Hematology
Allied Health Sciences I
Instructor: Melissa Lewis
How much blood does an
average adult have in
their body?
• Eight to Ten pints (8-10)
• Four to Five Quarts (4-5)
Functions of the Blood:
• Transporting fluid of the body
• Carries nutrients from digestive tract to
cells
• Carries waste products from cells to
excretory organs
• Carries hormones and other chemical
substances that control proper functioning
Functions of the Blood
Cont:
• Controls body temperature by circulating
excess heat to body surfaces and to lungs,
through which it is lost.
• Circulates antibodies and defensive cells
throughout body to combat infection and
disease.
Objective 1H07. 01:
Explain the structure of
the blood
• Blood composition: Blood is made up of
plasma, which is the liquid portion of the
blood without the cellular elements and the
celluar elements which are: 1.
Erythrocytes (RBC’s) 2. Leukocytes
(WBC’s) 3. Thrombocytes (platelets)
Plasma:
• Liquid portion of the blood
• Makes up 55% of the blood volume
Plasma Contains the
following Substances:
• 1. Water which is 92%of the total volume of
plasma.
• 2. Blood proteins-hemoglobin is a protien
found in red blood cells.
• 3. Nutrients- also part of the blood plasma
are the nutrient molecules such as glucose,
fatty acids, cholesterol, and amino acids that
are absorbed from the digestive tract
Cont…
• 4. Electrolytes- Sodium Chloride (NaCl) and
potassium (K) are the most abundant electrolytes
• 5. Hormones, Vitamins, and enzymes help the
body with it’s chemical reactions and are found in
very small amounts in the blood plasma.
• 6. Metabolic waste products- these are carried by
the blood plasma to the various excretory organs.
Cont…
• 7. Plasma proteins- Fibrinogen, serum albumin,
and serum globulin are the three most abundant
proteins in plasma.
– A. Fibrinogen- is the protein synthesized by the liver
than is necessary for blood clotting
– B. Albumin- is the protein also synthesized by the liver
that maintains the blood’s osmotic pressure and volume.
It is the most abundant of the plasma proteins.
– C. Globulin- formed in the liver and lymphatic system.
It has two parts- Gamma globulin is necessary for the
synthesis of antibodies to fight organisms. Prothrombin
is the other part that is formed continuously in the liver,
which helps bloods to coagulate. Vitamin K helps in the
synthesis of prothrombin.
Cont…
• 7. Plasma proteins- Fibrinogen, serum albumin,
and serum globulin are the three most abundant
proteins in plasma.
– A. Fibrinogen- is the protein synthesized by the liver
than is necessary for blood clotting
– B. Albumin- is the protein also synthesized by the liver
that maintains the blood’s osmotic pressure and volume.
It is the most abundant of the plasma proteins.
– C. Globulin- formed in the liver and lymphatic system.
It has two parts- Gamma globulin is necessary for the
synthesis of antibodies to fight organisms. Prothrombin
is the other part that is formed continuously in the liver,
which helps bloods to coagulate. Vitamin K helps in the
synthesis of prothrombin.
Red Blood Cells (RBC’s):
•
•
•
•
•
Called erythrocytes
Biconcave
Disc-shaped cells
Look like donuts
Thin in the middle & thicker on the outer
edges
Hemoglobin:
• Red pigment of erythrocyte
• Composed of a protein molecule called
globin and an iron compound called heme.
• Transports oxygen to tissues and carbon
dioxide from tissues
• Normal Hemoglobin Levels for men =14-18
grams per 100 cc, women = 12-16
grams/100cc
Hemoglobin cont:
• The RBC’s pick up oxygen from capillaries in
lungs as we inhale. The oxygen chemically
combines with hemoglobin forming compound
oxyhemoglobin. The RBC’s carry the
oxyhemoglobin to capillaries of body tissues and
releases the oxygen. The carbon dioxide that is
formed is picked up by plasma and the RBC’s
circulate back to lungs to give up the carbon
dioxide and absorb more oxygen. We exhale the
carbon dioxide.
Hemoglobin cont:
• The blood cells of the arteries (except
pulmonary artery) carry oxyhemoglobin.
This gives blood it’s bright red color.
• The blood cells of the veins (except
pulmonary veins) contain
carbominohemoglobin, which is responsible
for the dark, crimson-blue color
characteristic of venous blood.
Carbon Monoxide
Poisoning:
• Is a serious and sometimes fatal condition. It is an
odorless gas present in the exhaust of gasoline
engines. Carbon monoxide rapidly combines with
hemoglobin; and it binds at the same site on the
hemoglobin molecule as oxygen. It crowds the
oxygen out.
• Symptoms are headache, dizziness, drowsiness,
and unconiousness.Death can occur.
Carbon monoxide
poisoning cont…
• One should remember that the gas is
odorless. It is also present in gas furnaces
and gas or oil-fired space heaters. Always
allow plenty of ventilation. There are
commercial carbon monoxide detectors
available to measure for carbon monoxide.
Erythropoiesis:
• Erythropoiesis is the manufacture of RBC’s. Until
adolescence RBC’s are formed in the red marrow
of the bones. After adolescence RBC’s are formed
in the short and flat bones.
• RBC’s come from stem cells in the red bone
marrow called hemocytoblasts. As it matures into
an erythrocyte, it loses it’s nucleus and
cytoplasmic organelles. The hemocytoblasts gains
hemoglobin and develops into the biconcave
shape and enters into the bloodstream.
Cont…
• Erythrocytes only live 120 days. At the cells
age they deteriorate. They are broken down
by the spleen and liver. Hemoglobin breaks
down into the globin and heme and the iron
content of heme is used to make new red
blood cells
• Normal RBC count for men=4.5 to 6.2
• Normal RBC count for women=4.2 to 5.4
White blood cells
(Leukocytes):
• Granular or agranular, translucent, and
ameboid in shape.
• Much larger than RBC’s
• Two major groups: granulocytes and
agranulocytes
• Granulocytes are formed in the red marrow
from cells called myeoblasts. Their life span
is usually only a few days but does vary.
Three types of
Granulocytes:
• Neutrophils: Phagocytize (surround, engulf, and
digest harmful bacteria) bacteria with lysosomal
enzymes
• Eosinophils: Phagocytize antibody-antigen
reactions. Also increase allergic conditions.
• Basophils: Phagocytize. Their count increases
during chronic inflammation and during healing of
an infection. They produce histamine, which is a
vasodilator, and heparin, an anticoagulant.
Agranulocytes:
• Divided into lymphocytes and monocytes
Lymphocytes:
• Lymphocytes are divided into Blymphocytes and T-lymphocytes
• Life span ranges from few days to several
years
• Synthesize & release antibody molecules
• Protect against formation of cancer cells
Monocytes:
• Assist with phagocytosis
• Able to leave the bloodstream to attach
themselves to tissues
• When they attach themselves to tissues they
become macrophages/histiocytes
• Macrophages/histiocytes help wall off an
infected area
Inflammation:
• Process of our body that protects us
• Occurs when we have 1. chemical or
physical tissue damage or 2. invasion from
a microorganism
• Pathogen= a microorganism that is capable
of causing disease
Symptoms of
Inflammation:
•
•
•
•
Redness
Local heat
Swelling
Pain
Inflammation Cont…
• Histamine is released by basophils & this
increases blood flow to the area
• Capillary permeability is increased
• Neutrophils move through the capillary
walls by diapedesis and begin
phagocytizing the microorganism
Inflammation Cont…
• Result equals combination of dead tissue, dead &
living bacteria, dead leukocytes, & plasma
• This all looks like a cream-colored liquid (called
pus)
• If damaged area is below the epidermis an abscess
(pus filled cavity) forms
• If damaged area is on skin or mucosal surface it is
called an ulcer
Inflammation Cont…
• Sometimes during inflammation process
pyrogens are formed & they travel to the
hypothalamus
• In the hypothalamus, these pyrogens affect
the temperature control center which raises
the body temperature causing a fever or
pyrexia
Blood Clotting:
• Thrombocytes are blood platelets
• Thrombocytes are the smallest of the solid
components of the blood
• Normal platelet count is 250,000 to 450,000
per cubic millimeter of blood
Blood Clotting Process:
• 1. Platelets come in contact with vessel’s collagen
fibers
• 2. This stimulates the platelets to produce sticky
projecting structures, allowing them to stick
• 3. A platelet plug forms to stop bleeding
• 4. Platelets secrete a chemical called serotonin
• 5. Serotonin causes blood vessel spasm which
decreases blood flow
• 6. Clot is formed
Coagulation:
• Means blood clotting
• When blood vessel is injured platelets &
injured tissue release thromboplastin
• Thromboplastin is a complex substance that
can only allow cause coagulation if calcium
ions & prothrombin are present
• Prothrombin is a plasma protein that is
synthesized in the liver
Coagulation cont…
• The thromboplastin & calcium ions act as
enzymes in a reaction that converts prothrombin
into thrombin
• This occurs when there is bleeding
• Thrombin acts as an enzyme and changes
fibrinogen into fibrin
• The fibrin threads layer themselves over the cut
forming a network
• This network traps RBC’s, platelets, & plasma
• This creates a blood clot
• Serum oozes from the cut forming a scab over the
fibrin threads & completes the clotting process
Coagulation cont…
• There are 2 anticoagulants that must be
neutralized before clotting can occur
• They are antithromboplastin &
antiprothrombin (heparin)
• Both of these are neutralized by
thromboplastin
Coagulation cont…
• Prothrombin & fibrinogen are plasma
proteins that are made in the liver
• If liver disease present, the blood clotting
process will be affected
• Prothrombin can not be made without
Vitamin K
• Vit K is manufactured from a type of
bacteria found in the intestines
Clotting Time:
• Time is takes for the blood to clot
• Normal clotting times for humans is 5-15
minutes
• A person clotting time should be known
prior to doing surgery
Blood Types:
• There are four major blood types
–
–
–
–
A
B
AB
O
Blood Types Cont…
• Blood type is determined by presence or
absence of blood protein called
agglutinogen or antigen that is on the
surface of the RBC
–
–
–
–
Type A blood has B antibodies
Type B blood has A antibodies
Type O blood has A & B antibodies
Type AB contains no antibodies
Universal Donor:
• O blood because it has no A or B antigens
• O blood could be given to anyone
Universal Recipient:
• Type AB because has no antibodies
• Someone with Type AB blood could receive
any of the four blood types
Rh Factor:
• RBC contain Rh antigen
• This is the Rh factor since it was found in the
Rhesus monkey
• It is found on the surface of the RBC
• If it is present a person is said to be Rh positive
• If it is not present a person is said to be Rh
negative
• Most Americans are Rh positive
Rh Factor cont…
• If a Rh negative person receives a transfusion of
Rh positive blood, he or she will develop
antibodies to it (takes 2 weeks to acquire new
antibodies)
• Usually there is no problem the first transfusion
• If a second transfusion occurs with Rh positive
blood, the new antibodies will clump with the
antigens
Rh Factor & Pregnancy:
• This same problem can occur with a Rh
negative mother who is carrying a Rh
positive fetus
• The problem would occur with the second
pregnancy
• The second baby’s RBC’s would clump &
the baby would be born with
erythroblastosis fetalis
Rh Factor & Pregnancy
cont…
• Erythroblastosis fetalis is rare today because of a
drug call RHO Gam
• RHO Gam is an immune globulin
• This injection is given to Rh negative mothers
within 72 hours after delivery
• The antibodies in the RHO Gam will destroy any
Rh positive cells of the baby’s which have entered
the mother’s blood stream
• Therefore the mother will not produce antibodies
Disorders of the Blood:
• Anemia: deficiency of RBC’s & the
amount of hemoglobin in the blood
• Iron deficiency anemia: Caused by
inadequate amounts of iron in diet
• Pernicious anemia: Caused by deficiency of
Vit B12 (Vit B12 & Folic acid are necessary
for development of RBC’s
Disorders of the Blood
cont…
• Aplastic anemia: Occurs when the bone
marrow does not produce enough RBC or
WBC (usually occurs in chemo or radition
treatment patients)
• Sickle Cell Anemia: Chronic disease that is
inherited from both parents
– RBC’s are a crescent shape (abnormal)
– They carry less oxygen & break easily
Disorders of the Blood
cont…
• Cooley’s anemia: Caused by a defect in
hemoglobin formation (also called thalassemia)
• Polycytemia: Condition of too many RBC’s are
formed
• Embolism: Condition where a blood clot or
embolus is carried by the blood stream until it
reaches an artery that is too small for its passage
– Embolus could be made of air, cancer cells, blood clot,
bacterial clumps, needle or bullet
Disorders of the Blood
cont…
• Thrombosis: formation of a blood clot in a
blood vessel
• Hematoma: Localized clotted mass of
blood found in an organ, tissue, or space
• Hemophilia: Hereditary disease in which
the blood clots slowly or abnormally
Disorders of the Blood
cont…
• Thrombocytopenia: Blood disease which
there is a decrease in the number of platelets
• Leukemia: Cancerous or malignant
condition in which there is a great increase
in the number of the WBC’s
Umbilical Stem Cells:
• There are immunity-producing stem cells found in
the umbilical cord that are the same as the
immunity-producing stem cells in the bone
marrow
• Umbilical cells are easier to transplant
• Stem cells are young & the brand new donor has
not yet developed antibodies that turn against the
recipient
• These transplants are highly experimental & have
been used mainly in children
• They aid in the treatment of leukemia, anemia, &
Hodgkin’s disease
THE END