The Cardiovascular System: Blood

Icebreaker

• We know that the cells and tissues

of the body require nutrients and
oxygen to survive.
• Have you ever wondered how the
oxygen and nutrients reach the cells
and tissues?
• Also, how are the wastes that
tissues produce removed?
• To help answer those questions, in
this chapter we will discuss the
characteristics and functions of
blood.
General Composition
of Blood
• Blood is a fluid connective tissue
• Plasma is the liquid extracellular
matrix
• Formed elements are the cells and
cell fragments
• Erythrocytes (red blood cells)
• Leukocytes (white blood cells)
• Platelets (thrombocytes)
• Heart creates a pressure gradient that
helps move blood through the body
 Functions of Blood

• Transportation
• Transports nutrients, wastes, and
other substances as it moves
throughout body
• Defense
• White blood cells provide protection
against infection
• Platelets protect from blood loss
• Maintenance of homeostasis
• Aids in temperature and pH
regulation and fluid balance
Whole Blood

• Components of whole blood can

be separated by a centrifuge
• Plasma—liquid extracellular
matrix
• Cellular components
• Red blood cells
• White blood cells
• Platelets (cytoplasmic
fragments, not entire cells)
Anatomy of Flow

Movement of blood is Blood thickness

driven by pressure (viscosity) causes
gradient resistance to flow
• Blood moves from areas • Thicker blood has more
of higher pressure to resistance
areas of lower pressure • Resistance influenced
• Referred to as bulk flow by plasma proteins and
formed elements
Plasma
• Mainly water (92%)
• Contains plasma proteins
• Albumins, globulins,
fibrinogen
• Most produced by liver
• Other solutes
• Nutrients, gases,
wastes, regulatory
substances, electrolytes
• Includes ions, glucose,
lipids, oxygen, carbon
dioxide, and amino
acids
Plasma Proteins
• Account for approximately 7% of plasma
volume
• Albumins are the most abundant plasma
proteins
• Made by liver
• Major regulator of blood osmotic
pressure
• Globulins are second most abundant
plasma proteins
• Function as transport proteins and
as antibodies
• Many are produced by liver;
antibodies are produced by
leukocytes
• Fibrinogen is least abundant plasma
protein
• Involved in blood clotting
• Produced by liver
Knowledge
Check Activity

• The major component

of plasma is:
A. Plasma proteins
B. Erythrocytes
C. Water
D. Electrolytes
E. Gases
Knowledge
Check Activity
Answer
• The major component
of plasma is:
C. Water
Erythrocytes
• Most common formed element
• Transport gases in blood
• Biconcave disc shape
• Increases surface area for gas
exchange
• Few organelles and no nucleus
• Contain hemoglobin to
transport gases
Hemoglobin
• Made of proteins and iron
• Four folded globin proteins contain
four heme groups
• Each heme group contains an iron ion
(Fe2+)
• Can bind one molecule of oxygen
• Binds oxygen in oxygen-rich
environments
• Releases oxygen in oxygen-poor
environments
Pulse Oximetry
• Saturation of hemoglobin with
oxygen detected by pulse oximeter
• Oxygenated blood carries higher
amounts of oxygen
• 95-100% saturated
• Deoxygenated blood carries less
oxygen
• Usually 70-80% oxygenated
 Erythropoiesis
• Production of red blood cells
• Begins in red bone marrow
• Stimulated by erythropoietin (EPO)
• A hormone secreted in response to
hypoxemia
• Results in formation of new RBCs
• If all necessary components are
available
• Such as iron and vitamin B12
The Life Cycle of Erythrocytes
Globin—
RBCs live up to
recycled into
120 days
amino acids

Broken down Converted to

Iron—stored
and recycled in biliverdin and
and reused
liver or spleen then bilirubin

Non-iron Bilirubin
portion of heme incorporated
is toxic into bile by liver

Eliminated from
body in urine
and feces
Hematocrit
36-50% is homeostatic range
The percentage of RBCs in a
Can vary depending on muscle mass,
whole sample of blood gender, and fitness levels

Anemias = conditions with insufficient RBC numbers or

insufficient ability to carry oxygen

Polycythemias = conditions that

Increase viscosity of blood
lead to overproduction of RBCs
 Anemias

Result from decreased RBC production or defective RBC production

Sickle cell anemia – Megaloblastic anemia – due Aplastic anemia – due to
Iron deficiency anemia – Pernicious anemia – due to
defective hemoglobin to lack of vitamin B12 and/or deficient numbers of RBC
due to lack of iron inadequate vitamin B12
causes RBC shape change folate stem cells

Menstruation in women and other chronic bleeding conditions can

lead to anemia as well
 Think, Pair, Share Activity
Try to identify reasons red blood cells only last 120 days.
 Think, Pair, Share Activity Answer
During maturation, mature red blood cells eject their nucleus. Without
genetic information, mature red blood cells are unable to produce new
molecules necessary for cellular repair and must be replaced after
approximately 120 days.
Leukocytes and Platelets
• Leukocytes
• Also known as white blood
cells
• Help protect the body
against infection
• Eliminate body cells with
mutated DNA
• Clean up debris
• Platelets
• Involved in blood clotting and
vessel repair
Characteristics of Leukocytes

Produced by
Less numerous than Larger in size than
hematopoiesis in
RBCs RBCs
red bone marrow

Leave blood vessels

All have a nucleus Can last hours to via diapedesis
and organelles years • Attracted to areas where
needed by chemotaxis
 Classification of Leukocytes

Granular • Neutrophils
leukocytes—have
• Eosinophils
granules that can
be seen • Basophils

Agranular
leukocytes—have • Lymphocytes
granules, but not • Monocytes
easily seen
Granulocytes
• Neutrophils—most common • Basophils—least common
leukocyte (40–60%) leukocyte (less than 1% of
• Faint purple granules leukocyte count)
• Nucleus has two to five • Dark blue granules
lobes
• Nucleus with two lobes
• Phagocytic cells
• Granules release
• Eosinophils (2-4% of histamine
leukocyte count)
• Bright pink to red granules
• Nucleus has two to three
lobes
Agranulocytes
• Lymphocytes—second most • Monocytes
common leukocyte (20–30%)
• Large, with a horseshoe-
• Large nucleus with a thin shaped nucleus
rim of cytoplasm
• Phagocytes
• Three groups:
• Mature into macrophages
1. B lymphocytes
• Fixed versus wandering
2. T lymphocytes macrophages
3. Natural Killer (NK) cells
 Leukocyte Decision Tree
• Decision tree for
determining the
type of leukocyte
being observed.
Anatomy of Leukocytes
Breakout Group Activity

• On small pieces of paper or note

cards, write down the description of
each leukocyte. Place one description
on each card. Have each group
member read their description while
the others identify the leukocyte being
described.
Breakout Group Activity Answer

• Neutrophils—faint purple granules

and a nucleus with two to five lobes
• Eosinophils—pink to red granules and
a nucleus with two to three lobes
• Basophils—dark blue granules and a
nucleus with two lobes
• Lymphocytes—small cell with a large
nucleus surrounded by a thin rim of
cytoplasm
• Monocytes—large cell with a
horseshoe-shaped nucleus
 Leukocyte Responses
Specific leukocytes increase in number under certain
conditions

Neutrophils—increase during bacterial infections

Lymphocytes—increase during viral infections

Monocytes—increase during viral or fungal infections

Eosinophils—increase during allergic reactions or

parasitic infections

Basophils—increase during allergic reactions

Platelets
• Platelets are not cells
• Fragments of a megakaryocyte
• Contain growth factors and
chemicals involved in blood
clotting
• Also help promote repair of blood
vessels and tissue healing
Matching Activity
Match the formed element to the correct description.

1. Erythrocyte
A. Involved in blood clotting
2. Neutrophil B. Protect against bacterial infections
3. Monocyte C. Carry gases in blood
4. Platelet D. Protect against viral infections
5. Eosinophil E. Protect against parasites
F. Protect against fungal infections
6. Lymphocyte
Matching Activity Answer
Match the formed element to the correct description.

1. Erythrocyte—C
A. Involved in blood clotting
2. Neutrophil—B B. Protect against bacterial infections
3. Monocyte—F C. Carry gases in blood
4. Platelet—A D. Protect against viral infections
5. Eosinophil—E E. Protect against parasites
F. Protect against fungal infections
6. Lymphocyte—D
Production of
the Formed
Elements
Hematopoiesis
• Process of producing formed
elements
• Begins in red bone marrow
• Hematopoietic stem cells can
differentiate into any formed
element
• Differentiate into lymphoid or
myeloid stem cells first
 Hematopoietic Growth Factors
• Differentiation of hematopoietic stem cells is driven by
chemical growth factors, some of which are also
hormones
• Erythropoietin (EPO)—promotes erythrocyte production called
erythropoiesis
• Thrombopoietin—promotes development of megakaryocytes
and platelets
• Cytokines—chemical signals released from a variety of tissues
• Stimulate production of various leukocytes as necessary
Think, Pair, Share
Activity

• Identify conditions that would

lead the body to produce
specific formed elements.
Pair the cell or cells that need
to be produced with the
hormone or growth factor that
would lead to its production.
Think, Pair, Share
Activity Answer
• Anemias require production
of new red blood cells
stimulated by erythropoietin.
• Bleeding or hemorrhage
would require the production
of platelets stimulated by
thrombopoietin.
The Process of
Hemostasis
• Process by which the body
plugs a ruptured blood vessel
to minimize blood loss
• Platelets play a significant
role
• Effective for smaller vessels,
not larger ones
• Prevents loss of blood
• Allows for vessel to be
repaired
Steps of Hemostasis
1. Vascular spasm
• Smooth muscle in walls of blood vessels
contracts
• Limits blood flow to area and blood loss
2. Formation of platelet plug
3. Coagulation (blood clotting)
• Failure of these steps leads to
hemorrhage
Vascular Spasm
• Smooth muscle in the walls of the damaged vessel contracts
• Triggered by chemicals released from endothelium
• Continues for approximately 30 minutes
• Decreases blood flow and blood loss from damaged area
• Allows other steps of hemostasis to occur
 Formation of Platelet Plug

Platelets adhere to Activated platelets Forms platelet

exposed collagen attract more plug
fibers in vessel platelets to
wall damaged area,
leading to more
activated platelets
Release ADP, serotonin, This is a positive Von Willebrand factor
and prostaglandins feedback loop helps stabilize plug and
•Recruits more platelets bind it to collagen
and maintains
vasoconstriction
Platelet Plug Formation

69
 Think, Pair, Share Activity
• Platelets adhere to collagen to start formation of a
platelet plug. Why does exposure to collagen function
as a signal that platelets need to form a platelet plug?
 Think, Pair, Share Activity Answer
• Collagen fibers are not exposed to platelets if endothelial cells are
intact. If there is damage to the lining of the vessel, collagen fibers
are exposed and lead to platelet plug formation.
 Fibrin and Coagulation
• Coagulation involves a cascade of events
that allows repair of vessel
• Soluble fibrinogen will be converted into
insoluble fibrin to stabilize platelet plug into
a clot
• Individual fibrin proteins combine
• Form a netlike protein that stabilizes plug
Coagulation
• Two pathways initiate coagulation:
• Extrinsic pathway triggered by trauma that breaks blood vessel wall
• Intrinsic pathway triggered by internal damage to wall
• Third pathway is the common pathway
• Both the extrinsic and intrinsic pathways lead to the common pathway
• All three pathways are dependent on the presence of calcium and
vitamin K
 Clotting Factors
Involved in
Coagulation
Clotting factors prompt reactions
associated with coagulation
 Extrinsic Pathway

Activated by tissue Response is faster in Factor III enters vessel

trauma that breaks the comparison to the from tissues due to
wall of the blood vessel intrinsic pathway damage

Factor III activates

Factor VII that will Enters common
This enzyme complex
combine with calcium pathway after
will activate factor X
to form an enzyme activation of factor X
complex
 Intrinsic Pathway

Activated by internal Factor XII comes in

Response is slower
damage to the wall of contact with foreign
than extrinsic pathway
the vessel material

Activated factor IX
Activated factor XII combines with factor Enters common
activates factor XI VIII to activate factor X pathway after
which will then
• Requires presence of activation of factor X
activate factor IX
calcium
Common Pathway
• Both extrinsic and intrinsic pathways lead to the common
pathway
• Prothrombinase converts factor II (prothrombin) into
thrombin
• Thrombin converts factor I (fibrinogen) into fibrin that
stabilizes clot
 Think, Pair, Share Activity
Identify differences and similarities between the extrinsic and
intrinsic pathways of coagulation.
Think, Pair, Share Activity Answer
• Both the extrinsic and intrinsic pathways of coagulation result in the
formation of prothrombinase and require the presence of calcium to
occur. However, they differ in what initiates each pathway and the
speed in which the pathways occur.
 Breakout Group Activity

• Assign each group member one of

the pathways involved in
coagulation. Write the steps of each
pathway on note cards or small
pieces of paper. Mix the note cards
and then take turns attempting to
place the steps in the correct order.
Make note of the point at which the
common pathway starts also.
 Breakout Group Activity
Answer
• Steps in the pathways:
• Extrinsic pathway—Activated by tissue trauma that
breaks the wall of the blood vessel; factor III enters
vessel from tissues due to damage; in the
presence of calcium, will lead to activation of
factor X; enters common pathway after activation
of factor X
• Intrinsic pathway—Activated by internal damage
to the wall of the vessel; factor XII comes in
contact with foreign material; activated factor XII
activates factor XI which will then activate factor
IX; activated factor IX combines with factor VIII to
activate factor X; enters common pathway after
activation of factor X
• Common pathway—Prothrombinase converts
factor II (prothrombin) into thrombin; Thrombin
converts factor I (fibrinogen) into fibrin that
stabilizes clot
Fibrinolysis

• Once clot is formed, its edges are pulled

toward each other as vessel heals
• Clot is eventually removed by fibrinolysis
• Gradual degradation of the clot
• To accomplish this, plasminogen is activated
into plasmin
• Plasmin breaks down fibrin to dissolve clot
• Bradykinin causes vasodilation to restore
blood flow
Plasma Anticoagulants

• Substances that oppose coagulation

• Antithrombin
• Inactivates factor X
• Opposes conversion of prothrombin
into thrombin
• Heparin
• Opposes prothrombin
• Found on endothelial cells to prevent
abnormal clots
Blood Typing
Antigens
• Molecules or groups of molecules the
body does not recognize as “self”
• Trigger an immune response
• Found on surface of red blood cells
• Basis for blood types
• Can also cause transfusion reactions
when incompatible blood types are
mixed
Erythrocyte Antigens
• Blood types are determined
based on the antigens present on
the surface of RBCs
• Only three antigens commonly
used:
• Antigen A
• Antigen B
• Antigen D (Rh factor)
• Negative or positive blood type
Antibodies
• Proteins that are made by the immune system
• Designed to bind to foreign antigens the body doesn’t recognize
• Forms antigen-antibody complexes
• Antigen-antibody complexes can initiate transfusion reactions
• Cells agglutinate in response
• “Stick together”
Transfusion Reactions
• Occurs when incompatible blood types are
mixed
• Cells clump together
• Hemolysis of red blood cells can overload
kidneys
• Can lead to kidney failure
ABO Blood Groups
• In the ABO blood group
system, there are two types
of antigens, type A antigen
and type B antigen.
• Type A blood has type A
antigens, type B blood has
type B antigens, and type
AB blood has both types of
antigens.
• Type O blood has neither A
nor B antigens.
• The types of antigens found
on the surface of the red
blood cells are genetically
determined.
91
 ABO Blood Groups
• Antibodies against the antigens
are usually present in the
plasma of blood.
• Plasma from type A blood
contains anti-B antibodies,
which act against type B
antigens; plasma from type B
blood contains anti-A
antibodies, which act against
type A antigens.
• Type AB blood plasma has
neither type of antibody, and
type O blood plasma has both
anti-A and anti-B antibodies.
92
ABO Blood Groups
• Based on presence or absence of A antigen and B antigen
• Type A—A antigen only
• Type B—B antigen only
• Type AB—A and B antigens
• Type O—neither antigen
• Antibodies produced against antigen(s) not present on a person’s
red blood cells
ABO Blood Groups
Blood Donor and Recipient
According to ABO Blood Types

• O are universal donors because they have

no antigens
• Type A can receive A and O blood
• Type B can receive B and O blood
• Type AB are universal recipients, can
receive A, B, AB or O blood
• Type O can only receive O blood
Rh Blood Group
• Rh positive means you
have Rh antigens
• 95 to 85% of the
population is Rh+
• Antibodies only develop if
an Rh- person is exposed
to Rh+ blood by
transfusion or from
mother to fetus

96
Hemolytic Disease of a Newborn (HDN)
• Can possibly occur when a Rh– mother is pregnant with an Rh+
fetus
• Rare in first pregnancy, but complications may arise with second
pregnancy
• During first delivery, mother may be exposed to Rh antigen during
birth
• Anti-Rh antibodies will be produced in between pregnancies
• If the second fetus is also Rh+, the antibodies the mother made
will cross placenta and cause hemolysis
Rh Incompatibility in
Pregnancy
• If mother is Rh- and fetus
is Rh+ the mother can be
exposed to Rh+ blood if
fetal blood leaks through
placenta and mixes with
mother’s blood.
• First time this occurs
mother’s blood produces
antibodies against
antigens.
• Any repeated mixing of
blood causes a reaction. 98
 Hemolytic Disease of Newborn
• occurs when mother produces anti-Rh
antibodies that cross placenta and
agglutination and hemolysis of fetal
erythrocytes occurs
• can be fatal to fetus
• prevented if mother is treated with RhoGAM
which contains antibodies against Rh antigens

100
Blood Typing
Blood Transfusions
• Risk of transfusion immune reactions requires a
recipient to receive only compatible blood types
• An individual should only receive blood that
does not contain antibodies against their
own blood type
• Example:
• If the recipient is O- (O negative), they
contain antibodies against the A
antigen and B antigen in their blood
• This recipient should not receive
any blood with the A or B antigen
on the surface of the RBC of the
donor
• Due to risk of producing Rh
antibodies, they should not
receive blood with the Rh antigen
either
• They can only receive O negative blood
Think, Pair, Share Activity
• If you know your blood type, draw a diagram that
indicates the antigens present on the surface of
your erythrocytes. If you do not know your blood
type, choose a blood type at random and diagram
its antigens.
Think, Pair, Share Activity Answer
• Responses will vary depending on
student blood types. An example is A+
blood. If this is a student’s blood type,
they should draw a red blood cell with the
A antigen and the Rh antigen present.
Think, Pair, Share Activity 5 Answers
• If you know your blood type, draw a diagram that indicates the
antigens present on the surface of your erythrocytes. If you do not
know your blood type, choose a blood type at random and
diagram its antigens.
 Breakout Group Activity

• With other members of your group, compose a

table that details donors and recipients of each
blood type. Do you notice any trends? If so,
describe them.
Summary

• By the end of this chapter, you should be able to:

• Describe the anatomy of blood.
• Describe the components of plasma.
• Identify the appearance of the formed elements.
• Discuss the functions of the formed elements.
• Discuss the process of hemostasis.
• Discuss how blood types are determined.