The Blood - Worksheet

Human body must maintain a balance called a multicellular structure.

Body fluid inside the cells is called intracellular fluid; that outside is called extracellular or
interstitial fluid.
Two major fluid networks that help in connecting cells are cardiovascular and lymphatic
systems.

Branch of medicine that deals with blood, its formation and disorders is called hematology.

Functions of cardiovascular system:

 Three main functions of cardiovascular system are

1. Transport

2. Protection, and

3. Regulation.

Physical characteristics:
Volume of blood in average human body: 4-6 liters.
Viscosity of blood is about: 4.5- 5.5 .
Temperature of blood: 100.40F or 380C
pH of blood: 7.35 - 7.4; which is slightly basic on the pH scale.
Osmotic concentration of blood fluid:

Withdrawing blood:
Venipuncture: when blood is withdrawn from a vein closer to surface, lower BP,
smoother flow
Finger- stick: when blood is withdrawn from a fingertip, ear lobe, heel; small amount required
Arterial stick: when blood is withdrawn from an artery; for monitoring oxygenation

Blood is classified as a hemopoietic tissue

Liquid Plasma makes up the blood.
Suspended Formed Elements
45% of the blood

Blood plasma:
 Blood plasma is about 91.5% water and 7% proteins.
 Plasma protein that is made by liver, maintains blood viscosity, and transports water-
insoluble chemicals (fats and hormones) is called albumin.
  Plasma protein that is made by liver and WBC, protects against diseases, and
transports water- insoluble chemicals (fats and hormones) is called globulins.
 Plasma protein that is produced by liver and used for blood clotting is called fibrinogen.
 Ions present in blood plasma are called electrolytes.

Formed elements:

 The three types of formed elements that are present in blood are red blood cells (also
called erythrocytes), white blood cells (also called leukocytes), and platelets (also
called thrombocytes).

 The process of blood cell formation is called hemopoieses.

It takes place in yolk sac, liver, spleen, thymus, lymph nodes & red bone marrow in an
embryonic.
In an adult, it takes place mostly in RBC present in flat bones and ends of long bones.
The stem cells are referred to as the pluripotent stem cells.
These cells divide to form myloid stem cells that form the RBC, platelets, and certain
WBC (eosinophils, basophils, neutrophils, monocytes) and lymphoid stem cells that form
certain WBC (lymphocytes).
This process is stimulated by factors such hormone such as _testosterone, erythropoietin
and thrombopoietin and cytokines, growth factors and vitamins.

Erythrocytes:

There are about 4.8 -_5.4 million RBC present in each cu mm (ml) of blood.
They lack a nucleus and are therefore referred to as anucleate.
They also lack mitochondria and therefore they produce ATP by anaerobic
respiration.
Their cytoplasm has a red protein called hemoglobin. They
transport gases: most O2 and some CO2.
Hemoglobin
It is made of: 4 polypeptides called the globins.
Attached to each of these proteins is a non-protein pigment molecule called a
heme.
Attached to each of these non-protein pigment molecule is Fe2+
O2 binds to Fe of hemoglobin, and hemoglobin is now called oxyhemoglobin.
CO2 binds to globins of hemoglobin, and hemoglobin is now called
carbaminohemoglobin.
Production of RBCs is called erythropoiesis.
When oxygen supply is reduced, kidney release an erythropoietic factor, which
eventually forms a hormone called erythropoietin.
This hormone stimulates hematopoietic stem cell in red bone marrow.
Stem cells form erythroblast that eject their nucleus to form enucleated cells called
reticulocyte.
These enucleated cells migrate from bone marrow to enter the blood stream, circulate for
1- 2 days, increase their hemoglobin content, and form mature erythrocytes.
Complete Blood Count test refers to the complete blood count that is used in clinics
to determine the number of RBC and all the types of WBC.
Hematocrit test is used in the clinics to determine the % of RBC in blood.

Oxygen deficiency due to decreased oxygen in the atmosphere, decreased number of

RBC, lack of blood circulation is referred to as hypoxia.

Blood doping is when previously stored RBC are injected into the body to increase
oxygen to the muscles and performance. This procedure increases blood viscosity and
results in increased load on heart.

Hematocrit below 35% causing insufficient hemoglobin is referred to as insufficient

hemoglobin.
Iron- deficiency anemia is due to insufficient iron.
Pernicious anemia is due to lack of intrinsic factor needed for absorption of vitamin
B12 in stomach, needed for RBC production.
Hemorrhagic anemia is due to excessive bleeding.
Hemolytic anemia is due to lysis of RBC caused by parasites, toxins,
antibodies, or hemoglobin defects.
Aplastic anemia is due to lack of red bone marrow activity caused by radiation
or chemotherapy, or toxins.
Sickle cell anemia is a genetic disorder that is caused by a mutation of
hemoglobin gene and results in production of a defective hemoglobin. RBC become
sickle shaped and do not transport O2 and clog blood
Capillaries .

RBC breakdown
RBC circulate for about 120 days after which the worn out RBC are phagocytized by
macrophages in spleen and liver.
Cell membranes of worn out RBC are recycled and hemoglobin is processed by liver.
Globin of hemoglobin is a protein which is broken down into amino acids
 and recycled to make new proteins.
Heme is the non-protein pigment of hemoglobin which is converted by liver to form
bilirubin and _urobilin and excreted with feces and urine.
Fe of hemoglobin is transported by plasma transferrin to bone marrow and recycled for
making new hemoglobin.

Leukocytes:

There are about 4,300 – 10,800 WBC in each cu mm (ml) of blood.

They have a nucleus but do not have hemoglobin, the pigment found in RBC. Their
plasma membrane has antigens used to match cells, tissues and organs during
donation procedures.
Their main function is to protect the body against infections.
Differential test is used in the clinics to determine the % of each type of WBC in a
blood sample.
There are two groups of WBC:
1. Granular leukocytes have lobed nucleus and granules in the cytoplasm.
Included in this group are the neutrophil that have 2-6 lobed nucleus and pale lilac
granules in the cytoplasm. They are the phagocytic cells that engulf infections at injuries.
Also included in this group are the eosinophil that have bilobed nucleus and orange-red
granules in the cytoplasm. They are involved in allergic reactions and act as phagocytic
cells for parasitic worms.
This group also includes basophils that have bilobed nucleus and dark blue-black
granules in the cytoplasm. These cells release vasodilator histamine in allergic
reactions and become modified to form mast cells.
2. Agranular leukocytes have a dented nucleus and no prominent granules. Included
in this group are lymphocytes that are smaller cells with relatively large nucleus and
very little cytoplasm. They are involved in antigen-antibody immunity against viral
infections.
Also included in this group are the monocytes that are larger cells with large dented
nucleus and a lot of foamy cytoplasm. These cells are phagocytic cells that become
modified to form .
Production of WBC:
Hemopoietic pluripotent stem cells in red bone marrow divide to form myeloid stem cells
(4 of the 5 WBC and the platelets) and Lymphoid stem cells.
Myeloblasts form neutrophils, eosinophils, and basophils.
Monoblasts form monocytes.
Lymphoblasts form lymphocytes .
When leukocyte number goes above 10,000/cu mm of blood, it is referred to as
 leukocytosis.
When leukocyte number goes below 5,000/cu mm of blood, it is referred to as
leukopenia.
Cancer of leukocytes is called leukemia.

Thrombocytes:

These are actually platelet fragments

There are 250_- 400,000 platelets in each cu mm of blood. They are involved
in blood clotting.
They circulate for 5 - 9_ days in the blood stream.
Formation:
Hematopoietic stem cells in red bone marrow divide to form megakaryocyte
whose cytoplasm breaks up to form platelets.
Thrombocytosis is when number of platelets goes up and excessive clots may be
formed.
Thrombocytopenia is when number of platelets goes down and excessive internal
bleeding occurs.

 Hemostasis refers to the process by which bleeding stops.

There are three major steps of this process:
o Vascular spasm is where smooth muscle in the wall of the blood
vessels contract to reduce the opening and blood flow.
o Platelet plug formation is where platelets migrate to endothelial cells in the
wall of the blood vessels (platelet deposition and adhesion), become irregular
and stick to each other (platelet secretion), and form a mass (platelet
aggregation). Platelets release chemicals such as ADP, prostaglandins, serotonin,
enzymes, calcium ions and clotting actors.
o Coagulation phase is the third step and refers to blood clotting.
o Clot is a soft mass of protein fibers and blood cells.
Substances needed for clot formation are Ca 2+, enzymes from liver_,
chemicals released by platelets and damaged cells.
Vitamin K is made by intestinal bacteria and used for making liver factors II,
VII, IX and X.
 There are two pathways for blood clotting :
Intrinsic and extrinsic pathways.
In both pathways, prothrombinase and Ca 2+ convert prothrombin to thrombin .
Thrombin and Ca 2+ convert soluble fibrinogen to insoluble fibrin fibers.
Fibrin fibers trap blood cells to form a soft mass – clot is formed
Extrinsic pathway:
A very rapid process & takes place within a few seconds.
Damaged tissue releases tissue factor that along with Ca 2+ activate factor VII. This
activated factor combines with factor V and Ca 2+ to form prothrombin activator.
Then, prothrombinase and Ca 2+ convert prothrombin to form thrombin.
thrombin and Ca 2+ convert soluble fibrinogen to form insoluble fibrin fibers.
fibrin fibers trap blood cells to form a soft mass –clot is formed.
Intrinsic pathway:
More complex and slower process, takes place within a few minutes.
Damaged endothelial lining of blood vessels initiate platelets to come in contact with
collagen fibers in the basement membrane. Damaged blood vessels, factors XII, X,
phospholipids and Ca 2+ together combine to form factor X.
Then, prothrombinase and Ca 2+ convert prothrombin to form thrombin.
Thrombin and Ca 2+ convert soluble fibrinogen to form insoluble fibrin fibers.
Fibrin fibers trap blood cells to form a soft mass, clot is formed.
Thrombosis is a clot formed in an unbroken blood vessel.
Thrombus is the process of clot formation.
Stasis refers to slower blood flow that can cause thrombosis.
A clot can detach and travel to other body parts to cause ischemia and necrosis leading
to multisystem organ failure.
Embolus is a traveling clot
Pulmonary embolism is where an embolus lodges in the lungs and blocks blood
circulation in the lungs.
Stroke is caused by embolus in blood vessel going to the brain.
Hemophilia refers to continued bleeding due to lack of clotting factors.

Clot retraction, repair of the blood vessel and fibrinolysis:

Clot temporarily seals the blood vessel and platelets pull on the fibrin fibers to bring the
edges closer.
An outside clot dries to form a scab, and as the tissue heals, the scab fall off. A
thrombus formed inside a blood vessel and slowly dissolves –a process called
fibrinolysis.
An inactive plasma enzyme plasminogen is converted to active enzyme
plasmin.
This enzyme dissolves the clot.
Chemicals that dissolve a clot such as plasminogen activator, stroptokinase, are called
thrombolytic agents.
Chemicals that prevent clot formation such as heparin, warfarin, EDTA, are called
anticoagulants.
 Blood Groups:
Determining blood groups is referred to as ABO blood group.
: Examples -ABO, Rh
: Specific proteins on RBC antibodies or antigens
Cross- matching is mixing of donor and recipient blood for compatibility. Testing is
done by using commercially available specific agglutinins or antibodies.
ABO groups:
Four types: A,B, AB, O
Antigens A and/or B are present on RBC.
Corresponding antibodies A or B are present in plasma.
Antibodies recognize and bind to specific antigens, cause clumping of cells, termed as
agglutination.
Rh groups:
Two types: Rh+ and Rh-.
Rh antigen is present on RBC of Rh+ blood type; Rh antigen is absent on RH- blood
type.
Corresponding Rh antibody is normally absent in plasma and present in blood types.
If a person with Rh- blood is given a transfusion of Rh+ blood, the person starts making
Rh antibody.
If Rh- mother is carrying Rh+ fetus, mixing of blood at birth stimulates mother 's body
starts making Rh antibodies.
During second pregnancy, if the fetus is Rh+, mother's Rh antibodies cross placenta,
cause agglutinate of fetal RBC and hemolysis, eventually leading to fetal death.
Immune Globulin shot is given to the mother soon after the first delivery,
miscarriage or abortion. This shot is antibodies that bind to fetal RBC that may
have entered the mother and removes it from body before mother makes Rh
antibody .