CHAPTER 11

ANATOMY AND PHYSIOLOGY OF THE HEMATOLOGIC SYSTEM

(3 hours)

The blood is said to be the “River of Life”, not only because it flows and
circulate throughout the body, but also plays an important role in regulating the
body’s system and maintaining homeostasis.

Intended Learning Outcomes:

At the completion of this coverage, the students shall be able to:

1. Discuss the functions of the blood

2. Enumerate ad describe the characteristics of blood cells
3. Explain Hematopoiesis and hemolysis
4. Discuss blood clotting mechanism
5. Discuss blood typing

Specific Instructions in the completion of this Chapter:

1. Set your learning goals. At the end of this module you are expected to attain the
Intended Learning Outcomes stated above.
2. Prepare the following materials:
1. Anatomy and Physiology textbooks and other references
2. Notebook, bond papers and writing materials
3. Coloring materials
3. Lecture notes are provided for you. BE SURE NOT TO SKIP the lecture. Read and
understand before answering the activities. You are also given an electronic copy of this
module along with other materials such as video clips t further assist you.
4. As you go on, you will encounter exercises that will test your knowledge and
understanding as well as your critical thinking. Read the instructions carefully, and write
your answers to the space provided after each module

Key Terms

Hematopoiesis
Formed elements
Plasma
Hemolysis
Fibrinolysis
Let’s Start!
BLOOD

Functions of Blood
Blood helps maintain homeostasis in several ways:
1. Transport of gases, nutrients, waste products
2. Transport of processed molecules
3. Transport of regulatory molecules
4. Regulation of pH and osmosis
5. Maintenance of body temperature
6. Protects against foreign substances such as microorganisms and toxins
7. Blood clotting prevents fluid and cell loss and is part of tissue repair

Composition of Blood

 Blood is a connective tissue consisting of plasma and formed elements

 Blood is the body’s only fluid tissue
 It is composed of liquid plasma and formed elements
 Formed elements include:
1. Erythrocytes, or red blood cells (RBCs)
2. Leukocytes, or white blood cells (WBCs)
 3. Platelets
 Hematocrit: the percentage of RBCs out of the total blood volume
 Total blood volume is approximately 5 liters
 Blood is a sticky, opaque fluid with a metallic taste
 Color varies from scarlet to dark red
 The pH of blood is 7.35–7.45
 Temperature is 38C
 Blood accounts for approximately 8% of body weight
 Average volume: 5–6 L (1.5 gallons) for males, and 4–5 L for female

Plasma
 Pale yellow fluid containing over 100 solutes
 Mostly water (91%)
 Contains proteins (7%)
o Albumin (58% of the plasma proteins)
 Helps maintain osmotic pressure
o Globulins (38% of the plasma proteins)
o Immunity: antibodies and complement
o Transport: bind to molecules such as hormones
 Clotting Factors
o Fibrinogen (4% of the plasma proteins)
o Converted to fibrin during clot formation
 Other substances (2%)
o Ions (electrolytes): sodium, potassium, calcium, chloride, bicarbonate
o Nutrients: glucose, carbohydrates, amino acids
o Waste products: lactic acid, urea, creatinine
o Respiratory gases: oxygen and carbon dioxide
Formed Elements
1. Erythrocytes or red blood cells (RBCs)
o About 95% of formed elements
o RBCs have no nuclei or organelles
2. Leukocytes or white blood cells (WBCs)
 Most of the remaining 5% of formed elements
 Only WBCs are complete cells
 Five types of WBCs
3. Platelets
 Just cell fragments
Most formed elements survive in the bloodstream for only a few days
Production of Formed Elements
Most blood cells do not divide but are renewed by stem cells (hemocytoblasts) in bone
marrow

Hematopoiesis: blood cell production

 Occurs in different locations before and after birth
o Fetus
o Liver, thymus, spleen, lymph nodes, and red bone marrow
o After birth
o In the red bone marrow of the
o Axial skeleton and girdles
o Epiphyses of the humerus and femur
o Some white blood cells are produced in lymphatic tissues
 Hemocytoblasts give rise to all formed elements
 Growth factors determine the type of formed element derived from the stem cell
 Red Blood Cells
 Biconcave discs, anucleated, essentially no
organelles
 RBCs are dedicated to respiratory gas
transport
 Filled with hemoglobin (Hb), a protein that
functions in gas transport
 RBCs are an example of how structure fits
function
 Biconcave shape has a huge surface area
relative to volume
 Structural characteristics contribute to its gas
transport function
 Biconcave shape also allows RBCs to bend or
fold around their thin center

Hemoglobin (Hb)
 Accounts for about a third of the cell’s volume
 Consists of:
1. The protein globin, made up of two alpha and two beta chains, each bound to
a heme group
2. Each heme group bears an atom of iron, which can bind to one oxygen
molecule
3. Heme molecules transport oxygen (Iron is required)
 Oxygen content determines blood color
o Oxygenated: bright red
o Deoxygenated: darker red
2. Globin molecules transport carbon dioxide
3. One RBC contains 250 million Hb groups thus it can carry 1 billion molecules of O 2
4. Transport of Oxygen and Carbon Dioxide
 Oxygen
 Transported bound to hemoglobin ~98.5%
 Dissolved in plasma ~1.5%
 Each Hb molecule binds four oxygen atoms in a rapid and reversible
process
 Carbon dioxide
 Dissolved in plasma ~7%
 Transported as bicarbonate(HCO3–) ~70%
 Chemically bound to hemoglobin ~23%

Transport and Exchange of Carbon Dioxide

 Carbon dioxide diffuses into RBCs and combines with water to form carbonic acid
(H2CO3), which quickly dissociates into hydrogen ions and bicarbonate ions
  In RBCs, carbonic anhydrase reversibly catalyzes the conversion of carbon dioxide and
water to carbonic acid

Erythropoiesis is the production of RBCs

 A hemocytoblast is transformed into a proerythroblast
 Proerythroblasts develop into early erythroblasts
 The developmental pathway consists of three phases
1. Ribosome synthesis in early erythroblasts
2. Hb accumulation in intermediate erythroblasts and late erythroblasts
3. Ejection of the nucleus from late erythroblasts and formation of reticulocytes
 Reticulocytes are released from the red bone marrow into the circulating
blood, which contains ~1-3% reticulocytes
4. Reticulocytes then become mature erythrocytes

Red Blood Cell Production

1. Circulating erythrocytes: The number remains constant and reflects a balance between
RBC production and destruction
1. Too few RBCs leads to tissue hypoxia
2. Too many RBCs causes
undesirable blood
viscosity
2. Erythropoiesis is hormonally
controlled and depends on
adequate supplies of iron,
amino acids, and B vitamins
(folate and B12)
1. Erythropoietin (EPO)
release by the kidneys is
triggered by
1. Hypoxia due to
decreased RBCs
2. Decreased
oxygen
availability
3. Increased tissue
demand for
oxygen
2. Enhanced erythropoiesis
increases the
1. RBC count in
circulating blood
2. Oxygen carrying
ability of the
blood
Hemolysis- breaking down of red blood cells
1. The life span of an erythrocyte is 100–120 days
2. Old RBCs become rigid and fragile, and their Hb begins to degenerate
3. Dying RBCs are engulfed by macrophages located in the spleen or liver
4. Heme and globin are separated and the iron is salvaged for reuse
1. Globin chains are broken down to individual amino acids and are metabolized or
used to build new proteins
2. Iron released from heme is transported to the red bone marrow and is used to
produce new hemoglobin
3. Heme becomes bilirubin that is secreted in bile
1. In the intestines bilirubin is converted by bacteria into other pigments
1. Gives feces its brown color
2. Gives urine its yellow color
 White Blood Cells
 Only blood components that are
complete cells
 Are less numerous than RBCs
 Make up 1% of the total blood
volume
 Can leave capillaries via ameboid
movement and move through
tissue spaces
 Two functions of WBCs
 Protect the body against invading
microorganisms
 Remove dead cells and debris
from tissues by phagocytosis
 Named according to their
appearance in stained preparations
 Granulocytes: contain large cytoplasmic granules
 Agranulocytes: very small granules that cannot be easily seen with the
light microscope

Granulocytes: neutrophils, eosinophils, and basophils

 Contain cytoplasmic granules that stain specifically (acidic, basic, or both) with Wright’s
stain
 Are larger and usually shorter-lived than RBCs
 Have lobed nuclei
 Are all phagocytic cells
1. Neutrophils most common type of WBC
 Have two types of granules that:
1. Take up both acidic and basic dyes
2. Give the cytoplasm a lilac color
3. Contain peroxidases, hydrolytic enzymes, and defensins
(antibiotic-like proteins)
 Neutrophils are our body’s bacteria slayers
 Pus is an accumulation of dead neutrophils, cell debris and fluid at sites
of infections
2. Basophils account for 0.5% of WBCs
 Have large, purplish-black (basophilic) granules that contain
 Histamine: inflammatory chemical that acts as a vasodilator and attracts
other WBCs (antihistamines counter this effect)
 Heparin: prevents the formation of clots
3. Eosinophils
 Have red-staining, bilobed nuclei connected via a broad band of nuclear
material
  Have red to crimson (acidophilic) large, coarse, lysosome-like granules
 Lessen the severity of allergies by reducing inflammation
 Lead the body’s counterattack against parasitic worms

Agranulocytes: lymphocytes and monocytes

 Lack visible cytoplasmic granules
 Are similar structurally, but are functionally distinct and unrelated cell types
 Have spherical (lymphocytes) or kidney-shaped (monocytes) nuclei
1. Lymphocytes account for 25% or more of WBCs
 Have large, dark-purple, circular nuclei with a thin rim of blue cytoplasm
 Are found mostly enmeshed in lymphoid tissue (some circulate in the
blood)
 There are two types of lymphocytes: T cells and B cells
1. B cells
 Stimulated by bacteria or toxins
 Give rise to plasma cells, which produce antibodies
2. T cells
 Protect against viruses and other intracellular microorganisms
 Attack and destroy the cells that are infected
2. Monocytes account for 4–8% of leukocytes
 They are the largest leukocytes
 They have an abundant pale-blue cytoplasm
 They have purple-staining, U- or kidney-shaped nuclei
 They leave the circulation, enter tissue, and differentiate into
macrophages
 Are highly mobile and actively phagocytic
 Activate lymphocytes to mount an immune response
Platelets
 Fragments of megakaryocytes with a blue-staining outer region and a purple granular
center
 Function in clotting by two mechanisms
– Formation of platelet plugs, which seal holes in small vessels
– Formation of clots, which help seal off larger wounds in the vessels
 Their granules contain ADP and thromboxanes

Preventing Blood Loss

 A series of reactions for stoppage of bleeding
 Three phases occur in rapid sequence:
 Vascular spasms
– immediate vasoconstriction in response to injury
• Thromboxanes and endothelin can cause vascular spasms
– Platelet plug formation
– Coagulation (blood clotting)
– Platelet Plugs
– Platelets do not stick to each other or to blood vessels
– Upon damage to blood vessel endothelium platelets:
• With the help of von Willebrand factor (VWF) adhere to collagen
 •Are stimulated by and then release more thromboxane and ADP, which
attract still more platelets
• Stick to exposed collagen fibers and form a platelet plug
– The platelet plug is limited to the immediate area of injury by prostacyclin
– Can seal up a small breaks in a blood vessels that occur many times each day
Blood clotting
– or coagulation, is the formation of a clot (a network of protein fibers called fibrin)
– Blood clotting begins with the extrinsic or intrinsic pathway
– Both pathways end with the production of activated factor X
• Extrinsic pathway begins with the release of thromboplastin from
damaged tissue
• Intrinsic pathway begins with the activation of factor XII
– Activated factor X, factor V, phospholipids, and Ca 2+ form prothrombinase
– Prothrombin is converted to thrombin by prothrombinase
– Fibrinogen is converted to fibrin by thrombin
 Insoluble fibrin strands form the structural basis of a clot
 Fibrin causes plasma to become a gel-like trap
 Fibrin in the presence of calcium ions activates factor XIII that:
• Cross-links fibrin
• Strengthens and stabilizes the clot
– Away from the site of injury anticoagulants in the blood, such as antithrombin and
heparin, prevent clot formation
Clot Retraction and Fibrinolysis
 Clot retraction: stabilization of the clot by squeezing serum from the fibrin strands
– Results from the contraction of platelets, which pull the edges of damaged tissue
closer together
– Serum, which is plasma minus fibrinogen and some clotting factors, is squeezed
out to the clot
 Thrombin and tissue plasminogen activator activate plasmin, which dissolves fibrin
(fibrinolysis)

Blood Grouping
 RBC membranes have glycoprotein antigens on their external surfaces
 These antigens are:
– Unique to the individual
– Recognized as foreign if transfused into another individual
– Promoters of agglutination and are referred to as agglutinogens
 Presence or absence of these antigens is used to classify blood groups
 Transfusion reactions occur when mismatched blood is infused
 Antibodies can bind to the donor’s RBC antigens, resulting in agglutination or hemolysis
of RBCs, leading to
– Diminished oxygen-carrying capacity
– Clumped cells that impede blood flow
– Ruptured RBCs that release free hemoglobin into the bloodstream
 Blood Antigens Anti-Body
type Present Present
A B Anti Anti B
A
AB + + - -
B - + + -
A + - - +
O - - + +

ABO Blood Group

 The ABO blood groups
consists of:
– Two antigens (A
and B) on the
surface of the RBCs
–
– Two antibodies in
the plasma (anti-A
and anti-B)
Rh Blood Group
 Rh-positive blood has
certain Rh antigens (the D
antigen), whereas Rh-
negative blood does not
 Antibodies against the Rh
antigen are produced when
a Rh-negative person is
exposed to Rh-positive
blood
 The Rh blood group is responsible for hemolytic disease of the newborn, which can
occur when the fetus is Rh-positive and the mother is Rh-negative

Critical Thinking Application

Why is Type O blood considered Universal Blood Donor?
Why is Type AB blood considered Universal Blood Recipient?

---End of Chapter---