blood cells, its types and composition with blood grouping and hemostasis

1. BLOOD
BY
SONI KUMARI SHAH

2. Introduction
Blood is a fluid connective tissue. It circulates constantly around
the body, allowing constant communication between tissues
distant from each other.
It transports:
• oxygen
• nutrients
• hormones
• heat
• protective substances
• clotting factors.

3. Blood
Blood is composed of a clear, straw-colored, watery fluid called
plasma in which several different types of blood cell are
suspended.
Plasma normally constitutes 55% of the volume of blood and the
cell fraction.
Blood makes up about 7% of body weight (about 5.6 liters in a
70 kg man). This proportion is less in women and considerably
greater in children, gradually decreasing until the adult level is
reached.

4. Characteristics
Blood Volume: 5-6 Liters
Normal Reaction: Slightly Alkaline pH 7.35-7.45
Specific Gravity: 1.052-1.060
Viscosity: 4.5 Times More Than Water
Temperature: 36-380C
Osmotic Pressure: 25mmHg
Color: bright Red(oxygenated); dark red/purplish(deoxygenated)
Taste: Salty

5. Composition
Cellular substance: 45%
44% RBC & 1% buffy coat containing platelets and WBC
Plasma(fluid): 55%
91-92% water
8-9% solid
Organic Substances: proteins, carbohydrates, fat, urea,
uric acid, creatine, ammonia, enzymes,
antibodies, hormones, bilirubin, etc
Inorganic Substances: sodium, potassium, calcium,
magnesium, phosphorous, iron, copper, etc

6. Plasma
The constituents of plasma are water (90–92%) and dissolved and
suspended substances, including:
• plasma proteins
• inorganic salts
• nutrients, principally from digested foods
• waste materials
• hormones
• gases.

7. Plasma proteins
Plasma proteins, which make up about 7% of plasma, are normally
retained within the blood, because they are too big to escape through
the capillary pores into the tissues.
They are largely responsible for creating the osmotic pressure of
blood, which keeps plasma fluid within the circulation.
Plasma viscosity (thickness) is due to plasma proteins, mainly albumin
and fibrinogen.
Plasma proteins, with the exception of immunoglobulins, are formed in
the liver.

8. Important plasma proteins are
Albumin
Globulin
Fibrinogen
Prothrombin

9. Functions of plasma protein
They transport hormones, iron and other substances.
They exert osmotic pressure and regulate blood volume.
They provide viscosity to blood(which helps in maintaining
blood pressure).
Fibrinogen in plasma in necessary for clotting
Globulin of plasma is important for the synthesis of immune
substances called antibodies.

10. Electrolytes
These have a range of functions, including muscle
contraction (e.g. Ca2+), transmission of nerve impulses
(e.g. Ca2+ and Na+), and maintenance of acid–base
balance.

11. Nutrients
The products of digestion, e.g. glucose, amino acids, fatty acids
and glycerol, are absorbed from the alimentary tract.
Together with mineral salts and vitamins they are used by body
cells for energy, heat, repair and replacement, and for the
synthesis of other blood components and body secretions.

12. Waste products
Urea, creatinine and uric acid are the waste products of protein
metabolism.
They are formed in the liver and carried in blood to the kidneys
for excretion.
Carbon dioxide from tissue metabolism is transported to the
lungs for excretion.

13. Hormones
These are chemical messengers synthesized by endocrine
glands.
Hormones pass directly from the endocrine cells into the
blood, which transports them to their target tissues and
organs elsewhere in the body, where they influence cellular
activity.

14. Gases
Oxygen, carbon dioxide and nitrogen are transported round the
body dissolved in plasma.
Oxygen and carbon dioxide are also transported in combination
with hemoglobin in red blood cells.
Most oxygen is carried in combination with hemoglobin and most
carbon dioxide as bicarbonate ions dissolved in plasma.
Atmospheric nitrogen enters the body in the same way as other
gases and is present in plasma but it has no physiological
function.

15. Cellular Content Of Blood
There are three types of blood cell
• erythrocytes (red blood cells)
• platelets (thrombocytes)
• leukocytes (white blood cells).
Blood cells are synthesized mainly in red bone marrow. Some
lymphocytes, additionally, are produced in lymphoid tissue. In the
bone marrow, all blood cells originate from pluripotent (i.e. capable
of developing into one of a number of cell types) stem cells and go
through several developmental stages before entering the blood.
Different types of blood cell follow separate lines of development.
The process of blood cell formation is called hemopoiesis

17. Erythrocytes (Red Blood Cells)
Red blood cells are by far the most abundant type of blood cell; 99%
of all blood cells are erythrocytes.
They are biconcave discs with no nucleus, and their diameter is about
7 μm.
Their main function is in gas transport, mainly of oxygen, but they also
carry some carbon dioxide.
Their characteristic shape is suited to their purpose; the biconcavity
increases their surface area for gas exchange, and the thinness of the
central portion allows fast entry and exit of gases. The cells are
flexible so they can squeeze through narrow capillaries, and contain
no intracellular organelles, leaving more room for hemoglobin, the

18. Erythrocytes (Red Blood Cells)
Because they have no nucleus, erythrocytes cannot divide and so
need to be continually replaced by new cells from the red bone
marrow, which is present in the ends of long bones and in flat and
irregular bones.
They pass through several stages of development before entering
the blood.
Their life span in the circulation is about 120 days.
There are approximately 30 trillion (1014) red blood cells in the
average human body, about 25% of the body’s total cell count, and
around 1%, mainly older cells, are cleared and destroyed daily.

19. Red Blood Cells(Erythrocytes)
Can be deformed into any shape
• Excess cell membrane
• Less tendency of rupture
• Can squeeze through capillaries

20. Functions of RBC:
 Transport oxygen from lungs to tissue.
 Transport carbon dioxide from tissue to lungs.
 Hemoglobin in RBC Functions as good buffer
 Carry the blood group antigens like A Agglutinogen, B
Agglutinogen, and Rh factor. This helps in determining blood
group and blood transfusion.

21. Red Blood Cells
Sites of Production
Yolk sac- fetus less than 2 months
Liver: 2-5 months
Spleen: 2-5 months
Lymph nodes: adult life
Bone marrows: adult life

22. Development Of Erythrocytes
Formed in bone marrow
The process of development of red
blood cells from stem cells takes
about 7 days and is called
erythropoiesis.
The immature cells are released into
the bloodstream as reticulocytes,
and mature into erythrocytes over a
day or two within the circulation.
During this time, they lose their
nucleus and therefore become

23. Development Of Erythrocytes
Both vitamin B12 and folic acid
are required for red blood cell
synthesis. They are absorbed in
the intestines, although vitamin
B12 must be bound to intrinsic
factor to allow absorption to take
place. Both vitamins are present
in dairy products, meat and
green vegetables.
The liver usually contains
substantial stores of vitamin B12,
several years’ worth, but signs of
folic acid deficiency appear
within a few months

24. Control Of Erythropoiesis: The Role Of Erythropoietin

25. Hemoglobin
hemoglobin is a large, complex
molecule containing a globular
protein (globin) and a pigmented
iron-containing complex called hem.
Each hemoglobin molecule contains
four globin chains and four hem
units, each with one atom of iron. As
each atom of iron can combine with
an oxygen molecule, this means that
a single hemoglobin molecule can
carry up to four molecules of
oxygen.

26. Hemoglobin
An average red blood cell carries about 280 million hemoglobin
molecules, giving each cell atheoretical oxygen-carrying capacity of
over a billion oxygen molecules.
Iron is carried in the bloodstream bound to its transport protein,
transferrin, and stored in the liver.
Normal red cell production requires a steady supply of iron.
Absorption of iron from the alimentary canal is very slow, even if
the diet is rich in iron, meaning that iron deficiency can readily
occur if losses exceed intake.

27. Types Of Hemoglobin
Oxyhemoglobin: It is the combined form of oxygen and hemoglobin
which is found in arterial blood and is the oxygen carried to the body
tissue.
Methemoglobin: A compound formed from hemoglobin by oxidation of
its ferrous iron to ferric iron by injury or toxic substance.
Carboxyhemoglobin: The inhaled carbon monoxide combines with
hemoglobin binding more tightly then oxygen and rendering the
hemoglobin incapable of transporting oxygen is known as
carboxyhemoglobin.

28. Functions Of Hemoglobin
It transports respiratory gases(oxygen and carbon dioxide).
Maintenance of acid base balance.
It reserves iron and protein.

29. Erythrocyte Disorder
Polycythemia is excess of RBC.
Primary polycythemia is due to cancer of myeloid tissue.
Secondary polycythemia is caused by lung damage, high altitude
or other factors leading to hypoxia.

30. Erythrocyte Disorder
Anemia is deficiency of either RBC or hemoglobin.
Anemia falls into three categories: inadequate erythropoiesis or
hemoglobin production, hemorrhagic anemia from bleeding and
hemolytic anemia from RBC destruction.
Three potential consequences of anemia are hypoxia, reduced blood
osmolarity and reduced blood viscosity.

31. Leukocytes (White Blood Cells)
These cells have an important function in defense and immunity.
They detect foreign or abnormal (antigenic) material and destroy
it, through a range of defense mechanisms.
Leukocytes are the largest blood cells but they account for only
about 1% of the blood volume.
They contain nuclei and some have granules in their cytoplasm.

32. Leukocytes (White Blood Cells)
There are two main types:
Granulocytes (Polymorphonuclear Leukocytes) :
Neutrophils
Eosinophils
Basophils
Agranulocytes:
Monocytes
Lymphocytes
Rising white cell numbers in the bloodstream usually indicate a
physiological problem, e.g. infection, trauma or malignancy.

33. Leucocytes(White Blood Cells)
Life span
Granulocytes: 4-8 hrs in blood, 4-5 days in tissue
Monocytes: 10-20 hrs in blood, months in tissue
Lymphocytes: circulates continually, weeks to months

34. Leucocytes (White Blood Cells)

35. Granulocytes
All granulocytes have multilobed nuclei in their cytoplasm.
Their names represent the dyes they take up when stained in the
laboratory.
Eosinophils take up the red acid dye, eosin;
basophils take up alkaline methylene blue; and
neutrophils are purple because they take up both dyes.

36. Eosinophils
Eosinophils, although capable of phagocytosis, are less active in
this than neutrophils; their specialized role appears to be in the
elimination of parasites, such as worms, which are too big to be
phagocytosed.
They are equipped with certain toxic chemicals, stored in their
granules, which they release when the eosinophil binds to an
infecting organism.
Local accumulation of eosinophils may occur in allergic
inflammation, such as the asthmatic airway and skin allergies.

37. Neutrophils
These small, fast and active scavengers protect the body against bacterial
invasion, and remove dead cells and debris from damaged tissues.
They are attracted in large numbers to any area of infection by chemicals
called chemotaxins, released by damaged cells.
Their numbers rise very quickly in an area of damaged or infected tissue.
Once there, they engulf and kill bacteria by phagocytosis.
Neutrophils live on average 6–9 hours in the bloodstream.
Pus that may form in an infected area consists of dead tissue cells, dead
and live microbes, and phagocytes killed by microbes.

38. Phagocytic Action Of Neutrophils.

39. Basophils
Basophils, which are closely associated with allergic
reactions, contain cytoplasmic granules packed with heparin
(an anticoagulant), histamine (an inflammatory agent) and
other substances that promote inflammation.
Usually the stimulus that causes basophils to release the
contents of their granules is an allergen (an antigen that
causes allergy) of some type.

40. Neutrophils:
Protect against any foreign materials that gains entry to the body
To remove waste materials
Eosoniphils
Elimination of parasites
Often found at sites of allergic inflammation
Basophils:
Closely associated with allergic reaction
Packed with heparin, histamine,etc

41. Agranulocytes
The monocytes and lymphocytes make up 25 to 50% of
the total leukocyte count.
They have a large nucleus and no cytoplasmic granules.

42. Monocytes:
These are the largest of the white blood cells.
Some circulate in the blood and are actively motile and
phagocytic while others migrate into the tissues where
they develop into macrophages.

43. Monocytes:
Both types of cell produce interleukin 1, which:
acts on the hypothalamus, causing the rise in body temperature
associated with microbial infections
stimulates the production of some globulins by the liver
enhances the production of activated T-lymphocytes.
Macrophages have important functions in inflammation and
immunity.

44. Lymphocytes:
Smaller than monocytes and have large nucleus
Some circulate in the blood but most are found in tissues,
including lymphatic tissue such as lymph nodes and the
spleen.
Responds to antigens
Two distinct types: T- lymphocytes & B- lymphocytes

45. Disorders of Leukocytes
Leukopenia is a condition in which too few leukocytes are
produced.
If this condition is pronounced, the individual may be unable to
ward off disease.
Excessive leukocyte proliferation is known as leukocytosis.
Although leukocyte counts are high, the cells themselves are
often nonfunctional, leaving the individual at increased risk for
disease.

46. Disorders of Leukocytes
Leukemia is a cancer involving an abundance of leukocytes.
It may involve only one specific type of leukocyte from either the
myeloid line (myelocytic leukemia) or the lymphoid line
(lymphocytic leukemia).
In chronic leukemia, mature leukocytes accumulate and fail to
die.
In acute leukemia, there is an overproduction of young, immature
leukocytes. In both conditions the cells do not function properly.

47. Disorders of Leukocytes
Lymphoma is a form of cancer in which masses of malignant T
and/or B lymphocytes collect in lymph nodes, the spleen, the
liver, and other tissues.
As in leukemia, the malignant leukocytes do not function
properly, and the patient is vulnerable to infection.
Some forms of lymphoma tend to progress slowly and respond
well to treatment. Others tend to progress quickly and require
aggressive treatment, without which they are rapidly fatal.

48. Functions Of Leucocytes(WBC)
Protection against infection: done by neutrophils and monocytes by
phagocytosis.
To aid in repair of injured tissue.
To produce immune substances which defense against disease. This is
done by lymphocytes through synthesis of gamma globulin.
Basophils secretes an anticoagulant substance called heparin.

49. Thrombocytes(platelets)
The life span of platelets is between 8 and
11 days and those not used in hemostasis
are destroyed by macrophages, mainly in
the spleen.
About a third of platelets are stored within
the spleen rather than in the circulation; this
is an emergency store that can be released
as required to control excessive bleeding.

50. Platelets (Thrombocytes)
These are very small discs, 2–4 μm in
diameter, derived from the cytoplasm of
megakaryocytes in red bone marrow.
Although they have no nucleus, their
cytoplasm is packed with granules
containing a variety of substances that
promote blood clotting, which causes
hemostasis (cessation of bleeding).

51. Platelets are derived from cells called megakaryocytes.

52. Functions Of Platelet
Platelets are essential parts of blood coagulating mechanism.
The close minute lesions in the walls of vessels.

53. Disorders of Platelets
Thrombocytosis is a condition in which there are too many
platelets. This may trigger formation of unwanted blood clots
(thrombosis), a potentially fatal disorder.
If there is an insufficient number of platelets, called
thrombocytopenia, blood may not clot properly, and excessive
bleeding may result.

54. Functions of Blood
Carries respiratory gases, nutrients, hormones, enzymes, vitamins,
metabolites(body fluid, CSF) other chemicals and wastes
Regulates body temperature
Maintains water and electrolyte balance
Maintains acid base balance
Contains agents which protects against infection
Coagulation of blood by platelets.

55. Blood Cells Count
RBC count
4.7-6.1 million/mm3 in male
4.2-5.4 million/mm3 in female
WBC count
4000-11000/mm3
Platelets
2,00,000- 3,50,000/mm3
Hemoglobin
12-16gm/dl for female
14-18gm/dl for male

56. Blood is composed of straw colored transparent fluid when blood cells are
suspended. It is called
I. Serum
II. Plasma
III. Hemocrit
IV. Fibronigen
Viscosity of blood is mainly due to
I. RBCs
II. WBCs
III. Platelets
IV. Electrolytes
Approximate life span of platelet is:
I. 120 days
II. 7 days
III. 24 hrs
IV. 6 hrs

57. Formation of blood
The process of formation of blood is hemopoiesis.
Sites Of Blood Formation:
During intrauterine life:
yolk sac (1-2 months)
liver and spleen (2-5months)
bone marrow, lymph node, spleen (5months till birth)
After birth:
Bone marrow, lymph node, spleen

58. Haemopoiesis

59. Blood Grouping(ABO System)

60. Blood Grouping(Rhesus/Rh System)
Blood group RBC Antigen Antibody Frequency
Positive D None 85%
Negative None None by birth 15%

62. Prevalence Of Different Blood Group

63. Parents Child Blood Group Relationship

64. Purpose Of Blood Grouping
Blood transfusion: if non match blood will be transferred to the
patient then there will be antigen antibody reaction and hemolysis
will occur.
To prevent hemolytic disease of new born.
Relationship of blood groups, susceptibility to various diseases.

65. Basis Of Transfusion Reaction
Individual have different types of antigen on the surface of their RBCs.
These antigens, which are inherited, determine the individual’s
blood group .
Individuals can make antibodies to these antigens, but not to their
own type of antigen, since if they did the antigens and antibodies
would react, causing a potentially fatal transfusion reaction.
These antibodies circulate in the blood stream and the ability to make
them, like the antigens, is genetically determined and not associated
with acquired immunity.

66. Basis Of Transfusion Reaction
If individuals are transfused with blood of the same group, i.e.
possessing the same antigens on the surface of the cells, their
immune system will not recognize them as foreign and will not
reject them.
However, if they are given blood from an individual of a different
blood type, i.e. with a different type of antigen on the red cells,
their immune system will generate antibodies to the foreign
antigens and destroy the transfused cells.
This is the basis of the transfusion reaction; the two blood types,
the donor and the recipient, are incompatible.

67. Hemostasis
The process which causes stoppage of bleeding is called
hemostasis.
It keeps blood within a damaged blood vessel hence prevent
bleeding.
The opposite of hemostasis is hemorrhage.
It is the first stage of wound healing.

68. Steps Of Hemostasis:
1. Vasoconstriction
2. Platelet plug formation
3. Coagulation(blood clotting)
4. Fibrinolysis

69. Vasoconstriction:
Platelet come in contact with damaged blood vessel- become
sticky-adhere to the wall- release serotonin-constrict blood vessel-
reduce blood flow
Platelet Plug Formation:
Adherent platelet clump to each other-release ADP-attracts more
platelets-forms temporary seal-platelet plug

70. Coagulation
Blood clotting results in the formation
of insoluble thread like mesh of fibrin
which traps the blood cells and is
much stronger than the rapidly
formed platelet plug.
In the final stage of this process
prothrombin activator acts on the
plasma protein prothrombin
converting it to thrombin.
Thrombin acts on another plasma
protein fibrinogen and converts it to
fibrin.

71. Coagulation
Prothrombin activator can be formed
by two process: the extrinsic and
intrinsic pathway.
The extrinsic pathway is activated
rapidly (within seconds) following
tissue damage. Damaged tissue
releases a complex of chemicals
called thromboplastin or tissue factor,
which initiates coagulation.
The intrinsic pathway is slower (3–6
minutes) and is triggered when blood
comes into contact with damaged
blood vessel lining (endothelium) and
the effects of platelets adhering to it.

72. Fibrinolysis:
The breakdown of clot is called fibrinolysis.
An inactive substance called plasminogen is present in clot and is
converted to the enzyme plasmin by activators released from the
damaged endothelial cells.
Plasmin initiates breakdown of fibrin to soluble products that are
treated as waste materials and are removed by phagocytosis.

73. Clotting Factors

74. Erythroblastosis Fetalis
It is a clinical condition, if Rh –ve mother has Rh +ve fetus, at the time of
delivery fetal RBCs enter maternal circulation and cause sensitization
leading to formation of agglutin against Rh in large quantity.
If next time this woman becomes pregnant and bears Rh +ve fetus,
agglutin can enter from mother to fetus leading to agglutination of fetal
RBC and hemolysis. Severe hemolysis in fetus causes jaundice.
To compensate hemolysis more and more number of RBC are needed not
only from bone marrow but also from liver and spleen.
Now many large and immature proerythroblastic stage are released in
circulation because of this only disease is called erythroblastosis fetalis.
Ultimately due to excessive hemolysis anemia occurs and the infant dies
because of severe anemia.

75. Erythroblastosis Fetalis

76. Donated blood should be used within
I. 4 weeks
II. 4 months
III. 10 weeks
IV. 10 months
Which blood group is called universal receiver
I. A
II. B
III. AB
IV. O
Universal donar is one who has blood group
I. A
II. B
III. AB
IV. O

77. In blood group A there is:
I. No antibodies, A&B antigen
II. Anti-B antibody, A antigen
III. Anti-A antibody, B antigen
IV. Anti-A & anti-B antibody, no antigen
Donated blood is usually taken from
I. Artery
II. Vein
III. Capillary
IV. artery and vein