4. body fluid & blood

 Body fluids and blood
 Body fluids, composition and functions of blood, hemopoeisis, formation of
hemoglobin, anemia, mechanisms of coagulation, blood grouping, Rh factors,
transfusion, its significance and disorders of blood, Reticulo endothelial system.

1. Body Fluid & Blood
By
Yogeshwary M. Bhongade
Assistant Professor
KamlaNeharuCollege of Pharmacy, Butibori, Nagpur

2. Contents
•Body Fluid
•Composition and function of blood
•Hemopoesis
•Formation of heamoglobin
•Blood Grouping
•Rh factor
•Transfusion
•Disorder of blood
•Reticulo endothelial system

3. Body Fluid
•Fluids inside the body of living oranism which serve as medium
for carrying nutrients to and waste product from the cell and a
medium for carrying the chemical communication that co-
ordinate activities among cell.
eg-
•Interstitial fluid (26%)
•Blood plasma
•Urine
•lymph
•Cerebrospinal fluid (LT 7%)
•Aqueous humor
•Sensorial fluid

4. Body fluid comparment
Body Fluid
Extra-cellular fluidIntra-cellular fluid

6. Blood and its Components
Blood-
•Blood is a fluid connective tissue constituting about 7% of our
total body weight (5 liters in human).
•PH-7.2-7.4 (Slightly Basic)
•Temp.-38
o
C(100.4
o
F), about 1
o
C higher than oral or rectal
body temperature.
•Constitute 8% of body weight.
1. Blood Plasma-A watery liquid extracellular matrix that contain
dissolve substances
2. Formed Elements-Cells and cells fragments

7. Blood
Components
Plasma
55%
Neutrients
Solid Liquid Gas
Water
90%
Formed
Elements
(Blood Cell) 45%
Erythrocytes
(Red Blood Cells or RBC)
Leukocytes
(White blood cells or WBC
Granulocytes
Acidophill Basophill Nutrophill Eosinophill
Agranulocytes
Lymphocyte Monocytes
Platelets

8. Components of blood in normal adult

10. Plasma
•Liquidinwhichperipheralbloodcellsaresuspended.
•Itiscomposedofwater,electrolytessuchasNa
+
andCl
-
(0.9%),
7%plasmaproteins(suchasalbumin,fibrinogen,globulin),
Harmone,fats,aminoacids,vitamins,carbohydrates,
lipoproteinsaswellasotherfactors.
•Normalplasmavolumeis40ml/kgofbodyweight

11. Erythrocyte (RBC)-
•4.8million/microliter-Female
•5.4million/microliter-Male
Characteristics
•Diameter-7Micrimeter
•Shape-Bicavediscwithout
nuclei
•Lifespan-120days

12. Leukocytes (white blood cells or WBC) and platelet
•Togather make up about 1-2 % of total blood volume.
•Counts-5,000-10,000 microliter
•Characteristics-Have nuclei, do not contain Hemoglobin.
WBC
5,000-10,000 microliter
Granulocytes
Neutrophils
60-70% of all WBC
Basophils
0.5-1% of all WBC
Eosinophils
2-4% of all WBC
Agranulocytes
Monocytes
3-8%
Lymphocytes
20-25%

13. Platelets
•Non-nucleated flat, biconvex, round or ovoid disks
•Diameter-2-5 micron
•Functions:
-Hemostasis
-Promote the coagulation cascade
-To form a blood clot
•Blood contains 150,000-350.000/mm
3
•Life Span is 7-10 days

15. Function of blood
•TransportFunction-TransportofO
2
fromthelungstothecell
andco2fromcelltolungs,transportthenutrientsromdigestive
organtothecell,Transporthormonesandenzymetothetargrt
tissueandgland.
•HomeostaticFunction-Maintainthetemperatureofbodyparts
•BufferFunction-MaintainpHofallpartofthebody
•ProtectiveFunction-Carriesprotectivesubstancessuchas
antibodies,Protectagainstdiseasethroughphagocytosis,WBC
andantibodies.
•ClottingFunction-Carriesbloodclottingfactor

16. Hemopoesis/ Hematopoesis
•Hem-Blood;Poisis-Origine,development,maturation
•Productionofbloodcells(RBC/WBC)andplateletswhichoccures
withinthebonemarrow.
•Bloodcellsareconstantlyformedthroughaprocesscalled
hemopoiesis.
•Thetermerythropoiesisreferstotheformationoferythrocytes;
•leukopoiesisreferstotheformationofleukocytes.Theseprocesses
occurintwoclassesoftissues.Myeloidtissueistheredbone
marrowofthehumeri,femora,ribs,sternum,pelvis,andportions
oftheskullthatproduceserythrocytes,granularleukocytes,and
platelets.

17. •Hematopoesis occures in myloid tissue ( Bone Marrow) and
lymphoid tissue (Lymphatic Organ)

18. Types of Hematopoietic Tissue
•Tissuewhichisactivelyorpotentiallyproducebloodcellsare
knownashematopoietictissue
1.MyloidTissue-Bonemarrowalsocalledasmyloidtissue
2.LymphoidTissues-Lymphoidtissuesareorganizedstructures
thatsupportimmuneresponses.Thebonemarrowandthymus
areprimarylymphoidtissuesandthesitesoflymphocyte
development.Thelymphnodes,spleen,tonsilsandPeyer's
patchesareexamplesofsecondarylymphoidtissue.

19. Heamoglobin
•Heamoglobin/Hemoglobin-Heam-Pigment;Globin-Protein
•Haemoglobin(Hb)isaproteinfoundintheredbloodcellsthat
carriesoxygeninyourbodyandgivesblooditsredcolour.
•Haemoglobinlevelsvaryfrompersontoperson.
•Menusuallyhavehigherlevelsthanwomen.
•Thenormalrangeforhemoglobinis:Formen,13.5to17.5
gramsperdeciliter.
•Forwomen,12.0to15.5gramsperdeciliter.

20. •Synthesisofhemoglobinbeginsintheproerythroblastsand
continuesevenintothe
•reticulocytestageoftheredbloodcells.Therefore,when
reticulocytesleavethebone
•marrowandpassintothebloodstream,theycontinuetoform
minutequantitiesof
•hemoglobinforanotherdayorsountiltheybecomemature
erythrocytes.
•Figureshowsthebasicchemicalstepsintheformationof
hemoglobin.First,succinyl_x0002_CoA,formedintheKrebs
metaboliccycle,bindswithglycinetoformapyrrolemolecule.
Formation of Heamoglobin

21. •Inturn,fourpyrrolescombinetoform
protoporphyrinIX,whichthencombineswith
irontoformthehememolecule.
•Finally,eachhememoleculecombineswitha
longpolypeptidechain,aglobinsynthesized
byribosomes,formingasubunitof
hemoglobincalledahemoglobinchain.
•Eachchainhasamolecularweightofabout
16,000;fouroftheseinturnbindtogether
looselytoformthewholehemoglobin
molecule.

22. •Thereareseveralslightvariationsinthedifferentsubunit
hemoglobinchains,dependingontheaminoacidcomposition
ofthepolypeptideportion.
•Thedifferenttypesofchainsaredesignatedalphachains,beta
chains,gammachains,anddeltachains.

23. Types of Hemoglobin
1.HemoglobinA:
•Isacombinationoftwoalphachainsandtwoofbetachains,itis
themostcommonformofhemoglobin(95-98%)intheadult
humanbeing.
2.HemoglobinA2:
•Isacombinationoftwoalphachainsandtwoofdeltachains,it
represents2-3%ofhemoglobinintheadulthumanbeing.
3.HemoglobinF(fetusHb):
•Isacombinationoftwoalphachainsandtwoofgammachains,
alsoitfoundinnewbornsbloodofabout1%oftheirhemoglobin.

24. Anemia
•Aconditioninwhichtheblooddoesn'thaveenoughhealthyredblood
cells.
•Anaemiaresultsfromalackofredbloodcellsordysfunctionalred
bloodcellsinthebody.Thisleadstoreducedoxygenflowtothebody's
organs.
•Symptomsmayincludefatigue,skinpallor,shortnessofbreath,light-
headedness,dizzinessorafastheartbeat.
•Treatmentdependsontheunderlyingdiagnosis.Ironsupplementscan
beusedforirondeficiency.VitaminBsupplementsmaybeusedfor
lowvitaminlevels.Bloodtransfusionscanbeusedforbloodloss.

25. Types of Anemias
BloodLossAnemia-
•Anemiaduetoexcessivebleedingresultswhenlossofredblood
cellsexceedsproductionofnewredbloodcells.Whenbloodlossis
rapid,bloodpressurefalls,andpeoplemaybedizzy.Whenblood
lossoccursgradually,peoplemaybetired,shortofbreath,andpale.
AplasticAnemia-
•Aplasticanemiaisaconditionthatoccurswhenyourbodystops
producingenoughnewbloodcells.Theconditionleavesyou
fatiguedandmorepronetoinfectionsanduncontrolledbleeding.A
rareandseriouscondition,aplasticanemiacandevelopatanyage.
Itcanoccursuddenly,oritcancomeonslowlyandworsenover
time.

26. •Itcanbemildorsevere.Treatmentforaplasticanemiamight
includemedications,bloodtransfusionsorastemcell
transplant,alsoknownasabonemarrowtransplant.
MegaloblasticAnemia
•Megaloblasticanemiaischaracterizedbyredbloodcellsthat
arelargerthannormal.Therealsoaren'tenoughofthem.It's
knownasvitaminB-12orfolatedeficiencyanemia,or
macrocyticanemia,aswell.Megaloblasticanemiaiscaused
whenredbloodcellsaren'tproducedproperly.

27. Heamolytic Anemia
•Hemolyticanemiaisadisorderinwhichredbloodcellsare
destroyedfasterthantheycanbemade.Thedestructionofred
bloodcellsiscalledhemolysis.Redbloodcellscarryoxygentoall
partsofyourbody.Ifyouhavealowerthannormalamountofred
bloodcells,youhaveanemia.

28. Coagulation Cascade
•Coagulationcascadetheseriesofstepsbeginningwith
activationoftheintrinsicorextrinsicpathwaysofcoagulation,
orofoneoftherelatedalternativepathways,andproceeding
throughthecommonpathwayofcoagulationtotheformation
ofthefibrinclot.

29. Clotting Factors
•Coagulationdependsonthechemical
compoundsknownastheclottingfactor.
•Therearearound12clottingfactors
presentinthehumanbody.

30. Coagulation Cascade Pathway

31. Intrinsic pathway
•Themechanismoftheintrinsicpathwayofprothrombin
activationoccursin4steps.
•Theactivationoftheintrinsicpathwaystartswiththeexposure
offactorXIIwiththecollagensoftheinjuredbloodvessels.
•Thiscollagenthenstartsstimulatingtheprocessofplatelet
adhesionandaggregationbeforetheinitiationofblood
coagulation.
•ThisfurtheractivationoffactorXIisdonebytheactivationof
factorXII.ThiscovertthefactorXItofactorXIa.thenfactor
XIaistofactorIXbyfactorVIIa.

32. •Thefinalstepintheactivationoftheprothronmbinactivatoris
theactivationoffactorX.
•FormationofVIIIaisthekeytotheprocessofactivationof
factorX.
•Intheintrinsicsystemofbloodcoagulation,activationofone
clottingfactoractsasanenzymefortheactivationofthenext
factorthatleadstosequentialactivationofsubsequentfactorsin
aseriesofsteps.
•Beforetheintrinsicprocessofblood,coagulationiscalledan
enzymecascadehypothesis.

33. Extrinsic pathway
•The extrinsic pathway of blood coagulation occurs in 3 steps by
the release of thromboplastin and activation of factor VII and
activation of factor X.
•Thromboplastin is a tissue factor that is viewed as extrinsic to
circulating blood.
•The intrinsic and extrinsic coagulation, it is believed that these
two systems do not operate independently, and all the clotting
factors are interrelated for homeostasis.

34. Blood Groups
•Individuals have different types ofantigenon the surfaces of
their red blood cells.
•These antigens, which are inherited, determine the individual's
blood group.

35. ABO Blood Group System

36. Rh Blood Group System
•Discovered by Karl Landsteiner and Wiener in 1940s.
•“Rh” derived from Rhesus Monkey.
•Rh antigens are proteins and only found in RBCs
•Prsence of D antigen -Rh + ve
•Absence of D antigen -Rh-ve

37. Transfusion
•Atransfusionistransferofwholebloodorbloodcomponents
intobloodstreamofapersiontoalleviateanemiatoincrease
bloodvolume(eg.afteraseverehemorrhage)ortoimprove
immunity.
•Inanincompatiblebloodtransfussionantibodiesinthe
recipientsplasmabindtoantigenonthedonatedRBCswhich
causesagglutinationorclumpingofRBCs.
•Thecomplementmoleculeofdefencesystemcausehemolysis(
rupture)ofagglutinatedRBCsandthenreleasehemoglobin
maycausekidneydamage.

38. Blood Disorder
1.Anemia-Anemiaisaconditioninwhichyoulackenough
healthyredbloodcellstocarryadequateoxygentoyourbody's
tissues.
Classification of Anemia
a.Morphological Classification
i.Normocytic normochromic
ii.Macrocytic normochromic
iii.Macrocytic hypochromic
iv.Microcytic Macrocytic

39. b.Etiological Classification
i.Hemorrhagic Anemia-Loss of Blood (Hemorrhagic Anemia): If
there is massive bleeding from a wound or other lesion, the body
may lose enough blood to cause severe and acute anemia, which is
often accompanied by shock. Immediate transfusions are generally
required to replace the lost blood.
ii.Hemolytic Anemia-Hemolytic anemia is a disorder in which red
blood cells are destroyed faster than they can be made. The
destruction of red blood cells is called hemolysis. Red blood cells
carry oxygen to all parts of your body. If you have a lower than
normal amount of red blood cells, you have anemia.

40. iii.NutritionDificiencyAnemia-Nutritional-deficiencyanemiaisacommon
problem.Itcanoccurwhenthebodyisnotabsorbingenoughiron,folate,or
vitaminB-12fromthediet.Theissuemaybethatthedietisinsufficientorthat
anunderlyingmedicalconditionortreatmentisinterferingwiththebody's
abilitytoabsorbthesenutrients.
iv.AplasticAnemia-Aplasticanemiaisaconditionthatoccurswhenyourbody
stopsproducingenoughnewbloodcells.Theconditionleavesyoufatigued
andmorepronetoinfectionsanduncontrolledbleeding
v.AnemiaofChronicDisease-Theanemiaofchronicdiseaseisamultifactorial
anemia.Diagnosisgenerallyrequiresthepresenceofachronicinflammatory
condition,suchasinfection,autoimmunedisease,kidneydisease,orcancer.It
ischaracterizedbyamicrocyticornormocyticanemiaandlowreticulocyte
count.
Phagocytosis

41. 2.VariationinWBCCount
a.Leukocytosis-Leukocytosisisaconditioninwhichthewhite
cell(leukocytecount)isabovethenormalrangeintheblood.It
isfrequentlyasignofaninflammatoryresponse,most
commonlytheresultofinfection,butmayalsooccurfollowing
certainparasiticinfectionsorbonetumorsaswellasleukemia.
b.Neutrophilia-Neutrophiliaisanincreaseincirculating
neutrophilsabovethatexpectedinahealthyindividualofthe
sameage,sex,raceandphysiologicalstatus.Thisrepresentsan
increaseintheneutrophilcountabove7.5x109/landisoneof
themostfrequentlyobservedchangesintheFBC.Causesof
Neutrophilia.

42. c.Eosinophillia-Eosinophilia(e-o-sin-o-FILL-e-uh)isahigher
thannormallevelofeosinophils.Eosinophilsareatypeof
disease-fightingwhitebloodcell.Thisconditionmostoften
indicatesaparasiticinfection,anallergicreactionorcancer.
d.Basophillia-Basophiliaistheconditionofhavinggreaterthan
200basophils/μLinthevenousblood.Basophilsaretheleast
numerousofthemyelogenouscells,anditisrarefortheir
numberstobeabnormallyhighwithoutchangestootherblood
components.

43. e.Monocytosis-Monocytosisisanincreaseinthenumberof
monocytescirculatingintheblood.Monocytesarewhite
bloodcellsthatgiverisetomacrophagesanddendriticcellsin
theimmunesystem.Inhumans,monocytosisoccurswhen
thereisasustainedriseinmonocytecountsgreaterthan
800/mm3to1000/mm3.
f.Lymphocytosis-Lymphocytosisisahigher-than-normal
amountoflymphocytes,asubtypeofwhitebloodcells,inthe
body.Lymphocytesarepartofyourimmunesystemandwork
tofightoffinfections.

44. g.Leukemia-Leukemia,alsospelledleukaemia,isagroupof
bloodcancersthatusuallybegininthebonemarrowandresult
inhighnumbersofabnormalbloodcells.Thesebloodcellsare
notfullydevelopedandarecalledblastsorleukemiacells.
h.Leukopenia-Leukopeniaisaconditionwhereapersonhasa
reducednumberofwhitebloodcells.Thisincreasestheirriskof
infections.Aperson'sbloodismadeupofmanydifferenttypes
ofbloodcells.Whitebloodcells,alsoknownasleukocytes,
helptofightoffinfection.Leukocytesareavitalpartofthe
immunesystem.

45. 3.VariationinPlateletCount
a.Thrombocytopenia-Thrombocytopeniaisacondition
characterizedbyabnormallylowlevelsofplatelets,alsoknownas
thrombocytes,intheblood.Anormalhumanplateletcountranges
from150,000to450,000plateletspermicroliterofblood.
b.Thrombocytosis-Thrombocytosis(throm-boe-sie-TOE-sis)isa
disorderinwhichyourbodyproducestoomanyplatelets.It's
calledreactivethrombocytosisorsecondarythrombocytosiswhen
thecauseisanunderlyingcondition,suchasaninfection.
c.Thrombocythemia-(Persistantorabnormalincreaseinplatelet
count)asincarcinoma,chroniclukemia,Hodgkin’sDisease.

46. Thank You