The document discusses the components of blood, including red blood cells, white blood cells, platelets, and plasma. It defines each component and describes their functions, normal ranges, and some abnormal conditions. For example, it explains that red blood cells carry oxygen and carbon dioxide, white blood cells fight infection, and platelets help with clotting. The summary provides a high-level overview of the key topics and components covered in the document.

1. Lecture Title
Blood Components
Drs. Brenner and Chris Reilly
Block 2 Physiology

2. Bone Marrow and Blood
Components
• Describe production of RBC’s in regard to what tissues and what times in life
they are produced
• State normal and abnormal Hemocrit. Detail possible genetic, pathophysiolgic
disturbances that lead to abnormal RBC production
• Define the normal range for each of the following and state what a abnormal
elevated or reduced value may indicate
– Hemoglobin;
– Red Blood Cell (RBC) Count;
– White Blood Cell (WBC) Count;
– White Blood Cell Differential Count
– platelet Count
– Reticulocyte Count

3. Blood Percentages
• 55 % plasma
– Plasma is the straw-colored
liquid in which the blood cells
are suspended.
• 45 % formed elements
– Red blood cells (Erythrocytes)
– White blood cells (leukocytes)
– Platelets (thrombocytes)

4. Blood Components

5. Red blood cells (erythrocytes)
• Red blood cells are biconcave discs
erythrocytes

6. Red Blood Cells
• Red cells, or erythrocytes , are relatively large microscopic
cells without nuclei.
• Red cells normally make up 40-50% of the total blood
volume.
• They transport oxygen from the lungs to all of the living
tissues of the body and carry away carbon dioxide.
• The red cells are produced continuously in our bone marrow
from stem cells at a rate of about 2-3 million cells per
second.

7. Erythrocyte→7.5µm in dia
• Anucleate- so can't reproduce; however, repro in red
bone marrow
• Hematopoiesis- production of RBC
• Function- transport respiratory gases
• Hemoglobin- quaternary structure, 2 α chains and 2 β
chains
• Lack mitochondria. Why?
• 1 RBC contains 280 million hemoglobin molecules
• Men- 5 million cells/mm3
• Women- 4.5 million cells/mm3
• Life span 100-120 days and then destroyed in spleen
(RBC graveyard)

8. Red Blood Cells
• Hemoglobin is the gas transporting protein
molecule that makes up 95% of a red cell.
• Each red cell has about 270,000,000 iron-rich
hemoglobin molecules.
– People who are anemic generally have a deficiency in red cells.
• The red color of blood is primarily due to
oxygenated red cells.

9. Hemoglobin

10. CBC with Differential/
Platelet
White Blood Cells
• Red Blood Cell count
• Neutrophils
• White Blood Cell count
• Neutrophils, absolute
• Platelet count
• Lymphocytes
• Hemoglobin
• Monocytes
• Hematocrit
• Eosinophils
• Red Blood cell distribution width
• Basophils
(RDW)
• Lymphocytes, absolute
• Mean Cell Volume (MCV)
• Monocytes, absolute
• Mean Cell Hemoglobin (MCH)
• Eosinphils, absolute
• Mean Corpuscular Hemoglobin
• Basophils, absolute
Concentration (MCHC)

11. Carol
Brenner
11/5/12
RDW
RDW: Red Blood Cell Distribution Width,
normal RBC width 6-8 μm. Calculated by
(standard deviation of MCV/mean
MCV) x 100 Normal range: 11-15%
Used with MCV to determine type
of anemia
Iron Deficiency Anemia: high RDW,
low MCV
Folate and Vitamin B12 Deficiency
anemia: high RDW, high MCV

12. Mean Corpuscular
Volume
MCV: Mean Corpuscular Volume-measure
of the
# events counted
average RBC size (calculated by(Hct/#RBCs)
x 10)
Normal range is 80-99 femtoL
increased in pernicious anemia
(150 fL)
and alcoholism
allows differentiation between a
microcytic anemia and a
normocytic anemia
RBC Volume 

13. Mean Corpuscular Hemoglobin
MCH: Mean Corpuscular Hemoglobin—average mass of Hb/RBC (calculated by
total mass
of Hb/total # RBCs in a volume blood) normal range = 27-31 pg/cell
MCH is reduced in hypochromic anemias

14. Definitions:
MCH: Mean Corpuscular Hemoglobin—average mass of Hb/RBC (calculated by
total mass
of Hb/total # RBCs in a volume blood) normal range = 27-31 pg/cell
MCH is reduced in hypochromic anemias
MCHC: Mean Corpuscular Hemoglobin Concentration- a measure of the
amount of
hemoglobin in a given volume of packed RBCs (calculated by Hb/Hct)
reference range= 32-36 g/dL or 4.9-5.5 mmol/L
elevated in sickle cell disease, hereditary sperocytosis,
homozygous hemoglobin C disease
reduced in microcytic anemias
normal in macrocytic anemias

15. Complete Blood Count
(Hct)
Hematocrit-% of packed RBC volume
low HctAnemia
high Hct Polycythemia
(more RBCs that normal

16. Polycythemia Vera
What is it?
Bone marrow disease that leads to an abnormal increase in number of blood cells
(primarily RBCs, although platelets and WBCs can also increase)
Rare disease occurring more often in men than women
Linked to a gene mutation: JAK2V617F
Symptoms: dizziness, breathing difficulty when prone, enlarged spleen,
headache
blood clotting
Tests: complete CBC with differential, erythropoietin level, bone marrow biopsy
and
complete metabolic panel
Treatment: Goal to prevent clotting, weekly phlebotomy until Hct comes below
50%

17. Hemoglobin
Hb is a protein in RBC that binds O2
in lungs and delivers it to peripheral tissues
to maintain the cell’s metabolic activities and
Viability
One diabetes mellitus Type 2 test is:
HbA1c
Glucose in blood “sticks” to hemoglobin to
make
glycosylated Hb  HbA1c
More glucose in blood the higher the value for
HbA1c

18. Reticulocyte Count
This is a marker of effective erythropoiesis
Reticulocytes are immature RBCs typically
composing 1% of the RBCs in the body.
reticulocytes develop and mature in the red
bone marrow and then circulate in the blood
stream for about a day before maturing to RBC
Reticulocytes have no nucleus but do show a
reticular network (mesh-like) of rRNA that
Becomes visible under a mciroscope when
Staoned with new methylene blue..
Blood smear from a
patient
with hemolytic anemia

19. Red Blood Cell Diseases
Anemia- when blood has low O2 carrying capacity;
insufficient RBC or iron deficiency.
Factors that can cause anemia- exercise, B12
deficiency
Polycythemia- excess of erythrocytes, ↑ viscosity of
blood;
8-11 million cells/mm3
Usually caused by cancer, tissue hypoxia, dehydration;
however, naturally occurs at high elevations
Blood doping- in athletes→remove blood 2 days
before event and then replace it; Epoetin;- banned by
Olympics.

20. Red Blood Cell Diseases
Sickle-cell anemia-
HbS results from a change in just one of the
287 amino acids in the β chain in the globin
molecule.
Found in 1 out of 400 African Americans.
Abnormal hemoglobin crystalizes when O2
content of blood is low, causing RBCs to
become sickle-shaped.
Homozygous for sickle-cell is deadly, but in
malaria infested countries, the heterozygous

21. Genetics of Sickle Cell Anemia
Genetics of Sickle Cell Anemia

22. Platelets (thrombocytes)
Platelets

23. Platelets
• Platelets or thrombocytes—clear cell fragments
derived from fragmentation of precursor
megakaryocytes
• Life span 7-9 days
• Natural source of growth factors (PDGF, TGF-β) for
repair and regeneration of connective tissue
• Hemostasis  blood clotting
• Normal platelet count: 150,000-450,000 µL of
blood
High platelet count= clotting (thrombosis)
Low platelet count=heparin-induced
thrombocytopenia(HIT)

24. Platelets
WBC
RBC
Platelets clumping in a blood smear
Platelet
Platelet activation initiates the arachidonic acid pathway to produce
thromboxane 2 (TXA2)
TXA2 is involved in activating other platelets and its formation in inhibites by
COX inhibitors
such as aspirin

25. Platelets
• Platelets , or thrombocytes , are cell fragments
without nuclei that work with blood clotting chemicals
at the site of wounds.
– They do this by adhering to the walls of blood vessels, thereby plugging
the rupture in the vascular wall. They also can release coagulating
chemicals which cause clots to form in the blood that can plug up
narrowed blood vessels.
• There are more than a dozen types of blood clotting
factors and platelets that need to interact in the blood
clotting process.

26. Hemostasis- stoppage of
Platelets: 250,000-500,000 cells/mm3

27. Hemostasis- stoppage of
Platelets: 250,000-500,000 cells/mm3
Tissue Damage

28. Hemostasis- stoppage of
Platelets: 250,000-500,000 cells/mm3
Tissue Damage
Platelet Plug

29. Hemostasis- stoppage of
Platelets: 250,000-500,000 cells/mm3
Tissue Damage
Platelet Plug
Clotting Factors

30. Hemostasis
1. Vessel injury
2. Vascular spasm
3. Platelet plug formation
4. Coagulation

31. Platlets
• Recent research has shown that platelets help fight
infections by releasing proteins that kill invading bacteria
and some other microorganisms.
– In addition, platelets stimulate the immune system.
• Individual platelets are about 1/3 the size of red cells.
• They have a lifespan of 9-10 days.
• Like the red and white blood cells, platelets are produced
in bone marrow from stem cells.

32. Disorders of Hemostasis
• Thromboembolytic disorders: undesirable
clot formation
• Bleeding disorders: abnormalities that
prevent normal clot formation

33. Thromboembolytic Conditions
• Thrombus: clot that develops and persists in an
unbroken blood vessel
– May block circulation, leading to tissue death
• Embolus: a thrombus freely floating in the blood
stream
– Pulmonary emboli impair the ability of the body to
obtain oxygen
– Cerebral emboli can cause strokes

34. Bleeding Disorders
Thrombocytosis- too many platelets due to
inflammation, infection or cancer
Thrombocytopenia- too few platelets
• causes spontaneous bleeding
• due to suppression or destruction of bone
marrow (e.g., malignancy, radiation)
– Platelet count <50,000/mm3 is diagnostic
– Treated with transfusion of concentrated
platelets

35. Bleeding Disorders
• Hemophilias include several similar
hereditary bleeding disorders
• Symptoms include prolonged
bleeding, especially into joint cavities
• Treated with plasma transfusions and
injection of missing factors

36. Hemophilia-sex linked

37. White Blood Cell

38. White Blood Cells
• White cells, or leukocytes , exist in variable numbers and
types but make up a very small part of blood's volume--
normally only about 1% in healthy people.
• Leukocytes are not limited to blood.
– They occur elsewhere in the body as well, most notably in the spleen, liver, and
lymph glands.
• Most are produced in our bone marrow from the same
kind of stem cells that produce red blood cells and others
are produced in the thymus gland, which is at the base of
the neck.

39. White Blood Cells
• Some white cells (called lymphocytes ) are the first
responders for our immune system.
– They seek out, identify, and bind to alien protein
on bacteria, viruses, and fungi so that they can be
removed.
– Other white cells (called granulocytes and
macrophages ) then arrive to surround and destroy
the alien cells.

40. White Blood Cells
• They also have the function of getting rid of dead or dying
blood cells as well as foreign matter such as dust.
• Individual white cells usually only last 18-36 hours before
they also are removed, though some types live as much
as a year.
– Red cells remain viable for only about 4 months before
they are removed from the blood and their
components recycled in the spleen.

41. Leukocytes(wbc’s) Total
• Neutrophils 60-70% (N)EVER
• Lymphocytes 20-25% (L)ET
• Monocytes 3-8% (M)ONKEYS
• Eosinophils 1-3% (E)AT
• Basophils ½ to 1% (B)ANANAS

42. eosinophil
neutrophil
monocyte
RBC
neutrophil
monocyte
lymphocyte
lymphocyte
basophil

43. Granulocytes
• Granulocytes are white blood cells whose cytoplasm contains
tiny granules. The cells are named according to the staining
characteristics of the granules.
• Neutrophils - the granules do not stain with normal blood
stains so we generally see just the multilobed nucleus.
– Neutrophils are phagocytic cells; they engulf foreign
material
• Eosinophils have red-staining granules.
– They seem to be attracted to allergic reactions in the body.

44. Basophils
• Basophils have dark
blue-staining granules.
• They are the least
numerous blood cells.
• They help initiate the
inflammatory process at
sites of injury.

45. Agranulocytes
• Agranulocytes are white blood cells that have
no distinct granules in their cytoplasm.
• Lymphocytes have large single nuclei that
occupy most of the cells.
• They are an important part of the body's immune
system.

46. Lymphocytes
• Monocytes are the largest of the white blood
cells.
• They have large pleomorphic (variously
shaped) single nuclei and function mainly as
phagocytic (engulfing) cells.
• They are important in the long-term cleanup of
debris in an area of injury.

47. Lymphocytes
• Monocytes are the largest of the white blood
cells.
• They have large pleomorphic (variously
shaped) single nuclei and function mainly as
phagocytic (engulfing) cells.
• They are important in the long-term cleanup of
debris in an area of injury.

48. White Blood Cell Diseases
• Leukopenia
• Abnormally low WBC count—drug induced
• Leukemias
• Cancerous conditions involving WBCs
• Named according to the abnormal WBC clone involved
• Mononucleosis
• highly contagious viral disease caused by Epstein-Barr
virus; excessive # of agranulocytes; fatigue, sore throat,
recover in a few weeks

49. Key Concepts
Intracellular and extracellular ion concentrations are
different
extracellular: glucose, Na+. K+ HCO3- are a quick measure
of homeostasis
Lipids: reveal diet and genetic make-up
BUN and creatinine give you an estimate of renal function
Urine dipstick: can tell you about infection, liver and kidney
function, diabetes mellitus or Inspidus, metabolic state of
the body (starvation changes)