Blood is connective tissue in which the cells are separated by a liquid called Plasma

Normal Blood Volume: 4 to 6 litersFunctions of Blood

1. Helps maintain homeostasis

2. Helps regulate body temperature3. Contains buffers for acid/base balance

4. Transportation of vital substances

5. Protection from infection

6. Blood clotting

Formed Elements of Blood

1. Red Blood Cells (RBC's)

-- Erythrocytes

-- make up about 45% of ourblood volume

-- live for 120 days or 4 months

-- old RBC removed from the blood by the liver& spleen

-- normal count: 4.2 to 6.2 million/mm3

-- Leukocytes-- normal count: 5,000 to

10,000/mm3

-- Thrombocytes-- normal count:

150,000 to 300,000 /mm3

3. Platelets

-- essential for blood clotting

-- live only 10 days-- have no nucleus

-- considered a cell fragment

2. White Blood Cells (WBC's)

Cells that are found in the Red Bone Marrow are:STEM CELLS

(RBC, WBC, & Platelets)RBC's have a thin center & thicker edges

-- their large number & unique shape increasestheir total surface area equal to a football field

-- RBC's transport oxygen, carbondioxide, & hydrogen ions

A red pigment located on RBC's that carries Oxygen is called: Hemoglobin

-- when combined with O2 it's called:Oxyhemoglobin-- Oxyhemoglobin is bright red

-- hemoglobin without oxygen is dark purple

-- which give rise to allall your bloodcells

CBC -- Complete Blood count

1. Hematocrit 4. WBC’s

2. Hemoglobin 5. Differential white cell count. --counts each type of WBC

3. RBC’s 6. Stained Red Cell exam. --looks at the shape of the RBC’s

HEMOGLOBIN

----Measures amount of hemoglobin in whole blood.

----12 to 18g/100 ml. of whole blood.

HEMATOCRIT

----Measures % of volume of RBC’s in whole blood.

----Normal value is around 45%RBC's

WBC's

Plasma

----Looks at the number of each type of WBC and it’s shape.

DIFFERENTIAL

----Gives specific information about a patient’s immune system.

WBC – White Blood Cell count----an increase may indicate an infection or inflammatory response.

---increased WBC count: Leukocytosis

----a decrease could indicate bone marrow depression or a viral infection. ---decreased WBC count: Leukopenia

STEM STEM CELLCELL

PLATELETSPLATELETS

RED BLOOD CELLS

The nuclei in mature Neutrophils are divided into segments, so arecalled SEGSSEGS.Immature

Neutrophilshave unsegmentednuclei that look like bands, so arecalled BANDSBANDS

Eosinophils are weak phagocytes,but good at detoxifying allergens. Also, defend againstparasites.

Basophils secrete Histamine,Heparin, and Serotonin. They are involved in systemic hypersensitivity reactions.

Lymphocytes include T-cells,which turn immunity on or off,and B-cells, which produceantibodies.

Monocytes are phagocysticand produce substances thatmark invading organism fordestruction by lymphocytes.Slower than Neutrophil, but last longer.

Fast-acting Neutrophilsare the first line ofdefense against bacteria.Survive only 4 to 10 hours.

H2O

Water Salts Dissolved gases Hormones Glucose Wastes

Albumin

Fibrinogen

Prothrombin

Globulins

Plasma Proteins

Granulocytes

Neutrophils

Eosinophils

Basophils

Agranulocytes

Monocytes

Lymphocytes

Red Blood Cells

White Blood cells

Platelets

Formed Elements

Blood

Plasma

Complementsenzymes that help

antibodies fight infections

Steps in Blood ClottingSteps in Blood Clotting

•Injury to blood vessel

•Platelets break up & release Platelet factors

•Platelet Factors combine with Prothrombin (aninactive enzyme) and Calcium to form Thrombin (an active enzyme)

-- Vitamin K is needed to stimulate the liverto produce more Prothrombin

•Thrombin reacts with Fibrinogen to form afibrous gel called Fibrin (a clot)

FibrinogenFibrin

FibrinPlatelet plug

Trauma

Factor XII Activated factor XII

Factor XI Activated factor XI

Platelet

Ca+

Factor IX Activated factor IX

Ca+

Factor X

Factor VIII

Activated factor X

Prothrombin activator

Prothrombin Thrombin

Ca+

For normal clotting, we need:

Platelets & Platelet Factors

Vitamin KCalcium

Blood Proteins Prothrombin & Fibrinogen

A clot that remains stationary in the blood vessel is called:a

ThrombusA dislodged blood clot that moves in the blood is called an: Embolus

Partially blocked coronary arteries will cause:Ischemic Heart DiseaseThis can cause pain during exercise and stress

called: Angina Pectoris

If the coronary artery is totally blocked, the heart tissue will die.

Myocardial Infarctionor a M.I.

Serum

-- Blood Plasma minus its clotting factors

which are: Prothrombin Fibrinogen

-- still contain Antibodies, so can be used to treatpatient who have a need for a specific antibody

This is called a:

ANTIGEN -- A Substance that can stimulatethe body to make

AntibodiesANTIBODY-- is a Substance that reacts

withthe Antigen that stimulated its

Formation

TYPE A

TYPE A ANTIGEN(located on the RBC)

ANTI-B ANTIBODIES(located in the Plasma)

TYPE B

TYPE B ANTIGEN

ANTI-A ANTIBODIES

-- causes the Antigen to agglutinate (clump)

TYPE O TYPE AB

TYPE A ANTIGEN

TYPE B ANTIGEN&NO ANTIGEN

(located on the RBC)

ANTI-A ANTIBODIES

ANTI-B ANTIBODIES&

(located in the Plasma)

NO ANTIBODIES

Universal Donor

Universal Recipient

O

BAB

A

O

AB

A B

TYPE Rh - Positive TYPE Rh - Negative

(located on the RBC)TYPE Rh ANTIGEN NO ANTIGEN

NO ANTIBODIES(located in the Plasma)

Negative can give to Negative and to Positive

Positive can only give to Positive

ANTI-Rh ANTIBODIESwill be produced with

exposure

-- causes a problem when Mom is Rh-negative. and has a baby that is Rh-positive

-- at delivery a little of baby's blood mixes withMom's blood when placenta separates

-- this stimulates Mom's blood to make antibodies

-- eventually she has enough antibodies to cross theplacental barrier and attack baby's blood

-- a condition called Erythroblastosis Fetalis-- give Rho Gam to prevent production of

antibodies

-- not a problem with first pregnancy, but with eachsubsequent pregnancy, Mom makes moreantibodies

Plasma never naturally contains Anti-RhAntibodies

Membranes of the heart

Covering of the heart is called:Pericardium

Membrane that covers surface of heart: Epicardiumor

Visceral Pericardium

Membrane that lines the heart chambers: Endocardiu

m

Middle layer is major portion of the heart, is largely cardiac muscle, & is called: Myocardium

HEARTHEARTLeftAtrium

Pulmonaryarteries

Pulmonaryvalve

Aorticvalve

Left Ventricle

SeptumRightVentricle

Papillarymuscle

Cordaetendineae

Right Atrium

vena cavaInferior

Superiorvena cava

Pulmonaryveins

Right

Bicuspid orMitral Valve

Tricuspid valve

Apex

Aorta

SYSTEMIC SYSTEMIC CIRCULATIONCIRCULATION

BODY

LUNGS

RIGHT & LEFT PULMONARY VEINS

LEFT ATRIUM

BICUSPID OR MITRAL VALVE

LEFT VENTRICLEAORTIC VALVE

AORTA

PULMONARY PULMONARY CIRCULATIONCIRCULATION

LUNGS

Blood enters the RIGHT ATRIUM from the SUPERIOR & INFERIOR VENA CAVAS

RIGHT ATRIUM

TRICUSPID VALVE

RIGHT VENTRICLE

PULMONARY VALVE

PULMONARY TRUNK

Rt.. & Lt. PULMONARY ARTERIES

Heart SoundsHeart SoundsWhen you listen to the heart, the sounds you hear are the valves closing

The first sound (Lup) is the:

Pulmonary Valve Aortic

Valve

TricuspidValve

MitralValve

closing

The second sound (Dup) is the:

closing

Rt. Atrium

Rt. Ventricle

Lt. atrium

Lt. Ventricle

Atriums contractVentricles contract

SA node

AV nodeAV Bundle orBundle of HIS

Purkinje Fibers

Lt. Bundle Branch

Rt. Bundle Branch

Cardiac Cardiac ConductionConduction

-- a graph of the electricalactivity of the heart

-- the P-wave signifies theatriums contracting

P-wave

-- the QRS-wave signifies the ventricles contracting

QRS-- the T-wave signifies the

relaxing of the ventriclesT-wave

EKG

Terms-- Number of beats of the heart per min.

(Average is 70 beats per minute)

Bradycardia

-- heart rate less than 60 beats/min.

Tachycardia

Heart Beat(HR)

-- the volume of blood ejectedfrom the ventricles during each beat(Average = 70 cc/beat.)

Stroke Volume(SV)

Cardiac Output (CO)-- volume of blood pumped byone ventricle per minute

Cardiac output=(HR x SV)70 x 70=4900 cc ~ 5L/min.

Cardiac Cycle-- the complete heart beat

(Average = 5 Liters)

SystoleDiastole

-- heart rate greater than 100beats/min.

Coronary CirculationCoronary Circulation

by way of the right & leftcoronary arteries

-- blood flows into the heart

right coronary artery

left coronary artery

-- coronary arteries are theAorta's first branches

-- this way the blood with

the highest % of O2 is delivered to the heart muscle

-- the coronary arteries fillwhen the ventricles are relaxed

Coronary Artery Bypass Surgery--veins are removed from other areas of the body

& used to bypass the blockage in the coronary artery

Capillary

ArterioleArtery

Types of Blood Vessels

-- take blood away from theheart-- contain large amount of

elastic fibers to accommodate increase in blood volume with each heart beat-- blood flow is fastest in the

arteries

-- are small arteries that carry blood to the capillaries-- under control of the ANS (Sympathetic)-- whether dilated or constricted, affects blood pressure

Capillary

Vein

VenuleO2

CO2

-- exchange of nutrients and waste moleculestakes place here

-- O2 & glucose diffuse out& CO2 diffuses in

-- blood flow is the slowest here because:

-- takes blood to the heart-- wall are thinner & less

elastic than arteries

-- contains valves to prevent back flow

-- small vessels that drain blood from thecapillaries & then join together to form a vein

BrachiocephalicLt. subclavian

Lt. common carotid

Branches of the AortaBranches of the Aorta

Rt. carotid

Rt. subclavian

-- forms the right carotid & rt. subclavian-- supplies the rt. side of the head & rt. arm

-- supplies left arm

-- supplies lt. side ofhead

Other Systemic ArteriesOther Systemic Arteries

PedalPosterior

tibial

PoplitealFemoral

Common IliacArteries

Hepatic Vein

Inferior vena cava

Hepatic Portal CirculationHepatic Portal Circulation-- also called Portal Circulation

-- refers to blood flowthrough the liver-- digestive organs send theirblood to the liver by way of the Hepatic Portal Vein

-- Blood leaves the liver bythe Hepatic veins to theInferior Vena Cava

-- this detour serves 2 functions:1. remove excess glucose for storage as glycogen

2. remove & detoxify any poisonous substances

Blood PressureBlood Pressure-- the pressure or push of blood-- exists in all blood vessels

fastest? slowest?

Arteries Capillaries

Blood Pressure GradientBlood Pressure Gradient

-- it is the difference between 2 blood pressures

-- or the difference between the beginning & the end of a vessel

-- pressure drops throughout the vessel's length

BP in Aorta is 100 mm Hg

BP in Vena Cava is 0

-- blood does not circulateif not present

-- liquids can only flow from an area of higherpressure to an area of lower.

Systolic Blood Pressure-- pressure in an artery when left ventricle iscontracting

Diastolic Blood Pressure-- pressure in an artery when left ventricle is

resting

Textbook BP: 120/80

Pulse Pressure-- Difference between the Systolic & the Diastolic

blood pressure-- expressive of the health of the heart & tone of the

arteries

120- 80 = 40

-- over 50 points or under 30 is considered abnormal(hypertension or ICP) (shock)

PulsePulse -- surge of blood entering the artery

Apical

Carotid

Temporal

Brachial

Radial

Femoral

Popliteal

Posteriortibial

Dorsalispedis

-- Provides informationabout the heart beat:1. Rate

2. Strength

3. Rhythm

-- place fingertips overartery, & press it over abone or other firmsurface

-- vessel expands & thenreturns to normal

LymphLymph-- specialized fluid formed in the tissue spaces

-- this fluid is called:Interstitial Fluid

-- this fluid is now called:

Cells

Blood Capillary

Arteriole

Tissue Fluid

-- pressure in the arterioles forces fluid intothe interstitial spaces Lymph

Capillary

-- what doesn't, enter thelymphatic capillaries

-- lymph capillaries are similar to veins because theycontain valves & the fluid is moved by musclecontraction

Venule

-- most of this fluid will bereturned to the venules

Lymph

-- lymph veins empty into:

Right Lymphatic DuctThoracic Duct &

-- which then returns thelymph fluid to the venouscirculation

Function of the LymphaticSystem

1. Produce Lymphocytes

2. Transport fluids to the blood stream

3. Absorb fat molecules

Organs of the Lymphatic SystemOrgans of the Lymphatic SystemLymph Node

-- clustered along the lymphatic vessels-- Function

1. Defense -- filter the lymph fluid

-- fluid leaves by way of an efferent vessel2. White Blood Cell Formation

Thymus Gland

-- Produces: Thymosin-- decreases in size with age-- important for the maturation & maintenance

of the immune system & especially the T-Cells

-- fluid enters the node by way of an afferentvessel

Spleen-- largest lymphoid organ in the body

-- located upper left quadrant of the abdomen

-- protected by the ribs, but can be injured

-- Functions:1. Filters the blood2. Destroys worn out RBC's & salvages the iron

in hemoglobin -- what other organ does this? Liver

3. Serves as a reservoir for blood that can be returned to the circulatory system when needed

-- it stores up to 1 pint of bloodLymph nodes clean lymph fluid & the spleen cleans the blood

TonsilsTonsils-- composed of lymphoid tissue located

in the mouth & throat

1 . "tonsils"

2. "adenoids"

3. near the base of the tongue

-- serves as the first line of defense from the exterior

-- removal of the palatine tonsils is called:

Tonsillectomy

-- removal of the pharyngeal tonsils is called:

Adenoidectomy

Palatine tonsilsPharyngeal tonsils

Lingual tonsils

IIMMMMUUNNEE SSYYSSTTEEMM

----Protects us from: 1. Bacteria 2. Foreign tissue cells 3. Cancerous cells

Lymphocytes

----Originates from the Stem Cells in our Bone Marrow

2----Goes through stages of development

A. First stage of development occurs in the bone marrow.

1. These cells enter the blood stream and end in up the lymph nodes.

2. Contains antibodies for a specific antigen.

1. B-Cells (B Lymphocytes)

B. 2nd stage – immature B-Cells become activated because of contact with specific antigen.

1.These activated cells divide into Plasma Cells & Memory Cells

2. Function of B-Cells is to produce Humoral or Antibody-mediated Immunity.

2. T-Cells (T Lymphocyte)

----First stage of development occurs in the Thymus gland.

1. Ends up in the lymph nodes.2. As with B-Cells, 2nd stage begins with contact

with a specific antigen.

3. Functions in Cell-mediated Immunity.

STEM CELLS (BONE MARROW)

Plasma CellsMemory Cells Sensitized T-Cells

MemoryT-CellsAntibodies

Lymphoid Tissue

B-CELLS T-CELLS

Lymphocytes

Killer T-Cells

Helper

(Stimulates other immune cells including B & Killer T-Cells)

T-CellsSuppressor

T-Cells

(Stops the immuneresponse)