ANATOMI &

PHYSIOLOGY
HEMATOLOGY
CHARACTERISTICS OF BLOOD
Liquid connective tissue
4-5 times more viscous than water
Slightly alkaline
Warmer than body temperature
Volume is 4-6 liters
• Men=5-6 L
• Women=4-5 L
Salt concentration of .85-.90%
 CHARACTERISTICS OF BLOOD

• Heterogeneous mixture

Non-living matrix called PLASMA (55%)

Formed elements (45%)

PLASMA
 FORMED ELEMENTS
• Erythrocytes= red blood
cells (RBC)

• Leukocytes= white
blood cells (WBC)

• Thrombocytes=
platelets
 FUNCTIONS OF BLOOD
• Distribution • Regulation
 Oxygen and carbon  pH
dioxide  Body temperature
 Hormones  Fluid and electrolyte
 Wastes balance

• Protection
 Clotting mechanisms
 Phagocytosis and
antibody production
 ERYTHROCYTE
• CHARACTERISTICS

 Most numerous formed

element with (4.8 to 5.4
million per mm3)
 Very flexible
 No nucleus
 Biconcave disk
 Life span about 120 days
 Contains hemoglobin
 HEMOGLOBIN=Transport Pigment

• Oxyhemoglobin

• Deoxyhemoglobin

• Carbaminohemoglobin
 Hemoglobin values:

• Measured in grams per milliliter

• 14 – 20 g/100 ml in infants

• 13 – 18 g/100 ml in adult males

• 12 – 16 g/100 ml in adult females

 ERYTHROPOIESIS
=PRODUCTION OF RBC OCCURS IN THE RED BONE
MARROW OF FLAT BONES AND IN SOME LONG BONES
 Regulation of Erythropoiesis

• Hormonal Controls
– Erythropoietin
– RBC and Hemoglobin amounts
– Availability of oxygen

• Dietary Controls
– Adequate amino acids, lipids, and carbs
– Iron
– Vitamin B12 and folic acid
Regulation of Erythropoiesis
Life Cycle of Erythrocytes
 ERYTHROCYTE DISORDERS
• POLYCYTHEMIA
• ANEMIA  Primary polycythemia
 Insufficient #of RBCs  Secondary polycythemia
 Hemorrhagic anemia
 Hemolytic anemia
 Aplastic anemia
 Low hemoglobin
 Pernicious anemia - macrocytes
 Iron deficiency - microcytes
 Abnormal hemoglobin
 Thalassemia
 Sickle cell Anemia
Erythrocyte Disorder
 HEMATOCRIT

• 47% +/- 5% in males

• 45% +/- 5% in females
 LEUKOCYTES
• CHARACTERISTICS
 Less numerous than RBC (less
than 1% of blood with normal
range of 4800 – 10,800 WBC/ml)
 Critical defense cells of the body
 Distinct nuclei present
 Capable of diapedesis
 Demonstrate positive chemotaxis
 Lack hemoglobin
 TYPES OF LEUKOCYTES

• GRANULOCYTES
 Neutrophils (PMNs)
 Eosinophils
 Basophils

• Agranulocytes
 Lymphocytes
 Monocytes
TYPES OF LEUKOCYTES
LEUKOPOIESIS
 LEUKOCYTE IMBALANCES

• Leukocytosis (amounts greater than 11,000 WBC/ml)

• Leukopenia (amounts less than 4,000 WBC/ml)

• Leukemia
 Acute leukemia
 Chronic leukemia

• Infectious Mononucleosis = kissing disease

 THROMBOCYTES
• CHARACTERISTICS

 Involved in hemostasis
 Less than half the size of
RBC
 Numerous (250,000-
400,000 per ml3)
 Actually cell fragments
rather than true cells
 Life span is about 5-9 days
FORMATION OF PLATELETS

Regulated by thrombopoietin
 STAGES OF BLOOD CLOTTING

• Step 1: Vascular spasms

 Endothelin
 Serotonin

• Step 2: Formation of a platelet plug

 ADP
 Serotonin
 Thromboxane A2
 von Willebrand factor
 STEP 3: COAGULATION

• Phase 1: Formation of
prothrombinase (also known as
prothrombin activator)

• Phase 2: Conversion of
prothrombin to thrombin

• Phase 3: Conversion of soluble

fibrinogen into insoluble fibrin
Coagulation Cascade Animation –
Physiology of Hemostasis
CLOTTING FACTORS
 Factors Effecting Clot Formation

• Normal coagulation:
 Normal platelet #s
 ALL clotting factors
 Vitamin K
 Calcium ions
 TF and PF3
Preventing Undesirable Clotting

• Nitric oxide
• Prostacyclin (a prostoglandin)
• Vitamin E quinone
• Heparin
• Anti-prothrombin III and Protein C
 PLATELET DISORDERS
• Thrombus

• Embolus

• Hemophilia

• Thrombocytopenia

• Impaired liver function

• Disseminated Intravascular Coagulation (DIC)

 Effects of Drugs on Clotting

• Aspirin = antiprostaglandin that inhibits

thromboxane A2

• Heparin = natural anticoagulant produced by

basophils and mast cells that inhibits thrombin by
enhancing the activity of antithrombin III

• Warfarin = (a.k.a. Coumadin) interfers with the

action of vitamin K
Summary of Formed Elements
Summary of Formed Elements
 BLOOD TYPING
• Blood types are base on the presence of
agglutinogens (antigens) present on the red blood
cell surface.

• Also, based on presence of agglutinins (antibodies) in

the plasma.

• The ABO and Rh systems are based on antigen-

antibody type interactions.
ABO BLOOD GROUPS
 BLOOD TYPES

Blood Type of Type of Receive?

Type Antigen? Antibody?
A A antigen Anti-B A, O

B B antigen Anti-A B, O

AB Both A and None A, B, AB, O

B antigens
O None Both Anti-A O only
and Anti-B
 Rhesus Factor

Blood Type Presence of Type of Receive?

D Antigen? Antibody?

Rh Positive
Yes None + and -

Rh Negative
No Anti-D - only
BLOOD GROUPS
Type O 45% Type A 42%

Type B 10% Type AB 3%

ABO BLOOD TYPING
 BLOOD GROUPING DISORDERS

• Erythroblastosis fetalis
 Tugas kelompok Tugas Individu, upload
presentasi video youtube

Asuhan keperawatan pada pasien Patofisiologi

1. Leukemia
1. Leukemia
2. Anemia
3. Hemofilia 2. Anemia
4. DIC 3. Hemofilia
• wajib membawa refrensi (buku atu e-book) saat 4. DIC
diskusi
• Format makalah: times new roman, font 12, Syarat mengikuti ujian
spasi 1,5, rata kiri kanan Kirimkan alamat url video
• Refrensi berasal dari buku terutama pada Batas akhir pengumpulan video 13 mei 2018
pengkajian, diagnosa (Nanda), outcome (NOC)
dan intervensi (NIC)
Format penulisan judul
• Menggunakan sistem refrensi yang benar
(sesuai penulisan skripsi/ karya ilmiah) Nama lengkap_nim_patofisiologi leukemia_STIKMKS

Contoh url
TIDAK MENGAMBIL REFRENSI DARI BLOGSPOT DAN https://www.youtube.com/watch?v=itkRVTqfPsE
FILE PDF TANPA SUMBER YANG JELAS https://www.youtube.com/watch?v=IOit8rq6NBY
1. Leukemia No. Urut 31-47
2. Anemia No. Urut 1-10
3. Hemofilia No. Urut 20-30
4. DIC No. 11-19