Blood

Unit 3
Manasseh Mvula
 Introduction
 Blood is a connective tissue
 It’s composed of a straw coloured
transparent fluid called plasma
 Plasma constitute about 55% and cells
about 45% of blood volume
 Blood in the blood vessels is always in
motion because of the pumping action of
the heart and this continuous flow
maintains a fairly constant environment
for the body cells
 Functions of Blood
Blood provides one of the means of
communication between the cells of different
parts of the body and the external environment,
e.g. it carries
1. Oxygen from the lungs to the tissues, and
carbon dioxide from the tissues to the lungs
for excretion.
2. Nutrients from the alimentary tract to the
tissues, and cell wastes to the excretory
organs, principally the kidney
3. Hormones secreted by endocrine glands to
their target gland and tissue
Cont’d
1. Heat produced in active tissues to
other less active tissues
2. Protective substances, e.g.
antibodies, to areas of infection.
3. Clotting factors that coagulate
blood, minimizing bleeding from
ruptured blood vessels.
 Composition of the blood

 The circulating blood is composed of plasma

and cells.
 The cells are red blood cells (or erythrocytes),
white cells (or leucocytes) and platelets.
 Blood cells can be identified in blood films
stained with a mixture of basic and acidic dyes.
 Normal white cells are divided into
polymorphonuclear leucocytes (or granulocytes)
and mononuclear cells(agranuloctes).
 Composition of Plasma
 Plasma consists of water(>90%) and
dissolved substances including:
1. Plasma proteins

within blood vessels for osmotic pressure,

plasma viscosity-albumin & fibrinogen

albumin produced from liver most abundant act as
carrier protein for lipid and steroid hormones and
osmotic pressure

Globulins-act as antibodies, transportation of
hormones (thyroglobulins),inhibition of proteolytic
enzymes

Clotting factors-substances essential for clotting of
blood(serum is plasma without clotting factors)

List the blood clotting factors in correct order
 Cont’d
1. Inorganic(mineral) salts

Involved in many activities including: muscle
contraction ,transmission of nerve
impulses,maintainace of acid base balance
2. Nutrients(from digested foods)

Including monosaccharides, amino acids, fatty acids
and glycerol
3. Waste materials

These are waste products of protein metabolism: uric
acid, urea and creatinine produced from the liver to
be excreted in the kidney
Cont’d
1. Hormones

Produced by the endocrine glands and
transported to target organs
2. Gases

Oxygen, Carbondioxide and Nitrogen(No
physiological function) carried dissolved
in plasma. Most O2 as oxyhaemoglobin
and CO2 as bicarbonate ions
 Cellular Content of Blood
 They are three types of blood cells
namely:
1. Erythrocytes(Red Blood Cells)
2. Leucocytes(white blood cells)
3. Platelets (megakaryocytes)
 All blood cells originate from one
single cell known as the pluripotent
stem cell and individual cells
develop through a different line
 Cont’d
 The process of blood cell formation is
called hemopoiesis
 Hemopoiesis occurs predominantly in the
Bone marrow-in addition lymphocytes are
produced in the lymphoid tissue

What are the sites of hemopoiesis in the skeleton?
 Normal white cells are divided into
polymorphonuclear leucocytes (or
granulocytes) and mononuclear
cells(agranulocytes)
 Erythrocytes
 Biconcave discs without a nucleus about
7micrometer in diameter
 Their main function is gas transport mainly
oxygen but may also carry Carbondioxide
 The process of development of RBC from
the pluripotent cell in the red bone marrow
is called erythropoesis(7days) and the
immature RBC(Reticulocytes) are released
in the bloodstream for maturation(1-
2days)
 Cont’d
 The average life span of a RBC is
120days
 Its structure is suited for its function

Biconcavity-increased surface area

thinness of the central portion-easy
exchange of gasses

Flexibility-ability to squeeze through narrow
capillaries

abscence cell organelles-gives room for
haemoglobin
 RBCs Cont’
 Requirements for normal RBC
synthesis:
1.Folic acid
2.Vitamin B12 dairy products

3.Iron(Fe2+) meat, veg.

 These substances are absorbed in

the small intestines with vit B12
requiring the intrinsic factor for
absorption
 Measurement of RBC numbers,
volume and haemoglobin content
are routine and useful assessments
made in clinical practice
 Oxygen transport in RBCs
 Haemoglobin is a large complex protein containing
Globin protein and pigmented iron complex called
haem
 Each haemoglobin molecule contains 4 haem and 4
Globin molecules
 Oxygen combine with haem reversibly
(oxyhaemoglobin)
 Said to be saturated when all four haem are occupied
 Factors affecting release of O2 from oxyhaemoglobin
include:
 Low pH
 Low oxygen levels
 temperature
 Control of Erythropoiesis
 There is a balance between bone marrow
production of RBC and their destruction
keeping the number fairly constant

 This balance is as a result of the negative

homeostatic feed back mechanism shown
on the right
 Cont’d
 Primary stimulus to increased erythropoesis
is hypoxia i.e. deficient oxygen supply to
body cells which could be due to:
 Reduced oxygen-carrying power of blood

e.g. haemorrhage or excessive RBC

breakdown due to disease.
 Reduced oxygen tension in the air e.g.

high altitudes.
 Cont’d
 Erythropoietin stimulates an increase in the
production of erythroblasts and the release
of reticulocytes into the blood thereby
increasing RBCs and oxygen carrying
capacity reversing hypoxia the original
stimulus

 Hypoxia increases erythrocyte formation by

stimulating the production of the hormone
erythropoietin mainly by the kidneys.
 Blood Groups
 Individuals have different types of
antigens on their blood RBC which are
inherited and determine blood group
 Individuals make antibodies to these
antigens but not their own type of
antigens
 During transfusion compatible blood
means donor and recipient blood can not
react as antigens and antibodies
 Cont’d
 There are many different collection of red
cell surface antigens, but the most
important are the ABO and the Rhesus
system
 About 55% of population have either A-type
antigens(blood group A)or B-type antigens (
blood group B) or both (blood group AB) on
their red cell surface.
 The remaining 45% have neither A nor B
type antigen (blood group O)
 Cont’d
 Blood group AB is known as universal
recipient while blood group O is universal
donor (can give blood to A,B, AB or O
types )
 Another system is rhesus (Rh) system,85%
of people are have rhesus antigen (rhesus)
and therefore do not make anti-rhesus
antibodies. 15% are Rhesus-ve.
 Pregnant Rh – Ve mothers may destroy
their Rh+ve babies
•A person with Rh- blood can develop Rh antibodies in
the blood plasma if he or she receives blood from a
person with Rh+ blood, whose Rh antigens can trigger
the production of Rh antibodies.

•A person with Rh+ blood can receive blood from a

person with Rh- blood without any problems.
WHITE BLOOD CELLS

• Important in defense of the body against

microbes
• Two types exists
• Granulocytes (polymorphonuclear PMN
leukocyte)which are: BEN (Basophils,
Eosinophil and Neutrophils
• Agranulocytes: lymphocytes and Monocytes
GRANULOCYTES
• Granulopoiesis follow a common line of
development from pluripotent cells known
as myeloblasts to myelocytes before
differentiating into the three types.
• Named after there staining pattern
• Granulocytes have multilobed nucleus in
their cytoplasm as well as granules
 NEUTROPHILS
• protection against foreign
materials entering the body and
remove waste materials eg cell
debris
• move by chemotaxis as a result of
chemotaxins ( release by
damaged cells)
• highly mobile and leave capillaries
to affected areas by diapedesis
• granules are Lysozomes
containing enzymes to digest
engulfed material

• Neutrophilia physiologically occur:

 During exercise and late stage of
pregnancy
 Heavy smoking
 Use of oral contraceptives
 Leukaemia
 Metabolic disorder- DKA, acute gout
 .

EOSINOPHILS
• Less active than neutrophils and
specialized in elimination of parasites
such as worms which cant be
phagocytosed
• Promote/ dampen inflammation

BASOPHILS
• Closely associated with allergic reaction
• Contains granules with heparin
(anticoagulant) and histamine
(inflammating agent)
• Similar to mast cells found in tissue
performing similar functions.
.

LYMPHOCYTES
• Smaller than monocytes with large nucleus
• Circulate in blood and are greater in numbers in lymphatic
tissue like lymph nodes and spleen
• Produced in bone marrow and activated in spleen –
immunocompetent (able to respond to antigens)
• Antigens include;
abnormal cells e.g. infected cells, cancer cells
fungi
bacterial
large molecules, drugs- penicillin, aspirin
• two distinct types of lymphocyte are produced namely:
T-lymphocytes and B-lymphocytes
T- lymphocytes-processed in thymus-cell mediated immunity
B -lymphocytes-produced and processed in the Bone marrow-
produces antibodies-antibody mediated immunity
MONOCYTES

• Originate on bone marrow

• Some circulate in the blood and are actively motile and phagocytic while
others migrate into tissue where they develop into macrophages
• Both Agranulocytes produce interleukin 1 which cause
• increase in body temperature
• increase globulin production in liver
• enhances the production of activated T-lymphocytes
• Monocyte-macrophage system is also called
reticuloendothelial system consist of body’s complement of
monocytes and macrophages
• the fixed macrophage in different tissues include among others
microglia in the bone
kupfer cells in liver
alveolar cells in Lungs
mesangial cells in kidney
Osteoclasts in bone e.t.c.
.

PLATELETS
• Small non-nucleated discs
derived from megakaryocytes in
red bone marrow
• Contains a variety of substances
that promote blood clotting
(haemostasis)
• Stimulation of platelet synthesis
is by thromboplastin released by
kidney
• Life span of 8-12 days are
destroyed by macrophages and
spleen
• One third of platelets are stored
in spleen, released only as
required ( e.g. in excessive
bleeding)
 HAEMOSTASIS
When a blood vessel is damaged, loss of blood is
stopped and healing occurs in a series of overlapping
processes, in which platelets play a vital part.
1. Vasoconstriction.
 When platelets come into contact with damaged blood
vessels, their surface becomes sticky and they adhere to
the damaged wall.
 They then release serotonin which constricts the
vessel, reducing blood flow through it.
 Thromboxanes a vasoconstrictor is also released by the
damaged vessels itself.
2.Platelets plug
formation.
The adherent platelets clump to each other and
produce substances, including adenosine
diphosphate (ADP), which attract more platelets to
the site.
 Passing platelets stick to those already at the
damaged vessel.
 This is a positive feedback system by which many
platelets rapidly arrive at the site of vascular
damage and quickly form a temporary seal –the
platelets plug.
3. Coagulation (blood clotting).

This is a complex process that also involves a positive

feedback system and only few stages are included here
via various clotting factors listed below.
 Blood clotting results in formation of an insoluble
thread-like mess of fibrin, which traps blood cells and
is much stronger than the rapidly formed platelets
plug.
Cont’d
In the final stages of this process prothrombin activator acts
on the plasma protein prothrombin converting it to
thrombin
Thrombin then acts on another plasma protein fibrinogen
and converting it to fibrin
Prothrombin activator can be formed by two processes
which often occur together-the extrinsic and intrinsic
pathways.
The extrinsic pathway occurs rapidly (within seconds) when
there is a tissue damage outside the circulation.
 The intrinsic pathway is slower (3-6 minutes) and is
confined to the circulation.
Cont’d
It is triggered by damage to a blood vessel lining
(endothelium) and the effects of platelets adhering
to it.
After a time the clot shrinks because the platelets
contact, squeezing out serum, a clear sticky fluid
that consists of plasma from which clotting factors
have been moved.
Clot shrinkage pulls the edge of the damaged
vessel together, reducing blood loss and closing off
the hole in the vessel wall.
.
4.Fibrinolysis
 The breakdown of the clot, or fibronolysis, is the first
stage in healing the damaged blood vessel after clot
formation.
An inactive substance called plasminogen is present
in the clot and is converted to the enzymes plasmin
by activators released from the damaged endothelial
cells.
 Plasmin initiates the breakdown of fibrin to soluble
products that are treated as waste material and
removed by phagocytosis.
 As the clot is removed, the healing process restores
the integrity of the blood vessel wall.