Blood HAP

Blood presentation contains blood composition, blood clotting factors and mechanisms, blood grouping, blood transfusion & normal values of WBCs, RBCs, Thombocytes.

1. Prepared by Ms. Nisha S. Mhaske M.Pharm (Q.A.T) Lecturer, PRES’s COPD, Chincholi. Email : [email protected] Blood Loknete Dr.Balasaheb Vikhe Patil ( Padmabhushan Awardee ) Pravara Rural Education Society’s College of Pharmacy (D.Pharm) Nashik.

2. CONTENTS Introduction to blood Functions of blood Haemopoiesis Blood composition Blood groups ABO blood groups Blood transfusion Rh factor Blood clotting Factors & Mechanism Normal counts Diseases related to Blood

3. BLOOD Blood is specialized connective tissue which circulates in closed system blood vessels. Blood temperature-38°C Blood pH-7.4 (Slightly alkaline) Blood makes up 6–8% of our total body weight i.e.5600 ml in adult man. Normal adult blood volume is 5 L.

4. Functions of Blood 1.Blood is responsible for….. Transporting gases (oxygen & carbon dioxide) Transporting waste products Transporting nutrients, hormones, vitamins Helping remove toxins from the body Transports metabolites Regulation of pH Regulate water balance Maintain acid-base balance Maintenance of body temperature Protection against infection (foreign substances) Clot formation

5. Hemopoiesis/ Hematopoiesis Hemopoiesis is the process of development of the blood cells (WBCs, RBCs, Platelets) in bone marrow.

6. Composition of Blood

7. Blood Plasma- the normal plasma volume is about 8 % of body weight. is made up of 3 Basic components 1. Water 2. Dissolved organic & inorganic components 3. Plasma proteins Electrolytes Gases Nutrients Waste products Sodium Ions, Potassium Ions, Calcium Ions, Magnesium Ions, Chloride Ions, Bicarbonate Ions, Phosphate Ions. Carbon Dioxide, Oxygen, Nitrogen. Glucose, Carbohydrate, Amino Acids, Lipids, Cholesterol, Vitamins, Trace Elements. Urea, Uric Acid, Creatinine , Bilirubin . Albumins (54%) Globulins (38%) Fibrinogen (7%) Immunoglobulins (1%) Buffer action Blood clotting Protective (Antibodies)

8. Red blood cells (Erythrocytes) Structure Biconcave disc like Components Hemoglobin, lipids, ATP, Carbonic Anhydrase Function Transport oxygen from lungs to tissues and carbon dioxide from tissues to lungs Life span About 120 days Hemoglobin (iron protein)is found in the RBC Production Formed in the bone marrow

9. Hemoglobin ( Haeme -Non protein part & Globin - Protein part) 4 globin molecules : Transport carbon dioxide (carbonic anhydrase involved), nitric oxide Nitric oxide (NO) binds to hemoglobin Releases NO causing vasodilation to improve blood flow and oxygen delivery 4 heme molecules : Transport oxygen ---Iron is required for oxygen transport. Each RBCs contain---280 million Hb molecules. Molecular weight of Hb is about 68,000 The iron content of haem imparts Red color to Hb (RBCs)

10. White blood cells (Leukocytes) Structure Largest sized blood cells Components Contain nuclei with DNA, Function -Protect body against microorganisms and remove dead cells and debris -Primary cells of the immune system -Fights disease and foreign invaders Production Formed in the bone marrow and some in lymph glands Life span is from 24 hours to several years Size is 8-20 micrometers in diameter

11. Granulocytes Constitute 64.7% of total WBCs Life span – Few hours to 4 Days Agranulocytes Constitute about 30-45% of total WBCs Life span – Few months. Basophils Eosinophils Neutrophils Lymphocytes Monocytes Constitute less than 1% of the total WBCs Constitute about 0-7% of the total WBCs Constitute about 50-70% of the total WBCs Constitute about 20-30% of the total WBCs Constitute about 1.7-9% of the total WBCs Cytoplasmic granules stain with Basic dyes Cytoplasmic granules stain with Acidic dyes Play imp. role during Injury & allergic reaction. Engulf & digest Antigen-Antibody complexes formed. Engulf bacteria by the process of phagocytosis . Provide immunity from infection Remove dead cells & Toxic sub.s by phaagocytosis . They increase in No. during infection & allergic reaction. Increase in No. during infection & wounds by Bacteria.

12. Platelets (Thrombocytes) Production Formed in the bone marrow Structure Smallest of the blood cells Size 1-4 micrometers in diameter Shape round, oval, or appear spiky Life span around 8-12 days Functions Involved in the clotting process Seal wounds and prevent blood loss Helps repair damaged vessels Platelets stain bluish with reddish or purple granules

13. Blood groups Antigens on surface of RBCs- Agglutinogens Agglutinogens are genetically determined & are of 2 Types:- Type “A” & Type “B”. People have natural Antibodies –Agglutinins is of 2 types i.e. type “a” & type “b” Blood group – based on presence or absence of various antigens At least 24 blood groups and more than 100 antigens ABO and Rh Blood groups Agglutinogen in RBCs Agglutinin in plasma A A b B B a AB A & B No Agglutinin O No Agglutinogen a & b

14. ABO Blood group

15. Blood transfusion A Blood transfusion is taking out blood from one person and injecting it into vein of another person. Who can give you blood? People with TYPE O blood are called Universal Donors, because they can give blood to any blood type. People with TYPE AB blood are called Universal Recipients, because they can receive any blood type. Rh +  Can receive + or - Rh -  Can only receive A B O AB Universal Donor Universal Recipient

16. Rh factor Scientists sometimes study Rhesus monkeys to learn more about the human anatomy because there are certain similarities between the two species. While studying Rhesus monkeys, a certain blood protein was discovered. This protein is also present in the blood of some people. Other people, however, do not have the protein. The presence of the protein, or lack of it, is referred to as the Rh (for Rhesus ) factor. Types Rh positive : Have these antigens present on surface of RBCs Rh negative : Do not have these antigens present A+ A- B+ B- AB+ AB- O+ O-

17. Blood clotting Blood clot :- “ The fluid or solution form of the blood is changed into semisolid gel form known as blood clot. ” Factor Synonym 1 Fibrinogen 11 Prothrombin 111 Tissue factor / tissue thromboplastin IV Calcium ions V Labile ions VI Does not exist VII Stable factor VIII Antihaemophilic factor ‘A’ IX Antihaemophilic factor ‘B’ X Stuart factor XI Antihaemophilic factor ‘C’ XII Antihaemophilic factor ‘D’ OR Hageman factor XIII Fibrin stabilising factor Clotting factor

18. Clotting mechanism of blood Step- I Formation of Thrombin Prothrombin + Calcium+Thromboplastin Thrombin (Active) (inactive) Step- II Formation of Fibrin Thrombin + Fibrinogen fibrin (fine threads) Step- III Formation of Clot Fibrin + Blood cells Clot

19. Normal counts Erythrocytes (RBCs) Male about 5.4 million RBCs/ cu.mm of blood Female about 4.8 million RBCs/ cu.mm of blood Leukocytes (WBCs) 6000 – 10000 per cu.mm of blood Thrombocytes (Platelets) 3 – 4 lakhs per cu.mm of blood Haemoglobin Infants 14 – 20 gm/100 ml of blood Adult female 12-16 gm/100 ml of blood Adult male 13.5 – 18 gm/100 ml of blood Low haemoglobin in female is due to menstruation cycle, pregnancy & lactation. In male, testosterone secretion stimulates formation of RBC, hence Hb is higher than female.

20. Diseases related to Blood Erythrocytes (RBCs) Leukocytes Thrombocytes (Platelets) Clotting Anemia 1.Blood loss anemia 2.Aplastic anemia 3.Megaloblastic anemia 4.Haemolytic anemia 5.Iron deficiency anemia 6.Sickle cell anemia 7.Pernicious anemia Leukemia or Leucocytosis ---WBCs count is More than normal Hemophilia ---a genetic disorder where longer clotting time due to absence of clotting factor Polycythemia Leucoctyopenia ---WBCs count is Less than normal Thrmbocytopenia ---less platelet count than normal Haemolysis

21. Anaemia- Deficiency of hemoglobin leads to decreased oxygen carrying capacity of blood called anaemia. Causes of anaemia- Diet & haemorrhage etc. Aplastic anemia Aplastic anemia is a condition that occurs when your body stops producing enough new blood cells.  Aplastic anemia leaves you feeling fatigued and with a higher risk of infections and uncontrolled bleeding. A rare and serious condition, aplastic anemia can develop at any age. Megaloblastic anemia Megaloblastic anemia is a condition in which the bone marrow produces unusually large, structurally abnormal, immature red blood cells (megaloblasts). 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.

22. Iron deficiency anemia A condition in which blood lacks adequate healthy red blood cells.  Iron deficiency anemia is due to insufficient iron. Sickle cell anemia A group of disorders that cause red blood cells to become misshapen and break down.

23. Pernicious anemia A decrease in red blood cells when the body can't absorb enough vitamin B12. Common causes include a weakened stomach lining or an auto-immune condition. Symptoms include fatigue and weakness. Untreated pernicious anaemia can cause heart and nerve damage. Treatment involves vitamin B-12 shots or pills.

24. Polycythemia- Polycythemia (also known as polycythaemia or polyglobulia) is a disease state in which the hematocrit (the volume percentage of red blood cells in the blood) is elevated. Haemolysis- the rupture or destruction of red blood cells.

25. Bleeding time:- it is time interval between skin puncture and cessation of flow of blood. Normal bleeding time is 1 to 3 min. Clotting time:- it is time interval between onset of bleeding and appearance of jelly like semisolid mass i.e.blood clot Normal clotting time is 4 to 9 min.

26. References Human Anatomy & Physiology, by Rahul Phate , Career publications, First edition-Jan 2004, Page no:49-66. Human Anatomy & Physiology, by S.B.Bhise & A.V.Yadav , Nirali Prakashan , 25 th edition-July 2013, Page no:5.1-5.8