RODGE CUTIE >.<
BLOOD AND LYMPHATIC
SYSTEM
I. GENERAL
CHARACTERISTICS OF
BLOOD
•Blood Volume: 5-6L (Males) and
4-5L (Female) 250-350ml
(Newborn)
•Viscosity: 3.5-4.5x thicker
•Color: scarlet (oxygen rich) to
dull red or purple (oxygen poor)
In vivo and in vitro appearance:
• pH: 7.35-7.45 (average of 7.40)
venous blood 7.35 / arterial blood
7.45
•Specific gravity:
Regulation of Hematopoiesis
•Erythropoietin (EPO)
•Thrombopoietin (TPO)
•Granulocyte CSF (G-CSF)
•Granulocyte-macrophage CSF
(GM-CSF)
•Interleukins
→whole blood 1.045-1.066
→serum 1.024-1.028
→plasma 1.025-1.029
II. FUNCTIONS OF BLOOD
• Respiratory
• Nutritional
• Excretory
• Buffering action
• Maintenance of constant body
temperature
• Transportation of hormones and
other endocrine
secretion that
regulates cell function
• Body defense mechanism
III. HEMATOPOIESIS
• Blood cell formation
• Occurs in red bone marrow
• All blood cells are derived from a
common stem cell (hemocytoblast)
• Hemocytoblast differentiation
→Lymphoid stem cell produces
lymphocytes
→Myeloid stem cell produces
other formed elements
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• Major function of neutrophils is
to respond rapidly to microbial
invasion to kill the
invaders
(phagocytosis)
The life cycle of a red blood cell
IV. ERYTHROCYTES (RED
BLOOD CELLS)
→The main function is to carry
oxygen
→Anatomy of circulating
erythrocytes
• Biconcave disks
• Essentially bags of
hemoglobin
• Anucleate (no nucleus)
Hemoglobin
• Iron-containing protein
• Binds strongly, but reversibly, to
oxygen
• Each hemoglobin molecule has
four oxygen binding sites
• Each erythrocyte has 250 million
hemoglobin molecules
Control of Erythrocyte
Production
a. Kidneys respond to a lower than
normal oxygen
concentration in the blood by
releasing the hormone
erythropoietin.
b. Erythropoietin travels to the red
bone marrow and stimulates an
increase in the production of red
blood cells (RBCs).
c. The red bone marrow
manufactures RBCs from stem
cells that live inside the marrow.
d. RBCs squeeze through blood
vessel membranes to
enter the circulation.
e. The heart and lungs work to
supply continuous movement and
oxygenation of RBCs.
f. Damaged or old RBCs are
destroyed primarily by the
spleen.
• Steps:
1. adherence
2. migration
3. recognition and phagocytosis (or
ingestion)
4. degranulation
5. oxidative metabolism and
bacterial killing
Some parameters used in the
assessment of white blood cells
A. WBC count
• 5.0 -10.0 x 109/L
• At birth: 10.0 – 30.0 x 109/L
B. Differential Count
VI. PLATELETS
• Cytoplasmic fragments of
megakaryocytes
• Important in HEMOSTASIS
→Diameter: 2-4 um
→Volume: 7fL
→Anucleated cell (w/o golgi
bodies and
RER but with
mitochondria and granules)
Some parameters used in the
assessment of red blood cells
→Round or oval granular purple
dots on Wright’s stain
A. Cell count
• Male: 4.2 – 6.0 x 1012/L
• Female: 3.6 – 5.6 x 1012/L
• At birth: 5.0 – 6.5 x 1012/L
→Megakaryopoiesis takes about
5-7 days
→Life span: 7-11 days
B. Hemoglobin
• Male: 13-18 g/dL
• Female: 12-16 g/dL
• At birth: 15-20 g/dL
C. Hematocrit
• Male: 40-55%
• Female: 36-48%
• At birth: 45-60%
V. WHITE BLOOD CELLS
VI. PLATELETS
RODGE CUTIE >.<
HEMOSTASIS
• Series of complex processes by
which the body spontaneously
stops bleeding and maintains
blood on its fluid state within the
blood vessel compartment.
Some
parameters
in
assessment of platelets
coagulation
the
and
• hepatosplenomegally
• Bilirubinemia
→ 18-20mg/mL
A. Platelet count
• 150 - 400 x 109/L
B. Bleeding time
C. Clotting time
VII. HOMEOSTATIC
IMBALANCES
RBC Disorders
HEMOSTASIS
Anemia:
oxygen
carrying
capacity of blood is reduced
• Reduction of red cell mass
• Decreased concentration of
hemoglobin
• RELATIVE: normal rbc mass,
volume is low
→transient
• ABSOLUTE: low RBC mass,
normal volume
→ low rbc delivery to circulation
→loss of rbc from circulation
VIII. LYMPHATIC SYSTEM
Two parts
• Lymphatic vessels
• Lymphoid tissues and organs
WBC Disorders
A. Qualitative
• Inability to successfully
eliminate foreign substances
B. Quantitative
• Leukocytosis
• Leukopenia
Platelet Disorders
A. Thrombocytopenia
B. Thrombocytosis
Coagulation Disorders
A. Hemophilia
B. Thrombophilia
Hemolytic Disease of the
Newborn (HDN)
Pathogenesis
• FMH→ HDN
• Hemolytic anemia
→ <10g/dL
Lymphatic system functions
• Transport fluids back to the
blood
• Play essential roles in body
defense and resistance to disease
• Absorb digested fat at the
intestinal villi
Lymphatic Characteristics
•Lymph – excess tissue fluid
carried by lymphatic vessels
Properties of lymphatic vessels
1. One way system toward the
heart
2. No pump
3. Lymph moves toward the heart
→Milking action of skeletal
muscle
→Rhythmic contraction of smooth
muscle in vessel walls
RODGE CUTIE >.<
Distribution and Structure of
Lymphatic Vessels
A. Lymphatic capillaries
• Site where transport system
begins
• Remarkably permeable
B. Lymphatic collecting vessels
• Next area where the lymph flows
from the lymphatic capillaries
B. Thymus
•Prominent in newborns and
continues to
increase in size
during childhood
•Located
in
the
superior
mediastinum (in front of great
vessels of heart)
C. Lymphatic trunks
• Formed by the union of the
largest collecting vessels
• Named mostly from the regions
from which they collect lymph
• Structure
→Cortical:
densely
packed
lymphocytes
→Medullary: fewer lymphocytes
→ With cyst-like structures called
Hassall’s/Thymic corpuscles
IX. LYMPH TRANSPORT
Maintained by
• Skeletal muscle contraction
• Pressure changes in the thorax
→Backflow
valves
D. Ducts
1. Right Lymphatic duct: drains
lymph from
• Right side of neck
• Right side of head
• Right half of thorax
• Right upper extremities
2. Thoracic duct: receives lymph
from the rest of the body except
right side of head, neck, thorax,
and upper extremities
→Cisterna chyli: collects lymph
fluid from 2 lumbar trunks which
drains the lower limbs and
intestinal trunk that
drains
digestive organs
Lymphatic Vessels
is
prevented
by
→Pathogens and cancer cells may
spread through the body via the
lymphatic stream
X. LYMPHATIC ORGANS
A. Lymph Nodes
• Distributed along the lymphatic
vessels where lymph is filtered
and antibodies are added
• Lymphocytes are strategically
located inside for immune
response
• Structure: has a fibrous capsule
(cortex and medulla)
→Cortex: contains primary
follicles of lymphocytes
→Medulla: medullary cords
containing lymphocytes and
macrophages with spaces called
medullary sinuses
Lymph Node Structure
C. Spleen
• “graveyard for aged and
defective blood cells”
•Largest lymphoid organ
•Structure
→Surrounded by fibrous capsule
and has trabeculae that extends
inward
→Contains lymphocytes,
macrophages and red cells
→Red pulp and white pulp
D. Tonsil
RODGE CUTIE >.<
• Small masses of lymphoid tissue
around the pharynx (Waldeyer’s
Ring)
1.) Palatine Tonsil: located on
either side at the posterior end of
the oral cavity
2.) Pharyngeal Tonsil: posterior
wall of the nasopharynx
3.) Lingual Tonsil: base of the
tongue
• Structure
→Not fully encapsulated, with
invaginations forming blind-ended
structures called “crypts”
•Cellular: phagocytes, monocytes,
Natural Killer (NK) cells, mast
cells
• Humoral: Complement,
Cytokines
ADAPTIVE
• Specific
• Acquired
• 3rd line
• Has memory
• Cellular: B cells, T cells,
Antigen Presenting Cells (APCs)
• Humoral: Antibodies,
Complement, Cytokines
MALT (Mucosa Associated
Lymphatic Tissue)
→ Acts as a guard to protect
respiratory and digestive tracts
→ Tonsils, Peyer’s patches, small
accumulations of lymphoid tissue
Peyer’s Patches or GALT (Gut
Associated Lymphatic Tissue)
→Large isolated clusters of lymph
nodules found in the ileum
→Macrophages here destroy
bacteria, preventing them from
reaching the intestinal wall
X. IMMUNE RESPONSE
Immunity
• The ability to resist damage from
foreign substances
• Non-specific: first and second
line of defense
• Specific: third line of defense
INNATE AND ADAPTIVE
IMMUNITY
INNATE
• Non-specific
• Natural
• 1st and 2nd line
• No memory
Inflammatory Response
• Prevents spread of injurious
agents to adjacent tissues
• Local inflammation: response
confined to a specific area
• Cardinal Signs:
→Rubor
→Dolor
→Calor
→ Tumor
→ Functio Laesa
• Systemic inflammation:
distributed throughout the body
Mature Lymphocytes
A. T-cells: matures in thymus
• Involved in cell-mediated
immunity
• Antigens must be presented by
macrophages to an immunocompetent T cell (antigen
presentation)
1. Helper T-cells: stimulate the
proliferation of other T cells and of
B cells bound to an antigen
2. Cytotoxic T-cells: directly
attack and destroy infected cells
and cancer cells
3. Suppressor T-cells: terminate
normal immune responses by
releasing suppressor factors
Mature Lymphocytes
B. B-cells: matures in the bone
marrow
• Involved in humoral immunity
• Matures as plasma cells
• 1. Primary immune response:
when antigens bind to the
receptors of B-cells.
• 2. Secondary immune response:
other clone members become
memory B-cells
→Capable of mounting a rapid
attack of the same antigen
Specific Resistance
Active Immunity- what has been
introduced to the individual is the
antigen
❖Naturally acquired active
immunity- infective agent will
gain entry to the body, act as
stimulant for antibody formation
because the organism acts as
antigen.
❖Artificially acquired active
immunity- when the antigen has
been deliberately introduce like
injecting vaccines, they act as
antigen to stimulate antibody
formation.)
Specific Resistance
Passive Immunity- when what has
been introduced to the body is
already antibodies
❖Naturally acquired passive
immunity- exhibited by the
transfer of antibodies
from
mother’s placenta to the fetus and
RODGE CUTIE >.<
transfer of antibodies from breast
milk to the baby.
❖Artificially acquired passive
immunity- injection of artificially
prepared substance like immune
serum of gamma globulin. These
two are antibodies preparation
Immunoglobulins
• Globulin proteins that react
specifically with the antigen that
stimulated their production
• 20% of the protein in the blood
plasma
• Gamma globulins
Classes of Immunoglobulins
1. IgG: 75% of Ig’s
→ Crosses the placenta and
weakly activates complement
system
2. IgA: 15% of Ig’s
→In serum is a monomer and in
secretions is a dimer
→Found in secretions: tears,
saliva, colostrum, mucus
3. IgM: 7-10% of Ig’s
→Largest and exists as a
pentamer
→Most potent activator of
complement
Types:
HERD IMMUNITY
• Immunity of a group or a
community
•“resistance” of a group to
invasion and spread of an
infectious agent based on the
immunity of a high proportion of
individual members of the group
• Important factor underlying the
dynamics of propagated epidemics
Antigen VS Antibody
Antigens:
→reacts with antibodies
→Self antigen or Foreign antigen
Antibodies:
→Proteins (immunoglobulins)
→Binds to antigens or invaders
and kill/inactivate them
1. Alloantibody
• produced after exposure to
genetically different or non-self
antigens of the same species
2. Autoantibody
• produced in response to self
antigen
Immunoglobulin Structure
4. IgE: less than 1% of Ig’s
→Exists as a monomer
→Mediates allergic and parasitic
reaction
5. IgD: less than 1% of Ig’s
→Present in the membrane of
mature B cells
→Modulation of immune response
RODGE CUTIE >.<
XI. HOMEOSTATIC
IMBALANCES
Immunodeficiencies
• Production or function of
immune cells or complement is
abnormal
• May be congenital or acquired
• Includes AIDS – Acquired
Immune Deficiency Syndrome
Autoimmune Diseases
• The immune system does not
distinguish between self and
nonself
• The body produces antibodies
and sensitized T lymphocytes that
attack its own tissues
Examples
diseases
of
autoimmune
• Multiple sclerosis – white matter
of brain and spinal cord are
destroyed
• Myasthenia gravis – impairs
communication between nerves
and skeletal muscles
• Juvenile diabetes – destroys
pancreatic beta cells that produce
insulin
• Rheumatoid arthritis – destroys
joints
• Systemic lupus erythematosus
(SLE) – affects kidney, heart, lung
and skin
Immune Deficiency: AIDS
• HIV targets cells
• Retrovirus attaches to CD4
receptors of T helper cells
– Transmission: Body fluids, i.e.,
blood, semen, breast milk, vaginal
secretions