BLOOD
Blood is a connective tissue. It’s a means of communication between
the different cells and the external environment.
Blood makes up about 7% of body weight (about 5.6 litres in a 70
kg man). This proportion is less in women and considerably greater
in children.
Blood in the blood vessels is always in motion. The continual flow
maintains a fairly constant environment for the body cells.
Functions of blood:-
• Oxygen from the lungs to the tissues and carbon dioxide from the
tissues to the lungs for excretion.
• Nutrients from the alimentary tract to the tissues and cell wastes
to the excretory organs, principally the kidneys.
• Hormones secreted by endocrine glands to their target glands and
tissues.
• Heat produced in active tissues to other less active tissues.
• Protective substances, e.g. antibodies, to areas of Infection.
• Clotting factors that coagulate blood
Composition of blood:-
1) Plasma
Blood
2) Formed elements (Cellular content)
Plasma:-
The constituents of plasma are water (90 to 92%) and dissolved
substances.
• Plasma proteins: albumins, globulins (including antibodies),
fibrinogen, clotting factors
• Inorganic salts (mineral salts): sodium chloride, sodium
bicarbonate, potassium, magnesium, phosphate, iron, calcium,
copper, iodine, cobalt
• Nutrients-from digested foods, e.g. mainly glucose, amino acids,
fatty acids, glycerol and vitamins.
• Organic waste materials, e.g. urea, uric acid, creatinine.
• Hormones
• Enzymes, e.g. certain clotting factors.
• Gases, e.g. oxygen, carbon dioxide, nitrogen.
Cellular contents:-
There are three types of blood cells
• Erythrocytes or red blood cells (RBC)
• Leukocytes or white blood cells (WBC)
• Thrombocytes or platelets
All blood cells originate from pluripotent stem cells and go
through several developmental stages before entering the blood.
The process of blood cell formation is called Haemopoiesis and
takes place within red bone marrow.
In adults, erythropoiesis is confined to flat bones, irregular bones
and the ends (epiphyses) of long bones, the main sites being the
sternum, ribs, pelvis and skull.
1) Erythrocytes:-
Erythrocytes or RBCs are small cells, about 7.5µm in diameter.
They are non nucleated.
Erythrocytes are formed in red bone marrow. Their life span in the
circulation is about 120 days.
Erythrocyte count. This is the number of erythrocytes per litre (l)
or per cubic millimetre (mm3) of blood.
The process of development of red blood cells from pluripotent
stem cells takes about 7 days and is called erythropoiesis. It is
characterised by two main features:
• maturation of the cell
• formation of haemoglobin inside the cell
Formation of haemoglobin:-
Hb (complex protein)= globin+haem iron-containing substance,
synthesised inside developing erythrocytes in red bone marrow.
Haemoglobin in mature erythrocytes combines with oxygen to form
oxyhaemoglobin, giving arterial blood its red colour.
Each haemoglobin molecule contains four atoms of iron. Each atom
can carry one molecule of oxygen, therefore one haemoglobin
molecule can carry up to four molecules of oxygen. Haemoglobin is
said to be saturated when all its available binding sites for oxygen are
filled.
Therefore, transport of oxygen from lungs to the body cells and to a
lesser extend transport of CO 2 from body cells to lungs is done by
haemoglobin.
Haemoglobin (Hb):- Male- 13 to 18 g/100 ml
Female-11.5 to16.5 g/100 ml
2) Leukocytes:-
They are the largest cells about 15µm in diameter and life span of
about 13-21 days. They are nucleated cells and some are granular.
Leukocytes are the largest blood cells and they account for about
1% of the blood volume.
They defend the body against microbes and other foreign materials.
There are two main types:
• Granulocytes (contains granules oe sacs on their cytoplasm)
- neutrophils, eosinophils and basophils
• Agranulocytes (donot contain granules in their cytoplasm)
- monocytes and lymphocytes.
Granulocytes: They contain granules in cytoplasm and are multi-
lobed. Their names represent the dyes they take up when stained in
the laboratory. Eosinophils take up the red acid dye Eosin;
Basophils take up alkaline Methylene blue; and neutrophils are
purple because they take up both dyes.
Neutrophils- protect against microbes and remove waste
materials, e.g. cell debris by phagocytosis and the granules contain
lysosomes having enzymes which digest engulfed material.
Eosinophils- elimination of parasites, such as worms, which are
too big to be phagocytosed.
Basophils- allergic reactions, contain cytoplasmic granules
packed with heparin (an anticoagulant), histamine (an inflammatory
agent) and other substances that promote inflammation.
Agranulocytes:-
The types of leukocyte with a large nucleus and no granules in their
cytoplasm. They are of two types:
Monocytes
These are large cells that originate in red bone marrow. Some
circulate in the blood and are actively motile and phagocytic while
others migrate into the tissues where they develop into
macrophages.
Lymphocytes
They are smaller than monocytes and have large nuclei. They
circulate in the blood and are lymphatic tissue. They travel in the
blood to lymphoid tissue elsewhere in the body where they are
activated and are able to respond to antigens. They are of 2 types T-
Lymphocytes and B-Lymphocytes.
3) Thrombocytes:-
These are very small non-nucleated discs, 2-4 um in diameter, derived
from the cytoplasm of megakaryocytes in red bone marrow. The life
span of platelets is between 8-11 days.
Functions of platelet to maintain homeostasis are:
Vasoconstriction, Platelet plug formation, Coagulation (blood
clotting) etc.
Blood coagulation (clotting)- the process of making blood into clot
or when blood converts from liquid to gel for is known as blood
clotting or coagulation.
Blood groups
Individuals have different types of antigen on the surfaces of their
red blood cells. These antigens, which are inherited, determine the
individual's blood group.
Individuals make antibodies to these antigens, but not to their own
type of antigen. If a person is given blood from an individual of a
different blood type, i.e. with a different type of antigen on the red
cells, their immune system will mount an attack upon them and
destroy the transfused cells.
ABO System
About 55% of the population has either A-type antigens (blood
group A), B-type antigens (blood group B) or both (blood group
AB) on their red cell surface. The remaining 45% have neither A
nor B type antigens (blood group O).
The Rhesus system
The red blood cell membrane antigen important here is the Rhesus
(Rh) antigen, or Rhesus factor.
About 85% of people have this antigen; they are Rhesus positive
(Rh+) and do not therefore make anti-Rhesus antibodies.
The remaining 15% have no Rhesus antigen (they are Rhesus
negative, or Rh¯).
Rh¯ individuals are capable of making anti-Rhesus antibodies, but
are stimulated to do so only in certain circumstances, e.g. in
pregnancy, or as the result of an incompatible blood transfusion.
Erythrocyte disorders
In anaemia there is not enough haemoglobin available to carry
sufficient oxygen from the lungs to supply the needs of the tissues.
1) Iron deficiency anaemia
It is caused by deficiency of iron in the bone marrow and may be
due to dietary deficiency, excessively high requirement or
malabsorption.
2) Megaloblastic anaemia
Maturation of erythrocytes is impaired when deficiency of vitamin
B-12 and/or folic acid occurs and abnormally large erythrocytes
(megaloblasts) are found in the blood.
3) Hypoplastic and aplastic anaemia
Hypoplastic and aplastic anaemias are due to varying degrees
of bone marrow failure. Bone marrow function is reduced in
hypoplastic anaemia, and absent in aplastic anaemia.
4) Haemolytic anaemia
These occur when red cells are destroyed while in circulation or
are removed prematurely from the circulation because the cells
are abnormal or the spleen is overactive.
a) Sickle cell anaemia
The abnormal haemoglobin molecules become misshapen when
deoxygenated, making the erythrocytes sickle shaped.
b)Thalassaemia
There is reduced globin synthesis with resultant reduced
haemoglobin production and increased friability of the cell
membrane, leading to early haemolysis.
5) Polycythaemia
There are an abnormally large number of erythrocytes in
the blood.
Leukocyte disorders
1) Leukopenia
This is the name of the condition in which the total blood leukocyte
count is less.
Granulocytopenia (neutropenia)-an abnormal reduction in the
numbers of circulating granulocytes.
2) Leukocytosis
An increase in the number of circulating leukocytes occurs as a
normal protective reaction in a variety of pathological conditions.
Leukaemia
Leukaemia is a malignant proliferation of white blood cell
precursors by the bone marrow. As the tumour cells enter the blood
the total leukocyte count is usually raised.
LYMPHATIC SYSTEM
Introduction
The lymphatic system consists of:
• lymph
• lymph vessels
• lymph nodes
• lymph organs, e.g. spleen and thymus
• diffuse lymphoid tissue, e.g. tonsils
• bone marrow.
Lymph
•Lymph is a clear watery fluid, similar in composition to plasma,
with the important exception of plasma proteins and identical in
composition to interstitial fluid.
•Lymph transports the plasma proteins that seep out of the capillary
beds back to the bloodstream. It also carries away larger particles,
e.g. bacteria and cell debris from damaged tissues, which can then
be filtered out and destroyed by the lymph nodes.
•Lymph contains lymphocytes, which circulate in the lymphatic
system allowing them to patrol the different regions of the body.
Lymphatic organs and tissues
1) Lymph nodes-Lymph nodes are oval or bean-shaped organs that
lie, often in groups, along the length of lymph vessels. The lymph
drains through a number of nodes, usually 8 to 10, before returning
to the venous circulation. These nodes vary considerably in size:
some are as small as a pin head and the largest are about the size of
an almond.
2) Spleen
The spleen is formed by reticular and lymphatic tissue and is the
largest lymph organ. The spleen lies between the fundus of the
stomach and the diaphragm. It is purplish in colour and varies in size
in different individuals, but is usually about 12 cm long, 7 cm wide
and 2.5 cm thick. It weighs about 200 g.
3) Thymus gland
The thymus gland lies in the upper part of the mediastinum
behind the sternum and extends upwards into the root of the
neck. It weighs about 10 to 15 g at birth and grows until the
individual reaches puberty, when it begins to atrophy. Its
maximum weight, at puberty, is between 30 and 40 g and by
middle age it has returned to approximately its weight at birth.
4) Tonsils These are located in the mouth and throat and will
therefore destroy swallowed and inhaled antigens.
Functions of lymphatic system
Filters bacteria, foreign materials, toxins and harmful materials.
Drains away excess fluid to prevent clogging of the tissues and
cells.
Produces lymphocytes which protect and defend the body
against infection.
Produces antibodies to fight bacteria
Absorbs fat from intestine and transport it to liver.
It transports oxygen, food ,materials, hormones etc. to the body
cells and brings carbon dioxide and other metabolic wastes from
body cells to blood and then finally pours the same into the
venous system.
