CARDIOVASCULAR SYSTEM

BLOOD
HEART
BLOOD VESSELS
BLOOD


Chapter 17
Hematology=the study of
blood
Click Here For a Blood Tutorial
CHARACTERISTICS OF BLOOD
Liquid connective tissue
4-5 times more viscous than water
Slightly alkaline
Warmer than body temperature
Volume is 4-6 liters
Men=5-6 L
Women=4-5 L
Salt concentration of .85-.90%
CHARACTERISTICS OF BLOOD
Heterogeneous mixture

Non-living matrix called PLASMA (55%)


Formed elements (45%)
PLASMA
FORMED ELEMENTS
Erythrocytes= red
blood cells (RBC)

Leukocytes= white
blood cells (WBC)

Thrombocytes=
platelets
FUNCTIONS OF BLOOD
Distribution
Oxygen and carbon
dioxide
Hormones
Wastes

Protection
Clotting mechanisms
Phagocytosis and
antibody production

Regulation
pH
Body temperature
Fluid and electrolyte
balance
ERYTHROCYTE
CHARACTERISTICS

Most numerous
formed element with
(4.8 to 5.4 million per
mm
3
)
Very flexible
No nucleus
Biconcave disk
Life span about 120
days
Contains hemoglobin
HEMOGLOBIN=Transport Pigment
Oxyhemoglobin


Deoxyhemoglobin


Carbaminohemoglobin
Hemoglobin values:
Measured in grams per milliliter

14 20 g/100 ml in infants

13 18 g/100 ml in adult males

12 16 g/100 ml in adult females
ERYTHROPOIESIS
=PRODUCTION OF RBC OCCURS IN THE RED BONE
MARROW OF FLAT BONES AND IN SOME LONG BONES
Regulation of Erythropoiesis
Hormonal Controls
Erythropoietin
RBC and Hemoglobin amounts
Availability of oxygen

Dietary Controls
Adequate amino acids, lipids, and carbs
Iron
Vitamin B
12
and folic acid
Regulation of Erythropoiesis
Life Cycle of Erythrocytes
ERYTHROCYTE DISORDERS
ANEMIA
Insufficient #of RBCs
Hemorrhagic anemia
Hemolytic anemia
Aplastic anemia
Low hemoglobin
Pernicious anemia - macrocytes
Iron deficiency - microcytes
Abnormal hemoglobin
Thalassemia
Sickle cell Anemia
POLYCYTHEMIA
Primary polycythemia
Secondary
polycythemia
Erythrocyte Disorder
HEMATOCRIT
47% +/- 5% in males
45% +/- 5% in females
LEUKOCYTES
CHARACTERISTICS
Less numerous than RBC
(less than 1% of blood
with normal range of
4800 10,800 WBC/ml)
Critical defense cells of
the body
Distinct nuclei present
Capable of diapedesis
Demonstrate positive
chemotaxis
Lack hemoglobin
TYPES OF LEUKOCYTES
GRANULOCYTES
Neutrophils (PMNs)
Eosinophils
Basophils

Agranulocytes
Lymphocytes
Monocytes
TYPES OF LEUKOCYTES
Mnemonic Devices:
Granulated versus agranulated
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Relative Quantitates
Never Let Monkeys Eat Bananas!
LEUKOPOIESIS
LEUKOCYTE IMBALANCES
Leukocytosis (amounts greater than 11,000
WBC/ml)

Leukopenia (amounts less than 4,000 WBC/ml)

Leukemia
Acute leukemia
Chronic leukemia

Infectious Mononucleosis = kissing disease

THROMBOCYTES
CHARACTERISTICS

Involved in hemostasis
Less than half the size of
RBC
Numerous (250,000-
400,000 per ml
3
)
Actually cell fragments
rather than true cells
Life span is about 5-9
days
FORMATION OF PLATELETS
Regulated by thrombopoietin
STAGES OF BLOOD CLOTTING
Step 1: Vascular spasms
Endothelin
Serotonin


Step 2: Formation of a platelet plug
ADP
Serotonin
Thromboxane A
2

von Willebrand factor
STEP 3: COAGULATION
Phase 1: Formation of
prothrombinase (also
known as prothrombin
activator)

Phase 2: Conversion of
prothrombin to thrombin

Phase 3: Conversion of
soluble fibrinogen into
insoluble fibrin

Phase 1: Intrinsic versus Extrinsic
Pathways
Phase 2 and 3:
CLOTTING FACTORS
Hemostasis Continued
Clot Retraction
Also known as Syneresis
Serum (plasma minus clotting factors)

Repair: PDGF
Stimulates smooth muscle and fibroblast cells
to divide and rebuild the wall

Fibrinolysis
Plasmin = clot buster
Factors Effecting Clot Formation
Normal coagulation:
Normal platelet #s
ALL clotting factors
Vitamin K
Calcium ions
TF and PF
3

Preventing Undesirable Clotting
Nitric oxide
Prostacyclin (a prostoglandin)
Vitamin E quinone
Heparin
Anti-prothrombin III and Protein C

PLATELET DISORDERS
Thrombus

Embolus

Hemophilia

Thrombocytopenia

Impaired liver function

Disseminated Intravascular Coagulation (DIC)
Effects of Drugs on Clotting
Aspirin = antiprostaglandin that inhibits
thromboxane A
2

Heparin = natural anticoagulant produced by
basophils and mast cells that inhibits thrombin
by enhancing the activity of antithrombin III

Warfarin = (a.k.a. Coumadin) interfers with the
action of vitamin K
Summary of Formed Elements
Summary of Formed Elements
BLOOD TYPING
Blood types are base on the presence of
agglutinogens (antigens) present on the red
blood cell surface.

Also, based on presence of agglutinins
(antibodies) in the plasma.

The ABO and Rh systems are based on antigen-
antibody type interactions.
ABO BLOOD GROUPS
BLOOD TYPES
Blood
Type
Type of
Antigen?
Type of
Antibody?
Receive?
A A antigen Anti-B A, O
B B antigen Anti-A B, O
AB Both A and
B antigens
None A, B, AB, O
O None Both Anti-A
and Anti-B
O only
Rhesus Factor
Blood Type Presence of
D Antigen?
Type of
Antibody?
Receive?
Rh Positive
Yes

None

+ and -
Rh Negative
No

Anti-D

- only
BLOOD GROUPS
Type O 45%
Type A 42%
Type B 10% Type AB 3%
ABO BLOOD TYPING
BLOOD TYPE TUTORIAL
TEST YOUR KNOWLEDGE
BLOOD GROUPING DISORDERS

Transfusion Reaction
BLOOD GROUPING DISORDERS

Erythroblastosis
fetalis