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This 12 page Class Notes was uploaded by Charissa Notetaker on Wednesday September 21, 2016. The Class Notes belongs to Biol 215 at Liberty University taught by Ms. Lenz in Fall 2016. Since its upload, it has received 5 views. For similar materials see Human Anatomy and Physiology II in Science at Liberty University.
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Date Created: 09/21/16
Blood 19.1 Functions of Blood 1. Blood transports gases, nutrients, waste products, processed molecules, and regulatory molecules. 2. Blood is involved in the regulation of pH, osmosis, and body temperature. a. Bicarbonate buffer system. b. Maintenance of ion balance. c. Most body tissue pH is 7.357.45; body can typically function in range of 6.8 7.8 without irreversible damage. d. Acidemia: pH belpw 7.35 (acidic blood and tissues, increased H+ concentration). e. Alkalemia: pH above 7.45 (low H+ concentration). f. Most body heat is generated in the deep organs, especially the liver, brain, and heart, and in contraction of skeletal muscles. 3. Blood protects against disease and initiates tissue repair. a. White blood cells. b. Complement system. 4. Clot formation 19.2 Composition of Blood 1. Blood is a type of connective tissue that consists of plasma and formed elements. 2. Total blood volume in a male adult is 56 L and in female is 45 L. 19.3 Plasma 1. Liquid part of the blood a. Colloid: liquid containing suspended substances that don’t settle out of solution b. Colloidal osmotic pressure tends to pill fluid into the capillaries. 2. Plasma is mostly water (91%) and contains proteins, such as albumin (maintains osmotic pressure), globulins (function in transport and immunity), fibrinogen (involved in clot formation), and hormones and enzymes (involved in regulation). 3. Proteins: a. Albumins: viscosity, osmotic pressure, buffer, transports fatty acids, free bilirubin, thyroid hormones. i. 58% of plasma protein; maintains colloidal osmotic pressure. b. Globulins: transports lipids, carbohydrates, hormones, ions, antibodies, and complement. i. 38% of plasma proteins; carrier protein. c. Fibrinogen: blood clotting. i. 4% (coagulation). d. In conditions where plasma proteins are reduced, e.g. from being lost in the urine (proteinuria) or from malnutrition, there will be a reduction in colloidal osmotic pressure and an increase in filtration across the capillary, resulting in excess fluid buildup in the tissues (edema). 4. Serum: plasma without proteins. 5. Plasma contains ions, nutrients, waste products, and gases. a. Ions: involved in osmosis, membrane potentials, and acidbase balance. i. Ions are: sodium, potassium, calcium, magnesium, chloride, iron, phosphate, hydrogen, hydroxide, bicarbonate. b. Nutrients: glucose, amino acids, triacylglycerol, cholesterol, vitamins. c. Waste products: i. Urea, uric acid, creatinine, ammonia salts – breakdown products of protein metabolism ii. Bilirubin – breakdown product of RBCs iii. Lactic acid – end product of anaerobic respiration d. Gases: oxygen, carbon dioxide, and inert nitrogen. e. Regulatory substances: hormones, enzymes. 19.4 Formed Elements The formed elements are red blood cells (erythrocytes), white blood cells (leukocytes), and platelets (cell fragments). Production of Formed Elements 1. In the embryo and fetus, the formed elements are produced in a number of locations. 2. After birth, red bone marrow becomes the source of the formed elements. 3. In adults, red marrow is confined to ribs, sternum, vertebrae, pelvis, proximal femur, and proximal humerus. 4. All formed elements are derived from hemocytoblast, which gives rise to two intermediate stem cells: myeloid stem cells and lymphoid stem cells. Myeloid stem cells give rise to red blood cells, platelets, and most of the white blood cells. Lymphoid stem cells give rise to lymphocytes. 5. Hematopoiesis or hemopoiesis: process of blood cell production. 6. Stem cells: all formed elements derived from a single population. a. Proerythroblasts: develop into red blood cells. b. Myeloblasts: develop into basophils, neutrophils, and eosinophils. c. Lymphoblasts: develop into lymphocytes. d. Monoblasts: develop into monocytes. e. Megakaryoblasts: develop into platelets. Red Blood Cells 1. 95% of volume of formed elements. 2. Biconcave discs. a. Red blood cells are biconcave discs containing hemoglobin and carbonic anhydrase. 3. Transport oxygen and carbon dioxide. a. Oxygen from lungs to tissues: 98.5% attached to hemoglobin; 1.5% dissolved in plasma. b. Carbon dioxide from tissues to lungs: i. 7% dissolved in plasma. ii. 23% in combination with hemoglobin. iii. 70% transported as bicarbonate ions produced as a result of combination of H2O and CO2 because of enzyme carbonic anhydrase found within RBCs. c. A hemoglobin molecule consists of four heme and four globin molecules. The heme molecules transport oxygen, and the globin molecules transport carbon dioxide and nitric oxide. Iron is required for oxygen transport. d. Carbonic anhydrase is involved with the transport of carbon dioxide. e. Erythropoiesis is the production of red blood cells. i. Stem cells in red bone marrow eventually give rise to the late erythroblasts, which lose their nuclei and are released into the blood as reticulocytes. Loss of the endoplasmic reticulum by a reticulocyte produces a red blood cell. ii. In response to low blood oxygen, the kidneys produce erythropoietin, which stimulates erythropoiesis. iii. RBCs last 120 days in circulation (enucleated). iv. Stem cells (hemocytoblasts) → myeloid stem cell→ proerythroblasts → early erythroblasts → intermediate erythroblasts → late erythroblasts → reticulocytes. v. Production of single RBCs take about 4 days. vi. Intermediate erythroblasts continue to produce hemoglobin, then most of their ribosomes and other organelles degenerate. vii. 1/3 of cytoplasm in late erythroblasts is hemoglobin, so they are red. They lose nuclei to become immature RBCs (reticulocytes). viii. In ~2 days, ribosomes in reticulocytes degenerate and become mature RBCs. f. Erythropoietin (EPO). i. Hormone stimulates RBC production. ii. Produced by kidneys in response to low O l2 els. 4. Anucleate. 5. Contain hemoglobin. a. Types of hemoglobin: i. Embryonic ii. Fetal iii. Adult b. Hemoglobin from ruptured red blood cells is phagocytized by macrophages. The hemoglobin is broken down, and heme becomes bilirubin, which is secreted in bile. c. Hemoglobin is pigmented (hence red colour). i. Heme is a red pigmented molecule containing iron atom. d. It occupies 1/3 of the RBCs volume. e. Oxyhemoglobin: transporting oxygen. f. Deoxyhemoglobin: no oxygen. g. Carbaminohemoglobin: transporting carbon dioxide. h. Globin is a polypeptide. i. CO2 attaches to globin, not iron/heme. ii. Globulin molecules transport nitric oxide. NO brought from lungs to tissues, induces smooth muscles to relax, lowering BP. iii. Carbon monoxide (result of gas combustion) binds iron with high affinity, so O2 can’t bind. i. Hemoglobin breakdown: i. Hemoglobin is broken down by macrophages into heme and globin chains. ii. The globin chains of hemoglobin are broken down to individual amino acids. iii. The heme of hemoglobin releases the iron. iv. Blood transports iron in combination with transferrin to various tissues for storage or to the red bone marrow. v. Blood transports free bilirubin to the liver. vi. Coagulated bilirubin is excreted as part of the bile into the small intestine. vii. Some bilirubin derivatives contribute to the colour of feces. viii. Other bilirubin derivatives are reabsorbed from the intestine into the blood. 6. Red blood cell pathologies. a. Anemia: decrease in the amount of RBCs or hemoglobin in the blood. b. Hemolysis: abnormal breakdown of RBCs. i. RBCs rupture, release hemoglobin into plasma; hemoglobin denatures in new environment, becoming nonfunctional. ii. Grampositive bacteria, parasites. iii. Autoimmune disorders. iv. Genetic disorders. White Blood Cells 1. White blood cells protect the body against microorganisms and remove dead cells and debris. 2. Movements: a. Ameboid: pseudopods. b. Diapedesis: cells become thin, elongate and move either between or through endothelial cells of capillaries. c. Chemotaxis: attraction to and movement toward foreign materials or damaged cells. 3. Five types of white blood cells exist: a. Neutrophils are small, phagocytic cells. i. Stay in circulation 1012 hours. ii. Become motile, phagocytize bacteria, antigenantibody complexes and other foreign matter. iii. Secrete lysozyme. b. Eosinophils attack certain worm parasites and modulate inflammation. i. Defend against worm parasites. ii. Prevalent in allergic reactions. iii. Destroy inflammatory chemicals like histamine. c. Basophils release histamine and are involved with increasing the inflammatory response. i. Leave circulation and migrate through tissues. ii. Inflammatory response and allergic reactions. iii. Produce histamine and heparin. 1. Histamine: dilation of blood vessels. 2. Heparin: slows blood clotting. d. Lymphocytes are important in immunity, including the production of antibodies. i. Migrate to lymphatic tissues and proliferate. ii. Antibody production. iii. Immune function: Bcells, Tcells. e. Monocytes leave the blood, enter tissues, and become large, phagocytic cells called macrophages. i. Become macrophages and phagocytize bacteria, dead cells, and debris. ii. Stimulate responses in other cells. 4. Granulocytes: a. Cytoplasm contains large granules. b. Multilobed nuclei. c. Three distinctive types: neutrophils, eosinophils, basophils. 5. Agranulocytes: a. Cytoplasm contains small granules. b. Nuclei are not lobed. c. Two distinctive types: lymphocytes and monocytes. 6. WBC pathologies: a. Leukemia: cancer of red bone marrow. i. Cells usually immature or abnormal. ii. Lack of normal immune functions. Platelets 1. Platelets, or thrombocytes, are cell fragments pinched off from megakaryocytes in the red bone marrow. 2. Disc shaped cell fragment. 3. Form platelet plugs. a. Fill small holes. 4. Releases chemicals necessary for blood clotting. a. Seals larger wounds. 19.5 Hemostasis 1. Hemostasis, the cessation of bleeding, it is very important to the maintenance of homeostasis. Vascular Spasm 1. Vasoconstriction of damaged blood vessels reduces blood loss. a. It is immediate but temporary. Platelet Plug Formation 1. Platelets repair minor damage to blood vessels by forming platelet plugs: a. In platelet adhesion, platelets bind to collagen in damaged tissues. b. In the platelet release reaction, platelets release chemicals that activate additional platelets. i. ADP, thromboxane, and other chemicals released. ii. These bind receptors on surface of other platelets and activate them. iii. Positive feedback – activated platelets release chemicals and activate more platelets. c. Activated platelets change shape and express fibrinogen receptors. i. Fibrinogen is plasma protein. ii. Platelet aggregation – fibrinogen forms a bridge between fibrinogen receptors of different platelets, resulting in a platelet plug. 2. Platelets also release chemicals involved with coagulation. 3. Activated platelets also release coagulation factor V and phospholipid (platelet factor III) – important for coagulation. Coagulation 1. Coagulation is the formation of a blood clot. 2. Coagulation factors: a. Proteins found in plasma. b. Circulate in inactive state until tissues are injured. c. Damaged tissues and platelets produce chemicals that begin activation of the factors. 3. The first stage of coagulation occurs through the extrinsic or intrinsic pathway. Both pathways end with the production of activated factor X. a. The extrinsic pathway begins with the release of thromboplastin from damaged tissues. i. Stage 1: 1. Damaged tissues release thromboplastin (tissue factor III). 2. When Ca is present, forms complex with factor VII, activating factor X. 3. Prothrombinase is formed. ii. Stage 2: prothrombinase converts prothrombin into thrombin. iii. Stage 3: 1. Thrombin converts fibrinogen to fibrin. 2. Thrombin activates factor XIII, which stabilizes clot. b. The intrinsic pathway begins with the activation of factor XII and chemicals that are part of the blood. i. Stage 1: 1. In damaged blood vessels, factor XII comes in contact with exposed collagen, activating factor XII. 2. Stimulates factor XI, activated factor IX. 3. Activated factor IX joins with factor VIII, platelet phospholipids, and Ca to activate factor X. 4. Prothrombinase is formed. ii. Stages 2 and 3 progress to clot formation. 2+ 4. Activated factor X, factor V, phospholipids, and Ca form prothrombinase. 5. Prothrombinase converts prothrombin to thrombin. 6. Thrombin converts fibrinogen to fibrin. The insoluble fibrin forms the clot. 7. Thrombin also stimulates factor XII activation, which stabilizes clot. 8. Thrombin also activates many clotting proteins, creating a positivefeedback system (thrombin production stimulates more thrombin production). 9. Thrombin also stimulates platelet activation. Control of Clot Formation 1. Heparin and antithrombin inhibit thrombin activity. Therefore, fibrinogen is not yet converted to fibrin, and clot formation is inhibited. 2. Prostacyclin counteracts the effects of thrombin. 3. Anticoagulants: prevents coagulation factors from initiating clot formation. a. Antithrombin: i. Produced by the liver. ii. Slowly inactivates thrombin. b. Heparin: i. Produced by basophils and endothelial cells. ii. Increases effectiveness of antithrombin. c. Prostacyclin: i. Produced by endothelial cells. ii. Causes vasodilation and inhibits release of coagulating factors from platelets. 4. Uncontrolled clots: a. Thrombus: blood clot that forms in a vessel. b. Embolus: free floating clot in blood vessels. Clot Retraction and Dissolution 1. Clot retraction results from the contraction of platelets, which pull the edges of damaged tissue closer together. 2. Serum, which is plasma minus fibrinogen and some clotting factors, is squeezed out of the clot. 3. Factor XII, thrombin, tissue plasminogen activator, and urokinase activate plasmin, which dissolves fibrin (the clot). 4. Fibrinolysis: process of dissolving a blood clot. a. Inactive plasminogen is converted to the active enzyme plasmin. b. Plasmin breaks the fibrin molecules, and therefore the clot, into smaller pieces, which are washed away in the blood or phagocytized. 19.6 Blood Grouping 1. Blood groups are determined by antigens on the surface of red blood cells. 2. Antibodies can bind to red blood cells antigens, resulting in agglutination or hemolysis of red blood cells. 3. Transfusion: transfer of blood or blood components from one individual to another. 4. Infusion: introduction of fluid other than blood. 5. Determined by antigens (agglutinogens) on surface of RBCs. 6. Antibodies (agglutinins) can bind to RBC antigens, resulting in agglutination (clumping) or hemolysis (rupture) of RBCs. a. Antigen: toxin or other foreign substance that induces an immune response in the body. b. Antibodies are specific to certain antigens. ABO Blood Group 1. Type A blood has A antigens, type B blood has B antigens, type AB blood has A and B antigens, and type O blood has neither A nor B antigens. 2. Type A blood has antiB antibodies, type B blood has antiA antibodies, type AB blood has neither antiA nor antiB antibodies, and type O blood has both antiA and antiB antibodies. a. O is most common. b. A is next most common. c. B is not very common. d. AB is very uncommon. 3. Mismatching the ABO blood group results in a transfusion reaction. 4. Agglutination reaction: a. Type A blood of a donor antiB antibody in type A blood of recipient: no agglutination reaction. i. Type A blood donated to a type A recipient does not cause an agglutination reaction because the antiB antibodies in the recipient do not combine with the type A antigens on the red blood cells in the donated blood. b. Type A blood of donor antiA antibody in type B blood of recipient: agglutination. i. Type A blood donated to a type B recipient causes an agglutination reaction because the antiA antibodies in the recipient combine with the type A antigens on the red blood cells in the donated blood. Rh Blood Group 1. First studied in rhesus monkeys. 2. Rhpositive blood has the D antigen, whereas Rhnegative blood does not. 3. Antibodies against the D antigen are produced by an Rhnegative person when the person is exposed to Rhpositive blood. 4. The Rh blood group is responsible for hemolytic disease of the newborn. a. Rh positive fetus, Rh negative mother. b. Late in pregnancy, Rh antigens of fetus cross placenta. c. Mother creates antiRh antibodies (primary response). i. AntiRh antibodies do not develop unless person is exposed to opposite blood type (transfusion, motherfetus). d. Second Rh positive pregnancy might initiate secondary response and HDN. e. Mother can get an injection of RhoGAM. i. RhoGAM contains antibodies against Rh antigens. Antibodies attach to any fetal RBCs and they are destroyed. 19.6 Diagnostic Blood Tests Type and Crossmatch Blood typing determines the ABO and Rh blood groups of a blood sample. A crossmatch tests for agglutination reactions between donor and recipient blood. Complete Blood Count 1. A complete blood count consists of the following: a. Red blood count: number of RBCs per microliter of blood. b. Hemoglobin measurement: grams of hemoglobin per 100 mL of blood. c. Hematocrit measurement: percent volume of red blood cells. d. White blood count. 2. Differential white blood count: the percentage of each type of white blood cell. a. High neutrophil bacterial infection. b. High eosinophil/basophil allergic reaction. Clotting 1. Platelet count and prothrombin time measurement assess the blood’s ability to clot. a. Platelet count: 250,000 400,000/microliter. i. Thrombocytopenia: low platelet count. 1. Chronic bleeding in small vessels and capillaries. b. Prothrombin time measurement: measures how long it takes for blood to start clotting. Blood Chemistry 1. The composition of materials dissolved or suspended in plasma (e.g., glucose, urea, nitrogen, bilirubin, and cholesterol) can be used to assess the function and status of the body’s systems.
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