Blood: Structure and function

1. Blood: Structure and function M. Rich, RN, BSN

2. Standard Standard 18, Outline the in-depth normal structure and function of blood and related components. Summarize appropriate medical texts in order to list signs and symptoms of common blood diseases and disorders associated with each. Define the following common laboratory procedure, both normal and abnormal, and provide the reasoning for why the test should be obtained: • complete blood count • Complete metabolic panel • Fasting lipid panel • Hgb A1C

3. At the conclusion of class today I CAN: • Compare and contrast the various blood components by being engaged in lecture and participating in class discussion • Describe the components of blood by creating a model of blood components

4. Blood Facts The average adult has about FIVE liters of blood inside of their body, which makes up 7-8% of their body weight. Blood is living tissue that carries oxygen and nutrients to all parts of the body, and carries carbon dioxide and other waste products back to the lungs, kidneys and liver for disposal. It also fights against infection and helps heal wounds, so we can stay healthy. There are about one billion red blood cells in two to three drops of blood. For every 600 red blood cells, there are about 40 platelets and one white cell. http://www.bloodbankofalaska.org/about_blood/index.html

5. Hematologist • A medical doctor who applies this specialized knowledge to treat patients with blood conditions. • http://www.hematology.org/Patients/Blood-Disorders.aspx

6. What makes up our blood? • RED BLOOD CELLS (Erythrocytes) – The most abundant cells in our blood; they are produced in the bone marrow and contain a protein called hemoglobin that carries oxygen to our cells. • WHITE BLOOD CELLS (Leukocytes) – They are part of the immune system and destroy infectious agents called pathogens. • PLASMA – This is the yellowish liquid portion of blood that contains electrolytes, nutrients and vitamins, hormones, clotting factors, and proteins such as antibodies to fight infection. • PLATELETS (Thrombocytes) – The clotting factors that are carried in the plasma; they clot together in a process called coagulation to seal a wound and prevent a loss of blood.

7. Blood Video https://www.youtube.com/watch?v=vVOzKrcTNis

9. Blood Cells • Erythrocytes (RBC) • Leukocytes (WBC) • Thrombocytes (platelets) • Make up 45% of total volume of blood • Hematopoiesis: Process of blood formation, occurs in bone marrow

10. Erythrocytes • What is the other name for Erythrocytes? • Live about 120 days • Make up 99% of blood cells • Are formed in bone marrow • Carry oxygen and nutrients to tissues • Carry carbon dioxide and waste away from tissues

11. Iron • is an essential element for blood production. • About 70 percent of your body's iron is found in the red blood cells of your blood called hemoglobin and in muscle cells called myoglobin. • Hemoglobin is essential for transferring oxygen in your blood from the lungs to the tissues.

12. Think-Pair-Share • What protein is contained in RBCs that transports oxygen and carbon dioxide? • What is another important role of this protein? • What happens when there is not enough of this protein? • What mineral is lacking? • What is the shape of erythrocytes? • Why is the shape important?

13. RBC • Protein: Hemoglobin • Iron: About 70 percent of your body's iron is found in the red blood cells • Shape of Red Blood Cells Erythrocytes are biconcave discs with very shallow centers. This shape optimizes the ratio of surface area to volume, facilitating gas exchange. It also enables them to fold up as they move through narrow blood vessels

14. Leukocytes - WBC • What is another name for leukocytes? • Five different types • Formed in bone marrow • Help to fight off infection • Phagocytosis: engulf and destroy microorganisms and cellular debris • Classified as: Granulocytes and agranulocytes

15. Granulocyte vs Agranulocyte? • Agranulocytes: one-lobed nucleus. They are characterized by the absence of granules in their cytoplasm. • Granulocytes: have granules in their cytoplasm (jelly-like fluid that fills a cell)

16. Neutrophils • Granulocyte • 40–60% of WBC; most numerous • Phagocytosis • Mainly bacteria • Many-lobed nucleus • Increase numbers in bacterial infections

17. Eosinophils • Granulocyte • 0–4% of WBC • Assist inflammatory response • Increase numbers in allergic reactions, skin infections, and parasitic infections • Phagocytosis

18. Basophils • Granulocyte • 0–1% of WBC; least common • Assist in inflammatory response by releasing substances such as histamine and heparin • Phagocytosis

19. Lymphocytes • Agranulocyte • 20–40% of WBC • Produce antibodies • Increase numbers in viral infections • B cells: Produce antibiodies • T cells: aid the immune system • What organ produces these?

20. Monocytes • Agranulocyte • 3–8% of WBC • Phagocytosis • Largest in size • Effective against chronic infection • Leaves bloodstream and travels to tissues

21. Apply what you have learned… • Which type of WBC would you expect to find in large numbers in a patient with bacterial meningitis? • Which type of WBC would you expect to find in large numbers in a patient with the flu? • Which type of WBC would you expect to find in large numbers in a patient with hay fever?

22. Platelets • Small, irregular-shaped cell fragments • Life span 5–12 days • Necessary for blood-clotting process

23. Plasma • Yellowish liquid portion of blood  • 92% water, constitutes 55 percent of blood volume. • Supplies critical proteins for blood clotting (fibrinogen) and immunity

25. Make Blood • Water with yellow food coloring (plasma) • Cheerios (RBC) • Marshmallows (WBC) • Platelets (stars) • Clotting Factors (sprinkles)

26. Day 2

27. Bell Work 3-13 • What mineral is lacking if you have a low erythrocyte (RBC) count? • What is a type of WBC that produces antibodies and increases in viral infections. • What type of WBC leaves bloodstream and travels to tissues? • Which type of WBC would be high due to a bacterial infection? • What are the main components of blood?

28. Bell Work Answers • IRON • Lymphocytes • Monocytes • Neutrophils • RBC (erythrocytes), WBC (leukocytes), Plasma and Platelets

29. Hematology and Coagulation • Hematology—is the study of blood in health and disease. • includes problems with the RBCs, WBCs, platelets, blood vessels, bone marrow, lymph nodes, spleen. • Proteins involved in bleeding and clotting (hemostasis and thrombosis).

30. What is Hemostasis • Hemostasis is the process which stops bleeding after an injury. • Creates a clot. • Opposite of hemorrhage

31. Hemostasis • Primary: Platelet plug formed • Secondary: platelet plug is reinforced by fibrin. Coagulation factors convert fibrinogen to fibrin • Process is called the Coagulation Cascade • https://www.youtube.com/watch?v=rLIEeUP_e-Y

33. Coagulation • Coagulation the process by which a blood clot is formed • involves the interaction of numerous blood components called coagulation factors. • Secondary phase of hemostasis

34. Thrombosis • Thrombosis occurs when blood clots block your blood vessels. There are 2 main types of thrombosis: • Venous thrombosis is when the blood clot blocks a vein. Veins carry blood from the body back into the heart. • Arterial thrombosis is when the blood clot blocks an artery. Arteries carry oxygen-rich blood away from the heart to the body.

35. What causes Thrombosis • Disease or injury to the leg veins • Not being able to move around (immobility) for any reason • A broken bone (fracture) • Certain medicines • Obesity • Inherited disorders • Autoimmune disorders • Medicines that increase your risk of clotting

36. Blood • Transports nutrients, gases, medications, wastes, and other substances throughout the body • Average adult has 5–6 liters of blood • Females have less blood than males • Blood samples classified 3 ways: • Whole blood • Plasma • Serum

37. Whole Blood • Mixture of blood cells and plasma • When obtaining a sample there must be an anticoagulant present to prevent the blood from clotting

38. Centrifuge • Centrifugation is a technique used for the separation of particles from a solution according to their size, shape, density, viscosity of the medium and rotor speed. • The particles are suspended in a liquid medium and placed in a centrifuge tube.

39. Centrifuge Machine

40. Blood Types • Are the categories which define the differences in human blood due to the presence or absence of certain protein molecules called antigens and antibodies • antigens are located on the surface of the red blood cells • antibodies are in the blood plasma

41. Genetics of Blood Types • Your blood type is established before you are BORN, by specific GENES inherited from your parents. • You inherit one gene from your MOTHER and one from your FATHER. • These genes determine your blood type

42. Blood Types AA or AO = Type ABB or BO = Type BOO = Type OAB = Type AB There are 3 alleles or genes for blood type: A, B, & O. Since we have 2 genes, there are 6 possible combinations. http://learn.genetics.utah.edu/units/basics/blood/types.cfm What are blood types?

43. Blood Types • Depend on the antigens and antibodies an individual inherits from their parents • Can be determined by the: • ABO grouping system • Rh factor blood grouping system

44. The ABO Grouping System • Categorizes blood into one of four types: • type A- has A antigens on the surface of the red blood cells and B antibodies in the blood plasma • type B- has B antigens on the surface of the red blood cells and A antibodies in the blood plasma

45. The ABO Grouping System • Categorizes blood into one of four types: • type AB- has both A and B antigens on the surface of the red blood cells and no A or B antibodies at all in the blood plasma • type O- has neither A or B antigens on the surface of the red blood cells but has both A and B antibodies in the blood plasma

46. How common is your blood type? 46.1% 38.8% 11.1% 3.9%

47. Blood Transfusions O A B AB A blood transfusion is a procedure in which blood is given to a patient through an intravenous (IV) line in one of the blood vessels. Blood transfusions are done to replace blood lost during surgery or a serious injury. A transfusion also may be done if a person’s body can't make blood properly because of an illness. Who can give you blood? People with TYPE O blood are called Universal Donors, because they can give blood to any blood type. People with TYPE AB blood are called Universal Recipients, because they can receive any blood type. Rh +  Can receive + or - Rh -  Can only receive - Universal Donor Universal Recipient

48. Blood Type Compatibility • Is extremely important to know in order to avoid agglutination • agglutination • is the clumping of particles • results when incompatible blood types are mixed within the body and the antibodies of one blood type react against the antigens of the other • can result in kidney failure and death

49. Blood Types

50. Rh Factors • Scientists sometimes study Rhesusmonkeys to learn more about the human anatomy because there are certain similarities between the two species. While studying Rhesus monkeys, a certain blood protein was discovered. This protein is also present in the blood of some people. Other people, however, do not have the protein. • The presence of the protein, or lack of it, is referred to as the Rh (for Rhesus) factor. • If your blood does contain the protein, your blood is said to be Rh positive (Rh+). If your blood does not contain the protein, your blood is said to be Rh negative (Rh-). A+ A-B+ B-AB+ AB-O+ O- http://www.fi.edu/biosci/blood/rh.html