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    Blood 200L

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    Blood 200L

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    1 views38 pages

    Blood 200L

    Uploaded by

    chisomnwabunwanne5

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    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    of 38

    Blood

    By

    Dr. Alfred Ehiaghe


    Components of Whole Blood

    Plasma
    (55% of whole
    blood)

    Buffy coat:
    leukocyctes
    and platelets
    (<1% of whole blood)
    Formed
    elements
    Erythrocytes
    1 Withdraw blood 2 Centrifuge (45% of whole blood)
    and place in tube

    • Hematocrit
    • Males: 47% ± 5%
    • Females: 42% ± 5%
    Components of plasma
    (90% water rest
    solids) Solids

    Plasma Proteins Regulatory &


    protective Organic and inorganic substances
    6‐8 gm/dL proteins

    Albumin Waste material


    Hormones
    3‐4
    Antibodies Nutritive material
    gm/dL
    Globulin
    2.5‐4 gm/ Enzymes Ions

    dL
    Fibrinogen
    0.3 gm/ dl
    Functions of blood
    Distributive
    • Carries O2 (from lungs) and nutrients (from
    GIT and body stores) to all cells
    • Carries wastes from all cells to elimination
    sites (lungs for CO2, liver for bilirubin and
    kidneys for nitrogenous wastes)
    • Carries hormones (chemical signals) from
    endocrine organs to target tissues.
    Functions of blood…
    Regulatory functions
    • Body T° by absorbing and distributing heat
    • pH by virtue of its many buffers
    •Maintains adequate fluid volume in the body
    Protective functions
    • Prevents blood loss by initiating clotting
    mechanisms in response to blood vessel damage
    • Prevents infection via WBCs and plasma immune
    proteins
    Formation of cellular elements of
    blood
    In fetus: Extramedullary hematopoiesis(3 stages)
    • Mesoblastic: (16‐19 days): Clusters of
    mesenchymal cells in yolk sac ends by 12
    weeks
    • Hepatic (Second trimester) Liver, spleen
    and lymph node
    • Myeloid(Last month of gestation+ after birth):
    Bone marrow
    Bone marrow is the site of synthesis of
    all formed elements of blood after
    birth
    Red bone marrow
    Formation of cellular elements of
    blood
    Upto 5 yrs: all bone marrow
    Upto 20 yrs: bone marrow of membranous +
    ends of long bones
    After 20 yrs: bone marrow of membranous
    bone
    Erythropoiesis: Formation of RBCs

    This development takes about 7 days


    and involves three to four mitotic cell
    divisions, so that each stem cell
    gives rise to 8 or 16 cells.
    Erythropoiesis

    Basophilic Polychromatophil Orthochromatic


    erythroblast erythroblast erythroblast

    Early Intermediate Late


    Megaloblast normoblast normoblast normoblast

    7‐10 µ m
    15‐20µ m Nucleus: size 10‐14 µ m Nucleus: cart
    Nucleus: Big Nucleoli: absent Nucleus: Size wheal‐ pyknotic
    Hb: absent Hb: absent Hb: Starts Hb: increases
    appearing
    Reticulocytes VS mature RBC
    • Size: 8 μm • Size: 7 μm
    • Shape:Polylobulated • Shape: Biconcave disc
    • Adhesiveness more • Adhesiveness less
    • RNA and ribosomes • RNA and ribosomes
    present absent
    • Transferrin receptors • Transferrin receptors
    present absent
    • Hemoglobin • No more hemoglobin
    synthesis synthesis
    Erythrocytes (RBCs)

    Figure 17.3
    PBS under low power
    PBS under high power
    RBC indices
    • MCV gives you the average volume of
    erythrocytes.
    • MCH gives you the average weight of
    hemoglobin per eyrthrocyte.
    • MCHC gives you the average hemoglobin
    concentration per erythrocyte.
    RBC indices
    MCV: Average volume of the RBC
    MCV= PCV in % X 10 cubic microns
    RBC count in
    millions/mm3
    MCH: Average Hb
    concentration of a RBC
    MCH= Hb(gm/dl) X10 picogram
    RBC count in million/mm3
    MCHC: Ave. Hb concentration per RBC
    MCHC= Hb(gm/dl) X100
    PCV(%)
    Biconcave disc shape of RBC
    • Increased ratio of surface area : volume(40%
    more membrane)
    Facilitates gas transport
    • More deformable
    Maintenance of biconcave shape
    • Elastic forces within the membrane
    • Surface tension
    • Electrical forces on the membrane surface due
    to albumin adsorption
    • Osmotic /hydrostatic forces
    Spherocyt
    e

    Observed in immune induced hemolysis,


    post blood transfusions, and congenital
    anemia
    Target cell

    Observed in hemoglobinopathy, hepatic


    diseases, iron deficiency anemia, hemolytic
    anemia, and splenectomy.
    Schistiocytes

    Uremia, microangiopathic hemolytic anemias,


    hemolytic anemias cause by physical agents,
    and disseminated intravascular coagulation
    (DIC)
    Ovalocytes

    Hereditary defect present in the RBC


    cytoskeletal proteins (the spectrin chain),
    iron deficiency anemia, leukemia
    associated anemias, thalassemia, and
    dyserythropoiesis
    Poikilocytosis

    Indicator of abnormal erythropoiesis due to


    bone marrow effects and/or abnormal RBC
    destruction
    Howell‐Jolly bodies

    Observed in hemolytic anemias, pernicious


    anemia, post‐operative conditions,
    splenectomy, or splenic atrophy
    Echinocyte

    Observed in uremia, acute blood loss,


    stomach cancer, and pyruvate kinase
    deficiency
    Burr cell

    Observed in uremia, acute blood loss,


    stomach cancer, and pyruvate kinase
    deficiency
    Basophilic stippling

    Observed in lead poisoning, alcoholism


    megaloblastic anemias
    Hematocrit/ Packed cell volume
    Percentage of the total volume of blood that is
    occupied by packed red blood cell
    Normal values are as follows:
    • Adult male = 42% to 53%
    • Adult female = 36% to 46%
    • Newborn = 50% to 62%
    • One year = 31% to 39%
    Hematocrit
    • Increased
    Polycythemia
    Shock associated with surgery, burns, or traumas
    Dehydration
    • Decreased
    Anemias
    Pregnancy
    receiving IV fluids
    Cardiac decompensation (a failure to maintain a good blood
    circulation)
    Erythropoietin
    Site of synthesis

    90% kidney

    10% liver & hepatocytes


    Sites of erythropoiesis
    Mechanism of red cell destruction
    Averege life span 120 days
    4 major mechanisms of destruction
    1. Osmotic lysis
    2. Erythrophagocytosis
    3. Complement induced cytolysis
    4. Fragmentation
    Heme oxygenase system responsible for
    hemoglobin degradation is located in the
    phagocytic cells of Liver, Spleen& Bone marrow
    Sites of erythrocyte destruction
    • Extravascular hemolysis(80‐90 %)
    Spleen, Liver, Macrophages, Lymph node and
    Bone marrow
    • Intravascular hemolysis
    Hemoglobin is discharged directly into the
    circulation & is removed by several
    mechanisms
    THANKS

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