Title: The Cardiovascular System: Blood
1The Cardiovascular System Blood Blood
Components
- Biology 1612
- Anatomy Physiology II
2INTRODUCTION
- Blood inside blood vessels, interstitial fluid
around body cells, and lymph inside lymph vessels
constitute ones internal environment. - To obtain nutrients and remove wastes, cells must
be serviced by blood and interstitial fluid. - Blood, a connective tissue, is composed of plasma
and formed elements. - Interstitial fluid bathes body cells.
- The branch of science concerned with the study of
blood, blood-forming tissues, and the disorders
associated with them is called hematology.
3Blood Components
4Fluids of the Body
- Cells of the body are serviced by 2 fluids
- blood
- composed of plasma and a variety of cells
- transports nutrients and wastes
- interstitial fluid
- bathes the cells of the body
- Nutrients and oxygen diffuse from the blood into
the interstitial fluid then into the cells - Wastes move in the reverse direction
- Hematology is study of blood and blood disorders
5Functions of Blood
- Transportation
- O2, CO2, metabolic wastes, nutrients, heat
hormones - Regulation
- helps regulate pH through buffers
- helps regulate body temperature
- coolant properties of water
- vasodilatation of surface vessels dump heat
- helps regulate water content of cells by
interactions with dissolved ions and proteins - Protection from disease loss of blood
6Physical Characteristics of Blood
- Thicker (more viscous) than water and flows more
slowly than water - Temperature of 100.4 degrees F
- pH 7.4 (7.35-7.45)
- 8 of total body weight
- Blood volume
- 5 to 6 liters in average male
- 4 to 5 liters in average female
- hormonal negative feedback systems maintain
constant blood volume and osmotic pressure
7Techniques of Blood Sampling
- Venipuncture
- sample taken from vein with hypodermic needle
syringe - median cubital vein
- why not stick an artery?
- less pressure
- closer to the surface
- Finger or heel stick
- common technique for diabetics to monitor daily
blood sugar - method used for infants
8COMPONENTS OF BLOOD
- Blood consists of 55 plasma and 45 formed
elements. - Blood plasma consists of 91.5 water and 8.5
solutes. - Principal solutes include proteins (albumins,
globulins, fibrinogen), nutrients, enzymes,
hormones, respiratory gases, electrolytes, and
waste products.
9Components of Blood
- Hematocrit
- 55 plasma
- 45 cells
- 99 RBCs
- lt 1 WBCs and platelets
10Blood Plasma
- 0ver 90 water
- 7 plasma proteins
- created in liver
- confined to bloodstream
- albumin
- maintain blood osmotic pressure
- globulins (immunoglobulins)
- antibodies bind to foreignsubstances called
antigens - form antigen-antibody complexes
- fibrinogen
- for clotting
- 2 other substances
- electrolytes, nutrients, hormones, gases, waste
products
11Formed Elements of Blood
- Red blood cells (erythrocytes )
- White blood cells (leukocytes )
- granular leukocytes
- neutrophils, eosinophils, basophils
- agranular leukocytes
- lymphocytes T cells, B cells, and natural
killer cells - monocytes
- Platelets (special cell fragments)
12FORMATION OF BLOOD CELLS
- Blood cells are formed from pluripotent
hematopoietic stem cells. - Bone marrow may be obtained through aspiration or
biopsy. The sample is then sent to pathology for
examination. - Originating from the pluripotent stem cells are
the myeloid stem cells and lymphoid stem cells.
13Hematocrit
- Percentage of blood occupied by cells
- female normal range
- 38 - 46 (average of 42)
- male normal range
- 40 - 54 (average of 46)
- testosterone
- Anemia
- not enough RBCs or not enough hemoglobin
- Polycythemia
- too many RBCs (over 65)
- dehydration, tissue hypoxia, blood doping in
athletes
14Blood Doping
- Injecting previously stored RBCs before an
athletic event - more cells available to deliver oxygen to tissues
- Dangerous
- increases blood viscosity
- forces heart to work harder
- Banned by the International Olympic Committee
15Formation of Blood Cells
- Most blood cells types need to be continually
replaced - die within hours, days or weeks
- process of blood cells formation is hematopoiesis
or hemopoiesis - In the embryo
- occurs in yolk sac, liver, spleen, thymus, lymph
nodes red bone marrow - In adult
- occurs only in red marrow of flat bones like
sternum, ribs, skull pelvis and ends of long
bones
16Hematopoiesis
17Stages of Blood Cell Formation
- Pluripotent stem cells
- .1 of red marrow cells
- replenish themselves as they differentiate into
either myeloid or lymphoid stem cells - Myeloid stem cell line of development continues
- progenitor cells(colony-forming units) no longer
can divide and are specialized to form specific
cell types - example CFU-E develops eventually into only red
blood cells - next generation is blast cells
- have recognizable histological characteristics
- develop within several divisions into mature cell
types - Lymphoid stem cell line of development
- pre-B cells prothymocytes finish their develop
into B T lymphocytes in the lymphatic tissue
after leaving the red marrow
18Hemopoietic Growth Factors
- Regulate differentiation proliferation
- Erythropoietin (EPO)
- produced by the kidneys increase RBC precursors
- Thrombopoietin (TPO)
- hormone from liver stimulates platelet formation
- Cytokines are local hormones of bone marrow
- produced by some marrow cells to stimulate
proliferation in other marrow cells - colony-stimulating factor (CSF) interleukin
stimulate WBC production
19Medical Uses of Growth Factors
- Available through recombinant DNA technology
- recombinant erythropoietin (EPO) very effective
in treating decreased RBC production of end-stage
kidney disease - other products given to stimulate WBC formation
in cancer patients receiving chemotherapy which
kills bone marrow - granulocyte-macrophage colony-stimulating factor
- granulocyte colony stimulating factor
- thrombopoietin helps prevent platelet depletion
during chemotherapy
20Blood Cells
- Myeloid stem cells give rise to RBCs, platelets,
and all WBCs except for lymphocytes. - Lymphoid stem cells give rise to lymphocytes.
- Myeloid stem cells differentiate into progenitor
cells or precursor cells (blast cells) which will
develop into the actual formed elements of blood. - Lymphoid stem cells differentiate into pre-B and
prothymocytes which develop into B-lymphocytes
and T-lymphocytes, respectively. - This process of hematopoiesis is stimulated by
several hematopoietic growth factors. These
hematopoietic growth factors stimulate
differentiation and proliferation of the various
blood cells.
21Red Blood Cells or Erythrocytes
- Contain oxygen-carrying protein hemoglobin that
gives blood its red color - 1/3 of cells weight is hemoglobin
- Biconcave disk 8 microns in diameter
- increased surface area/volume ratio
- flexible shape for narrow passages
- no nucleus or other organelles
- no cell division or mitochondrial ATP formation
- Normal RBC count
- male 5.4 million/drop ---- female 4.8
million/drop - new RBCs enter circulation at 2 million/second
22Hormones
- Erythropoietin increases the number of RBC
precursors. - Thrombopoietin increases the number of platelet
precursors. - Cytokins (colony-stimulating factors and
interleukins) increase the number of WBC
precursors. - Growth factors, available through recombinant DNA
technology, hold great potential for use in
patients who cannot normally form the blood
cells.
23Hemoglobin
- Globin protein consisting of 4 polypeptide chains
- One heme pigment attached to each polypeptide
chain - each heme contains an iron ion (Fe2) that can
combine reversibly with one oxygen molecule
24 Transport of O2, CO2 and Nitric Oxide
- Each hemoglobin molecule can carry 4 oxygen
molecules from lungs to tissue cells - Hemoglobin transports 23 of total CO2 waste
from tissue cells to lungs for release - combines with amino acids in globin portion of Hb
- Hemoglobin transports nitric oxide super nitric
oxide helping to regulate BP - iron ions pick up nitric oxide (NO) super
nitric oxide (SNO) transport it to from the
lungs - NO causing vasoconstriction is released in the
lungs - SNO causing vasodilation is picked up in the lungs
25RBCs
- Production of abnormal hemoglobin can result in
serious blood disorders such as thalassemia and
sickle cell anemia. - The blood test, hemoglobin A1c, can be used to
monitor blood glucose levels in diabetics
26RBC Life Cycle
- RBCs live only 120 days
- wear out from bending to fit through capillaries
- no repair possible due to lack of organelles
- Worn out cells removed by fixed macrophages in
spleen liver - Breakdown products are recycled
27Recycling of Hemoglobin Components
- In macrophages of liver or spleen
- globin portion broken down into amino acids
recycled - heme portion split into iron (Fe3) and
biliverdin (green pigment)
28Fate of Components of Heme
- Iron(Fe3)
- transported in blood attached to transferrin
protein - stored in liver, muscle or spleen
- attached to ferritin or hemosiderin protein
- in bone marrow being used for hemoglobin
synthesis - Biliverdin (green) converted to bilirubin
(yellow) - bilirubin secreted by liver into bile
- converted to urobilinogen then stercobilin
(brown pigment in feces) by bacteria of large
intestine - if reabsorbed from intestines into blood is
converted to a yellow pigment, urobilin and
excreted in urine
29Erythropoiesis Production of RBCs
- Erythrocyte formation, called erythropoiesis,
occurs in adult red bone marrow of certain bones. - The main stimulus for erythropoiesis is hypoxia.
- Proerythroblast starts to produce hemoglobin
- Many steps later, nucleus is ejected a
reticulocyte is formed - orange in color with traces of visible rough ER
- Reticulocytes escape from bone marrow into the
blood - In 1-2 days, they eject the remaining organelles
to become a mature RBC
30Feedback Control of RBC Production
- Tissue hypoxia (cells not getting enough O2)
- high altitude since air has less O2
- anemia
- RBC production falls below RBC destruction
- circulatory problems
- Kidney response to hypoxia
- release erythropoietin
- speeds up development of proerythroblasts into
reticulocytes
31Normal Reticulocyte Count
- Should be .5 to 1.5 of the circulating RBCs
- Low count in an anemic person might indicate bone
marrow problem - leukemia, nutritional deficiency or failure of
red bone marrow to respond to erythropoietin
stimulation - High count might indicate recent blood loss or
successful iron therapy
32WHITE BLOOD CELLS
- Leukocytes (white blood cells or WBCs) are
nucleated cells and do not contain hemoglobin.
Two principal types are granular (neutrophils,
eosinophils, basophils) and agranular
(lymphocytes and monocytes). - Granular leukocytes include eosinophils,
basophils, and neutrophils based on the straining
of the granules. - Agranular leukocytes do not have cytoplasmic
granules and include the lymphocytes and
monocytes, which differentiate into macrophages
(fixed and wandering). - Leukocytes have surface proteins, as do
erythrocytes. They are called major
histocompatibility antigens (MHC), are unique for
each person (except for identical siblings), and
can be used to identify a tissue.
33WBC Physiology
- Less numerous than RBCs
- 5000 to 10,000 cells per drop of blood
- 1 WBC for every 700 RBC
- Leukocytosis is a high white blood cell count
- microbes, strenuous exercise, anesthesia or
surgery - Leukopenia is low white blood cell count
- radiation, shock or chemotherapy
- Only 2 of total WBC population is in circulating
blood at any given time - rest is in lymphatic fluid, skin, lungs, lymph
nodes spleen
34Function of WBCs
- Different WBCs combat inflammation and infection
in different ways. - Neutrophils and wandering or fixed macrophages
(which develop from monocytes) do so through
phagocytosis. - Eosinophils combat the effects of histamine in
allergic reactions, phagocytize antigen-antibody
complexes, and combat parasitic worms. - Basophils develop into mast cells that liberate
heparin, histamine, and serotonin in allergic
reactions that intensify the inflammatory
response. - B lymphocytes, in response to the presence of
foreign substances called antigens, differentiate
into tissue plasma cells that produce antibodies. - T lymphocytes destroy foreign invaders directly.
35Function of WBCs
- WBCs leave the blood stream by emigration.
- Some WBCs, particularly neutrophils and
macrophages, are active in phagocytosis. - The chemical attraction of WBCs to a disease or
injury site is termed chemotaxis.
36WBC examination
- A differential white blood cell count is a
diagnostic test in which specific white blood
cells are enumerated. Because each type of WBC
plays a different role, determining the
percentage of each type in the blood assists in
diagnosing the condition. - Bone marrow transplants may be used to treat
several types of anemia, leukemia, and numerous
other blood disorders.
37Emigration Phagocytosis in WBCs
- WBCs roll along endothelium, stick to it
squeeze between cells. - adhesion molecules (selectins) help WBCs stick to
endothelium - displayed near site of injury
- molecules (integrins) found on neutrophils assist
in movement through wall - Neutrophils macrophages phagocytize bacteria
debris - chemotaxis of both
- kinins from injury site toxins
38Neutrophil Function
- Fastest response of all WBC to bacteria
- Direct actions against bacteria
- release lysozymes which destroy/digest bacteria
- release defensin proteins that act like
antibiotics poke holes in bacterial cell walls
destroying them - release strong oxidants (bleach-like, strong
chemicals ) that destroy bacteria
39Monocyte Function
- Take longer to get to site of infection, but
arrive in larger numbers - Become wandering macrophages, once they leave the
capillaries - Destroy microbes and clean up dead tissue
following an infection
40Basophil Function
- Involved in inflammatory and allergy reactions
- Leave capillaries enter connective tissue as
mast cells - Release heparin, histamine serotonin
- heighten the inflammatory response and account
for hypersensitivity (allergic) reaction
41Eosinophil Function
- Leave capillaries to enter tissue fluid
- Release histaminase
- slows down inflammation caused by basophils
- Attack parasitic worms
- Phagocytize antibody-antigen complexes
42Lymphocyte Functions
- B cells
- destroy bacteria and their toxins
- turn into plasma cells that produces antibodies
- T cells
- attack viruses, fungi, transplanted organs,
cancer cells some bacteria - Natural killer cells
- attack many different microbes some tumor cells
- destroy foreign invaders by direct attack
43Complete Blood Count
- Screens for anemia and infection
- Total RBC, WBC platelet counts differential
WBC hematocrit and hemoglobin measurements - Normal hemoglobin range
- infants have 14 to 20 g/100mL of blood
- adult females have 12 to 16 g/100mL of blood
- adult males have 13.5 to 18g/100mL of blood
44Differential WBC Count
- Detection of changes in numbers of circulating
WBCs (percentages of each type) - indicates infection, poisoning, leukemia,
chemotherapy, parasites or allergy reaction - Normal WBC counts
- neutrophils 60-70 (up if bacterial infection)
- lymphocyte 20-25 (up if viral infection)
- monocytes 3 -- 8 (up if fungal/viral
infection) - eosinophil 2 -- 4 (up if parasite or allergy
reaction) - basophil lt1 (up if allergy reaction or
hypothyroid)
45Bone Marrow Transplant
- Intravenous transfer of healthy bone marrow
- Procedure
- destroy sick bone marrow with radiation
chemotherapy - donor matches surface antigens on WBC
- put sample of donor marrow into patient's vein
for reseeding of bone marrow - success depends on histocompatibility of donor
recipient - Treatment for leukemia, sickle-cell, breast,
ovarian or testicular cancer, lymphoma or
aplastic anemia
46PLATELETS
- Thrombopoietin stimulates myeloid stem cells to
produce platelets. - Myeloid stem cells develop into
megakaryocyte-colony-forming cells that develop
into megakaryoblasts. - Megakaryoblasts transform into megakaryocytes
which fragment. - Each fragment, enclosed by a piece of cell
membrane, is a platelet (thrombocyte). - Normal blood contains 250,000 to 400,000
platelets/mm3. Platelets have a life span of only
5 to 9 days aged and dead platelets are removed
by fixed macrophages in the spleen and liver.
47PLATELETS
- Platelets help stop blood loss from damaged
vessels by forming a platelet plug. Their
granules also contain chemicals that promote
blood clotting. - A complete blood count (CBC) is a test that
screens for anemia and various infections. It
usually includes counts of RBCs, WBCs, and
platelets per µL of whole blood hematocrit and
differential white blood cell count. The amount
of hemoglobin in grams per ml is also determined.
48Platelet (Thrombocyte) Anatomy
- Disc-shaped, 2 - 4 micron cell fragment with no
nucleus - Normal platelet count is 150,000-400,000/drop of
blood - Other blood cell counts
- 5 million red 5-10,000 white blood cells
49Platelets--Life History
- Platelets form in bone marrow by following steps
- myeloid stem cells to megakaryocyte-colony
forming cells to megakaryoblast to megakaryocytes
whose cell fragments form platelets - Short life span (5 to 9 days in bloodstream)
- formed in bone marrow
- few days in circulating blood
- aged ones removed by fixed macrophages in liver
and spleen
50STEM CELL TRANSPLANT FROM BONE MARROW AND
CORD-BLOOD
- Bone marrow transplant replaces diseased marrow
with healthy marrow. - Patients diseased marrow is destroyed.
- Healthy marrow is supplied by a donor or the
patient. - There are several problems with this method.
51Cord-blood transplant
- Stem cells are taken from the umbilical cord and
frozen - This method offers several advantages over marrow
transplant.
52HEMOSTASIS
- A clot is a gel consisting of a network of
insoluble protein fibers (fibrin) in which formed
elements of blood are trapped. - The chemicals involved in clotting are known as
coagulation (clotting) factors most are in blood
plasma, some are released by platelets, and one
is released from damaged tissue cells. - Blood clotting involves a cascade of reactions
that may be divided into three stages formation
of prothrombinase (prothrombin activator),
conversion of prothrombin into thrombin, and
conversion of soluble fibrinogen into insoluble
fibrin.
53HEMOSTASIS
- The clotting cascade can be initiated by either
the extrinsic pathway or the intrinsic pathway. - Normal coagulation requires vitamin K and also
involves clot retraction (tightening of the clot)
and fibrinolysis (dissolution of the clot). - The fibrinolytic system dissolves small,
inappropriate clots and clots at a site of damage
once the damage is repaired. - Plasmin (fibrinolysin) can dissolve a clot by
digesting fibrin threads and inactivating
substances such as fibrinogen, prothrombin, and
factors V, VIII, and XII.
54Hemostasis
- Stoppage of bleeding in a quick localized
fashion when blood vessels are damaged - Prevents hemorrhage (loss of a large amount of
blood) - Methods utilized
- vascular spasm
- platelet plug formation
- blood clotting (coagulation formation of fibrin
threads)
55Vascular Spasm
- Damage to blood vessel produces stimulates pain
receptors - Reflex contraction of smooth muscle of small
blood vessels - Can reduce blood loss for several hours until
other mechanisms can take over - Only for small blood vessel or arteriole
56Platelet Plug Formation
- Platelets store a lot of chemicals in granules
needed for platelet plug formation - alpha granules
- clotting factors
- platelet-derived growth factor
- cause proliferation of vascular endothelial
cells, smooth muscle fibroblasts to repair
damaged vessels - dense granules
- ADP, ATP, Ca2, serotonin, fibrin-stabilizing
factor, enzymes that produce thromboxane A2 - Steps in the process
- (1) platelet adhesion (2) platelet release
reaction (3) platelet aggregation
57Platelet Adhesion
- Platelets stick to exposed collagen underlying
damaged endothelial cells in vessel wall
58Platelet Release Reaction
- Platelets activated by adhesion
- Extend projections to make contact with each
other - Release thromboxane A2 ADP activating other
platelets - Serotonin thromboxane A2 are vasoconstrictors
decreasing blood flow through the injured vessel
59Platelet Aggregation
- Activated platelets stick together and activate
new platelets to form a mass called a platelet
plug - Plug reinforced by fibrin threads formed during
clotting process
60Blood Clotting
- Blood drawn from the body thickens into a gel
- gel separates into liquid (serum) and a clot of
insoluble fibers (fibrin) in which the cells are
trapped - If clotting occurs in an unbroken vessel is
called a thrombosis - Substances required for clotting are Ca2,
enzymes synthesized by liver cells and substances
released by platelets or damaged tissues - Clotting is a cascade of reactions in which each
clotting factor activates the next in a fixed
sequence resulting in the formation of fibrin
threads - prothrombinase Ca2 convert prothrombin into
thrombin - thrombin converts fibrinogen into fibrin threads
61Overview of the Clotting Cascade
- Prothrombinase is formed by either the intrinsic
or extrinsic pathway - Final common pathway produces fibrin threads
62Extrinsic Pathway
- Damaged tissues leak tissue factor
(thromboplastin) into bloodstream - Prothrombinase forms in seconds
- In the presence of Ca2, clotting factor X
combines with V to form prothrombinase
63Intrinsic Pathway
- Activation occurs
- endothelium is damaged platelets come in
contact with collagen of blood vessel wall - platelets damaged release phospholipids
- Requires several minutes for reaction to occur
- Substances involved Ca2 and clotting factors
XII, X and V
64Final Common Pathway
- Prothrombinase and Ca2
- catalyze the conversion of prothrombin to
thrombin - Thrombin
- in the presence of Ca2 converts soluble
fibrinogen to insoluble fibrin threads - activates fibrin stabilizing factor XIII
- positive feedback effects of thrombin
- accelerates formation of prothrombinase
- activates platelets to release phospholipids
65Clot Retraction Blood Vessel Repair
- Clot plugs ruptured area of blood vessel
- Platelets pull on fibrin threads causing clot
retraction - trapped platelets release factor XIII stabilizing
the fibrin threads - Edges of damaged vessel are pulled together
- Fibroblasts endothelial cells repair the blood
vessel
66Role of Vitamin K in Clotting
- Normal clotting requires adequate vitamin K
- fat soluble vitamin absorbed if lipids are
present - absorption slowed if bile release is insufficient
- Required for synthesis of 4 clotting factors by
hepatocytes - factors II (prothrombin), VII, IX and X
- Produced by bacteria in large intestine
67Hemostatic Control Mechanisms
- Fibrinolytic system dissolves small,
inappropriate clots clots at a site of a
completed repair - fibrinolysis is dissolution of a clot
- Inactive plasminogen is incorporated into the
clot - activation occurs because of factor XII and
thrombin - plasminogen becomes plasmin (fibrinolysin) which
digests fibrin threads - Clot formation remains localized
- fibrin absorbs thrombin
- blood disperses clotting factors
- endothelial cells WBC produce prostacyclin that
opposes thromboxane A2 (platelet adhesion
release) - Anticoagulants present in blood produced by
mast cells
68Intravascular Clotting
- Thrombosis
- clot (thrombus) forming in an unbroken blood
vessel - forms on rough inner lining of BV
- if blood flows too slowly (stasis) allowing
clotting factors to build up locally cause
coagulation - may dissolve spontaneously or dislodge travel
- Embolus
- clot, air bubble or fat from broken bone in the
blood - pulmonary embolus is found in lungs
- Low dose aspirin blocks synthesis of thromboxane
A2 reduces inappropriate clot formation - strokes, TIAs and myocardial infarctions
69Anticoagulants and Thrombolytic Agents
- Anticoagulants suppress or prevent blood clotting
- heparin
- administered during hemodialysis and surgery
- warfarin (Coumadin)
- antagonist to vitamin K so blocks synthesis of
clotting factors - slower than heparin
- stored blood in blood banks treated with citrate
phosphate dextrose (CPD) that removes Ca2 - Thrombolytic agents are injected to dissolve
clots - directly or indirectly activate plasminogen
- streptokinase or tissue plasminogen activator
(t-PA)
70Hemostatic Control Mechanisms
- Clots are generally localized due to fibrin
absorbing thrombin into the clot, clotting
factors diffusing through blood, and the
production of prostacyclin, a powerful inhibitor
of platelet adhesion and release. - Substances that inhibit coagulation, called
anticoagulants, are also present in blood. An
example is heparin. - Patients who are at increased risk of forming
blood clots may receive an anticoagulant drug
such as heparin or warfarin. To prevent clots in
donated blood, a substance that removes Ca2 such
as EDTA or CPD may be added to the blood. - Despite the anticoagulating and fibrinolytic
mechanisms, blood clots sometimes form within the
cardiovascular system.
71HEMOSTASIS
- Clotting in an unbroken blood vessel is called
thrombosis. - A thrombus (clot), bubble of air, fat from broken
bones, or piece of debris transported by the
bloodstream that moves from its site of origin is
called an embolus. - At low doses aspirin inhibits vasoconstriction
and platelet aggregation thereby reducing the
chance of thrombus formation. Thrombolytic
agents are injected into the body to dissolve
clots that have already formed. Streptokinase or
tissue plasminogen activator (TPS) are
thrombolytic agents.
72ABO Group
- In the ABO system, agglutinogens (antigens) A and
B determine blood types. - Plasma contains agglutinins (antibodies),
designated as a and b, that react with
agglutinogens that are foreign to the individual.
73Blood Groups and Blood Types
- RBC surfaces are marked by genetically determined
glycoproteins glycolipids - agglutinogens or isoantigens
- distinguishes at least 24 different blood groups
- ABO, Rh, Lewis, Kell, Kidd and Duffy systems
74ABO Blood Groups
- Based on 2 glycolipid isoantigens called A and B
found on the surface of RBCs - display only antigen A -- blood type A
- display only antigen B -- blood type B
- display both antigens A B -- blood type AB
- display neither antigen -- blood type O
- Plasma contains isoantibodies or agglutinins to
the A or B antigens not found in your blood - anti-A antibody reacts with antigen A
- anti-B antibody reacts with antigen B
75RH blood groups
- Antigen was discovered in blood of Rhesus monkey
- People with Rh agglutinogens on RBC surface are
Rh. Normal plasma contains no anti-Rh
antibodies - Antibodies develop only in Rh- blood type only
with exposure to the antigen - transfusion of positive blood
- during a pregnancy with a positive blood type
fetus - Transfusion reaction upon 2nd exposure to the
antigen results in hemolysis of the RBCs in the
donated blood
76Hemolytic Disease of Newborn
- Rh negative mom and Rh fetus will have mixing of
blood at birth - Mom's body creates Rh antibodies unless she
receives a RhoGam shot soon after first delivery,
miscarriage or abortion - RhoGam binds to loose fetal blood and removes it
from body before she reacts - In 2nd child, hemolytic disease of the newborn
may develop causing hemolysis of the fetal RBCs
77Transfusions
- Knowledge of blood types is essential to safe
transfusion of blood and may also be used in
proving or disproving paternity, linking suspects
to crimes, or as a part of anthropology studies
to establish a relationship among races. - The interactions of the blood types of the ABO
system are summarized in Table 19.6.
78Transfusion and Transfusion Reactions
- Transfer of whole blood, cells or plasma into the
bloodstream of recipient - used to treat anemia or severe blood loss
- Incompatible blood transfusions
- antigen-antibody complexes form between plasma
antibodies foreign proteins on donated RBC's
(agglutination) - donated RBCs become leaky (complement proteins)
burst - loose hemoglobin causes kidney damage
- Problems caused by incompatibility between
donors cells and recipients plasma - Donor plasma is too diluted to cause problems
79Universal Donors and Recipients
- People with type AB blood called universal
recipients since have no antibodies in plasma - only true if cross match the blood for other
antigens - People with type O blood cell called universal
donors since have no antigens on their cells - theoretically can be given to anyone
80Typing and Cross-Matching Blood for Transfusion
- The Rh and ABO blood groups may be detected by a
simple medical test, blood typing, in which a
sample of blood is mixed with serum containing
agglutinins to each of the major agglutinogens
(AB, B, and Rh). - Typing is the determination of blood types,
whereas cross-matching is the mixing of donor and
recipient blood for compatibility.
81DISORDERS HOMEOSTATIC IMBALANCES
- Anemia
- Sickle-cell
- Hemophilia
- Disseminated intravascular clotting
- Acute leukemia
- chronic leukemia
82Anemia Not Enough RBCs
- Symptoms
- oxygen-carrying capacity of blood is reduced
- fatigue, cold intolerance paleness
- lack of O2 for ATP heat production
- Types of anemia
- iron-deficiency lack of absorption or loss of
iron - pernicious lack of intrinsic factor for B12
absorption - hemorrhagic loss of RBCs due to bleeding
(ulcer) - hemolytic defects in cell membranes cause
rupture - thalassemia hereditary deficiency of hemoglobin
- aplastic destruction of bone marrow
(radiation/toxins)
83Sickle-cell Anemia (SCA)
- Genetic defect in hemoglobin molecule (Hb-S) that
changes 2 amino acids - at low very O2 levels, RBC is deformed by changes
in hemoglobin molecule within the RBC - sickle-shaped cells rupture easily causing
anemia clots - Found among populations in malaria belt
- Mediterranean Europe, sub-Saharan Africa Asia
- Person with only one sickle cell gene
- increased resistance to malaria because RBC
membranes leak K lowered levels of K kill the
parasite infecting the red blood cells
84Hemophilia
- Inherited deficiency of clotting factors
- bleeding spontaneously or after minor trauma
- subcutaneous intramuscular hemorrhaging
- nosebleeds, blood in urine, articular bleeding
pain - Hemophilia A lacks factor VIII (males only)
- most common
- Hemophilia B lacks factor IX (males only)
- Hemophilia C (males females)
- less severe because alternate clotting activator
exists - Treatment is transfusions of fresh plasma or
concentrates of the missing clotting factor
85Disseminated Intravascular Clotting
- Life threatening paradoxical presence of blood
clotting and bleeding at the same time throughout
the whole body - so many clotting factors are removed by
widespread clotting that too few remain to permit
normal clotting - Associated with infections, hypoxia, low blood
flow rates, trauma, hypotension hemolysis - Clots cause ischemia and necrosis leading to
multisystem organ failure
86Leukemia
- Acute leukemia
- uncontrolled production of immature leukocytes
- crowding out of normal red bone marrow cells by
production of immature WBC - prevents production of RBC platelets
- Chronic leukemia
- accumulation of mature WBC in bloodstream because
they do not die - classified by type of WBC that is
predominant---monocytic, lymphocytic.