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Introduction To Hematology

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    Introduction To Hematology Introduction To Hematology Document Transcript

    • Introduction to Hematology Annette Baker, MS, PA-C Objectives •At this end of this lecture the student will know: •The anatomy of blood •The function of plasma •The structure and function of erythrocytes, leukocytes, platelets and hemostasis Introduction •Represents about 8% of total body weight •Average volume of 5 liters in women •Average of 5.5 liters in men •Consists of three types of cellular elements •Erythrocytes, leukocytes and platelets •These are suspended in complex liquid called plasma
    • Introduction •99% of cells are erythrocytes •Hematocrit or packed cell volume is defined as the percentage of total blood volume occupied by erythrocytes •Plasma accounts for the remaining volume •Hematocrit averages 42% for women and 45% for men Plasma •Functions of plasma are carried out by plasma proteins •Composed of 90% water •Plasma is able to absorb and distribute much of the heat generated metabolically within tissues •Most abundant electrolytes in the plasma are Na and Cl Plasma •Three groups of plasma proteins: •Albumin •Globulin •Fibrinogen
    • •These are classified according to various physical and chemical properties •Plasma proteins establish osmotic gradient between blood and interstitial fluid Plasma •Responsible for the plasma’s capacity to buffer changes in pH •Contribute to blood viscosity •Used as metabolic fuels in starvation states •Albumin the most abundant contribute most extensively to the colloid osmotic pressure •There are three subclasses of globulins: alpha, beta and gamma Plasma •Alpha and beta globulins bind and transport substances •Affects the process of blood clotting •Regulates the role of salt balance in the body •Gamma globulins are immunoglobulins that defends the body •Fibrinogen key factor in blood-clotting process
    • Erythrocytes •Primary function to transport oxygen transport in the blood •5 billion erythrocytes clinically in a red blood cell count •Hemoglobin is transported by erythrocytes •Hemoglobin consists of two parts Erythrocytes •Hemoglobin combines with carbon dioxide to transport gas from tissue to lungs •Buffers acid so that it minimally alters the pH of the blood •Carbon monoxide Erythrocytes •Bone marrow replaces worn-out erythrocytes •Spleen destroys red blood cells •Erythropoiesis is the generation of new red blood cells
    • •Erythrocytes are generally produced by the yolk sac first Erythropoiesis •Erythropoietin is produced by the kidney •Immature red blood cells are called reticulocytes •Red bone marrow can be found in adults in the sternum, vertebrae, ribs, upper end of the long bones, and base of the skull Leukocytes •Also known as white blood cells •Mobile units of the body’s immune defense system •Function outside the blood •Leukocytes work by phagocytosis Leukocytes •Five different types of leukocytes •They lack hemoglobin; colorless unless stained •Five types of circulating leukocytes are: neutrophils, eosinophils, basophils, monocytes, and lymphocytes Leukocytes
    • •Polymorphonuclear granulocytes are the neutrophils, eosinophils and basophils •Monocytes and lymphocytes are known as mononuclear agranulocytes •Monocytes are larger of the two •Lymphocytes the smallest Leukocytes •Produced at varying rates depending on the changing defense needs of the body •Leukocytes originate from undifferentiated stem cells in the red bone marrow •Granulocytes and monocytes are produced only in the red bone marrow Hemopoiesis •All blood-cell types ultimately originate from the same undifferentiated pluripotent stem cells •Bone marrow produces all circulating blood cells except lymphocytes •These are produced by lymphoid tissue Leukocytes •Neutrophils accompanies bacteria infection
    • •Eosinophils associated with allergic conditions and internal parasite infestations •Basophils dispersed in the connective tissue •Basophils secrete histamine and heparin •Monocytes are phagocytes Lymphocytes •Provide immune defense against targets • Two types of lymphocytes •B and T •B lymphocytes produce antibodies •T lymphocytes destroy cell-mediated immune response Platelets
    • •Bone-marrow-bound cells known as megakaryocytes •Derived from undifferentiated stem cells Complete Blood Count •Also known as CBC •Provides detailed information about three types of cells in the blood: red blood cells, white blood cells and platelets •Blood cells made from bone marrow •Measures white blood cell count, red blood cell count, hemoglobin, hematocrit and platelet count CBC •WBC (White Blood Cell) count measured in thousands per cubic milliliter (K/mm3) of blood •Normal range: 3.4-9.6 K/mm3 •RBC measured in millions/cubic millimeter (mil/mm3) of blood •RBC: 4.5-6.0 mil/mm3 males; 4.0-5.5 mil/mm3 in female CBC
    • •Hemoglobin measured in grams per deciliter (g/dl) of blood •Hgb range is 13.5-17.5 g/dl for males •Hgb range is 12.5-15.5 g/dl for females •Hematocrit is the percentage of red blood cells in relation to your total blood volume •HCT 41%-52% male and 36%-48% female Indices •MCV: average red cell volumes •Measured in fl •Value 80-100 fl •MCH: average red cell hemoglobin concentration •Measured in picograms •Values: 27-32 pg Indices •MCHC: compares the weight of hemoglobin in a red cell to the size of the cell •Reported in percentage or g/dl •Values: 33-38 percent CBC
    • •Leukopenia- decrease in number of leukocytes in blood •Leukocytosis – increase in number of leukocytes in blood •Neutropenia- decrease neutrophil count •Neutrocytosis- increase neutrophil count CBC •Anisocytosis: markedly different sizes of red cell •Poikilocytosis: significantly variation in shape of the erythrocytes •Macrocytosis increase in size of cell •Microcytosis decrease in size of cell • Helmet cell membrane injured cells found in certain conditions CBC •Spherocytosis: dense stained red cells lacking in central pallor •Diameter less than normal sized red cells •Target cells: have central are of hemoglobin pigment surrounded by relatively clear are and peripheral rim of hemoglobin to center of cell