Principles of Anatomy and Physiology

Thirteenth Edition

Chapter 19The Cardiovascular System: The Blood

Copyright © 2012 by John Wiley & Sons, Inc.

Gerard J. Tortora • Bryan H. Derrickson

Plasma (55%)

Red blood cells(45%)

Buffy coat,composed ofwhite blood cellsand platelets

(a) Appearance of centrifuged blood

White blood cells5000–10,000

Formed elements45%

Platelets150,000–400,000

Red blood cells4.8–5.4 million

Neutrophils60–70%

Lymphocytes20–25%

Monocytes3–8%

Eosinophils2–4%

Basophils0.5–1.0%

PLASMA (weight) SOLUTES

FORMED ELEMENTS(number per μL)

WHITE BLOOD CELLSVOLUMEBODY WEIGHT

Whole blood8%

Other fluidsand tissues

92%

Blood plasma55%

Proteins7%

Water91.5%

Other solutes1.5%

Albumins 54%

Electrolytes

Globulins 38%

Fibrinogen 7%

All others 1%

NutrientsGases

Regulatorysubstances

Waste products

(b) Components of blood

White blood cell

Platelet

Red blood cell

SEM 3500x

(a) Scanning electron micrograph

White blood cell(leukocyte—monocyte)

LM 400x

(b) Blood smear

Platelet

Red blood cell (erythrocyte)

Blood plasma

White blood cell(leukocyte—neutrophil)

Progenitor cells

Precursor cells or "blasts"

Formed elements of circulating blood

Tissue cells

Proerythroblast Megakaryoblast Eosinophilicmyeloblast

Basophilicmyeloblast

Myeloblast Monoblast Tlymphoblast

Blymphoblast

NK lymphoblast

CFU–E CFU–Meg CFU–GM

CFU–GM

CFU–Meg

CFU–E

Key:

Colony-forming unit—erythrocyte

Colony-forming unit—megakaryocyte

Colony-forming unit—granulocyte macrophage

Lymphoid stem cell

Pluripotent stem cell

Red blood cell(erythrocyte)

Platelets(thrombocytes)

Eosinophil Basophil Neutrophil Monocyte T lymphocyte(T cell)

B lymphocyte(B cell)

Natural killer (NK) cell

Reticulocyte Megakaryocyte

Nucleusejected

Granular leukocytes Agranular leukocytes

Mast cell Macrophage Plasma cell

Myeloid stem cell

Key:

8μm

Surface view

Sectioned view

(a) RBC shape

Beta polypeptidechains (globins)

Heme

Iron(Fe2+)

Alphapolypeptidechains (globins)

(b) Hemoglobin molecule (c) Iron-containing heme

+

+

Circulation for about120 days

Reused forprotein synthesis

Aminoacids

Red blood celldeath andphagocytosis

Macrophage inspleen, liver, orred bone marrow

Urine

Kidney

Feces

Bacteria

Largeintestine

Smallintestine

Liver

Erythropoiesis inred bone marrow

Erythopoietin

Vitamin B12

Key:in blood

in bile

1

2

3

4 56

7

8

14

9

1011

1213

Globin

TransferrinFerritin

TransferrinFe3+

Fe3+

Fe3+Heme

BiliverdinBilirubin

Bilirubin

Bilirubin

Urobilinogen

Stercobilin

Globin+

Urobilin

Some stimulus disrupts homeostasis by

Oxygen delivery to kid-neys (and other tissues)

Receptors

Kidney cellsdetect lowoxygen level

Control center

Proerythroblasts inred bone marrowmature more quicklyinto reticulocytes

Effectors

Larger numberof RBCs incirculation

Increased oxygendelivery to tissues

Return to homeostasiswhen oxygen deliveryto kidneys increases tonormal

Increased erythropoietinsecreted into blood

Input

Increased erythropoietinsecreted into blood

Output

Decreasing

(a) Eosinophil (b) Basophil (c) Neutrophil (d) Lymphocyte (e) MonocyteLM all 1600x

Interstitial fluid

Neutrophil

Endothelial cell

Rolling

Sticking

Squeezing betweenendothelial cells

Key:Selectins onendothelial cells

Integrins onneutrophil

Blood flowBlood flow

Neutrophils

Lymphocytes

Monocytes

Eosinophils

Basophils

Red Blood Cells (RBCs) or Erythrocytes

Neutrophils

Eosinophils

Basophils

Platelets (thrombocytes)

Monocytes

Lymphocytes

Red blood cell

Platelet

Collagen fibersand damagedendothelium

1 Platelet adhesion

Collagenfibers

Liberated ADP,serotonin, andthromboxane A2

2 Platelet release reaction

Collagenfibers

Platelet plug

3 Platelet aggregation

Platelet

Red blood cell

Fibrin threads

SEM 1445x

(a) Early stage

SEM 900x

(b) Intermediate stage

Fibrin threads

Red blood cell

SEM 3400x

(c) Late stage showing red blood cells trapped in fibrin threads

(a) Extrinsic pathway (b) Intrinsic pathway

Blood traumaTissue trauma

Damaged endothelial cells exposecollagenfibersTissue

factor(TF)

Damaged platelets

Activated XII

Activatedplatelets

Ca2+Ca2+

Plateletphospholipids

Activated X Activated X

Ca2+

Ca2+

Ca2+

Ca2+

PROTHROMBINASE

V V

Prothrombin(II) THROMBIN

XIII

Activated XIII

Loose fibrinthreads

Fibrinogen(I)

STRENGTHENEDFIBRIN THREADS

(c) Commonpathway

(c) Commonpathway

3

2

1

BLOOD TYPE TYPE A TYPE B TYPE AB TYPE O

A antigen B antigen Both A and B antigens NeitherA nor B antigen

Red blood cells

Plasma

Anti-Bantibody

Anti-Aantibody

Neitherantibody

Both anti-A andanti-B antibodies

Rh–

mother

Placenta

FirstRh+

fetus

Rh+

antigens

Anti-Rhantibodies Second

Rh+

fetus

(a) First pregnancy

(b) Between pregnancies

(c) Second pregnancy

Anti-A serum Anti-B serum

Untreated bloodTreated withanti-A serum

Treated withanti-B serum

Blood type

A

B

AB

O

CrenatedNormalSickled

SEM 1665xRed blood cells