INTRODUCTION TO BLOOD

- Blood is known as the “river of life”.

- Blood transports everything that must be
carried from one place to another within the
body - nutrients, hormones, wastes (headed
for elimination from the body), and body
heat - through blood vessels.
- Blood also participates in processes such
as clotting and fighting infections.
- Transportation via blood is the only way
substances can be moved to distant body
locations. In addition, clotting proteins are
found only in blood.
- Blood is moved through blood vessels by
the pumping action of the heart.

COMPOSITIONS AND FUNCTIONS OF

BLOOD
- Blood is the only fluid tissue in the body.
- Although blood appears to be a thick,
homogeneous liquid, it has both solid and
liquid components.
PHYSICAL CHARACTERISTICS AND
COMPONENTS VOLUME
- Blood is a complex connective tissue in - Blood is a sticky, opaque fluid that is
which living blood cells, the formed heavier than water and about 5 times
elements, are suspended in plasma which thicker mostly because of its formed
is a nonliving fluid matrix. elements.
- The collagen and elastin fibers typical of - The color of blood varies depending on the
other connective tissues are absent from amount of oxygen it is carrying; scarlet
blood; instead dissolved proteins become (oxygen-rich) to dull red or purple
visible as fibrin strands during blood (oxygen-poor).
clotting. - Blood is slightly alkaline, with a pH
between 7.35 and 7.45.
- If a sample of blood is separated, the - Blood accounts for approximately 8% of
plasma rises to the top, the formed body weight, and its volume in healthy
elements, which are heavier, fall to the adults is 5-6 liters.
bottom.
- Most of the reddish “pellet” at the bottom PLASMA
of the tube is erythrocytes, or red blood - Plasma, which is approximately 90%
cells which are the formed elements that water, is the liquid part of blood.
function in oxygen transport. - Over 100 substances are dissolved in
plasma, these substances include nutrients,
- There is a thin, whitish layer called the salts (electrolytes), respiratory gases,
buffy coat at the junction between the hormones, plasma proteins, and various
erythrocytes and the plasma. wastes and products of cell metabolism.
- This layer contains the remaining formed
elements, leukocytes (white blood cells) - Plasma Proteins are the most abundant
which act in various ways to protect the solutes in plasma. Except for antibodies
body; and platelets which are cell and protein-based hormones, the liver
fragments that help stop bleeding. makes most plasma proteins.
- The plasma proteins serve a variety of
- Erythrocytes make up 45% of the total functions.
volume of a blood sample, a percentage ●​ Albumin, acts as a carrier to shuttle
known as the hematocrit (blood fraction). certain molecules through the
White blood cells and platelets contribute circulation, is an important blood
less than 1%, while plasma makes up most buffer, and contributes to the
of the remaining 55% of whole blood. osmotic pressure of blood, which
 acts to keep water in the FORMED ELEMENTS ​
bloodstream.
●​ Fibrinogen (clotting proteins) help
stem blood loss when a blood vessel
is injured.
●​ Globulins (antibodies &
transporting proteins) help protect
the body from pathogens and help in
lipid transport.

Erythrocytes (Red Blood Cells - RBCs)

Main Function: Transports oxygen from the

lungs to all cells in the body and remove
carbon dioxide.

Key Features:
●​ Anucleate: Lack a nucleus and
most organelles.
●​ Filled with hemoglobin (Hb), an
iron-bearing protein that binds
oxygen.
●​ It lacks mitochondria, so they
produce energy anaerobically,
ensuring they don’t use the oxygen
they transport.
●​ They are small, flexible shaped like
- The composition of plasma varies biconcave discs for a larger
continuously as cells exchange substances surface area and efficient gas
with the blood. It is kept relatively constant exchange.
by various homeostatic mechanisms of
the body. Blood Viscosity and RBC Count
- When blood proteins drop to undesirable
levels, the liver is stimulated to make more Normal RBC count: About 5 million
proteins, and when the blood starts to cells/mm3 of blood.
become too acid (acidosis) or too basic
(alkalosis), both the respiratory and Impact on Viscosity:
urinary systems are called into action to ●​ High RBC count: Increases blood
restore it to its normal, slightly alkaline pH thickness, slowing flow.
range of 7.35 to 7.45. ●​ Low RBC count: Blood becomes
- Besides transporting various substances thinner, flows faster.
around the body, plasma helps to distribute
body heat, a by-product of cellular Importance: Proper RBC count ensures
metabolism, evenly throughout the body. balanced blood flow and oxygen delivery.
Hemoglobin (The Oxygen Carrier) Survival Advantage:
●​ Common in people from the malaria
Role: Binds and transports most oxygen in belt of Africa.
blood. ●​ The sickle cell gene helps prevent
malaria by making infected RBCs
Composition: lose potassium, which the malaria
●​ Each RBC has about 250 million parasite needs to survive.
hemoglobin molecules.
●​ Each hemoglobin can carry 4 Genetics:
oxygen molecules. ●​ Sickle Cell Anemia: Occurs when
an individual has two copies of the
Oxygen Capacity: defective gene.
●​ Normal levels: ●​ Sickle Cell Trait (SCT): One
-​ Men: 13–18 g/dL defective gene; usually no
-​ Women: 12–16 g/dL symptoms but can pass the gene to
offspring.
Low levels indicate anemia (decrease in the
oxygen-carrying ability of the blood). Polycythemia (Too Many RBC’s)

Anemia (Lack of Oxygen Transport) Polycythemia is an excessive increase in

RBC count.
Anemia is a decrease in RBCs or abnormal
hemoglobin. Causes:
●​ Primary: Bone marrow cancer
Types of Anemia: (polycythemia vera).
●​ Iron-deficiency anemia: Low iron ●​ Secondary: High altitudes with low
levels reduce hemoglobin. oxygen (secondary polycythemia).
●​ Sickle cell anemia: Abnormal ●​ Blood doping: Athletes re-inject
hemoglobin causes RBCs to form a their RBCs for higher oxygen levels.
sickle shape.
Problem: Increases blood viscosity, making
Effects: it flow slowly and impairing circulation.
●​ Reduced oxygen delivery leads to
fatigue and weakness. Leukocytes (WBCs) - (Body’s Defense
●​ Sickle-shaped cells can block blood System)
flow, causing pain.
Main Function: Protect against infections
Sickle Cell Anemia (Abnormal and foreign invaders.
Hemoglobin)
Key Features:
Cause: Abnormal hemoglobin due to a ●​ Have nuclei and organelles (only
single amino acid change. complete cells in blood).
●​ Move in and out of blood vessels
Effect: (diapedesis).
●​ Red blood cells (RBCs) become ●​ Respond to chemicals from
sickle-shaped (crescent-like). damaged cells (positive
●​ Sickle cells rupture easily and chemotaxis).
block small blood vessels. ●​ Use amoeboid motion to reach
●​ Leads to reduced oxygen delivery infection sites.
and extreme pain.
Normal Count: 4,800–10,800 cells/mm3.
●​ Leukocytosis (>11,000 cells/mm3):
Indicates infection.
●​ Leukopenia: Low WBC count, often
due to drugs (e.g., corticosteroids
anti-cancer agents).
Leukemia (Abnormal WBC Production) 2.​ Monocytes:
●​ Largest WBCs.
Leukemia is the cancer of bone marrow ●​ When they migrate into the
causing excessive immature WBC tissues, they transform into
production. macrophages (macro =
large; phage = one that eats)
Problems: to consume pathogens and
●​ Immature WBCs can’t fight debris.
infections effectively. ●​ Fight chronic infections (e.g.,
●​ Crowding of bone marrow affects tuberculosis).
RBC and platelet production,
causing anemia and bleeding. Memory Tip for WBC Abundance

Symptoms: Frequent infections, fatigue, Order of Abundance:

and easy bruising. Neutrophils > Lymphocytes > Monocytes >
Eosinophils > Basophils
2 Major Groups of Leukocytes:
Mnemonic:
Granulocytes and Agranulocytes “Never Let Monkeys Eat Bananas”
- depending on whether or not they contain
visible granules in their cytoplasm. Platelets (Blood Clotting Helpers)

1. Granulocytes ( visible granules ) Platelets are not technically cells. They are
fragments of bizarre multinucleate cells
Types of Granulocytes (3) called megakaryocytes which pinch off
thousands of anucleate platelet “pieces” that
1.​ Neutrophils: quickly seal themselves off from
●​ Most numerous. surrounding fluids.
●​ Phagocytes: Engulf bacteria
and fungi, which they kill Function:
during a respiratory burst. ●​ Essential for the clotting process to
stop bleeding.
2.​ Eosinophils: ●​ Form plugs at injury sites.
●​ Increase during parasitic
worm infections. Normal Count: About 300,000/mm3 of
●​ Release enzymes to digest blood.
parasites.
Blood Clotting
3.​ Basophils:
●​ Rarest of WBCs Process:
●​ Release histamine to cause 1. Vessel injury: Platelets become sticky
inflammation and attract and clump together.
other WBCs. 2. Clot formation: Release chemicals to
form a stable blood clot.
2. Agranulocytes ( lack visible granules ) 3. Prevents blood loss: Seals broken
blood vessels.
Types of Agranulocytes (2)​
Importance: Quick clotting prevents
1.​ Lymphocytes: excessive blood loss during injuries.
●​ Second most numerous.
●​ Crucial for immune response
(T-cells and B-cells).
●​ Reside in lymphatic tissues
(e.g., tonsils).
 Formation of Red Blood Cells
●​ Red blood cells do not have
anucleate (nucleus), RBCs are
unable to synthesize proteins, grow,
or divide. As they age, RBCs
become rigid and begin to fall apart
in 100 to 120 days.
●​ Their remains are eliminated by
phagocytes in the spleen, liver, and
other body tissues.
●​ RBC components are salvaged.

Mechanism For Regulating the Rate of

RBC Production
- The group is degraded to bilirubin, which
is then secreted into the intestine by liver
cells. There it becomes a brown pigment
called stercobilin that leaves the body in
feces.
- Lost blood cells are replaced more or less
continuously by the division of
hemocytoblasts in the red bone marrow.

- The result is the young RBC, called a

Hematopoiesis reticulocyte.
- Blood cell formation, or hematopoiesis, - The reticulocytes enter the bloodstream to
occurs in red bone marrow, or myeloid begin their task of transporting oxygen.
tissue. - The entire developmental process from
- Each type of blood cell is produced in hemocytoblast to mature RBC takes 3 to 5
different numbers in response to changing days.
body needs and different stimuli.
- On average, the red bone marrow turns - The rate of erythrocyte production is
out an ounce of new blood containing 100 controlled by a hormone called
billion new cells every day. erythropoietin (EPO).
- When the blood level of oxygen begins to
All the formed elements arise from a decline for any reason, the kidneys step up
common stem cell, the hemocytoblast their release of erythropoietin.
(blood cell former), which resides in red - Erythropoietin targets the bone marrow,
bone marrow. prodding it into “high gear” to turn out more
RBCs.
The hemocytoblast forms two types of
descendants:
●​ the lymphoid stem cell, which
produces lymphocytes
●​ the myeloid stem cell, which can
produce all other classes of formed
elements.
Formation of White Blood Cells and - This combination interacts with other
Platelets clotting factors and calcium ions (Ca2+),
which are essential for many steps in the
- Like erythrocyte production, the formation clotting process, to form an activator that
of leukocytes is stimulated by hormones leads to the formation of thrombin, an
called colony-stimulating factors (CSFs) enzyme. Thrombin then joins soluble
and interleukins. fibrinogen proteins into long, hairlike
- The hormone thrombopoietin accelerates molecules of insoluble.
the production of platelets from
megakaryocytes, but little is known about
how that process is regulated.

Hemostasis
- Normally, blood flows smoothly past the
endothelium (intact lining) of blood vessel
walls.
- But if a blood vessel wall breaks, a
series of reactions starts the process of
hemostasis or stopping the bleeding.
- This response, which is fast and localized,
involves many substances normally present
in plasma, as well as some that are
released by platelets and injured tissue
cells.

Phases of Hemostasis:
- Hemostasis involves three major phases,
which occur in rapid sequence:
vascular spasms, platelet plug
formation, and coagulation or blood
clotting.
Disorder of Hemostasis
Vascular Spasms Occur
- The immediate response to blood vessel Undesirable Clotting
injury is vasoconstriction, which causes - Despite the body’s safeguards against
blood vessel spasms. The spasms narrow abnormal clotting, undesirable clots
the blood vessel, decreasing blood loss sometimes form in unbroken blood
until clotting can occur. vessels, particularly in the legs. A clot that
develops and persists in an unbroken blood
Other factors causing vessels spasm: vessel is called a thrombus.
●​ direct injury to the smooth muscle - If a thrombus breaks away from the
cells vessel wall and floats freely in the
●​ stimulation of local pain receptors bloodstream, it becomes an embolus
●​ release of serotonin by anchored (plural emboli).
platelets
What Causes Undesirable Clotting?
Platelet Plug Forms - Damaged Blood Vessel Walls – When
- Platelets are repelled by an intact the inner lining of a blood vessel
endothelium, but when the underlying (endothelium) is roughened, platelets stick
collagen fibers of a broken vessel are and start forming a clot.
exposed, the platelets become “sticky” and - Slow or Pooling Blood Flow – Blood that
cling to the damaged site. isn’t moving properly increases the risk of
clotting because:
Coagulation Events Occur ●​ Clotting factors aren’t washed away,
- At the same time, the injured tissues are so they build up and trigger clot
releasing tissue factor, which interacts with formation.
PF3 (platelet factor 3), a phospholipid that
coats the surfaces of the platelets.
Bleeding Disorders Phlebotomy Procedures
The most common causes of abnormal - Usual blood bank procedures involve
bleeding are thrombocytopenia (platelet collecting blood from a donor and mixing it
deficiency) and deficits of some of the with an anticoagulant to prevent clotting.
clotting factors, such as might result from - The treated blood can be stored
impaired liver function or certain genetic (refrigerated at 4°C, or 39.2°F) until needed
conditions. for about 35 days.

Thrombocytopenia
- It results from an insufficient number of
circulating platelets.
- In this disorder, even normal movements
cause spontaneous bleeding from small
blood vessels. This is evidenced by many
small purplish blotches, called petechiae
that resemble a rash on the skin.

Human Blood Groups

- An antigen is a substance that the body
recognizes as foreign, it stimulates the
immune system to mount a defense against
it.
- Plasma membranes of RBCs, like those
Hemophilia of all other body cells, bear genetically
- Hemophilia is inherited that results from a determined proteins (antigens), which
lack of any factors needed for clotting. identify each person as unique.
- Even small injuries can cause serious - Most antigens are foreign proteins, such
bleeding that takes a long time to stop. as those that are part of viruses or bacteria
- When a bleeding episode occurs, that have managed to invade the body.
hemophiliacs are given a transfusion of - Proteins will be recognized as foreign if
fresh plasma or injections of the purified transfused into another person with different
clotting factor they lack. RBC antigens.

- The “recognizers” are antibodies

present in plasma that attach to RBCs
bearing surface antigens different from
those on the patient’s (recipient’s) RBCs.
- Binding of the antibodies causes the
Blood Groups and Transfusions foreign RBCs to clump, a phenomenon
called agglutination, which leads to the
Importance of Blood clogging of small blood vessels throughout
- Blood is vital for transporting substances the body.
through the body. - Foreign RBCs are lysed (ruptured), and
- When blood is lost, the blood vessels their hemoglobin is released into the
constrict, and the bone marrow steps up bloodstream.
blood cell formation in an attempt to
maintain circulation. Blood Transfusions and Reactions
- The body can compensate for a loss of - Transfused blood is sometimes unable to
blood volume only up to a certain limit. deliver the increased oxygen-carrying
Losses of 15 to 30% lead to pallor and capacity hoped for and some tissue
weakness. areas may be deprived of blood, causing
- Loss of over 30% causes severe shock, severe transfusion reactions, the freed
which can be fatal. hemoglobin molecules may block the kidney
- Whole blood transfusions are routinely tubules, causing kidney failure and death.
given to replace substantial blood loss and
to treat severe anemia or
thrombocytopenia.
- Transfusion reactions can also cause - A typical transfusion reaction occurs in
fever, chills, nausea, and vomiting, but in which the patient’s antibodies attack and
the absence of kidney shutdown these rupture the donor’s Rh+ RBCs.
reactions are rarely fatal.
- Treatment is aimed at preventing kidney Blood Typing
damage, infusing fluids to dilute and - The general procedure for determining
dissolve the hemoglobin and diuretics, ABO blood type essentially involves testing
flushing it out of the body in urine. the blood, mixing it with two different types
of immune serum—anti-A and anti-B.

ABO and RH Blood Groups

- The antigens of the ABO and Rh blood
groups that cause the most vigorous
transfusion reactions.
- The ABO blood groups are based on Blood Typing of ABO blood groups
which of two antigens, type A or type B, a - When serum containing anti-A or anti-B
person inherits. antibodies is added to a blood sample
- In the ABO blood group, antibodies form diluted with saline, agglutination will occur
during infancy against the ABO antigens between the antibody and the
not present on your own RBCs. corresponding antigen (If present).
- The Rh blood groups are so named
because one of the eight Rh antigens
(agglutinogen D) was originally identified in
Rhesus monkeys.
- Remember that antibodies against a
person’s own blood type will NOT be
produced.

Understanding RH Incompatibility
- Most Americans are Rh+, meaning that
their RBCs carry Rh antigen.
- Anti-Rh antibodies are not automatically
formed by Rh−individuals.
- If an Rh− person receives Rh+ blood, after
the transfusion his or her immune system
becomes sensitized and begins producing
anti Rh+ antibodies against the foreign
blood type.
- Hemolysis does not occur in an Rh−
person with the first transfusion of
Rh+ blood because it takes time for the
body to react and start making antibodies.
Blood Typing
- Agglutination occurs when RBCs of a
group A person are mixed with the anti-A
serum but not when they are mixed with the
anti-B serum.
- RBCs of type B blood are clumped by
anti-B serum but not by anti-A serum.
- Cross matching involves testing for
agglutination of donor RBCs by the
recipient’s serum and of the recipient’s
RBCs by the donor serum.