 Body fluids and blood  Body fluids, composition and functions of blood, hemopoeisis, formation of hemoglobin, anemia, mechanisms of coagulation, blood grouping, Rh factors, transfusion, its significance and disorders of blood, Reticulo endothelial system.

1. Body Fluid & Blood
By
Yogeshwary M. Bhongade
Assistant Professor
Kamla Neharu College of Pharmacy, Butibori, Nagpur

2. Contents
• Body Fluid
• Composition and function of blood
• Hemopoesis
• Formation of heamoglobin
• Blood Grouping
• Rh factor
• Transfusion
• Disorder of blood
• Reticulo endothelial system

3. Body Fluid
• Fluids inside the body of living oranism which serve as medium
for carrying nutrients to and waste product from the cell and a
medium for carrying the chemical communication that co-
ordinate activities among cell.
eg-
• Interstitial fluid (26%)
• Blood plasma
• Urine
• lymph
• Cerebrospinal fluid (LT 7%)
• Aqueous humor
• Sensorial fluid

4. Body fluid comparment
Body Fluid
Extra-cellular fluid Intra- cellular fluid

6. Blood and its Components
Blood-
• Blood is a fluid connective tissue constituting about 7% of our
total body weight (5 liters in human).
• PH- 7.2-7.4 (Slightly Basic)
• Temp.- 38o C(100.4o F), about 1o C higher than oral or rectal
body temperature.
• Constitute 8% of body weight.
1. Blood Plasma- A watery liquid extracellular matrix that contain
dissolve substances
2. Formed Elements- Cells and cells fragments

7. Blood
Components
Plasma
55%
Neutrients
Solid Liquid Gas
Water
90%
Formed
Elements
(Blood Cell) 45%
Erythrocytes
(Red Blood Cells or RBC)
Leukocytes
(White blood cells or WBC
Granulocytes
Acidophill Basophill Nutrophill Eosinophill
Agranulocytes
Lymphocyte Monocytes
Platelets

8. Components of blood in normal adult

10. Plasma
• Liquid in which peripheral blood cells are suspended.
• It is composed of water, electrolytes such as Na+ andCl- (0.9%),
7% plasma proteins (such as albumin, fibrinogen, globulin),
Harmone, fats, amino acids, vitamins, carbohydrates,
lipoproteins as well as other factors.
• Normal plasma volume is 40ml/kg of body weight

11. Erythrocyte (RBC)-
• 4.8 million/microliter- Female
• 5.4 million/microliter- Male
Characteristics
• Diameter- 7 Micrimeter
• Shape- Bicave disc without
nuclei
• Life span- 120 days

12. Leukocytes (white blood cells or WBC) and platelet
• Togather make up about 1- 2 % of total blood volume.
• Counts- 5,000- 10,000 microliter
• Characteristics- Have nuclei, do not contain Hemoglobin.
WBC
5,000- 10,000 microliter
Granulocytes
Neutrophils
60-70% of all WBC
Basophils
0.5-1% of all WBC
Eosinophils
2-4% of all WBC
Agranulocytes
Monocytes
3- 8%
Lymphocytes
20- 25%

13. Platelets
• Non- nucleated flat, biconvex, round or ovoid disks
• Diameter- 2-5 micron
• Functions:
-Hemostasis
-Promote the coagulation cascade
-To form a blood clot
• Blood contains 150,000- 350.000/mm3
• Life Span is 7- 10 days

15. Function of blood
• Transport Function- Transport of O2 fromt he lungs to the cell
and co2 from cell to lungs, transport the nutrients rom digestive
organ to the cell, Transport hormones and enzyme to the targrt
tissue and gland.
• Homeostatic Function- Maintain the temperature of body parts
• Buffer Function- Maintain pH of all part of the body
• Protective Function- Carries protective substances such as
antibodies, Protect against disease through phagocytosis, WBC
and antibodies.
• Clotting Function- Carries blood clotting factor

16. Hemopoesis/ Hematopoesis
• Hem- Blood; Poisis- Origine, development, maturation
• Production of blood cells (RBC/ WBC)and platelets which occures
within the bone marrow.
• Blood cells are constantly formed through a process called
hemopoiesis.
• The term erythropoiesis refers to the formation of erythrocytes;
• leukopoiesis refers to the formation of leukocytes. These processes
occur in two classes of tissues. Myeloid tissue is the red bone
marrow of the humeri, femora, ribs, sternum, pelvis, and portions
of the skull that produces erythrocytes, granular leukocytes, and
platelets.

17. • Hematopoesis occures in myloid tissue ( Bone Marrow) and
lymphoid tissue (Lymphatic Organ)

18. Types of Hematopoietic Tissue
• Tissue which is actively or potentially produce blood cells are
known as hematopoietic tissue
1. Myloid Tissue- Bone marrow also called as myloid tissue
2. Lymphoid Tissues-Lymphoid tissues are organized structures
that support immune responses. The bone marrow and thymus
are primary lymphoid tissues and the sites of lymphocyte
development. The lymph nodes, spleen, tonsils and Peyer's
patches are examples of secondary lymphoid tissue.

19. Heamoglobin
• Heamoglobin/ Hemoglobin- Heam- Pigment; Globin- Protein
• Haemoglobin (Hb) is a protein found in the red blood cells that
carries oxygen in your body and gives blood its red colour.
• Haemoglobin levels vary from person to person.
• Men usually have higher levels than women.
• The normal range for hemoglobin is: For men, 13.5 to 17.5
grams per deciliter.
• For women, 12.0 to 15.5 grams per deciliter.

20. • Synthesis of hemoglobin begins in the proerythroblasts and
continues even into the
• reticulocyte stage of the red blood cells. Therefore, when
reticulocytes leave the bone
• marrow and pass into the blood stream, they continue to form
minute quantities of
• hemoglobin for another day or so until they become mature
erythrocytes.
• Figure shows the basic chemical steps in the formation of
hemoglobin. First, succinyl_x0002_CoA, formed in the Krebs
metabolic cycle, binds with glycine to form a pyrrole molecule.
Formation of Heamoglobin

21. • In turn, four pyrroles combine to form
protoporphyrin IX, which then combines with
iron to form the heme molecule.
• Finally, each heme molecule combines with a
long polypeptide chain, a globin synthesized
by ribosomes, forming a subunit of
hemoglobin called a hemoglobin chain.
• Each chain has a molecular weight of about
16,000; four of these in turn bind together
loosely to form the whole hemoglobin
molecule.

22. • There are several slight variations in the different subunit
hemoglobin chains, depending on the amino acid composition
of the polypeptide portion.
• The different types of chains are designated alpha chains, beta
chains, gamma chains, and delta chains.

23. Types of Hemoglobin
1. Hemoglobin A:
• Is a combination of two alpha chains and two of beta chains, it is
the most common form of hemoglobin (95-98%) in the adult
human being.
2. Hemoglobin A2:
• Is a combination of two alpha chains and two of delta chains, it
represents 2-3% of hemoglobin in the adult human being.
3. Hemoglobin F (fetus Hb):
• Is a combination of two alpha chains and two of gamma chains,
also it found in newborns blood of about 1% of their hemoglobin.

24. Anemia
• A condition in which the blood doesn't have enough healthy red blood
cells.
• Anaemia results from a lack of red blood cells or dysfunctional red
blood cells in the body. This leads to reduced oxygen flow to the body's
organs.
• Symptoms may include fatigue, skin pallor, shortness of breath, light-
headedness, dizziness or a fast heartbeat.
• Treatment depends on the underlying diagnosis. Iron supplements can
be used for iron deficiency. Vitamin B supplements may be used for
low vitamin levels. Blood transfusions can be used for blood loss.

25. Types of Anemias
Blood Loss Anemia-
• Anemia due to excessive bleeding results when loss of red blood
cells exceeds production of new red blood cells. When blood loss is
rapid, blood pressure falls, and people may be dizzy. When blood
loss occurs gradually, people may be tired, short of breath, and pale.
Aplastic Anemia-
• Aplastic anemia is a condition that occurs when your body stops
producing enough new blood cells. The condition leaves you
fatigued and more prone to infections and uncontrolled bleeding. A
rare and serious condition, aplastic anemia can develop at any age.
It can occur suddenly, or it can come on slowly and worsen over
time.

26. • It can be mild or severe. Treatment for aplastic anemia might
include medications, blood transfusions or a stem cell
transplant, also known as a bone marrow transplant.
MegaloblasticAnemia
• Megaloblastic anemia is characterized by red blood cells that
are larger than normal. There also aren't enough of them. It's
known as vitamin B-12 or folate deficiency anemia, or
macrocytic anemia, as well. Megaloblastic anemia is caused
when red blood cells aren't produced properly.

27. Heamolytic Anemia
• Hemolytic anemia is a disorder in which red blood cells are
destroyed faster than they can be made. The destruction of red
blood cells is called hemolysis. Red blood cells carry oxygen to all
parts of your body. If you have a lower than normal amount of red
blood cells, you have anemia.

28. Coagulation Cascade
• Coagulation cascade the series of steps beginning with
activation of the intrinsic or extrinsic pathways of coagulation,
or of one of the related alternative pathways, and proceeding
through the common pathway of coagulation to the formation
of the fibrin clot.

29. Clotting Factors
• Coagulation depends on the chemical
compounds known as the clotting factor.
• There are around 12 clotting factors
present in the human body.

30. Coagulation Cascade Pathway

31. Intrinsic pathway
• The mechanism of the intrinsic pathway of prothrombin
activation occurs in 4 steps.
• The activation of the intrinsic pathway starts with the exposure
of factor XII with the collagens of the injured blood vessels.
• This collagen then starts stimulating the process of platelet
adhesion and aggregation before the initiation of blood
coagulation.
• This further activation of factor XI is done by the activation of
factor XII. This covert the factor XI to factor XI a. then factor
XIa is to factor IX by factor VIIa.

32. • The final step in the activation of the prothronmbin activator is
the activation of factor X.
• Formation of VIIIa is the key to the process of activation of
factor X.
• In the intrinsic system of blood coagulation, activation of one
clotting factor acts as an enzyme for the activation of the next
factor that leads to sequential activation of subsequent factors in
a series of steps.
• Before the intrinsic process of blood, coagulation is called an
enzyme cascade hypothesis.

33. Extrinsic pathway
• The extrinsic pathway of blood coagulation occurs in 3 steps by
the release of thromboplastin and activation of factor VII and
activation of factor X.
• Thromboplastin is a tissue factor that is viewed as extrinsic to
circulating blood.
• The intrinsic and extrinsic coagulation, it is believed that these
two systems do not operate independently, and all the clotting
factors are interrelated for homeostasis.

34. Blood Groups
• Individuals have different types of antigen on the surfaces of
their red blood cells.
• These antigens, which are inherited, determine the individual's
blood group.

35. ABO Blood Group System

36. Rh Blood Group System
• Discovered by Karl Landsteiner and Wiener in 1940s.
• “Rh” derived from Rhesus Monkey.
• Rh antigens are proteins and only found in RBCs
• Prsence of D antigen - Rh + ve
• Absence of D antigen - Rh- ve

37. Transfusion
• A transfusion is transfer of whole blood or blood components
into bloodstream of a persion to alleviate anemia to increase
blood volume (eg. after a severe hemorrhage) or to improve
immunity.
• In an incompatible blood transfussion antibodies in the
recipients plasma bind to antigen on the donated RBCs which
causes agglutination or clumping of RBCs.
• The complement molecule of defence system cause hemolysis (
rupture) of agglutinated RBCs and then release hemoglobin
may cause kidney damage.

38. Blood Disorder
1. Anemia- Anemia is a condition in which you lack enough
healthy red blood cells to carry adequate oxygen to your body's
tissues.
Classification of Anemia
a. Morphological Classification
i. Normocytic normochromic
ii. Macrocytic normochromic
iii. Macrocytic hypochromic
iv. Microcytic Macrocytic

39. b. Etiological Classification
i. HemorrhagicAnemia- Loss of Blood (Hemorrhagic Anemia): If
there is massive bleeding from a wound or other lesion, the body
may lose enough blood to cause severe and acute anemia, which is
often accompanied by shock. Immediate transfusions are generally
required to replace the lost blood.
ii. Hemolytic Anemia- Hemolytic anemia is a disorder in which red
blood cells are destroyed faster than they can be made. The
destruction of red blood cells is called hemolysis. Red blood cells
carry oxygen to all parts of your body. If you have a lower than
normal amount of red blood cells, you have anemia.

40. iii. Nutrition Dificiency Anemia- Nutritional-deficiency anemia is a common
problem. It can occur when the body is not absorbing enough iron, folate, or
vitamin B-12 from the diet. The issue may be that the diet is insufficient or that
an underlying medical condition or treatment is interfering with the body's
ability to absorb these nutrients.
iv. Aplastic Anemia- Aplastic anemia is a condition that occurs when your body
stops producing enough new blood cells. The condition leaves you fatigued
and more prone to infections and uncontrolled bleeding
v. Anemia of Chronic Disease-The anemia of chronic disease is a multifactorial
anemia. Diagnosis generally requires the presence of a chronic inflammatory
condition, such as infection, autoimmune disease, kidney disease, or cancer. It
is characterized by a microcytic or normocytic anemia and low reticulocyte
count.
Phagocytosis

41. 2. Variation in WBC Count
a. Leukocytosis- Leukocytosis is a condition in which the white
cell (leukocyte count) is above the normal range in the blood. It
is frequently a sign of an inflammatory response, most
commonly the result of infection, but may also occur following
certain parasitic infections or bone tumors as well as leukemia.
b. Neutrophilia- Neutrophilia is an increase in circulating
neutrophils above that expected in a healthy individual of the
same age, sex, race and physiological status. This represents an
increase in the neutrophil count above 7.5 x 109/l and is one of
the most frequently observed changes in the FBC. Causes of
Neutrophilia.

42. c. Eosinophillia- Eosinophilia (e-o-sin-o-FILL-e-uh) is a higher
than normal level of eosinophils. Eosinophils are a type of
disease-fighting white blood cell. This condition most often
indicates a parasitic infection, an allergic reaction or cancer.
d. Basophillia- Basophilia is the condition of having greater than
200 basophils/μL in the venous blood. Basophils are the least
numerous of the myelogenous cells, and it is rare for their
numbers to be abnormally high without changes to other blood
components.

43. e. Monocytosis- Monocytosis is an increase in the number of
monocytes circulating in the blood. Monocytes are white
blood cells that give rise to macrophages and dendritic cells in
the immune system. In humans, monocytosis occurs when
there is a sustained rise in monocyte counts greater than
800/mm3 to 1000/mm3.
f. Lymphocytosis- Lymphocytosis is a higher-than-normal
amount of lymphocytes, a subtype of white blood cells, in the
body. Lymphocytes are part of your immune system and work
to fight off infections.

44. g. Leukemia- Leukemia, also spelled leukaemia, is a group of
blood cancers that usually begin in the bone marrow and result
in high numbers of abnormal blood cells. These blood cells are
not fully developed and are called blasts or leukemia cells.
h. Leukopenia- Leukopenia is a condition where a person has a
reduced number of white blood cells. This increases their risk of
infections. A person's blood is made up of many different types
of blood cells. White blood cells, also known as leukocytes,
help to fight off infection. Leukocytes are a vital part of the
immune system.

45. 3. Variation in Platelet Count
a. Thrombocytopenia- Thrombocytopenia is a condition
characterized by abnormally low levels of platelets, also known as
thrombocytes, in the blood. A normal human platelet count ranges
from 150,000 to 450,000 platelets per microliter of blood.
b. Thrombocytosis- Thrombocytosis (throm-boe-sie-TOE-sis) is a
disorder in which your body produces too many platelets. It's
called reactive thrombocytosis or secondary thrombocytosis when
the cause is an underlying condition, such as an infection.
c. Thrombocythemia-(Persistant or abnormal increase in platelet
count) as in carcinoma, chronic lukemia, Hodgkin’s Disease.

46. Thank You