blood and related tissues physiology.ppt
- 1. Physiology Physiology Is the scientific study of the normal Is the scientific study of the normal function in living systems in living systems The branch of The branch of biology that deals that deals with the study of all the parts of with the study of all the parts of living organisms and their various and their various function function . .
- 3. White blood cells Platelets Red blood cells Artery
- 4. Blood: Blood:Blood: Blood: is a connective tissue in fluid is a connective tissue in fluid form. It is considered as the fluid of life form. It is considered as the fluid of life because it carries oxygen from lungs to all because it carries oxygen from lungs to all parts of the body and carbon dioxide from all parts of the body and carbon dioxide from all parts of the body to the lungs. parts of the body to the lungs. PROPERTIES OF BLOOD PROPERTIES OF BLOOD 1. Color: Blood is red in color. Arterial blood 1. Color: Blood is red in color. Arterial blood is Scarlet red because of more O2 and is Scarlet red because of more O2 and venous blood is purple red because of more venous blood is purple red because of more CO2. CO2.
- 5. 2. Volume: 2. Volume: The average volume of blood in a normal The average volume of blood in a normal adult is 5 L. In newborn baby it is 450 ml. It adult is 5 L. In newborn baby it is 450 ml. It increases during growth and reaches 5 L increases during growth and reaches 5 L at the time of puberty. In females, it is at the time of puberty. In females, it is slightly less and is about 4.5 L. It is about slightly less and is about 4.5 L. It is about 8% of the body weight in a normal young 8% of the body weight in a normal young healthy adult weighing about 70 kg. healthy adult weighing about 70 kg.
- 6. 3. Reaction and pH: Blood is slightly alkaline 3. Reaction and pH: Blood is slightly alkaline and its pH in normal conditions is 7.4. and its pH in normal conditions is 7.4. 4. Viscosity: Blood is five times more 4. Viscosity: Blood is five times more viscous than water. It is mainly due to red viscous than water. It is mainly due to red blood cells and plasma protein blood cells and plasma protein
- 7. Blood is made of two parts: Blood is made of two parts: 1-Plasma which makes up 55% of blood 1-Plasma which makes up 55% of blood volume volume 2-Formed cellular elements (red and white 2-Formed cellular elements (red and white blood cells, and platelets) which combine blood cells, and platelets) which combine to make the remaining 45% of blood to make the remaining 45% of blood volume. volume.
- 9. Functions of the blood include: Functions of the blood include: 1. Nutrient Function 1. Nutrient Function Nutritive substances like glucose, amino Nutritive substances like glucose, amino acids, lipids and vitamins derived from acids, lipids and vitamins derived from digested food are absorbed from digested food are absorbed from gastrointestinal tract and carried by blood gastrointestinal tract and carried by blood to different parts of the body for growth to different parts of the body for growth and production of energy. and production of energy.
- 10. 2. Respiratory Function 2. Respiratory Function Transport of respiratory gases is done by Transport of respiratory gases is done by the blood. It carries O2 from alveoli of lungs the blood. It carries O2 from alveoli of lungs to different tissues and CO2 from tissues to to different tissues and CO2 from tissues to alveoli. alveoli. 3. Excretory Function 3. Excretory Function Waste products formed in the tissues during Waste products formed in the tissues during various metabolic activities are removed by various metabolic activities are removed by blood and carried to the excretory organs blood and carried to the excretory organs like kidney, skin, liver, etc. for excretion. like kidney, skin, liver, etc. for excretion.
- 11. 4. Transport of Hormones and Enzymes 4. Transport of Hormones and Enzymes Hormones which are secreted by ductless Hormones which are secreted by ductless (endocrine) glands are released directly (endocrine) glands are released directly into the blood. The blood transports these into the blood. The blood transports these hormones to their target organs/tissues. hormones to their target organs/tissues. Blood also transports enzymes. Blood also transports enzymes.
- 12. 5. Regulation of Acid-base Balance 5. Regulation of Acid-base Balance The plasma proteins and hemoglobin act as buffers and The plasma proteins and hemoglobin act as buffers and help in regulation of acid-base balance. help in regulation of acid-base balance. 6. Regulation of Body Temperature Because of the high 6. Regulation of Body Temperature Because of the high specific heat of blood, it is responsible for maintaining the specific heat of blood, it is responsible for maintaining the thermoregulatory mechanism in the body, i.e. the balance thermoregulatory mechanism in the body, i.e. the balance between heat loss and heat gain in the body. between heat loss and heat gain in the body.
- 13. 8. Storage Function 8. Storage Function Water and some important substances like Water and some important substances like proteins, glucose, sodium and potassium proteins, glucose, sodium and potassium are constantly required by the tissues. All are constantly required by the tissues. All these substances are present in the blood these substances are present in the blood are taken by the tissues during the are taken by the tissues during the conditions like starvation, fluid loss, conditions like starvation, fluid loss, electrolyte loss, etc. electrolyte loss, etc.
- 14. 9. Defensive Function 9. Defensive Function The WBCs in the blood provide the The WBCs in the blood provide the defense mechanism and protect the body defense mechanism and protect the body from the invading organisms. Neutrophils from the invading organisms. Neutrophils and monocytes engulf the bacteria by and monocytes engulf the bacteria by phagocytosis. Lymphocytes provide phagocytosis. Lymphocytes provide cellular and humoral immunity. cellular and humoral immunity.
- 15. Plasma is a straw colored clear liquid part of Plasma is a straw colored clear liquid part of blood. It contains 91 to 92% of water and 8 to blood. It contains 91 to 92% of water and 8 to 9% of solids. The solids are the organic and 9% of solids. The solids are the organic and inorganic substances. inorganic substances. Plasma
- 16. Serum Serum Serum is the clear straw colored fluid that Serum is the clear straw colored fluid that oozes out from the clot. When the blood is oozes out from the clot. When the blood is shed or collected in a container, it clots shed or collected in a container, it clots because of the conversion of fibrinogen because of the conversion of fibrinogen into fibrin. After about 45 minutes, serum into fibrin. After about 45 minutes, serum oozes out of the clot. For clinical oozes out of the clot. For clinical investigations, serum is separated from investigations, serum is separated from blood cells by centrifuging. blood cells by centrifuging.
- 18. Volume of the serum is almost the same as Volume of the serum is almost the same as that of plasma (55%). It is different from that of plasma (55%). It is different from plasma only by the absence of fibrinogen, plasma only by the absence of fibrinogen, i.e. serum contains all the other i.e. serum contains all the other constituents of plasma except fibrinogen. constituents of plasma except fibrinogen. Fibrinogen is absent in serum because it is Fibrinogen is absent in serum because it is converted into fibrin during blood clotting. converted into fibrin during blood clotting. Thus, the Serum = Plasma – Fibrinogen. Thus, the Serum = Plasma – Fibrinogen.
- 19. PLASMA PROTEINS PLASMA PROTEINS The plasma proteins are: The plasma proteins are: 1. Serum albumin 1. Serum albumin 2. Serum globulin 2. Serum globulin 3. Fibrinogen. 3. Fibrinogen. Globulin is of three types, Globulin is of three types, Α-globulin, Α-globulin, β-globulin and β-globulin and γ-globulin. γ-globulin.
- 20. NORMAL VALUES NORMAL VALUES The normal values of the plasma proteins The normal values of the plasma proteins are: are: Total proteins: 7.3 g/dL (6.4-8.3 g/dL) Total proteins: 7.3 g/dL (6.4-8.3 g/dL) Serum albumin: 4.7 g/dL Serum albumin: 4.7 g/dL Serum globulin: 2.3 g/dL Serum globulin: 2.3 g/dL Fibrinogen: 0.3 g/d Fibrinogen: 0.3 g/d Albumin/globulin Ratio Albumin/globulin Ratio
- 21. The ratio between plasma level of albumin and globulin is called Albumin/Globulin (A/G) ratio. It is an important indicator of some liver and kidney diseases. Normal A/G ratio is 2:1.
- 22. ORIGIN OF PLASMA PROTEINS ORIGIN OF PLASMA PROTEINS In embryonic stage, the plasma proteins are In embryonic stage, the plasma proteins are synthesized by the mesenchyme cells. In synthesized by the mesenchyme cells. In adult s, the plasma proteins are synthesized adult s, the plasma proteins are synthesized mainly from reticuloendothelial cells of liver mainly from reticuloendothelial cells of liver and also from spleen, bone marrow, and also from spleen, bone marrow, disintegrating blood cells and general tissue disintegrating blood cells and general tissue cells. Gamma globulin is synthesized from cells. Gamma globulin is synthesized from B lymphocytes. B lymphocytes.
- 23. FUNCTIONS OF PLASMA PROTEINS FUNCTIONS OF PLASMA PROTEINS 1. 1. Role in Coagulation of Blood Fibrinogen is Role in Coagulation of Blood Fibrinogen is essential for the coagulation of Blood. essential for the coagulation of Blood. 2. Role in Defense Mechanism of Body the 2. Role in Defense Mechanism of Body the gamma globulins play an important role in gamma globulins play an important role in the defense mechanism of the body by the defense mechanism of the body by acting as antibodies. These proteins are acting as antibodies. These proteins are also called immunoglobulins. also called immunoglobulins.
- 24. 3. Role in Transport Mechanism: 3. Role in Transport Mechanism: Plasma proteins are essential for the Plasma proteins are essential for the transport of various substances in the transport of various substances in the blood. Albumin, alpha globulin and beta blood. Albumin, alpha globulin and beta globulin are responsible for the transport globulin are responsible for the transport of the hormones, enzymes, etc. of the hormones, enzymes, etc. The alpha and beta globulins transport The alpha and beta globulins transport metals in the blood. metals in the blood.
- 25. 4. Role in Maintenance of Osmotic: 4. Role in Maintenance of Osmotic: Pressure in Blood Plasma proteins exert the Pressure in Blood Plasma proteins exert the colloidal osmotic (oncotic) pressure. The colloidal osmotic (oncotic) pressure. The osmotic pressure exerted by the plasma osmotic pressure exerted by the plasma proteins is about 25 mm Hg. Since the proteins is about 25 mm Hg. Since the concentration of albumin is more than the concentration of albumin is more than the other plasma proteins, it exerts maximum other plasma proteins, it exerts maximum pressure. pressure.
- 26. 5. Role in Regulation of Acid-base 5. Role in Regulation of Acid-base Balance: Plasma proteins, particularly the Balance: Plasma proteins, particularly the albumin, play an important role in albumin, play an important role in regulating the acid-base balance in the regulating the acid-base balance in the blood. This is because of the virtue of their blood. This is because of the virtue of their buffering action. buffering action.
- 27. 6. Role in Viscosity of Blood: 6. Role in Viscosity of Blood: The plasma proteins provide viscosity to the The plasma proteins provide viscosity to the blood, which is important to maintain the blood, which is important to maintain the blood pressure. Albumin provides maximum blood pressure. Albumin provides maximum viscosity than the other plasma proteins. viscosity than the other plasma proteins. 7. Role in Erythrocyte Sedimentation Rate 7. Role in Erythrocyte Sedimentation Rate (ESR): Globulin and fibrinogen accelerate (ESR): Globulin and fibrinogen accelerate the tendency of rouleaux formation by the the tendency of rouleaux formation by the red blood cells. Rouleaux formation is red blood cells. Rouleaux formation is responsible for ESR, which is an important responsible for ESR, which is an important diagnostic and prognostic too. diagnostic and prognostic too.
- 28. 7. Role in Erythrocyte Sedimentation Rate (ESR): 7. Role in Erythrocyte Sedimentation Rate (ESR): Globulin and fibrinogen accelerate the tendency Globulin and fibrinogen accelerate the tendency of rouleaux formation by the red blood cells. of rouleaux formation by the red blood cells. Rouleaux formation is responsible for ESR, Rouleaux formation is responsible for ESR, which is an important diagnostic and prognostic which is an important diagnostic and prognostic too. too.
- 29. 8. Role as Reserve Proteins 8. Role as Reserve Proteins During fasting, inadequate food intake or During fasting, inadequate food intake or inadequate protein intake, the plasma proteins inadequate protein intake, the plasma proteins are utilized by the body tissues as the last are utilized by the body tissues as the last source of energy. The plasma proteins are split source of energy. The plasma proteins are split into amino acids by the tissue macrophages. into amino acids by the tissue macrophages. The amino acids are taken back by blood and The amino acids are taken back by blood and distributed throughout the body to form cellular distributed throughout the body to form cellular protein molecules. Because of this, the plasma protein molecules. Because of this, the plasma proteins are called the reserve proteins. proteins are called the reserve proteins.
- 31. Red blood cells (RBCs) Red blood cells (RBCs) Red blood cells (RBCs), also known as erythrocytes Red blood cells (RBCs), also known as erythrocytes are the non-nucleated formed elements in the blood. are the non-nucleated formed elements in the blood. The red color of the RBC is due to the presence of The red color of the RBC is due to the presence of hemoglobin. hemoglobin. NORMAL VALUE NORMAL VALUE The RBC count ranges between 4 and 5.5 millions/cu The RBC count ranges between 4 and 5.5 millions/cu mm of blood. In adult males, it is 5 millions/cu mm mm of blood. In adult males, it is 5 millions/cu mm and in adult females it is 4.5 millions/cu mm. and in adult females it is 4.5 millions/cu mm.
- 32. MORPHOLOGY OF RED BLOOD CELLS MORPHOLOGY OF RED BLOOD CELLS NORMAL SHAPE NORMAL SHAPE Normally, the RBCs are disk-shaped and Normally, the RBCs are disk-shaped and biconcave (dumbbell-shaped). The central biconcave (dumbbell-shaped). The central portion is thinner and periphery is thicker. portion is thinner and periphery is thicker. The biconcave contour of RBCs has some The biconcave contour of RBCs has some mechanical and functional advantages. mechanical and functional advantages.
- 33. Advantages of Biconcave Shape of RBCs Advantages of Biconcave Shape of RBCs 1. It helps in equal and rapid diffusion of 1. It helps in equal and rapid diffusion of oxygen and other substances into the interior oxygen and other substances into the interior of the cell. of the cell. 2. Large surface area is provided for absorption 2. Large surface area is provided for absorption or removal of different substances. or removal of different substances. 3. While passing through minute capillaries, 3. While passing through minute capillaries, RBCs can squeeze through the capillaries RBCs can squeeze through the capillaries easily without getting damaged. easily without getting damaged.
- 34. NORMAL SIZE NORMAL SIZE Diameter: 7.2 μ (6.9 to 7.4 μ). Thickness: Diameter: 7.2 μ (6.9 to 7.4 μ). Thickness: At the periphery it is thicker with 2.2 μ and At the periphery it is thicker with 2.2 μ and at the center it is thinner with 1μ. at the center it is thinner with 1μ. The difference in thickness is because of The difference in thickness is because of the biconcave shape. the biconcave shape. Surface area: 120 sq μ. Surface area: 120 sq μ. Volume: 85 to 90 cu μ. Volume: 85 to 90 cu μ.
- 35. NORMAL STRUCTURE NORMAL STRUCTURE RBC is non-nucleated cell. Because of the RBC is non-nucleated cell. Because of the absence of nucleus, the DNA is also absent. absence of nucleus, the DNA is also absent. Other organelles such as mitochondria and Other organelles such as mitochondria and Golgi apparatus also are absent in RBC. Golgi apparatus also are absent in RBC. Since, mitochondria are absent; the energy is Since, mitochondria are absent; the energy is produced from glycoltic process. produced from glycoltic process.
- 36. PROPERTIES OF RED BLOOD CELLS PROPERTIES OF RED BLOOD CELLS 1. ROULEAUX FORMATION 1. ROULEAUX FORMATION When blood is taken out of the blood vessel, When blood is taken out of the blood vessel, the RBCs pile up one above another like the the RBCs pile up one above another like the pile of coins. pile of coins. This property of the RBCs is called rouleaux This property of the RBCs is called rouleaux (pleural = rouleau) formation . It is (pleural = rouleau) formation . It is accelerated by plasma proteins, namely accelerated by plasma proteins, namely globulin and fibrinogen. globulin and fibrinogen.
- 37. 2. PACKED CELL VOLUME 2. PACKED CELL VOLUME Packed cell volume (PCV) is the volume of the Packed cell volume (PCV) is the volume of the RBS expressed in percent age. It is also called RBS expressed in percent age. It is also called hematocrit value. It is 45% of the blood and the hematocrit value. It is 45% of the blood and the plasma volume is 55%. plasma volume is 55%.
- 38. LIFE SPAN OF RED BLOOD CELLS LIFE SPAN OF RED BLOOD CELLS Average lifespan of RBC is about 120 Average lifespan of RBC is about 120 days. After the lifetime, the senile (old) days. After the lifetime, the senile (old) RBCs are destroyed in reticuloendothelial RBCs are destroyed in reticuloendothelial system. system.
- 39. FATE OF RED BLOOD CELLS FATE OF RED BLOOD CELLS When the RBCs become older (120 days), the When the RBCs become older (120 days), the cell membrane becomes very fragile. So these cell membrane becomes very fragile. So these cells are destroyed while trying to squeeze cells are destroyed while trying to squeeze through the capillaries which have lesser or through the capillaries which have lesser or equal diameter as that of RBC. The destruction equal diameter as that of RBC. The destruction occurs mainly in the capillaries of spleen occurs mainly in the capillaries of spleen because these capillaries are very much narrow. because these capillaries are very much narrow. So, the spleen is called graveyard of RBCs. So, the spleen is called graveyard of RBCs.
- 40. The destroyed RBCs are fragmented and The destroyed RBCs are fragmented and hemoglobin is released from the fragmented hemoglobin is released from the fragmented parts. Hemoglobin is degraded into iron, globin parts. Hemoglobin is degraded into iron, globin and porphyrin. Iron combines with the protein and porphyrin. Iron combines with the protein called apoferritin to form ferritin, which is stored called apoferritin to form ferritin, which is stored in the body and reused later. Globin enters the in the body and reused later. Globin enters the protein depot for later use. The porphyrin is protein depot for later use. The porphyrin is degraded into bilirubin which is excreted by liver degraded into bilirubin which is excreted by liver through bile. through bile.
- 41. FATE OF RED BLOOD CELLS FATE OF RED BLOOD CELLS
- 42. FUNCTIONS OF RED BLOOD CELLS FUNCTIONS OF RED BLOOD CELLS 1. Transport of O2 from the Lungs to the tissues 1. Transport of O2 from the Lungs to the tissues Hemoglobin combines with oxygen to form Hemoglobin combines with oxygen to form oxyhemoglobin. oxyhemoglobin. 2. Transport CO2 from the Tissues to the Lungs 2. Transport CO2 from the Tissues to the Lungs Hemoglobin combines with carbon dioxide and Hemoglobin combines with carbon dioxide and form carbhemoglobin. form carbhemoglobin. 3. Buffering Action in Blood: Hemoglobin functions 3. Buffering Action in Blood: Hemoglobin functions as a good buffer. By this action, it regulates the as a good buffer. By this action, it regulates the hydrogen ion concentration and thereby plays a hydrogen ion concentration and thereby plays a role in the maintenance of acid-base balance. role in the maintenance of acid-base balance.
- 43. 4. In Blood Group Determination: 4. In Blood Group Determination: RBCs carry the blood group antigens like RBCs carry the blood group antigens like A antigen, B antigen and Rh factor. This A antigen, B antigen and Rh factor. This helps in determination of blood group and helps in determination of blood group and enables to prevent the reactions due to enables to prevent the reactions due to incompatible blood transfusion. incompatible blood transfusion.
- 44. Erythropoiesis Erythropoiesis Erythropoiesis is the process of the origin, Erythropoiesis is the process of the origin, development and maturation of development and maturation of erythrocytes. erythrocytes. Hemopoiesis is the process of origin, Hemopoiesis is the process of origin, development and maturation of all the development and maturation of all the blood cells. blood cells.
- 45. SITE OF ERYTHROPOIESIS SITE OF ERYTHROPOIESIS IN FETAL LIFE IN FETAL LIFE In fetal life, the erythropoiesis occurs in In fetal life, the erythropoiesis occurs in different sites in different periods: different sites in different periods: Fetus 0-2 months (yolk sac) Fetus 0-2 months (yolk sac) 2-7 months (liver, spleen) 2-7 months (liver, spleen) 5-9 months (bone marrow) 5-9 months (bone marrow) Infants bone marrow (practically all Infants bone marrow (practically all bones) bones)
- 46. PROCESS OF ERYTHROPOIESIS PROCESS OF ERYTHROPOIESIS STEM CELLS STEM CELLS RBCs develop from the hemopoietic stem RBCs develop from the hemopoietic stem cells in the bone marrow. These cells are cells in the bone marrow. These cells are called uncommitted pluripotent called uncommitted pluripotent hemopoietic stem cells (PHSC). PHSC are hemopoietic stem cells (PHSC). PHSC are not designed to form a particular type of not designed to form a particular type of blood cell; hence the name uncommitted blood cell; hence the name uncommitted PHSC. ytes. PHSC. ytes.
- 47. The different units of colony forming cells The different units of colony forming cells are: are: i. Colony forming Unit – Erythrocytes (CFU- i. Colony forming Unit – Erythrocytes (CFU- E) from which RBCs develop. E) from which RBCs develop. ii. Colony forming Unit – ii. Colony forming Unit – Granulocytes/Monocytes (CFU-GM) from Granulocytes/Monocytes (CFU-GM) from which ganulocytes (neutrophils, basophils which ganulocytes (neutrophils, basophils and eosinophils) and monocytes develop. and eosinophils) and monocytes develop.
- 49. iii. Colony forming Unit – Megakaryocytes (CFU-M) iii. Colony forming Unit – Megakaryocytes (CFU-M) from which platelets develop from which platelets develop. . STAGES OF ERYTHROPOIESIS STAGES OF ERYTHROPOIESIS The various stages between CFU-E cells and matured The various stages between CFU-E cells and matured RBC are: RBC are: 1. Proerythroblast 1. Proerythroblast 2. Early normoblast 2. Early normoblast 3. Intermediate normoblast 3. Intermediate normoblast 4. Late normoblast 4. Late normoblast 5. Reticulocyte 5. Reticulocyte 6. Matured erythrocyte 6. Matured erythrocyte
- 50. 1. Proerythroblast (Megaloblast) 1. Proerythroblast (Megaloblast) Proerythroblast or megaloblast is very large in Proerythroblast or megaloblast is very large in size with a diameter of about 20 μ. A large size with a diameter of about 20 μ. A large nucleus with two or more nucleoli and a nucleus with two or more nucleoli and a chromatin network is present. Hemoglobin is chromatin network is present. Hemoglobin is absent. The cytoplasm is basophilic in nature. absent. The cytoplasm is basophilic in nature. The proerythroblast multiplies several times and The proerythroblast multiplies several times and finally forms the cell of next stage called early finally forms the cell of next stage called early normoblast. normoblast.
- 51. 2. Early Normoblast 2. Early Normoblast It is smaller than proerythroblast with a It is smaller than proerythroblast with a diameter of about 15 μ. The nucleoli diameter of about 15 μ. The nucleoli disappear from the nucleus and disappear from the nucleus and condensation of chromatin network occurs. condensation of chromatin network occurs. The condensed network becomes dense. The condensed network becomes dense. The cytoplasm is basophilic in nature. So, The cytoplasm is basophilic in nature. So, this cell is also called basophilic this cell is also called basophilic erythroblast. This cell develops into the erythroblast. This cell develops into the next stage called intermediate normoblast. next stage called intermediate normoblast.
- 52. 2. Thyroxine 2. Thyroxine Being a general metabolic hormone, thyroxine accelerates Being a general metabolic hormone, thyroxine accelerates the process of erythropoiesis at many levels. the process of erythropoiesis at many levels. 3. Hemopoietic Growth Factors Hemopoietic growth factors 3. Hemopoietic Growth Factors Hemopoietic growth factors or growth inducers are the interleukins – 3, 6 and 11 and or growth inducers are the interleukins – 3, 6 and 11 and stem cell factor (steel factor). Generally these factors stem cell factor (steel factor). Generally these factors induce the proliferation of PHSCs. induce the proliferation of PHSCs. 4. Vitamins 4. Vitamins The vitamins A, B, C, D and E are necessary for The vitamins A, B, C, D and E are necessary for erythropoiesis. Deficiency of these vitamins causes erythropoiesis. Deficiency of these vitamins causes anemia. anemia.
- 53. 3. Intermediate Normoblast It is smaller 3. Intermediate Normoblast It is smaller than the early normoblast with a diameter of 10 to 12 than the early normoblast with a diameter of 10 to 12 μ. The nucleus is still present. But, the chromatin μ. The nucleus is still present. But, the chromatin network shows further condensation. This stage is network shows further condensation. This stage is marked by the appearance of hemoglobin. Because marked by the appearance of hemoglobin. Because of the presence of small quantity of acidic of the presence of small quantity of acidic hemoglobin, the cytoplasm which is basophilic hemoglobin, the cytoplasm which is basophilic becomes polychromatic, i.e. both acidic and basic in becomes polychromatic, i.e. both acidic and basic in nature. So this cell is called polychromophilic or nature. So this cell is called polychromophilic or polychromatic erythroblast. This cell develops into polychromatic erythroblast. This cell develops into the next stage called late normoblast the next stage called late normoblast. .
- 54. 4. Late Normoblast 4. Late Normoblast The diameter of the cell decreases further The diameter of the cell decreases further to about 8 to 10 μ. Nucleus becomes very to about 8 to 10 μ. Nucleus becomes very small with very much condensed small with very much condensed chromatin network and is called ink spot chromatin network and is called ink spot nucleus. Quantity of hemoglobin increases nucleus. Quantity of hemoglobin increases making the making the
- 55. cytoplasm almost acidophilic. So, the cell is cytoplasm almost acidophilic. So, the cell is now called orthochromic erythroblast. At now called orthochromic erythroblast. At the end of late normoblastic stage, just the end of late normoblastic stage, just before it passes to the next stage, the before it passes to the next stage, the nucleus disintegrates and disappears by nucleus disintegrates and disappears by the process called pyknosis. The final the process called pyknosis. The final remnant is extruded from the cell. Late remnant is extruded from the cell. Late normoblast develops into the next stage normoblast develops into the next stage called reticulocyte. called reticulocyte.
- 56. 5. Reticulocyte 5. Reticulocyte It is slightly larger than matured RBC. It is It is slightly larger than matured RBC. It is otherwise known as immature RBC. It is otherwise known as immature RBC. It is called reticulocyte because, the reticular called reticulocyte because, the reticular network or reticulum that is formed from network or reticulum that is formed from the disintegrated organelles are present in the disintegrated organelles are present in the cytoplasm. the cytoplasm. In newborn babies, the reticulocyte count In newborn babies, the reticulocyte count is 2 to 6% of RBCs, i.e. 2 to 6 reticulocytes is 2 to 6% of RBCs, i.e. 2 to 6 reticulocytes are present for every 100 RBCs. are present for every 100 RBCs.
- 57. The number of reticulocytes decreases The number of reticulocytes decreases during the first week after birth. Later, the during the first week after birth. Later, the reticulocyte count remains constant at or reticulocyte count remains constant at or below 1%. The number increases below 1%. The number increases whenever the erythropoietic activity whenever the erythropoietic activity increases. increases. Reticulocytes can enter the capillaries Reticulocytes can enter the capillaries through the capillary membrane from the through the capillary membrane from the site of production by diapedesis. site of production by diapedesis.
- 58. 6. Matured Erythrocyte 6. Matured Erythrocyte The cell decreases in size with the diameter The cell decreases in size with the diameter of 7.2 μ. The reticular network disappears of 7.2 μ. The reticular network disappears and the cell becomes the matured RBC with and the cell becomes the matured RBC with biconcave shape and hemoglobin but without biconcave shape and hemoglobin but without nucleus. It requires seven days for the nucleus. It requires seven days for the proerythroblast to become fully developed proerythroblast to become fully developed and matured RBC. and matured RBC.
- 60. General factors General factors 1. Erythropoietin 1. Erythropoietin Erythropoietin is a hormone secreted mainly by peritubular Erythropoietin is a hormone secreted mainly by peritubular capillaries in the kidney and a small quantity is also secreted from capillaries in the kidney and a small quantity is also secreted from the liver and the brain. Hypoxia is the stimulant for the secretion of the liver and the brain. Hypoxia is the stimulant for the secretion of erythropoietin. erythropoietin. Erythropoietin promotes the following processes: Erythropoietin promotes the following processes: i. Production of proerythroblasts from CFU-E of the bone marrow. i. Production of proerythroblasts from CFU-E of the bone marrow. ii. Development of proerythroblasts into matured RBCs through the ii. Development of proerythroblasts into matured RBCs through the several stages several stages iii. Release of matured erythrocytes into blood. Some reticulocytes iii. Release of matured erythrocytes into blood. Some reticulocytes are also are also released along with matured RBCs. released along with matured RBCs.
- 61. MATURATION FACTORS MATURATION FACTORS 1. Vitamin B12 (Cyanocobalamin). Vitamin B12 is 1. Vitamin B12 (Cyanocobalamin). Vitamin B12 is essential for synthesis of DNA, cell division and essential for synthesis of DNA, cell division and maturation in RBCs. It is also called extrinsic factor as it maturation in RBCs. It is also called extrinsic factor as it is obtained mostly from diet. It is also produced in the is obtained mostly from diet. It is also produced in the large intestine by the intestinal flora. It is absorbed from large intestine by the intestinal flora. It is absorbed from the small intestine in the presence of intrinsic factor of the small intestine in the presence of intrinsic factor of Castle. Vitamin B12 is stored mostly in liver and in Castle. Vitamin B12 is stored mostly in liver and in small quantity in muscle. Its deficiency causes small quantity in muscle. Its deficiency causes pernicious anemia (macrocyticanemia) in which the pernicious anemia (macrocyticanemia) in which the cells remain larger with fragile and weak cell cells remain larger with fragile and weak cell membrane. membrane.
- 62. 2. Intrinsic Factor of Castle 2. Intrinsic Factor of Castle It is produced in gastric mucosa by the parietal It is produced in gastric mucosa by the parietal cells of the gastric glands. It is essential for the cells of the gastric glands. It is essential for the absorption of vitamin B12 from intestine. absorption of vitamin B12 from intestine. Absence of intrinsic factor also leads to Absence of intrinsic factor also leads to pernicious anemia because of failure of vitamin pernicious anemia because of failure of vitamin B12 absorption. The deficiency of intrinsic factor B12 absorption. The deficiency of intrinsic factor occurs in conditions like severe gastritis, ulcer occurs in conditions like severe gastritis, ulcer and gastrectomy. and gastrectomy.
- 63. 3. Folic Acid 3. Folic Acid Folic acid is also essential for the synthesis Folic acid is also essential for the synthesis of DNA. Deficiency of folic acid decreases of DNA. Deficiency of folic acid decreases the DNA synthesis causing maturation the DNA synthesis causing maturation failure. Here the cells are larger and failure. Here the cells are larger and remain in megaloblastic (proerythroblastic) remain in megaloblastic (proerythroblastic) stage which leads to megaloblastic stage which leads to megaloblastic anemia. anemia.
- 64. FACTORS NECESSARY FOR HEMOGLOBIN FACTORS NECESSARY FOR HEMOGLOBIN FORMATION FORMATION Various materials are essential for the formation of Various materials are essential for the formation of hemoglobin in the RBCs such as: hemoglobin in the RBCs such as: 1.First class proteins and amino acids of high biological 1.First class proteins and amino acids of high biological value — for the formation of globin. value — for the formation of globin. 2.Iron — for the formation of heme part of the 2.Iron — for the formation of heme part of the hemoglobin. hemoglobin. 3.Copper — for the absorption of iron from GI tract. 3.Copper — for the absorption of iron from GI tract. 4.Cobalt and nickel — for the utilization of iron during 4.Cobalt and nickel — for the utilization of iron during hemoglobin synthesis. hemoglobin synthesis. 5.Vitamins: Vitamin C, riboflavin, nicotinic acid and 5.Vitamins: Vitamin C, riboflavin, nicotinic acid and pyridoxine — for hemoglobin synthesis. pyridoxine — for hemoglobin synthesis.
- 65. VARIATIONS IN NUMBER OF RED VARIATIONS IN NUMBER OF RED BLOOD CELLS BLOOD CELLS PHYSIOLOGICAL VARIATIONS PHYSIOLOGICAL VARIATIONS A-Increase in RBC Count — Polycythemia: A-Increase in RBC Count — Polycythemia: The increase in number during this condition is marginal and The increase in number during this condition is marginal and temporary. It occurs in the following conditions: temporary. It occurs in the following conditions: 1. 1. Age Age 2. 2. Sex Sex
- 66. 3. High altitude 3. High altitude
- 67. 4. Muscular exercise 4. Muscular exercise 5. Emotional Conditions 5. Emotional Conditions
- 68. 6. Increased environmental temperature 6. Increased environmental temperature generally increased temperature increases generally increased temperature increases all the activities in the body including all the activities in the body including production of RBCs. production of RBCs. 7. After meals 7. After meals There is a slight increase in the RBC count There is a slight increase in the RBC count after taking meals. It is because of need after taking meals. It is because of need for more oxygen for metabolic activities. for more oxygen for metabolic activities.
- 69. B. Decrease in RBC Count B. Decrease in RBC Count Decrease in RBC count occurs in the following physiological Decrease in RBC count occurs in the following physiological conditions: conditions: 1. High Barometric Pressures 1. High Barometric Pressures 2. During Sleep 2. During Sleep 3. Pregnancy 3. Pregnancy
- 70. Pathological Polycythemia Pathological Polycythemia Pathological polycythemia is the abnormal Pathological polycythemia is the abnormal increase in the RBC count. The count increase in the RBC count. The count increases above 7 millions/cu mm of the increases above 7 millions/cu mm of the blood. Polycythemia is of two types, the blood. Polycythemia is of two types, the primary polycythemia and secondary primary polycythemia and secondary polycythemia. polycythemia. Pathological Polycythemia Pathological Polycythemia
- 71. Primary Polycythemia — Polycythemia Primary Polycythemia — Polycythemia Vera Primary polycythemia is otherwise Vera Primary polycythemia is otherwise known as polycythemia vera. It is a disease known as polycythemia vera. It is a disease characterized by persistent increase in RBC characterized by persistent increase in RBC count above 14 millions/cu mm of blood. count above 14 millions/cu mm of blood. This is always associated with increased This is always associated with increased WBC count above 24,000/cu mm of blood. WBC count above 24,000/cu mm of blood. Polycythemia vera occurs because of red Polycythemia vera occurs because of red bone marrow malignancy. bone marrow malignancy.
- 72. Secondary Polycythemia Secondary Polycythemia It is the pathological condition in which It is the pathological condition in which polycythemia occurs because of diseases polycythemia occurs because of diseases in some other system such as: in some other system such as: 1. Respiratory disorders like emphysema 1. Respiratory disorders like emphysema 2. Congenital heart disease 2. Congenital heart disease 3. Ayerza’s disease — condition associated 3. Ayerza’s disease — condition associated with hypertrophy of right ventricle and with hypertrophy of right ventricle and obstruction of blood flow to lungs. obstruction of blood flow to lungs.
- 73. 4. Chronic carbon monoxide poisoning. 4. Chronic carbon monoxide poisoning. 5. Poisoning by chemicals like phosphorus 5. Poisoning by chemicals like phosphorus and arsenic and arsenic 6. Repeated mild hemorrhages. 6. Repeated mild hemorrhages. All these conditions lead to hypoxia which All these conditions lead to hypoxia which stimulates the release of erythropoietin. stimulates the release of erythropoietin. Erythropoietin stimulates the bone marrow Erythropoietin stimulates the bone marrow resulting in increased RBC count. resulting in increased RBC count.
- 74. Anemia Anemia The abnormal decrease in RBC count is called The abnormal decrease in RBC count is called anemia. anemia. VARIATIONS IN SIZE OF RED BLOOD VARIATIONS IN SIZE OF RED BLOOD CELLS CELLS Under physiological conditions, the size of Under physiological conditions, the size of RBCs in venous blood is slightly larger than RBCs in venous blood is slightly larger than those in arterial blood. those in arterial blood.
- 75. In pathological conditions, the variations in In pathological conditions, the variations in size of RBCs are: size of RBCs are: 1. Microcytes —smaller cells 1. Microcytes —smaller cells 2. Macrocytes — larger cells 2. Macrocytes — larger cells 3. Anisocytosis —cells of different sizes. 3. Anisocytosis —cells of different sizes. Microcytes Microcytes Microcytes are present in: Microcytes are present in: i. Iron deficiency anemia i. Iron deficiency anemia ii. Prolonged forced breathing ii. Prolonged forced breathing iii. Increased osmotic pressure in blood iii. Increased osmotic pressure in blood
- 76. Macrocytes Macrocytes Macrocytes are present in: Macrocytes are present in: i. Megaloblastic anemia i. Megaloblastic anemia ii. Muscular exercise ii. Muscular exercise iii. Decreased osmotic pressure in blood iii. Decreased osmotic pressure in blood Anisocytes Anisocytes Anisocytes are found in pernicious anemia. Anisocytes are found in pernicious anemia.
- 77. VARIATIONS IN SHAPE OF RED BLOOD VARIATIONS IN SHAPE OF RED BLOOD CELLS CELLS The shape of RBCs is altered in many The shape of RBCs is altered in many conditions including different types of conditions including different types of anemia: anemia: 1. Crenation: Shrinkage as in hypertonic 1. Crenation: Shrinkage as in hypertonic conditions conditions 2. Spherocytosis: Globular form as in hypotonic 2. Spherocytosis: Globular form as in hypotonic conditions conditions 3. Elliptocytosis: Elliptical shape as in certain 3. Elliptocytosis: Elliptical shape as in certain types of anemia types of anemia
- 78. 4. Sickle cell: Crescentic shape as in sickle 4. Sickle cell: Crescentic shape as in sickle cell anemia. cell anemia. 5. Poikilocytosis: Unusual shapes due to 5. Poikilocytosis: Unusual shapes due to deformed cell membrane. The shape will deformed cell membrane. The shape will be of flask, hammer or any other unusual be of flask, hammer or any other unusual shape. shape.
- 79. HEMOLYSIS AND FRAGILITY OF RBC HEMOLYSIS AND FRAGILITY OF RBC DEFINITION DEFINITION Hemolysis Hemolysis Hemolysis is the destruction of formed Hemolysis is the destruction of formed elements. To define more specifically, it is elements. To define more specifically, it is the process, which involves the the process, which involves the breakdown of RBC and liberation of breakdown of RBC and liberation of hemoglobin. hemoglobin.
- 80. Fragility Fragility The susceptibility of RBC to hemolysis or tendency The susceptibility of RBC to hemolysis or tendency to break easily is called fragility (Fragile = easily to break easily is called fragility (Fragile = easily broken). broken).
- 81. Anemia is the blood disorder Anemia is the blood disorder characterized by the reduction in: characterized by the reduction in: 1. Red blood cell count 1. Red blood cell count 2. Hemoglobin content 2. Hemoglobin content 3. Packed cell volume. 3. Packed cell volume.
- 82. CLASSIFICATION OF ANEMIA CLASSIFICATION OF ANEMIA Anemia is classified by two methods: Anemia is classified by two methods: A. Morphological classification A. Morphological classification B. Etiological classification. B. Etiological classification.
- 83. MORPHOLOGICAL CLASSIFICATION MORPHOLOGICAL CLASSIFICATION Morphological classification depends Morphological classification depends upon the size and color of RBC. upon the size and color of RBC. Size of RBC is expressed as mean Size of RBC is expressed as mean corpuscular volume (MCV) and the color is corpuscular volume (MCV) and the color is expressed as mean corpuscular expressed as mean corpuscular hemoglobin concentration (MCHC). By this hemoglobin concentration (MCHC). By this method, the anemia is classified into four method, the anemia is classified into four types as given. types as given.
- 88. Normal Hb types: Normal Hb types: Hb A: Hb A: Hb A2: Hb A2: Hb F (Fetal Hb): Hb F (Fetal Hb):
- 89. Variant forms of normal Hb: Variant forms of normal Hb: Oxyhemoglobin: hemoglobin combined Oxyhemoglobin: hemoglobin combined with oxygen. with oxygen. Carboxyhemoglobin:hemoglobin Carboxyhemoglobin:hemoglobin combined with combined with CO2 CO2 Methemoglobin : Ferrous iron in Methemoglobin : Ferrous iron in converted into ferric iron. converted into ferric iron.