‫بسم هللا الرحمن الرحيم‬
‫المملكة العربية السعودية‬
‫قسـم العلوم الطبيـة التطبيقيـة‬
‫وزارة التعليـــــم العـــالي‬
‫تخصــص أجــــهزة طبيــــــــة‬
‫جامعــــة المـــلك سعــود‬
‫أجهزة المختبرات اإلكلينيكية ‪ 210‬أجــز‬
‫كليـة المجتمـع بالريـاض‬
‫الفصل الدراسى األول ‪35-34‬‬
‫‪Clinical Laboratory‬‬
‫‪Equipment‬‬
‫‪1‬‬
‫‪MASH 210, A. Eshra, Spring 2013/14, 1st Semester‬‬
Course Instructor
Ayman Elsayed Eshra
Assistant Prof. Dr. Eng.
Tel. +9664735277 – 401
Room:24A 7-3
Office hours: see time table
E-mail: aeshra@ksu.edu.sa
2
Textbooks
1- Carr, J. J. & Brown, J. M. “Introduction to biomedical
equipment technology” 4th ed., ch.16 pp.427.
2- Despopoulos, A. & Silernagl, S. “Color Atlas of Physiology”
5th ed. Thieme, stuttgart . New York, pp.88-105, 2003.
3- Health care product comparison system
3
Grading & Assessment
Assignments
Reports
Quizzes
Midterm
lab
Final
10%
10%
10%
20%
10%
40%
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Contents
• Blood and its Components
• Blood Tests
• Centrifuge
• Colorimeter
• Spectrophotometer
• Flam Photometer
• Blood cells Counter
• Blood Gas Analyzer
• Autoanalyzer
• Chromatography
• Oxygen Concentrator
5
Objective
1- Be able to state the purpose of blood.
2- Be able to list the components and describe the composition of
blood.
3- Be able to list and describe blood tests ( cell and chemistry).
4- Be able to state the purpose, uses, principle of operation, and
maintenance of the following equipment: centrifuge, colorimeter,
spectrophotometer, flame photometer, blood gas analyzers (pH,
PO2, PCO2), Chromatograph, and autoanalyzers.
5- Be able to describe renal physiology, including types of renal
failure and the hemodialysis machine operation, safety, and
maintenance.
Medical Laboratory department
The medical laboratory department includes facilities, personnel, and
equipment within the hospital or public or private location. The facilities must include
a clean, safe surrounding with a special area for sterilization of contaminated blood
urine samples and equipment. Since high-volume blood testing occurs in this
department , sufficient storage and cleaning area must be designed. In such a
situation, the chance of error (misreading or a patient record mixup) is high.
Medical laboratory personnel include equipment operators (medical
technologists), supervisors, and physicians. The director of theses facilities is usually a
physician.
Equipment contained in the laboratory includes glassware, centrifuges,
suction devices, and sophisticated instrumentation, such as colorimeters,
spectrophotometers, blood cell and gas analyzers, chromatographs, autoanalyzers,
and computerbased record and operation systems.
Recordkeeping is extremely important. This information is used by
physicians as an aid in diagnosing disease and imblanced physiological states.
Standard cards with printouts of RBC or WBC counts, Hct, MCV, MCHC, and blood
chemistry are presented by most clinical Instrumentation.
Purpose of Clinical laboratory Equipment
The purpose of Clinical laboratory Equipment is to provide a means of measuring
required substances and metabolic waste products in blood and urine.
What is blood?
Blood is the life-maintaining fluid that circulates through the body's:
1-Heart.
2-Arteries.
3-Veins.
4-Capillaries.
What is the function of blood?
Blood carries the following to the body tissues:
1-Nourishment.
2-Electrolytes.
3-Hormones.
4-Vitamins.
5-Antibodies.
6-Heat
7-Oxygen.
red blood cells
Blood carries the following away from the body tissues:
1-Waste matter.
2-Carbon dioxide.
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Where are blood cells made?
Blood cells are made in the bone marrow. The bone
marrow is the spongy material in the center of the bones
that produces about 95 percent of the body's blood cells.
There are other organs and systems in our bodies that
help regulate blood cells. The lymph nodes, spleen, and
liver help regulate the production, destruction, and
differentiation (developing a specific function) of cells.
The production and development of new cells is a process
called hematopoiesis.
Blood cells formed in the bone marrow start out as a
stem cell. A "stem cell" (or hematopoietic cell) is the
initial phase of all blood cells. As the stem cell matures,
several distinct cells evolve such as the red blood cells,
white blood cells, and platelets. Immature blood cells are
also called blasts. Some blasts stay in the marrow to
mature and others travel to other parts of the body to
develop into mature, functioning blood cells.
Bone marrow [4].
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What are the components of blood?
Human blood consists of about 22 percent solids and 78 percent water.
The components of human blood are:
Plasma is the fluid portion of the blood in which the blood cells are suspended,
including: electrolytes, nutrients, metabolites, vitamins, hormones, gases, and
proteins.
1-Red blood cells (erythrocytes) - carry oxygen from the lungs to the rest of the body.
2-White blood cells (leukocytes) - help fight infections and aid in the immune process.
Types of white blood cells include:
■Lymphocytes.
■Monocytes.
■Eosinophils.
■Basophils.
■Neutrophils (granulocytes).
3-Platelets (thrombocytes) - help in blood clotting.
4-Fat globules.
5-Chemical substances, including:
■Carbohydrates.
■Proteins.
■Hormones.
6-Gases, including:
■Oxygen.
■Nitrogen.
■Carbon dioxide.
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Spinning of Blood components
Clear to straw colored (90% water)
Solids (8% by mass)
Plasma proteins – albumin, globulin, fibrinogen
Growth/protective – hormones, vitamins, antibodies, enzymes
Inorganic substances – Na+, K+, Cl-, Fe
Organic substances – urea waste and protein, fat, glucose nutrient
Respiratory gases – O2 and Co2
White blood cells – Leukocytes
Defense against bacteria
Amoeba – like shaped
Red blood cells – erythrocytes
Transport O2 and CO2
Concave disc shaped
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Composition of Blood
•The blood volume of an adult correlates with his or her (fat-free) body mass and
amounts to ca. 4–4.5 L in women (♀) and 4.5–5 L in men of 70 kg BW (♂); table1.
The blood consists of a fluid (plasma) formed elements:
•Red blood cells (RBCs): The primary function of red blood cells, or erythrocytes, is to
carry oxygen and carbon dioxide. Hemoglobin (Hgb) is an important protein in the red
blood cells that carries oxygen from the lungs to all parts of our body. RBCs play an
important role in pH regulation.
•White blood cells (WBCs):
The primary function of white blood cells, or leukocytes, is to fight infection.
There are several types of white blood cells and each has its own role in fighting
bacterial, viral, fungi, and parasitic infections. Types of white blood cells that are most
important for helping protect the body from infection and foreign cells include the
following:
1-Neutrophils.
2-Eosinophils.
3-Lymphocytes.
4-Monocytes.
5-Granulocytes.
Seen here are two lymphocyte (left)
cells and one neutrophil (right) cell of
the human immune system [5].
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White blood cells:
•Help heal wounds not only by fighting infection but also by ingesting matter
such as dead cells, tissue debris and old red blood cells.
•Are our protection from foreign bodies that enter the blood stream, such as
allergens.
•Are involved in the protection against mutated cells, such as cancer.
•Platelets (thrombocytes):
The primary function of platelets, or thrombocytes, is blood clotting.
Platelets are much smaller in size than the other blood cells. They group
together to form clumps, or a plug, in the hole of a vessel to stop bleeding.
erythrocyte (left), thrombocyte (center), and leukocyte (right)
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•Blood volume in liters relative to body weight (BW)
♂ 0.041 X BW (kg) + 1.53, ♀ 0.047 X BW (kg) + 0.86
•Hematocrit (cell volume/ blood volume):
♂: 0.40–0.54
♀: 0.37–0.47
•Erythrocytes (1012/L of blood = 106/μL of blood):
♂ 4.6–5.9♀ 4.2–5.4
•Hemoglobin (g/L of blood):
♂ 140–180
♀ 120–160
•MCH, MCV, MCHC— mean corpuscular (MC) mean cell , hemoglobin
(Hb), MC volume, MC Hb concentration Fig.1
•Leukocytes (109/L of blood = 103/ μL of blood):
3–11 (64% granulocytes, 31% lymphocytes, 6% monocytes)
•Platelets (109/L of blood = 103/ μL of blood):
♂ 170–360
♀ 180–400
•Plasma proteins (g/L of serum):
66–85 (including 55–64% albumin)
Table 1
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Fig.1-C Erythrocyte parameters MCH, MCV and MCHC
Pico-
10-12
Femto-
10-15
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Composition of Blood
1. Cells
1.1.
1.2.
1.3.
Red
white
Platelets
2.1.
2.2.
2.3.
2.4.
2.5.
Protein
Nutrients
Regulatory and protective substances
Electrolytes
Metabolic waste substances
2. Plasma
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1.1. Red Blood Cells (RBC’s)
•No Nucleus
•Disc shaped
•120 days life span
Consists of :
•Hemoglobin and water
•Each RBC contains 4 iron atoms in structure known as the hemoglobin
1.2. White Blood cells
(WBC’s)
•Amoeba like
•Nucleus
•10-14 days life span
•6-10
103 cells/mm3
Purpose: Surround/ swallow invading bacteria and foreign substance to
destroy the invader’s effect.
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1.3. Platelets (PLT’s)
•Size: 2-3 μm
•Normal range: 15-40 104/ μ L
•Number 2-8 105 cells/mm3
•Cell fragments
•No nucleus
•Purpose: Blood coagulation and clotting
2. Blood plasma
•Plasma proteins.
•Plasma nutrients-energy-storing.
•Regulatory and protective substances.
•Plasma electrolytes.
•Metabolic waste substances.
2.1. Plasma proteins
•Albumins
•Fibrinogen and prothrombin
•Globulin
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2.2. Plasma nutrients-energy- storing
•Glucose (blood sugar).
•Lipids (fats)
•Amino acids (Proteins for tissue growth)
2.3. Regulatory and protective substances
•Enzymes
•Hormones
•Antibodies
2.4. Plasma electrolytes-acid-base
•Sodium Na+
•Potassium K+
•Chloride Cl-
2.5. Metabolic waste substances
•Urea.
•Uric.
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BLOOD TESTS
Cell tests
Chemical tests
20
Common hematology tests
Hematology Analyzer measures and determines
several parameter such as:
•RBC’s
•WBC’s
•Hgb
•PLT
•Hct: Hematocrit is the volume ratio of red cells to whole blood
(Table 1).
•MCV : Mean Cell Volume
•MCH : Mean Cell Hemoglobin
•MCHC : Mean Cell Volume Hemoglobin Concentration
•MPV : Mean Platelet Volume
•RDW : Red Blood Cell Distribution width
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Blood cell tests include the following
1-RBC count:
Accomplished manually (diluting a blood sample 100:1 and counting the cells
per cubic millimeter by use of a microscope) or automatically (blood cell counting
analyzers).
2-WBC count:
Accomplished manually (diluting a blood sample 10:1 and counting the cells
per cubic millimeter by use of a microscope) or automatically (blood cell counting
analyzers).
3-Hematocrit (Hct):
Percentage of total blood volume that is solid (WBCs volume is negligible).
This is measured by spinning a blood sample in a test tube and optically observing
the percentage of packed RBCs. It normally ranges from 45% to 55%.
4-Mean cell (corpuscular) volume (MCV):
Average volume of an RBC measured by a value based on the RBC count
(number per mm3). This volume is measured in femtoliters (10-15 L)
MCV = Hct / RBC
These testes aid in diagnosing anemia and other blood disorders and certain cancers of
the blood; to monitor blood loss and infection; to monitor a patient's response to
cancer therapy, such as chemotherapy and radiation.
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5-Platelet count:
To diagnose and/or monitor bleeding and clotting disorders. Accomplished
automatically by a blood cell analyzer.
6-Mean cell hemoglobin (MCH):
The proportional mass of RBC/100 mL of the total number of RBCs is
expressed as:
This value is indicated in picograms (10-12 g), measured by lysing RBCs (breaking their
membranes) to release hemoglobin (27–32pg). Acid hematin or cyanmethemoglobin
can be generated by hemoglobin chemical reaction.
The resultant value is measured by a colorimeter and normally indicates 32 % to 36 %
color index.
7-Mean cell hemoglobin concentration (MCHC):
Hemoglobin color concentration measured by lysing RBCs (breaking their
membranes) to release hemoglobin.
The resultant value is measured by colorimeter and normally indicates 32 % to 36%
color index.
23
Blood Chemical Tests
1-pH
4-Urea waste
2-Glucose
5-Uric acid
3-Amino acids
6-Cholesterol
Other Blood Tests
1- Blood serological tests:
They involve testing for agglutination (clumping) of cells due to the addition
of antigens (bacterial toxins) to blood serum. This occurs following the reaction of a
specific antibody produced by WBCs in response to the specific invader.
2- Blood bacteriological testes :
They include growth of blood bacteria in a petri dish with appropriate
nutrients.
3- Historical tests:
They are studies of small, thin tissue samples under the microscope.
Specimens are obtained by cutting tissues with a precision slicer known as a microtome.
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Collecting
Documenting
Labeling
Processing
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Analyzing
Results
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Blood transport heat
References
1.
2.
3.
4.
5.
http://www.medicine.mcgill.ca/physio/vlab/bloodlab/eryfrag2_n.htm
http://labtestsonline.org/lab/photo/blood1/?start=3
http://anthro.palomar.edu/blood/blood_components.htm
http://www.chw.org/display/PPF/DocID/21846/router.asp
http://www.blood.co.uk/about-blood/components/
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