Hematology
1H07.01 Explain the structure of the blood.
A. Adult = 8-10 pints
B. Composition
1. Plasma
2. Serum
3. Cellular components (red blood cells, white blood cells, platelets)
C. Plasma
1. Straw colored
2. Contains water, blood proteins, plasma proteins, nutrients, etc.
D. Erythrocytes
1. Shape = biconcave discs, donut-shaped
2. Hemoglobin
a. Gives red color
b. Heme is iron, globin is protein
c. Arterial blood is bright red = lots of oxygen
d. Venous blood is dark crimson = lots of CO2
E. Leukocytes
1. May be granular, agranular, translucent or ameboid
2. Larger than erythrocytes
3. Types of white cells
a. Neutrophils
b. Eosinophils
c. Basophils
d. Lymphocytes
e. Monocytes
F. Thrombocytes
1. Platelets
2. Make the blood clot
3. Smallest solid components of blood
4. Not cells – fragments of megakaryocytes
1H07.02 Analyze the function of the blood.
A. 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
B. Plasma
1. Liquid part of blood
2. Plasma proteins
a. Fibrinogen – blood clotting
b. Albumin – osmotic pressure and volume
c. Prothrombin – helps blood coagulate, production dependent on Vitamin K
4. Reduction of Heparin
C. Erythrocytes
1. Contain hemoglobin
a. Transports O2 to tissues and CO2 away from cells
b. Red cells travel to lungs to get O2 and give up CO2, then to tissues to deliver O2 and pick up CO2
2. Erythropoiesis – manufacture of red cells in bone marrow
3. Life span
a. Red cells live 120 days
b. Old cells broken down by spleen and liver
4. Hemolysis – rupture of erythrocyte from blood transfusion or disease
D. Leukocytes
1. Fight infection
2. Phagocytosis – white cells surround, engulf and digest harmful bacteria
3. Basophils produce heparin – and anticoagulant
4. Diapedesis – when white cells move through capillary walls into neighboring tissues
5. Inflammation
a. Body’s reaction to chemical and physical trauma
b. Pathogenic – disease producing microorganisms that can cause infection
c. Symptoms – redness, local heat, swelling and pain
d. Why? Bacterial toxins, increased blood flow, collection of plasma in tissues (edema)
E. Thrombocytes (Platelets)
1. Synthesized in red marrow
2. Necessary for the initiation of the blood clotting process
F. Coagulation
1. Cut or injury causes to break/clump
2. Chain reaction follows and involves the release of thromboplastin, prothrombin, thrombin and fibrinogen
3. Fibrin creates a mesh that traps red blood cells, platelets and plasma, creating a blood clot
4. Anticoagulants prevent blood clotting
5. Heparin is an anticoagulant
G. Blood types
1. Four major types, determined by presence or absence of an antigen on the surface of the red blood cell
a. A
b. B
c. O
d. AB
2. Inherited from parents
3. Antibody – a protein in the plasma that will inactivate a foreign substance that enters the body
a. Someone with type A blood has b antibodies
b. Someone with type B blood has a antibodies
c. Someone with type AB blood has no antibodies
d. Someone with type O blood has a and b antibodies
4. Universal donor – O
5. Universal recipient – AB
6. Red cells may also contain Rh factor
1H07.03 Discuss characteristics and treatment of common blood disorders.
A. Inflammation
1. Pus
2. Abscess
3. Pyrexia
4. Leukocytosis
5. Edema
B. Leukopenia – decrease in WBCs
C. Anemia – deficiency in number or % of RBCs
1. Iron-deficiency anemia
a. Usually women, children and adolescents
b. Deficiency of dietary iron causing insufficient hemoglobin
c. Rx with iron supplements, green leafy vegetables
2. Aplastic anemia
a. Bone marrow does not produce enough blood cells
b. Cause – drugs or radiation therapy
3. Sickle cell anemia
a. Chronic, inherited blood disorder
b. RBCs abnormal sickle (crescent) shape
c. Sickle cells break easily and carry less oxygen
d. Occurs primarily in African Americans
D. Polycythemia – too many RBCs
E. Embolism – moving blood clot
F. Thrombosis (thrombus) – formation of a blood clot in a vessel
G. Hematoma
1. Localized mass of blood found in organ, tissue or space
2. Caused by injury that causes a blood vessel to rupture
H. Hemophilia
1. Hereditary – sex-linked, transmitted from mother to son
2. Missing clotting factor
3. Blood clots slowly
4. Rx with missing clotting factor, avoid trauma
I. Thrombocytopenia
1. Not enough platelets
2. Blood does not clot properly
J. Leukemia
1. Malignancy
2. Overproduction of immature white blood cells
3. Research on cord blood
Unit E: Hematology
Terminology List
Summer 2005 E.15
1. albumin
2. antibody
3. anticoagulant
4. antigen
5. basophil
6. coagulation
7. diapedesis
8. eosinophil
9. erythrocyte
10. erythropoiesis
11. fibrin
12. fibrinogen
13. hemoglobin
14. hemolysis
15. heparin
16. inflammation
17. leukocyte
18. lymphocyte
19. monocyte
20. neutrophil
21. pathogenic
22. phagocytosis
23. plasma
24. platelets
25. prothrombin
26. Rh factor
27. serum
28. thrombin
29. thrombocyte
30. universal donor
31. universal recipient
Summer 2005 E.15
Disorders and Related Terminology
32. abscess
33. anemia
34. aplastic anemia
35. edema
36. embolism
37. hematoma
38. hemophilia
39. inflammation
40. iron-deficiency anemia
41. leukemia
42. leukocytosis
43. leukopenia
44. polycythemia
45. pus
46. pyrexia
47. Sickle cell anemia
48. thrombocytopenia
49. thrombosis
50. thrombus
Average adult = 8-10 pints of blood
Functions:
· Transports nutrients, oxygen, cellular waste products, and hormones
· Aids in distribution of heat
· Regulates acid-base balance
· Helps protect against infection
Composition:
· PLASMA – liquid portion of blood without cellular components
· Serum – plasma after a blood clot is formed
· Cellular elements are red cells, white cells and platelets
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
ERYTHROCYTES
Shape = biconcave discs
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
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
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.
White Blood Cells – LEUKOCYTES
· Larger than erythrocytes
· 5 types
· Normal leukocyte count = 3,200 – 9,800
Types of White Cells
· Neutrophils
· Eosinophils
· Basophils
· Lymphocytes
· Monocytes
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.
· 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
· LEUKOCYTOSIS – increase in the number of white cells in response to infection
· LEUKOPENIA – decrease in number of white cells due to chemotherapy or radiation
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
Cut or injury à platelets and injured tissue release THROMBOPLASTIN à act on PROTHROMBIN in plasma à + Calcium ions converts to THROMBIN à the thrombin acts as an enzyme and changes FIBRINOGEN à 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
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
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
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 –
DISORDERS OF THE BLOOD
ANEMIA
· Deficiency in number or % of red cells
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
APLASTIC ANEMIA
· Bone marrow does not produce enough red and white blood cells
· Caused by drugs or radiation therapy
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
POLYCYTHEMIA
· Too many red blood cells are formed
· May be a temporary condition that occurs at high altitude
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”
THROMBOSIS
· The formation of a blood clot in a blood vessel
· The blood clot is a THROMBUS
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
HEMOPHILIA
· Hereditary
· Missing clotting factor
· Blood clots slow or abnormally
· Sex-linked – transmitted genetically from mothers to sons
· Treat with missing clotting factor, avoid trauma
THROMBOCYTOPENIA
· Not enough platelets
· Blood will not clot properly
LEUKEMIA
· Malignant condition
· Overproduction of immature white blood cells
· Hinders synthesis of red cells
Summer 2005 E.15