2402 ch 18 cardiovascular system (part 1) ppt.pdf

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Chapter 18 Cardiovascular System: Blood

Hematology

Cells immersed in body fluids:• Blood

- Plasma - Formed elements (cells)

• Interstitial fluid

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Functions of Blood

Transportation

Regulation• Body pH• body temp• Fluid balance

- H2O content of cells- BP

Protection• Blood loss• Immunity

http://encarta.msn.com/media_461557603_761578429_-1_1/Lymphocyte.html

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Physical Characteristics of Blood

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Components of Blood

Centrifuge

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Com

pone

nts

of B

lood

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Components of Blood: Plasma

>90% water ~7% proteins: albumin,

fibrinogen, globulins (immunoglobulins)

~2% other solutes: electrolytes, nutrients, gases, hormones, wastes

Common Electrolytes in Plasma

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Common Nutrients in Plasma

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Components of Blood: Formed Elements

RBC (erythrocyte) WBC (leukocyte)

• Granular leukocytes- neutrophil,

eosinophil, basophil

• Agranular leukocytes - lymphocyte = T, B

& NK cell, monocyte

Platelet (thrombocyte)

• megakaryocyteBlood Smear

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Stages of Hematopoiesis--Pluripotent hematopoietic stem cell=hemocytoblast

--Myeloid stem cells-Erythroblast reticulocyte RBC

-Megakaryoblast megakaryocyte proplatelet platelet

-Granulocytes (PMN, basophil, eosinophil)

-Monocyte macrophage

--Lymphoid stem cells-T, B & NK cells

Thrombopoiesis

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Hemopoietic Growth Factors

Regulate differentiation & proliferation

• Erythropoietin (EPO)• Thrombopoietin

(TPO)• Cytokines

- colony-stimulating factor (CSF)

- interleukin (IL)

Recombinant DNA advances

• Growth factor production

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Red Blood Cells or Erythrocytes Biconcave disk

• Increases surface area:volume ratio• Spectrin flexible protein

Anucleate amitotic

Shape of a RBC

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Hemoglobin: Structure & Fxn

Globin protein consists of 4 polypeptides (22)• 1 heme attached to each polypeptide heme contains iron

binds 1 oxygen

• Oxyhemoglobin

• Deoxyhemoglobin

• Carbaminohemoglobin

Myoglobin

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HgB: Blood Pressure Regulation?

HgB helps regulate nitric oxide (NO)• When released NO induces vasodilation

• NO released from endothelial cells

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Clinical Application: Abnormal HgB

Sickle-cell anemia –• Defective HgB gene (HbS)• RBC’s become sickle-shaped

in low oxygen situations• Cause anemia, ischemia &

infarctionhttp://www.nlm.nih.gov/medlineplus/ency/imagepages/1223.htm

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Red blood celldeath andphagocytosis

Key:

in blood

in bile

Macrophage inspleen, liver, orred bone marrow

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Globin


Key:

in blood

in bile


Heme2

1

Aminoacids

Reused forprotein synthesisGlobin


Key:

in blood

in bile


Heme

3

2

1

Aminoacids



Transferrin

Fe3+

Key:

in blood

in bile


Heme

4

3

2

1

Aminoacids



Transferrin

Fe3+

Liver

Key:

in blood

in bile


FerritinHeme

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3

2

1

Aminoacids



Transferrin

Fe3+

Fe3+ Transferrin

Liver

Key:

in blood

in bile


FerritinHeme

654

3

2

1

Aminoacids



Transferrin

Fe3+

Fe3+ Transferrin

Liver

+Globin

+Vitamin B12

+Erythopoietin

Key:

in blood

in bile


FerritinHeme Fe3+

7

654

3

2

1

Aminoacids


Circulation for about120 days


Transferrin

Fe3+

Fe3+ Transferrin

Liver

+Globin

+Vitamin B12

+Erythopoietin

Key:

in blood

in bile

Erythropoiesis inred bone marrow


FerritinHeme Fe3+

8

7

654

3

2

1

Aminoacids




Transferrin

Fe3+

Fe3+ Transferrin

Liver

+Globin

+Vitamin B12

+Erythopoietin

Key:

in blood

in bile



FerritinHeme

Biliverdin Bilirubin

Fe3+

9

8

7

654

3

2

1

Aminoacids



Bilirubin


Transferrin

Fe3+

Fe3+ Transferrin

Liver

+Globin

+Vitamin B12

+Erythopoietin

Key:

in blood

in bile



FerritinHeme


Fe3+

10

9

8

7

654

3

2

1

Aminoacids


Stercobilin

Bilirubin

Urobilinogen

Feces

Smallintestine


Bacteria

Bilirubin


Transferrin

Fe3+

Fe3+ Transferrin

Liver

+Globin

+Vitamin B12

+Erythopoietin

Key:

in blood

in bile



FerritinHeme


Fe3+

12

1110

9

8

7

654

3

2

1

Aminoacids


Urine

Stercobilin

Bilirubin

Urobilinogen

Feces

Smallintestine


Bacteria

Bilirubin


Transferrin

Fe3+

Fe3+ Transferrin

Liver

+Globin

+Vitamin B12

+Erythopoietin

Key:

in blood

in bile


Kidney


Ferritin

Urobilin

Heme


Fe3+

13 12

1110

9

8

7

654

3

2

1

Aminoacids


Urine

Stercobilin

Bilirubin

Urobilinogen

Feces

Largeintestine

Smallintestine


Bacteria

Bilirubin


Transferrin

Fe3+

Fe3+ Transferrin

Liver

+Globin

+Vitamin B12

+Erythopoietin

Key:

in blood

in bile


Kidney


Ferritin

Urobilin

Heme


Fe3+

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13 12

1110

9

8

7

654

3

2

1

Formation and Destruction of RBC’s: Recycling of HgB

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Formation and Destruction of RBC’s: Recycling of HgB

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Erythropoiesis: Production of RBC

Requires protein, lipids, CHO, iron, vB12, folic acid Three phases in developmental pathway

• Reticulocyte Erythrocyte- Reticulocyte count = Diagnostic test

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Total Erythrocytes (RBC)

Circulating erythrocytes

• # remains constant• Normal RBC count

- male 5.4 million/drop - female 4.8

million/drop

Reticulocytes• Should be ~1% of

circulating RBC’s

http://www.nlm.nih.gov/medlineplus/ency/imagepages/1491.htm

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Hematocrit

% blood occupied by RBC• female normal range - 38 - 46%• male normal range - 40 - 54%

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Erythropoietin Mechanism

Reduces O2

levels in blood

Erythropoietin stimulates red bone marrow

Enhanced erythropoiesis increases RBC count

Normal blood oxygen levels Stimulus: Hypoxia due to decreased RBC count, decreased availability of O2

to blood, or increased tissue demands for O2

Start

Kidney (and liver to a smaller extent) releases erythropoietin

Increases O2-carrying ability of blood

Erythropoietin Mechanism

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Erythrocyte Disorders

Polycythemia• Compensatory – smokers• Relative – dehydration• Erythrocytosis – EPO high• Induced polycythemia

- Blood dopingi. recEPO or injecting previously stored RBC’s before an

athletic event more cells available to deliver oxygen to tissues

ii. Dangerous increases blood viscosity forces heart to work harder banned by Olympic committee

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Anemia: Low O2 -carrying capacity

General signs/Sx

Types of anemia:• Hemorrhagic anemia

• Hemolytic anemia

• Aplastic anemia

• Iron-deficiency anemia

• Pernicious anemia

• Sickle-cell anemia

Fig 1. Normal bone marrow. 30-70% of marrow space consists of hematopoeitic cells w/ remainder being fat.

Fig 2. Patient's bone marrow biopsy w/ almost no identifiable hematopoeisis.

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White Blood Cells/ Leukocytes

“Complete” blood cells • Far less numerous than

RBCs

Usually live a few days• Except for lymphocytes

– live for months or years

Leukocytosis Leukopenia

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Leukocyte Functions:

Inflammation & fight infection

• Emigration• Chemotaxis • Diapedesis

- Adhesion molecules (Selectins & integrins)

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Classification of Leukocytes

Granulocytes • neutrophils, eosinophils, basophils,

dendritic cells

Agranulocytes • monocytes (m) or lymphocytes

http://encarta.msn.com/media_461557603_761578429_-1_1/Lymphocyte.html

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Neutrophils: Polymorphonuclear leukocytes

Aka: PMN, Segs, Polys

• 60-70% of circulating WBCs

• Multi-lobed nuclei• Granules = peroxidases,

hydrolytic enz & defensins

• Band (shift)

Functions target bacteria

• Lysozymes• Defensin proteins • Strong oxidants• Phagocytosis

http://cal.vet.upenn.edu/histo/mammalblood/felbandneutbas.htm

http://www.physioweb.org/blood_cells.html

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Eosinophils (Granulocyte)

~1-4% circulating WBC• Nucleus w/ 2-3 lobes

• Large, uniform-sized granules stain orange-red w/ acidic dyes

Functions• Release histaminase

• Phagocytize Ab-Ag complexes

• Attack parasitic worms

http://greenfield.fortunecity.com/rattler/46/blood.htm


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Basophils (Granulocyte)

< 1% of circulating WBC• Large, dark purple, variable-

sized granules • Histamine• Irregular, s-shaped, bilobed

nuclei Functions

• Leave capillaries & enter CT • Release heparin, histamine &

serotonin• Intensify the inflammatory &

allergy rxn- Involved with hypersensitivity rxns

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Identify these cells:

Basophil

PMN

Eosinophil

RBC

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Monocyte (Agranulocyte)

3-8% of circulating WBC’s Physical features

• U or kidney shaped nucleus

Migratory• Differentiate into macrophage (m)

- Fixed m- Free (wandering) m

Phagocytes• Antigen presenting cell (APC) via

MHC (major histocompatibility complex)


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Lymphocyte (Agranulocyte)

General features• ~25% of circulating

WBCs• Dark, oval to round

nucleus

Types of lymphocytes• NK cells (Innate)

- Viral infected & tumor cells

• B cells (plasma)- Make antibody to

antigens• T cells

- virus, fungi, cancer, some bacteria, transplants

http://greenfield.fortunecity.com/rattler/46/blood.htm

http://www.phototakeusa.com/results.asp?txtkeys=Dennis+Kunkel

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Clinical Application: Leukemia

Acute leukemia• uncontrolled

production of immature leukocytes

Chronic leukemia• accumulation of

mature WBC in bloodstream because they do not die

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Bone Marrow Transplant

Procedure• donor match (MHC)• destroy sick bone marrow• IV transfer of healthy bone

marrow

Risky business!• Tx used for leukemia,

sickle-cell, breast, ovarian or testicular cancer, lymphoma or aplastic anemia

- Regimen-related toxicities - Infection - Graft versus host

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Another option?

Cord blood transplant• More Tolerant Matching • More Quickly Available • Less Graft-Versus-Host

Disease• Stem cells taken from

umbilical cord & frozen -painless

2402 ch 18 cardiovascular system (part 1) ppt.pdf

Documents

blood plasma

plasma89components of

blood hematology cells

blood pressure regulation

lymphoid stem cellst

body fluids

eosinophilmonocyte macrophage

structure fxn globin