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____________________________________________________________Chapter 13 Blood System

Lesson Plan

1 Blood System
3
TEACHING FOCUS
Students will have the opportunity to learn about the various functions of blood. Students will be exposed to
blood formation and composition, including different cell types and whole blood samples; identification of
blood types; blood transfusion therapy; diseases of the blood; and laboratory tests, clinical procedures, and
abbreviations associated with diagnosis and treatment of blood abnormalities. Students also will be exposed
to medical terminology in the proper context of medical reports and records.

MATERIALS AND RESOURCES

Bingo cards (Lesson 13.1)


Electron micrographs of red blood cell
(Lesson 13.1)
Glass cover slips (Lesson 13.1)
Glass slides (Lesson 13.1)

Light microscopes (Lesson 13.1)


Medical journals (Lesson 13.3)
Permount (Lesson 13.1)
Stain for whole blood smears (Lesson 13.1)
Sterile blood-drawing device (Lesson 13.1)

LESSON CHECKLIST

Preparations for this lesson include:


Lecture
Demonstration
Student performance evaluation of all entry-level skills required for student comprehension and
application of principles of the blood system, including:
o identification of terms relating to blood and blood clotting
o application of abbreviations in medical reports and records
o differentiation of blood types
o application of pathological conditions affecting blood

KEY TERMS

Vocabulary (pp. 512-513)


albumin
antibody
antigen
basophil
bilirubin
coagulation
colony-stimulating factor (CSF)
differentiation
electrophoresis
eosinophil
erythrocyte
erythropoietin (EPO)
fibrin
fibrinogen
globulin
granulocyte
hemoglobin
hemolysis
heparin

immune reaction
immunoglobulin
leukocyte
lymphocyte
macrophage
megakaryocyte
monocyte
mononuclear
neutrophil
plasma
plasmapheresis
platelet
prothrombin
reticulocyte
Rh factor
serum
stem cell
thrombin
thrombocyte

____________________________________________________________Chapter 13 Blood System


Terminology (pp. 514-516)
bas/o
chrom/o
coagul/o
cyt/o
eosin/o
erythr/o
granul/o
hem/o
hemat/o
hemoglobin/o
is/o
kary/o
leuk/o
mon/o
morph/o
myel/o
neutr/o
nucle/o
phag/o
Pathology (pp. 517-522)
anemia

poikil/o
sider/o
spher/o
thromb/o
-apharesis
-blast
-cytosis
-emia
-globin
-globulin
-lytic
-oid
-osis
-penia
-phage
-philia
-phoresis
-poiesis
-stasis
mononucleosis

Legend

CD
Companion CD

iTerms

IRM
Instructors
Resource Manual
available on CD
and Evolve

Evolve
Evolve
Resources

aplastic anemia
granulocytosis
hemochromatosis
hemolytic anemia
hemophilia
leukemia
Laboratory Tests and Clinical Procedures (pp. 522-525)
antiglobulin test (Coombs test)
bleeding time
coagulation time
complete blood count (CBC)
erythrocyte sedimentation rate (ESR or
sed rate)
hematocrit (Hct)
hemoglobin test (H, Hg, HGB)
partial thromboplastin time (PTT)
platelet count

REFERENCE LIST
PowerPoint slides (CD, Evolve): 1-44

LESSON 13.1
PRETEST
IRM Exercise Quiz A, B

PPT
PowerPoint
Slides

MTO
Medical
Terminology
Online

Class Activities are indicated in bold italic.

multiple myeloma
pernicious anemia
polycythemia vera
purpura
sickle cell anemia
thalassemia
prothrombin time (PT)
red blood cell count (RBC)
red blood cell morphology
white blood cell count (WBC)
white blood cell differential
apharesis
blood transfusion
bone marrow biopsy
hematopoietic stem cell transplant

____________________________________________________________Chapter 13 Blood System

BACKGROUND ASSESSMENT
Question: Red and white blood cells develop from a common hematopoietic stem cell, which is large and
nucleated. After cell differentiation and maturation, red cells no longer have nuclei and are very small, and
white cells are nucleated, often large, filled with granules, and are capable of phagocytosis. Why do mature
red blood cells look so different from their white counterparts?
Answer: Mature red blood cells are designed to squeeze in and out of the bone marrow and capillaries and
have a large surface area to carry and deliver gases to cells and tissues in the body. They shed their nuclei
during maturation after they make protein called hemoglobin. Hemoglobin molecules allow red blood cells
to carry oxygen in the form of oxy-hemoglobin, a molecule that produces the bright red color. Without
nuclei, red blood cells are incapable of reproducing themselves. Instead, after 120 days they are destroyed by
macrophages, which are cells in the spleen, liver, and bone marrow.
Question: What is the term for white blood cells? How many types are there and what does each one do?
What is an easy way to remember the names of the different types?
Answer: White blood cells are called leukocytes. There are three granulocytes and two mononuclear
leukocytes. The granulocytes include eosinophils, which are active and elevated in allergic conditions such
as asthma; basophils, which play a role in inflammation; and neutrophils, which are disease-fighting cells.
Within the mononuclear leukocytes there are lymphocytes, which fight disease by producing antibodies and
destroying foreign cells and monocytes, which engulf and destroy cellular debris, after neutrophils have
attacked foreign cells. An easy way to remember the names of the five leukocytes is Never (neutrophil) Let
(lymphocyte) Monkeys (monocyte) Eat (eosinophil) Bananas (basophil).

CRITICAL THINKING QUESTION


Susan finally visits her physician after feeling tired, dizzy, nauseous, and feverish for a long time.
During her physical, the doctor draws whole blood to do a complete blood count and white cell
differential. How might this help in making a diagnosis?
Guidelines: The white cell differential breaks down cellular components of peripheral whole blood. In a
normal differential, the percentage of leukocytes in the blood includes 0% to 1% basophils, 1% to 4%
eosinophils, 50% to 70% neutrophils, 20% to 40% lymphocytes, and 3% to 8% monocytes. Susan may be
fighting an infection if her lymphocyte count is elevated, or she may have a parasitic infection if her
eosinophil count is elevated. The doctor may find an unusually high percentage of a particular cell type or
more immature cells that are overcrowding other cell types. This may indicate blood dyscrasia of the bone
marrow or acute leukemia. If her red blood cells are showing changes in their morphology, this could
indicate a reduction in cells that transport oxygen to the tissues.

OBJECTIVES
Identify terms
relating to the
composition,
formation, and
function of blood

CONTENT

Introduction (p. 504)


Composition and formation of
blood (p. 504)

TEACHING RESOURCES
PPT 5-11
MTO Module 13, Section I, Lessons 1-4
Figure 13-1 Stages in blood cell development
(p. 505)

Cells (p. 504)

Erythrocytes (p. 504)

Leukocytes (p. 507)

Platelets (p. 508)

Figure 13-3 The breakdown of hemoglobin


(p. 506)

Plasma (p. 509)

Figure 13-4 Normal leukocytes (p. 506)

Figure 13-2 Erythrocytes (p.505)

Figure 13-5 Phagocytosis (p. 507)


Table 13-1 Leukocytes (p. 508)
Figure 13-6 A, Megokaryocyte; B, Platelets
(p. 508)
Figure 13-7 The composition of blood (p. 509)
Exercises A-C (pp. 528-529)
Class Activity Have

students make flash cards


using the names, abbreviations, and

____________________________________________________________Chapter 13 Blood System

OBJECTIVES

CONTENT

TEACHING RESOURCES
combining forms for blood. Have them
practice the definitions in pairs.
Read the terms for the
formation, composition, and functions of the
blood. Ask students to correctly spell, analyze,
and define them.
Class Activity

Differentiate
among the
different types of
blood groups.

Blood types (p. 510)

PPT 12
MTO Module 13, Section I, Lesson 5
Table 13-2 Blood types (p. 510)
Exercise D (p. 529)
Class Activity Ask

students to use the Internet


to answer the following questions: What is
the distribution of blood types among the
general U.S. population? World population?
Does it differ by race or ethnicity? If so, why?
Have them report their results to the class.
Divide students into the four
different blood types by taping a specific type
to their backs. Ask them to find their
particular type by playing a form of Twenty
Questions. They are allowed to ask Am I
type __? only once. If wrong, they must sit
down. At the end of the exercise, have all
students who can donate to each type gather
together. Then ask all who can receive from a
specific type to gather together. Ask students
Class Activity

to sit, and then discuss the problem of


inadequate blood donation in the United
States and what can be done to address the
need.
Identify terms
related to blood
clotting.

Blood clotting (p. 510)

PPT 13
MTO Module 13, Section I, Lesson 6
Figure 13-8 The usual sequence of events in
blood clotting (p. 511)
Figure 13-9 A red blood cell enmeshed in
threads of fibrin (p. 511)
Exercises E, F (pp. 530)
Ask groups of three to develop a
description of the process of blood clotting.
Ask that this be a visual display that can be
drawn on the board or displayed on a
transparency. Pick a group to present their
description to the class. Have the class offer
improvements.
Class Activity

Apply your new


knowledge to
understanding

Vocabulary (p. 512)

PPT 14-15
Class Activity

Divide the class into two teams.

____________________________________________________________Chapter 13 Blood System

OBJECTIVES

CONTENT

medical terms in
their proper
contexts, such
as medical
reports and
records.

Build words and


recognize
combining forms
used in the
blood system
terminology.

TEACHING RESOURCES
Call out definitions and see which team
names the most correct terms. Assign points
to determine the winner.
Alternatively, read exercise A to
students, asking them to spell, analyze, and
underline the accented syllable in the terms
that fit the definitions read.
Class Activity

Terminology (p. 514)

13.1 Homework/Assignments:

13.1 Teachers Notes:

PPT 16-20
Class Activity Create

a set of bingo cards with


a different combining form in each box
(5 x 5); vary the combining forms and/or the
order so cards are not all alike. Bingo card
generators are available online. Create a list
of definitions related to the blood system and
corresponding to the combining forms on the
bingo cards. Call out a definition. Students
must circle the correct combining form on the
bingo card. Award a point to the first student
to complete bingo. If a student claims to have
bingo and is incorrect, he or she is
disqualified from that round.

____________________________________________________________Chapter 13 Blood System

LESSON 13.2
CRITICAL THINKING QUESTION
Anemia is characterized by generalized fatigue because of a deficiency in erythrocytes or hemoglobin.
What are different types of anemia and their deficiencies?
Guidelines: Anemia can be produced by a deficiency of normal red blood cells, and abnormal red cell
formation can produce symptoms. With sickle cell anemia, for example, the crescent or sickle shapes of
erythrocytes cause difficulty with normal passage through small blood vessels, leading to thrombosis and
infarction (dead tissue). The condition is caused by an abnormal type of hemoglobin, a genetic defect
prevalent in persons of African or African-American ancestry. Hemolytic anemia is the reduction of red
cells resulting from a destruction of fragile red cells of abnormal spheroidal shape. Aplastic anemia is the
reduction of red blood cells caused by the failure of stem cells in the marrow to produce cells. Thalassemia is
an inherited defect, usually in people of Mediterranean background, in which hemoglobin content in red
cells is diminished.

OBJECTIVES
Describe various
pathological
conditions
affecting blood.

CONTENT

Pathology (p. 517)

Diseases of red blood cells


(p. 517)
Disorders of blood clotting
(p. 519)

TEACHING RESOURCES
PPT 22-31
MTO Module 13, Section II, Lessons 1-3
Figure 13-10 A, Normal red blood cells; B,
iron deficiency anemia (p. 517)

Diseases of white blood cells


(p. 520)

Figure 13-11 Normal red blood cells and the


abnormal cells in several types of anemia
(p. 518)

Diseases of the bone marrow


(p. 522)

Figure 13-12 A, Petechiae; B, Ecchymoses


(p. 520)
Figure 13-13 Acute leukemia; A, Acute
myeloblastic leukemia; B, Acute lymphoblastic
leukemia (p. 521)
Exercises G-I (pp. 531-532)
Class Activity Divide

students into four groups


with each group reporting on one type of
anemia. Have students explain the underlying
cause of the anemia, potential therapies, and
general prognosis. With regard to genetic
abnormalities, have students explain which
groups are most affected and why
abnormalities are prevalent among certain
groups.
Class Activity Discuss

the various types of


leukemia and the age groups most affected.
Divide students into groups and have each
group report on current therapies and the
general prognosis for each type of leukemia.

13.2 Homework/Assignments:

____________________________________________________________Chapter 13 Blood System

13.2 Teachers Notes:

____________________________________________________________Chapter 13 Blood System

LESSON 13.3
CRITICAL THINKING QUESTION
Question: People who need blood transfusions after injury are blood-typed before being transfused. Both
recipients and donors are tested to be certain their blood is compatible. This is especially important for the
recipient. Why?
Answer: Blood-group antigens and antibodies in blood determine blood type. Type A blood contains A
antigen and anti-B antibody, and Type B blood contains B antigen and anti-A antibody. The problem with
transfusing from a type A donor into a type B recipient is that A antigens will react adversely with the anti-A
antibodies in the recipients type B bloodstream. The accidental adverse reaction is hemolysis, or breakdown
of blood cells. Intravascular hemolysis may lead to disseminated intravascular coagulation, which is a
serious coagulopathy.

OBJECTIVES
Differentiate
among various
laboratory tests,
clinical
procedures, and
abbreviations
used in
connection with
the blood
system.

CONTENT

Laboratory tests, clinical


procedures, and abbreviations
(p. 522)

TEACHING RESOURCES
PPT 33-35
MTO Module 13, Section III, Lessons 1-2

Laboratory tests (p. 522)

Figure 13-14 Leukapheresis (p. 524)

Clinical procedures (p. 524)

Practical Applications (pp. 526-527)


Exercises J, K (pp. 532-533)
Class Activity Divide

the class into four


groups. Their mission: to determine the
appropriate lab tests for certain conditions.
Have students create cards with a different
lab test and its definition written on each one.
When the teacher describes a symptom or
condition being tested, each group holds up
the card with the proper blood test. There
may be several right answers. Discuss which
tests should be performed and why. Give
points for correct answers; deduct points if
test names or medical conditions are
mispronounced.
Class Activity Have

four student groups create


crossword puzzles relating to terms about
transplant or transfusion therapy. Have
groups exchange puzzles.

Apply your new


knowledge to
understanding
medical terms in
their proper
contexts, such
as medical
reports and
records.

Practical Applications (p. 526)

PPT 36-43
MTO Module 13, Section V
Practical Applications (pp. 526-527)
Read the case report
and ask students to write the answers to
the questions. Ask them to spell out all
abbreviation and analyze and define terms
Class Activity

____________________________________________________________Chapter 13 Blood System

OBJECTIVES

CONTENT

TEACHING RESOURCES
used in the answers.

Differentiate
among various
laboratory tests,
clinical
procedures, and
abbreviations
used in
connection with
the blood system.
Define
combining forms
for blood system
and the meaning
of related
terminology
using these
words.

Abbreviations (p. 525)

Exercise L (p. 533)


Class Activity Blood

Terminology Bingo:
Create bingo cards with blood terminology
abbreviations and acronyms. To play, the
meanings of terms are called out. Switch
callers.

Pronunciation of terms (p. 538)

Vocabulary and terminology


(p. 538)

Pathological conditions,
laboratory tests, and clinical
procedures (p. 540)

Pronunciation of Terms (pp. 538-541)


Review Sheet (pp. 542-543)
iTerms Chapter 13
Class Activity Word

Component Terminology
Bingo: Create bingo cards with word
components that are presented in this chapter.
To play, the meanings of terms are called out.
The first winner becomes the next caller.
Spell a medical term to the class.
Ask students to copy the term, underlining the
accented syllable and analyzing the terms.
Ask students to pronounce the word. Repeat
this for 10 to 20 terms.
Class Activity

Divide the class into teams of


two. Have one student practice pronouncing
half of the list of terms while the other
student keeps track of the correct and
incorrect pronunciations. Have the students
switch sides for the second half of the list of
terms.
Class Activity

Performance
Evaluation

ESLR Student Quiz Chapter 13


MTO Module 13, Sections I-III quizzes
MTO Module 13 Exam

____________________________________________________________Chapter 13 Blood System


13.3 Homework/Assignments:

Have students find articles from medical journals, newspapers, or periodicals that include terminology
associated with the blood system. Students should underline about 15 to 25 terms. In class, have students
exchange articles and together identify meanings of the underlined terms.

13.3 Teachers Notes:

10