Blood cells

&
Hemopoietic
System
Composition of Blood

Blood consists of:

 Blood cells

– Red blood cells

– Platelets
– White blood cells
 Plasma
Composition of Blood

Plasma
 Carries cells

– Transport gases
– Aid in body defense
– Prevent blood loss
Composition of Blood
 When blood is removed from
circulation, it clots
 Clot consists of:
– Blood cells
– Fibrin strands – formed from conversion of
plasma protein – Fibrinogen
 Serum – yellowish liquid
 Composition of Blood
 Blood is kept in fluid state by
Anticoagulants – EDTA, Heparin, Citrate
 After Centrifugation separates into:
– Lower layer 42 – 47 % - Red cells –
Hematocrit
– Intermediate layer – 1% - Leukocytes –
Buffy coat
– Top layer – 55% – yellowish fluid –
Plasma
 Plasma Proteins
Most abundant solutes in plasma.
Major proteins are albumin, globulins and
fibrinogen
Albumin: The most important protin;
Its functions like,
1. Maintenance of blood volume,
2. Plasma osmotic pressure
3. carrier protein.
Globulin: The 2nd most important protein
It comprises mainly of three types,
1. alpha globulin
2. beta globulins
3. gamma globulins
Fibrinogen: It has impotent role in clotting of
Blood cells
 Erythrocytes (red blood cells)
 Leucocytes (white blood cells)
 Thrombcytes (Platelets)
Site of haemopoiesis

 first few weeks of gestation the yolk

sac is the main site of haemopoiesis.
 Definitive haemopoiesis derives from a
population of stem cells - first
observed on the dorsal aorta termed
the AGM (aorta-gonads-mesonephros)
region.
 These common precursors of
endothelial & haemopoietic cells
(haemangioblasts) are believed to
seed the liver, spleen and bone
marrow
Sites of Hemopoiesis
 Fetus – 0 t0 2 months – Yolk Sac
2 to 7 months – Liver, Spleen
5 to 9 months – Bone marrow

 Infants – Bone marrow ( All bones)

 Adults - Vertebrae, ribs, sternum, skull,

sacrum,
Pelvis, Proximal end of femur
 HEMATOPOISIS

 Bone marrow consists mainly of two

portions;
– Red bone marrow
– Yellow bone marrow
 In adults – BM is restricted to
- Pelvis
- Sternum
- Vertebrae
 Blood cells precursors

 Blood forming population of bone

marrow is made up of three types of
cells
– Self renewing stem cells
– Differentiated progenitor cells
– Functional mature blood cells
Haematopoiesis
Regulation of
Hematopoisis
 Blood cells are produced by the
BM according to need &
regulatory factors
 Cytokine – family of glycoproteins
– stimulate
– Proliferation
– Differentiation
– Functional activation of various BM
precursors
Regulation of Hematopoisis
 Erythropoietin (EPO)
 Thrombopoitin (TPO)
 Cytokines (CSFs)
– G-CSF
– M-CSF
– GM-CSF
 Androgens
 Growth factors
 Trace elements(iron,Cu)
 B12,Folic acid.
Regulation of Hematopoisis
 Erythrocytes

 Most numerous of the formed

elements
 Small,biconcave disk,large surface
area.
 Contain hemoglobin
 Function is to transport oxygen.
 Total life in circulation is
approximately is 120 days.
Erythrocytes
Erythrocytes
Erythrocytes
 Leucocytes

 1% of total blood volume.

 Function in inflammatory and in
immune process.
 They include
grannulocytes,lymphocytes and
monocytes.
Granulopoiesis
 Grannulocytes

 Phagocytic cells
 They have identical
grannulation,spherical in shape and
have distinctive multilobar nucleus.
 Mainly these are of three types.

 Neutrophils

 Basophils

 Eosinophils
 Neutrophils
 50-60%
 They get neutral stain with an
acidic and basic dye, so they
called neutrophils.
 Because they have multilabar
neucleus (3-5),so they also
called Polymorphoneuclear
leucocytes.
 Functions in defence mechnism
against microorganisms.
 Grannule of these cells contains
certain enzymes which have
important role in these defence
mechanisms.
 Total life in circulation is only 10
hours.
 Eosinophils
 Granules stain red
with acidic dye (Eosin).
 1-3% of total WBCs.
 Main role in allergic
conditions and in
parasitic infections.
 Basophils

 Granules of these cells

stain blue with basic dye.
 0.3-0.5% of total WBCs.
 Granules contain
– heparin (anticoagulant)
– histamine (vasodilator).
Monocytes and Macrophages

 Largest cells of the WBCs series.

 3-8% of total WBCs.
 Total life Spain of these is 1-3 days, in
tissues survive for many days.
 Mainly these are phagocytic cells.
 Many types due to their various locations
- Histiocytes in tissue
- Kupffer cell in liver
- Microglial cells in brain
Monocytes

– Larger than other

peripheral blood cells
– Nuecleus –Central
oval or indented
– Cytoplasm
 Blue –abundant

 Fine granules

 Ground glass
Monocytes
 Lymphocytes
 20-30% of total WBCs
 No grannules in cytoplasms and also
called agrannulocytes.
 Two types

• B-cells
• T-cells
 Important role in immune responses.
 B-cells also produce antibodies.
Lymphocytes
 Thrombocytes

 Originate from megakaryocytes.

 They form platelet plug to control
bleeding.
 In their cytoplasmic granules, certain
mediators have important role in
hemostasis.
 They have no nucleus and can never
replicate.
 Total life is 8-9 days.
 All blood cell precursors are derived
from primitive cells
– pluripotent stem cells.
– Colony forming units (burst forming
units)
– Disorders of the stem cells is the
aplastic anaemia & leukemia's
– Potential cures of these disorders is
done by successful BM transplantation
 Sources of stem cells for transplant are
 Bone marrow,
 Peripheral blood and
 Umbilical cord blood
 BM and Peripheral blood transplant may
be
 Autologous
 Allogenic
 Umbilical cord transplants are the best
option in children's, because less risk
factors of Graft-verses-Host disease.
Regulation of Erythropoiesis
Normal haemoglobins in adult blood
Red cell

 In order to carry haemoglobin into close

contact with the tissues and for successful
gaseous exchange, the red cell, 8 µm in
diameter, must be able:
– to pass repeatedly through the microcirculation
whose minimum diameter is 3.5 µ m,
– to maintain haemoglobin in a reduced (ferrous)
state and
– to maintain osmotic equilibrium despite the
high concentration of protein (haemoglobin) in
the cell.
– Its total journey throughout its 120-day
lifespan has been estimated to be 480 km (300
miles).
Red cell metabolism
Embden-Meyerhof pathway

 In this series of biochemical reactions, glucose

that enters the red cell from plasma by facilitated
transfer is metabolized to lactate
 This ATP provides energy for maintenance of red
cell volume, shape and flexibility.
 The Embden-Meyerhof pathway also generates
NADH - to reduce functionally dead
methaemoglobin (oxidized haemoglobin)
containing ferric iron to functionally active,
reduced haemoglobin.
 The Luebering Rapoport shunt - generates 2,3-
DPG which forms a 1 : 1 complex with
haemoglobin - is important in the regulation of
Red cell membrane
 The red cell membrane comprises a lipid bilayer,
integral membrane proteins and a membrne
skeleton
 Approximately 50% of the membrane is protein,
20% phospholipids, 20% cholesterol molecules
and up to 10% is carbohydrate.
 Carbohydrates occur only on the external surface
while proteins are either peripheral or integral,
penetrating the lipid bilayer.
 The membrane skeleton is formed by structural
Horizontal Lattice
proteins: maintain
– α and β spectrin, Biconcave shape

– ankyrin,
– protein 4.1 and
The structure of the red cell membrane. Some of the penetrating & integral
proteins carry carbohydrate antigens; other antigens are attached directly to the
lipid layer.
 Diagnostic tests

 CBC
 ESR
 Bone marrow aspiration & Biopsy
Normal adult red cell values.
Differential Count
Differential Count
Causes of Neutrophil Leukocytosis

• Bacterial infections – Pyogenic bacterial, localized or

generalised
• Inflammation & tissue necrosis
• Neoplasms – carcinoma or lymphoma
• Acute haemorrhage
• Drugs – corticsteroid therapy
• hronic myeloid Leukaemia
ESR
 Screening test
 Anticoagulated blood aggregates &
sediments to the bottom of tube
 Rate of Aggregation increases in
presence of fibrinogen & other
proteins
 It is measured as distance in mm that
red cell column travels in one hour
 BoneMarrow aspiration &
Biopsy
 Supplies &Equipment

Supplies & equipment

Tray:
– Wooden
– Plastic
– Steel
Bone Aspiration Needle
 Positioning the Patient
Patient is positioned – depending
on
the location of the procedure:

– Posterior iliac crest (PIC) –

patient is placed in a right or
left lateral position with their
knees flexed, a pillow under
their head, and their eyes
away
– Anterior iliac crest (AIC) –
patient is placed in a supine
position, with their hips and
knees flexed, and eyes
averted away.
– Sternum – Supine position, Diagram of Posterior pelvic bone – position of
Right posterior iliac crest
head and eyes away, light
towel over face “to keep
things sterile” and cover eyes.