BIO2203 BIO2203 HAEMATOLOGY HAEMATOLOGY 1. 1. Nicki Laws Nicki Laws [email protected] [email protected]
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ObjectivesObjectives
describe the composition & general describe the composition & general characteristics of blood (Chapt 18.1)characteristics of blood (Chapt 18.1)
describe erythrocytes & their life cycle (p669)describe erythrocytes & their life cycle (p669)
Understand blood gas transport (Respiratory Understand blood gas transport (Respiratory lectures and p670)lectures and p670)
explain the anaemias & polycythemiaexplain the anaemias & polycythemia
discuss the blood groups (p674)discuss the blood groups (p674)
Blood CharacteristicsBlood Characteristics
8% body weight (5.5L men)8% body weight (5.5L men)
Connective tissueConnective tissue
pH 7.4 (7.35-7.45)pH 7.4 (7.35-7.45)
Plasma: 90% water, solutesPlasma: 90% water, solutesFormed elements: erythrocytes, Formed elements: erythrocytes, leukocytes, plateletsleukocytes, platelets
PlasmaPlasma
Water (90%)Water (90%)
Proteins: albumin, globulins, Proteins: albumin, globulins, fibrinogenfibrinogen
Waste products: urea and lactic acidWaste products: urea and lactic acid
Nutrients : glucose, lipids, aasNutrients : glucose, lipids, aas
ElectrolytesElectrolytes
Respiratory gasesRespiratory gases
Germann & Stanfield 16.1
HaematopoiesisHaematopoiesis
Bone marrowBone marrow
Derived from type of stem cellDerived from type of stem cell– Pleuripotential haematopoietic stem cellPleuripotential haematopoietic stem cell
Controlled by cytokines / hormonesControlled by cytokines / hormones– Colony stimulating factors for Colony stimulating factors for
leukopoiesisleukopoiesis– Thrombopoietin for thrombopoiesis Thrombopoietin for thrombopoiesis
(platelets)(platelets)– Erythropoietin for erythropoiesisErythropoietin for erythropoiesis
ErythrocytesErythrocytes
7-8 7-8 m m diameterdiameter5 000 000/5 000 000/llBiconcave Biconcave discs, discs, flattened in flattened in centrecentreDeformableDeformableNo nucleus or No nucleus or organellesorganelles
Fig 18.2
Marieb, Fig 17.2
Haemoglobin (Hb)Haemoglobin (Hb)
Globin, haeme Globin, haeme contains ironcontains iron
1 O1 O22 binds to 1 binds to 1 haemehaeme
Approx 280 000 Approx 280 000 000 molecules Hb 000 molecules Hb / erythrocyte/ erythrocyte
Germann & Stanfield Fig 16.3
Hb combinationsHb combinationsOO22 on haeme on haeme
– Oxyhaemoglobin (Hb.[OOxyhaemoglobin (Hb.[O22]]44))
Reduced HbReduced Hb– Deoxyhaemoglobin (HHb)Deoxyhaemoglobin (HHb)
COCO22 on globin on globin
– Carbaminohaemoglobin (HbCOCarbaminohaemoglobin (HbCO22))
Acidic HAcidic H++ from CO from CO22
Nitric oxide (vasodilator )Nitric oxide (vasodilator )CO2 + H2O H2CO3 H+
+ HCO3_
carbonic acid
ErythropoiesisErythropoiesis
Pluripotent heamatopoietic stem cell
Committed proerythroblast
Ribosome synthesisHb synthesis
Ejection of nucleus
Reticulocyte
Erythrocyte
Normal 1-2% of RBC
Indicates rate of RBC production
EPO Control of ErythropoiesisEPO Control of Erythropoiesis
Sherwood 2001, Fig 11.4
Dietary Needs for ErythropoiesisDietary Needs for Erythropoiesis
Protein, fats, carbohydratesProtein, fats, carbohydratesIronIron– For Hb synthesisFor Hb synthesis– Transported to liver bound to transferrinTransported to liver bound to transferrin– Excess stored in liver as ferritinExcess stored in liver as ferritin
Vitamin BVitamin B1212
Folic acidFolic acid
DNA SYNTHESIS
Erythrocyte agingErythrocyte aging
Lose deformability, survive 120 daysLose deformability, survive 120 days
Old are removed by spleenOld are removed by spleen
HaemeHaeme– Iron to liver, recycled to bloodstream for use Iron to liver, recycled to bloodstream for use
in new RBCin new RBC– Bilirubin to liver, secreted into intestine in Bilirubin to liver, secreted into intestine in
bile and excreted through faecesbile and excreted through faeces
GlobinGlobin– Amino acids recycled to bloodstreamAmino acids recycled to bloodstream
Marieb Fig 17.7
AnaemiasAnaemias
Low OLow O22 carrying capacity carrying capacity
CLASSIFICATIONCLASSIFICATION
NutritionalNutritional
AplasticAplastic
RenalRenal
HaemorrhagicHaemorrhagic
Haemolytic Haemolytic
PolycythemiaPolycythemia
Excess erythrocytesExcess erythrocytes
Primary: polycythemia veraPrimary: polycythemia vera
Secondary: physiological Secondary: physiological polycythemiapolycythemia
Blood GroupsBlood GroupsErythrocytes have surface Erythrocytes have surface antigens antigens Develop antibodies to Develop antibodies to destroy foreign antigensdestroy foreign antigens– Agglutination: block small Agglutination: block small
blood vesselsblood vessels– Haemolysis of foreign Haemolysis of foreign
erythrocytes: release of erythrocytes: release of Hb & kidney failureHb & kidney failure
Blood groups
Jenkins Fig 18.7
Blood groupsBlood groups
ABO: based on type A & B antigensABO: based on type A & B antigens– AB - type A & B antigens (& neither antibody)AB - type A & B antigens (& neither antibody)– B - type B antigen (& anti-A antibodies)B - type B antigen (& anti-A antibodies)– A - type A antigen (& anti-B antibodies)A - type A antigen (& anti-B antibodies)– O - neither antigen (& both antibodies)O - neither antigen (& both antibodies)
Rhesus (Rh) factor: based on presence or absence of Rh Rhesus (Rh) factor: based on presence or absence of Rh factorfactor– Rh-positive or Rh-negativeRh-positive or Rh-negative