Blood is essential to life. Blood circulates through our body and delivers essential substances like oxygen and nutrients to the body’s cells. It also transports metabolic waste products away from those same cells. There is no substitute for blood. It cannot be made or manufactured. Generous blood donors are the only source of blood for patients in need of a blood transfusion.

1. Blood
Presented by
Prof. Amol B Deore
MVPs Institute of Pharmaceutical Sciences,
Nashik

2. What is blood?
 Blood is a specialized fluid connective
tissue.
 Blood is a suspension in which blood
cells are distributed in fluid plasma.
 Blood consists of two components: the
blood cells, and the fluid plasma.
 Blood makes up about 8% of body
weight (Average volume: 5-6 liters in
male and 4-5 liters in female).

3.  Color of blood: reddish brown
 PH: slightly alkaline 7.35 to 7.45.

4. Composition of Blood
Whole blood is composed of two portions:
 Plasma constitutes about 55%
 blood cells make up about 45% of the total blood
volume.

6. PLASMA (55%) BLOOD CELLS (45%)
1) Water (98% of plasma)
2) Plasma proteins
Albumin, globulins, glycoproteins & antibodies
3) Clotting factors
Fibrinogen, prothrombin, thromboplastin
4) Electrolytes ions
Na+
, K+
, Ca+2
, Mg, Cu, iodine, cobalt, bicarbonate,
iron, phosphate,
5) Nutrients
Carbohydrates, proteins, lipids, amino acids, fatty
acids, vitamins
6) Gases
Oxygen, carbon dioxide, nitrogen
7) Enzymes
acid phosphatase
8) Hormones
Growth hormone, thyroid hormone, insulin,
testosterone, oxytocin, antidiuretic hormone
9) Waste products
Urea, uric acid, creatinine, ammonia
1) Erythrocytes or
Red blood cells (RBCs),
2) Leukocytes or
White blood cells
(WBCs),
3) Thrombocytes or
Platelets

7. Functions of the blood
1. It transports oxygen from the lungs to the
cells of the body.
2. It transports carbon dioxide from the cells
to lungs for excretion.
3. It transports nutrients, ions, and water from
the digestive tract to cells.
4. It transports waste products from cells to
sweat glands and kidneys.
5. It transports hormones to target organs
and enzymes to body cells.

8. 6. It regulates physiological pH and acid base
electrolyte balance.
7. It helps to regulate normal body temperature
(98.40F).
8. It helps to prevent blood loss from rupturing
blood vessels through the blood clotting
mechanism.
9. It protects against foreign microbes, virus,
bacteria, parasites, worms, fungi and others
due to immune defence system of leukocytes.

9.  The process of blood cell formation takes
place in bone marrow is known as
hematopoiesis.
 Red bone marrow found in epiphysis of long
and flat bones such as pelvic girdle, sternum,
cranium, ribs, vertebrae, scapula, femur and
humerus.
 Hematopoiesis occurs in red bone marrow,
which is composed of pluripotent stem
cells.
Formation of the blood

10.  All blood cells are
produced from
pluripotent stem
cells and pass
through several
developmental
stages before
entering in the
blood.

12. RED BLOOD CELLS

13.  RBCs (or erythrocytes) are circular
biconcave discs shaped.
 They are non-nucleated and simple
in structure.
 They are composed of a network of
protein called stroma, cytoplasm,
and the oxygen carrying red pigment
called hemoglobin which is
responsible for the red color of whole
blood.

14. Properties of Red Blood Cells
Scientific
name:
Erythrocytes
Color Reddish- brown (due to Hemoglobin
pigment)
Stroma Consist of antigens and Hemoglobin
pigment
Normal
counts
In male: 4.5-6 million RBCs/µL
In female: 4-5 million RBCs/µL
Higher values in male due to higher levels
of testosterone and erythropoietin
hormones
Life span ~120 days (3-4 months)
Production
site
Red bone marrow

15. Function : 1. It transports oxygen from the
lungs to cells of the body
2. It transports carbon dioxide
from the cells to the lungs for
excretion
Disorders: Anemia, polycythemia

16. Hemoglobin
 Red blood cells contain the oxygen-
carrying protein hemoglobin, which is a
pigment that gives its red color to the
blood.
 Hemoglobin molecule consists of a
polypeptide protein called globin and
four non-protein pigments called hemes.
 Each heme contains four iron atoms
(ferrous, Fe+2).
 Each iron atom can carry one molecule
of oxygen; therefore one hemoglobin
molecule can carry four molecules of
oxygen.

18.  Hemoglobin that is carrying oxygen is
bright red in color, whereas
hemoglobin not carrying oxygen is a
darker red in color.
 Female shows less Hb count because
maximum blood transported in to the
fetus, during pregnancy and bleeding
during menstruation cycle.
 Each Erythrocyte contains about 280
million molecules of hemoglobin.

19. Table 5.3: Properties of hemoglobin
Molecular weight 68,000 units
Normal count
In male: 13-18 gm% of blood
In female: 12-16 gm% of blood
In infants: 13-20 gm% of blood
Color Brownish red (due to ferrous pigment)
Life span About 120 days
Capacity
1 gram of Hb can carry 1.34 ml of oxygen
molecules to body tissues.

20. Functions of Hemoglobin
1. Transport of oxygen
In the lungs, molecular oxygen binds to Hb to form oxyhemoglobin (pure blood).
Oxyhemoglobin is transported to body tissue to supply O2.
O2 + Hb Oxyhemoglobin
2. Transport of carbon dioxide
The CO2 formed in body tissues due to biochemical reactions. CO2 molecules
bind with Hb to form carbaminohemoglobin (impure blood) to transport back to
the lungs.
CO2 + Hb carbaminohemoglobin

21. Erythropoiesis

22. Disorders of RBCS
Polycythemia
 It is characterized by abnormally rise in
RBC count more than 7 million/µL in
blood. Blood viscosity and blood
pressure become elevated.
 That may result in risk of internal injury
to blood vessels, hemorrhage, blood
clotting, thrombosis etc.
 Causes include- Over transfusion of
blood, abnormally large no. of
erythrocytes etc.

23. Anemia
Anemia is characterized by reduction in oxygen carrying
capacity of blood. It is caused by four factors:
 decrease in the normal number of erythrocytes;
 decrease of normal amounts of hemoglobin in the
RBCs;
 deficiency of normal hemoglobin; or
 production of abnormal hemoglobin.
Anemia reduces the amount of oxygen that RBCs can
transport resulting in a lack of energy, shortness of breath
on minor exertions, exhaustion, increased heart rate,
anorexia, pale skin, and a general feeling of tiredness.

24. Sickle cell anemia
 Sickle cell anemia is a genetically inherited disease
characterized by abnormal hemoglobin.
 The abnormal hemoglobin forms sickle shape RBC (S or C
shape) when deoxygenated. Hence oxygen carrying
capacity of blood becomes reduced.
 The life span of sickle RBCs become reduced due to early
hemolysis. Sickle shaped RBCs do not move smoothly
through small blood vessels like capillaries, veins.

25. Iron-deficiency anemia
 Iron-deficiency anemia results from nutritional
deficiencies of iron (ferrous) from the body, resulting in
lower RBC production.
 It is most commonly observe in pregnancy because of
deficiency of iron in RBCs.
 The normal daily requirement of iron in women is 3
mg.
 Its causes include dietary deficiency of iron, calorie
controlled diet, poorly planned food, malabsorption of
iron in body, peptic ulcer, intestinal ulcer,
menstruation, blood loss etc.

26. Megaloblastic anemia (pernicious anemia)
 It is characterized by deficiency of Vitamin B12
and folic acid which affect maturation of RBCs
during erythropoiesis.
 Abnormally large sized RBCs found in the blood.
Life span of RBCs becomes reduced up to 45-50
days.
 Its causes include deficiency of intrinsic factor
which is needed for absorption of Vitamin B12,
gastritis or peptic ulcer.

27. The ABO Blood
Group

28.  The two most important blood group systems
are ABO and Rh factor. They determine some
blood groups: A, B, AB, O and Rh positive; Rh
negative
 The ABO blood group system is based on
presence or absence of two major antigens on
the RBC membrane (stroma): antigen A and
antigen B.
 In addition, individuals make antibodies but not
to their own type of antigen. Hence on
incompatible blood transfusion, antibodies
would be produced by immune system causing
agglutination/ antigen-antibody reaction.

29. Classification of ABO blood groups with compatible blood
transfusion
Blood
Group
Antigen on
RBC
membrane
Antibody in
Plasma
Can receive
blood from?
(compatible)
Can donate
blood to?
(compatible)
A A Anti-B A,O A,AB
B B Anti-A B,O B,AB
AB A and B --------
A,B,AB,O
(Universal
receiver)
AB
O --------
Anti-A &
Anti-B
O
A,B,AB,O
(Universal Donor)

31. Blood transfusion
Match blood transfusion
 If individual donates blood to compatible blood
group as shown in table, then immune system of
recipient person accept it. This is called as match
blood transfusion.
Mismatch blood transfusion
 If individual donates blood to incompatible blood
group, then immune system of recipient person
starts producing antibodies that result in antigen:
antibody complex reaction (clumping or
agglutination).
 It causes hemolysis, loss of RBCs, headache,
difficulty for breathing, jaundice, kidney failure etc.
This is called as mismatch blood transfusion.

33. Universal Donor
 Individuals with blood group O do not
have antigen on their RBC membrane.
Hence if they donate blood to any blood
groups A, B, AB, & O then recipient will
not produce any antibody.
 It becomes compatible (match
transfusion) and safe. Therefore blood
group O is known as “Universal Donor”.
Individuals with O Rh-negative blood
may be given to people with any other
blood type.

34. Universal Recipient
 Individuals with blood group AB contain
both antigens A and B on their RBC
membrane but neither produces anti-A
nor Anti-B antibodies.
 Transfusion of A, B, AB, O blood groups
in such individuals is safe and
compatible, because there are no
antibodies to react with antigen (match
transfusion).
 Therefore blood group AB is known as
“Universal Recipient”.

35. Rhesus System (Rh Factor)
 The Rh blood group was named after the Rhesus
monkeys. Rhesus monkeys consist of Rh antigen
on their RBC membrane. This Rh antigen (or
antigen D) was later discovered in humans.
Hence it is identified as Rhesus factor.
 If Rh-antigen found on the RBC membrane, then
blood is Rh positive. About 85% people have Rh
antigen on RBCs membranes, they are Rh-
positive.
 They do not produce anti-Rh antibodies.
Whereas 15% people have no Rh-antigen on
RBCs membrane, they are Rh-negative. They
can capable of producing anti-Rh antibodies.

36. Rh
factor
Antigen on
RBC
membrane
Antibody in
Plasma
Rh +ve Rh ---
Rh -ve ----
Anti-Rh
antibody
If Rh-negative person receives a blood from Rh-
positive person then the Rh-negative person begins
to produce anti-Rh antibodies against the foreign
blood.
This is mismatched blood transfusion. This initial
mismatch has no immediate serious complications
because it takes the body time to react and produce
antibodies.

37.  However, if same Rh-negative person
again receives a blood transfusion of
Rh-positive blood (mismatched) then
the patient’s anti-Rh antibodies will
undergo agglutination reaction.
 Agglutination leads to hemolysis, kidney
failure, difficulty for breathing, jaundice
etc. Hence, Rh negative person should
not receive blood from Rh positive
person.

38. Compatible blood transfusion chart

39. WHITE BLOOD CELLS

40. White blood cells or leukocytes have nucleus
(polymorphonuclear).
They are colorless because they do not
contain hemoglobin.
Their general function is to fight against
inflammation and microbial infection.
Leukocytes are categories into two major
types: granulocytes and agranulocytes.

41. Classification of leukocytes

43. GRANULOCYTES
Granulocytes have cytoplasmic granules.
These granules consist of lysosomal
enzymes, strong oxidants and several
inflammatory mediators including cytokines,
prostaglandins, interleukins, histamine and
heparin.
Granulocytes are polymorphonuclear i.e.
having two or more lobes of nucleus.
Granulocytes are summarized below.

44. Phagocytosis

45. TYPE FIGURE FUNCTIONING
Neutrophils
40-75%
Phagocytosis: It is the process of engulfment,
digestion, killing & fragmentation of microbes. It
is performed by lysosomal enzymes, defensins,
and strong oxidants of cytoplasmic granules.
WBCs are act as immune system of body
against foreign pathogens.
Basophils
1%
Release histamine and prostaglandin from
granules which leads to inflammation and
allergic reactions.
Basophils also release heparin to stop blood
clotting.

46. Agranulocytes
Agranulocytes do not have cytoplasmic
granules. They also consist of cytoplasmic
granules. Due to their small size they cannot
be seen under microscope.
Eosinophils
1-6%
Phagocytosis of parasites, worms and
microbes. Promote allergic inflammation,
asthmatic allergy, skin allergy etc.

47. Monocytes
2-10%
They circulate in the blood and promote
Phagocytosis. Some monocytes migrate from
blood into tissues then develop into
macrophages to promote phagocytosis.
Monocytes release interleukin &
Prostaglandin which act on hypothalamus
causing rise In body temperature (fever) due to
microbial infection.

48. Lymphocytes
20-50%
B-lymphocytes produce antibodies, showing
antigen- antibody reaction.
T-lymphocytes fight against viruses, bacteria,
cancer cells, transplanted tissue cells etc.

49. Table 5.8: Properties of white blood Cells
Scientific name Leukocytes
Size and shape Circular, spherical shaped 10-20 µm
Color Colorless (no pigment)
Normal counts In male and In female:
4000-11,000 WBCs/µL
Life span Few hours to few days
After phagocytosis the microbes, WBC itself also
get dies. Hence its life span become few hours to
few days.
Production site Red Bone marrow, Thymus gland
Destruction
site
Spleen and liver, lymph node, tonsils
Function Immune defense, Inflammatory response,
Antibody production, Cellular immune response
and Phagocytosis
Disorders Leukopenia, Leukocytosis, Leukemia

50. Disorders of WBC
Leukopenia
 Leukopenia is characterized low WBC count;
less than 4000 WBCs/µL. It’s causes include
chemotherapy, exposure of X-rays, alpha rays
and other radioactive substances, Bone
marrow failure, enlargement of spleen, aplastic
anemia; certain infection like typhoid, dengue,
AIDS etc.
 Symptoms include frequent headache,
anemia, heavy bleeding and menstruation in
woman; inflammation on chicks, lips, tongue
and tonsils etc.

51. Leukocytosis
 It is characterized by high WBC count;
more than 30,000 WBCs/µL. Its
causes include acute infection, hay
fever, hepatitis, cancer, tuberculosis,
pneumonia, bronchial asthma, stress,
excess exercise, arthritis, skin allergy,
burning etc.
 Symptoms include- fever, weakness,
tired, sick, feeling dizzy, sweaty,
tingling in the arms, legs, abdomen;
weight loss, loss of appetite etc.

52. Leukemia
 Leukemia is characterized by an
overproduction of immature white blood
cells (more than 200,000 WBCs/µL).
These immature cells cannot perform
their normal functions, and the person
becomes very susceptible to infection.
 Its causes include exposure of radiations
like X-rays, UV rays, gamma rays,
Chemical exposures, Smoking, and
stressful lifestyle.

53. Agranulocytosis
 It is a condition in which there is
severe leukopenia characterized by
fall in WBC count below 500
WBCs/µL.

54.  Table 5.9: Difference between RBC
and WBC

55. Sr.
No.
Points Red blood cells White blood cells
1. Scientific
Name
Erythrocytes Leukocytes
2. Shape Biconcave disc Spherical disc
3. Color Red brown Colorless
4. Hemoglobin
pigment
Present Absent
5. Normal
Count
In male:
4.5-6 million RBCs/µL
In female:
4-5million RBCs/µL
In male and In female:
4000-11,000 WBCs/µL
6. Life span 120 days Few hours to few days
7. Function O2 and CO2 transport Immune defense system,
Phagocytosis
8. Types --------- Granulocytes,
agranulocytes
9. Nucleus Absent Polymorphonuclear
10. Disorders Anemia, polycythemia Leukemia, Leukopenia,
leukocytosis
11. Cytoplasmic
granules
Absent Present
12. Antigens Antigen A, Antigen B, &
Rh factor
Absent

56. PLATELETS

57. Table 5.10: Properties of Platelets
Scientific name Thrombocytes
Size and shape Disc shaped, 2-4 µm size
Fig 5.6: Platelets
Normal counts In male and In female:
250,000-400,000 platelets/µL
Life span 9-11 days
Production site Red bone marrow
Destruction site Spleen and liver
Cytoplasmic
granules
Alpha granules: clotting factors
Dense granules: ADP, Ca2+
, thromboxane
A2, prostaglandin, and serotonin
Function Hemostasis: stoppage of bleeding
Blood clotting,
Platelets help to repair slightly damaged
blood vessels
Disorders Thrombocytopenia

58. Hemostasis
 Hemostasis refers to the stoppage of
bleeding i.e. arrest of blood loss.
 If any small blood vessel like blood
capillary is damaged or ruptured, then
there are three basic mechanisms that
promote hemostasis to arrest the
bleeding.
 Platelets play vital role in hemostasis.

59. The series of three mechanisms of
hemostasis include:
1) Vascular Spasm
 When platelets come in contact with a blood
vessel damaged, they adhere on damaged
wall.
 Platelets undergo degranulation and
release serotonin and thromboxane A2,
which cause contraction of blood vessel
(vascular spasm).
 Thereby reducing blood loss from rupturing
blood vessel.

60. 2. Platelet Plug Formation
 In this stage, platelets stick on damaged
part of blood vessel. This process is called
as platelet adhesion.
 Platelet adhesion promotes degranulation to
release ADP and thromboxane-A2 in blood.
These chemicals attract other platelets to
stick on each other. This gathering of
platelets is called as platelet aggregation.
 The aggregation of large number of
platelets form a mass at damaged site is
called as a platelet plug. Platelet plug acts
as a temporary seal.

61. Table 5.11: Blood clotting
factors
Factor No. Description
I Fibrinogen
II Prothrombin
III Thromboplastin (or tissue factor)
IV Calcium ions
V Labile factor
VI Does not exist
VII Stable factor
VIII Antihemophilic factor A
IX Antihemophilic factor B
X Stuart factor
XI Antihemophilic factor C
XII Hagemans factor
XIII Fibrin stabilizing factor

63. Blood Clotting (or
coagulation)
 Blood clotting is a complex process of
the formation of semisolid insoluble gel
of blood & fibrin threads at the damaged
wall of blood vessel.
 Blood clotting involves several enzymes
and other chemicals known as clotting
factors.

64. Stages of blood clotting are
discussed below
Stage 1: Formation of prothrombinase
(prothrombin activator)
Stage 2: Conversion of prothrombin into the
thrombin
Stage 3: Conversion of fibrinogen into fibrin

65. The clot is made up from fibrin. Fibrin is
a thread-like protein. The blood clot
contains RBCs and platelets.
This blood clot creates a wall across the
breaking site in the blood vessel.
Once the clot has formed and bleeding
has stopped, clot retraction and
fibrinolysis occur.

66. Pathways of blood
coagulation

70.  Normal range of clotting time: 4-11 minutes
 Serum: Serum is a clear, transparent and
sticky fluid coming out from shrinking of
blood clot.
Factors affecting blood coagulation
 Physiological factors: Clotting time is
reduced during menstruation and parturition.
 Pathological factors: Clotting time
becomes prolong in hemophilia, liver
diseases, afibrinogenemia, diabetes, vitamin
K deficiency, and Christmas disease

71. Disorders of Platelets
Thrombocytopenia
Thrombocytopenia is a disorder characterized by
reduction in platelet count below 40,000
platelets/µL. It may be due to reduction in tare of
platelet production or increase in rate of destruction
from spleen and liver.
Symptoms includes
 Frequent bleeding from gums, nose, skin, teeth
etc.;
 Internal organ bleeding like brain hemorrhage,
gastric ulcer;
 Bleeding gums, skin rash, red colored patch on
skin etc.

72. Hemophilia
 Hemophilia is characterized by the inability
of the blood to clot properly. Hemophilia is
a genetic blood disorder involves
deficiency of blood clotting factors
including factor VIII, factor IX and factor
XI. Without factor VIII, the first stage of
chemical clotting cannot be completed,
and prothrombinase is not formed.
 Blood clotting factors are needed to stop
bleeding after a cut or injury and to prevent
spontaneous bleeding.

73. Symptoms includes
 Prolonged spontaneous bleeding due to
minor trauma (injury);
 Bleeding from the joints;
 Bleeding from muscles leads to severe
pain;
 Blood in urine;
 Frequent nose and dental bleeding.

74. Thrombosis
Clotting in such an unbroken blood vessel
(usually a vein) is called thrombosis.
Usually platelets get deposited on that to
form a blood clot known as thrombus. It
may dissolve spontaneously.
Embolism
If pieces of a blood clot or air bubble get
transported into the bloodstream, it is called
an embolus. When an embolus becomes
blocked in a blood vessel and cuts off
circulation, it is known as an embolism.

75. Thanking u