RED BLOOD CELLS (ERYTHROCYTES)
FEATURES
● Biconcave Disc - Spectrin, a
contractile protein responsible for
it’s shape.
● Size: 6.7 to 7.7 µm (7.5 µm)
Thickness - Periphery 2 µm
Center 1 µm
● No Nuleus
● Hb (Granules) in cytoplasm (Stroma).
● Importance of biconcave shape
i. Increase surface area
ii. Can easily pass through
capillary (6 µm).
iii. Can tolerate hypotonicity.
● Poikilocytosis – Change in shape.
● Anisocytosis - Excessive variation in
size.
CONSTITUENTS OF RBC
• Haemoglobin – 34% (By weight)
• Stroma – 5%
• Water – 61%
• Cell membrane: It is semipermeable membrane.
i. Bimolecular layer of phospholipids.
ii. Proteins present on inner & outer side.
iii. Other protein passing through and through.
• Energy source – Glycolysis
Embden Mayerhof pathway – 90 %
Pentose Phosphate pathway – 10 %
Enzyme for glycolysis – Carbonic Anhydrase
• Function
Transport of oxygen and carbondioxide.
• Destruction of RBC
– Life span about 120 days.
– Macrophages (Reticuloendothelial Cells) take the senile RBC and
destroy it.
– Destroyed mainly in Spleen. Liver, bone and lymph nodes also
contains these macrophages.
• Normal RBC count
Adult male - 5.5 million/cu mm (5 - 6 million)
Adult female - 4.5 million/cu mm (4.5 - 5.5 million)
Count - Anaemia
Count - Polycythemia.
• VARIATION IN RBC COUNT
I. PHYSIOLOGICAL
Diurnal variation - Slightly less during sleeping
hours.
Age - More in new born.
High altitude - Increase (Hypoxia)
After exercise - More (Haemoconcentration)
II. PATHOLOGICAL
Anaemia – Nutritional, aplastic, pernicious.
Hypoxia – Heart and lung diseases
Polycythemia – More than 6 million/cu mm.
• OSMOTIC FRAGILITY
Normal saline – No change in morphology
Hypotonic saline – Size , Cells burst.
Hypertonic saline – Size, Cells shrink.
Haemolysis begins at 0.5 % completes at 0.3 %
Osmotic Fragility increases in –
i. Spherocytosis (Hereditary spherocytosis)
ii. G6PD deficiency
PACKED CELL VOLUME
WINTROBE’S TUBE
• BLOOD + DOUBLE OXALATE / EDTA
(Ammo. Oxalate + Pot. Oxalate )
• 2500 rmp in Centrifuge machine
• Plasma + Settled cells PCV
• Normal Value - 45 %
Male - 47 %
Female - 42 %
FACTORS AFFECTING PCV
I. Increased
i. Less fluid intake
ii. Dehydration
iii. Burns
iv. Polycythemia
II. Decreased
i. Less in female
ii. Pregnancy
iii. Anaemia
ERYTHROCYTE SEDIMENTATION RATE
(ESR)
Definitions:
Rate of settling of cells of anticoagulant mixed blood in a
vertical tube. ( After one hour at 22 - 27 ˚C)
I. WESTERGREN’S METHOD
Normal value – Male – 0 – 4 mm, Female – 0 – 8 mm
II. WINTROBE’S METHOD
Normal value – Male – 0 – 4 mm, Female – 0 – 6 mm
More than 20 mm is abnormal.
FACTORS AFFECTING ESR
1. Rouleaux formation - ESR - Fibrinogen, Gamaglobulin
2. Pregnancy - ESR - Haemodilution, Plsma Fibrinogen
3. Sex variation - More in woman ( Because of less RBC count)
4. Pathological causes -
i. Anaemia
ii. Acute and chronic infection
iii. Post operative
Importance:
i) Diagnostic (Non specific)
ii) Prognostic
