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Principles of Circulatory system

Anatomy and ▪ The circulatory system, also called the
Physiology cardiovascular system or the vascular
system, is an organ system that permits blood
14th Edition to circulate and transport nutrients (such as
amino acids and electrolytes), oxygen, carbon
dioxide, hormones, and blood cells to and from
the cells in the body to provide nourishment and
CHAPTER 19
help in fighting diseases, stabilize temperature
The Cardiovascular System: The Blood and pH, and maintain homeostasis.

Copyright © 2014 John Wiley & Sons, Inc. All rights reserved.

The circulatory system consists of four

The circulatory system is a body-wide major components:
network of blood, blood vessels, and
❖The Heart: About the size of two adult hands held
lymph. Powered by the heart, it is the body’s together, the heart rests near the center of the chest.
distribution system to organs with oxygen, Thanks to consistent pumping, the heart keeps the
hormones and essential nutrients that helps it circulatory system working at all times.
function properly. ❖Arteries: Arteries carry oxygen-rich blood away from
the heart and where it needs to go.
❖Veins: Veins carry deoxygenated blood to the lungs
The study of the blood flow is called where they receive oxygen.
hemodynamics. ❖Blood: Blood is the transport media of nearly
everything within the body. It transports hormones,
nutrients, oxygen, antibodies, and other important
things needed to keep the body healthy.

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The Blood Functions

❖ Supply of oxygen to tissues (bound to hemoglobin, which is
▪ Blood is a bodily fluid that delivers necessary carried in red cells)
substances such as nutrients and oxygen ❖ Supply of nutrients such as glucose, amino acids, and fatty acids
(dissolved in the blood or bound to plasma proteins (e.g., blood
to the cells and transports metabolic waste lipids))
products away from those same cells. When it ❖ Removal of waste such as carbon dioxide, urea, and lactic acid
reaches the lungs, gas exchange occurs ❖ Immunological functions, including circulation of white blood
cells, and detection of foreign material by antibodies
when carbon dioxide is diffused out of the ❖ Coagulation, the response to a broken blood vessel, the
blood into the pulmonary alveoli and oxygen is conversion of blood from a liquid to a semi-solid gel to stop
bleeding.
diffused into the blood. Blood contains ❖ Messenger functions, including the transport of hormones and
antibodies, nutrients, oxygen and much the signaling of tissue damage
❖ Regulation of body pH
more to help the body work.
❖ Regulation of core body temperature

What's Inside of Blood

Blood accounts for 7% of the human body

weight. The average adult has a blood volume
of roughly 5 liters , which is composed of
plasma and several kinds of cells.
These blood cells (which are also called
corpuscles or "formed elements") consist of
erythrocytes (red blood cells, RBCs),
leukocytes (white blood cells), and
thrombocytes (platelets).
By volume, the red blood cells constitute about
45% of whole blood, the plasma about 54.3%.

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Functions and Properties of Blood Functions and Properties of Blood

Blood is a liquid connective tissue
consisting of cells surrounded by a liquid ▪ The cellular components (formed
matrix (plasma). elements) of blood include red blood
cells, white blood cells and platelets.
▪ The plasma portion of blood consists of
water, proteins and other solutes.

Copyright © 2014 John Wiley & Sons, Inc. All rights reserved.

Blood plasma ❖ About 55% of blood is blood plasma, a fluid that is the
blood's liquid medium, which by itself is straw-yellow in color.
❖ It is essentially an aqueous solution containing 92% water,
is the pale yellow liquid component of blood that 8% blood plasma proteins, and trace amounts of other
normally holds the blood cells in whole blood in materials.
suspension; this makes plasma the extracellular ❖ Plasma circulates dissolved nutrients, such as glucose,
amino acids, and fatty acids (dissolved in the blood or bound
matrix of blood cell. to plasma proteins), and removes waste products, such as
carbon dioxide, urea, and lactic acid.
Blood plasma is prepared by spinning a tube of ❖ Other important components include:
fresh blood containing an anticoagulant in a • Serum albumin
centrifuge until the blood cells fall to the bottom • Blood-clotting factors (to facilitate coagulation)
of the tube. The blood plasma is then poured or • Immunoglobulins (antibodies)
drawn off. It makes up about 55% of the body's • lipoprotein particles
total blood volume. • Various other proteins
• Various electrolytes (mainly sodium and chloride)

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❖Left tube: after standing,

the RBCs have settled at
the bottom of the tube.
❖ Right tube: contains
freshly drawn blood.
❖The proportion of blood
occupied by red blood cells
is referred to as the
hematocrit, and is normally
about 45%.

Copyright © 2014 John Wiley & Sons, Inc. All rights reserved.

BLOOD SERUM
❖Serum is an essential factor for the self-renewal
The term serum refers to plasma from which the
clotting proteins have been removed.
of embryonic stem cells in combination with the
cytokine leukemia inhibitory factor.
Most of the proteins remaining are albumin and
immunoglobulins. ❖The serum of convalescent patients successfully
recovering (or already recovered) from an
❖The clear yellowish fluid
infectious disease can be used as a
❖Serum includes all proteins not used in blood clotting biopharmaceutical in the treatment of other
(coagulation) and all the electrolytes, antibodies, people with that disease, because the
antigens, hormones, and any exogenous substances antibodies generated by the successful recovery
(e.g., drugs and microorganisms).
are potent fighters of the pathogen. Such
❖A study of serum is serology, and may also include convalescent serum (antiserum) is a form of
proteomics. immunotherapy.
❖Serum is used in numerous diagnostic tests, as well as
blood typing.

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Functions and Properties of Blood

Copyright © 2014 John Wiley & Sons, Inc. All rights reserved.

Formation of Blood Cells

▪ Lymphocytes are able to live for years while most
other blood cells live for hours, days, or weeks.
▪ The number of red blood cells and platelets
remains rather steady while that of white blood
cells varies depending on invading pathogens and
other foreign antigens.
▪ The process of producing blood cells is
hemopoiesis (hematopoiesis).
Pluripotent stem cells differentiate into each of
the different types of blood cells.
Copyright © 2014 John Wiley & Sons, Inc. All rights reserved.

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Formation of Blood Cells Red blood cells (RBCs)

❖also called erythrocytes, are the most

common type of blood cell and the vertebrate
organism's principal means of delivering
oxygen (O2) to the body tissues—via blood
flow through the circulatory system.
❖ RBCs take up oxygen in the lungs and
release it into tissues while squeezing through
the body's capillaries.

Copyright © 2014 John Wiley & Sons, Inc. All rights reserved.

Red Blood Cells

▪ Red blood cells (erythrocytes) contain the
protein hemoglobin that is used to carry
oxygen to all cells and to carry 23% of total
carbon dioxide to the lungs.
▪ Each hemoglobin molecule contains an iron
ion which allows each molecule to bind four
oxygen molecules.
▪ Red blood cells have no nucleus or other
organelles and are biconcave discs. The lack
of a nucleus and the shape allow the cells to
efficiently carry oxygen.

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Red Blood Cells Red Blood Cells

▪ Hemoglobin is also involved in regulating
blood flow and blood pressure via the
release of nitric oxide which causes
vasodilation that improves blood flow and
enhances oxygen delivery.
▪ Red blood cells also contain carbonic
anhydrase which catalyzes the conversion of
carbon dioxide and water to carbonic acid. This
compound transports about 70% of carbon
dioxide in the plasma. It is also a buffer.
Copyright © 2014 John Wiley & Sons, Inc. All rights reserved.

In humans, mature red blood cells are flexible and Red Blood Cells
oval biconcave disks. They lack a cell nucleus and
most organelles, in order to accommodate
maximum space for hemoglobin; they can be ▪ Red blood cells live for only about 120
viewed as sacks of hemoglobin, with a plasma days. Dead cells are removed from the
membrane as the sack.
circulation by the spleen and liver.
Approximately 2.4 million new erythrocytes are
produced per second in human adults. ▪ Breakdown products from the cells are
The cells develop in the bone marrow and circulate recycled and reused.
for about 100–120 days in the body before their
components are recycled by macrophages.
Each circulation takes about 20 seconds.
Approximately a quarter of the cells in the human
body are red blood cells. Nearly half of the blood's
volume (40% to 45%) is red blood cells.
Copyright © 2014 John Wiley & Sons, Inc. All rights reserved.

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Red Blood Cells

▪ Erythropoiesis (production of red blood cells)
begins in the red bone marrow.
Reticulocytes (immature red blood cells)
enter the circulation and mature in 1 to 2
days.
▪ Erythropoietin, a hormone released by the
kidneys in response to hypoxia (lowered
oxygen concentration) stimulates
differentiation of hematopoietic stem cells into
erythrocytes.
Copyright © 2014 John Wiley & Sons, Inc. All rights reserved.

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Red Blood Cells

Interactions Animation: Red Blood Cells

◼ Erythropoietin

You must be connected to the Internet and in Slideshow Mode to

run this animation.

Copyright © 2014 John Wiley & Sons, Inc. All rights reserved. Copyright © 2014 John Wiley & Sons, Inc. All rights reserved.

Polycythemia (also known as polycythaemia) is a disease Anemia is a decrease in the total amount of red blood cells (RBCs)
state in which the hematocrit (the volume percentage of red or hemoglobin in the blood, or a lowered ability of the blood to
blood cells in the blood) is >55%. carry oxygen.
It can be due to an increase in the number of red blood cells When anemia comes on slowly, the symptoms are often vague and
("absolute polycythemia") or to a decrease in the volume of may include feeling tired, weakness, shortness of breath or a poor
plasma ("relative polycythemia"). ability to exercise.
The emergency treatment of polycythemia (e.g., in Anemia that comes on quickly often has greater symptoms, which
hyperviscosity or thrombosis) is by phlebotomy (removal of may include confusion, feeling like one is going to pass out, loss of
blood from the circulation). Depending on the underlying consciousness, or increased thirst.
cause, phlebotomy may also be used on a regular basis to Anemia must be significant before a person becomes noticeably
reduce the hematocrit. Cytostatics such as busulfan and pale. Additional symptoms may occur depending on the underlying
hydroxyurea are sometimes used for long-term management cause.
of polycythemia.

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The three main types of anemia are White Blood Cells

due to blood loss,
decreased red blood cell production, and
increased red blood cell breakdown.
▪ White blood cells (leukocytes) contain a
Causes of blood loss include trauma and gastrointestinal nucleus and organelles, but no hemoglobin.
bleeding, among others.
Causes of decreased production include iron deficiency, a
▪ Leukocytes are classified as either granular
lack of vitamin B12, thalassemia, and a number of (containing vesicles that appear when the
neoplasms of the bone marrow. cells are stained) or agranular (containing no
Causes of increased breakdown include a number of genetic
conditions such as sickle cell anemia, infections like malaria,
granules).
and certain autoimmune diseases. ▪ Granular leukocytes: neutrophils,
It can also be classified based on the size of red blood cells
and amount of hemoglobin in each cell. eosinophils, basophils
If the cells are small, it is microcytic anemia. If they are ▪ Agranular leukocytes: lymphocytes,
large, it is macrocytic anemia while if they are normal sized,
it is normocytic anemia monocytes
Copyright © 2014 John Wiley & Sons, Inc. All rights reserved.

White Blood Cells

Copyright © 2014 John Wiley & Sons, Inc. All rights reserved.

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White Blood Cells

White Blood
▪ White blood cells may live for several months or Cells
years. Their main function is to combat
invading microbes.
▪ During an invasion, many white blood cells are
able to leave the bloodstream and collect at
sites of invasion. The process is called
emigration (diapedesis).

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Neutrophil Eosinophil
Neutrophils are the most abundant white blood cell, ❖Eosinophils compose about 2-4% of the WBC total. This
constituting 60-70% of the circulating leukocytes . count fluctuates throughout the day, seasonally, and
during menstruation. It rises in response to allergies,
They defend against bacterial or fungal infection. They parasitic infections, collagen diseases, and disease of
are usually first responders to microbial infection; their the spleen and central nervous system.
activity and death in large numbers forms pus. ❖They primarily deal with parasitic infections. Eosinophils
Neutrophils are active in phagocytosing bacteria and are are also the predominant inflammatory cells in allergic
present in large amount in the pus of wounds. These reactions.
cells are not able to renew their lysosomes (used in ❖The most important causes of eosinophilia include
digesting microbes) and die after having phagocytosed allergies such as asthma, hay fever, and hives; and also
a few pathogens. parasitic infections.
Neutrophils are the most common cell type seen in the ❖They secrete chemicals that destroy these large
early stages of acute inflammation. The life span of a parasites, such as hook worms and tapeworms, that are
circulating human neutrophil is about 5.4 days. too big for any one WBC to phagocytize.

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Basophils Lymphocyte
❖Basophils are chiefly responsible for allergic and
antigen response by releasing the chemical histamine ❖Lymphocytes are much more common in the lymphatic
causing the dilation of blood vessels system than in blood.
❖They excrete two chemicals that aid in the body's ❖Lymphocytes include:
defenses: histamine and heparin.
❖B cells make antibodies that can bind to pathogens,
❖Histamine is responsible for widening blood vessels and block pathogen invasion, activate the complement
increasing the flow of blood to injured tissue. It also system, and enhance pathogen destruction.
makes blood vessels more permeable, so neutrophils
and clotting proteins can get into connective tissue ❖T cells:
more easily. • CD4+ helper T cells:
❖Heparin is an anticoagulant that inhibits blood clotting T cells displaying co-receptor CD4 are known as CD4+ T
and promotes the movement of white blood cells into an cells
area.
• CD8+ cytotoxic T cells
❖ Basophils can also release chemical signals that attract ❖Natural killer cells
eosinophils and neutrophils to an infection site.

Monocytes White Blood Cells

❖Monocytes, the largest type of WBCs, share the
"vacuum cleaner" (phagocytosis) function of neutrophils,
but are much longer lived as they have an extra role: ▪ In general, an elevation in the white blood
❖they present pieces of pathogens to T cells so that the count usually indicates an infection or
pathogens may be recognized again and killed. This inflammation.
causes an antibody response to be mounted.
❖Monocytes eventually leave the bloodstream and ▪ A low white blood cell count may develop
become tissue macrophages, which remove dead cell due to several causes.
debris as well as attacking microorganisms. Neither
dead cell debris nor attacking microorganisms can be ▪ A differential white blood cell count will help
dealt with effectively by the neutrophils.
to determine if a problem exists.
❖Unlike neutrophils, monocytes are able to replace their
lysosomal contents and are thought to have a much
longer active life. They have the kidney shaped nucleus
and are typically agranulated. They also possess
abundant cytoplasm. Copyright © 2014 John Wiley & Sons, Inc. All rights reserved.

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Leukemia, also spelled leukaemia, is a group of

cancers that usually begin in the bone marrow and
result in high numbers of abnormal white blood cells.
These white blood cells are not fully developed and are
called blasts or leukemia cells.
Symptoms may include bleeding and bruising
problems, feeling tired, fever, and an increased risk of
infections. These symptoms occur due to a lack of
normal blood cells.
Diagnosis is typically made by blood tests or bone
marrow biopsy

Copyright © 2014 John Wiley & Sons, Inc. All rights reserved. Copyright © 2014 John Wiley & Sons, Inc. All rights reserved.

Platelets (thrombocytes)
There are four main types of leukemia —

acute lymphoblastic leukemia (ALL), are colorless blood cells that help blood
acute myeloid leukemia (AML), clot. Platelets stop bleeding by clumping
chronic lymphocytic leukemia (CLL) and and forming plugs in blood vessel injuries.
chronic myeloid leukemia (CML)
Thrombocytopenia often occurs as a result
Leukemias and lymphomas both belong to a
broader group of tumors that affect the blood,
of leukemia or an immune system
bone marrow, and lymphoid system, known as problem.
tumors of the hematopoietic and lymphoid
tissues.

Copyright © 2014 John Wiley & Sons, Inc. All rights reserved.

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Platelets

▪ Platelets are used to clot the blood.

▪ Under the influence of the hormone
thrombopoietin, hemopoietic stem cells
differentiate into platelets.
▪ Megakaryocytes in red bone marrow splinter
into 2000–3000 fragments to create the
platelets that contain many vesicles but no
nucleus.
▪ Platelets survive for only 5 to 9 days.
Copyright © 2014 John Wiley & Sons, Inc. All rights reserved.

Platelets, also called thrombocytes, are a

component of blood whose function (along
with the coagulation factors) is to stop
bleeding by clumping and clotting blood
vessel injuries.
Platelets have no cell nucleus: they are
fragments of cytoplasm that are derived from
the megakaryocytes of the bone marrow, and
then enter the circulation. These unactivated
platelets are biconvex discoid (lens-shaped)
structures, 2–3 µm in greatest diameter.

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The main function of platelets is to contribute Thrombocytopenia is a condition characterized by abnormally

low levels of thrombocytes
to hemostasis: the process of stopping
bleeding at the site of interrupted endothelium. A normal human platelet count ranges from 150,000 to 450,000
They gather at the site and unless the platelets per microliter of blood
interruption is physically too large, they plug One common definition of thrombocytopenia requiring
the hole. emergency treatment is a platelet count below 50,000 per
microliter
➢ First, platelets attach to substances outside
the interrupted endothelium: adhesion. Thrombocytopenia usually has no symptoms and is picked up on
a routine full blood count (or complete blood count). Some
➢ Second, they change shape, turn on individuals with thrombocytopenia may experience external
receptors and secrete chemical messengers: bleeding such as nosebleeds, and/or bleeding gums. Some
activation. women may have heavier or longer periods or breakthrough
bleeding. Bruising, particularly purpura in the forearms and
➢Third, they connect to each other through petechiae in the feet, legs, and mucous membranes, may be
receptor bridges: aggregation. caused by spontaneous bleeding under the skin
Copyright © 2014 John Wiley & Sons, Inc. All rights reserved.

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Stem Cell Transplants from Bone Hemostasis

Marrow and Cord Blood
Hemostasis means to stop bleeding.
▪ Bone marrow transplants are performed to
replace cancerous red bone marrow with The process involves:
normal red bone marrow. The donor’s marrow ▪ Vascular spasm
is usually collected from the iliac crest of the ▪ Platelet plug formation
hip bone. ▪ Blood clotting (coagulation)
▪ Stem cells collected from an umbilical cord
after birth are frozen and may also be used and
have advantages over bone marrow
transplants.

Hemostasis Hemostasis

Copyright © 2014 John Wiley & Sons, Inc. All rights reserved.

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Hemostasis

▪ Blood clotting involves several clotting Hemostasis

(coagulation) factors identified by
Roman numerals and divided into three
stages.
▪ The three stages are the extrinsic
pathway, intrinsic pathway and
common pathway.

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Copyright © 2014 John Wiley & Sons, Inc. All rights reserved.

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Hemostasis
▪ Once the clot forms, it consolidates
(tightens) to pull the edges of the damaged
vessel together.
▪ Vitamin K is needed for normal clot formation
although it is not directly involved. It is used in
the synthesis of 4 clotting factors.
▪ Small, unwanted clots are usually dissolved by
plasmin (fibrinolysin).

Copyright © 2014 John Wiley & Sons, Inc. All rights reserved.

Blood typing Blood is often grouped according to the

ABO blood typing system.
This method breaks blood types down into four
a method to tell what specific type of
types:
blood you have. What type you have
depends on whether or not there are • Type A
certain proteins, called antigens, on your • Type B
red blood cells. Blood is often grouped
• Type AB
according to the ABO blood typing system.
• Type O
Your blood type (or blood group) depends on the
types that are been passed down to you from
your parents.

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Blood Groups and Blood Types

▪ Blood is characterized into different blood groups
based on the presence or absence of Blood typing is also done to tell whether or not
glycoprotein and glycolipid antigens
(agglutinogens) on the surface of red blood cells.
you have a substance called Rh factor on the
surface of your red blood cells. If you have this
▪ There are 24 blood groups and more than 100
antigens
substance, you are considered Rh+ (positive).
Those without it are considered Rh- (negative).
▪ Because these antigens are genetically controlled,
blood types vary among different populations.
Rh typing uses a method similar to ABO typing.
▪ Classification is based on antigens labeled A, B or
AB with O being the absence of the antigens.
▪ An additional antigen, Rh, is present in 85% of
humans. Copyright © 2014 John Wiley & Sons, Inc. All rights reserved.

Blood Groups and Blood Types This test is done to determine a person's blood type.
Health care providers need to know your blood type
when you get a blood transfusion or transplant, because
not all blood types are compatible with each other. For
example:
•If you have type A blood, you can only receive types A
and O blood.
•If you have type B blood, you can only receive types B
and O blood.
•If you have type AB blood, you can receive types A, B,
AB, and O blood.
•If you have type O blood, you can only receive type O
blood.
Type O blood can be given to anyone with any blood type.
That is why people with type O blood are called
universal blood donors.
Copyright © 2014 John Wiley & Sons, Inc. All rights reserved.

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Blood Groups and Blood Types Blood Groups and Blood Types

Blood plasma usually contains antibodies

(agglutinins) that react with A or B antigens.
An individual will not have agglutinins against
his or her own blood type.

Copyright © 2014 John Wiley & Sons, Inc. All rights reserved. Copyright © 2014 John Wiley & Sons, Inc. All rights reserved.

Blood Groups and Blood Types Blood Groups and Blood Types

▪ In order to determine a person’s blood

type, typing and cross-matching are
performed.
▪ A drop of blood is mixed with an
antiserum that will agglutinate blood
cells that possess agglutinogens that react
with it.

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Blood typing is especially important during

Blood pregnancy. If the mother is found to be Rh-, the
father should also be tested. If the father has
Groups and Rh+ blood, the mother needs to receive a
Blood Types treatment to help prevent the development of
substances that may harm the unborn baby. See:
Rh incompatibility

If you are Rh+, you can receive Rh+ or Rh-

blood. If you are Rh-, you can only receive Rh-
blood.

Copyright © 2014 John Wiley & Sons, Inc. All rights reserved.

Hemolytic Disease of the Newborn Hemolytic Disease of the Newborn

▪ At birth, small amounts of fetal blood leak into

the maternal circulation. If the baby is Rh+ and
the mother is Rh–, she will develop antibodies
to the Rh factor.
▪ During her next pregnancy with an Rh+ baby,
when she transfers antibodies to the fetus (a
normal occurrence), transferred anti Rh
antibodies will attack some of the fetus’ red
blood cells causing agglutination and
hemolysis.

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Disorders: Homeostatic Imbalances

▪ Sickle cell disease is a genetic anemia ▪ https://www.youtube.com/watch?v=noMsCGRkwSE
(oxygen-carrying capacity of the blood
is reduced).
▪ The red blood cells of individuals with this
disease contain hemoglobin-S (Hb-S)
that causes red blood cells to bend into a
sickle shape when it gives up oxygen to
the interstitial fluid.

Copyright © 2014 John Wiley & Sons, Inc. All rights reserved.

Disorders Blood Testing

❖ Hematology is the branch of medicine
concerning the study of blood, the blood-
forming organs, and blood diseases.
Hematology tests include laboratory
assessments of blood formation and blood
disorders.
❖ Hematologists and hematopathologists
are specially trained doctors who specialize
in diseases of the blood and blood
components, including blood and bone
marrow cells. Hematological tests can help
diagnose anemia, infection, hemophilia,
blood-clotting disorders, and leukemia.
Copyright © 2014 John Wiley & Sons, Inc. All rights reserved.

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Hematology Tests Complete Blood Count:

❖Full blood count - A count of the total ➢ Red blood cell count
number of red blood cells, white blood ➢ Hemoglobin
cells and platelets present in blood. ➢ Hematocrit
➢ MCV (mean corpuscular volume)
❖Blood film - Blood is smeared over a
➢ MCH (mean corpuscular hemoglobin)
glass slide that is stained with specific
➢ MCHC (mean corpuscular hemoglobin
dyes and viewed under a microscope. The concentration)
number, shape and size of blood cells and ➢ RDW (red blood cell distribution)
the presence of any abnormal cells or ➢ White blood cell count
immature cells are noted. ➢ Differential count
➢ Platelet count

❖The erythrocyte sedimentation rate (ESR) A blood chemistry panel

❖The bone marrow may be examined.
❖another common test used to evaluate a
❖Iron status and anemias are assessed using tests
such as serum ferritin, vitamin B12 and folate variety of components. Usually, it consists
levels. of about 7-25 tests. The information below
❖The Coombs' test or antiglobulin test may be is meant to provide an overview of these
used for blood typing and blood matching prior to tests.
blood transfusion, for example.
❖Platelet function in bleeding and coagulation This panel contains the following
may be checked using a test called prothrombin tests:
time.
❖Fine-needle aspiration of lymph nodes and ❖Blood Sugar:
tumors. •Fasting glucose
❖Examination of spleen biopsy.

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Kidney Function: Electrolytes and Minerals:

➢Uric acid •Sodium
➢BUN (blood urea nitrogen) •Potassium
➢Creatinine •Chloride
➢BUN/creatinine ratio •Calcium
➢eGFR (estimated glomerular filtration rate) •Phosphorus
•Iron

Liver Function: Lipid Profile:

•Total protein •Total cholesterol
•Albumin •Triglycerides
•Globulin
•HDL cholesterol
•Albumin/globulin ratio
•LDL cholesterol (calc.)
•Bilirubin
•Alkaline phosphatase •Total cholesterol/HDL ratio
•LDH (lactate dehydrogenase) •Estimated CHD risk
•AST (aspartate aminotransferase)
•ALT (alanine transaminase)

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▪ Some of the number and type of tests contained in specific panels, and the
A comprehensive metabolic panel (CMP) names of the panels, have been standardized nationally. Examples of
common chemistry panels include:
▪ Basic Metabolic Panel (BMP) – usually contains 8 tests, all of which are
a blood test that measures your sugar found in the CMP (below); provides information about the current status of
a person's kidneys and respiratory system as well as electrolyte and
level, electrolyte and fluid balance, plus acid/base balance and level of blood glucose
kidney and liver function. Our ▪ Comprehensive Metabolic Panel (CMP) – usually includes 14 tests;
provides the same information as the BMP with the addition of the status of
CBC/chemistry profile also includes a lipid a person's liver and important blood proteins
panel and complete blood count (CBC) so ▪ Electrolyte Panel – helpful for detecting a problem with the body's fluid and
electrolyte balance
you have the opportunity to detect signs of ▪ Lipid Profile – used to assess a person's risk of developing cardiovascular
disease
heart disease, anemia, clotting and
▪ Liver Panel (also called Hepatic Function Panel) – used to screen for,
immune disorders, as well as metabolic detect, evaluate, and monitor actue and chronic liver inflammation
(hepatitis), liver disease and/or damage
conditions that could threaten your health. ▪ Renal Panel (also called Kidney Function Panel) – contains tests such as
albumin, creatinine, BUN, eGFR to evaluate kidney function
▪ Thyroid Function Panel – to help evaluate thyroid gland function and to
help diagnose thyroid disorders

Hematological disorders Infectious disorders of blood.

Anemia Insufficient red cell mass (anemia) can be the result of bleeding, blood disorders like Blood is an important vector of infection.
thalassemia, or nutritional deficiencies; and may require blood transfusion. Several countries
HIV, the virus that causes AIDS, is transmitted through contact with blood, semen or
have blood banks to fill the demand for transfusable blood. A person receiving a blood
other body secretions of an infected person.
transfusion must have a blood type compatible with that of the donor.
Sickle-cell anemia Hepatitis B and C are transmitted primarily through blood contact. Owing to blood-
borne infections, bloodstained objects are treated as a biohazard.
Disorders of cell proliferation Leukemia is a group of cancers of the blood-forming tissues and
cells. Bacterial infection of the blood is bacteremia or sepsis. Viral Infection is viremia.
Non-cancerous overproduction of red cells (polycythemia vera) or platelets (essential
Malaria and trypanosomiasis are blood-borne parasitic infections.
thrombocytosis) may be premalignant. Carbon monoxide poisoning
Myelodysplastic syndromes involve ineffective production of one or more cell lines. Substances other than oxygen can bind to hemoglobin; in some cases this can cause
Disorders of coagulation. Hemophilia is a genetic illness that causes dysfunction in one of irreversible damage to the body. Carbon monoxide, for example, is extremely dangerous
the blood's clotting mechanisms. This can allow otherwise inconsequential wounds to be life- when carried to the blood via the lungs by inhalation, because carbon monoxide
threatening, but more commonly results in hemarthrosis, or bleeding into joint spaces, which irreversibly binds to hemoglobin to form carboxyhemoglobin, so that less hemoglobin is
can be crippling. free to bind oxygen, and fewer oxygen molecules can be transported throughout the
Ineffective or insufficient platelets can also result in coagulopathy (bleeding disorders). blood. This can cause suffocation insidiously. A fire burning in an enclosed room with
Hypercoagulable state (thrombophilia) results from defects in regulation of platelet or
poor ventilation presents a very dangerous hazard, since it can create a build-up of carbon
clotting factor function, and can cause thrombosis. monoxide in the air. Some carbon monoxide binds to hemoglobin when smoking tobacco.

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