PowerPoint Lecture Outlines to accompany

Hole’s HumanAnatomy and Physiology

Tenth Edition

Shier Butler Lewis

Chapter

14

Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. 14-1

Chapter 14Blood

Functions• transports vital substances• maintains stability of interstitial fluid• distributes heat

Blood Cells• form mostly in red bone marrow• red blood cells• white blood cells• platelets (cell fragments)

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Blood Volume

•about 8% of body weight• about 5 liters•varies with

• body size• changes in fluid concentration• changes in electrolyte concentration• amount of adipose tissue

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Blood Composition

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Origin of Blood Cells

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Red Blood Cells

• erythrocytes• biconcave• one-third hemoglobin

• oxyhemoglobin• deoxyhemoglobin

• can readily squeeze through capillaries• lack nuclei and mitochondria

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Red Blood Cell Count

• number of RBCs in a cubic millimeter of blood

• 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

• reflects blood’s oxygen carrying capacity

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Red Blood Cell Production

• low blood oxygen causes kidneys and liver to release erythropoietin which stimulates RBC production

• vitamin B12, folic acid and iron necessary

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Life Cycle of Red Blood Cell

• circulate for about 120 days

• macrophages in spleen and liver destroy worn out RBCs

• hemoglobin is broken down into heme and globin

• iron return to red bone marrow

• bilirubin and biliverdin excreted in bile

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Types of Anemia

• aplastic anemia• bone marrow damaged• toxic chemicals• radiation

• hemolytic anemia• RBCs destroyed• toxic chemicals

• iron deficiency anemia• hemoglobin deficient• lack of iron

• pernicious anemia• excess of immature RBCs• inability to absorb B12

• sickle cell anemia• abnormal shape of RBCs• defective gene

• thalassemia• hemoglobin deficient• RBCs short-lived• defective gene

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Hemolytic Anemia

Normal RBCs

RBCs of person with hemolytic anemia

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White Blood Cells

• leukocytes• protect against disease• interleukins and colony-stimulating factors stimulate development

• granulocytes• neutrophils• eosinophils• basophils

• agranulocytes• lymphocytes• monocytes

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Neutrophils

• light blue granules in acid-base stain• lobed nucleus• other names

• segs• polymorphonuclear leukocyte• bands (young neutrophils)

• first to arrive at infections• phagocytic• 54% - 62% of leukocyte• elevated in bacterial infections

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Basophils

• deep blue granules is basic stain• release histamine• release heparin• less than 1% of leukocytes

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Eosinophils

• deep red granules in acid stain• bilobed nucleus• moderate allergic reactions• defend against parasitic worm infestations• 1% - 3% of leukocytes• elevated in worm infestations and allergic reactions

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Monocytes

• largest blood cell• kidney-shaped or oval nuclei• leave bloodstream to become macrophages• 3% - 9% of leukocytes• elevated in typhoid fever, malaria, tuberculosis

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Lymphocytes

• about the size of RBC• large spherical nuclei• thin rims of cytoplasm• T cells• B cells• important in immunity• produce antibodies• 25% - 33% of leukocytes• decreased T Cells in AIDS

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Diapadesis

• leukocytes squeeze through capillary walls to enter tissue space outside the blood vessel

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White Blood Cell Counts

• number of WBCs per cubic millimeter of blood• 5,000 – 10,000 per cubic millimeter of blood

• leukopenia • low WBC count• typhoid fever, flu, measles, mumps, chicken pox, AIDS

• leukocytosis • high WBC count• acute infections, vigorous exercise, great loss of body fluids

• differential WBC count• lists percentages of types of leukocytes• may change in particular diseases 14-19

Blood Platelets

• thrombocytes• cell fragments of megakaryocytes• 130,000 – 360,000 per cubic millimeter of blood• helps control blood loss from broken vessels

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Blood Plasma

• straw colored• liquid portion of blood• 55% of blood

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Plasma Proteins

Albumins• most numerous plasma proteins• originate in liver• help maintain osmotic pressure of blood

Fibrinogen• originate in liver• plays key role in blood coagulation

Alpha and Beta Globulins• originate in liver• transport lipids and fat-soluble vitamins

Gamma Globulins• originate in lymphatic tissues• constitute the antibodies of immunity

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Gases and Nutrients

Gases• oxygen• carbon dioxide• nitrogen

Nutrients • amino acids• simple sugars• nucleotides• lipids• lipoproteins

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Plasma Lipoproteins

Chylomicrons• high concentration of triglycerides• transport dietary fats to muscles and adipose cells

HDLs• relatively high concentration of proteins• relatively low concentration of lipids• transport remnants of chylomicrons to liver

LDLs• relatively high concentration of cholesterol• formed from VLDLs• deliver cholesterol to various cells

VLDLs• relatively high concentration of triglycerides• produced in the liver• transport triglycerides from liver to adipose cells

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Nonprotein Nitrogenous Substances

• molecules containing nitrogen but are not proteins• urea – product of protein catabolism; about 50% of NPN 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; indicate health of kidney

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Plasma Electrolytes

• sodium• potassium• calcium• magnesium• chloride• bicarbonate• phosphate• sulfate• sodium and potassium most abundant

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Hemostasis

• stoppage of bleeding

Blood Vessel Spasm• triggered by pain receptors, platelet release, or serotonin• smooth muscle in vessel contracts

Platelet Plug Formation

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

Blood Coagulation• triggered by cellular damage and blood contact with foreign surfaces• blood clot forms

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Platelet Plug Formation

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Blood Coagulation

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Blood Coagulation

Extrinsic Clotting Mechanism• chemical outside of blood triggers blood coagulation• triggered by thromboplastin (not found in blood)• triggered when blood contacts damaged tissue

Intrinsic Clotting Mechanism• chemical inside blood triggers blood coagulation• triggered by Hageman factor (found inside blood)• triggered when blood contacts a foreign surface

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Blood Clots

• After forming, blood clot retracts and pulls the edges of a broken vessel together

• Platelet-derived growth factor stimulates smooth muscle cells and fibroblasts to repair damaged blood vessels

• Plasmin digests blood clots

• thrombus – abnormal blood clot• embolus – blood clot moving through blood

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Prevention of Coagulation

• The smooth lining of blood vessels discourages the accumulation of platelets

• As a clot forms, fibrin absorbs thrombin and prevents the reaction from spreading

• Antithrombin interferes with the action of excess thrombin

• Some cells secrete heparin

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ABO Blood Group

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Agglutination

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Preferred and Permissible Blood Types for Transfusion

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Clinical Application

Leukemia

Myeloid Leukemia• bone marrow produces too many immature granulocytes• leukemic cells crowd out other blood cells• anemia• bleeding• susceptible to infections

Lymphoid Leukemia• lymphocytes are cancerous• symptoms similar to myeloid leukemia

Treatments• blood transfusions• marrow transplants• anti-cancer drugs• stem cell transplants

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