Blood

B. Pimentel, M.D.
University Of Makati – College of Nursing
Functions

1. Transport of gases, nutrients, and waste products.

2. Transport of processed molecules.
3. Transport of regulatory molecules.
4. Regulation of pH and osmosis.
5. Maintenance of body temperature.
6. Protection against foreign substances.
7. Clot formation.
Composition

 Total blood volume in adult is 4-5L in females and 5-6L for

males
 It is a connective tissue that consists of cells and cell fragments
surrounded by a fluid matrix

 Formed elements, cells and cell fragments

 Plasma, liquid matrix
 Pale yellow fluid, 91 % water, 7% protein and 2% other
solutes
Plasma

Plasma Components Function

Water Solvent
Plasma Proteins
Albumin Blood viscosity & osmotic
pressure
Transport lipids, hormones &
Globulins Fe; antibodies and
complements.
Fibrinogen Clotting
Ions
Na, K, Mg, Cl, Fe Osmosis, membrane potentials,
pH.
Plasma
Nutrients
Glucose, amino acids, Energy and building blocks of
triacylglycerol, cholesterol molecules.
Vitamins Promote enzyme activity
Waste Products
Urea, uric acid, creatinine, Catabolic products of protein
ammonia salts metabolism, excreted by
kidneys
Bilirubin Catabolic product of RBC's,
excreted as bile.
Lactic acid End product of anaerobic
respiration, converted to
glucose by the liver
Plasma

Gases
Aerobic respiration, terminal
Oxygen
electron carrier in electron
transport chain
Carbon dioxide Waste product of aerobic
respiration, helps buffer
blood.
Nitrogen Inert

Regulatory Enzymes, hormones

Erythrocytes (RBC)

 95% of formed elements of

blood

 Biconcave discs approx. 7.5-

micrometer diameter

 Able to flexible and bend

 Rouleaux formation

 Anucleated and most organelles

absent in mature stage
Erythrocytes (RBC)
Erythrocytes (RBC)

 Life span of an RBC = ± 120 days

 Make up 1/3 of all cells in human body = ±2.5 trillion in healthy

adult

 ± 1 % of RBC replaced each day → ± 2-3 million new RBC per

second enter circulation

 Function - transports oxygen from lungs to tissues, and

transports carbon dioxide from tissues to lungs.

 Hemoglobin - iron containing pigmented protein.

Erythrocytes (RBC) & Hemoglobin

 Transports oxygen, called oxyhemoglobin, when it gives up its

oxygen it is deoxyhemoglobin.

 Also binds and transports carbon dioxide,

carbaminohemoglobin.

 Makes up ± 97 % of RBC → ± 250 million Hb molecules per

RBC

 Men: 14-18 mg/dl blood

 Women: 12-16 mg/dl blood

Iron and Hb

 ± 80% of iron in body is complexed to Hb; some in myoglobin

and plasma (transferrin); ± 20% stored in BM, liver (ferritin),
spleen, and other organs
 Iron from diet:
1. Red meats
2. Absorbed in small intestine
3. Excess is excreted
ERYTHROPOIESIS

The process by which red blood cells (RBC) are produced.

The process of cell division requires vit. B12 and folate necessary of
DNA synthesis

Three distinct phases:

1. Immature erythrocyte prepares to synthesize hemoglobin
(Hg) by producing huge numbers of ribosomes.
2. Hemoglobin is synthesized and accumulates in the cell's
cytoplasm.
3. The erythrocyte ejects its nucleus and most of its
organelles.
ERYTHROPOIESIS

 Reticulocytes are releases from the bone marrow into circulating

blood, consisting of 1 to 3% of the formed elements
 In 24 to 48 hrs it mature to an erythrocyte
Regulation

 Low blood oxygen levels stimulate RBC development by

increasing the formation of erythropoietin a hormone produced
by the kidneys
 Erythropoietin stimulates red bone marrow to produce more RBC's
by increasing the number of proerythroblasts

 Eventually RBC's will rupture or lyse

 Macrophages located in the spleen, liver, and lymphatic tissue
takes up hemoglobin releases from the RBC's.
 Hemoglobin is catabolized by the macrophages into amino acids,
iron and heme molecules.
Regulation

 The heme molecules are converted to biliverdin and then to

bilirubin and released into the plasma. In the plasma the
bilirubin is bound to albumin and transported to the liver. It is
then conjugated to glucuronic acid, which is more water-
soluble.

 The conjugated bilirubin is converted to bile, and is secreted into

the small intestines.
Regulation (Life Cycle)
LEUKOCYTES (WBC)

 Collectively known as White Blood Cells (WBC)

 Formed elements of the blood with organelles and a nucleus but

lack hemoglobin

 Protect the body against microorganisms and remove dead cells

and debris from the body.
LEUKOCYTES (WBC)

 Ameboid Movement - WBC's exhibit motility, by moving similar

to an ameba, putting out irregular cytoplasmic projections.

 Diapedesis - WBC's enter tissues by elongating and thinning to

slip between cells of the vessel walls.

 Chemotaxis - attraction of WBC's to dead or foreign matter

Platelets (Thrombocytes)

 Minute fragment of cells consisting of small amount of

cytoplasm, surrounded by a cell membrane

 Produced in the bone marrow from megakaryocytes which

fragments and enter the circulation as platelets
 Important role in clot formation
 Platelet plug formation
 Clot formation
HEMOSTASIS

The arrest of bleeding or hemorrhage

Three steps
A. Vascular spasm - immediate but temporary constriction of a
blood vessel in response to damage. Constriction can be
complete to partial reduction in flow, dependent on size of
vessel. Response triggered by prostaglandins released from
vascular endothelial cells and from platelets releasing
thromboxanes.
HEMOSTASIS

B. Platelet plug formation - an accumulation of platelets that can

seal up small breaks in blood vessels. This occurs many times
each day in a normal healthy individual. Platelet plug formation
consists of a series of steps.
 Platelet adhesion - platelets bind to collagen exposed by blood
vessel damage, mediated through von Willebrand factor ( a protein
produced and secreted by blood vessel endothelial.
 Platelet release reaction - once platelets are adhered to collagen
they activate. ADP, thromboxanes, and other chemicals are
extruded from platelets by exocytosis. This stimulates other
platelets to adhere and become activated.
HEMOSTASIS

 Platelet aggregation - as platelets become activated they

express a surface protein which binds to fibrinogen.
Fibrinogen forms a bridge between the surface receptors of
different platelets, resulting in the formation of a platelet
plug.

C. Coagulation - when a blood vessel is severely damaged

coagulation or blood clotting results in the formation of a clot.
the formation of a blood clot is dependent on coagulation
factors.
HEMOSTASIS
Coagulation Cascade: Intrinsic and Extrinsic Pathways

Extrinsic Pathway

 Begins with chemicals that are outside or extrinsic to the blood.

Damaged tissue releases thromboplastin also known as tissue
factor (TF) or factor III. Thromboplastin, in the presence of
calcium, forms a complex with factor VII, which activates factor
X. On the surface of the platelets activated factor X, factor V,
platelet phospholipids, and calcium form prothrombinase.
Coagulation Cascade: Intrinsic and Extrinsic Pathways

Extrinsic Pathway

 Prothrombinase converts the soluble prothrombin into enzyme

thrombin.

 Thrombin converts soluble fibrinogen into the insoluble protein

fibrin. Fibrin forms the fibrous network of the clot. Thrombin
also stimulates factor XIII activation, which is necessary to
stabilize the clot.
Coagulation Cascade: Intrinsic and Extrinsic Pathways

Intrinsic Pathway

 Begins with chemicals that are intrinsic or inside the blood.

Damage to the endothelial lining exposes collagen fibrils. When
plasma factor XII comes into contact with collagen, factor XII is
activated and it stimulates factor XI, which in turn activates
factor IX. Activated factor IX joins with factor VIII, platelet
phospholipids and calcium to activate factor X. On the surface
of platelets, activated factor X, factor V, platelet phospholipids
and calcium complex to form thrombinase
Coagulation
Cascade
Clot Retraction and Dissolution

Once a clot has formed it begins to condense into a compact

structure. Platelets contain actin and myosin, which contract on
the fibrin, and condense the clot.

Fibroblasts move into the area to make new connective tissue, in

addition epithelial cells proliferate and fill in the damaged area.

Fibrinolysis - clot is dissolved within a few days by the activity of

plasmin.
Regulation of Clot Formation

Anticoagulants - prevent clotting factors from initiating a clot

formation.

Examples:
Antithrombin - plasma protein produced by the liver, slowly
inactivates thrombin.
Heparin - produced by basophils and endothelial cells, increases
the effectiveness of antithrombin because heparin and
antithrombin rapidly inactivate thrombin.
Prostacyclin - produced by endothelial cells. It counteracts the
effects of thrombin by causing vasodilatation and by inhibiting
the release of coagulation factors
BLOOD GROUPING

Transfusion - the transfer of blood or blood components from one

individual to another.

Infusion - introduction of a fluid other than blood, such as saline or

glucose solution into the blood.

Antigens - molecules on the surface of RBC's.

Antibody - part of the immune system, recognizes foreign antigens

and binds to them. This binding can inactivate the antigen,
cause agglutination - clumping of cells, or cause hemolysis -
rupture of RBC's.
BLOOD GROUPING

ABO Blood Grouping

Blood Antigen Antibody Donor to Recipient

group from
A A Anti-B A A, O

B B Anti-A B B, O

AB AB Neither AB A, B, AB, O

O Neither Anti-A/Anti-B O, A, B, AB O

Universal donor "O"

Universal recipient "AB"
Rh Blood Group

Rh positive if they have certain Rh antigens on RBC

surface.
Rh negative if they do not have antigen on RBC
surface.
PLEASE DONATE BLOOD!
fin