blood and clotting slides

8/3/2019 Blood and Clotting Slides

1/20

1

Blood

Blood The only fluid tissue in the human body Classified as a connective tissue Components of blood

1) Living cells called_______________

Erythrocytes red blood cellstransports oxygen and carbon dioxide

Leukocytes white blood cellsdefend body against pathogens

Platelets cell fragments formedfrom megakaryocytes, important in

blood clotting

2) Non-living matrix: plasma is the fluid

and solutes

Blood Hematocrit and Beyond

When blood is centrifuged Erythrocytes sink to the bottom

(45% of blood, a percentageknown as the hematocrit)

_______________coat containsleukocytes and platelets (lessthan 1% of blood), the buffycoat is a thin, whitish layer

between the erythrocytes andplasma

Plasma rises to the top (55% ofblood)

Average blood volume Women = 5.0 L Men = 5.5 L


2/20

2

kwashiorkor

Physical Characteristics of Blood

Blood is used as a vehicle of transport Color range

Oxygen-rich blood is scarlet red Oxygen-poor blood is dull red

pH between 7.357.45 (7.4) Blood temperature is slightly higher than body temperature at 38

(_______________)

Blood makes up 8% of body weight

Blood Plasma is ~90% Water

6-8% proteins which: increase osmotic pressure, buffer H+,increaseblood viscosity, provide fuel during starvation

3 Major Classes of Plasma Proteins (synthesized in liver, except someglobulins synthesized by lymphocytes)

Albumins: Major contributor to plasma oncotic osmotic pressureand act as carriers

Globulins: Carriers, Clotting factors, Precursor proteins

(angiotensinogen), Immunoglobulins Fibrinogen:_______________

Nutrients: glucose, amino acids, lipids, vitaminsWastes: urea, bilirubin, creatinineGases (dissolved): oxygen, carbon dioxideHormonesElectrolytes

Relatively high concentrations of Na+ and Cl-

Relatively low concentrations of H+, HCO3-, K+, and Ca2+


3/20

3

Ringers Solution

A solution of distilled water containing 8.6g sodium chloride, 0.3gpotassium chloride, and 0.33g calcium chloride per liter, the same

concentrations as their occurrence in body fluids.This solution is_______________to our blood and tissuesWhy?

Blood Plasma

Acidosis: blood becomes too acidicAlkalosis: blood becomes too basicIn each scenario, the respiratory system and kidneys help

restore blood pH to normal

Carbon dioxide can dissolve in water (blood plasma) andform_______________

CO2 + H2O H2CO3 (carbonic acid) H+ + HCO3- (bicarbonate)

Im an acid!

Cellular or Formed Elements

_______________: Red bloodcells (RBCs)

Leukocytes: White blood cells(WBCs)

Platelets (cell fragments)


4/20

4

Developmental Aspects of Blood Cells

Sites of blood cell formation The fetal liver and spleen are early sites of

blood cell formation

Bone marrow takes over_______________by the seventh month

Fetal hemoglobin differs from hemoglobinproduced after birth, fetal hemoglobin has a

gamma subunit in place of the beta subunit and

higher affinity for oxygen

Physiologic jaundice results when the livercannot rid the body of hemoglobin

breakdown products fast enough

Erythrocytes

Erythrocytes (red blood cells or RBCs) Main function is to carry oxygen Anatomy of circulating erythrocytes

biconcave disk: large surface areawhich favors diffusion

Essentially bags of hemoglobin

Anucleate (no nucleus) Contain very few organelles No_______________ Use anaerobic glycolysis

5-6 billion RBCs per ml of blood Flexible membrane Also function to maintain osmolarity and

blood/plasma pH


5/20

5

Hemoglobin in RBCs

Hb binds strongly (but reversibly) to oxygen98.5% oxygen bound to Hb and 1.5% dissolved

in plasmaEach hemoglobin molecule has four oxygen

binding sites

Globin + 4 heme groups = 4 polypeptides andHeme = iron-containing group

_______________-containing proteinCan also bind to CO2 and H+

Formation of Erythrocytes

Mature RBCs are unable to divide, grow, or synthesize proteinsWear out in 100 to 120 daysWhen worn out, RBCs are eliminated by phagocytes in the spleen or

liver

Lost cells are replaced by division of hemocytoblasts in the red bonemarrow

Iron is a component of_______________Normal hemoglobin content of blood

Men: 13 18 gram /dL Women: 12 16 gram /dL

Control of Erythrocyte Production

Rate is controlled by a hormone (_______________) Kidneys produce most erythropoietin as a response to reduced

oxygen levels in the blood

Homeostasis is maintained by negative feedback from blood oxygenlevels


6/20

6

Control of Erythrocyte Production

Reduced O2

levels in blood

Stimulus: DecreasedRBC count, decreased

availability of O2 to

blood, or increased

tissue demands for O2Increased

O2- carrying

ability of blood

Kidney releases

erythropoietinEnhanced

erythropoiesis

Red bone

marrow

More

RBCs

Normal blood oxygen levels 100 mmHg

Imbalance

Imbalance

Erythropoietinstimulates

60 mmHg

Hemoglobin in RBCs

Homeostatic imbalance of RBCs Anemia is a decrease in the oxygen-carrying ability of the blood

Sickle cell anemia (SCA) results from abnormally shapedhemoglobin due to gene mutation on the Beta subunit of HB

_______________is an excessive or abnormal increase in thenumber of erythrocytes

Anemia: Decrease in the oxygen-carryingcapacity of blood

Dietary _______________ Iron: iron-deficiency anemia Pernicious: lack of Vitamin B12

Hemorrhagic anemia: bleedingHemolytic anemia

Malaria or Sickle cell anemiaAplastic anemia: bone marrow

defectRenal anemia: kidney disease


7/20

7

Anemia

Leukocytes (white blood cells)

Leukocytes (white blood cells orWBCs)

Crucial in the bodys defenseagainst disease

These are complete cells, with anucleus and organelles

Able to move into and out of bloodvessels (diapedesis)

Can move by_______________motion

Can respond to chemicals releasedby damaged tissues (cytokines)

4,000 to 11,000 WBC per cubicmillimeter (microliter) of blood


8/20

8

Types of Leukocytes

Two Major Classes of Leukocytes

Granulocytes Granules in their cytoplasm can be stained Possess lobed nuclei Include 1)neutrophils, 2)eosinophils, and 3)basophilsAgranulocytes Lack visible cytoplasmic granulesNuclei are spherical, oval,

or kidney-shaped

Include:1) _______________

2)monocytes

Abundance of Leukocytes

List of the WBCs from most toleast abundant

Neutrophils Lymphocytes Monocytes Eosinophils Basophils

Easy way to rememberthis list

Never Let Monkeys Eat Bananas

Leukocytes: Granulocytes

Types of granulocytes_______________Multilobed nucleus with fine granules

Act as phagocytes at active sites of infection Eosinophils

Large brick-red cytoplasmic granules Found in response to allergies and parasitic worms

Basophils Have histamine-containing granules Initiate inflammation


9/20

9

Leukocytes: Agranulocytes

Types of agranulocytes_____________________

Nucleus fills most of the cell Play an important role in the immune response

Monocytes Largest of the white blood cells Function as macrophages Important in fighting chronic infection

Granulocyte: Neutrophils

40-70% of leukocytes in blood Phagocyte Secretes _________________ Circulate in blood 7-10 hours Migrate to tissues for a few days Increase in number during infections

Granulocyte: Eosinophils

1-4% of __________________ Phagocytes (but not main mechanism of action) Defend against parasitic invaders (e.g. worms) Granules contain toxic molecules that attack parasites


10/20

10

Granulocyte: Basophils


11/20

11

Lymphocytes: B Cells

B cells associated with antibodies2 major classes of B cells:

1)effector B cells become__________ cells and secrete

antibodies

2) memory B cells

B cell contacts antigen thenbecome a plasma cell

Plasma cell secretes antibodies(immunoglobulins)

Antibodies mark invaders fordestruction

Lymphocytes: T Cells

Helper T Cells secrete cytokines that enhance activity of B cells andother T cells enhances activity of macrophages and NK cells

Cytotoxic T Cells kill virus-infected cells, abnormal cells, and bacteria,Secretory products form pores in target cell membrane, Kills cells bylysis

Memory T cells used for _______________ infectionSuppressor (regulatory) T Cells secrete cytokines that suppress activity

of B cells and other T cells and used to end an immune response

Lymphocytes: Natural Killer Cells(Null Cells)

Recognize abnormal or infected cellscause lysis by secreting perforins

Can attack virus-infected cells withoutidentifying virus

Early defense against viral infections Cause lysisFast acting early immune response_______=major histocompatibility

complex

(a) Inhibitory NK cell receptors recognize self MHC class I and restrain NK cellactivation.

(b) When unimpeded by the inhibitory receptors, binding of NK cell activationreceptors to their ligands on target cells results in NK cell stimulation.


12/20

12

Leukocyte Issues

Abnormal numbers of leukocytes____________________

WBC count above 11,000 leukocytes/mm3 Generally indicates an infection

Leukopenia Abnormally low leukocyte level Commonly caused by certain drugs such as corticosteroids

and anticancer agents Leukemia occurs when bone marrow

becomes cancerous, turns out excess

WBC

Platelets

Platelets (a.k.a. thrombocytes) Derived from ruptured multinucleate cells

(_____________________)

Needed for the clotting processNormal platelet count = 300,000/mm3(l)

Characteristics of Formed Elementsof the Blood


13/20

13

Characteristics of Formed Elementsof the Blood

Hematopoiesis

Blood cell formation Occurs in red bone marrow All blood cells are derived from

a common stem cell

(________________)

Hemocytoblast differentiationLymphoid stem (lymphoblast)

cell produces lymphocytes

Myeloid stem (myeloblast) cellproduces all other formed

elements

Erythrocyte synthesisstimulated by erythropoietin

secreted from kidneys under

conditions of low oxygen levels

in blood flowing to kidneys

monocyte

Formation of White Blood Cells andPlatelets

Controlled by _____________ Colony stimulating factors (CSFs) and interleukins

prompt bone marrow to generate leukocytes

Thrombopoietin stimulates production of platelets


14/20

14

Hemostasis

Stoppage of bleeding resulting from abreak in a blood vessel

Hemostasis involves three phases1) __________________Vasoconstriction causes blood vessel to

spasm

Spasms narrow the blood vessel,decreasing blood loss

2) Platelet plug formation

Collagen fibers are exposed by a breakin a blood vessel a platelets become

sticky and cling to fibers

Anchored platelets release chemicalsto attract more platelets

Platelets pile up to form a platelet plug3) Coagulation (blood clotting)

Platelet Components

Platelet Plug needed forformation of a Blood Clot

____________Cell fragments

no nucleus has organelles & granules

100,000 500,000 / mL blood

Damagedtissue

Healthytissue

Preventing the Spread of Plug

Chemicals that prevent platelet aggregation: Prostacyclin (PGI2) - produced

in healthy endothelial cellsNitric oxide released by

healthy endothelial cells CD39 is an integral membraneprotein that keeps ADP levels

_______________

5 factors that activate a plateletplug are highlighted


15/20

15

Aspirin

Prevents platelet_______________ Inhibits the activation of thromboxane A2

Hemostasis

_______________ Injured tissues release tissue factor (TF) PF3 (a phospholipid) interacts with TF, blood protein clotting

factors, and calcium ions to trigger a clotting cascade Prothrombin activator converts prothrombin to thrombin (an

enzyme) Thrombin joins fibrinogen proteins into hair-like molecules of

insoluble fibrin Fibrin forms a meshwork

(the basis for a clot)Blood usually clots within

3 to 6 minutesThe clot remains as

endothelium regeneratesThe clot is broken down

after tissue repair

Intrinsic and Extrinsic CoagulationPathways

Intrinsic Pathway

trigger = exposed collagen

Extrinsic Pathway

Requires Tissue Factor III


16/20

16

Role of Thrombin in Blood Clotting

Clot Formation

Fibrinogen

_______________

(mesh)

(Fibrin clot = blood

clot)

Plasminogen

Plasmin

Dissolves Clot

Dissolving a Clot

Requires another cascade initiated by exposure of_______________

plasminogen activators


17/20

17

Undesirable Clotting

Thrombus A clot in an unbroken blood vessel Can be deadly in areas like the

heart

_______________ A thrombus that breaks away and

floats freely in the bloodstream

Can later clog vessels in criticalareas such as the brain

Role of Coagulation Factors in ClotFormation Disorders

_______________: a group of geneticdisorders caused by deficiency of gene

for specific coagulation factors

Von Willebrands disease: reducedlevels of vWf and decreases platelet

plug formation

Vitamin K deficiencies cause decreasedsynthesis of clotting factors

Thrombocytopenia Platelet deficiency Even normal movements can cause

bleeding from small blood vessels

that require platelets for clotting

Blood Groups and Transfusions

Large losses of blood have serious consequences Loss of 1530% causes_______________ Loss of over 30% causes shock, which can be fatal

Transfusions are the only way to replace blood quicklyTransfused blood must be of the same or compatible blood group(s)


18/20

18

Human Blood Groups

Blood contains_______________determined proteins

Antigens (a substance the bodyrecognizes as foreign) may beattacked by the immune system

Antibodies are the recognizers thatattack foreign cells

Blood is typed by using antibodiesthat will cause blood with certain

proteins to clump (agglutination)

There are over 30 common red bloodcell antigens

The most vigorous transfusionreactions are caused by ABO and Rhblood group antigens

ABO Blood Groups

AB+

O-


19/20

19

ABO Blood Groups

Blood type AB can receive A, B, AB, and Oblood, so AB+ is the universal recipient

Blood type B can receive Band O blood

Blood type A can receiveA and O blood

Blood type O can receive O blood, soO- is the universal donor

Blood types: _______________

Due to antigens on surface of RBCs Type A A antigens, anti-B antibodies Type B B antigens, anti-A antibodies Type AB A and B antigens, no A or B

antibodies

Type O no modified antigens, anti-A andanti B antibodies

Blood Typing

Blood samples are mixed with anti-Aand anti-B serum

Agglutination or no agglutinationleads to determining blood type

Typing for ABO and Rh factors isdone in the same manner

Cross matchingtesting foragglutination of donor RBCs by therecipients serum, and vice versa

Rh Blood Groups

Named because of the presence or absence of one of eightRh antigens (agglutinogen D) that was originally definedin Rhesus monkeys

Most Americans are Rh+ (Rh positive)Problems can occur in mixing Rh+ blood into a body with

Rh(_______________) blood


20/20

20

Rh Dangers During Pregnancy:Erythroblastosis fetalis, Rhesus disease

The mismatch of an Rhmother carrying an Rh+ baby can causeproblems for the unborn child

The first pregnancy usually proceeds without problems The immune system is sensitized after the first pregnancy In a second pregnancy, the mothers immune system produces

antibodies to attack the Rh+ blood (hemolytic disease of thenewborn)

Danger occurs only when themother is Rhand the fatheris Rh+, and the child inheritsthe Rh+ factor

A_______________shot can preventbuildup of anti-Rh+ antibodiesin mothers blood

blood and clotting slides

Documents