ANATOMOY AND PHYSIOLOGY

CHAPTER 11: BLOOD  Certain cells and chemicals in the blood form a
vital part of the immune system.
11.1 FUNCTIONS OF BLOOD  They protect against pathogens, including
microorganisms, and some toxins.
DEFINITION: Blood - Blood is a vital bodily fluid
7. CLOT FORMATION:
that circulates through the cardiovascular system,
serving various essential functions in maintaining  Blood clotting is activated when blood vessels
the body's health and equilibrium. are damaged.
 Clotting prevents excessive blood loss.
Functions of Blood:  Blood clots formed also initiate tissue repair and
1. TRANSPORT OF GASES, NUTRIENTS, AND the restoration of normal function after tissue
WASTE PRODUCTS: damage.
 Blood acts as a major transport medium in the
body.
 Oxygen is absorbed into the blood in the lungs 11.2 COMPOSITION OF BLOOD
and delivered to cells. BLOOD: Blood is a type of connective tissue
 Carbon dioxide, a waste product of cells, is consisting of a liquid matrix called plasma, which
carried in the blood to the lungs for removal. contains cells and cell fragments known as formed
 Blood transports ingested nutrients, ions, and elements.
water from the digestive tract to cells.
 Waste products of cell metabolism are BLOOD COMPOSITION:
transported to the kidneys for elimination.  Plasma:
2. TRANSPORT OF PROCESSED - Liquid matrix of blood.
MOLECULES: - Accounts for approximately 55% of total blood
 Some substances undergo processing at various volume.
body locations.  Formed Elements:
 For example, vitamin D precursor is produced in - Cells and cell fragments found in blood.
the skin, transported by blood to the liver and - Account for approximately 45% of total blood
kidneys for activation, and then to the small volume.
intestine to promote calcium absorption.  Blood Volume:
 Lactate, produced by muscles during anaerobic - Average Adult Female:
respiration, is carried to the liver and converted  Total blood volume: Approximately 4–5
into glucose. liters (L).
3. TRANSPORT OF REGULATORY - Average Adult Male:
MOLECULES:  Total blood volume: Approximately 5–6
 Blood carries hormones and enzymes that liters (L).
regulate various body processes from one part of  Blood Percentage in Total Body Weight:
the body to another. - Blood makes up approximately 8% of the total
4. REGULATION OF PH AND OSMOSIS: body weight.
 Blood contains buffers to maintain its pH within
the normal range of 7.35–7.45.
 Osmotic composition of blood is crucial for 11.3 PLASMA
maintaining fluid and ion balance in the body.
5. MAINTENANCE OF BODY PLASMA:
TEMPERATURE:
 Definition: A pale yellow fluid.
 Blood helps regulate body temperature.
 Composition:
 Metabolically active areas generate heat, which  About 91% water.
warms the blood.  7% proteins.
 Warm blood is transported from the body's  2% other components, including ions, nutrients,
interior to the surface, where heat is released, gases, waste products, and regulatory
contributing to temperature regulation. substances.
6. PROTECTION AGAINST FOREIGN
SUBSTANCES: PLASMA PROTEINS:
 Definition: Proteins dissolved in plasma.
 ANATOMOY AND PHYSIOLOGY
TYPES:  Specific growth factors regulate the
development of different formed elements.
 ALBUMIN: Makes up 58% of plasma proteins.
Contributes to osmotic pressure and water RED BLOOD CELLS (RBCS):
balance. It attracts water.
 Normal RBCs are biconcave disk-shaped cells.
 GLOBULINS: Account for 38% of plasma
 Lack nuclei and most organelles, making them
proteins. Some are part of the immune system
unable to divide.
(e.g., antibodies and complement) and function
 Live for about 120 days in males and 110 days
as transport molecules.
in females.
 FIBRINOGEN: Constitutes 4% of plasma
 1/3 of their volume is hemoglobin, responsible
proteins. A clotting factor that converts to fibrin
for their red color.
for blood clot formation.
 Primary functions:
SERUM: - Transport O2 from the lungs to tissues.
- Assist in transporting CO2 from tissues to
 Definition: Plasma without clotting factors.
the lungs.
PLASMA VOLUME AND COMPOSITION:  Hemoglobin consists of four protein chains
(globins) and four heme groups.
 Normally constant due to a balance between
 Hemoglobin binds O2 in the lungs and releases
intake and loss of water.
it in tissues.
 Water intake through the digestive tract matches
 Hemoglobin also binds other molecules like CO,
water loss via the kidneys, lungs, digestive tract,
affecting O2 transport.
and skin.
 Oxygen and carbon dioxide are essential blood RED BLOOD CELL PRODUCTION:
gases.
 Stimulated by low blood O2 levels.
- Oxygen enters from the lungs.
 Regulated by erythropoietin (EPO) released by
- Carbon dioxide enters from tissues.
the kidneys.
 Other substances in the blood come from
 EPO increases red blood cell production in
various organs (liver, kidneys, intestines,
response to low O2 levels.
endocrine glands) and immune tissues (lymph
 Old or damaged RBCs are removed by
nodes, spleen).
macrophages in the spleen and liver.
 Concentration of these substances is regulated
 Hemoglobin is broken down, and iron is
and maintained within narrow limits.
recycled.
WHITE BLOOD CELLS (WBCS):
11.4 FORMED ELEMENTS  Spherical cells with nuclei.
FORMED ELEMENTS OF BLOOD:  Found in the buffy coat, between plasma and
RBCs.
 Formed elements constitute 45% of total blood  Functions:
composition. 1. Protect against pathogens.
 Formed elements include: 2. Remove dead cells and debris from tissues
1. Red Blood Cells (RBCs) or erythrocytes. by phagocytosis.
2. White Blood Cells (WBCs) or leukocytes.
3. Platelets or thrombocytes. TYPES OF WBCS

HEMATOPOIESIS: The continuous process of  Granulocytes: Neutrophils, basophils,

producing formed elements in the blood. eosinophils.
 Agranulocytes: Lymphocytes, monocytes.
FORMATION OF FORMED ELEMENTS:
GRANULOCYTES:
 All formed elements come from hematopoietic
stem cells (hemocytoblasts). 1. Neutrophils:
 Differentiation yields myeloid and lymphoid - Most common type of WBC.
stem cells. - Phagocytize microorganisms.
 Most formed elements come from myeloid stem - Short lifespan.
cells. 2. Basophils:
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- Release histamine (promotes inflammation) EMBOLUS: A clot that breaks loose and floats
and heparin(prevents clot formation). through the circulation.
3. Eosinophils:
CLOT RETRACTION: The process of a clot
- Involved in allergic responses, asthma and
condensing into a more compact structure, aided by
parasitic attacks. AAA
platelet contraction.
- Contain granules that stain red.
FIBRINOLYSIS: The process of dissolving clots
AGRANULOCYTES: through the activation of plasminogen to plasmin.
1. Lymphocytes: PROCESSES AND MECHANISMS:
- Small with little cytoplasm.
- Key role in immune responses.  Blood Loss and its Consequences**:
- Produce antibodies and regulate immunity. - Blood vessel damage can lead to blood
- leakage, interfering with tissue function.
2. Monocytes: - Large blood loss can be fatal.
- Largest WBCs.  Minimization of Blood Loss:
- Transform into macrophages in tissues. - Vascular Spasm: Immediate vessel
- Phagocytize debris and foreign substances. constriction due to smooth muscle
contraction.
PLATELETS: - -Platelet Plug Formation: Accumulation of
 Small fragments of cells. platelets to seal small vessel breaks.
 Produced from megakaryocytes in red bone - Blood Clotting: Formation of fibrin-based
marrow. clots for large vessel damage.
 Prevent blood loss by aiding in clot formation.  Vascular Spasm:
- Immediate but temporary vessel
constriction.
- Triggered by chemicals released by
11.5 PREVENTING BLOOD LOSS
damaged vessel cells and platelets.
VASCULAR SPASM: Immediate but temporary - Substance that stimulates VS: thromboxane
constriction of a blood vessel due to smooth muscle (prostaglandin) and endothelin (endothelial)
contraction in response to vessel damage.  Platelet Plug Formation:
- Platelet adhesion: Platelets stick to exposed
PLATELET PLUG: An accumulation of platelets
that seals a small break in a blood vessel. collagen.
- Platelet release reaction: Activated platelets
BLOOD CLOTTING (COAGULATION): The release chemicals.
process of forming a clot, a network of fibrin fibers - Platelet aggregation: Fibrinogen bridges
that traps blood cells, platelets, and fluid. platelets, forming a plug.
CLOTTING FACTORS: Proteins in plasma that are  Blood Clotting:
necessary for blood clot formation. - Involves clotting factors and three stages:
Prothrombinase production, thrombin
PROTHROMBINASE: A complex formed during production, and fibrin production.
clot formation that converts prothrombin to - Many factors affect clotting, including
thrombin. vitamin K, calcium, and platelet chemicals.
THROMBIN: An active form of prothrombin that  Control of Clot Formation:
converts fibrinogen to fibrin. - Anticoagulants prevent clotting factors from
forming clots under normal conditions.
FIBRIN: Threadlike protein fibers that form the - Rapid activation of clotting factors at an
structural basis of a blood clot. injury site overrides anticoagulant action.
ANTICOAGULANTS: Substances that prevent the  Thrombus and Embolus:
formation of blood clots. - Thrombus: Attached clot in blood vessels.
- Embolus: A detached clot floating in
circulation.
THROMBUS: A clot that forms and remains
attached to a blood vessel wall.
 Preventing Abnormal Coagulation:
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- Anticoagulants like heparin and warfarin can ABO BLOOD GROUP: A system categorizing
hinder clot formation. human blood based on the presence of A and B
- Heparin acts rapidly, while warfarin acts antigens.
more slowly.
RH BLOOD GROUP: A system categorizing
 Clot Retraction:
human blood based on the presence of Rh antigens.
- Platelets contain contractile proteins and
help in clot compaction. HEMOLYTIC DISEASE OF THE NEWBORN
- Serum is squeezed out during clot retraction. (HDN): A disorder where maternal antibodies
 Fibrinolysis: against fetal Rh antigens can harm fetal red blood
- Plasminogen is converted to plasmin. cells.
- Thrombin, clotting factors, and tissue
plasminogen activator stimulate this process.
- Plasmin breaks down fibrin. TRANSFUSIONS AND INFUSIONS:
 Heart Attack Treatment: - Large blood loss during surgery or injury can
- Injecting chemicals that activate plasmin can lead to shock and death if not addressed.
dissolve clots and restore blood flow. - Two methods to restore blood's oxygen-carrying
- Streptokinase and t-PA are used for this capacity: transfusion (transfer of blood or blood
purpose. components) or infusion (introduction of non-
 Vitamin K: blood fluids).
- Required for the synthesis of many clotting - Restoring blood volume to normal levels is
factors. often sufficient to prevent shock.
- Obtained from diet and intestinal bacteria. - The body eventually replaces lost red blood
- Antibiotics can reduce vitamin K levels. cells.
 Maternal Supplementation:
- Breast-fed infants may require vitamin K TRANSFUSION REACTIONS:
supplementation. - Early transfusion attempts had issues like
- Cow's milk contains more vitamin K than clumping and clotting due to transfusion
human milk. reactions.
 Injury Healing: - Transfusion reactions are caused by interactions
- Clot retraction helps in vessel repair. between antigens on red blood cells and
- Fibroblasts and epithelial cells play roles in antibodies in plasma.
tissue healing. - Antibodies bind specifically to antigens, leading
to clumping (agglutination) or rupture
(hemolysis) of red blood cells.
- Hemolysis and debris can damage tissues,
11.6 BLOOD GROUPING
especially in the kidneys, potentially leading to
TRANSFUSION: The transfer of blood or blood death.
components from one individual to another.
INFUSION: The introduction of a fluid other than
ABO BLOOD GROUP:
blood, such as a saline or glucose solution, into the
blood. - Human blood categorized based on A and B
antigens on red blood cells.
ANTIGENS: Molecules on the surface of red blood
- Types: A (A antigens), B (B antigens), AB (both
cells.
A and B antigens), O (neither A nor B antigens).
ANTIBODIES: Proteins in plasma that bind to - ABO blood types are genetically determined.
antigens. - Plasma contains antibodies against antigens not
AGGLUTINATION: The clumping of red blood present in a person's blood type.
cells due to the interaction between antibodies and
antigens.
Rh BLOOD GROUP:
HEMOLYSIS: The rupture of red blood cells,
leading to their destruction. - Rh blood group named after the rhesus monkey.
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- People are Rh-positive (have Rh antigens) or  Blood doping increases red blood cell count to
Rh-negative (lack Rh antigens). improve oxygen transport and athletic
- Rh status combined with ABO blood type (e.g., performance.
A-positive).
HEMOGLOBIN MEASUREMENT
- Rh antibodies only develop if an Rh-negative
person is exposed to Rh-positive blood.  Hemoglobin is measured in grams per 100 mL
- Rh incompatibility can cause issues in of blood.
pregnancies and transfusions.  Normal hemoglobin levels are 14–18 g per 100
mL for males and 12–16 g per 100 mL for
Hemolytic Disease of the Newborn (HDN): females.
- Occurs when an Rh-negative mother is  Low hemoglobin levels indicate anemia, which
sensitized to Rh antigens from an Rh-positive can result from reduced red blood cell count or
fetus. hemoglobin content.
- Sensitization can happen through blood mixing HEMATOCRIT MEASUREMENT
during pregnancy or delivery.
- In later pregnancies, maternal antibodies can  Hematocrit is the percentage of blood volume
harm the fetus. composed of red blood cells.
- Prevention involves monitoring antibody levels  It is determined by spinning blood in a
and using RhoGAM injections to inactivate fetal centrifuge.
Rh antigens.  Normal hematocrit ranges from 40–52% in
males and 38–48% in females.
- Severe cases may require transfusions through
 Hematocrit is affected by red blood cell number
the umbilical cord or early delivery.
and size.
 Disorders can cause abnormally small or large
red blood cells, such as iron deficiency anemia.
11.7 DIAGNOSTIC BLOOD TESTS
CLOTTING
BLOOD TYPING AND CROSSMATCHING
 Platelet count is 250,000–400,000 per μL of
 Blood typing determines ABO and Rh blood blood.
groups of a blood sample.  Thrombocytopenia is a condition with a
 It involves separating cells from plasma and significantly reduced platelet count, leading to
testing them with known antibodies to identify chronic bleeding.
cell surface antigens.  Prothrombin time measures how long it takes
 Agglutination during typing reveals antigen blood to start clotting (9–12 seconds).
presence; for example, agglutination with anti-A  It is determined by adding thromboplastin to
antibodies indicates type A antigen. plasma and is standardized as the International
 Serum is mixed with known antigens to Normalized Ratio (INR).
determine serum antibodies.  Abnormal prothrombin time can result from
 Donor blood must match recipient's ABO and deficiencies in clotting factors, vitamin K
Rh type to prevent transfusion reactions. deficiency, liver diseases, or certain drugs.
 Crossmatch involves mixing donor blood cells
with recipient's serum and vice versa. BLOOD CHEMISTRY
 Donor blood is safe if no agglutination occurs in  Blood chemistry assesses dissolved or
either match. suspended materials in plasma to evaluate body
COMPLETE BLOOD COUNT (CBC) system functioning.
 High blood glucose may indicate pancreas
 CBC analyzes red blood cell count, hemoglobin, dysfunction; high blood urea nitrogen (BUN)
hematocrit, and white blood cell count. suggests reduced kidney function.
 Red Blood Count (RBC) is typically 4.6–6.2  Increased bilirubin levels may indicate liver
million per μL for males and 4.2–5.4 million per dysfunction, while high cholesterol levels can
μL for females. signify cardiovascular disease risk.
 Erythrocytosis is an excess of red blood cells,  Various blood chemistry tests are performed
leading to increased viscosity and potential during routine blood sampling to assess overall
complications. health.