Hematologic system

Anatomy and Physiology

BLOOD 2. Supplying nutrients from food to

cells around the body
● A connective tissue that consists
of a liquid matrix. 3. Removal of waste, including carbon
● Blood contributes to dioxide
homeostasis by transporting
oxygen, carbon dioxide, 4. Defense against diseases and
nutrients, and detection of foreign material (by
hormones to and from your WBCs)
body’s cells. It helps regulate
body pH and temperature, and 5. Clotting and prevention of blood
provides protection against loss (platelets and clotting proteins)
disease through phagocytosis
and the production of 6. Messenger functions by
antibodies. transporting hormones to various
● The extracellular matrix is systems, allowing them to interact
called blood plasma, and it (e.g. insulin is created by the digestive
suspends various cells and cell system and circulated through the
fragments. Interstitial fluid is blood, allowing cells to absorb sugars
the fluid that bathes body cells. from food we eat)

7. Helping regulate and maintain

FUNCTIONS OF BLOOD body temperature

➔ Recall that blood is a

➔ Blood is a vital fluid in our
connective tissue. Like all connective
bodies and performs many
tissues, it is made up of cellular
important functions. Some of
elements and an extracellular matrix.
these functions include:
The cellular elements-referred to as
the formed elements-include red
1. Supplying oxygen to tissues
blood cells (RBCs), white blood cells
(carried by RBCs)
(WBCs), and cell fragments called
platelets. The extracellular matrix,
called plasma, makes blood unique

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among connective tissues because it granulocytes and agranulocytes. The
is fluid. This fluid, which is mostly granulocytes all contain granules in the
water, suspends the formed elements cytoplasm of the cell and include
and enables them to circulate neutrophils, eosinophils, and basophils.
throughout the body within the The agranulocytes have no granules in
cardiovascular system. the cytoplasm and include monocytes
and lymphocytes.
Blood Plasma
FORMATION OF BLOOD CELLS
When the formed elements are
removed from blood, a straw-colored
Hemopoiesis or Hematopoiesis
liquid called blood plasma (or simply
(making)
plasma) is left.
➔ The process by which the
formed elements of blood
Red Blood Cells (RBCs)
develop.
➔ Before birth, hemopoiesis first
These are the most common cells in
occurs in the yolk sac of an
the blood. These cells contain a special
embryo and later in the liver,
protein called hemoglobin that allows
spleen, thymus, and lymph
them to transport oxygen and carbon
nodes of a fetus. Red bone
dioxide within the bloodstream. This
marrow becomes the primary
function makes these cells extremely
site of hematopoiesis in the last
important.
3 months before birth, and
continues as the source of
White Blood Cells (WBCs)
blood cells after birth and
throughout life.
The general function of all leukocytes
is to defend against various
Red Bone Marrow
pathogens such as bacteria and
viruses. These cells are part of the
is a highly vascularized connective
immune system, acting to defend the
tissue located in the microscopic
body from infectious diseases or
spaces between trabeculae of
intruding cells. They destroy and
spongy bone tissue. It is present
remove old cells and debris from the
chiefly in bones of the axial
blood, while also attacking foreign
skeleton, pectoral and pelvic girdles,
disease-causing agents and foreign
and the proximal epiphyses of the
substances in the body.
humerus and femur. About 0.05–0.1%
Leukocytes (white blood cells, or
WBCs) are divided into two groups:

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of red bone marrow cells are called
pluripotent stem cells (ploo-RI-poˉ- RED BLOOD CELLS
tent; pluri-several) or hemocytoblasts (ERYTHROCYTES)
and are derived from mesenchyme
(tissue from which almost all ● contain the oxygen-carrying
connective tissues develop). protein hemoglobin, which is a
pigment that gives whole blood
Lymphatic tissue its red color.
● A healthy adult male has about
found in the spleen, lymph nodes, and 5.4 million red blood cells per
thymus gland—supplement blood cell microliter (𝛍L) of blood,* and a
production by producing lymphocytes, healthy adult female has about
a specific type of WBC. 4.8 million. (One drop of blood is
about 50 𝛍L.)
ORIGIN, DEVELOPMENT & ● To maintain normal numbers of
STRUCTURE OF BLOOD CELLS RBCs, new mature cells must
enter the circulation at the
astonishing rate of at least 2
million per second, a pace that
balances the equally high rate
of RBC destruction.
● Mature RBCs have no nucleus
● Each RBC contains about 280
million hemoglobin molecules
● A hemoglobin molecule consists
of a protein called globin, com-
posed of four polypeptide
chains (two alpha and two beta
chains).
● a ringlike non protein pigment
called a heme

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 WHITE BLOOD CELL
RBC LIFE CYCLE LEUKOCYTES

➔ Red blood cells live only about ● have nuclei and a full
120 days because of the wear complement of other
and tear their plasma organelles.
membranes undergo as they ● do not contain hemoglobin
squeeze through blood ● classified as either granular or
capillaries. agranular, depending on
whether they contain
➔ Without a nucleus and other conspicuous chemical-filled
organelles, RBCs cannot cytoplasmic granules (vesicles)
synthesize new components to that are made visible by
replace damaged ones. The staining when viewed through a
plasma membrane becomes light microscope. Granular
more fragile with age, and the leukocytes include neutrophils,
cells are more likely to burst, eosinophils, and basophils;
especially as they squeeze agranular leukocytes include
through narrow channels in the lymphocytes and monocytes.
spleen.
Granular Leukocytes
➔ Ruptured red blood cells are
removed from circulation and After staining, each of the three types
destroyed by fixed phagocytic of granular leukocytes dis-
macrophages in the spleen and plays conspicuous granules with
liver, and the breakdown distinctive coloration that can be
products are recycled and used recognized under a light microscope.
in numerous metabolic Granular leukocytes can be
processes, including the distinguished as follows:
formation of new red blood
cells. ● Neutrophil. The granules of a
neutrophil (NOO-troˉ-fil) are
smaller than those of other
granular leukocytes, evenly
distributed, and pale lilac.

● Eosinophil. The large,

uniform-sized granules within

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 an eosinophil (e¯-oˉ-SIN-oˉ-fil)
are eosinophilic
(eosin-loving)—they stain
red-orange with acidic dyes.

● Basophil. The round, Study Tip:

variable-sized granules of a
basophil (BAˉ-soˉ-fil) are To rank the leukocytes from most
basophilic (-basic loving)—they common to least common, use the
stain blue-purple with basic following mnemonic: Never Let
dyes. Monkeys Eat Bananas. This gives you
the correct order: Neutrophils,
Agranular Leukocytes Lymphocytes, Monocytes, Eosinophils,
and Basophils.
Even though so-called agranular
leukocytes possess cytoplasmic
granules, the granules are not visible Platelets
under a light microscope because of
their small size and poor staining These cells are responsible for the
qualities. clotting of blood, also referred to as
‘coagulation’. When the skin is cut,
● Lymphocytes. The nucleus of a these cells create a mesh-like barrier
lymphocyte (LIM-foˉ-sı¯t) stains over the cut. Other blood cells become
dark and is round or slightly caught in the mesh and collect to form
indented. a clot, which stops blood from leaving
● Monocyte. The nucleus of a the body and prevents bacteria from
monocyte (MON-oˉ-sı¯t-) is entering the bloodstream. Platelets
usually kidney-shaped or are very important in tissue healing.
horseshoe-shaped, and the
cytoplasm is blue-gray and has Plasma
a foamy appearance.
Plasma is the liquid component of
blood that the cells are suspended in.
It accounts for around 50% of the
total volume of blood and contains
things like dissolved proteins, glucose,
and platelets, as well as the blood cells
themselves.

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Plasma Proteins

Approximately 7 percent of the plasma

that is not water is made of proteins.
These include several plasma proteins
(proteins that are unique to the plasma),
plus a much smaller number of
regulatory proteins, including enzymes
and hormones. The three major groups
of plasma proteins are as follows:
Albumin, Globulins and Fibrinogen.

By analyzing the components of blood,

one can gain clues about diseases and
disorders throughout the body, which is
why blood tests are performed more
often than any other medical test. HEMOSTASIS
Interpreting those results, though,
depends upon a solid understanding of Hemostasis (he¯-moˉ-STAˉ-sis), not to
the components and functions of blood. be confused with the very similar term
When a sample of blood is spun down in homeostasis, is a sequence of
a centrifuge, its two main components responses that stops bleeding. When
become apparent. blood vessels are damaged or
ruptured, the hemostatic response
must be quick, localized to the region
of damage, and carefully controlled in
CLINICAL INSIGHT
order to be effective.
A complete blood count (CBC) is a very
valuable test that screens for anemia and
various infections. Usually included are counts ~Three mechanisms reduce blood loss:
of RBCs, WBCs, and platelets per microliter of (1) vascular spasm, (2) platelet plug
whole blood; hematocrit; and differential white formation, and (3) blood clotting
blood cell count. The amount of hemoglobin in
(coagulation). When successful,
grams per milliliter of blood also is deter
-mined. Normal hemoglobin ranges are as hemostasis prevent hemorrhage
follows: infants, 14–20 g/100mL of blood; adult (HEM-o-rij; -rhage -burst forth), the
females, 12–16 g/100 mL of blood; and adult loss of a large amount of blood from
males, 13.5–18 g/100 mL of blood. the vessels. Hemostatic mechanisms

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can prevent hemorrhage from smaller ~Plasma also is provided with a
blood vessels, but extensive mechanism for dissolving clots after
hemorrhage from larger vessels they have been formed. Plasmin is a
usually requires medical intervention. proteolytic enzyme—a substance that
causes breakdown of
~The blood is contained under proteins—derived from an inert
pressure in a vascular system that plasma precursor known as
includes vast areas of thin and plasminogen. When clots are formed
delicate capillary membranes. Even within blood vessels, activation of
the bumps and knocks of everyday life plasminogen to plasmin may lead to
are sufficient to disrupt some of these their removal.
fragile vessels, and serious injury can
be much more damaging. Loss of ~When a blood vessel is cut, the body
blood would be a constant threat to must react quickly to stop the flow of
survival if it were not for protective blood. It does so through the following
mechanisms to prevent and control sequence of events: vascular spasm,
bleeding. the formation of a platelet plug, and
the formation of a blood clot.
~The platelets contribute to the
resistance of capillaries, possibly
because they actually fill chinks in VASCULAR SPASM
vessel walls. In the absence of
platelets, capillaries become more ● When arteries or arterioles are
fragile, permitting spontaneous loss of damaged, the circularly
blood and increasing the tendency to arranged smooth muscle in
form bruises after minor injury. their walls contracts
immediately, a reaction called
~Platelets immediately aggregate at vascular spasm.
the site of injury of a blood vessel,
tending to seal the aperture. A blood ● This reduces blood loss for
clot, forming in the vessel around the several minutes to several
clump of adherent platelets, further hours, during which time the
occludes the bleeding point. other hemostatic mechanisms
go into operation. The spasm is
~The coagulation mechanism involves probably caused by damage to
a series of chemical reactions in which the smooth muscle, by
specific proteins and other substances released from
constituents of the blood, including activated platelets, and by
the platelets, play a part.

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 reflexes initiated by pain proteins called clotting factors.
receptors. The first several reactions in the
clotting process vary,
depending upon whether the
process has been stimulated by
factors inside or outside the
blood. Specifically, when the
damaged blood vessel and
surrounding tissues—areas
outside or extrinsic to the
blood—release clotting factors,
this kicks off a cascade of
events called the extrinsic
pathway.
FORMATION OF PLATELET PLUG
● When the clotting factors are
● The break in the blood vessel activated within the
exposes collagen fibers, creating blood—such as by the platelets
a rough spot on the vessel’s as they adhere to the collagen
normally slick interior. This rough
in the damaged vessel
spot triggers changes in the
wall—this sets off a different
passing platelets, transforming
cascade of events called the
them into sticky platelets.
intrinsic pathway.

FORMATION OF BLOOD CLOT

● Blood clotting, or coagulation,

involves a complex series of
chemical reactions using

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 form. If blood flow decreases—such as
DISSOLUTION OF BLOOD CLOTS when blood pools in the legs during
prolonged sitting or lying
The blood clotting process doesn’t down—thrombin can accumulate to
stop with the formation of the clot. the point that a clot develops.

● Anticoagulants: Basophils and mast

cells normally secrete the
anticoagulant heparin, which prevents
blood clots by blocking the action of
thrombin. Heparin is also given by
injection to inhibit clot formation in
patients who are susceptible to
developing unwanted blood clots

BLOOD GROUPS &

BLOOD TYPES

For centuries, people have realized

PREVENTION OF BLOOD CLOTS that excessive blood loss often proved
fatal. However, when they tried to
When a blood vessel has broken, fight the effects of hemorrhage by
speedy clot formation is essential to transfusing blood from one person
stop the bleeding. However, it’s just as into another, they were mystified as to
crucial to prevent clots from forming why some recovered while others died.
when they aren’t needed. The It wasn’t until 1900, when a scientist
following factors discourage blood discovered the blood types A, B, and
clot formation. O, that the matter became clear.

● Smooth endothelium: The inner This scientist discovered that the

lining of undamaged blood vessels is surface of each red blood cell carries
very smooth, which helps prevent a protein called an antigen (also
platelets from sticking. called agglutinogen).

● Blood flow: The blood normally There are two antigens: A and B.
produces small amounts of thrombin.
When blood is circulating normally,
the rapidly moving bloodstream
dilutes the thrombin before a clot can

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While the blood cell carries antigens, *The clumping of RBCs blocks blood
the blood plasma carries antibodies vessels, cutting off the flow of oxygen.
(called agglutinins) against the The RBCs also burst (called hemolysis)
antigens of the other blood types. and release their hemoglobin into the
bloodstream. The free hemoglobin
could block tubules in the kidneys,
leading to renal failure and possibly
death.

THE RH GROUP

Besides being classified according to

*Transfusions are successful as long ABO type, blood is also classified as
as the recipient’s plasma doesn’t being Rh positive or Rh negative.
contain antibodies against the ABO Rh-positive blood contains the Rh
type being transfused. If such antigen; Rh-negative blood lacks this
antibodies are present, they will specific antigen. Blood does not
attack the donor’s RBCs, causing a normally contain anti-Rh antibodies;
transfusion reaction. however, it’s possible for someone
with Rh-negative blood to develop
anti-Rh antibodies. There are two
ways this can occur. The first way is
when someone with Rh-negative
blood receives a transfusion of
Rh-positive blood. The second way is
when an Rh-negative mother becomes
pregnant with an Rh-positive fetus.

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*A similar condition may result when a
woman with Rh-negative blood and a
man with Rh-positive blood conceive a
baby who is Rh positive.

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