this ppt consists of many characteristics like blood composition and features and types of all the blood cells and their morphology

1. BLOOD

2. OBJECTIVE
S
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INTRODUCTION
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BLOOD CELLS
BLOOD GROUPS

3. INTRODUCTION
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 Blood : liquid connective tissue.
 A blood cell/ hematopoietic
cell/ hemocyte / hematocyte,
 produced through haematopoiesis

4. 4
•TYPES OF BLOOD CELLS
•Red blood cells
•(Erythrocytes)
•White blood cells
(leukocytes)
•Platelets
(thrombocytes)
Component of blood ( volume)
 45% : blood tissue
 55% : plasma (liquid component)
 Colour- red (RBC and haemoglobin (Heme)
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5. 5
AMOUNT OF BLOOD:
ADULT MALE
5 Liters
7-8% of total
body weight
(about 5.6 litres
in a 70 kg man).
ADULT FEMALE
4.5 Liters
Proportion is less
in women
considerably
greater in children
NEW BORN
450 Milliliters
8% of total
body weight.
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6. 6
PH
Range
7.35 – 7.45
Average
7.4 (slightly
alkaline)
Viscous
Blood is 5 times
more viscous than
water
due to RBC and
plasma protiens
Formed elements
1. Red blood cells /
erythrocyte
2. White blood cells/
leukocytes
3. Platelets /
thrombocytes
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7. 7
PLASMA
Normal Values
Substance Normal Value
Glucose 100-120 mg/dl
creatinine 0.5-1.5 mg/dl
cholesterol Up to 200 mg dl
Plasma proteins 6.4-8.3 g/dl
Bilirubin 0.5 – 1.5 mg/dl
IRON 50 – 150 mg/dl
Copper 100-200 mg/dl
Bicarbonate 22 - 26 meq/l
Chloride 100 – 11.0 meq/l
- Straw coloured clear liquid.

8. 8
Plasma proteins/ Reserve proteins.
1. Serum albumin.
2. Serum globulin.
3. Fibrinogen.
Ratio between plasma level of albumin and globulin =A/ G = 2:1
NORMAL VALUES
Total plasma protein average 7.3 g/dl
Fibrinogen 0.3 g/dl
serum globulin 2.3 g/dl
serum albumin 4.7 g/dl
• Synthesized in liver [Reticuloendothelial cells] and spleen, Bone marrow and
lymphoid tissues EXCEPT Immunoglobulins
• Stored in liver.
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9. ALBUMIN Most abundant of plasma proteins
Responsible for maintaining osmotic pressure of blood.
Plays important role in buffer system
Acts as carrier protein for lipid, lipoprotein
Maximum Viscosity of blood is due to albumin , fibrinogen
Fluid escapes from intravascular compartments to extravascular compartments in
case of Deficiency of plasma protein /albumin causes edema : eg:- nephrotic
syndrome , PEM
Total Osmotic Pressure Of Blood= 35 Mm Of Hg
Total colloid osmotic pressure by plasma protein or oncotic pressure of blood =
25mm of hg.
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10. PRESENTATION
TITLE

11. • Osmotic pressure: Osmotic pressure is the pressure exerted to
prevent the movement of free solvent molecules in blood across
membrane into a region of high solute concentration, allows
space
• Oncotic pressure: Oncotic pressure is the pressure exerted by
colloidal plasma proteins to reabsorb water back into the blood
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PRESENTATION
TITLE

12. Waste products of protein metabolism
• Urea,
• Creatinine
• Uric acid
• formed in the liver
• carried in blood to the kidneys for excretion
1 2
PRESENTATION
TITLE

13. GLOBULIN
α= responsible for transport of hormones, enzymes, metals
β= same like alpa
Y= responsible for formations of antibodies (Immunoglobulins)
If person has more deficiency of globulin, he is prone to infection.
Proverty , PEM , low socio- economic stats - play role in osmotic
pressure, buffers etc.
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14. FIBRINOGEN
It is soluble in plasma
• Responsible for blood clotting & coagulation /
clotting protein
• Most abundant clotting factor : fibrinogen
• During this process fibrinogen is converted in
to fibrin (insoluble in plasma)
Fibrinolysis - Dissolving of blood clot

15. 1 5
In adults, haemopoiesis : flat bones, irregular bones and the ends (epiphyses)
of long bones,
main sites OF HEMOPOISES: the sternum, ribs, pelvis and skull
For the first few years of life, red marrow occupies the entire bone capacity
over the next 20 years, gradually replaced by fatty yellow marrow that has no
haemopoietic function.
Blood cells are synthesised in red bone marrow.
In the bone marrow, all blood cells
originate from pluripotent stem cells
go through several developmental
stages before entering the blood
HAEMOPOIESIS The process of blood cell formation
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16. HEMATOPOIESIS

17. 1 7
PRESENTATION
TITLE

18. 1 8
PRESENTATION
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19. 1 9
 It is jelly like substance present inside the
bone cavity, produces 75% WBC, 25% RBC.
 Has different cells as - stem cells ,adipocytes,
osteoblast, chondrocytes etc.
BONE MARROW
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RBC
 Non-nucleated formed element of blood, All other cell
organelles are absent
ADULT NEW BORN
Limited life
span-
120 days 90 days
MALE FEMAL
E
Normal Value 4.5 – 5.5
millions /
mm3
4.0 – 5.0
millions/
mm3
8.0 – 10.0
millions/mm3
Size diameter = 7.2 µ [6.2 – 8.2 µ]
Shape disc and dumble shaped, biconcave,
biconcavity increases their surface area for
gas exchange
thinness of the central portion allows fast
entry and exit of gases
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21. 2 1
PRESENTATION
TITLE

22. 2 2
ERYTHROPOIESIS
Daily 1% erythropoiesis takes place in human body
Requirement for red blood cell synthesis.
Vit. B12 Folic acid
Cells are released into blood stream within 1-2 days
The immature cells - as
reticulocytes
Mature cells as- erythrocytes
Process of development and maturation of RBC.
Takes about 7 days
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23. 2 3
SITE OF ERYTHROPOIESIS
BEFORE BIRTH
1st trimester Mesenchymal cells of yolk sac
2nd trimester Spleen & liver
3rd trimester Red bone marrow
AFTER BIRTH
All bones 0-3 years
All long bones 3-14 years
Membranous bones > 14 years. Eg: sternum, scapula, ribs, vertebrae
Storage of RBC (100-300 ml)– in SPLEEN (blood bank of human body) , destruction
of RBC-SPLEEN / GRAVE YARD FOR RBC
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HAEMOGLOBIN Large, complex conjugate protein containing
a globular protein (globin) and a pigmented iron
containing complex called haem.
Each haemoglobin molecule : four globin chains
and four haem units= one atom of iron
The normal hemoglobin (Hb A) in adults contains
two α chains and two β chains. Each α
chain contains 141 amino acids, and each β
chain contains 146 amino acids.
 single haemoglobin molecule = four
molecules of oxygen.
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25. • The gene for the α chain is located in chromosome 16 (two genes in
each chromosome, for a total of four genes)
• genes for β (one gene in each chromosome, for a total of two genes
located on chromosome 11.
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PRESENTATION
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26. 2 6
PRESENTATION
TITLE
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.
Erythropoietin, the hormone produced by the kidney
regulates erythropoiesis.

27. 2 7
• Adult male – 15 gm/dl
• Adult female – 14 gm/dl
• New born – 25 gm/dl
Normal HB
value
Variation in the size of RBC
Microcyte
(small size RBC)
Macrocyte
(Large size RBC)
Anisocytosis
(Unequal size
RBC)
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 It is a glycated hemoglobin.
 It develops when hemoglobin, joins with
glucose in the blood, becoming
‘glycated’.
 RBC survives for a period of 120 days,
measuring glycated haemoglobin (or
HbA1c) used to reflect average blood
glucose levels over that duration
providing a useful longer-term gauge of
blood glucose control.
HbA1c mmol/mol %
Normal Below 42 mmol/mol Below 6.0%
Prediabetes 42 to 47 mmol/mol 6.0% to 6.4%
Diabetes
48 mmol/mol or
over 6.5% or over
HbA1c
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30. 3 0
HEMOLYSIS-
 Daily 1% of RBCs undergo
hemolysis
 1% erythropoiesis occurs
daily.
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31. 3 1
LEUKOCYTES (WHITE BLOOD CELLS)
 Useful in defence and immunity.
 Largest blood cells & account for 1%
of the blood volume.
 They contain nuclei and some have
granules in their cytoplasm
TYPES
Granulocytes
Neutrophils,
eosinophils ,
basophils
Agranulocytes
Monocytes
lymphocytes.
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GRANULOCYTES (POLYMORPHONUCLEAR LEUKOCYTES):
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;
 neutrophils are purple because they take up both dyes.
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These small, fast and active scavengers protect the
body against bacterial invasion, and remove dead cells
and debris from damaged tissues.
Neutrophils are highly mobile, and squeeze through the
capillary walls in the affected area by diapedesis after
getting signal from chemo toxins
NEUTROPHILS
Six lobes, and their granules are lysosomes
containing enzymes to digest engulfed material, live
on average 6–9 hours in the bloodstream.
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Although capable of phagocytosis, are less active in this than neutrophils;
their specialised role appears to be in the elimination of parasites, such as
worms and for allergic inflammation, such as the asthmatic airway and
skin allergies.
EOSINOPHILS
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Closely associated with allergic reactions, contain cytoplasmic granules packed
with heparin (an anticoagulant), histamine (an inflammatory agent) and other
substances that promote inflammation.
A cell type very similar to basophils, except that it is found in the tissues, not in
the circulation, is the mast cell. Mast cells release their granule contents within
seconds of binding an allergen, which accounts for the rapid onset of allergic
symptoms following exposure to, for example, pollen in hay fever
BASOPHILS
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 The monocytes and lymphocytes make up 25 to 50% of the total
leukocyte count.
 They have a large nucleus and no cytoplasmic granules.
AGRANULOCYTES
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These are the largest of the white blood cells.
They develop into macrophages @site of infection
.
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
MONOCYTES
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The monocyte–macrophage system / reticuloendothelial
system
Some macrophages are fixed, providing effective defence at key body
locations
 Synovial cells in joints
 Langerhans cells in the skin
 microglia in the brain
 hepatic macrophages (Kupffer cells) in the liver
 alveolar macrophages in the lungs
 Sinus-lining macrophages (reticular cells) in the spleen, lymph nodes and
thymus gland
 mesangial cells in the glomerulus of nephrons in the kidney
 osteoclasts in bone.
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 Synthesizes cytokines
Lymphocytes
 Lymphocytes
Lymphocytes develop from pluripotent
stem cells in red bone marrow and gets
matured at lymphoid tissue such as
lymph nodes and the spleen, acts
againt viruses, cancer cells,
transplanted tissue pollen from flowers
and plants fungi bacteria some large
molecule drugs, e.g. penicillin, aspirin.
T-lymphocytes and B-lymphocytes.
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41. PLATELETS (THROMBOCYTES)
 Colourless small non-nucleated discs, 2 to
4 μm in diameter (smallest cell of blood).
 The normal blood platelet count : 200 000
to 350 000/mm3
 The kidneys release a substance called
thrombopoietin, which stimulates platelet
synthesis.
 The life span of platelets : 8 and 11 days and those not used in haemostasis 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.

42. 4 2
CLOTTING FACTORS
Factor I Fibrinogen Factor VIII Anti hemophilic
Factor
Factor II Prothrombin Factor IX Christmas Factor
Factor III Thromboplastin
(Tissue factor)
Factor X Stuart prower
Factor
Factor IV Calcium Factor XI Plasma
Thromboplastin
Antecedent
Factor V Labile Factor Factor XII Hegman Factor
Factor VI Presence has not
been proved
Factor XIII Fibrin stabilizing
Factor
Factor VII Stable Factor
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43. PLATELETS FORMATION
(THROMBOPOIESIS)
Regulation of thrombopoiesis
by
Thrombombopoietin

44. PLATELETS
• Platelets are non-nucleated, small, round or oval discs.
• They are formed in the bone marrow by fragmentation of the
cytoplasm of giant cells called “Megakaryocytes”.
• Platelet count normally = 150,000-400,000/µl.
44

45. FUNCTION OF PLATELETS
• Plays a role in Hemostasis = prevention of blood loss.
• Whenever a vessel is severed or ruptured, Hemostasis
is achieved by several mechanisms;
1. Vascular spasm.
2. Formation of a platelet plug.
3. Formation of a blood clot as a result of blood coagulation.

46. PLATELET ACTIVATION
•Adhesion
•Shape change
•Aggregation
•Release
•Clot Retraction

47. PLATELET RELEASE
REACTION
• Platelets activated by adhesion
• Extend projections to make contact with each other
• Release Thromboxane A2, Serotonin & ADP activating other platelets
• Serotonin & Thromboxane A2 are vasoconstrictors decreasing blood flow
through the injured vessel. ADP causes stickiness

48. BLEEDING & CLOTTING
DISORDERS
A. Liver diseases & Vitamin-K deficiency
B. Hemophilia
C. Thrombocytopenia

49. BLEEDING DISORDERS
Liver diseases & Vitamin-K deficiency
• e.g. Hepatitis, Cirrhosis
• Decreased formation of clotting factors
• Increased clotting time
• Vitamin K dependent factors
• Prothrombin, Factor VII, IX, X

50. HEMOPHILIA
• HEMOPHILIA - A
• Classic Hemophilia
• 85 % cases
• Def. Of factor VIII
• HEMOPHILIA - B
• 15 % cases

51. HEMOPHILIA
• Genetic disorders
• Transmitted by female chromosome as recessive
trait, it is X linked.
• Occurs exclusively in male. Females are carriers.
• Types
• Hemophilia A
• Hemophilia B

52. HEMOPHILIA
• Clinical Features
• Easy bruising, massive bleeding after trauma or
operation, hemorrhages in joints
• Deficiency of Factor VIII ---- Hemophilia A
• Deficiency of Factors IX ---- Hemophilia B

53. THROMBOCYTOPENIA
• PLT count upto 50,000 ul
• Less than 10,000 ------ Fatal
• ETIOLOGY
• Decreased production
• Aplastic anemia
• Leukemia
• Drugs
• Infections (HIV, Measles)

54. THROMBOCYTOPENIA
• Increased destruction
• ITP
• Drugs
• Infections
• Clinical Features
• Easy brusability
• Epistaxis

55. THROMBOCYTOPENIA
• Diagnosis
• PLT decreased
• B.T increased
• Rx
• Rx of the underlying
cause
• PLT concentrates

56. BLEEDING DISORDERS CONT…
• Hemophilia:
• ↑ bleeding tendency.
• X-linked disease.
• Affects males.
• 85% due to FVIII deficiency (hemophilia A), and 15% due to
FIX deficiency (hemophilia B).
• Vitamin K deficiency & liver disease:
• Almost all coagulation factors are synthesized in the liver.

57. ANTICOAGULANTS
• Heparin
• Liver, lungs, mast cells, basophils
• Direct antithrombin
• Prevent the conversion of Prothrombin to Thrombin
• Injection only
• 6-8 hours
• Warfarin
• Almost all coagulation factors are synthesized in the liver.
• Suppresses the synthesis of Prothrombin, FVII, FIX, & FX

58. 5 8
 These are determined by
Antigen which is present on cell
membrane of RBC
 It is described by Karl
Landsteiner, also called ABO
blood group system
BLOOD GROUPS
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59. 5 9
 If a person has blood Group A, then corresponding antibody would be Anti-A
which is absent, but will have Anti -B antibodies (antibodies against type B
red cells)
 If, in transfusion, type B blood is injected into persons with type A blood, the
red cells in the injected blood will be destroyed by the antibodies in the
recipient’s blood.
 Similarly for the AB blood group the antigens present are both A and B and
both the corresponding antibodies (Anti-A &Anti -B) are absent
 Persons with type AB blood can receive type A, B, or O blood (universal
recipient)
 O blood group does not have antigens but it has antibodies for A & B
(universal donors )
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61. 6 1
Rh blood group system, system for classifying blood
groups according to the presence or absence of the Rh antigen, often
called the Rh factor, on the cell membranes of the red blood cells
erythrocytes. Rh “+” or “-”
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