LEARNING GUIDE: HEMATOLOGY DIAGNOSTICS
Section 2
OVERVIEW OF
BLOOD
LEARNING OBJECTIVES
When you complete this section, you will be able to:
1. Indicate the four major functions of blood
2. Recognize the components of blood
3. Identify the chief characteristics of red blood cells, white blood cells, and platelets
4. Recognize normal values for the cellular elements in blood
5. Recognize a general description of blood cell formation
6. Indicate the role of the spleen
LEARNING GUIDE: HEMATOLOGY
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LEARNING GUIDE: HEMATOLOGY DIAGNOSTICS
FUNCTIONS OF BLOOD
Blood is essential to all cell life. It distributes oxygen, nutrients, electrolytes, hormones, and enzymes
throughout the body. Table 1 shows four major functions of blood.
Four major functions of blood
TRANSPORTS FROM: TO:
Oxygen (O2) Lungs All cells
Carbon dioxide (CO2) Cells Lungs
Nutrients Digestive organs All cells
Waste products All cells Organs of excretion
Hormones Endocrine glands Target organs
Regulates fluid and electrolyte balance between cells and interstitial fluid, and of body and cell temperature
Protects against toxins produced by bacteria
Prevents fluid loss through the clotting mechanism
Table 1. Primary functions of blood.
Components of Blood
Blood consists of plasma and formed elements. Plasma, which makes up about 55% of blood, is the straw-
colored clear liquid in which cellular elements and dissolved substances (solutes) are suspended. (Serum
is the fluid portion of the blood that remains after fibrin and the formed elements have been removed
with centrifugation.) Plasma is approximately 92% water and 8% a mixture of both organic and inorganic
substances. Table 2 shows the components of plasma and their functions.
COMPONENTS OF PLASMA AND THEIR FUNCTIONS
WATER (92%): Carries formed elements and dissolved substances; absorbs heat
Major proteins. Albumin controls water movement across membranes; affects blood viscosity (thickness),
pressure, and volume; transports substances such as drugs. Globulin forms antibodies to fight bacteria and
viruses. Fibrinogen forms fibrin and, with platelets, coagulates blood
Nonprotein nitrogen. Products of metabolism: urea, uric add, creatine, creatinine, ammonium salts; toxic if not
removed; carried in blood to organs of excretion
Products of digestion. Amino acids, glucose, fatty adds – all needed by cells for energy, repair, and reproduction
Regulatory substances. Enzymes for cellular chemical reactions; hormones to regulate growth and
development
Electrolytes. Sodium (Na+), potassium (K+), calcium (Ca++), magnesium (Mg+), chloride (Cl–), phosphate
(PO4–), sulfate (SO4–), bicarbonate (HCO3–), and inorganic salts
Table 2. Components of plasma.
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LEARNING GUIDE: HEMATOLOGY DIAGNOSTICS
BLOOD CELLS AND PLATELETS
The blood has three types of formed elements: erythrocytes (red blood cells), leukocytes (white blood cells),
and platelets or thrombocytes (Figure 1).
Most blood samples are measured in microliters (µL); to give youPlate
a reference, a drop of blood is roughly 30
4. Cell Types Found on Blood Smears from Normal Individuals
µL.
A
Erythrocytes. Also called red blood cells (RBCs),
erythrocytes are the body’s most numerous blood cells.
Average normal values indicating numbers of RBCs
in the blood may be recorded as 4.60 x 106/µL (4.60 B
million/µL) for women and 5.20 x 106/µL (5.20 million/
µL) for men.
To transport oxygen and carbon dioxide through the
circulation, each RBC contains approximately 280 C
million hemoglobin molecules. Each hemoglobin
molecule contains four iron atoms. As RBCs pass E
through the lungs, iron atoms combine with oxygen D
molecules. RBCs travel the circulatory system until, at
the tissues, iron atoms release oxygen into interstitial H
fluid and hemoglobin molecules take up carbon dioxide.
Back at the lungs, RBCs release carbon dioxide and take
up oxygen again. F
G
Leukocytes. The body normally contains 4,500-11,000
white blood cells (WBCs) per µL of blood. This value
may be reported as 4.5-11.0 x 10³/µL or k/µL (k =
thousand). Unlike RBCs, WBCs occur in many different
I
types. Most WBCs are filled with tiny grains and are J
called granulocytes (gran = grain). The normal range for
granulocytes is 1.8-8.5 x 10³/µL of blood.
Granulocytes include:
4A. Erythrocytes Figure 1. The blood has three
4F. types
Monocyteof formed
with elements:
gray blue cytoplasm, coarse linear chromatin, blunt .
• Neutrophils: 50%-70% of total WBCs or ≈1.8-7.7
.
x 103/µL erythrocytes (red blood cells),
4B. Large lymphocyte with purplish-red (azurophil) granules and deeply
indented by adjacent erythrocytes
. pseudopods
leukocytes (white blood
4G. Platelets (thrombocytes)
4C. Neutrophilic segmented cells), and platelets or thrombocytes.
4H. Lymphocyte Blood cells and
• Eosinophils: up to 5% of total WBCs or ≈0-0.450 x 103/
4D. Eosinophilic segmented
4E. Neutrophilic segmented platelets. A = erythrocytes,4J.B-F
4I. Neutrophilic band
= leukocytes, G = platelets
Basophil
µL (thrombocytes), H-J = leukocytes.
The arrangement is arbitrary and the number of leukocytes in relation to erythrocytes and thrombocytes is greated than would occur in an actual
microscopic field.
• Basophils: up to 2% of total WBCs or ≈0-0.2 x 103/µL
Lymphocytes and monocytes are non-granular WBCs. The normal range for lymphocytes and monocytes
are:
• Lymphocytes: 20%-47% of total WBCs or about 1.0-4.8 x 103/µL
• Monocytes: 3%-10% of total WBCs or about 0.0-0.8 x 103/µL
WBCs fight infection; some surround and destroy debris and foreign invaders while others produce
antigen/antibody reactions [an antigen is any substance (foreign or part of the body) which causes
production of an antibody; an antibody is a protein which neutralizes antigens].
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LEARNING GUIDE: HEMATOLOGY DIAGNOSTICS
NICE TO KNOW
• The average adult circulation contains 5 liters of blood (roughly 5.28 quarts).
• Blood completes the entire systemic circuit – from left heart through the body to right heart – in 90
seconds.
• Every cubic millimeter of blood contains 5 million RBCs.
• RBCs survive about 4 months; neutrophils survive about 6 hours.
Platelets. Also called thrombocytes, platelets are cell fragments that travel in the bloodstream. The normal
range for platelets is 140-440 x 10³/µL of blood.
Platelets help prevent blood and fluid loss by clumping together to begin the coagulation process. A blood
clot is formed when sticky platelets become covered with fibrin – a plasma protein that holds the blood clot
together.
Each of the formed elements of blood will be covered in more detail in the following sections.
HEMATOPOIESIS: THE FORMATION OF BLOOD CELLS
All blood cells begin as undifferentiated stem cells capable of reproducing themselves. Generations of cells
eventually differentiate into cell lines that will mature to produce erythrocytes, leukocytes, and platelets.
Stem cells in bone marrow continuously proliferate – usually at a steady state to maintain a constant
population of mature blood cells. A disruption in this process can lead to serious illnesses.
As a group, immature cells are large. As they age and mature, they become smaller and change in their
reaction to the dyes used to stain them for identification.
Role of the Spleen. Located beneath the diaphragm and behind the stomach, the spleen is an intricate filter
that receives 5% of the total blood volume each minute. In the embryo, the spleen is a blood-forming center;
it loses this function as the fetus matures.
In the spleen, RBCs and WBCs are “inspected” by specialized WBCs. Old or damaged cells are removed;
salvageable cells may be “pitted”, that is, unwanted particles are removed without destroying the cells.
Because it is not essential to life, the spleen may be removed (splenectomy) without serious effects.
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