Chapter 18: Blood

10/25/2013 10:28:00 AM

Functions of the Circulatory System Circulatory system- heart, blood vessels, and blood. Cardiovascular system- ONLY heart and vessels Hematology- the study of blood Functions are o Transport Blood carries oxygen from lungs to body Picks up nutrients from the digestive tract Carries metabolic wastes to the kidneys Carries hormones from endocrine cells to target organs Transports stem cells from bone marrow to tissues o Protection Inflammation WBCs destroy microorganisms and cancer cells Antibodies neutralize toxins and help destroy pathogens Platelets help initiate blood clotting and prevent blood loss o Regulation Capillaries stabilize fluid distribution in body by absorbing or giving off fluid Stabilizes the pH of extracellular fluids by buffering bases and acids Regulate body temp. by routing blood to skin for heat loss or retaining it deeper in the body to conserve heat Components and General Properties of Blood Adults = 4-6 L of blood Liquid connective tissue made of cells and an extracellular matrix Plasma- clear, light yellow fluid constituting a little over half of the blood volume Formed elements- cells and cell fragments including the RBC, WBC, and platelets Formed elements: o Erythrocytes (RBCs) o Platelets o Leukocytes (WBCs) Granulocytes

Neutrophils Eosinophils Basophils Agranulocytes Lymphocytes Monocytes

Blood Plasma Mixture of water, proteins, nutrients, electrolytes, nitrogenous wastes, hormones, and gases. Serum- plasma that has no clotting protein fibrinogen Plasma protein helps clotting, defense and transport of solutes 3 categories of plasma proteins o Albumin- smallest and most abundant plasma protein Transports various solutes Buffers pH of plasma Contributes to the viscosity and osmolarity of blood o Globulins 3 subclasses Alpha globulins (smallest) Beta globulins Gamma globulins (largest) Solute transport Clotting Immunity o Fibrinogen- soluble precursor of fibrin, a sticky protein that forms the framework of a blood clot. Liver produces 4 g of plasma protein per hour Liver produces all except gamma globulins which come from plasma cells Nitrogenous wastes- toxic end products of catabolism o Urea- product of amino acid catabolism, excreted by the kidneys at a rate that balances their production Transports nutrients TABLE 18.2 & 18.3 Electrolytes are an important part of plasma Sodium ions = 90% of plasma cations

Sodium is important for osmolarity of blood and influences blood volume and pressure Blood Viscosity and Osmolarity Viscosity- the resistance of a fluid to flow (the thickness or stickiness of a fluid) o Blood = 4.5-5.5 times as viscous as water o Important because it governs the flow of blood through the vessels Lack of RBC reduces blood viscosity and causes blood to flow too easily Excess of RBC = sluggish flow of blood Osmolarity- total molarity of dissolved particles that cannot pass through the blood vessel wall o Substances need to pass between the bloodstream and tissue fluid through the capillary walls. This depends on a balance of fluid from the capillary and its reabsorption by osmosis. o Important for blood pressure o Colloid osmotic pressure (COP)- the contribution of protein to blood osmotic pressure

How Blood is Produced Adult produces 400 billion platelets, 200 billion RBCs, and 10 billion WBCs Hemopoiesis- production of blood, especially its formed elements Hemopoietic tissues- tissues that produce blood cells Myeloid hemopoiesis- blood formation in the bone marrow Lymphoid hemopoiesis- blood formation in the lymphatic organs Hemopoietic stem cell- multipotent stem cells that develop into multiple mature cell types Colony forming units- specialized hemopoietic stem cells that produce one or another class of formed elements

ERYTHROCYTES
Erythrocytes (RBCs)o 2 functions Pick up oxygen from the lungs and deliver it to tissues Pick up carbon dioxide from tissues and deliver to lungs

o Most abundant formed elements Form and Function Discodial cell with a biconcave shape 7.5 um in diameter and 2.0 um thick at the rim No internal structure Anaerobic fermentation produces ATP Hemoglobin- makes up 33% of the cytoplasm in the RBC, red pigment that gives an RBC its color and name o Oxygen transport o Transport of CO2 o Buffering of blood pH RBC has glycolipids on outer surface that determine blood type Inner surface has spectrin and actin to give the membrane resilience and durability. o Important when passing through small blood capillaries and sinusoids Hemoglobin Globins- 4 protein chains that make up hemoglobin o Alpha chains are 141 AA long o Beta chains are 146 AA long Heme- nonprotein moiety that binds oxygen to a ferrous ion at its center Quantities of Erythrocytes and Hemoglobin Hematocrit- percentage of whole blood volume composed of RBCs o Men 42-52% o Women 37-48% Hemoglobin concentration- 13-18 g/dL men; 12-16 g/dL women Lower in women than men o Androgens stimulate RBC production and men have higher androgen levels o Women have periodic menstrual losses o Hematocrit is inversely proportional to percentage body fat, which is higher in women The Erythrocyte Life Cycle Lives for 120 days Erythrocyte Production

o Erythropoiesis- Erythrocyte production Takes 3-5 days 4 developments Reduction in cell size Increase in cell number Synthesis of hemoglobin Loss of the nucleus and other organelles Erythropoietin- stimulates the erythrocyte colonyforming unit to transform into an erythroblast which multiply and synthesize hemoglobin. Nucleus shrivels and is discharged from the cell. Reticulocyte- temporary network composed of ribosome clusters (when the nucleus shrivels) Iron Metabolism o Gastroferritin- protein produced by the stomach binds Fe2+ and transports it to the small intestine o Transferrin- plasma protein which the Fe2+ is binded to and travels to bone marrow, liver and other tissues Erythrocyte Homeostasis o Negative feedback o Hypoxemia- oxygen deficiency in the blood Can be caused by blood loss, hemorrhaging, low level of oxygen, abrupt increase in bodys oxygen consumption Erythrocyte Death and Disposal o As RBC ages its membrane grows fragile o Hemolysis- rupture of RBCs that releases hemoglobin and leaves empty plasma membranes o Bile pigments- biliverdin and bilirubin

o Responsible for brown color of feces and yellow color of urine Erythrocyte Disorders Polycythemia o Primary Polycythemia- due to cancer of the erythropoietic line of the red bone marrow that produces excess amounts of RBCs o Secondary polycythemia- polycythemia from all other causes, 6-8 million RBCs

Can result from hydration Caused by smoking, air pollution, emphysema, high altitude, excessive aerobic exercise or other factors that create a state of hypoxemia and stimulate erythropoietin secretion. o Dangers include Increased blood volume Increased blood pressure Increased blood viscosity Can lead to embolism, stroke, or heart failure Anemia o Anemia- deficiency of RBCs or hemoglobin o Causes Inadequate erythropoiesis or hemoglobin synthesis Hemorrhagic anemia from bleeding Hemolytic anemia from RBC destruction o Results in kidney failure o Iron-deficiency anemia- nutritional anemia from a dietary deficiency of iron characterized by small pale erythrocytes o Pernicious anemia- deficiency of vitamin B12 o Intrinsic factor- substance the small intestine needs to absorb vitamin B12 o Hypoplastic anemia- caused by decline in erythropoiesis o Aplastic anemia- failure or destruction of the myeloid tissue that is a complete cessation of erythropoiesis. Leads to grotesque tissue necrosis and blackening of the skin o 3 potential consequences Hypoxia- (oxygen deprivation) of tissues which makes a person lethargic and becomes short of breath upon physical exertion, pallid skin, can cause life-threatening necrosis of brain, heart and kidney tissues Blood osmolarity is reduced which means more fluid transfers from the blood to intercellular spaces resulting in edema

Blood viscosity is reduced which makes the heart beat faster than normal. Cardiac failure and low blood pressure Sickle-Cell Disease o Sickle-cell disease- caused by a recessive allele that modifies the hemoglobin Doesnt bind well to oxygen Causes erythrocytes to become elongated and pointed at the ends Agglutinate- clump together

BLOOD TYPES
Antigens- complex molecules such as proteins, glycoproteins, and glycolipids that are genetically unique to each individual Antibodies- proteins (gamma globulins) secreted from the plasma cells when the body detects an antigen of a foreign origin Agglutination- each antibody molecule binds to 2 or more antigen molecules and sticks them together. Antigen-antibody complexes- repetition of agglutination that

immobilizes the antigens until certain immune cells can break them down. Agglutinogens- antigens on the surfaces of the RBCs Agglutinins- antibodies in the blood plasma The ABO Group ABO blood group- formed by blood types A, B, AB, and O Alpha agglutinin- anti-A antibodies, present in type O or type B Beta agglutinin- anti-B antibodies, present in type O and type A Transfusion reaction- when blood donor and recipients blood type mismatch and the agglutinated RBCs block small blood vessels, hemolyze, and release their hemoglobin over the next few hours to days. Type AB is the universal recipient Type O is the universal donor Group Rh blood group- named for the rhesus monkey in which Rh antigens were discovered

The Rh

o Rh positive if Antigen D is present (DD or Dd) o Rh negative if Antigen D is not present (dd) Body doesnt produce Antigen D naturally. Not a huge risk first time theres a mismatched transfusion Hemolytic disease of the newborn (HDN)- also called erythroblastosis fetalis, it is when a baby is born with agglutinated RBCs that have hemolyzed.

LEUKOCYTES
Form and Function Leukocytes (WBCs)- least abundant formed elements, 5,00010,000 Provide protection against infection and diseases Different than erythrocytes because they retain their organelles throughout life. Types of Leukocytes Nonspecific (azurophilic) granules- absorb the blue or violet dyes of blood stains Granulocytes- WBCs that have specific granules o Neutrophils Most abundant WBC 60-70% of WBCs Nucleus is clearly visible and consiss of three to five lobes connected by nuclear strands Primary task is to destroy bacteria o Eosinophils 2-4% of WBC total Rises in allergies, parasitic infections, collagen diseases and diseases of the spleen and central nervous system 2 large lobes connected by a thin strand Secrete chemicals that weaken or destroy large parasites. Phagocytize and dispose of inflammatory chemicals, antigen-antibody complexes, and allergens o Basophils Rarest of the WBCs

Secretes 2 chemicals Histamine- a vasodilator that widens the blood vessels, speeds the flow of blood to an injured tissue, and makes the blood vessels more permeable so that blood components such as neutrophils and clotting proteins can get into the connective tissues quicker Heparin- anticoagulant that inhibits blood clotting Releases chemical signals that attract eosinophils and

neutrophils to a site of infection. Agranulocytes- lack specific granules o Monocytes Nucleus fills almost entire cell Immune functions o Lymphocytes Largest WBCs Nucleus is large, horseshoe shaped Count rises in inflammation and viral infections

Macrophages- highly phagocytic cells that destroy dead or dying host and foreign cells, pathogenic chemicals and microorganisms and other foreign matter The Leukocyte Life Cycle Leukopoiesis- production of WBCs o Myeloblasts-differentiate into granulocytes o Monoblasts- look identical to myeloblasts but produce monocytes o Lymphoblasts- produce lymphocyte Leukocyte Disorders Leukopenia- WBC count below the normal (5,000-10,000) range o Seen in lead, arsenic, and mercury poisoning, radiation sickness and such infectious diseases as measles, mumps, chickenpox, polio, influenza, typhoid fever and AIDS Leukocytosis- a count above 10,000 WBCs which indicates infection, allergy, or other diseases but can also occur in response to dehydration or emotional disturbances

Leukemia- cancer of the hemopoietic tissues that usually produces an extraordinarily high number of circulating leukocytes and their precursers Myeloid leukemia- uncontrolled granulocyte production Lymphoid leukemia- uncontrolled lymphocyte or monocyte production Acute leukemia- appears suddenly, progresses rapidly and causes death in a few months if not treated. Chronic leukemia- develops more slowly and may go undetected for many months; if untreated survival time = 3 years Opportunistic infection- the establishment of pathogenic organisms that usually cannot get a foothold in people with healthy immune systems

PLATELETS AND HEMOSTASIS- THE CONTROL OF BLEEDING

Hemostasis- stopping of bleeding Platelet Form and Function Platelets- small fragments of marrow cells called megakaryocytes o Complex internal structure that includes lysosomes, mitochondria, microtubules and microfilaments, granules filled with platelet secretions and a system of channels called the open canalicular system which open onto the platelet surface. o No nucleus Functions o Secrete vasoconstrictors (chemicals that stimulate spasmodic constriction of broken vessels) which help reduce blood loss o Stick together to form temporary platelet plugs that seal small breaks in injured blood vessels o Secrete procoagulants (clotting factors) which promote blood clotting o Initiate the formation of a clot-dissolving enzyme that dissolves blood clots that have outlasted their usefulness.

o Secrete chemicals that attract neutrophils and monocytes to sites of inflammation o Internalize and destroy bacteria o Secrete growth factors that stimulate mitosis in fibroblasts and smooth muscle and thereby help to maintain and repair blood vessels. Platelet Production Thrombopoiesis- division of hemopoiesis that produces platelets Megakaryocyte- a gigantic cell, visible to the naked eye with a huge multilobed nucleus and multiple sets of chromosomes Thrombocytopenia- platelet deficiency Hemostasis 3 hemostatic mechanisms o Vascular spasm- prompt constriction of the broken vessel o Platelet Plug Formation- mass of platelets that adhere to broken vessel and reduce or stop minor bleeding Prostacyclin- platelet repellent that coats the smooth endothelium of blood vessels and the heart Degranulation- exocytosis of their cytoplasmic granules and release of factors that promote hemostasis Thromboxane A2- eicosanoid that promotes platelet aggregation, degranulation and vasoconstriction o Coagulation (clotting)- clotting to stop bleeding Convert plasma protein fibrinogen to Fibrin- a sticky protein that adheres to the walls of a vessel Extrinsic mechanism- initiated by clotting factors released by the damaged blood vessel Intrinsic mechanism- only uses clotting factors found in the blood itself Procoagulants- clotting factors Reaction cascade- series of reactions, each of which depends on the product of the preceding one The Fate of Blood Clots

Clot retraction- spinous pseudopods of the platelets that have adhered to strands of fibrin and contract pulling the fibrin threads and edges of the broken vessel together Platelet derived growth factor- mitotic stimulant that stimulates fibroblasts and smooth muscle cells to multiply and repair the damaged blood vessel. Fibrinolysis- dissolution of a clot Kallikrein- converts the inactive protein plasminogen into plasmin Plasmin- fibrin-dissolving enzyme that breaks up the clot Prevention of Inappropriate Clotting Platelet repulsion o Platelets dont adhere to smooth prostacyclin-coated endothelium of healthy blood vessels Dilution o Small amounts of thrombin are present (diluted by normal flow of blood) but do not accumulate unless the blood flow slows. Anticoagulants o Antithrombin- secreted by the liver, deactivates thrombin

before it can act on fibrinogen o Heparin- secreted by basophils and mast cells, interferes with the formation of prothrombin activator, blocks the action of thrombin on fibrinogen, and promotes the action of antithrombin Clotting Disorders Hemophilia- family of hereditary diseases characterized by deficiencies of one factor or another Hematomas- masses of clotted blood in the tissues Thrombosis- abnormal clotting of blood in an unbroken vessel Thrombus- clot

10/25/2013 10:28:00 AM

10/25/2013 10:28:00 AM