I. Blood (5 liters)

A. Definition
1. Opaque red liquid connective tissue consisting of microscopically visible, formed elements (erythrocytes, leukocytes, platelets) suspended in an fluid called plasma.

B. Composition
1. 55% plasma
2. 45% formed elements

C. Functions
1. Transport
a. Nutrients
b. Respiratory gases
c. Wastes
d. Hormones
2. Regulatory
a. Body temperature
b. pH
3. Protective
a. Clot formation
b. Nonspecific immunity
c. Specific immunity

II. Blood Cells

A. Erythrocytes (RBCs)
1. Physical characteristics
a. Biconcave disc
b. 7.2 um diameter and anucleate
i. Squeezes through capillaries



c. Stimulators of RBC production
i. Occurs in bone marrow
ii. Stimulated by:
(a) Testosterone

d. Dietary factors for RBC production
i. Folic acid
ii. Vitamin B12
iii. Iron for hemoglobin
iv. Protein for globin subunits

e. RBC destruction (pg ________ in Lec notebook)
i. Spleen and liver remove dead RBCs
ii. Salvage iron and protein
iii. Remainder becomes bilirubin
iv. Liver incorporates it into bile
v. Secreted into intestine
vi. Some lost with feces

2. Count and hematocrit
a. Count: # RBCs/ul blood
b. Hematocrit

3. Hemoglobin (Hb) and iron
a. Hb structure
b. Hb content of blood (gm/dl)

4. Oxygen-carrying capacity of whole blood
a. Def: amount of oxygen transported in 100 ml of blood
b. O2-carrying capacity

(15 gm Hb/dl) x (1.34 ml oxygen/gm Hb)= 20.1 ml O2/dl


c. Normal: 16-25 ml O2/dl


5. Anemia
1) Due to:
a) Decrease in RBC #
b) Decrease in Hb content
c) Decrease in both

2) Changes in RBCs
a) Microcytic
b) Macrocytic
c) Hypochromic
d) Hyperchromic
e) Poiklocytosis

b. Symptoms and types of anemia
1) Symptoms
2) Types
a) Iron-deficiency anemia
1) What is it?
2) RBCs shape

b) Pernicious anemia
1) Intrinsic Factor
2) Maturation
3) RBCs shape



c) Aplastic anemia
d) Hemolytic anemia
e) Thalassemia
f) Hemorrhagic anemia



6. Polycythemia
a. Definition
a) Erythrocytosis

b. Relative polycythemia
c. Polycythemia vera
d. Physiological polycythemia

B. Leukocytes (WBCs)
1. General Leukocyte function
a. Diapedesis:
c. Phagocytosis:
d. Secretion:
1) monocytes or macrophages
2) helper T cells

2. Major Types and Counts
a. Neutrophils (50-70%)
1) Functions

2) Characteristics:
a) Phagocytosis
b) Chemotaxic
c) Diepidesis


b. Eosinophils (1-5%)
1) Antigen Presentation
2) Attack mechanisms
3) Eosinophilia



c. Basophil (Less than 1%)
1) Produce heparin
2) Produce histamine



d. Monocyte (1-6%)
1) Antigen Presentation
2) Secretion



e. Lymphocytes (20-40%)
1) B cells: Antibody-Mediated Immune Response
b. plasma cell (2000/sec 4-5 days)
c. Antibodies tags

2) T cells: Evidence for 3 types
a) Cytotoxic T cells
b) Helper T cells
1. HIV



c) Suppressor T cells



f. Leukocytosis
a. Physiological
b. Pathological
1) Leukemia
2) Leukopenia
a. Immune responses
Nonspecific:
1. Neutrophils
2. Natural killer cells
3. Local inflammatory response

Specific

C. Platelets

III. Plasma (55%)

A. Plasma vs. serum
1. Plasma
2. Serum

B. Physical characteristics
C. Chemical composition
1. H2O
2. Solutes
a. Electrolytes:
b. Plasma proteins
1)Functions
c. Hormones
d. Amino acids
e. Blood coagulation

2) Specific proteins
a) Albumin (60%)
b) Globulins (36%)
c) Fibrinogen (4%)

c. Nutrients

3. Respiratory gases
4. Hormones

IV. Hemostasis

A. Definition:
B. Coagulation
***Note: all stages require calcium***
1. Stage I
1) Extrinsic
2) Intrinsic


2. Stage II:
3. Stage III:C. Anti-coagulants and Clot Busters
1. Clots
2. Anti-coagulants
3. Thrombocytopenia

V. Blood Groups

A. Antigen vs. Antibody
1. Antigen
a. RBC marker



2. Antibody
a. Preformed antibodies

3. Agglutination
a. May cause the foreign RBCs to clump



B. ABO Blood Groups

D. Major vs. Minor agglutination
1. Major
2. Minor

E. Erythroblastosis Foetalis
1. Mom has Rh- blood but has not been exposed to Rh+ blood
a. Her blood contains RBCs with no D marker no and anti-D antibodies
2. During her first pregnancy, the fetus has Rh+ blood so the RBCs have a D marker
3. During the delivery, the mom is exposed to the fetal blood (D markers), so the mom's body makes anti-D antibodies.
4. During the second pregnancey, if this fetus has Rh+ blood, the anti-D antibodies from the mom can cross the placenta and bind to the D marker on the RBCs of the fetus causing RBC agglutination (clumping).
5. Avoid: mom receives RhoGam twice during each pregnancy and within 72 hours after delivery
a. RhoGam interferes with the ability of the mom's body to make anti-D antibodies