Chapter 19 – Blood

• Blood (5.2 Liters in body)

o Made up of 2 ( Plasma and formed elements)

 Plasma – water, dissolved plasma proteins and other solutes

 Formed Elements – RBC, WBC, platelets

•
Plasma

Proteins Other

• Serumalbumins (albumins – 60%) – • Water, electrolytes, sodium chloride,

produced in the liver. potassium, calcium.

• Globulins (35%) – Contribute to • Hormones, Nutrients

Antibodies, lymphoid. Gama Globulins (fatty acids, lipids, carbs) , wastes (uric
– ready made antibodies for vaccines. acid, bilirubin, urea, creatine)

• Fibrinogen (4%) – (Gen = not active).

Blood clotting, produce long strands of
fibrin. (produced in liver)

Formed
Elements

RBC WBC (leucocytes) Platelets (Thrombocytes)

• Capillaries
• No nucleus • Can squeeze through capillaries • Pass through same
• No mitosis (divide)
• Nucleated • Cell fragments (no nucleus)
• Bi-concave
• Able to fold, pass through • Can perform mitosis (divide) • Blood clotting mechanism
joints, etc
• No organelles
• hemoglobin

• RBC
o Life span is 90-120 days
o Hematocrit (Blood count) : Blood – plasma (amount of packed RBC counts)
 All formed blood cells : RBC make up 99% of formed elements. 1% make
up WBC and platelets.
 Male = 46 (because of testosterone)
 • RBC count : 4.8 – 5.2 per million / cc
 Female = 42 (more body fat / more fat the less RBC)
• RBC count : 4.2 – 4.8 per million / cc
o No Aerobic respiration (no mitochondria)
o Does have Anaerobic respiration because of Glucose. (H2O + CO2 = ATP)
 ATP / Lactic Acid – RBC doesn’t use the Oxy, it carries it to other parts of
body.
o RBC can fold because the plasma membrane is made of Spectrin (allows
flexibility)
o Hemoglobin (Quaternary Protein)
 Polypeptide (long chain of amino acids)
 View pg 657
 Attach
• Lungs – where hemoglobin attaches to Oxy (98%)
 O2 + Hb = HbO2 (not every seat will get filled but has the
possibility to be filled with Oxy. (orange-red color)
 Detach
• Tissues : Oxy enters into the tissue (HbO2 = Hb + O2)
• What is left behind is reduced to Hb
• After Oxy leaves Hb (RBC), it “marks” it place, so CO2 loads and
loads at tissues
 CO2 loading – tissues
• CO2 +Hb = CO2Hb (carbamino hemoglobin) – very dark red
 CO2 unloads @ lungs and separates CO2 from Hb
• Carbon monoxide (poison) – also loads @ lungs
 CO (1 oxy) + Hb = HBCO (carboxy hemoglobin) – This
carbon monoxide competes with the Oxy, and Oxy has no
room to attach.
 Pinkish – orangish color
 Gives 100% oxy to lungs
o Recycling RBC (waste and Disorders) – every 90-120 days
 Liver and spleen (damaged RBC are removed),
 RBC still has a membrane – Macrophages eats the membrane and only
certain parts remain.
• Iron (Fe) – released into blood and bone marrow (myeloid tissue) –
where Erythropoiesis occurs (formation of new RBC)
 Erythropoiesis uses the left over Fe to make new RBC
• Globin – breaks down Poly peptide chains and into the amino acids
(pearl necklace, break it but still keep the pieces)
• Heme (w/o Fe) – single molecule found in Hb.
 Turns into waste – Bilirubin (Green), so it becomes part of
bile and sent to liver .
 Sent to Liver as bile.
 Then goes through digestive tract to digest
 Goes into intestines (large), where bacteria breaks
down Bilirubin.
 The waste and gas produced from break down turns it

into Urobilin (this is then released into the urine and
feces, this is where it turns diff. color)
 UV light helps break up bilirubin or stay in blood – this
can cause brain damage.
o Formation of RBC (production)
 Hemocytoblast (HMB) – Formation of …
• Myeloid stem cells (bone marrow) – gives rise to all blood cells
except lymphoid cells
 Erythropoietin (EPO) hormone start the maturity
process
 Proeryhorblasts (blast = immature cell) begins formation
on day 1
 Erythroblast (Hb shape begins) – No ER (endoplasmic
reticulum) but has a nucleus.
 Loses Nucleus
 Normoblast - ejects the nucleus
 Reticulocyte (cyte = mature cell) – ER can’t produce Hb (24
hrs later)
 Erythrocyte (mature cell)
 RBC : Nutrients needed for formation – carbs, amino acids, lipids
• So Erythropoiesis can occur normally. Needed for protein synthesis
• Vitamins – B6, B12, folic acid, Iron
 B12 - is needed in for normal stem cell production, without it
you can get pernicious anemia. This is caused by ….
 B12 – can also come from animal products
 Lining of the stomach produces intrinsic factor (part of
the stomach lining). This factor helps absorb B12
(pernicious anemia)
• Oxy is also needed – link to Anemia
 Hypoxia – Oxy deficiency
 High altitudes.
 EPO is released when :
• During anemia
• When blood flow declines to kidneys
• Oxy content to lungs are low. – high altitude
• Damage to lungs
• Testosterone – helps produce more RBC (male has more but less
body fat)
 Body fat is proportional to Erythropoiesis (produce RBC)
 More fat the less RBC
• Blood doping – athletes elevate their RBC, working out in low oxy
environment, then remove blood (Packed RBC), then later take in
blood with packed RBC.
 Anemia - Iron deficiency (types)
 • Pernicious – lack of intrinsic factor in the stomach lining, able to
absorb B12 Vit.
• Hemorrhage – loss of blood
• Hemolytic – malaria (malaria grows in the RBC – immune attacks
the RBC)
• Sickle cell – auto disorder, mutation of the amino acid chain in the
Hb molecule. Effects the shape of the RBC
• Aplastic – from chemo / radiation therapy. Slows mitosis
• Age – get older produce less RBC
• Thalassemia – genetic, able to produce Hb chains, RBCs are short
lived and fragile, have less Hb.
• Blood typing
o Antigens ( on the RBC)
o Antibodies (in the plasma)
o Donating and Accepting Blood types
 o
Donating Accepting
+ (pos) Can donate + (pos) + (pos) Can accept + (pos)
– (neg) can donate + (pos) + (pos) Can accept – (neg)
+ (pos) Never donate – – (neg) Can accept – (neg)
(neg)
– (neg) Never accept +
(pos)
o
Antibod Blood
y type Donate Accept
(plasma) (Antigen)

B A+ A+, AB+ A+, A-, O+, O-

B A- AB-, A-, A+, AB+ A-, O-

A B+ B+, AB+ B+, B-, O+, O-

A B- B-, B+, AB+, AB- B-, O-

none AB + AB + All

none AB - AB +, AB - A-, B-, AB-, O-

A, B O+ A+, B+, AB+, O+ O+, O-

A, B O- All O-

o Hemolytic Disease of the newborn (HDN) – also called Erythroblastosis Fetalis

- Rh factor during pregnancies from first born to second pregnancy.
 Between pregnancy the Rh antibodies are able to cross the placenta and
enter into the fetal blood stream. Cross mixing of the blood can have
mother generate immune system to produce anti Rh antibodies, which
then enters the fetal blood stream during another pregnancy and
eventually the fetus will die. Pg 664
• White Blood Cells (WBC) – called Leukocytes
o Have no Hb
o Have a nucleus and organelles
o Able to divide
o Defend body against pathogens, bacteria, and virus
o Remove toxins, wastes, cancers (abnormal cells)
o WBC are found in connective (proper) tissue – blood
 Lymphoid system
 Connective tissue
 4k – 10k ( count) – if the count is high, means you have an infection some
where.
o Amoeboid movement – squeeze through capillaries (like an amoeba), move like
actin and myosin filament using ATP and calcium ions.
  Move towards chemicals – positive chemotaxis (ie histamine) – guides
WBC to damaged cells, pathogens and other active WBC
 Phagocytic – neutrophils, eosinophils, and monocytes are capable of
eating or engulfing other cells (pathogens).
• Nuetrophils and eosinophils spit out a chemicals
o Types of WBC (NLMEB)
 Neutrophil – polymophonnuclear leukocyte (most abundant)
• Lysomal enzyme – very powerful enzyme (help detect bacteria)
 Release Hydrogen peroxide to kill pathogen, then it lets body
know to get ready for immune system
 Releases Prostaglandins – contributes to inflammation of
the area and restricting the spread of the injury and infection.
– also forms puss
 Eosinophils – acidophils (also attracted to site of injury)
• Attack large parasites
• Secrete nitric oxide – using toxic compounds for large parasites and
also help open up blood vessels
• Cytotoxic enzyme - another enzyme to help eat pathogens /
parasites.
 Basophiles – less than 1%
• They discharge their granules into the interstitial fluids, granules
contain histamines, which dilates blood vessels, help with
inflammation and attraction of Eosinophils and other basophiles.
 Monocytes – eat allot, become very large, stay in blood.
• Macrophages
 This part sticks out of antigens, part of pathogen it ate sticks
out and shows it off, telling the immune system. Tells the
immune system what is needed to continue.
 Lymphocytes – 30%, come from Lymphoid system, lymphoid stem cells.
(B / T Cells)
• “B” cells work on the pathogens outside the cell, extra cellular
pathogens.

• “T” cells – work on the pathogens inside the cell by killing the entire
cell along with the pathogen inside the cells.

 Natural Killer cells (NK) – detect and destroy cancer cells.

o WBC increase – when there is an infection, inflammation, allergic reaction.
o WBC disorders –
 Leukopenic/ leukopenia (penic = low count) , low WBC count
 Leucoytosis – high count of WBC
 Leukemia – Extremely high WBC count.

o WBC formation – (chart) – Colony stimulating Factor (CSF) – triggers the
production of WBC
 Myloid stem cells – gives rise to WBC
 Lymphoid stem cells – migrate in the thymus and become mature “T”
Cells.
 

• Platelets (nearly 1 million)

o Megakaryocytes = (platelets) found in bone marrow, for the production of
thrombocytes (platelets)
o Thrombocytes – (thrombo = clot), is lost in a few days (3-4 days)
 Formed in the spleen
o Thrombopenia – low platelet count in blood
o 3 Functions of Platelets
 Release important clotting chemicals
 Acts as Temporary patch
 Seal entire area
o Thrombopoietin – activates the immune system, precursor to platelets, factor
that stimulates the Megakaryocytes (formation of platelets).
 Positive Feedback – Birth, blood clotting, immune system
 3 phases of blood clotting – injury
 Phase I
 Vascular Phase – (spasms) stop blood loss
  The Plug (blood clotting – coagulation) – Very tender /
still red, some plasma still coming out.
 Clot retraction (scab) – hardening of the blood clot (24
hrs)
2. Phase II – healing / eat clot
3. Phase III – Dissolving the Clot

• Phase 1 –
 Vascular Spasm
• Help from the endothelium, releases a hormone
(Serotonin)
• Thrombomondulin Comes from the wall of
endothelium
• Serotonin constricts smooth muscle
 Clot formation (requires 13 factors) – pg 676, 13
factors for blood clotting.
• Factors are Produced by the liver, vitamin K
helps also helps (produced in large intestines /
small)
• First injection for babies is Vit. K
• Calcium Ions – help speed up chemical reaction,
activate / speed up enzymes for clotting.
 Blood vessels that eat.
 Injury - collagen fibers + platelets
 Become sticky
 Collagen fibers that are damaged activate the platelets
 [process] Prothrombinase (Pro= inactive) – Then
Factor (IX = 9) Thromboplastiogen an enzyme
• Add Factor VIII (Antihemopholic), along with
calcium Ions and Vit. K – Becomes active (see
Red and tender below)
stage of the clot  [product] (inactive) Prothrombin  Thrombin
(active)
• Fibrinogen (soluble) – don’t see in plasma -
• - Turns into Fibrin
o Must create a weaving fiber for clot
o Then factor XII (Hageman factor) – protein
interlinks the fibers
 Clot retraction (hard) – (like actin and myosin) – pulling and
tightening, contractile proteins
 They pull ends of vessels together (Syneresis)
 Pull the clot and tighten it.
• Phase 2 – Healing
 (PDGF) – Platelet Derived General Factor – needs ATP

• Phase 3 – Dissolving the Clot (Fibrinolysis)
  Lysis = breakdown
 Utilizes Factor XII (Hageman)
 Plasminogen (factor XII) into Plasmin (this helps
dissolve the clot from outside – in)
o Thrombus – localized clot (intact blood vessel)
Vessel thinks there is an injury from plaque being removed, then a clot
begins to form.
o Embolus – Moving clot
 Prevent these – heparin (anticoagulant) = Antithrombin
• Hirudin (chemical) – from leeches, it is used as anticoagulant
• Food sources – Natural Tea and red grapes.
o Disorders
 Hemophilia – sex linked (X Chromosome) – mother to children
• Boys will have it more than girls
• Girls are carries and can’t show signs.
•