BLOOD, LYMPHATIC AND IMMUNE SYSTEM

BLOOD SYSTEM Blood maintains a constant environment for other living tissues of the body. Transports nutrients, gases and wastes to and from the cells of the body Transports chemical messengers called hormones from the site of secretion to the recipient cells Contains proteins, white blood cells and antibodies that fight infection Contain platelets (thrombocytes) for blood clotting

BLOOD COMPOSITION Blood is composed of cells suspended in a liquid called plasma Cells constitute 45% and blood plasma 55% of the total volume Cells erythrocytes, leukocytes and platelets or thrombocytes Plasma a solution of water, protein, sugar, salts, hormones and vitamins

ERYTHROCYTES Red cells contain the unique protein hemoglobin, composed of heme (iron containing pigment) and globin (protein) Hemoglobin enables the erythrocyte to carry oxygen The combination of oxygen and hemoglobin (oxyhemoglobin) produces bright red color of blood. Erythrocytes originate in bone marrow Erythropoietin secreted by kidneys stimulate RBC erythrocyte production The life span of RBC is 120 days The macrophages destroy the worn-out erythrocytes, this process is called hemolysis 2 to 10 million red cells are destroyed each second but they are constantly replaced

BREAKDOWN OF HEMOGLOBIN

HEMOGLOBIN

Is broken down by macrophages into

HEME GLOBIN

BILIRUBIN

IRON

PROTEIN

Excreted by liver in bile LEUKOCYTES

Reused or stored in liver, spleen and bone marrow

White blood cells are less numerous than RBC (7000 to 9000 cells per microlitre) There are 5 different types of mature leukocytes POLYMORPHONUCLEAR GRANULOCYTIC LEUKOCYTES

1. Neutrophil 2. Eosinophil 3. Basophil 4. Lymphocyte 5. Monocyte LEUKOCYTES COMPOSITION LEUKOCYTES GRANULOCYTES Basophil NORMAL PERCENTAGE IN BLOOD 0-1 FUNCTION MONONUCLEAR AGRANULOCYTIC LEUKOCYTES

Eosinophil Neutrophil MONONUCLEAR CELLS Lymphocytes Monocytes

1-4 50 70

Contains heparin (prevents clotting) and histamine (involved in allergic responses) Phagocytic cell involved in allergic reaction Phagocytic cell that accumulates at sites of infection Controls the immune response, makes antibodies to antigens Phagocytic cell that becomes a macrophage and digests bacteria and tissue debris

20-40 3-8

PLATELETS (THROMBOCYTES) Blood cell fragments are formed in red bone marrow from giant cells with multilobed nuclei called megakaryocytes Tiny fragments of a megakaryocyte break off to form platelets Main function of platelets is to help blood to clot

PLASMA Plasma, the liquid part of the blood consists of water, dissolved proteins, sugar, wastes, salts, hormones, and other substances. There are 4 major plasma proteins, Alpha Beta Gamma Clotting proteins BLOOD TYPES TYPE A B AB O PERCENTAGE IN POPULATION 41 10 4 45 RED CELL ANTIGENS A B A&B NO A & B SERUM ANTIBODIES YES (anti-B) YES (anti-A) NO (anti-A or anti-B) YES (anti-A and anti-B) Immunoglobulin (antibodies)

1. Albumin 2. Globulins 3. Fibrinogen 4. Prothrombin

PATHOLOGY DISEASES OF RED BLOOD CELLS Anemia Aplastic anemia Hemolytic anemia Pernicious anemia Sickle cell anemia DESCRIPTION Deficiency in erythrocytes or hemoglobin Failure of blood cell production in the bone marrow Reduction in red cells due to excessive destruction Lack of mature erythrocytes caused by inability to absorb vitamin B12 into the body Hereditary condition characterized by abnormal sickle shape of erythrocytes and by hemolysis

Thalessemia

Hemochromatosis Polycythemia vara DISORDERS OF BLOOD CLOTTING Hemophilia

Inherited defect in the ability to produce hemoglobin, usually seen in persons of Mediterranean background Excess iron deposits throughout the body General increase in red blood cells (erythremia) Excessive bleeding caused by hereditary lack of blood clotting factors (VIII or IX) necessary for blood clotting Multiple pinpoint hemorrhages and accumulation of blood under the skin Increase in cancerous white blood cells (leukocytes) Abnormal increase in granulocytes in the blood Infectious disease marked by increased numbers of leukocytes and enlarged cervical lymph nodes Malignant neoplasm of bone marrow

Purpura DISORDERS OF WHITE BLOOD CELLS Leukemia Granulocytosis Mononucleosis DISEASES OF BONE MARROW CELLS Multiple myeloma

TESTS AND PROCEDURES LABORATORY TESTS Antiglobulin test Bleeding time Coagulation time Complete blood count (CBC) DESCRIPTION Test for the presence of antibodies that coat and damage erythrocytes Time required for blood to stop flowing from a tiny puncture wound Time required for venous blood to clot in a test tube Determination of numbers of blood cells, hemoglobin concentration, hematocrit, and red cell values MCH, MCV, MCHC Speed at which erythrocytes settle out plasma Percentage of erythrocytes in a volume of blood Total amount of hemoglobin in a sample of peripheral blood Number of platelets per cubic millimeter or microliter of blood Test of the ability of blood to clot Number of erythrocytes per cubic millimeter or microliter of blood Microscopic examination of a stained blood smear to determine the shape of individual red cells Number of leukocytes per cubic millimeter or microliter of blood Percentages of different types of leukocytes in the blood

Erythrocyte sedimentation rate ESR Hematocrit (Hct) Hemoglobin test (H, Hg, Hgb, HGB) Platelet count Prothrombin time (PT) Red blood cell count (RBC) Red blood cell morphology White blood cell count (WBC) White blood cell differential count CLINICAL PROCEDURES

Apheresis Blood transfusion Bone marrow biopsy Hematopoietic stem cell transplantation

Separation of blood into component parts and removal of a selected portion from the blood Whole blood cells are taken from a donor and infused into a patient Microscopic examination of a core of bone marrow removed with a needle Peripheral stem cells from a compatible donor are administered to a recipient

LYMPHATIC AND IMMUNE SYSTEM Lymph capillaries begin at the spaces around cells throughout the body. Lymph capillaries drain into larger lymph vessels Lymph vessels has valves like veins to prevent back flow of lymph Collection of stationery lymph tissues, located along the path of the lymph vessels are called lymph nodes. Each lymph node is a mass of lymph cells and vessels surrounded by a fibrous connective tissue capsule All the lymph vessels drain into the two large ducts, the right lymphatic duct and the thoracic duct, in the thoracic cavity. Thoracic duct drains the lower body and the left side of the head. Right lymphatic duct drains the right side of the head and the chest (a much smaller area) Both ducts carry the lymph into larger veins in the neck, where the lymph then enters the blood stream

LYMPH NODES Lymph nodes produce lymphocytes Filter lymph and trap substances from infectious, inflammatory and cancerous lesions Macrophages present in the lymph nodes swallow foreign substances When bacteria are present in the lymph nodes that drain a particular area , the nodes becomes swollen with collection of the cells and the debris and become tender Major sites of lymph nodes are, cervical, axillary, mediastinal and inguinal regions of the body.

SPLEEN AND THYMUS GLAND

The spleen and the thymus gland are specialized organs that are also part of the lymphatic system.

SPLEEN Located in the left upper quadrant of the abdomen next to the stomach.

FUNCTIONS: Destruction of old erythrocytes by macrophages Filtration of microorganisms and other foreign material from the blood Activation of lymphocytes by antigens filtered from the blood Storage of blood

THYMUS GLAND Lymphatic organ located in the upper mediastinum between the lungs During fetal life and childhood it is quite large and becomes smaller with age It plays an important role in the immunity, especially in fetal life and during the early years of growth Acceptance of self antigens is called tolerance When the tolerance process fails, immune cells react against normal cells, resulting in autoimmune disease

IMMUNE SYSTEM The immune system is specialized to defend the body against antigens (such as toxins, bacteria, proteins or foreign blood cells) This system includes leukocytes such as neutrophils, monocytes, and macrophages, which are phagocytes found in tissues throughout the body. Lymphoid organs such as the lymph nodes, spleen, and thymus gland, produce lymphocytes and antibodies.

PATHOLOGY IMMUNODEFICIENCY AIDS (Acquired Immunodeficiency Syndrome (AIDS) DESCRIPTION Group of clinical signs and symptoms associated with suppression of the immune system and marked by oppurtunistic infections, secondary neoplasms, and neurogenic problems Abnormal hypersensitivity acquired by exposure to

HYPERSENSITIVITY Allergy

an antigen MALIGNANCIES Lymphoma Multiple Myeloma Thymoma LABORATORY TESTS CD4+ cell count ELISA Immunoelectrophoresis Viral load test CLINICAL PROCEDURES Computed tomography CT scan Malignant tumor of lymph nodes and lymph tissue Malignant tumor of bone marrow cells Malignant tumor of the thymus gland Measures the number of CD4+ T cells in the bloodstream of patients with AIDS Screening test to detect anti-HIV antibodies in the blood stream Tests that separates immunoglobulins Measurement of the amount of AIDS virus in the blood stream -ray imaging produces cross sectional and other views of anatomical structures

EXERCISE 1. Liquid portion of the blood -------2. Orange-yellow pigment produced from hemoglobin when red blood cells are destroyed -------3. Iron-containing nonprotein part of the hemoglobin-------4. Proteins in plasma, separated into alpha, beta, and gamma types ------5. Hormones secreted by the kidneys to stimulate bone marrow to produce red blood cells ---------6. Foreign material that stimulates the production of an antibody --------------7. Proteins made by lymphocytes in response to antigens in the blood --------------------------------------------------------------------------------------------------------------------------------------------------