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  1. 1. Blood<br />
  2. 2. Blood<br />The liquid form of connective tissue in which cells are suspended in a circulating fluid, the plasma<br />About 5.5 L in humans<br />
  3. 3. Composition of blood<br />Liquid Intercellular substance (Plasma)<br />50-60% of actual blood volume<br />Homogenous, slightly alkaline fluid which contains:<br />Organic substances<br />Inorganic substances<br />Enzymes<br />Hormones<br />Solid or formed elements<br />40-50% of actual blood volume<br />Cellular elements<br />RBC/erythrocytes<br />WBC/leukocytes<br />Platelets/thrombocytes<br />Non-cellular elements<br />Hemoconia – blood dusts<br />Chylomicrons or tiny fat droplets<br />
  4. 4. Serum<br />Clear yellow liquid of clotted blood<br />When circulation ceases, or when blood is exposed to air, one of the globulins of plasma (fibrinogen) precipitates as a network of fine filaments, the fibrin. The contraction of clotted blood or plasma (syneresis) expresses a clear yellow fluid called SERUM<br />
  5. 5. Composition of Plasma<br />Plasma is an aqueous solution containing substances of low or high molecular weight that make up 10% of its volume<br />Plasma proteins – 7%<br />Albumin – alpha and beta<br />Gamma globulins <br />Lipoproteins <br />Proteins that precipitate in blood coagulation (prothrombin and fibrinogen)<br />Inorganic salts – 0.9%<br />Organic compounds – amino acids, vitamins, hormones, lipoproteins – of various origins<br />
  6. 6. Hematocrit<br />Is an estimate of the volume of packed erythrocytes per unit volume of blood<br />Normal value:<br />Adult male – 40-50%<br />Adult female – 35-45% and diminishes by physiologic hemodilution during pregnancy<br />Children up to 10 – 35%<br />Newborn – 45-60%<br />
  7. 7. Cellular Elements of blood<br />
  8. 8. RBC or Erythrocytes<br />Anucleate (no nucleus)<br />Packed with the oxygen-carrying protein, HEMOGLOBIN (heme-iron portion;globin-protein portion)<br />Small 7.5 μm in diameter<br />Biconcave in profile<br />Non-granular<br />Non-motile<br />Acidophilic staining cells<br />
  9. 9. RBC or Erythrocytes<br />“dumbbell” in shape - in profile<br /> osmotic pressure of vacuum of blood vessels sucks RBC membrane causing constriction at the middle<br />provides the erythrocytes a large surface-to-volume ratio, thus facilitating gas exchange<br />Elastic – suffers changes in shape when passing into environmental obstacles<br />Cytoplasm – homogenous and non-granular<br />Fresh cytoplasm – yellowish green<br />Cytoplasm when stained – red, orange, pink due to acid stain<br />
  10. 10. RBC or Erythrocytes<br />Acidophilic staining property is due to hemoglobin (14-16 grams/100 cc of blood)<br />Lifespan – 10 to 120 days (during its life = 700 miles of travel)<br />Normal RBC count 4.5 M/cu mm of blood<br />Female – 3.9 to 5.5 M/cu mm of blood<br />Male – 4.1 to 6 M/cu mm of blood<br />
  11. 11. Terminologies<br />
  12. 12. Anemia<br />Decreased concentration of red blood cells in the circulating blood<br />It is also possible for the number of red blood cells to be normal but for each cell to contain a reduced amount of hemoglobin <br />May be caused by:<br />Loss of blood (hemorrhage)<br />Insufficient production of red blood cells by the bone marrow<br />Production of RBC with insufficient hemoglobin – related to iron deficiency anemia<br />Accelerated blood cell destruction<br />
  13. 13. Polycythemia or Erythrocytosis<br />Increase in RBC count<br />Physiologic adaptation – found in people living in high altitudes where oxygen tension is low<br />
  14. 14. Special Features/Behavior of Red Blood Cells<br />
  15. 15. Rouleaux formation<br />RBC adhere themselves to one another due to surface tension<br />Appear as “columns” or “piles of coins”<br />
  16. 16. Crenation<br />RBC’s spiked shrunk appearance<br />Induced in vitro by: exposure to fatty acids, lysolecithin, anionic compunds or elevated pH<br />Erythrocytes assume a spiny configuration with 10 – 30 spicules regularly distributed over their surface and are thus called echinocytes<br />
  17. 17. Behavior of RBC when exposed to solutions of different concentrations<br />Hypertonic solution<br />Hypotonic solution<br />Solution of greater concentration gradient<br />Flow of water: from low to high<br />RBC shrinks<br />Isotonic solution<br />Equal concentration, equal pressure (0.9% NaCl)<br />No change<br />Solution of lesser concentration and less osmotic pressure causing swelling of RBC<br />Water goes to cell causing the cell to swell and eventually burst and disintegrate<br />
  18. 18. Anisocytosis – variation in RBC size<br />Macrocyte – large RBC (9 μm)<br />Normocyte – normal RBC (7 – 8 μm)<br />Microcyte – small RBC (6 μm)<br />Poikilocytosis – variation in RBC shape<br />Ovalocytes<br />Spherocytes - inelastic<br />Sickle cells – “crescent-like”, sickling, inelastic, with abnormal hemoglobin, hereditary factors (etiology)<br />Target cells – abnormally shaped RBC in some cases of anemia; do not undergo roleaux formation<br />
  19. 19. Anisochromia – variation in RBC color<br />Hyperchromic – more color, more hemoglobin<br />Normochromic – normal color, normal hemoglobin<br />Hypochromic – less color, less hemoglobin<br />Agglutination - sludging<br />Clumping of RBC due to agglutinin (anti-bodies)<br />Happens in unmatched blood<br />
  20. 20. RBC particles<br />Heinz bodies <br />Granules found in normal RBC<br />Due to congenital suseptibility to drugs<br />Howell-Jolly bodies<br />Remnants of nuclear chromatin (inside RBC)<br />Makes RBC with basophilic particles inside<br />Cabot’s ring<br />Remnants of nuclear membrane (artifact)<br />
  21. 21. WBC or Leukocytes<br />
  22. 22. Leukocytes or WBC<br />Involved in the cellular and humoral defense of the organism against foreign materials<br />Normal lifespan – a few days to a week<br />Normal count – 6,000 to 10,000 per microliter of blood<br />Divided into two groups:<br />Granular<br />Non-granular<br />
  23. 23. Terminologies<br />Diapedesis– a process that accounts for the unidirectional flow of granulocytes and monocytes thru intact walls of blood vessels<br />Chemotaxis – attraction of specific cells by chemical mediators; migration of blood cells to the site of infection<br />
  24. 24. Granular WBC<br />
  25. 25. Neutrophils/Heterophils<br />60-70% <br />12-15 μm in diameter<br />2-5 lobes<br />In females, the inactive x-chromosome appears as a drumstick appendage on one of the lobes of the nucleus (Barr body)<br />First line of cellular defense (phagocytes)<br />Normal lifespan – 1-4 days (6-7 hours halflife)<br />
  26. 26. Eosinophils or Acidophils<br />2-4% <br />Bilobed, with numerous large acidophilic granules<br />Increase in number during parasitism and allergic reactions<br />
  27. 27. Basophils<br />Less than 1%<br />12-15 µm in diameter<br />S-shaped nucleus obscured by large basophilic granules<br />May supplement the function of mast cells in immediate hypersensitivity reaction<br />
  28. 28. Non-granular WBC<br />
  29. 29. Lymphocytes<br />6-8 µm (small), medium-sized and large-sized (18 μm) are present in circulating blood<br />Diverse function, all related to immune reactions in defending against invading microorganism<br />Lifespan – a few days<br />The only leukocyte that return to the tissue after diapedesis<br />25 – 30%<br />
  30. 30. Monocytes<br />12-20 µm in diameter<br />U-shaped or kidney-shaped nucleus<br />Precursor cells of the mononuclear phagocyte system<br />4-8%<br />
  31. 31. Platelets or Thrombocytes<br />
  32. 32. Thrombocytes<br />Lightest formed elements<br />Nonnucleated, disklike fragments 2-4 µm<br />Promote blood clotting and help repair gaps in the walls of blood vessels, preventing blood loss<br />Normal count – 200,000 to 400,000 per microliter of blood<br />Normal lifespan – about 10 days<br />