/ o/ a "i/e.t /ea"-out hemo%lo!i*mete/&

Ca* !e estimate" usi*% a visual .oma/ative te.h*i;ue Hemo%lo!i* values .a/e e5/esse" i* %/ams e/ lite/ (%@l+ o/ %/ams e/ "e.ilite/

(%@"l+& G/ams@lite/ is the /e.omme*"e" $a# of e5/essi*% the mass .o*.e*t/atio*of hemo%lo!i*&

I C!"#MET$EM%&L%BI# ($EMI&L%BI#C!"#I'E$IC#) MET$%' This te.h*i;ue is 0CH /e.omme*"e" !e.ause sta!le hemi%lo!i*.#a*i"e (HiC


27/28

This is a /elia!le a*" i*e5e*sive metho" of measu/i*% hemo%lo!i* !ut the/e is

*o sta!le o5#hemo%lo!i* (H!O+ /efe/e*.e sta*"a/" solutio* availa!le fo/ the"i/e.t .ali!/atio* of the H!O te.h*i;ue& '/ea/atio* of a .ali!/atio* %/ah fo/use $ith a filte/ .olo/imete/, /e;ui/es the use of a se.o*"a/# !loo" sta*"a/", i&e&a $hole !loo" o/ hemol#sate of )*o$* hemo%lo!i* value (!et$ee* 1D-1I%@l+that has !ee* /eviousl# a*al#e" !# the HiC< metho" o/ othe/ $ell .ali!/ate"

te.h*i;ue&

'/i*.ile of the test4

?loo" is "ilute" i* a $ea) ammo*ia solutio*& This l#es the /e" .ells& The

a!so/!a*.e of the solutio* is measu/e" as o5#hemo%lo!i* i* a filte/ .olo/imete/usi*% a #ello$-%/ee* filte/ o/ at $avele*%th 2D*m& Hemo%lo!i* values a/eo!tai*e" f/om ta!les /ea/e" f/om a .ali!/atio* %/ah& Methemo%lo!i* a*".a/!o5#hemo%lo!i* a/e *ot a..u/atel# "ete.te" !ut these a/e *o/mall# /ese*to*l# i* t/a.e amou*ts a*" a/e *ot o5#%e*-.a//#i*% fo/ms of hemo%lo!i*&

$V' "lkaline $ematin Metho-

A useful a*.illa/# metho" u*"e/ se.ial .i/.umsta*.es as it %ives a t/ue estimateof total H! eve* if H!CO, Hi o/ H! is /ese*t&

V' "ci- $ematin Metho- (Sahli$elli,e)

This visual .oma/ative metho" of estimati*% hemo%lo!i* althou%h still use" i*

some health .e*te/s a*" hositals is *ot /e.omme*"e" !e.ause of itsu*a..eta!le im/e.isio* a*" i*a..u/a.#& Most of the /o!lems asso.iate" $iththe ahli metho" a/e "ue to the i*sta!ilit# of a.i" hemati*, fa"i*% of the .olo/%lass sta*"a/" a*" "iffi.ult# i* mat.hi*% it to the a.i" hemati* solutio*&Co*ve/sio* to a.i" hemati* is slo$& H! is *ot .o*ve/te" to a.i" hemati* a*"the/efo/e the ahli metho" is *ot suita!le fo/ measu/i*% hemo%lo!i* levels i*

i*fa*ts u to 3 mo*ths&

'/i*.ile of the test4

Hemo%lo!i* i* a samle of !loo" is .o*ve/te" to a !/o$* .olo/e" a.i" hemati*

!# t/eatme*t $ith &1 < HCl a*" afte/ allo$i*% the "ilute" samle to sta*" fo/ 2mi*ute to e*su/e .omlete .o*ve/sio* to a.i" hemati* it is "ilute" $ith "istille"$ate/ u*til its .olo/ mat.h as $iththe .olo/ of a* a/tifi.ial sta*"a/" (ti*te" %lass+&

V$' Copper Sulphate 'ensitometery

This is a ;ualitative metho" !ase" o* the .aa.it# of a sta*"a/" solutio* of

.oe/ sulhate to .ause the suse*sio* o/ si*)i*% of a "/o of a samle of

!loo" as a measu/e of se.ifi. %/avit# of the latte/ a*" .o//eso*"i*% to itshemo%lo!i* .o*.e*t/atio*& The metho" is /outi*el# utilie" i* some !loo"!a*)i*% la!o/ato/ies i* the s./ee*i*% of !loo" "o*o/s fo/ the /ese*.e of a*emia&The t$o st/e*%ths of .oe/ sulhate solutio* of se.ifi. %/avit# 1&DD a*" 1&DFa/e /ove" to !e simle a*" a..u/ate i* "ete.ti*% hemo%lo!i* level of 8 %@"l a*"11 %@"l, /ese.tivel#&

B4 #ematocr(t +'ace) cell 0olume,

the /oo/tio* of $hole !loo" o..uie" !# /e" .ells

e5/esse" as a /atio (lite/@lite/+ o/ as a e/.e*ta%e

0t is o*e of the simlest, most a..u/ate a*" most valua!le of all hematolo%i.al

i*vesti%atio*s

Of %/eate/ /elia!ilit# a*" useful*ess tha* the /e" .ell .ou*t that is e/fo/me"

ma*uall#

use" to s./ee* fo/ a*emia $he* it is *ot ossi!le to measu/e hemo%lo!i*

to "ia%*ose ol#.#themia ve/a a*" to mo*ito/ its t/eatme*t

suita!le fo/ s./ee*i*% la/%e .li*i. oulatio*s


28/28

Determination of ematocrit concentration

$' Microhematocrit metho- ?loo" samles fo/ mi./ohemato./it measu/eme*ts shoul" !e .e*t/ifu%e" $ithi* I

hou/s of .olle.tio*&

00& Macrohematocr(t metho) Althou%h /e.omme*"e" !# the 0CH as a* alte/*ative metho", it is *o lo*%e/ i*

/outi*e use !e.ause of te.h*i.al /o!lems a*" the .e*t/ifu%atio* time /e;ui/e"(atleast 3 mi*utes+ to a.hieve ma5imal a.)i*% of .ells& The metho" uses a>i*t/o!e tu!e $hi.h .a* also !e use" to "ete/mi*e the e/#th/o.#tese"ime*tatio* test&

C4 ERYT#ROCYTE SEDIMENT$TIONR$TE

>he* $ell-mi5e" ve*ous !loo" is la.e" i* a ve/ti.al tu!e, e/#th/o.#tes $ill te*"

to fall to$a/" the !ottom&

The le*%th of fall of the to of the .olum* of e/#th/o.#tes i* a %ive* i*te/val oftime is .alle" the e/#th/o.#te se"ime*tatio* /ate (ER+

The /ate is e5/esse" i* mm@h/&

hematology 1 lecture

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