BLOOD

Blood is the “river of life” that surges within us. It transports

everything that must be carried from one place to another within
the body- nutrients, wastes (headed for elimination from the body)
and body heat through blood vessels. Long before modern
medicine, blood was viewed as magical, because when it drained

BLOOD
from the body, life departed as well.
Instructor: Catherine F. Tambis, RN, MAN
 BLOOD

Blood is the “river of life” that surges within us. It transports

everything that must be carried from one place to another within
the body- nutrients, wastes (headed for elimination from the body)
and body heat through blood vessels. Long before modern
medicine, blood was viewed as magical, because when it drained
from the body, life departed as well.
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1. Transportation
 Transport gases,
nutrients, and 2. Regulation
waste products • Maintain
osmosis 3. Protection
 Transport  WBC protects
processed  Adjusts and against disease
molecules maintains body
temperature  Performs
 Transport of haemostasis
regulatory  Regulates pH
molecules
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Physical Characteristics and Volume
Blood is a sticky, opaque fluid with a characteristic metallic taste.

• Color: Depending on the amount of oxygen it is carrying, the color of blood varies

from scarlet (oxygen-rich) to a dull red (oxygen-poor).

• Weight: Blood is heavier than water and about five times thicker, or more viscous,

largely because of its formed elements.

• pH: Blood is slightly alkaline, with a pH between 7.35 and 7.45.

• Temperature: Its temperature (38 degrees Celsius, or 100.4 degrees Fahrenheit) is

always slightly higher than body temperature.

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Components of Blood
 Essentially, blood is a complex connective tissue in which living blood cells, the formed
elements, are suspended.
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A. Plasma
 Plasma makes up 55% of whole blood.

 It is the liquid part of the blood and is pale

yellow in colour/straw transparent fluid.

 Made up mostly of water, about 90%.

 Dissolved substances including: plasma

proteins, inorganic salts, nutrients, waste
materials, hormones, gases.
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A. Plasma
 Functions:

a. It is used to transport nutrients (sugars), salts (electrolytes), respiratory gases,

hormones, plasma proteins, and various wastes and products of cell
metabolism.

b. It helps to distribute body heat evenly throughout the body.

 Plasma proteins are the most abundant solutes in plasma; make up about 7% of
plasma; normally retained within the blood.
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A. Plasma

 Plasma proteins
a) Albumin - contributes to the osmotic pressure of blood, which acts to keep
water in the bloodstream; act as carrier molecules for lipids and steroid
hormones.

b) Globulins – formed in the liver and the remainder in lymphoid tissue; function as
antibodies (immunoglobulins), transport of some hormones and mineral salts.

c) Clotting factors – substances essential for blood coagulation.

Fibrinogen – synthesized in the liver and is necessary for blood coagulation.

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B. Formed Elements

If you observe a stained smear of human blood under a light

microscope, you will see disc-shaped red blood cells, a variety of gaudily
stained spherical white blood cells, and some scattered platelets that
look like debris.

1. Red Blood Cells (Erythrocytes)

2. White Blood Cells (Leukocytes)

3. Platelets (Thrombocytes)
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B. Formed Elements

1. Red Blood Cells (Erythrocytes)

 Function primarily to carry oxygen in blood to all cells of the body.

 RBCs contain the iron-rich protein called hemoglobin, which transports the
bulk of oxygen that is carried in the blood; give blood its RED colour.
 A single RBC contains about 250 million of hemoglobin molecules.

 RBCs differ from other blood cells because they are anucleate, that is,
they lack a nucleus; they also contain a very few organelles.
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B. Formed Elements

1. Red Blood Cells (Erythrocytes)

 Microscopic appearance: Erythrocytes are small, flexible cells shaped like

biconcave discs- flattened discs with depressed centers on both sides

 Number of RBCs: There are normally about 5 million cells per cubic millimeter

of blood; When the number of RBCs/mm3 increases, blood viscosity increases.

 Normal blood: Clinically, normal blood contains 12-18 grams of hemoglobin per

100 milliliters (ml); the hemoglobin content is slightly higher in men (13-18 g/dl)

than in women (12-16 g/dl).

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Hematopoiesis (Blood Cell Formation)
• Blood cell formation, or hematopoiesis, occurs in red bone marrow, or
myeloid tissue.

• In adults, this tissue is found mainly in the flat bones of the skull, pelvis, ribs,
sternum, humerus and femur.

• All the formed elements arise from a common type of stem cell, the
hemocytoblast.

• The hemocytoblast forms two types of descendants- the lymphoid stem

cell, which produces lymphocytes, and the myeloid stem cell, which can
produce all other classes of formed elements.
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Formation of Red Blood Cells
• Because they are anucleate, RBCs are unable to synthesize proteins, grow, or divide.

• Life span: As they age, RBCs become more rigid and begin to fragment, or fall apart, in
100 to 120 days.

• Lost RBCs: Lost cells are replaced more or less continuously by the division of
hemocytoblasts in the red bone marrow.

• Immature RBCs: Developing RBCs divide many times and then begin synthesizing huge
amounts of hemoglobin.

• Suddenly, when enough hemoglobin has been accumulated, the nucleus and most
organelles are ejected and the cell collapses inward; the result is the young RBC, called
a reticulocyte because it still contains some rough endoplasmic reticulum (ER).
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Formation of Red Blood Cells
• Mature erythrocytes: Within 2 days of release, they have rejected the
remaining ER and have become fully functioning erythrocytes; the entire
developmental process from hemocytoblast to mature RBC takes 3 to 5 days.

• The rate of erythrocyte production is controlled by a hormone called

erythropoietin; normally a small amount of erythropoietin circulates in the
blood at all times, and red blood cells are formed at a fairly constant rate.

• Control of RBC production: An important point to remember is that it is not the

relative number of RBCS in the blood that controls RBC production; control is
based on their ability to transport enough oxygen to meet the body’s demands.
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What depresses
erythropoietin release
and RBC production?

• Over abundance of
erythrocytes

• Excessive amount
of oxygen
 BLOOD GROUPS
HUMAN BLOOD GROUPS
 Blood loss of 15 – 30% can be fatal.

 Blood saves lives but incompatible or mismatched blood can also be fatal.

 Antigen is a substance that the recognizes as foreign; it stimulates the immune

system to release antibodies for defense.

 Agglutination is the binding of the antibodies to RBCs antigen which lead to

clogging of small blood vessels throughout the body.

 Agglutinogens are RBC antigens that promote clumping; agglutinins refer to

antibodies that bind them together.

 ABO Blood group are based on two antigens, type A or type B, a person inherits.
 BLOOD GROUPS
HUMAN BLOOD GROUPS
Blood Type RBC Antigen Antibody Blood type that
can be received
A A antigen Anti-B A, O
B B antigen Anti-A B, O
AB A & B antigen None A,B, AB, O
O None Anti-A & Anti-B O

• Blood type AB is a universal recipient

• Blood type O is a universal donor
* AO most common incompatible blood
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B. without Agglutination
A. with
Agglutination
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Rhesus (Rh) BLOOD GROUPS
 are so named because one of the eight Rh antigens (agglutinogen D) was
originally identified in Rhesus monkeys.

Rhesus Type Rh that can be received

Rh + Both Rh + and -
Rh - Rh - only

Rh - Rh + (Rh incompatibility)
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B. Formed Elements
2. White Blood Cells (Leukocytes)

 Leukocytes are colorless blood cells because it is lack of hemoglobin.

 There are 4,000 to 11,000 WBC/mm³ , and they account for less than 1 percent
of total body volume.

 They are crucial to body defense against disease.

 Leukocytes form a protective, movable army that helps defend the body
against damage by bacteria, viruses, parasites, and tumor cells.
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B. Formed Elements
2. White Blood Cells (Leukocytes)

 Types of White Blood Cells

I. Granulocytes
II. Agranulocytes
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2. White Blood Cells (Leukocytes)

I. Granulocytes (B-E-N)

They are leukocytes, with the presence of granules in their cytoplasm.

A. Basophils (20-50/mm³)

 They are the least common of the granulocytes which contain large
cytoplasmic granules.

 They secrete serotonin, histamine and heparin.

 These cells are best known for their role in asthma and their result in
inflammation and bronchoconstriction in the airways.
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2. White Blood Cells (Leukocytes)

I. Granulocytes (B-E-N)
B. Eosinophils (100-400/mm³)

 Eosinophils have blue red nucleus that resembles an old-fashioned

telephone receiver.
 These cells are present in high concentrations in the digestive tract.

 Their number increases rapidly during allergies and infections by

parasitic worms.
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2. White Blood Cells (Leukocytes)

I. Granulocytes (B-E-N)

C. Neutrophils (3000-7000/ mm³)

 Neutrophil are the most numerous of the WBCs.

 Neutrophils are the first cells of the immune system to

respond to an invader such as a bacteria or a virus.
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2. White Blood Cells (Leukocytes)

II. Agranulocytes

They are leukocytes, with the absence of granules in their cytoplasm

A. Monocytes (100-700/ mm³)

 Monocytes are the largest of the WBCs;

 They have a single bean-shaped nucleus, hence referred to as

monocytes.

 They are the garbage trucks of the immune system.

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2. White Blood Cells (Leukocytes)

II. Agranulocytes

A. Monocytes
 Functions:

 Migrate into tissues and clean up dead cells (they transform into
macrophages with huge appetites)

Protect against the bloodborne pathogens and they move very

quickly to the sites of infections in the tissues.

 Increase in number during chronic infections such as TB

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2. White Blood Cells (Leukocytes)

II. Agranulocytes

B. Lymphocytes (1500-3000/ mm³)

 Lymphocytes have a large, dark purple nucleus that occupies

most of the cell volume

 They tend to take up residence in lymphatic tissues, where they

play an important role in the immune response.

 Involved in graft rejection, fighting tumors and viruses

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B. Formed Elements

3. Platelets (250,000-450,000)

 Platelets are not cells in the strict sense.

 They are fragments of bizarre multinucleate cells called megakaryocytes,

which pinch off thousands of anucleate platelet “pieces” that quickly seal

themselves off from surrounding fluids.

 Platelets are needed for the clotting process that occurs in plasma when blood

vessels are ruptured or broken.

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Hemostasis
 Is a process which causes bleeding to stop, to keep blood within a
damaged blood vessel.
 The opposite of hemostasis is hemorrhage.

FOUR STEPS:

1. Vascular spasm (vasoconstriction)

2. Platelet plug formation

3. Clot formation (blood clotting)

4. Clot retraction/Fibrinolysis
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Hemostasis
1. The immediate response to blood vessel injury is vasoconstriction, which
causes that blood vessel to go into spasms; the spasms narrow the blood vessel,
decreasing blood loss until clotting can occur.

2. Injury to the lining of vessels exposes collage fibers; platelets adhere to the
damaged site and platelet plug or white thrombus forms.

3. At the same time, the injured tissues are releasing thromboplastin, a substance
that plays an important role in clotting.

4. PF3, a phospholipid that coats the surfaces of the platelets, interacts with Tissue
Factor, vitamin K, and other blood clotting factors to form an activator that triggers
clotting cascade.
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Hemostasis
5. This prothrombin activator converts prothrombin to thrombin (an enzyme).

6. Thrombin then joins soluble fibrinogen proteins into long, hairlike

molecules of insoluble fibrin, which forms the meshwork that traps RBCs
and forms the basis of the clot; within the hour, the clot begins to retract,
squeezing serum from the mass and pulling the ruptured edges of the blood
vessel closer together.

* Normally, blood clots within 3-6 minutes. Once the clotting cascade has
started, the triggering factors are rapidly inactivated to prevent widespread
clotting (solid blood).
CLOTTING PROCESS
 CLOTTING FACTORS

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Source: https://medizzy.com/
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