BLOOD

Blood is a specialised connective tissue which is fluid in nature . The total

volume of blood in the body is about 6liters. Blood is slightly alkaline with a pH
of about 7.4 . The specific gravity of blood is about 1.005.

Function of blood : Blood serves the following important function:

1. It transports oxygen and nutrients to various tissues.

2. It transports waste products to organs of excretion.
3. It carries hormones from endocrine glands to various tissues.
4. It redistributes water from one part to the body to other.
5. It contains antibodies and white blood cells which protect the body from
diseases.
6. Clotting of blood protects against haemorrhage.

Composition of blood : Blood contains a fluid called plasma, in which the

cellular elements of blood are suspended.

PLASMA : plasma contains :

1. water to the extent of 91%.

2.proteins ( albumin, globulin and fibrinogen )

3. Other substances like glucose, sodium chloride, iron ,urea uric acid and
cholesterol.

1. Serum is obtained from plasma after removing fibrinogen. ( Serum =

plasma –fibrinogen)
Plasma proteins : Plasma proteins occur in blood to the extent of 7 to 8 % The
plasma proteins are:

1. Albumin: It is present in very high concentration . It is responsible for

osmotic pressure of blood It is synthesized in liver.
2. Globulin : It is of three types : alpha, beta and gamma . It is produced in
lymphoid tissues . It produces antibodies and immune substances.
 3. Fibrinogen: It is responsible for coagulation of blood. It is synthesised in
liver.
Functions of plasma proteins :
1. They transport hormores, iron and other substances
2. They exert osmotic pressure and regulate blood volume.
3. They provide viscosity to blood ( which help in maintaining blood
pressure).
4. Fibrinogen of plasma is necessary for clotting.
5. Globulin of plasma is plasma is important for the synthesis of
immune substances called ant+ibodies.

CELLULAR ELEMENTS OF BLOOD : The cellular elements of blood are :

1. Red blood cells

2. White blood cells
3. Platelets blood cells
1. RED BLOOD CORPUSCLES ( RBC ) OR ERYTHROCYTES :They are circular
biconcave, disc shaped cells. They do not have a nucleus. But they have a
respiratory pigment called hemoglobin. The normal RBC count is 4.5 to 5
millions per cu.mm. RBCs serve important function such as transport of
oxygen and maintenance of acid base balance. They are synthesised in
the bones. The average life span of RBC is about 120 days .

Rouleaux formation is the tendency of RBCs to stick to one another like a

pile of coin. This occurs due to the discoid shape of RBC.

Polycythemia is a condition where there is an increase in the number of

RBCs.

Anemia is a condition where there is a decrease in the number of RBCs or

hemoglobin.

Erythrocyte sedimentation rate (ESR)is the rate at which RBCs sink to the
bottom (when placed in a vertical column after adding an anticoagulant ).
Norma values of ESR are :

3 to 5 m.m per hour in males.

4 to 7 m.m per hour in females .

Erythropoiesis : It is the process by which RBCs are formed . In the foetus ,
RBCs are formed in the liver,spleen and red bone marrow . After birth, they
are formed only in the red bone marrow of sternum,ribs, vertebrae etc.The
stages in the development of RBCs are as follows.

1. Proerythroblast is the first stage.It is a large cell having a nucleus.It does

not have hemoglobin initially.In the latter stage,hemoglobin starts
appearing.
2. Normoblast is the second stage.It is a smaller cell with degenerated
nucleus.But hemoglobin is fully present.
3. Reticulocyte develops from normoblast.It contains hemoglobin and
reticulum in the cytoplasm.
4. Erythrocyte which is the fully developed RBC.It does not contain
reticulum but contains adequate hemoglobin.

Both vitamin B12 and folic acid are necessary for the development
of RBCs.

HEMOGLOBIN: It is the respiratory pigment of erythrocytes.The red color of

blood is due to hemoglobin.It contains globin,a protein which is conjugated
with heme(hemoglobin=heme+globin).Heme molecule contains four pyrrole
rings with iron in the centre.The hemoglobin content of body is about 15g
per 100ml of blood,Anemia occurs due to a decrease in hemoglobin.
The functions of hemoglobin are:

1.Transport of oxygen and carbondioxide.

2.Maintenance of acid base equilibrium.

3.As a source for the formation of bilirubin (Bilirubin is formed from

porphyrin fraction of hemoglobin).

Hemolysis is the escape of hemoglobin from RBC into blood.This is

caused by hypotonic condition,certain drugs nd toxins.

WHITE BLOOD CELLS(WBC): They are colourless cells containing a nucleus.

They are larger is size than RBCs.Also their number is less when compared to
RBCs (about 8000 per cu.mm of blood).

Classification of WBCs: WBCs are classified as:

1. Granulocytes which are of three types: neutrophils,eosinophils and
basophils.
2. Agranulocytes which are of two types: lymphocytes and monocytes.

ORANULOCYTES: These WBCs have granules in the cytoplasm.They have a

nucleus which contains two or more lobes.Granulocytes are further divided
into the following three types:

1. Neutrophils (Polymorphos): They contain granular cytoplasm which stains

with neutral dyes.The nucleus may contain 2 to 5 lobes.Neutrophils occur
to extent of 65 to 70 percent of total WBCs.
2. Eosinophils (Acidophils): These cells are slightly larger than neutrophils.
The granules are coarse and closely packed.These granules take up acid
stain.The nucleus contains two lobes. Normal eosinophil count is 2 to 4
percent of total WBCs.
3. Basophils (Mast cells):They contain coarse granules as in eosinophils.But
these granules stain blue with basic dyes.The nucleus is kidney shaped or
lobulated.The basophils contain heparin,histamine and 5-
hyroxytryptamine.Normal basophil count is 0.5 percent of total WBCs.

Agranulocytes: This type of WBCs do not have granules.But they have a

single nucleus which is not lobes.Agranulocytes are further classified into the
following two types.

1.Lymphocytes: They are of two types:

a) Small lymphocytes:They occur to the extent of 2 percent of total

WBCs.Thry are smaller in size with a nucleus occupying almost the whole of
the cell So the cytoplasm is less.

b)Large lymphocytes: They are larger in size containing more cytoplasm.

2. Monocytes: They are the largest of WBCs.They occur to the extent of 2 to

4 pecent of WBCs.They contains an eccentric nucleus which is notched in the
inner side.

Functions of WBCs

1.Protection against infection.This is done by neutrophils and

monocytes which engulf bacteria.This process is called as Phagocytos.
 2. To aid in the repair of injured tissues.
3. To produce immune substances which defend against diseases.This is
done by lymphocytes through the synthesis of gammaglobulin.
4. Basophils secrete an anticoagulant substance calle heparin.

PLATELETS OR THROMBOCYTES: There are round or oval shaped cells with

bioconvex surface.They are roughly one fourth of the size of a RBC.Normal
platelet count is 2 to 5 lakh per cu.mm of blood.Platelets do not have a
nucleus.But cytoplasm contains distinct granules.They are synthesised by
megakaryocytes(giant cells) of bone marrow.

NORMAL AND AVERAGE VALUES OF CELLULAR

ELEMENTS OF BLOOD

Blood elements Normal value Average

value
Red blood cells (RBC’S) 4.5 to 5.5 million 5 million
White blood cells (WBC’s) 6,000 to 10,000 8,000
Granulocytes 60 to 70% 66%
Eosinophils 1 to 2% 1%
Basophils 0.5 to 2% 1%
Lymphocytes 20 to 30% 25%
(Large and small)
Monocytes 4 to 8% 5%
Platelets 2 to 5 lakhs 3.5 lakhs

Function of platelets:

1. Thromboplastin liberated from platelets is essential for clotting.

2. They close minute lesions in the walls of blood vessels.
3. They aid in body`s defence mechanism against bacteria.
4. They contain histamine and serotonin.
5. They contain some artigenic substance also.

Thrombocytopenia: It is a condition where there is a decrease in platelet

count.

CLOTTING OF BLOOD(Coagulation of blood)

 Clotting of blood is a defence mechanism of the body.It prevents loss of
blood from the site of injury.If a leak develops in blood vessels,a clot is
formed and it plugs the leak.This prevents the loss of blood.

Mechanism of clotting: Clotting of blood occurs in the following stages:

1.Thromboplastin is liberated from disintegrated tissues and damaged

platelets.

2.Thromoplastin converts prothrombin into thrombin.This occurs in the

presence of calcium ions.

3.Thrombin converts fibrinogen to fibrin.

4.The insoluble fibrin forms threads.The formed elements of blood get

entangled in this and form the clot.

Tissues and

Platelets----->Thromboplastin

Ca++

Prothrombin Theombin

Fibrinogen Fibrin Clot

Blood cell
 I. Clotting factors : The various factors involved in the scheme of clotting
described above are dersignated by numbers as factors These
factors are.
Factor - Fibrinogen
Factor - prothrombin
Factor - Thromboplastin
Factor - Calcium
Factor - Quick’s Labile factor
Factor - Existance of this factor not factor
Factor - Quick’ s stable factor
Factor - Antihemophilic factor
Factor - Christmas factor

Factor and are required for the conversion of damaged tissue into
thromboplatin. Factor is the antithemophilic factor. Absence of this factor
leads to a disease called haemophilia. Factor is called as Christmas factor. In
an American Negro named Christmas, all the other factor wera present. But his
blood did not clot. So this factor was called as Christmas factor.

Clotting time : It is the time taken for the clotting of human blood removed
from circulation. The average clotting time varies from 5 to 15 minutes.

BLOOD GROUP : In early time , transfusion of blood from one person to

another was dangerous and unsuccessful. This is because , plasma of some
individuals contain some factors. These factor produce agglutination or
hemolysis of the erythrocytes of other persons. These reactions occur due to
the presence of agglutinins and agglutinogens in blood. Agglutinogens are
present in erythrocytes. They are of two types : A and B Agglutinins are
present in plasma. They are of types : a and b. Depending on the presence of
these of these two substances, blood is grouped as follows :

Group A contains A agglutinogen and agglutinin

Group B contains B agglutinogen and agglutinin sss

Group AB contains AB agglutionogens and no agglutinins.

Group o contains no agglutinogen but a and b agglutinins.

 Agglutination occurs between the same type of agglutinogen (e.g A and a )
But no agglutination occurs between different types of agglutinogen and
agglutinin (contains no agglutinogen ) can match with all other blood only from
0 group and not from any other group of blood are called universal donors.

Individuals with blood group AB(contains no agglutinins)can

receive blood from all groups. They are called as (universal receipients).

Rh factor: it is another type of agglutinogen . It is called as Rhesus factor

(Rh factor) since it was first seen in Rhesus monkey . Rh +ve individuals
have this factor . But Rh-ve indiduals have this. The corresponding
agglutinin is nevr present in the body . But it is developed after the first
exposure to the agglutinogen. Ifa Rh+ve biood is to a Rh-ve person,no
immediate reaction occurs . But during a second transufusion, the Rh-ve
person develops Anti-Rh agglutinin .this further leades to agglutination.

Erythroblastosis foetalis : the foetus of a Rh-ve mother and RH+Ve father is

Rh –ve serious complications may occur. Then the Rh antigen will traval
from the foetus to mothers blood . As a result . Rh antibodies will
develop in the mothers blood .when these antibodies reah the foetus, they
produce servere hemolytic reactions. This condition is called as
erythroblastosis foetalis.

DISORDERS OF BLOOD
DISORDERS OF RED BLOOD CELLS : The disorders of red blood cells may
occur in the form of either anemia or polycythemia.

It is the disease involving 1. Deficiency in the number of red cells or 2.

Deficiency of hemogiobin. Because of any one of these,there is a decrease in
important oxygen carrying capacity of blood . the symptoms of anemia in the
form of breathless ness,tiredness, loss of appetitle and pallor of skin. The
important types of anemia are :

1. Iron deficiency anemia

2. Megaloblastic anemia
3. Hemolytic anemia
4. Aplastic anemia
1) Iron deficiency anemia : In this types of anemia, these is a deficiency of
iron due to 1) low dietery intake or 2) decreased absorption. Due to lack
of iron , sufficient hemoglobin is not synthesised. So the defect in this
type of anemia is, inadequate hemoglobin synthesis.
 2) Megaloblastic anemia : This type of anemia occurs due to the deficiency
of cither vitamin B12 or folic acid. Both vitamin B12 and folic are
necessary for the maturation of red blood cells. Ln the deficiency of
either of them , the maturation of red blood cells does not occur. So
immature, large sized red blood cells called magaloblaste are relased in
circulation.

3) Hemolytic anemia : It occurs due to increased destruction of red blood

cells. It occurs due to 1) hereditary disorders 2) mechanical injury to red
blood cells 3) infection like malaria.

4) Aplastic anemia : Lt occurs due to suppression of bone marrow function.

It can be caused by drugs, chemicals, irradiation or malignant diseases.

POLYCYTHEMIA : In this condition there is an abnormal increase in the

number of red blood cells. This increases the viscosity of blood. This decreases
the rate of flow and increases risk of intravascular clotting.

Polycythemia vera : In this condition, there is an abnormal execessive

production of erythrocyte precursors ( myeloid stem calls ) .This raises the
hemoglobin level. Also the viscosity of increased . This leads to
cerebral,coronary and mesenteric thrombosis.

DISORDERS OF WHITE BLOOD CELLS : It is increase in the total number of

white blood cells beyond 10,000 per cubic millimeter. It may be of the
following types:

1 Neutrophilia :An increase in the number of neutrophils It occurs in many

inflammatory conditions.
2 Eosinophilia : An increase in the number of eosinophils. It is an indication
for allergic manifestations.

3 Leukemia : It is a cancerous condition characterised by an overproduction

of white blood cells. According to the type of the affected, it can be classified
as myeloid leukemia or lymphocytic leukemia. Leukumia can occur at any age
but it is more common in childhood.
LEUCOPENIA: It is a decrease in the number of white blood cells. It is
produced by infection and some drugs. Depending on the type of WBC which
is reduced, it may be called as netropenia,lymphopenia and eosinopenia.

DISORDER OF PLATELETS: They occur in the form of thrombocytopenia.It is a

condition where there is a decrease in platelet count . It results in.

1 petichial hemorrhages
2 Increase in bleeding time
3 Defect in the retraction of clot

DISORDERS OF CLOTTING

1 Haemophilia: The disease is caused caused due the absence of factor

(Antihemophilic factor ). This disease occurs in men But it is genetically
transmitted through women . Women carry the genes but not the disease.

2 Thrombosis : Intravascular clottingof blood is called thrombosis.

Thrombosis may occur due to roughening of thickrening of blood vessels (as
in artherosclerosis) Thrombosis can obstruct essentruct blood vessels (like
coronary or cerebral vessels ). This may lead to
death. s