Introduction to Blood, Erythrocytes and Anemia

1
Introduction to Blood, Erythrocytes and Anemia

• Clinical Pathology
• Ms. Canga

2
Introduction to Blood, RBCs, and AnemiaTopics
for discussion

• Function of blood and various components
• Composition
• Fluid
• Cellular (Specific to erythrocytes)
• Anemia
• Staining

3
The Function of Blood

• Classified as a _____________________ tissue
• Fun Fact Approximately ___ of animals body wt.
  is blood.
• _________________________
• _________________________
• _________________________

4
Function Transportation

• Carries _______, nutrients, etc
• To every living cell in the body.
• Carried by _______ in erythrocytes
• Nutrients, etc. are dissolved and delivered via
  ____________
• Carries waste products of cellular metabolism
• Primary waste product is ___________
• Carried to disposal organs that excrete from body
• ______________________________

5
Transportation continued

• Transports _______________________
• From ______________ glands to target _________
• Transports _______________________
• From _______________________ in to circulation
• Final destination is the _____________ as needed
• Transports _______________________
• To site of ______________ within
  _________________
• Clump together to prevent further escape.

6
Function Defense

• Leukocytes
• (Will be covered in more detail later)
• Defense from foreign invaders
• _______________________
• _______________________
• Platelets (Will be covered in more detail later)
• Work along side 13 clotting factors in the blood
• Are activated when a _______________________wall
  is damaged.
• Very complex process in which ALL factors must be
  activated in ____________ and __________________
  in order for clot to form.
• Each factor depends on the _____________ factor
  to activate it.

7
Function Regulation

• Regulatory system
• _______________________
• _______________________
• _______________________

8
Regulation

• Acid-base balance
• Regulation of blood ______.
• Normal range is ________________(IDEAL _____)
• Higher pH _______________________
• Lower pH _______________________
• Required for _______________________
• Assists with neutralizing acidic waste products
  of cellular metabolism.
• Which blood is MORE alkaline? Arterial or
  venous?
• Why?

9
Regulation continued

• Body temperature
• Regulators located in the _____________are
  influenced by temperature of the blood that
  passes over them.
• Most dogs and cats average 101.0 102.5oF
• Homeostasis
• Body tissue fluid is maintained as
  __________________ as possible.
• If fluid is lost in large amounts, fluid moves
  from ________________________ into tissues to
  compensate.
• Leaves less plasma in bloodstream, causing
  _______________________.
• If fluids are given or excessive fluids are
  present, fluid moves from ______________________
  into bloodstream.
• Excessive fluid in bloodstream causes
  _______________________.

10
Composition of Blood

• _______________________ tissue
• Composed of ____________and __________
• Cellular portion is composed of
• _____________ Responsible for gas exchange
• _____________ Responsible for defense and
  immunity
• _____________ Prevent leakage of blood from
  vessels
• Liquid portion of whole blood is called
  __________
• Whole Blood Blood in cardiovascular system, OR
  blood that contains plasma and all other
  components.
• Plasma is 90 water.

11
Recipe for an RBC

• __________
• __________ (for the synthesis of heme-)
• __________ is also important in release of iron
  from tissues into plasma
• ____________________ (formation of -globin)
• Essential ______________ (phospholipid bilayer)
• __________________ helps form RBC
• __________________ also helps in RBC formation
• ____________________ works with B12 to help form
  RBC.

12
Formation of RBCs

• Formerly known as __________
• Process of formation is called _______________.
• Erythropoiesis takes place in __________________
  and is initiated by the cytokine called
  __________________ (EPO).
• EPO produced by __________, is released when
  kidney cells detect __________in blood.
• EPO acts on __________ ______and causes it to
  begin undergoing __________divisions, developing
  into several RBC precursors.

13
Maturation Cycle of an Erythrocyte
14
Morphological Changes during Maturation

• Rubriblast
• Is very large, with royal blue __________.
• Contains a large purple nucleus in a loose
  __________ pattern.
• Prorubricyte
• Is slightly smaller, with a __________
  cytoplasm.
• The __________ composing the nucleus is slightly
  smaller and __________ and stains __________.
• Rubricyte
• Is smaller still, with either a __________or
  slightly __________ cytoplasm as it begins to
  acquire the __________molecules.

15
Morphological Changes during Maturation

• Metarubricyte
• Cytoplasm is similar in color to __________ RBC.
  
• Nucleus is now considered __________ (becoming
  more dense) and stains dark blue.
• (____________________ may be seen here)
• Reticulocyte
• __________is pushed out of cell leaving behind
  ____________________ composed of RNA.
• Cytoplasm stains slightly blue, and
  ____________________ may be seen if stained with
  Wrights stain. (Deff-Quick is a modified
  Wrights stain)
• Mature RBC is seen after all ____________________
  is lost from reticulocyte.

16
Morphological Changes During RBC Maturation
17
The End Result Erythrocytes
18
Erythrocytes

• Mature RBC is ____________________ sac.
• Contains _____ water and _____ solids
  (mainly __________)
• Canines have __________RBCs __________ in
  diameter
• µ a micron. One micron is one millionth of a
  meter (VERY TINY)
• Cats, horses, cows, sheep and goats are smaller
  __________ in diameter.

19
(No Transcript)
20
Erythrocytes - Morphology

• Membrane is ____________________
• Can change shape, but is not __________.
• _______________ shape provides more
  ____________________ to allow for gas exchange to
  take place.
• Disk shape allows for shorter __________ distance
  in and out of cell compared to a sphere.
• Animals with __________ biconcave shape usually
  have __________ number of RBCs on average.

21
Erythrocytes Hemoglobin

• Carry __________ to all tissues of the body.
• O2 carried through hemoglobin, which binds to the
  oxygen.
• __________ pigment portion
• produced in __________
• __________ protein portion
• Produced by __________

22
Hemoglobin - structure

• For every heme group, there is one __________
  molecule
• Four __________ groups attach to each globin
  molecule.
• This means that each hemoglobin molecule can
  carry __________ molecules of oxygen.

23
Hemoglobin molecule
24
Hemoglobin Types

• __________ hemoglobin (HbE)
• __________ hemoglobin (HbF)
• __________ hemoglobin (Hb)
• Each type of hemoglobin is found during different
  stages of development in the animal.

25
Embryonic and Fetal hemoglobin

• Embryonic hemoglobin (HbE) is found in early
  developing __________.
• Fetal hemoglobin (HbF) is present in fetal blood
  during mid to late __________.
• Is also present up to a couple of months after
  birth.
• Highest concentration of HbF is at __________.

26
Adult Hemoglobin (Hb)

• Found in the RBCs of all animals beginning a
  couple of weeks to months after birth.
• Gradually replaces __________ as primary type
  being produced by the body.
• Inside normal RBCs, Hb is ___________________.

27
Function of (Adult) Hemoglobin

• Transports __________to the tissues
• Exists in two normal physiological states.
• ____________________ Carrying oxygen
• One oxygen molecule is associated with each iron
  molecule.
• pH, temperature, and O2 and CO2 levels influence
  ability of Hb to carry O2
• ____________________ Has given up oxygen.
• Also known as __________ hemoglobin.
• CO2 is transported directly and indirectly in the
  RBC and is dissolved in the __________.

28
RBC Life Span and Destruction

• Average in dogs is ____ days
• Average in cats is ____ days
• As an RBC ages, they are replaced by young, but
  mature RBCs from __________ in constant
  ______________________ cycle.
• Process of aging is called ____________________.

29
Senescence

• The process of cellular __________
• Enzyme activity __________
• Cell loses ____________________ and becomes
  __________ as its volume decreases.
• 90 of destruction of senescent RBCs occurs
  through ____________________.
• Takes place __________ the cardiovascular system
  via macrophage ____________________.
• Macrophages of __________ are especially active
  in removal of senescent RBCs

30
Extravascular Hemolysis

• Once inside a macrophage, the __________________
  of the RBC is destroyed.
• Contents are recovered from the macrophages and
  ________is transported back to red bone marrow.
• Heme is eliminated from the body by being
  converted to ____________. Bilirubin binds to
  ___________ (plasma protein) and is carried to
  the liver.
• Because it is not ____ soluble, it is called
  ________________________ or free bilirubin.

31
Extravascular Hemolysis, contd.

• Once in the liver, bilirubin is _________________
  to ________________________, making the
  combination water soluble.
• Conjugated bilirubin is excreted as a ______
  pigment into the intestines.
• Some conjugated bilirubin is converted into
  _____________________ by bacteria and eliminated
  in the ____________ as urobilin.
• Other conjugated bilirubin is converted into
  ______________________ and excreted in the
  __________ as stercobilin.

32
Senescence

• ____ of RBC destruction takes place through
  _________________________ hemolysis
• Takes place within _____________________________.
• Results in blood cell fragmentation and/or
  destruction
• When RBC membrane ruptures in blood vessel, _____
  is released directly into the blood.
• ____________________ Hb is picked up by transport
  protein called __________.
• __________carries unconjugated Hb to macrophages
  in the __________ for breakdown.
• Once in liver, ____________________hemolysis
  continues.

33
Senescence

• When ____________________is filled with
  ____________________ hemoglobin, the excess
  unconjugated Hb has nothing to bind to.
• Excess Hb is carried to __________ for excretion
  in urine.
• _________________ ____hemolysis results in plasma
  that is pink, red, or brownish.
• C/S will be ____________________.
• Urine will be pink, red, or brownish in color.

34
Anemia

• Anemia a pathological condition resulting in
  decreased oxygen-carrying capacity of the blood.
• May be caused by
• Low number of circulating mature RBCs
• Increased __________ (RBC parasites/radiation
  therapy)
• Decrease __________ (Bone marrow suppression)
• Inappropriate __________ (hemorrhage)
• Not enough ____________________being produced for
  normal RBCs present. (Iron deficiency)
• Appropriate of RBCs are present
• Insufficient Hb to fill each cell.

35
Classifying Anemia

• Anemia may be classified as either
• Regenerative Usually caused by hemorrhage or
  hemolysis.
• Non-regenerative Involves the bone marrow
• (More on Anemia in next presentation)

36
Polycythemia

• An __________ above normal in the number of RBCs.
• Three common types
• _______________________________________
• _______________________________________
• _______________________________________

37
Relative Polycythemia

• Seen in ____________________
• Common in __________ animals due to sensible and
  insensible losses such as
• Excessive __________, __________, __________or
  reduced __________intake.
• You will learn more about sensible and insensible
  losses in Special Topics.

38
Treatment of Relative Polycythemia

• Correction of cause of _____________________
• Use of ____________________
• Managing __________ intake is critical

39
Compensatory Polycythemia

• Also known as __________ Polycythemia
• Result of __________
• Bone marrow is stimulated to produce more RBCs
  because tissues arent getting enough oxygen.
• Animals living in ____________________ often
  develop this type of polycythemia.
• Patient in heart failure may develop this type of
  polycythemia because heart isnt pumping enough
  blood to tissues, resulting in __________.

40
Treatment of Compensatory Polycythemia

• ____________________may be required if no
  inappropriate physiological cause
• If there is an underlying __________, surgical
  correction, followed by __________ treatment is
  required. (phlebotomy to normalize PCV may also
  be required)

41
Polycythemia Rubra Vera

• Rare ____________________ disorder
• Characterized by increased _______________ of
  RBCs
• EPO levels are __________. Bone marrow is
  producing __________ stimulation from EPO.

42
Treatment of Polycythemia Rubra Vera

• __________is required
• __________mLs/kg
• Simultaneous __________therapy to maintain
  overall blood __________.
• Treatment with Rx Hydroxyurea will help to
  suppress the production of RBCs.

43
Staining of Blood

• Different __________ within cell stain specific
  colors.
• Many different hematology stains
• Different names but similar staining
  characteristics.
• Many are _________________-_________stains
  (Wrights stain, Giemsa, Leishmans,
  Wright-Giemsa, and May-Grunwald are all
  Romanovsky-type stains)
• Also called ____________________ stains because
  they stain more than one color.
• Combination of basic blue and acidic red dyes
  dissolved in __________alcohol.
• Allows ____________________ structures to stain
  blue
• Allows ____________________ structures to stain
  red.

44
Staining Blood

• Stain depends on ________ you are performing.
• Each test we do in here will have specific stain
  instructions.
• ____________________stain is the most widely used
  hematology stain.
• Alkaline part is ____________________ blue
• Acidic part is __________
• Modified Wrights stains offer faster staining
  times but dont stain some cellular structures as
  effectively.
• ____________________ is a Modified Wrights stain.

45
Sources

• http//compepid.tuskegee.edu/syllabi/pathobiology/
  pathology/clinpath/chapter2.html
• Clinical Anatomy and Physiology for Veterinary
  Technicians Colville and Bassert. Second Edition
• Merckvetmanuals.com