ANATOMY AND PHYSIOLOGY

The Blood
Blood is considered the essence of life because the uncontrolled loss of it can result to
death. Blood is a type of connective tissue, consisting of cells and cell fragments
surrounded by a
liquid matrix which circulates through the heart and blood vessels. The cells and cell
fragments
are formed elements and the liquid is plasma. Blood makes about 8% of total weight
of the body.

Functions of Blood:
>transports gases, nutrients, waste products, and hormones
>involve in regulation of homeostasis and the maintenance of PH, body temperature,
fluid
balance, and electrolyte levels
>protects against diseases and blood loss

The blood consists of cells and cell fragments, called formed elements, and water
with dissolved molecules, called blood plasma (see Table 1 ).

TABLE 1 Formed Elements and Plasma of Blood

Constituent Characteristics/Functions
Formed Elements (45%)
Erythrocytes (red blood cells) (98– anucleate, contain hemoglobin; O2 &
99%) CO2 transport
Leukocytes (white blood cells) granulocytes, polymorphonuclear;
(0.1–0.3%): Neutrophils (60–70%) phagocytosis, wound healing
Eosinophils (2–4%) granulocytes, bilobed nucleus; phagocytosis
Basophils (0.5–1%) granulocytes, 2 to 5 lobed nucleus; release
histamine
Lymphocytes (20–25%) agranulocytes, circular nucleus, T cells, B cells;
immune response, antibodies
Monocytes (3–8%) agranulocytes, large kidneyshaped nucleus;
phagocytotic macrophages
Thrombocytes (platelets) (1–2%) anucleate, megakaryocyte fragments; blood
clotting
Blood Plasma (55%)
Water (90%)
Plasma Proteins (8%): Albumin maintain osmotic pressure between blood &
Constituent Characteristics/Functions
Formed Elements (45%)
(54%) tissues
Globulins (38%) lipid and metal ion transporters, antibodies
Fibrinogen (7%) clotting factor
Others (1%) enzymes, hormones, clotting factors
Electrolytes: Na+, K+, Ca2+, Mg2+, CI−, HCO3−, SO42−, HPO42−
Gases: O2, CO2, N2
Nutrients:
Glucose, other carbohydrates sources of energy
Amino acids protein-building blocks
Lipids fats, steroids, phospholipids
Cholesterol component of plasma membranes & steroid
hormones
Waste products:
Urea from breakdown of proteins
Creatinine from breakdown of creatine phosphate (from
muscles)
Uric acid from breakdown of nucleic acids
Bilirubin from breakdown of hemoglobin
Hormones: Various

Eyrthrocytes

Erythrocytes, or red blood cells (RBCs), transport oxygen (O2) and carbon dioxide
(CO2) in the blood. Erythrocytes contain the protein hemoglobin to which both O2 and
CO2 attach.

Mature erythrocytes lack a nucleus and most cellular organelles, thereby maximizing
the cell's volume and thus its ability to carry hemoglobin and to transport O2.

Erythrocytes are shaped like flattened donuts with a depressed center (rather than a
donut hole). Their flattened shape maximizes surface area for the exchange of O2 and
CO2 and allows flexibility that permits their passage through narrow capillaries.

Hemoglobin contains both a protein portion, called globin, and nonprotein heme
groups. Globin consists of four polypeptide chains, each of which contains a heme
group. The heme group is a red pigment that contains a single iron atom surrounded
by a ring of nitrogen-containing carbon rings. One oxygen atom attaches to the iron of
each heme group, allowing a single hemoglobin molecule to carry four oxygen atoms.
Each erythrocyte contains about 250 million hemoglobin molecules.

Oxyhemoglobin (HbO2) forms in the lungs when erythrocytes are exposed to oxygen
as they pass through the lungs. Deoxyhemoglobin (Hb) forms when oxygen detaches
form the iron and diffuses into surrounding tissues.

Carbaminohemoglobin (HbCO2) forms when CO2 attaches to amino acids of the

globin part of the hemoglobin molecule. About 25 percent of the CO2 transported
from tissues to lungs is in this form.

Carbonic anhydrase, an enzyme in erythrocytes, converts CO2 and H2O in the blood
plasma to H+ and HCO3− About 65% of the CO2 collected from tissues travels in the
blood plasma as HCO3−.

Because they lack cellular organelles and thus physiology to maintain themselves,
erythrocytes survive for only about 120 days. Degenerated erythrocytes are broken
down in the spleen and liver by macrophages (phagocytic white blood cells) as
follows:

1. The globin and heme parts of the hemoglobin are separated. The globin
is reduced to amino acids, which are returned to the blood plasma.
2. Iron is removed from the heme group and bound to the proteins ferritin
and hemosiderin, which store the iron for later use (because unbound iron is
toxic). Iron is also attached to transferrin, which enters the bloodstream.
Transferrin may be picked up by muscles or liver cells, where it may be stored
as ferritin or hemosiderin or picked up by bone marrow, where the iron is used
to produce new erythrocytes.
3. The remainder of the heme group is broken down into bilirubin (a
yellow-orange pigment), which enters the bloodstream and is picked up by the
liver. Liver cells incorporate bilirubin into bile, which enters the small
intestine during the digestion of fats. Bilirubin is then converted into
urobilinogen by intestinal bacteria. Finally, most urobilinogen is converted to
the brown pigment stercobilin, which is eliminated with the feces (and which
gives feces its brown color). A small amount of urobilinogen is absorbed into
the blood, converted to the yellow pigment urobilin, picked up by the kidneys,
and eliminated with the urine (contributing to the yellow color of urine).

Leukocytes

Leukocytes, or white blood cells (WBCs), are cells that protect the body from foreign
microbes and toxins. Although all leukocytes can be found in the bloodstream, some
permanently leave the bloodstream to enter tissues where they encounter microbes or
toxins, while other kinds of leukocytes readily move in and out of the bloodstream.
Leukocytes are classified into two groups, granulocytes and agranulocytes, based
upon the presence or absence of granules in the cytoplasm and the shape of the
nucleus.
 • Granulocytes contain numerous granules in the cytoplasm and have a
nucleus that is irregularly shaped with lobes. Each of the three types of
granulocytes is named after the bloodstains that its granules absorb.
• Neutrophils, the most numerous of granulocytes, have an S- or
Cshaped nucleus with three to six lobes. Their granules, which are small and
inconspicuous, poorly absorb both basic and acidic stains (neutral pH
preference), producing a pale, lilac color. Because the shape of the nucleus is
so variable, neutrophils are referred to as polymorphonuclear leukocytes
(PMNs), or polys. Young neutrophils, with immature nuclei that are shaped
like rods, are called band neutrophils. Neutrophils are the first leukocytes to
arrive at a site of infection, responding (by chemotaxis) to chemicals released
by damaged cells. The neutrophils, by phagocytosis, actively engulf bacteria,
which are then destroyed by the various antibiotic proteins (such as defensins
and lysozymes) contained within the granules. The neutrophils, usually
destroyed in the process, contribute, together with other dead tissue, to the
formation of pus.
• Eosinophils have a bilobed nucleus (two lobes connected by a narrow
strand of chromatin). Their granules, which stain red with acid (eosin) dyes,
contain digestive enzymes and are considered lysosomes. Eosinophils actively
phagocytize complexes formed by the action of antibodies on antigens
(foreign substances). Numbers of eosinophils increase during parasitic
infection and allergic reactions.
• Basophils have a U- or S-shaped nucleus with two to five lobes
connected by a narrow strand of chromatin. Their granules, which stain blue-
purple with basic dyes, contain histamine, serotonin, and heparin. Basophils
release histamine in response to tissue damage and to pathogen invasion (as
part of the inflammatory response). Basophils resemble mast cells, cells
similar in appearance and function to basophils, but found only in connective
tissues.
• Agranulocytes, the second group of leukocytes, do not have visible
granules in the cytoplasm and the nucleus is not lobed. There are two types of
these leukocytes:
• Lymphocytes, often classified as small, medium, and large, have a
roughly round nucleus surrounded by a small amount of blue-staining
cytoplasm. Lymphocytes are the only leukocytes that return to the
bloodstream, circulating among the bloodstream, tissue fluids, tissues, and
lymph fluid. There are two major groups of lymphocytes, which vary based
upon their role in an immune response. T lymphocytes (T cells), which mature
in the thymus gland, attack aberrant cells (such as tumor cells, organ transplant
cells, or cells infected by viruses). B lymphocytes (B cells), which mature in
the bone marrow, respond to circulating antigens (such as toxins, viruses, or
bacteria) by dividing to produce plasma cells, which in turn, produce
antibodies.
• Monocytes have a large, kidney-shaped nucleus surrounded by ample
blue-gray-staining cytoplasm. When monocytes leave the bloodstream and
move into tissues, they enlarge and become macrophages, which engulf
microbes and cellular debris.

Platelets
Platelets (thrombocytes) are fragments of huge cells called megakaryocytes.
Platelets lack a nucleus and consists of cytoplasm (with few organelles) surrounded
by a plasma membrane. Platelets adhere to damaged blood vessel walls and release
enzymes that activate hemostasis, the stoppage of bleeding.

Plasma

Plasma is the straw-colored, liquid portion of the blood. It consists of the following:

• Water (90 percent).

• Proteins (8 percent). Albumin, the most common protein, is produced
by the liver and serves to preserve osmotic pressure between blood and
tissues. Other proteins include alpha and beta globulins (proteins that transport
lipids and metal ions), gamma globulins (antibodies), fibrinogen and
prothrombin (clotting proteins), and hormones.
• Waste products (urea, uric acid, creatinine, bilirubin, and others).
• Nutrients (absorbed from the digestive tract).
• Electrolytes (various ions such as sodium, calcium, chloride, and
bicarbonate).
• Respiratory gases (O2 and CO2).

Serum is the liquid material remaining after blood-clotting proteins have been
removed from plasma as a result of clotting.