THE HEMATOLOGIC SYSTEM

Hematologic System is consisting of the blood and bone marrow.

Blood- delivers oxygen and nutrients to all tissues

-removes wastes,

-transports gases, blood cells, immune cells, and hormones throughout

the body.

-manufactures new blood cells through process called hematopoiesis.

-Multipotential stem cells in bone marrow give rise to 5 distinct cell types called
unpotential stem cells which differentiate one of the following 4 types of blood cells:

 Erythrocyte
 Granulocyte
 Agranulocyte
 Platelet

Blood Components

-blood consists of various formed elements, or blood cells, suspended in a fluid called plasma.

Elements in the blood:

-red blood cells (RBC’s), or erythrocytes

-white blood cells (WBC’s), or leukocytes

-platelets, or thrombocytes

*RBCs and platelets function entirely within blood vessels

*WBCs act mainly in the blood tissues outside the blood vessels.

RBC (Red Blood Cells)

 Transport oxygen and carbon dioxide to and from body tissues.

 Contain hemoglobin-the oxygen-carrying substance that gives blood its red color.
 RBC surface carries antigens which determine a person’s blood group, or blood type.

*The life and times of the RBC

 Average lifespan of 120 days

 Bone marrow releases RBs into circulation in immature form as reticulocytes.
 Reticulocytes mature into RBCs in about 1 day
 The spleen sequesters, or isolates old, wornout RBCs from circulation.
 *A balance between removal and renewal

 The rate of the reticulocyte release usually equals the rate of old RBC removal.
 When RBC depletion occurs (hemorrhage), the bone marrow increases
reticulocyte production to maintain the normal RBC count.

SENIOR MOMENT
Hematologic Changes with Aging
 Fatty bone marrow replaces some of the body’s active blood-forming marrow
(First in the long bones and later in the flat bones)
 The altered bone marrow cannot increase erythrocyte production as readily response to
such stimuli as hormones, anoxia, hemorrhage, and hemolysis.
 Vit B12 absorption may also diminish with age, resulting in reduced erythrocyte mass
and decreased hemoglobin levels in hematocrit.

White Blood Cells

 Body’s defense and immune systems

 Classified into 2:
 Granulocyte serve as the body’s first line of cellular defense
 Neutrophils
 Eosinophils polymorphonuclear leukocytes
 Basophils

-all granulocytes contain a single multilobular nucleus and granules in

the cytoplasm.

-each cell type exhibits different properties and each is activated by

different stimuli

*Swallowing up your enemies


Neutrophils-the most numerous granulocytes
-50%-75% of circulating WBCs.
-these phagocytic cells engulf, ingest, and digest foreign materials
-they leave the bloodstream by passing through the capillary walls
into the tissues (diapedesis)
-then migrate to and accumulate at infection sites.
-key word: the “n” for neutrophils could also mean numerous and
neutralize
* Making the band-
-worn-out neutrophils form the main component of pus.

-Bone marrow produces their replacements, immature neutrophils called bands.

-In response to infection, bone marrow must produce many immature cells and release
them into circulation, elevating the band out.
*Allies against Allergies

- Eosinophils account for 0.3% to 7% of circulating WBCs

-These granulocytes migrate from the bloodstream by diapedesis but in charge to

respond in an allergic reaction.

-eosinophils accumulate in loose connective tissue, where they become involved in

theingestion of antigen-antibody complexes.

*Fighting the flames

-Basophils usually constitute fewer than 2% of circulating WBCs.

-littleor no phagocytic ability

-their cytoplasmic granules secrete histamine in response to certain inflammatory and

immune stimuli.

*Histamine makes the blood vessels more permeable and eases thepassage of
fluids from the capillaries into body tissues.

 Agranulocyte
WBCs in the agranulocyte category are:
 Monocytes
Lack specific
 cytoplasmic
 granules and have nuclei
 without lobes
 Lymphocytes

*The few and the large

-Monocytes, the largest of the WBCs, constitute only 1%-9% of WBCs in

circulation

-Monocytes are phagocytic and enter the tissue by diapedesis

-outside the bloodstream, monocytes enlarge and mature, becoming tissue

macrophages (also called histocytes)

*Protection against infection

-as macrophages, monocytes may roam freely through the body when
stimulated by inflammation.

-usually they remain immobile, populating most organs and tissues.

-collectively, they serve as components of the reticuloendothelial system, which

defends the body against infection and disposes of cell breakdown products.
 *Fluid Finders

-macrophages concentrate in the structures that filter large amounts of body

fluid, such as, liver, spleen and lymph nodes, where they defend against
invading organisms

-macrophages are efficient phagocytes (cells that ingest microorganisms,

cellular debris-that includes worn-out neuotrophils, and necrotic tessue)

-when mobilized at an infection site, they phagocytise cellular remnants and

promote wound healing

*Last and Least (in size)

-Lymphocytes, the smallest of the WBCs and the second most numerous (20%-43%),
derive from stem cells to bone marrow.

-two types:

-T lymphocytes-directly attack an infected cell

-B lymphocytes-produce antibodies against specific antigens

Platelets

 Small, colorless, disk-shaped cytoplasmic fragments split from cells in bone marrow called
megakaryocytes.
 Life span approximately 10 days
 Vital functions:
-initiating contraction of damaged blood vessels to minimize blood loss
-forming hemostatic plugs in injured blood vessels
-with plasma, providing materials that accelerate blood coagulation.

BLOOD CLOTTING
Hemostasis is the complex process by which platelets, plasma, and coagulation factors interact
to control bleeding.

*STOP the bleeding!

-when a blood vessels ruptures, local vasoconstriction (decrease in calibre of
blood vessels) and platelet clumping (aggregation) at the site of the injury
initially help prevent hemorrhage.
-the damaged cells will release tissue factor (thromboplastin), which activates the
extrinsic pathway of the coagulation system.
 *Long term solution
-formation of more stable clot requires initiation of the complex clotting mechanisms
known as the intrinsic pathway.
Intrinsic pathway
-activated by protein (factor XII)

*Come together
-the final result of coagulation is a fibrin clot, an accumulation of fibrous, insoluble
protein at the site of the injury.

CoagulationFactor
The materials that platelets and plasma provide work with coagulation factors to serve
as precursor compounds in the clotting of blood.

12 Clotting Factors (chain reaction) (designated by name and roman numeral)

Factor I
Name : Fibrinogen
Source : Liver
Pathway : Both extrinsic and intrinsic
Activator : Thrombin
Actions : When fibrinogen is converted into fibrin by thrombin, it forms long strands
that compose the mesh network for clot formation.

Factor II
Name : Prothrombin
Source : Liver
Pathway : Both extrinsic and intrinsic
Activator : Prothrombin activator
Actions : Prothrombin is converted into thrombin which then activated fibrinogen into
fibrin.

Factor III
Name : Thromboplastin / Tissue factor
Source : Platelets (intrinsic) and damaged endothelium (cells) lining the blood vessel
(extrinsic).
Pathway : Both extrinsic and intrinsic
Activator : Injury to blood vessel
Action : Activates factor VII (VIIa).

Factor IV
Name : Calcium
Source : Bone and absorption from food in gastrointestinal tract
Pathway : Both extrinsic and intrinsic
Action : Works with many clotting factors for activation of the other clotting factors.
These are called calcium-dependent steps.
Factor V
Name : Proaccerin / Labile factor / Ac-globulin (Ac-G)
Source : Liver and platelets
Pathway : Both extrinsic and intrinsic
Activator : Thrombin
Action : Works with Factor X to activate prothrombin (prothrombin activator).

Factor VII
Name : Proconvertin / Serum prothrombin conversion accelerator (SPCA) / stable factor
Source : Liver
Pathway : Extrinsic
Activator : Factor III (tissue factor)
Actions : Activates Factor X which works with other factors to convert prothrombin into
thrombin.

Factor VIII
Name : Anti-hemoplytic factor / Antihemophilic factor (AHF) or globulin (AHG) /
antihemophilic factor A
Source : Endothelium lining blood vessel and platelets (plug)
Pathway : Intrinsic
Activator : Thrombin
Actions : Works with Factor IX and calcium to activate Factor X.
Deficiency : Hemophilia A

Factor IX
Name : Christmas factor / Plasma thromboplastin component (PTC) / Antihemophilic
factor B
Source : Liver
Pathway : Intrinsic
Activator : Factor XI and calcium
Actions : Works with Factor VIII and calcium to activate Factor X.
Deficiency : Hemophilia B

Factor X
Name : Stuart Prower factor / Stuart factor
Source : Liver
Pathway : Extrinsic and intrinsic
Activator : Factor VII (extrinsic) / Factor IX + Factor VIII + calcium (intrinsic)
Actions : Works with platelet phospholipids to convert prothrombin into thrombin. This
reaction is made faster by activated Factor V.

Factor XI
Name : Plasma thromboplastin antecedent (PTA) / antihemophilic factor C
Source : Liver
Pathway : Intrinsic
Activator : Factor XII + prekallikrein and kininogen
Actions : Works with calcium to activate Factor IX.
Deficiency : Hemophilia C
Factor XII
Name : Hageman factor
Source : Liver
Pathway : Intrinsic
Activator : Contact with collagen in the torn wall of blood vessels
Actions : Works with prekallikrein and kininogen to activate Factor XI. Also activates
plasmin which degrades clots.

Factor XIII
Name : Fibrin stabilizing factor
Source : Liver
Activator : Thrombin and calcium
Actions : Stabilizes the fibrin mesh network of a blood clot by helping fibrin strands to
link to each other. Therefore, it also helps to prevent fibrin breakdown (fibrinolysis).

BLOOD TYPING

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