Blood

Blood is the “river of life” that surges within us. It transports everything that must be carried
from one place to another within the body- nutrients, wastes (headed for elimination from the
body) and body heat through blood vessels. Long before modern medicine, blood was viewed as
magical, because when it drained from the body, life departed as well.

Functions of the Skeletal System

1. Carrier of gases, nutrients, and waste products
Oxygen enters blood in the lungs and is transported to cells. Carbon dioxide, produced by cells, is
transported in the blood to the lungs, from which it is expelled. Ingested nutrients, ions, and water
are carried by the blood from the digestive tract to cells, and the waste products of the cells are
moved to the kidneys for elimination.

2. Clot formation
Clotting proteins help stem blood loss when a blood vessel is injured

3. Transport of processed molecules

Most substances are produced in one part of the body and transported in the blood to another
part.

4. Protection against foreign substances

Antibodies help protect the body from pathogens

5. Transport of regulatory molecules

Various hormones and enzymes that regulate body processes are carried from one part of the body
to another within the blood.

6. Maintenance of body temperature

Warm blood is transported from the inside to the surface of the body, where heat is released from
the blood.

7. pH and osmosis regulation

Albumin is also an important blood buffer and contributes to the osmotic pressure of blood, which
acts to keep water in the blood stream.

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 Physical Characteristics and Volume of Blood
Blood is a sticky, opaque fluid with a characteristic metallic taste
Depending on the amount of oxygen it is carrying, the color of blood varies
from scarlet (oxygen-rich) to a dull red (oxygen-poor).
Blood is heavier than water and about five times thicker, or more viscous,
largely because of its formed elements.
Blood is slightly alkaline, with a pH between 7.35 and 7.45.
Its temperature (38 degrees Celsius, or 100.4 degrees Fahrenheit) is always
slightly higher than body temperature.

Components of Blood
Plasma Plasma, which is approximately 90 percent water, is the liquid part of the blood.

Dissolved substances
Examples of dissolved substances include nutrients, salts (electrolytes),
respiratory gases, hormones, plasma proteins, and various wastes and
products of cell metabolism.
Plasma proteins
Plasma proteins are the most abundant solutes in plasma; except for
antibodies and protein-based hormones, most plasma proteins are made by
the liver.
Composition
The composition of plasma varies continuously as cells remove or add substances to the blood; assuming
a healthy diet, however, the composition of plasma is kept relatively constant by various homeostatic
mechanisms of the body.

Erythrocytes function primarily to ferry oxygen in blood to all cells of the body.
RBCs differ from other blood cells because they are anucleate,
that is, they lack a nucleus; they also contain a very few
organelles.
Hemoglobin, an iron bearing protein, transports the bulk of oxygen
that is carried in the blood
Erythrocytes are small, flexible cells shaped like biconcave discs-
flattened discs with depressed centers on both sides; they look like
miniature doughnuts when viewed with a microscope.
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 There are normally about 5 million cells per cubic millimeter of blood; RBCs outnumber WBCs by about 1000
to 1 and are the major factor contributing to blood viscosity.
Clinically, normal blood contains 12-18 grams of hemoglobin per 100 milliliters (ml); the hemoglobin content
is slightly higher in men (13-18 g/dl) than in women (12-16 g/dl).

Leukocytes are far less numerous than red blood cells, they are crucial to body defense against disease.

On average, there are 4,000 to 11,000 WBC/mm3 , and

they account for less than 1 percent of total body
volume.
Leukocytes form a protective, movable army that
helps defend the body against damage by bacteria,
viruses, parasites, and tumor cells.

Diapedesis
White blood cells are able to slip into and out of the
blood vessels- a process called diapedesis.
Positive chemotaxis
In addition, WBCs can locate areas of tissue damage and infection in the body by responding to certain
chemicals that diffuse from the damaged cells; this capability is called positive chemotaxis.
Ameboid motion
Once they have “caught the scent”, the WBCs move through the tissue spaces by ameboid motion (they
form flowing cytoplasmic extensions that help move them along).
Leukocytosis
A total WBC count above 11, 000 cells/mm3 is referred to as leukocytosis.
Leukopenia
The opposite condition, leukopenia, is an abnormally low WBC count.
Granulocytes
Granulocytes are granule-containing WBCs; they have lobed nuclei, which typically consist of several
rounded nuclear areas connected by thin strands of nuclear material, and includes neutrophils, eosinophils,
and basophils.
Neutrophils
Neutrophil are the most numerous of the WBCs; they have a multilobed granules and very fine granules
that respond to acidic and basic stains; neutrophils are avid phagocytes at sites of acute infection, and
are particularly partial to bacteria and fungi.

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Eosinophils
Eosinophils have blue red nucleus that resembles an old-fashioned telephone receiver and sport coarse,
lysosome-like, brick-red cytoplasmic granules; their number increases rapidly during allergies and
infections by parasitic worms or entering via the skin.

Basophils
Basophils, the rarest of the WBCs, contain large, histamine-containing granules that stain dark blue;
histamine is an inflammatory chemical that makes blood vessels leaky and attracts other WBCs to the
inflammatory site.
Agranulocytes
The second group of WBCs, the agranulocytes, lack visible cytoplasmic granules; their nuclei are closer
to the norm- that is, they are spherical; they are spherical, oval, or kidney-shaped; and they include
lymphocytes and monocytes.

Lymphocytes
Lymphocytes have a large, dark purple nucleus that occupies most of the cell volume; they tend to take
up residence in lymphatic tissues, where they play an important role in the immune response.
Monocytes
Monocytes are the largest of the WBCs; when they migrate into the tissues, they transform into
macrophages with huge appetites; macrophages are very important in fighting chronic infections.

Platelets
Platelets are not cells in the strict sense; they are fragments of bizarre multinucleate cells called
megakaryocytes, which pinch off thousands of anucleate platelet “pieces” that quickly seal themselves
off from surrounding fluids; platelets are needed for the clotting process that occurs in plasma when
blood vessels are ruptured or broken.

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 Hematopoiesis
Blood cell formation, or hematopoiesis, occurs in red bone marrow, or myeloid tissue.

Hemocytoblast

All the formed elements arise from a common type of stem cell, the hemocytoblast.

Descendants of hemocytoblasts

The hemocytoblast forms two types of descendants- the lymphoid stem cell, which produces
lymphocytes, and the myeloid stem cell, which can produce all other classes of formed elements.

Formation of Red Blood Cells

Because they are anucleate, RBCs are unable to synthesize proteins, grow, or divide.
As they age, RBCs become more rigid and begin to fragment, or fall apart, in 100 to 120 days.

Lost RBCs
Lost cells are replaced more or less continuously by the division of hemocytoblasts in the red bone
marrow.

Immature RBCs
Developing RBCs divide many times and then begin synthesizing huge amounts of hemoglobin.

Reticulocyte
Suddenly, when enough hemoglobin has been accumulated, the nucleus and most organelles are ejected
and the cell collapses inward; the result is the young RBC, called a reticulocyte because it still contains
some rough endoplasmic reticulum (ER).
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Mature erythrocytes
Within 2 days of release, they have rejected the remaining ER and have become fully functioning
erythrocytes; the entire developmental process from hemocytoblast to mature RBC takes 3 to 5 days.
Erythropoietin
The rate of erythrocyte production is controlled by a hormone called erythropoietin; normally a small
amount of erythropoietin circulates in the blood at all times, and red blood cells are formed at a
fairly constant rate.
Control of RBC production
An important point to remember is that it is not the relative number of RBCS in the blood that controls
RBC production; control is based on their ability to transport enough oxygen to meet the body’s
demands.

Formation of White Blood Cells and Platelets

Like erythrocyte production, the formation of leukocytes and platelets is stimulated by hormones.

Colony stimulating factors and interleukins

These colony stimulating factors and interleukins
not only prompt red bone marrow to turn out
leukocytes, but also marshal up an army of WBCs
to ward off attacks by enhancing the ability of
mature leukocytes to protect the body.

Thrombopoietin
The hormone thrombopoietin accelerates the
production of platelets, but little is known
about how that process is regulated.

Hemostasis
The multistep process of hemostasis begins when a blood vessel is damaged and connective tissue in
the vessel wall is exposed to blood.

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Vascular spasms occur
The immediate response to blood vessel injury is vasoconstriction, which causes that blood vessel to go
into spasms; the spasms narrow the blood vessel, decreasing blood loss until clotting can occur.
Platelet plug forms
Injury to the lining of vessels exposes collage fibers; platelets adhere to the damaged site and
platelet plug forms.
Coagulation events occur
At the same time, the injured tissues are releasing tissue factor (TF), a substance that plays an
important role in clotting; PF3, a phospholipid that coats the surfaces of the platelets, interacts with
TF, vitamin K, and other blood clotting factors; this prothrombin activator converts prothrombin,
present in the plasma, to thrombin, an enzyme; thrombin then joins soluble fibrinogen proteins into long,
hairlike molecules of insoluble fibrin, which forms the meshwork that traps RBCs and forms the basis of
the clot; within the hour, the clot begins to retract, squeezing serum from the mass and pulling the
ruptured edges of the blood vessel closer together.

Blood Groups and Transfusions

As we have seen, blood is vital for transporting substances through the body; when blood is lost, the
blood vessels constrict and the bone marrow steps up blood cell formation in an attempt to keep the
circulation going.
Although whole blood transfusions can save lives, people have different blood groups, and transfusing
incompatible or mismatched blood can be fatal.

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Antigen
An antigen is a substance that the body recognizes as foreign; it stimulates the immune system to
release antibodies or use other means to mount a defense against it.

Antibodies
One person’s RBC proteins will be recognized as foreign if transfused into another person with
different RBC antigens; the “recognizers” are antibodies present in the plasma that attach to RBCs
bearing surface antigens different from those on the patient’s (blood recipient’s) RBCs.

Agglutination
Binding of the antibodies causes the foreign RBCs to clump, a phenomenon called agglutination, which
leads to the clogging of small blood vessels throughout the body.

ABO blood groups

The ABO blood groups are based on which of two antigens, type A or type B, a person inherits; absence
of both antigens results in type O blood, presence of both antigens leads to type AB, and the presence
of either A or B antigen yields type A or B blood.

Rh blood groups
The Rh blood groups are so named because one of the eight Rh antigens (agglutinogen D) was
originally identified in Rhesus monkeys; later the same antigen was discovered in human beings; most
Americans are Rh+ (Rh positive), meaning that their RBCs carry the Rh antigen.

Anti-Rh antibodies
Unlike the antibodies of the ABO system, anti-Rh antibodies are not automatically formed and
present in the blood of Rh- (Rh-negative) individuals.
Hemolysis
Hemolysis (rupture of RBCs) does not occur with the first transfusion because it takes time for the
body to react and start making antibodies.

Blood Typing
The importance of determining the blood group of both the donor and the recipient before blood is
transfused is glaringly obvious.
Blood typing of ABO blood groups
When serum containing anti-A or anti-B antibodies is added to a blood sample diluted with saline,
agglutination will occur between the antibody and the corresponding antigen.
Cross matching
Cross matching involves testing for agglutination of donor RBCs by the recipient’s serum and of the
recipient’s RBCs by the donor serum;
Blood typing for Rh factors
Typing for the Rh factors is done in the same manner as ABO blood typing.
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