Hematology

1H07.01Explain the structure of the blood.

  1. Adult = 8-10 pints
  2. Composition
  3. Plasma
  4. Serum
  5. Cellular components (red blood cells, white blood cells, platelets)
  6. Plasma
  7. Straw colored
  8. Contains water, blood proteins, plasma proteins, nutrients, etc.
  9. Erythrocytes
  10. Shape = biconcave discs, donut-shaped
  11. Hemoglobin
  12. Gives red color
  13. Heme is iron, globin is protein
  14. Arterial blood is bright red = lots of oxygen
  15. Venous blood is dark crimson = lots of CO2
  16. Leukocytes
  17. May be granular, agranular, translucent or ameboid
  18. Larger than erythrocytes
  19. Types of white cells
  20. Neutrophils
  21. Eosinophils
  22. Basophils
  23. Lymphocytes
  24. Monocytes
  25. Thrombocytes
  26. Platelets
  27. Make the blood clot
  28. Smallest solid components of blood
  29. Not cells – fragments of megakaryocytes

1H07.02Analyze 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

1H07.03Discuss 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.1

  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.1

Disorders and Related Terminology

  1. abscess
  2. anemia
  3. aplastic anemia
  4. edema
  5. embolism
  6. hematoma
  7. hemophilia
  8. inflammation
  9. iron-deficiency anemia
  10. leukemia
  11. leukocytosis
  12. leukopenia
  13. polycythemia
  14. pus
  15. pyrexia
  16. Sickle cell anemia
  17. thrombocytopenia
  18. thrombosis
  19. 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  platelets and injured tissue release THROMBOPLASTIN act on PROTHROMBIN in plasma  + Calcium ions converts to THROMBIN the thrombin acts as an enzyme and changes FIBRINOGEN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.1