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Hematology
Plasma
Formed elements (cells)
Interstitial fluid
Functions of Blood
Transportation
Regulation
Body pH
body temp
Fluid balance
http://encarta.msn.com/media_461557603_761578429_-1_1/Lymphocyte.html
Protection
Blood loss
Immunity
2
Components of Blood
Centrifuge
Components of Blood
Components of
Blood: Plasma
>90% water
~7% proteins: albumin,
fibrinogen, globulins
(immunoglobulins)
~2% other solutes:
electrolytes, nutrients, gases,
hormones, wastes
Components of Blood:
Formed Elements
RBC (erythrocyte)
WBC (leukocyte)
Granular leukocytes
Agranular leukocytes
lymphocyte = T, B
& NK cell, monocyte
Platelet
(thrombocyte)
Blood Smear
neutrophil,
eosinophil, basophil
megakaryocyte
Stages of
Hematopoiesis
--Pluripotent
hematopoietic stem
cell=hemocytoblast
--Myeloid stem cells
-Erythroblast
reticulocyte RBC
-Megakaryoblast
megakaryocyte
proplatelet platelet
-Granulocytes (PMN,
basophil, eosinophil)
-Monocyte
macrophage
10
Thrombopoiesis
11
Erythropoietin (EPO)
Thrombopoietin
(TPO)
Cytokines
colony-stimulating
factor (CSF)
interleukin (IL)
Recombinant DNA
advances
Growth factor
production
12
Anucleate amitotic
Shape of a RBC
13
Oxyhemoglobin
Deoxyhemoglobin
Carbaminohemoglobin
Myoglobin
14
15
16
3
Reused for
protein synthesis
Amino
acids
Globin
Fe3+
Fe3+ Transferrin
2 Heme
Fe3+
Ferritin
Transferrin
Bilirubin
9
1 Red blood cell
Biliverdin
Bilirubin
11
10
death and
phagocytosis
Small
intestine
Kidney
13
12
Urobilin
Macrophage in
spleen, liver, or
red bone marrow
Bilirubin
Urobilinogen
Stercobilin
Urine
Liver
Feces
+
Globin
+
Vitamin B12
+
Erythopoietin
8 Erythropoiesis in
red bone marrow
Bacteria
Key:
in blood
Large 14
intestine
in bile
17
Formation
and
Destruction
of RBCs:
Recycling of
HgB
18
Reticulocyte Erythrocyte
19
# remains constant
Normal RBC count
Reticulocytes
http://www.nlm.nih.gov/medlineplus/ency/imagepages/1491.htm
Should be ~1% of
circulating RBCs
20
Hematocrit
% blood occupied by RBC
21
Erythropoietin Mechanism
Start
Normal blood oxygen levels
Increases
O2-carrying
ability of blood
Reduces O2
levels in blood
Enhanced
erythropoiesis
increases RBC
count
Erythropoietin
stimulates red
bone marrow
22
Erythropoietin Mechanism
23
Erythrocyte Disorders
Polycythemia
Compensatory smokers
Relative dehydration
Erythrocytosis EPO high
Induced polycythemia
- Blood doping
recEPO or injecting previously stored RBCs before an
athletic event
24
25
General signs/Sx
Types of anemia:
Hemorrhagic anemia
Hemolytic anemia
Aplastic anemia
Iron-deficiency anemia
Pernicious anemia
Sickle-cell anemia
27
Leukocytosis
Leukopenia
28
Leukocyte
Functions:
Inflammation &
fight infection
Emigration
Chemotaxis
Diapedesis
Adhesion
molecules
(Selectins &
integrins)
29
Classification of Leukocytes
Granulocytes
Agranulocytes
30
60-70% of circulating
WBCs
Multi-lobed nuclei
Granules = peroxidases,
hydrolytic enz &
defensins
Band (shift)
http://cal.vet.upenn.edu/histo/mammalblood/felbandneutbas.htm
Functions target
bacteria
Lysozymes
Defensin proteins
Strong oxidants
Phagocytosis
http://www.physioweb.org/blood_cells.html
31
Eosinophils (Granulocyte)
http://greenfield.fortunecity.com/rattler/46/blood.htm
Large, uniform-sized
granules stain orangered w/ acidic dyes
Functions
Release histaminase
Phagocytize Ab-Ag
complexes
32
Basophils (Granulocyte)
< 1% of circulating WBC
Functions
PMN
Basophil
34
35
Monocyte (Agranulocyte)
3-8% of circulating WBCs
Physical features
Migratory
http://www.physioweb.org/blood_cells.html
Fixed m
Free (wandering) m
Phagocytes
36
Lymphocyte (Agranulocyte)
General features
~25% of circulating
WBCs
Dark, oval to round
nucleus
Types of lymphocytes
NK cells (Innate)
http://greenfield.fortunecity.com/rattler/46/blood.htm
B cells (plasma)
Make antibody to
antigens
T cells
http://www.phototakeusa.com/results.asp?txtkeys=Dennis+Kunkel
37
38
uncontrolled
production of
immature leukocytes
Chronic leukemia
accumulation of
mature WBC in
bloodstream because
they do not die
39
Risky business!
Regimen-related toxicities
Infection
Graft versus host
40
Another option?
Cord blood transplant
41