Chapter 5: Blood Flashcards
What is blood?
It is a special type of C.T. That circulates inside blood.
What is blood formed of?
Cells and an extracellular fluid matrix called plasma.
What is the composition of blood?
It is made of 45% blood cells (erythrocytes, leukocytes, and platelets) and 55% plasma.
Examination of the blood using a blood film.
A drop of blood is spread on a glass slide and left to dry in air.
Blood examination using staining
With a neutral stain (Eg. Leishmans stain) formed of a mixture of red acidic stain Eosin and blue basic stain methylene blue dissolved in methyl alcohol (fixative).
Erythros
Red
What are Red blood corpuscles?
Non-nucleated biconcave discs.
RBC’s shape
Top view: rounded.
Side view: biconcave, to increase surface area for the exchange of gases.
What is the reason behind abnormal shapes of the RBC’s?
It is due to changes either in the cell membrane or Hb content. They are more fragile and more prone to hemolysis causing anemia.
What are the types of abnormal shapes?
- Spherocytes: spherical.
- Ovalocytes: oval.
- Sickle cell: crescent.
- Poikilocytes: pear.
RBC’s size
Diameter: 6-9 micrometers in with an average of 7.5 (the median).
Thickness: 2.2 micrometers (edge) and 0.8 (center).
Abnormal sizes of RBC’s
Microcytes: less than 6 micrometers.
Macrocytes: more than 9 micrometers.
Anisocytosis: different sizes.
RBC’s LM
Unstained blood film: appear colored due to Hemoglobin.
Stained blood film: stained with leishmans stain, RBC’s are rounded, non nucleated and acidophilic (hemoglobin is a basic protein), with a pale center (1/3 of the diameter of RBC’s are Normochromic).
RBC rouleaux appearance
- RBC’s may adhere to each other resembling piles of coins.
- This process occurs in slow circulation (abnormal).
- Due to the surface tension caused by their biconcave surface.
- Reversible, no damage to cells.
Erythrocyte sedimentation rate (ESR)
The long chains of RBC’s sediment more easily. This is the mechanism for ESR, which increases non specifically due to inflammation.
RBC’s EM
- No nucleus
- No organelles
- Filled with hemoglobin: appears electron dense and homogeneous.
- Cell membrane is flexible
- Cytoskeleton (actin and spectrin): keeps stability of shape and membrane.
- Glycocalyx includes antigenic sites for blood groups (ABO) and RH factor.
Life span of RBC’s
120 days
Fate of RBC’s
Old RBC’s are phagocytosed by macrophages in the liver, bone marrow, and spleen. It is secreted as bile pigments while iron is reused to form new RBC’s.
Osmotic fragility of RBC’s
RBC’s maintain normal shape in plasma (isontonic solution: OP of 0.9% saline.
Crenation: if placed in hypertonic solution, they shrink and show notches.
Hemolysis: if placed in hypotonic solution, they swell, burst, and leak hemoglobin.
Remaining cell membrane is called Cell ghost.
How are RBC’s counted?
- Hemocytometer.
- Electronic counting instruments.
What is the number of RBC’s?
- Average number of RBC’s: 5 million/mm3
- Adult male: 5-5.5 million/mm3
Stimulators effect of male hormones on the bone marrow. - Adult female: 4.5-5 million/mm3
- Newborns: highest in newborns and decreases gradually.
Abnormalities in number
- Anemia
- Polycythemia
Anemia
Decreased number of RBC’s below 4 million/mm3 (oligocythemia) and/or decreased hemoglobin concentration.
What are types of anemia?
- Pernicious anemia.
- Sickle cell anemia.
- Aplastic anemia.
Pernicious anemia
Vitamin B12 deficiency anemia due to failed production of intrinsic factor by the stomach.
Sickle cell anemia
Abnormal rigid type of hemoglobin that accumulates at one side of the cell giving a crescent shape (Sickle RBC’s).
Aplastic anemia
Destruction of bone marrow Eg. By chemotherapy of irradiation. This leads to pancytopenia which is the decreased count of all blood cells).
Polycythemia
Increased number of RBC’s above 6 million/mm3. Due to hypoxia that stimulates the bone marrow to produce more RBC’s. It can be:
1. Physiological: high altitudes, muscular exercise, and in newborns.
2. Pathological: chronic lung and heart diseases.
Factors of adaptations of RBC’s
- Plasmalemma.
- Shape.
- Content: 33% Hemoglobin, 66% H2O, 1% enzymes.
Plasmalemma
- Flexible: to be squeezed inside narrow capillaries.
- Lipoproteins: highly selective for gas exchange.
Shape mode of adaptation
- Biconcave: increasing surface area for gas exchange.
- Rounded edges: easy passage in branched blood vessels.
Content mode of adaptation
- No nuclei or organelles: do not divide and give more space for hemoglobin.
- Enzymes (Hemoglobin reductase): combine O2 and carbonic anhydrase which will carry CO2.
Platelets (thrombocytes)
Small oval cytoplasmic fragments.
What is the origin of platelets?
Develop from megakaryocytes.
Platelets number
200,000- 400,000/mm3.
Platelets diameter
2-4 micrometers
Platelets LM
Oval, non nucleated fragments which have 2 zones:
1. Outer pale basophilic (clear) peripheral zone= hyalomere.
2. Central dark granular zone: granulomere.
Platelets EM
Cell membrane has a thick cell coat that helps platelets aggregation (platelet plug) to stop bleeding.
Hyalomere
- Cytoskeleton
- Membranous channels
Cytoskeleton hyalomere
- Microtubules: maintain cell shape.
- Actin microfilaments: help activated platelets to change shape and aid clot retraction.
Membranous channels hyalomere
- Open canalicular system: invaginations of cell membrane to release serotonin ( vasoconstriction of injured vessel).
- Dense tubular system: storage for Ca++.
Granulomere
Few mitochondria, ribosomes, glycogen (energy) and 3 types of granules:
1. a (specific) granules.
2. Delta (dense) granules.
3. Lambda granules.
a (specific) granules
- Clotting factors.
- Growth factors.
- Ca++.
Delta (dense) granules
- Serotonin.
- ATP.
- ADP.
Lambda granules
Lysosomes for clot removal after healing of vessels.
Purpura or Thrombocytopenia
Decreased number of platelets less than XX.
What are the causes of thrombocytopenia?
- Decreased production (bone marrow depression).
- Increased breakdown (autoimmune disease).
Thrombocytopenia is characterized by?
- Prolonged bleeding time.
- Excessive bleeding after minor trauma.
Erythrocytes types
One type
Leukocytes types
5 types.
Erythrocytes content
Not true cells nor organelles.
Leukocytes content
True cells with nuclei and organelles.
Erythrocytes number
- 4.5-5.5 million/mm3 in males.
- 4-5 million/mm3 in females.
Leukocytes number
4000-11000/mm3
Erythrocytes size
6-9 micrometers with an average of 7.5.
Leukocytes size
6-20 micrometers.
Erythrocytes life span
120 days.
Leukocytes life span
Days to years.
Erythrocytes osmotic fragility
Easily hemolysed.
Leukocytes osmotic fragility
Not easily hemolysed.
Erythrocytes origin and maturation
Bone marrow.
Leukocytes origin and maturation
Bone marrow and lymphoid tissue.
Erythrocytes shape
Biconcave discs.
Leukocytes shape
Spherical.
Erythrocytes functions
Gas exchange.
Leukocytes function
Defense
Erythrocytes motility
Nonmotile
Leucocytes motility
Motile.
Life span of granular leucocytes
Shirt life span (few days) and are compensated by new cells from the blood stem cells in the bone marrow.
Nucleus of granular leucocytes
- Single but segmented.
- Condensed nucleus with peripheral heterochromatin and central euchromatin.
Cytoplasm of granular leucocytes
- Few organelles:
1. Golgi apparatus.
2. Mitochondria.
3. rER. - Contain both non specific (azurophilic) and specific granules.
- Azurophilic= affinity for azure dye (oxidized methylene blue).
Granular leucocytes are classified according to?
Affinity of their specific granules to stain.
Neutrophils are also called
Polymorphonuclear leucocytes (PMNs).
Neutrophils percentage
60-70%.