HBHD 13e Ch13

Copyright © 2015 Wolters Kluwer Health | Lippincott Williams & Wilkins
Chapter 13
The Blood

Copyright © 2015 Wolters Kluwer • All Rights Reserved
Overview

Key Terms
agglutination erythrocyte lymphocyte
albumin fibrin megakaryocyte
anemia hematocrit monocyte
antigen hematopoietic neutrophil
antiserum hemoglobin plasma
basophil hemolysis platelet (thrombocyte)
centrifuge hemorrhage serum
coagulation hemostasis thrombin
cryoprecipitate leukemia thrombocytopenia
eosinophil leukocyte transfusion

Blood
• Important in maintaining homeostasis
• Classified as a connective tissue
• Accounts for 8% of total body weight

Functions of the Blood
Learning Objective
1. List the functions of the blood.

Blood Constituents
Learning Objectives
•Identify the main components of
plasma.
•Describe the formation of blood
cells.
•Name and describe the three types
of formed elements in the blood, and
give the functions of each.
•Characterize the five types of
leukocytes.

Hemostasis and Coagulation
Learning Objectives
6.Define hemostasis, and cite three
steps in hemostasis.
7.Briefly describe the steps in blood
clotting.

Blood Types
Learning Objectives
8.Define blood type, and explain the
relation between blood type and
transfusions.
9.Explain the basis of Rh
incompatibility and its possible
consequences.

Use of Blood and Blood Components
Learning Objective
10.List four possible reasons for
transfusions of whole blood and blood
components.

Blood Disorders
Learning Objectives
11.Define anemia, and list six causes
of anemia.
12.Define leukemia, and name the
two types of leukemia.
13.Describe four forms of clotting
disorders.

Blood Studies
Learning Objective
14.Identify six types of tests used to
study blood.

Case Study
Learning Objective
15.Referring to the case
study, discuss the adverse
effects of bone marrow
damage.

Word Anatomy
Learning Objective
16.Show how word parts are used to build words related
to the blood.

Functions of the Blood

Functions of the Blood (cont.)
✓
Checkpoints
13-1 What are four types of substances transported in
the blood?
13-2 What is the pH range of the blood?

Blood Constituents (cont.)
• Plasma
– Liquid portion
• Formed elements
– Cellular portion

Figure 13-1 Composition of whole blood.

Figure 13-2 Blood cells as viewed under the microscope.
Which cells are the most numerous in the blood?

Blood Plasma
•Plasma is 55% of blood.
•Components
– Water
– Protein
• Albumin
• Clotting factors
• Antibodies
• Complement

Formed Elements
•Produced in red bone marrow from hematopoietic cells
– Erythrocytes
– Leukocytes
• Neutrophils
• Eosinophils
• Basophils
• Lymphocytes
• Monocytes
– Platelets

Erythrocytes
•Red blood cells (RBCs)—most numerous
•Biconcave shape
•Mature cells anuclear
•Contain hemoglobin
– Binds to oxygen for transport
– Carries hydrogen ions for buffering
– Carries carbon dioxide for elimination

Figure 13-3 Red blood cells as seen under a scanning electron
microscope.
Why are these cells described as biconcave?

✓
Checkpoints
13-3 What are the two main components of blood?
13-4 Next to water, what is the most abundant type of
substance in plasma?
13-5 Where do blood cells form?
13-6 What type of cell gives rise to all blood cells?
13-7 What is the main function of hemoglobin?

Leukocytes
•White blood cells (WBCs)—colorless, round, with
prominent nuclei
– Granulocytes
• Neutrophils (polymorphs)
• Eosinophils
• Basophils
– Agranulocytes
• Lymphocytes
• Monocytes
•Clear body of foreign material, cellular debris, pathogens

Figure 13-4 Stages in neutrophil development.

Figure 13-5 Phagocytosis.
What type of epithelium makes up the capillary wall?

Platelets (Thrombocytes)
•Smallest formed element
•Not cells—no nuclei or DNA
•Fragments release from megakaryocytes
•Essential for blood coagulation (clotting)

Figure 13-6 Platelets (thrombocytes).

✓
Checkpoints
13-8 What are the three types of granular leukocytes?
What are the two types of agranular leukocytes?
13-9 What is the most important function of
leukocytes?
13-10 What is the function of blood platelets?

Hemostasis and Coagulation (cont.)
• Prevents blood loss when blood vessel ruptures
• Events include:
– Contraction of smooth muscle in the damaged blood
vessel wall
– Formation of a platelet plug
– Formation of a blood clot
• Formation of prothrombinase
• Conversion of prothrombin into thrombin (by
prothrombinase)
• Conversion of fibrinogen into fibrin (via thrombin)

Figure 13-7 Blood clotting
(coagulation).
What part of the word
prothrombinase indicates
that it is an enzyme? What
part of the word prothrombin
indicates that it is a
precursor?

✓
Checkpoints
13-11 What is the general term for the process that
stops blood loss?
13-12 What substance in the blood forms a clot?
13-13 How does serum differ from blood plasma?

Blood Types (cont.)
• Blood types must be compatible for blood transfusion
from donor to patient.
• Proteins (antigens or agglutinogens) on red cells cause
incompatibility.
– A and B antigens
– Rh factor

Blood Types (cont.)
The ABO Blood Type Group

Figure 13-8 Blood typing.
Can you tell from these
reactions whether these cells
are Rh-positive or Rh-
negative?
Blood Types (cont.)

Blood Types (cont.)
ABO Blood Type Compatibility
•Safest transfusion is with same blood type.
•Type O blood can be given to any ABO type.
•Type AB blood can receive any ABO type.

Blood Types (cont.)
Rh Factor
•Red cell antigen group Rh (D antigen)
– Rh-positive blood has antigen.
– Rh-negative blood lacks antigen.
•Rh incompatibility can lead to hemolytic disease of
newborn (HDN).

Figure 13-9 Rh incompatibility.
Blood Types (cont.)

Blood Types (cont.)
✓
Checkpoints
13-14 What is the term for any substance that activates
an immune response?
13-15 What are the four ABO blood types?
13-16 What blood factor is associated with
incompatibility during pregnancy?

(cont.)
• Blood stored in blood banks up to 35 days
– Anticlotting solution added
– Expiration date added
• Blood donated before elective surgery (autologous
blood)

(cont.)
Whole-Blood Transfusions
•Used for loss of large volume of blood
•Massive hemorrhage from serious injuries
•During internal bleeding
•During or after an operation
•Blood replacement in treatment of HDN

(cont.)
Blood Components
•Centrifuge separates plasma from formed elements.
•Hemapheresis—keeps desired elements and returns
remainder to donor.
•Plasmapheresis—keeps plasma and returns formed
elements to donor.

(cont.)
Use of Plasma
•Replace blood volume
•Treat circulatory failure (shock)
•Treat plasma protein deficiency
•Replace clotting factors
•Provide needed antibodies

(cont.)
✓
Checkpoint
13-17 How is blood commonly separated into its
component parts?

Blood Disorders (cont.)
• Blood abnormalities
• Anemia (low level of hemoglobin or red cells)
• Leukemia (increase in white cells)
• Clotting disorders (abnormal tendency to bleed)

Anemia
•Excessive loss or destruction of red cells
– Hemorrhagic anemia
– Hemolytic anemia
– Sickle cell anemia
•Impaired production of red cells or hemoglobin
– Nutritional anemia
– Pernicious anemia
– Thalassemia
– Bone marrow suppression

Figure 13-10 A blood smear in sickle cell anemia.
What kind of microscope was used to take this picture?

Leukemia
•Characterized by enormous increase in white cells
– Myelogenous leukemia from bone marrow
– Lymphocytic leukemia from lymphoid tissue
•Bone marrow transplants sometimes successful in
restoring blood-producing stem cells lost after leukemia
treatment

Figure 13-11 Leukemia.

Clotting Disorders
•Abnormal bleeding through disruption of coagulation
process
– Hemophilia
– von Willebrand disease
– Thrombocytopenia
– Disseminated intravascular coagulation (DIC)

✓
Checkpoints
13-18 What is anemia?
13-19 What is leukemia?
13-20 What blood components are low in cases of
thrombocytopenia?

Blood Studies (cont.)
• Some blood tests are a standard part of a routine
physical examination.
• Machines can perform several tests simultaneously.

Hematocrit
•mL of red cells per 100 mL of whole blood
•Performed in centrifuge
•Adult range for men: 42% to 54%
•Adult range women: 36% to 46%

Figure 13-12 Hematocrit.

Hemoglobin Tests
•g of hemoglobin per 100 mL of whole blood
•Performed by electrophoresis
•Adult range for men: 14 to 17 g/dL
•Adult range for women: 12 to 15 g/dL

Blood Cell Counts
•Red cell counts
– Range: 4.5 to 5.5 million cells per microliter (mcL)
•White cell counts
– Range: 5,000 to 10,000 cells per microliter (mcL)
•Platelet counts
– Range: 150,000 to 450,000 per microliter (mcL)

Blood Slide (Smear)
•Complete blood count (CBC) performed on stained blood
smear
•Red cells examined
•Platelets examined
•Parasites may be found
•Differential white count performed

Blood Chemistry Tests
•Electrolytes
•Blood glucose
•Nitrogenous waste products (creatine)
•Enzymes
•Lipids
•Plasma proteins
•Hormones
•Vitamins
•Antibodies
•Drug levels

Coagulation Studies
•Performed before surgery and during treatment of certain
diseases
– Amounts of clotting factors
– Bleeding time
– Clotting time
– Capillary strength
– Platelet function

Bone Marrow Biopsy
•Sample of red marrow through needle from sternum,
sacrum, or iliac crest
•Used in diagnosing bone marrow disorders
– Leukemia
– Some types of anemia

✓
Checkpoints
13-21 What test measures the relative volume of red
cells in blood?
13-22 What are two ways of expressing hemoglobin
level?

Case Study (cont.)
• All of the blood’s formed elements are produced in the
red bone marrow.
• Continuous cell replacement is essential to life.
• Eleanor, losing the protective functions of the blood
cells due to her bone marrow damage, exhibited the
following symptoms:
– Pallor and fatigue due to low red cells and
hemoglobin
– Hemorrhage due to platelet loss
• Eleanor acquired:
– An infection due to diminished leukocytes
– Strain on her heart and an increased heart rate to
compensate for low hemoglobin

Word Anatomy (cont.)

HBHD 13e Ch13

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