Hematology

1. Hematology

2. Objectives Explain the structure of the blood. Analyze the function of the blood Discuss characteristics and treatments of common blood disorders

3. Structure of Blood Average adult = 8-10 pints of blood Composition: • PLASMA – liquid portion of blood without cellular components • SERUM – plasma after a blood clot is formed • CELLULAR COMPONENTS – (elements are red cells, white cells and platelets)

4. PLASMA • Straw colored, contains – • Water • Blood proteins • Plasma proteins • FIBRONOGEN – necessary for blood clotting, synthesized in the liver • ALBUMIN – from the liver, helps maintain blood’s osmotic pressure and volume • PROTHROMBIN – a globulin which helps blood coagulate. Vitamin K necessary for prothrombin synthesis. • Nutrients • Electrolytes • Hormones, vitamins, enzymes • Metabolic waster products

5. ERYTHROCYTES Shape = biconcave disc donut-shaped HEMOGLOBIN – gives red color, heme is iron and globin is protein. Function = transports oxygen to tissues and carbon dioxide away from cells Normal – men =14-18 gm, women = 12-16 gm

6. Function of Hemoglobin • Red cells travel through the lungs where O2 is carried to tissues and released • CO2 picked up and carried back to lungs for exchange • Arterial blood – lots of oxygen = bright red • Venous blood – lots of CO2 = dark crimson What is carbon monoxide poisoning?

7. What is carbon monoxide poisoning?

8. ERYTHROPOIESIS • Manufacture of red blood cells • Occurs in bone marrow • Red cells live 120 days • Old cells broken down by the spleen and liver • HEMOLYSIS – rupture or bursting of erythrocyte, can be from a blood transfusion or disease.

9. LEUKOCYTES White Blood Cells – LEUKOCYTES • Larger than erythrocytes • 5 types • Normal leukocyte count = 3,200 – 9,800

10. Types of White Cells Neutrophils Eosinophils Basophils Lymphocytes Monocytes

11. PHAGOCYTOSIS – process when white cells surround, engulf, and digest harmful bacteria Basophils produce HEPARIN – an anticoagulant DIAPEDESIS – when white cells move through capillary wall into neighboring tissue.

12. INFLAMMATION • Body’s reaction to chemical or physical trauma • PATHOGENIC – disease producing microorganisms can cause inflammation • Symptoms – redness, local heat, swelling and pain • Why? Bacterial toxins, increased blood flow, collection of plasma in tissues (edema) • HISTAMINE increases the blood flow to the injured area • PUS produced – a combination of dead tissue, dead and living bacteria, dead leukocytes and plasma • ABSCESS – pus-filled cavity below the epidermis • PYREXIA – increase in body temperature by the hypothalamus – in response to pathogenic invasion

13. LEUKOCYTOSIS – increase in the number of white cells in response to infection LEUKOPENIA – decrease in number of white cells due to chemotherapy or radiation

14. THROMBOCYTES (Platelets) • Smallest of solid components of blood • Synthesized in red marrow • Not cells – fragments of megakaryocytes • Necessary for the initiation of the blood clotting process COAGULATION

15. COAGULATION: Cut or injury  platelets and injured tissue release THROMBOPLASTIN act on PROTHROMBIN in plasma  + Calcium ions converts to THROMBIN the thrombin acts as an enzyme and changes FIBRINOGENFIBRIN creating a mesh that traps red blood cells, platelets and plasma creating a blood clot. ANTICOAGULANTS – prevent blood clotting HEPARIN = antiprothrombin PROTHROMBIN – dependent on Vitamin K

16. Function of the Blood Four main functions: 1.Transport oxygen, nutrients, cellular waste products and hormones 2. Aids in distribution of heat 3. Regulates acid-base balance 4. Helps protect against infection

17. BLOOD TYPES • Four major types of blood- A, B, AB and O • Inherited from parents • Determined by presence or absence of an ANTIGEN on the surface of the red blood cell A B O AB AB

18. ANTIBODY – a protein in the plasma that will inactivate a foreign substance that enters the body. Someone with type A blood has b antibodies Someone with type B blood has a antibodies Someone with type AB blood has no antibodies Someone with type O blood has a and b antibodies

19. UNIVERSAL DONOR – O UNIVERSAL RECIPIENT – AB Red cells also may contain Rh factor If you have it, you’re Rh + If you don’t, you’re Rh –

20. DISORDERS OF THE BLOOD • ANEMIA • IRON-DEFICIENCY ANEMIA • APLASTIC ANEMIA • SICKLE CELL ANEMIA • POLYCYTHEMIA • EMBOLISM • THROMBOSIS • HEMATOMA

21. DISORDERS OF THE BLOOD • HEMOPHILIA • THROMBOCYTOPENIA • LEUKEMIA

22. IRON-DEFICIENCY ANEMIA • Usually in women, children and adolescents • Deficiency of iron in the diet causing insufficient hemoglobin synthesis • Treat with iron supplements and green, leafy vegetables

23. APLASTIC ANEMIA • Bone marrow does not produce enough red and white blood cells • Caused by drugs or radiation therapy

24. SICKLE CELL ANEMIA • Chronic blood disease inherited from both parents • Causes the red cells to form in abnormal sickle shape • Sickle cells break easily and carry less oxygen • Occurs primarily in blacks • Treatment – blood transfusions

25. POLYCYTHEMIA • Too many red blood cells are formed • May be a temporary condition that occurs at high altitude

26. EMBOLISM • Air, blood clot, cancer cells, fat, etc. that is carried by the bloodstream until it reaches an artery too small for passage • Also known as a “moving blood clot”

27. THROMBOSIS • The formation of a blood clot in a blood vessel • The blood clot is a THROMBUS

28. HEMATOMA • Localized clotted mass of blood found in an organ, tissue or space. • Caused by an injury that can cause a blood vessel to rupture

29. HEMOPHILIA • Hereditary • Missing clotting factor • Blood clots slow or abnormally • Sex-linked – transmitted genetically from mothers to sons Treatment: with missing clotting factor, avoid trauma

30. THROMBOCYTOPENIA • Not enough platelets • Blood will not clot properly

31. LEUKEMIA • Malignant condition • Overproduction of immature white blood cells • Hinders synthesis of red cells • Treatment: Research on cord blood