Chapter 14
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Chapter 14 The Cardiovascular System: Blood
Copyright 2010, John Wiley & Sons, Inc.
Functions
Transportation: water, gases, nutrients, hormones, enzymes, electrolytes, wastes, heat Regulation: pH, temperature, water balance Protection: blood clotting, defense: phagocytic cells, interferons, complement
Copyright 2010, John Wiley & Sons, Inc.
Composition
A connective tissue with components readily seen when blood is centrifuged:
Plasma(~55%): soluble materials (mostly water); lighter so at top of tube Formed elements (~45%): cells (heavier so at bottom of tube)
Mostly red blood cells (RBCs) Percent of blood occupied by RBCs = hematocrit (Hct) Normal hematocrit value: 42-47% Females: 38 to 46%; males: 40 to 54%
Buffy coat: site of white blood cells (WBCs), platelets
Copyright 2010, John Wiley & Sons, Inc.
Composition
Copyright 2010, John Wiley & Sons, Inc.
Composition
Copyright 2010, John Wiley & Sons, Inc.
Plasma: Liquid Portion of Blood
Water: 91.5% Plasma proteins: 7%
Albumin (54%): function in osmosis; carriers Globulins (38%): serve as antibodies Fibrinogen (7%): important in clotting
Other: 1.5%
Electrolytes, nutrients, gases, hormones, vitamins, waste products
Copyright 2010, John Wiley & Sons, Inc.
Formed Elements I. Red Blood Cells (RBCs) II. White blood cells (WBCs) A. Granular leukocytes 1. Neutrophils 2. Eosinophils 3. Basophils
B. Agranular leukocytes 1. Lymphocytes and natural killer (NK) cells 2. Monocytes
III Platelets
Copyright 2010, John Wiley & Sons, Inc.
Formation of Blood Cells
Called hemopoiesis or hematopoiesis Occurs throughout life
In response to specific hormones, stem cells undergo a series of changes to form blood cells
Pluripotent stem cells in red marrow
Lymphoid stem cells lymphocytes (in lymphatic tissues) Myeloid stem cells all other WBCs, all RBCs, and platelets (in red bone marrow)
Copyright 2010, John Wiley & Sons, Inc.
Formation of Blood Cells
Copyright 2010, John Wiley & Sons, Inc.
Formation of Blood Cells
Copyright 2010, John Wiley & Sons, Inc.
Erythrocytes (RBCs)
Hemoglobin (red pigment)
RBC count: about 5 million/µl
Carries 98.5% of O2 and 23% of CO2 Male: 5.4 million cells/µl; female: 4.8 million/µl
Structure of mature RBC
No nucleus/DNA so RBCs live only 3 to 4 mos Lack of nucleus causes biconcave disc shape with extensive plasma membrane
Provides for maximal gas exchange Is flexible for passing through capillaries
Copyright 2010, John Wiley & Sons, Inc.
RBC Recycling
Cleared by macrophages (liver and spleen) Recycled components
Globin amino acids recycled to form proteins Heme broken down into:
Fe Carried in blood by transferrin (“protein escort” of Fe) Recycled in bone marrow for forming synthesis of new hemoglobin; proteins and vitamin B12 required also
Non-Fe portion of heme biliverdin bilirubin Bilirubin to liver bile helps absorb fats Intestinal bacteria convert bilirubin into other chemicals that exit in feces (stercobilin) or urine (urobilin)
Copyright 2010, John Wiley & Sons, Inc.
Formation and Destruction of RBC’s Circulation for about 120 days
7
3 Reused for protein synthesis
Amino acids
Globin
4
6
5
Fe3+
Fe3+ Transferrin
2 Heme
Fe3+
Ferritin Transferrin Bilirubin
9 1 Red blood cell
Biliverdin
Bilirubin
11
10
death and phagocytosis
Small intestine
Kidney
13
12
Urobilin
Macrophage in spleen, liver, or red bone marrow
Bilirubin
Urobilinogen Stercobilin
Urine
Liver
+ Globin + Vitamin B12 + Erythopoietin
8 Erythropoiesis in red bone marrow
Bacteria
Key: in blood
Large 14 intestine
Feces
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in bile
RBC Synthesis: Erythropoiesis
Develop from myeloid stem cells in red marrow Cells lose nucleus; are then released into bloodstream as reticulocytes
These almost-mature RBCs develop into erythrocytes after 1-2 days in bloodstream High reticulocyte count (> normal range of 0.5% to 1.5% as more of these circulate in bloodstream) indicates high rate of RBC formation
Copyright 2010, John Wiley & Sons, Inc.
RBC Synthesis: Erythropoiesis
Production and destruction: normally balanced
Stimulus for erythropoiesis is low O2 delivery (hypoxia) in blood passing to kidneys Kidneys release erythropoietin release (EPO) Stimulates erythropoiesis in red marrow increased O2 delivery in blood (negative feedback mechanism)
Copyright 2010, John Wiley & Sons, Inc.
RBC Synthesis: Erythropoiesis
Signs of lower-than-normal RBC count changes in skin, mucous membranes, and finger nail beds
Cyanosis: bluish color Anemia: pale color
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Regulation of Erythropoiesis
Copyright 2010, John Wiley & Sons, Inc.
White Blood Cells (WBCs or Leukocytes) Appear white because lack hemoglobin Normal WBC count: 5,000-10,000/µl
WBC count usually increases in infection
Two major classes based on presence or absence of granules (vesicles) in them]
Granular: neutrophils, eosinophils, basophils
Neutrophils usually make up 2/3 of all WBCs
Agranular: lymphocytes, monocytes
Major function: defense against
Infection and inflammation Antigen-antibody (allergic) reactions Copyright 2010, John Wiley & Sons, Inc.
White Blood Cell Functions
Neutrophils: first responders to infection
Monocytes macrophages (“big eaters”)
Phagocytosis Release bacteria-destroying enzyme lysozyme Known as wandering macrophages
Eosinophils
Phagocytose antibody-antigen complexes Help suppress inflammation of allergic reactions Respond to parasitic infections
Copyright 2010, John Wiley & Sons, Inc.
White Blood Cell Functions Basophils
Intensify inflammatory responses and allergic reactions Release chemicals that dilate blood vessels: histamine and serotonin; also heparin (anticoagulant)
Copyright 2010, John Wiley & Sons, Inc.
White Blood Cell Functions Lymphocytes
Three types of lymphocytes
T cells B cells Natural killer (NK) cells
Play major roles in immune responses
B lymphocytes respond to foreign substances called antigens and differentiate into plasma cells that produce antibodies. Antibodies attach to and inactivate the antigens. T lymphocytes directly attack microbes.
Copyright 2010, John Wiley & Sons, Inc.
White Blood Cell Functions
Major histocompatibility (MHC) antigens
Proteins protruding from plasma membrane of WBCs (and most other body cells) Called “self-identity markers”
Unique for each person (except for identical twins) An incompatible tissue or organ transplant is rejected due to difference in donor and recipient MHC antigens MHC antigens are used to “type tissues” to check for compatibility and reduce risk of rejection
Copyright 2010, John Wiley & Sons, Inc.
WBC Life Span
WBCs: 5000-10,000 WBCs/µl blood RBCs outnumber WBCs about 700:1 Life span: typically a few hours to days Abnormal WBC counts
Leukocytosis: high WBC count in response to infection, exercise, surgery Leukopenia: low WBC count
Differential WBC count: measures % of WBCs made up of each of the 5 types Copyright 2010, John Wiley & Sons, Inc.
Platelets
Myeloid stem cells megakaryocytes 2000–3000 fragments = platelets Normal count: 150,000-400,000/µl blood Functions
Plug damaged blood vessels Promote blood clotting
Life span 5–9 days
Copyright 2010, John Wiley & Sons, Inc.
Hemostasis: “Blood Standing Still” Sequence of events to avoid hemorrhage 1. Vascular spasm
Response to damage Quick reduction of blood loss
2. Platelet plug formation
Platelets become sticky when contact damaged vessel wall
3. Blood clotting (coagulation)
Series of chemical reactions involving clotting factors
Copyright 2010, John Wiley & Sons, Inc.
Blood Clotting (Coagulation)
Extrinsic pathway
Intrinsic Pathway
Tissue factor(TF) from damaged cells 1 2 3 Materials “intrinsic” to blood 1 2 3
Common pathway: 3 major steps 1. Prothrombinase 2. Prothrombin thrombin 3. Fibrinogen fibrin clot
Ca++ plays important role in many steps Copyright 2010, John Wiley & Sons, Inc.
Clot Retraction and Vessel Repair
Clot plugs ruptured area Gradually contracts (retraction)
Pulls sides of wound together
Repair
Fibroblasts replace connective tissue Epithelial cells repair lining
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Hemostatic Control Mechanisms
Fibrinolysis: breakdown of clots by plasmin
Inappropriate (unneeded) clots
Inactivated plasminogen Activated (by tPA) plasmin Clots can be triggered by roughness on vessel wall = thrombosis Loose (on-the-move) clot = embolism
Anticoagulants: decrease clot formation
Heparin Warfarin (Coumadin) Copyright 2010, John Wiley & Sons, Inc.
(a) Extrinsic pathway
Stages of Clotting
Tissue trauma
(b) Intrinsic pathway Blood trauma Damaged endothelial cells expose collagen fibers
Tissue factor (TF)
Damaged platelets
Activated XII Activated platelets
Ca2+
Ca2+
+ Platelet phospholipids
Activated X Activated X V
1
Ca2+
Ca2+
V +
PROTHROMBINASE (c) Common pathway Ca2+ Prothrombin (II)
THROMBIN Ca2+
2
XIII
Fibrinogen (I)
Activated XIII
Loose fibrin threads
STRENGTHENED FIBRIN THREADS
3
Copyright 2010, John Wiley & Sons, Inc.
Blood Groups and Blood Types
RBCs have antigens (agglutinogens) on their surfaces Each blood group consists of two or more different blood types
There are > 24 blood groups Two examples:
ABO group has types A, B, AB, O Rh group has type Rh positive (Rh+), Rh negative (Rh–)
Blood types in each person are determined by genetics Copyright 2010, John Wiley & Sons, Inc.
ABO Group
Two types of antigens on RBCs: A or B
Type A has only A antigen Type B has only B antigen Type AB has both A and B antigens Type O has neither A nor B antigen
Most common types in US: type O and A
Typically blood has antibodies in plasma
These can react with antigens Two types: anti-A antibody or anti-B antibody Blood lacks antibodies against own antigens
Type A blood has anti-B antibodies (not anti-A) Type AB blood has neither anti-A nor anti-B antibodies Copyright 2010, John Wiley & Sons, Inc.
ABO Group
Copyright 2010, John Wiley & Sons, Inc.
Rh Blood Group
Name Rh: antigen found in rhesus monkey Rh blood types
If RBCs have Rh antigen: Rh+ If RBCs lack Rh antigen: Rh–
Rh+ blood type in 85-100% of U.S. population Normally neither Rh+ nor Rh– has anti-Rh antibodies Antibodies develop in Rh- persons after first exposure to Rh+ blood in transfusion (or pregnancy hemolytic disease of newborn) Copyright 2010, John Wiley & Sons, Inc.
Transfusions
If mismatched blood (“wrong blood type”) given, antibodies bind to antigens on RBCs hemolyze RBCs Type AB called “universal recipients” because have no anti-A or anti-B antibodies so can receive any ABO type blood Type O called “universal donors” because have neither A nor B antigen on RBCs so can donate to any ABO type
Misleading because of many other blood groups that must be matched Copyright 2010, John Wiley & Sons, Inc.
End of Chapter 14
Copyright 2010 John Wiley & Sons, Inc. All rights reserved. Reproduction or translation of this work beyond that permitted in section 117 of the 1976 United States Copyright Act without express permission of the copyright owner is unlawful. Request for further information should be addressed to the Permission Department, John Wiley & Sons, Inc. The purchaser may make back-up copies for his/her own use only and not for distribution or resale. The Publishers assumes no responsibility for errors, omissions, or damages caused by the use of theses programs or from the use of the information herein. Copyright 2010, John Wiley & Sons, Inc.
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