Chapt14 holes lecture

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Chapter 14Lecture

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Chapter 14

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Hole’s Human Anatomyand Physiology

Twelfth Edition

Shier Butler Lewis

Chapter 14

Blood


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14.1: Introduction

Blood: • Is connective tissue• Transports vital substances• Maintains stability of interstitial fluid• Distributes heat

Blood cells:• Form mostly in red bone marrow and are:• Red blood cells (RBCs)• White blood cells (WBCs)• Platelets (cell fragments)

• The amount of blood varies with body size, changes in fluid concentration, changes in electrolyte concentration, and amount of adipose tissue• Blood is about 8% of body weight• Adult blood volume is about 5 liters

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Centrifuged Blood Sample

Peripheral Blood Smear

Liquid (plasma)

“Buffy coat” (white blood cells and platelets)

Red blood cells

Red blood cellsPlatelets

White bloodcells

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Plasma = 55%

Capillary tube

Plug

Buffy coat

Red cells = 45%(hematocrit)

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Blood

(4.8%) (95.1%) (0.1%)

Plasma

Hormones

MonocytesBasophilsEosinophilsNeutrophils

(54–62%) (1–3%) (<1%) (3–9%) (25–33%)

GlobulinsAlbumins

(92%) (7%)

N2 O2 CO2

Platelets Red blood cells Proteins Nutrients Gases

45% 55%

WastesWaterWhite blood cells Electrolytes

Vitamins

Lymphocytes Fibrinogen

Formed elements


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14.2: Blood Cells

• Blood cells originate in red marrow from hemocytoblasts or hematopoietic stem cells• Stem cells can then:

• Give rise to more stem cells• Specialize or differentiate

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The Origin of Blood CellsCopyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.

(b)

Megakaryoblast

Myeloid stem cell

Megakaryocyte

Monocyte

Macrophage

T lymphocyte B lymphocyte

Plasma cell

Hematopoietic stem cell

Myeloblast

Progranulocyte

Erythroblast

Normoblast

Reticulocyte

Erythrocyte

In c

ircu

lati

ng

blo

od

NeutrophilBasophil

Granulocytes

Eosinophil

ProerythroblastMonoblast

PromonocyteProlymphocyte

Prolymphocyte

In r

ed b

on

e m

arro

w

Agranulocytes

(a)

Lymphoid stem cell

LymphoblastB cell

precursorLymphoblast

T cellprecursor

Neutrophilicmyelocyte

Basophilicmyelocyte

Eosinophilicmyelocyte

Eosinophilicband cell

Basophilicband cell

Neutrophilicband cell

Thrombocytes(platelets)

Act

ivat

ed in

tis

sues

(so

me

cells

)

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Characteristics of Red Blood Cells

Red blood cells are:• Erythrocytes• Biconcave discs • One-third hemoglobin or:

• Oxyhemoglobin• Deoxyhemoglobin

• Able to readily squeeze through capillaries• Lack nuclei and mitochondria


Top view

2.0 micrometers

7.5 micrometers

Sectional view(a)

(b)

b: © Bill Longcore/Photo Researchers, Inc.

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Red Blood Cell Counts

• RBC counts is the number of RBCs in a cubic millimeter or microliter of blood• It may vary depending on age and health• Typical ranges include:

• 4,600,000 – 6,200,000 in males• 4,200,000 – 5,400,000 in adult females• 4,500,000 – 5,100,000 in children

• RBC counts reflects blood’s oxygen carrying capacity

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Red Blood Cell Production and Its Control

• Low blood oxygen causes the kidneys and the liver to release erythropoietin (EPO) which stimulates RBC production• This is a negative feedback mechanism• Within a few days many new blood cells appear in the circulating blood

Low blood oxygen

Liver Kidney

Erythropoietin

Red bone marrow

+

–

Bloodstream

Stimulation

Inhibition

Release intobloodstream

Increasedoxygen-carryingcapacity

Increasednumber ofred blood cells


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Dietary Factors Affecting Red Blood Cell Production

• Vitamin B12 and folic acid are necessary• They are required for DNA synthesis making them necessary for the growth and division of all cells

• Iron is also necessary• It is required for hemoglobin synthesis

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Bilirubin

Bone

Blood

Liver

Globin + Heme

3

2

1 Absorption

4

5Macrophage

Hemoglobin

Iron + Biliverdin

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6

7Bile

Red bonemarrow

Red bloodcells produced

Red blood cellscirculate inbloodstream forabout 120 days

Old redblood cells

Blood transportsabsorbed nutrients

Nutrientsfrom food

Vitamin B12

Folic acidIron

Smallintestine


(b)

(a)

a: © The McGraw-Hill Companies, Inc./Al Telser, photographer :b © Ed Reschke


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14.1 Clinical Application

King George III

and Porphyria Variegata

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Destruction of Red Blood Cells

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Types of White Blood Cells

• White blood cells:• Are leukocytes• Protect against disease• WBC hormones are interleukins and colony-stimulating factors which stimulate development• There are five types of WBCs in two categories:

• Granulocytes• Neutrophils• Eosinophils• Basophils

• Agranulocytes• Lymphocytes• Monocytes

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Neutrophils

• Light purple granules in acid-base stain• Lobed nucleus• Other names

• Segs• Polymorphonuclear leukocyte• Bands (young neutrophils)

• First to arrive at infections• Phagocytic• 54% - 62% of leukocytes• Elevated in bacterial infections

© Ed Reschke


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Eosinophils

• Deep red granules in acid stain• Bi-lobed nucleus• Moderate allergic reactions• Defend against parasitic worm infestations• 1% - 3% of leukocytes• Elevated in parasitic worm infestations and allergic reactions

© Ed Reschke


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Basophils

• Deep blue granules in basic stain• Release histamine• Release heparin• Less than 1% of leukocytes• Similar to eosinophils in size and shape of nuclei

© Ed Reschke


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Monocytes

• Largest of all blood cells• Spherical, kidney-shaped, oval or lobed nuclei• Leave bloodstream to become macrophages• 3% - 9% of leukocytes• Phagocytize bacteria, dead cells, and other debris

© R. Kessel/Visuals Unlimited


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Lymphocytes

• Slightly larger than RBC• Large spherical nucleus surrounded by thin rim of cytoplasm• T cells and B cells

• Both important in immunity

• B cells produce antibodies• 25% - 33% of leukocytes

© Ed Reschke


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Functions of White Blood Cells

• WBCs protect against infection• These leukocytes can squeeze between the cells of a capillary wall and enter the tissue space outside the blood vessel (called diapedesis)

Blood capillary

Leukocyte

Connectivetissue


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Epidermis

Dermis Blood vessels

1 Splinterpuncturesepidermis

5 6

2 3 4 Injured cellsrelease histamine,causing bloodvessels to dilate

Bacteriamultiply

Bacteria are introduced into the dermis

Neutrophils destroybacteria by phagocytosis

Neutrophils move throughblood vessel walls andmigrate toward bacteria


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White Blood Cell Counts

• A procedure used to count number of WBCs per cubic millimeter of blood

• Typically 5,000 – 10,000 per cubic millimeter of blood• Leukopenia:

• Low WBC count (below 5,000)• Typhoid fever, flu, measles, mumps, chicken pox, AIDS

• Leukocytosis: • High WBC count (above 10,000)• Acute infections, vigorous exercise, great loss of body fluids

• Differential WBC count• Lists percentages of types of leukocytes• May change in particular diseases

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Leukemia

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Blood Platelets

• Platelets are also known as thrombocytes• They are cell fragments of megakaryocytes• They lack a nucleus and are roughly half the size of a RBC• There are approximately 130,000 – 360,000 per cubic millimeter of blood• They help repair damaged blood vessels by sticking to broken surfaces

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14.3: Blood Plasma

• Blood plasma is:• Straw colored• The liquid portion of blood• 55% of blood volume• 92% water• Includes transporting nutrients, gases, and vitamins• Helps regulate fluid and electrolyte balance and maintain pH

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Plasma Proteins

• These are the most abundant dissolved substances (solutes) in plasma

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Gases and Nutrients

• The most important blood gases:• Oxygen• Carbon dioxide

• Plasma nutrients include:• Amino acids• Simple sugars• Nucleotides• Lipids

• Fats (triglycerides)• Phospholipids• Cholesterol

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Nonprotein Nitrogenous Substances

• These are molecules containing nitrogen but are not proteins• In plasma they include:

• Urea – product of protein catabolism; about 50% of nonprotein nitrogenous substances• Uric acid – product of nucleic acid catabolism• Amino acids – product of protein catabolism• Creatine – stores phosphates• Creatinine – product of creatine metabolism• BUN – blood urea nitrogen; indicates health of kidney

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Plasma Electrolytes

• Plasma contains a variety of these ions called electrolytes

• They are absorbed from the intestine or released as by-products of cellular metabolism

• They include:• Sodium (most abundant with chloride)• Potassium• Calcium• Magnesium• Chloride (most abundant with sodium)• Bicarbonate• Phosphate• Sulfate

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14.4: Hemostasis

• Hemostasis refers to the stoppage of bleeding• Actions that limit or prevent blood loss include:

• Blood vessel spasm• Platelet plug formation• Blood coagulation

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Blood Vessel Spasm

• Blood vessel spasm• Triggered by pain receptors, platelet release, or serotonin• Smooth muscle in blood vessel contracts

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Platelet Plug Formation• Platelet plug formation

• Triggered by exposure of platelets to collagen• Platelets adhere to rough surface to form a plug


Endothelial lining Collagen fiber

Platelet Red blood cell

1

2

3

4

Break invessel wall

Blood escapingthrough break

Platelet plug helps control blood loss

Platelets adhere to each other , to end of broken vessel, and to exposed collagen

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Blood Coagulation

• Blood coagulation• Triggered by cellular damage and blood contact with foreign surfaces• A blood clot forms• This is a:

• Hemostatic mechanism• Causes the formation of a blot clot via a series of reactions which activates the next in a cascade• Occurs extrinsically or intrinsically

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Extrinsic Clotting Mechanism

• Extrinsic clotting mechanism• Chemical outside of blood vessel triggers blood coagulation• Triggered by tissue thromboplastin (factor III) (not found in blood)• A number of events occur that includes factor VII, factor X, factor V, factor IV, and factor II (prothrombin)• Triggered when blood contacts damaged blood vessel walls or tissues• This is an example of a positive feedback mechanism

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© SPL/Photo Researchers, Inc.


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Intrinsic Clotting Mechanism

• Intrinsic clotting mechanism• Chemical inside blood triggers blood coagulation• Triggered by Hageman factor XII (found inside blood)• Factor XII activates factor XI which activates IX which joins with factor VIII to activate factor X• Triggered when blood contacts a foreign surface

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Tissue damage

Releases

Factor Vll

Factor X

(Ca+2)

(Ca+2)

Activates (Ca+2)

Converts

Converts

(Ca+2)

(Ca+2)

Activates

Activates

Factor V

Fibrin

Factor lX

Factor Xl

Factor X

Activates

Activates

Activates

Activates

Activates

Hageman Factor Xll

Factor V

StabilizesFactor Xlll

Extrinsic ClottingMechanism

Tissue thromboplastin(Factor lll)

Blood contactsforeign surface

Intrinsic ClottingMechanism

Prothrombinactivator

Prothrombin(Factor ll)

Thrombin(Factor lla)

Fibrinogen(Factor l)

Fibrinclot

Factor Vlllplatelet phospholipids

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Fate of Blood Clots

• After a blood clot forms it retracts and pulls the edges of a broken blood vessel together while squeezing the fluid serum from the clot• Platelet-derived growth factor stimulates smooth muscle cells and fibroblasts to repair damaged blood vessel walls• Plasmin digests the blood clots• A thrombus is an abnormal blood clot• An embolus is a blood clot moving through the blood vessels

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Lumen LumenArtery wall Plaque Artery wall

(a) (b)

© The McGraw-Hill Companies, Inc./Al Telser, photographer


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Deep Vein Thrombosis

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Prevention of Coagulation

• The smooth lining of blood vessels discourages the accumulation of platelets and clotting factors• As a clot forms fibrin absorbs thrombin and prevents the clotting reaction from spreading• Anti-thrombin inactivates additional thrombin by binding to it and blocking its action on fibrinogen• Some cells such as basophils and mast cells secrete heparin (an anticoagulant)

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14.5: Blood Groups and Transfusions

• In 1910, identification of the ABO blood antigen gene explained the observed blood type incompatibilities• Today there are 31 different genes known to contribute to the surface features of RBCs determining compatibility between blood types

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Antigens and Antibodies

• Terms to become familiar with:

• Agglutination – clumping of red blood cells in response to a reaction between an antibody and an antigen

• Antigens – a chemical that stimulates cells to produce antibodies

• Antibodies – a protein that reacts against a specific antigen

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Type B blood

Type AB blood Type O blood

Red blood cell

Red blood cell Anti-B antibody

Antigen A

Anti-A antibody Anti-B antibodyRed blood cell

Antigen A

Antigen B

Red blood cell Anti-A antibody

Antigen B

Type A blood


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Red blood cell

Anti-B antibody

(a)

(c) (d)

(b)

Agglutinated redblood cells

Anti-A antibody

Antigen A

c: © G.W. Willis/Visuals Unlimited; figure d: © George W. Wilder/Visuals Unlimited


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14.1 From Science to Technology

Blood Typing and Matching: From Serology to DNA Chips

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ABO Blood Group

• Based on the presence or absence of two major antigens on red blood cell membranes

• Antigen A

• Antigen B

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Rh Blood Group

• The Rh blood group was named for the rhesus monkey

• The group includes several Rh antigens or factors

• Rh positive – presence of antigen D or other Rh antigens on the red blood cell membranes

• Rh negative – lack of these antigens

• The seriousness of the Rh blood group is evident in a fetus that develops the condition erythroblastosis fetalis or hemolytic disease of the newborn

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Rh-negativewoman withRh-positivefetus

Cells fromRh-positivefetus enterwoman’sbloodstream

In the nextRh-positivepregnancy,maternalantibodiesattack fetal redblood cells

Womanbecomessensitized—antibodies ( + )form to fightRh-positiveblood cells

+

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Important Points in Chapter 14:Outcomes to be Assessed

14.1: Introduction

Describe the general characteristics of blood and discuss its major functions.

Distinguish among the formed elements of blood and the liquid portion of blood.

14.2: Blood Cells

Describe the origin of blood cells.

Explain the significance of red blood cells counts and how they are used to diagnose disease.

Discuss the life cycle of a red blood cell.

Summarize the control of red blood cell production.

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Distinguish among the five types of white blood cells and give the function(s) of each type.

Describe a blood platelet and explain its functions.

14.3: Blood Plasma

Describe the functions of each of the major components of plasma.

14.4: Hemostasis

Define hemostasis and explain the mechanisms that help to achieve it.

Review the major steps in coagulation.

Explain how to prevent coagulation.

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14.5: Blood Groups and Transfusions

Explain blood typing and how it is used to avoid adverse reactions following blood transfusions.

Describe how blood reactions may occur between fetal and maternal tissues.

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Quiz 14

Complete Quiz 14 now!

Read Chapter 15.

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