Anatomy

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Blood: Dr Karim

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Anatomy

  1. 1. BLOOD and HEMOPOIESIS Assoc. Prof. Dr. Karim Al-Jashamy IMS/MSU 2010
  2. 2. Formed Elements of Blood • Erythrocytes (RBC) • Leukocytes (WBC) – Granulocytes – Agranulocytes • Platelets (Thrombocytes) • Blood smear, stain using Wright. • Aspirate bone (sternum, iliac crest) for bone marrow smear.
  3. 3. Functions of Blood • Transport of: – Gases, nutrients, waste products – Processed molecules – Regulatory molecules • Regulation of pH and osmosis • Maintenance of body temperature • Protection against foreign substances • Clot formation 19-3
  4. 4. Composition of Blood
  5. 5. Plasma • Liquid part of blood – Pale yellow made up of 91% water, 9% other • Colloid: Liquid containing suspended substances that don’t settle out – Albumin: Important in regulation of water movement between tissues and blood – Globulins: Immune system or transport molecules – Fibrinogen: Responsible for formation of blood clots 19-5
  6. 6. Formed Elements • Red blood cells (erythrocytes) • White blood cells (leukocytes) – Granulocytes • Neutrophils • Eosinophils • Basophils – Agranulocytes • Lymphocytes • Monocytes • Platelets (thrombocytes) 19-6
  7. 7. Production of Formed Elements • Hematopoiesis or hemopoiesis: Process of blood cell production • Stem cells: All formed elements derived from single population – Proerythroblasts: Develop into red blood cells – Myeloblasts: Develop into basophils, neutrophils, eosinophils – Lymphoblasts: Develop into lymphocytes – Monoblasts: Develop into monocytes – Megakaryoblasts: Develop into platelets 19-7
  8. 8. Erythrocytes • Structure – Biconcave, anucleate • Components – Hemoglobin – Lipids, ATP, carbonic anhydrase • Function – Transport oxygen from lungs to tissues and carbon dioxide from tissues to lungs 19-8
  9. 9. ERYTHROCYTE • Numerous (5 x 106) / ml. • Mature cell has no nucleus, organelles. • Transports O2 and CO2. SEM RBC
  10. 10. RBC Biconcave shape increases surface area 20-30%. Readily deform and pass through capillaries. Cytoskeleton is unique. Spectrin is major protein. Hemoglobin. Energy from anaerobic respiration of glucose. (No mitochondria present) Lifespan is 120 days. Removed by spleen and liver. 19-10
  11. 11. TEM RBC Reticulocyte with a RBC in capillary few organelles. 19-11
  12. 12. Hemoglobin Hemoglobin (haemoglobin and abbreviated Hb or Hgb) is the iron- containing oxygen-tran also spelled sport metalloprotein in the red blood cells of vertebrates. In mammals, the protein makes up about 97% of the red blood cell's dry content, and around 35% of the total content (including water). Hemoglobin has an oxygen binding capacity of between 1.36 and 1.37 ml O2 per gram of hemoglobin, which increases the total blood oxygen capacity seventyfold. 19-12
  13. 13.  Hemoglobin is also found in outside red blood cells and their progenitor lines.  Other cells that contain hemoglobin include dopaminergic neurons in the substantia nigra, macrophages, alveolar cells, and mesangial cells in the kidney.  In these tissues, hemoglobin has a non-oxygen carrying function as an antioxidant and a regulator of iron metabolism. 19-13
  14. 14. Hemoglobin • Consists of: – 4 globin molecules: Transport carbon dioxide (carbonic anhydrase involved), nitric oxide – 4 heme molecules: Transport oxygen • Iron is required for oxygen transport
  15. 15. Normal values Hemoglobin is measured in grams per deciliter of blood. The normal levels are 1.5-3 years - 12±.5 5 y - 12.7±1 Birth - 17±2 10 y - 13.2±1 1 day - 19±2 Men - 15.5±1 2-6 d - 19±2.5 Women - 13.7 14-23 d - 15.5±1 Pregnant women: 11 to 12 24-37 d - 14±2 g/dl 40-50 d - 13±2 Women: 12.1 to 15.1 g/dl 2-2.5 month- 11.5±1 Men: 13.8 to 17.2 g/dl 3-3.5 m - 11±1 Children: 11 to 16 g/dl 5-7 m - 11.5±1 Pregnant women: 11 to 12 g/dl 8-10 m - 11.7±.5 19-15 11-13.5 m - 12±.5
  16. 16. Erythropoiesis • Production of red blood cells – Stem cells proerythroblasts early erythroblasts intermediate late reticulocytes • Erythropoietin: Hormone to stimulate RBC production 19-16
  17. 17. Hematopoiesis 19-17
  18. 18. Hemoglobin Breakdown 19-18
  19. 19. Leukocytes 19-19
  20. 20. Leukocytes • Protect body against microorganisms and remove dead cells and debris • Movements – Ameboid – Diapedesis – Chemotaxis – Passive Immunity – Active Immunity – Antigen – Antibody Diapedesis: The movement or passage of blood cells, especially white blood cells, through intact capillary walls into surrounding body tissue
  21. 21. • Types – Neutrophils: Most common; phagocytic cells destroy bacteria (60%) – Eosinophils: Detoxify chemicals; reduce inflammation (4%) – Basophils: Alergic reactions; Release histamine, heparin increase inflam. response (1%) – Lymphocytes: Immunity 2 types; b & t Cell types. IgG-infection, IgM-microbes, IgA-Resp & GI, IgE- Alergy, IgD-immune response – Monocytes: Become macrophages 19-21
  22. 22. NEUTROPHIL
  23. 23. Neutrophils, mature and almost!
  24. 24. Neutrophil Characteristics • 60-70% of leukocytes • diameter 10-12 µm • nucleus 2-8 lobes • chromatin in dense coarse lumps • 'drumstick' on lobe in 3% of neutrophils in females (Barr body)
  25. 25. Neutrophils Mature and younger Cells (lobes) Movement by pseudopodia. Engulfed bacterium.
  26. 26. Neutrophils (Polymorphs) • Produced in bone marrow. Granulocyte. • Highly motile, phagocytic. • Acute inflammatory response to tissue injury; ingest, destroy damaged tissue & bacteria. • Lifetime activity consists of one burst of phagocytosis!
  27. 27. TEM Neutrophil 5 lobed nucleus. Primary granules are lysosomes. Secondary granules (secretory) contain substances for inflammatory processes (comple- ment activation, leucocyte adhesion, bacterial cell wall lysis). Few other organelles (mitochondria). Glycogen for glycolysis in O2- depleted areas.
  28. 28. LYMPHOCYTE
  29. 29. Lymphocyte Characteristics • 20-25% of leukocytes • Diameter 6-8 µm. • Nucleus spheroid or ovoid. • Chromatin in dense lumps. • Cytoplasm scarce and stained pale blue
  30. 30. Functions of Lymphocyte • Central role in immunological defense. • Most in circulating blood are inactive. • Large lymphocytes (9-15m) are active B cells en route to tissues where they become plasma cells. • T lymphocytes form in red marrow and move to thymus.
  31. 31. Lymphocytes Large (activated) and small (inactive) lymphocytes.
  32. 32. Lymphocyte A few mitochondria and other organelles are present.
  33. 33. MONOCYTE
  34. 34. Monocyte Characteristics • 3-8% of leukocytes. • Largest leukocyte (20 µm). • Nucleus indented and pale. • Cytoplasm abundant and basophilic, non- uniform (foamy) appearance. • Cytoplasm may contain a few fine azurophilic granules.
  35. 35. Functions of Monocytes • Migrate to tissues and become microphages. • Respond to necrotic material, invading microorganisms, and inflammation. • Large content of hydrolytic enzymes. • Great capacity for phagocytosis! • Concept of a single functional unit, the monocyte- macrophage system consisting of Kupffer cells of liver, microglia of CNS, osteoclasts.
  36. 36. Monocytes Mature cell has greater Indentation of nucleus.
  37. 37. SEM Monocyte Granules are similar to lysosomes (acid phosphatase, peroxidase). Numerous golgi, mitochondria, ribosomes.
  38. 38. BASOPHIL
  39. 39. Basophil Characteristics • Less than 1% of leukocytes. • Diameter 14 µm. • Forms in red bone marrow. • Nucleus large and bilobed. • Chromatin is more finely textured so nucleus is more pale staining. • Cytoplasm filled with large dark-blue staining granules (basophilic) which may obscure nucleus (blackberry appearance).
  40. 40. Basophil Function: immunological response to parasites. Contain many mediators of inflammatory response. Closely related to mast cells. Basophils and mast cells bind to IgE produced in response to allergens. Triggers rapid exocytosis of granule contents (degranulation). This is the cause of immediate hypersensitivity reaction characteristic of allergic rhinitis, some forms of asthma, urticaria, anaphylactic shock).
  41. 41. Basophil Bilobed nucleus Granules (S) contain heparin, leukotrienes, histamine. Mitochondria, ribosomes, glycogen in cytoplasm.
  42. 42. EOSINOPHIL
  43. 43. Eosinophil Characteristics • Up to 5% of leukocytes. • Diameter 12-15 µm. • Nucleus usually bilobed. • Chromatin clumped but not as dense as in neutrophil. • Cytoplasm filled with numerous large eosinophilic (acidophilic) granules which stain pale-pink.
  44. 44. Functions of Eosinophils • Phagocytic for antigen-antibody complexes. • Defense against parasites. • Release granules against parasites which are injured by enzymes. • Undergo chemotaxis in response to bacteria but preferentially respond to basophils and mast cells.
  45. 45. SEM Eosinophil Specific granules (S) stains reddish. S granules contain many hydrolytic enzymes. Contains glycogen, some mitochondria, rER, sER.
  46. 46. Thrombocytes • Cell fragments pinched off from megakaryocytes in red bone marrow • Important in preventing blood loss – Platelet plugs – Promoting formation and contraction of clots 19-46
  47. 47. Hemostasis • Arrest of bleeding • Events preventing excessive blood loss – Vascular spasm: Vasoconstriction of damaged blood vessels – Platelet plug formation – Coagulation or blood clotting 19-47
  48. 48. Platelets Very complex with organelles but no nuclei. Function: form plugs in damaged vessels, promote clot formation, secrete substances that are involved in repair of vessels.
  49. 49. Platelet Plug Formation 19-49
  50. 50. Coagulation • Stages – Activation of prothrombinase – Conversion of prothrombin to thrombin – Conversion of fibrinogen to fibrin • Pathways – Extrinsic – Intrinsic 19-50
  51. 51. Clot Formation 19-51
  52. 52. Fibrinolysis • Clot dissolved by activity of plasmin, an enzyme which hydrolyzes fibrin 19-52
  53. 53. Blood Grouping • Determined by antigens (agglutinogens) on surface of RBCs • Antibodies (agglutinins) can bind to RBC antigens, resulting in agglutination (clumping) or hemolysis (rupture) of RBCs • Groups – ABO and Rh 19-53
  54. 54. ABO Blood Groups 19-54
  55. 55. Agglutination Reaction 19-55
  56. 56. Rh Blood Group • First studied in rhesus monkeys • Types – Rh positive: Have these antigens present on surface of RBCs – Rh negative: Do not have these antigens present • Hemolytic disease of the newborn (HDN) – Mother produces anti-Rh antibodies that cross placenta and cause agglutination and hemolysis of fetal RBCs 19-56
  57. 57. Erythroblastosis Fetalis 19-57
  58. 58. Diagnostic Blood Tests • Type and crossmatch • Complete blood count – Red blood count – Hemoglobin measurement – Hematocrit measurement • White blood count • Differential white blood count • Clotting 19-58
  59. 59. Blood Disorders • Erythrocytosis: RBC • Hemophilia overabundance • Thrombocytopenia • Anemia: Deficiency of • Leukemia hemoglobin • Septicemia – Iron-deficiency • Malaria – Pernicious – Hemorrhagic • Infectious – Hemolytic mononucleosis – Sickle-cell • Hepatitis 19-59

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