BLOOD

elimination of
food, water intake oxygen intake carbon dioxide

DIGESTIVE RESPIRATORY
SYSTEM SYSTEM

nutrients,
water, O2 CO2
salts

CIRCULATORY URINARY
SYSTEM SYSTEM
water,
solutes
elimination rapid transport to and elimination of excess
of food from all living cells water, salts, wastes
residues

Functional Interconnections
 lungs

heart’s right half heart’s left half

liver

digestive tract

kidneys

skeletal muscle

brain

skin

bone

cardiac muscle

all other regions

 tonsils

right lymphatic duct

thymus gland

thoracic duct

spleen
The
Lymphatic
lymph vessels
System
lymph nodes

bone marrow
 Lymph Vascular System
• Fluid enters lymph
capillaries
• Capillaries merge into
lymph vessels
• Lymph vessels converge
into ducts that funnel fluid
into veins in the lower
neck flaplike “valve” at tip
of a lymph capillary
Fig. 31.18b
 lymph trickles past organized arrays of
lymphocytes within the lymph node

valve (prevents backflow)

lymph node
(cross section)
 Components of Blood

Plasma portion (50-60% of total volume)

Blood
• Water
6-8%
• Proteins
of body
• Ions, sugars, lipids, amino acids,
weight
hormones, vitamins, dissolved gases

Cellular portion (40-50% of total volume)

• White blood cells
Neutrophils
Lymphocytes
Monocytes
Eosinophils
Basophils
• Red blood cells
• Platelets
NEUTROPHIL Characteristics:
• 10-12 µm in diameter
• Nucleus: 2-5 lobes
• Granules: very fine pale lilac

Function: phagocytosis

Clinical significance:
Increased:
• Bacterial infections
• Burns
• Stress
• Inflammation
Decreased
• Radiation
• Certain drugs
• Vit B12 deficiency
• SLE
 Characteristics:
EOSINOPHIL • 10-12 µm in diameter
• Nucleus: 2-3 lobes
• Granules: large red-orange

Functions:
– combats effects of histamine in
allergic reactions
– phagocytizes Ag-Ab complexes
– destroys certain parasitic worms

Clinical significance
Increased:
• allergic reactions
• parasitic infections
• autoimmune disease
• adrenal insufficiency
Decreased
• certain drugs
• stress
• Cushing’s syndrome
 Characteristics:
BASOPHIL • 8-10 µm in diameter
• Nucleus: 2 lobes
• Granules: large deep blue-purple

Function:
- liberates heparin, histamine and
serotonin in allergic reactions that
intensify the overall inflammatory
response

Clinical significance
Increased:
• some types of allergic responses
• leukemias
• cancers
• hyperthyroidism
MONOCYTE
Characteristics:
• 12-20 µm in diameter
• nucleus: kidney-shaped or
horseshoe-shaped
• cytoplasm: blue-gray with
foamy appearance

Function: phagocytosis

Clinical significance
Increased:
• certain viral or fungal
infections
• tuberculosis
• some leukemias
• chronic diseases
LYMPHOCYTE Characteristics:
• small: 6-9 ; large : 10-14 µm in
diameter
• nucleus: round or slightly indented
• cytoplasm: sky blue in color; forms a
rim around the nucleus
Function: mediates immune
responses
Clinical significance
Increased:
• viral infections
• immune diseases
• some leukemias
Decreased
• prolonged severe illness
• high steroid levels
• immunosuppression
 Complete Blood Analysis
Normal Values:

1.RBC count: about 5.4M/µL in males

about 4.8 M/µL in females

2. Hemoglobin 14-18 g/dl in adult males

12-16 g/dl in adult females

3. Hematocrit 38-46 (ave. 42) in females

40-54 (ave. 47) in males
Clinical Significance:

A. Increased in RBC count, Hgb and Hct

1. Polycythemia
2. CHD
3. Hypoxia

B. Decreased in RBC count, Hgb and Hct

1. Hemorrhage
2. Certain types of anemia
4. WBC count:
Normal value: 5,000-10,000/µL

Clinical significance:
A. Increased
1) acute or chronic infections
2) trauma
3) leukemia
4) stress
B. Decreased
1) anemia
2) viral infections
5. Platelet count
Normal values: 150,000-300,000/µL

Clinical significance:
A. Increased
1) cancer
2) trauma
3) cirrhosis
B. Decreased
1) anemia
2) allergic conditions
3) hemorrhage
 6. Differential (WBC) Count
WBC Type and
Normal Percentage
1. neutrophils
60-70%
2. eosinophils
2-4%
3. basophils
0.5-1%
4. lymphocytes
20-25%
5. monocytes
3-8%
 Type of Cell – Increase – Decrease
Red Blood Cells (RBC)
-erythrocytosis or polycythemia
-anemia / erythroblastopenia

White Blood Cells (WBC):

leukocytosis - leukopenia
• Lymphocytes: lymphocytosis -- lymphocytopenia
• granulocytes: granulocytosis -- granulocytopenia
/ agranulocytosis
• Neutrophils: neutrophilia -- neutropenia
• Eosinophils: eosinophilia -- eosinopenia
• Basophils: basophilia -- basopenia

Platelets: thrombocytosis -- thrombocytopenia

All cell lines - pancytopenia

 BLOOD TYPING
(ABO TYPING and Rh TYPING)
Hemolytic Disease of the
Newborn (HDN)
(Erythroblastosis fetalis)
Rh E
R
F
E
Y
T T
T
A
H L
Y R
O I
s
P B
L
A
I S
T
N O
S
I
G s
Benefits of Amniocentesis
Inheritance of the Rh Trait
Complications of HDN
• anemia (in some cases, the anemia is
severe with enlargement of the liver
and spleen)
• jaundice - yellowing of the skin, eyes,
and mucous membranes.
• hydrops fetalis - heart failure and large
amounts of fluid build up in the fetal
tissues and organs (see figure)
• After birth, the red blood cell
destruction may continue. Problems
may include the following:
a) severe jaundice
b) enlarged liver
c) anemia
d) kernicterus - too much bilirubin in
the brain causing seizures, brain
damage, deafness, and death.
 Symptoms of Rh disease
• Mother – no physical signs of Rh disease

• Fetus:
– Amniocentesis - the amniotic fluid may have a yellow
coloring and contain bilirubin.
– Ultrasound of the fetus - enlarged liver, spleen, or
heart and fluid build up in the fetus' abdomen.
– The symptoms of Rh disease may resemble other
conditions or medical problems.
• Always consult your physician for a diagnosis.
 Diagnosis of the Rh Disease
• Blood testing of both parents (Rh negative
mother, Rh positive father).

• Diagnosis of previous pregnancy via:

– complete medical history and physical examination,
– diagnostic procedures for Rh disease :
• presence of Rh positive antibodies in the mother's blood
• ultrasound of fetus.
• amniocentesis - measure the amount of bilirubin in the
amniotic fluid.
• sampling of some of the blood from the fetal umbilical cord
during pregnancy - checks for antibodies, bilirubin, and
anemia in the fetus.
 Treatments for Rh disease
• Intrauterine blood transfusion of red blood cells
into the baby's circulation - a procedure that is performed
by placing a needle through the mother's uterus and into
the abdominal cavity of the fetus or directly into the vein
in the umbilical cord. It may be necessary to give a
sedative medication to keep the baby from moving.
Intrauterine transfusions may need to be repeated.

• Early delivery, if the fetus develops complications (if

the fetus has mature lungs, labor and delivery may be
induced to prevent worsening of the disease)
 Prevention of Rh disease
• Administration of Rh immunoglobulin
(RhIg), also known as RhoGAM.
– destroys any anti-Rh antibodies that enter the
mother's circulation before her immune
system becomes sensitized; protection for a
future Rh positive baby.
– given around the 28th week of pregnancy.
– after delivery, a woman should receive a
second dose of the drug within 72 hours.
The End