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Chapter 47 Care of the Patient with a Blood or Lymphatic Disorder -Overview of

Chapter 47 Care of the Patient with a Blood or Lymphatic Disorder -Overview of Anatomy and Physiology. Overview of Anatomy and Physiology: -Characteristics of blood. Ancient times Referred to as “river of life” or “fluid of life” Contains

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Chapter 47 Care of the Patient with a Blood or Lymphatic Disorder -Overview of

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  1. Chapter 47 Care of the Patient with a Blood or Lymphatic Disorder -Overview of Anatomy and Physiology

  2. Overview of Anatomy and Physiology: -Characteristics of blood • Ancient times • Referred to as “river of life” or “fluid of life” • Contains • RBC, WBC, platelets which are suspended in a light yellow fluid called plasma • Consistency • 45% blood cells • 55% blood plasma • pH • 7.35 to 7.45 • Volume • 5 to 6 liters or 10 to 12 pints

  3. Overview of Anatomy and Physiology: -Characteristics of blood • 3 Functions • 1. transports oxygen and nutrition to cells and waste products away from cells and transports hormones from endocrine glands to tissue cells • 2. regulates acid-base balance (pH) with buffers, aids with body temperature because of its water content and controls the water content of its cells as a result of dissolved sodium ions • 3. protects body against infection with special cells and prevents blood loss with special clotting mechanisms

  4. Figure 47-1 (From Thibodeau, G.A., Patton, K.T. [2003]. Anatomy and physiology. [5th ed.]. St. Louis: Mosby.) Human blood cells.

  5. Overview of Anatomy and Physiology: -Characteristics of blood • Red blood cells (RBC) • Erythrocytes • Men = 5.5 million per cubic millimeter • Women = 4.8 million per cubic millimeter • Contains cytoplasm and Hgb • Transport oxygen and carbon dioxide • Men = 14 to 18 gm/dL • Women = 12 to 16 gm/dL • Life span of 120 days • Produced in • Red bone marrow in vertebrae, ribs, sternum, proximal ends of humerus and femur

  6. Overview of Anatomy and Physiology: -Characteristics of blood • Erythropoiesis: RBC production • depends on: health condition of BM; dietary substances like rion and copper, plus essential AA; and vitamins like B12, folic acid, riboflavin (B2), pyridoxine (B6) • Feedback mechanism: • Decreased oxygen triggers release of erythropoietin from the kidneys • Erythropoietin increases maturation of RBC • Increased RBC allows more O2 delivered to cells and signals RBC production to shut off • Hematocrit • Measure of packed cell volume of RBC

  7. Overview of Anatomy and Physiology: -Characteristics of blood • Erythropoiesis: RBC production (cont’d) • Hematocrit • Measure of packed cell volume of RBC • Men 42% to 52% • Women 37% to 47% • Hemoglobin falls below normal (anemia): • Less hemoglobin, less oxygen transported to cells, slower breakdown and use of nutrients by cells, less energy produced by cells, decreased cellular function • Anemic complains of feeling “tired all the time”

  8. Overview of Anatomy and Physiology: -Characteristics of blood • White blood cells (WBC) – leukocytes • Nucleated, colorless, live from few days to years • Body defenses: destruction of bacteria and viruses • Two broad categories: • Granulocytes and agranulocytes • Granulocytes: • Neutrophils, eosinophils, basophils • Agranulocytes • Lymphocytes and monocytes

  9. Overview of Anatomy and Physiology: -Characteristics of blood • White blood cells (WBC) – leukocytes (cont’d) • Neutrophils • Granular circulating leukocytes for phagocytosis • Ingest bacteria and dispose of dead tissue • Primary phagocytic cells in acute inflammatory response • Mature are called segmental neutrophil or “seg” • Release lysozyme • Immature neutrophils • Immature polymorphonuclear leukocytes (polys) called bands in their final stages of development • Presence of excess bands in the periphery is called shift to the left and indicates a severe infection

  10. Overview of Anatomy and Physiology: -Characteristics of blood • White blood cells (WBC) – leukocytes (cont’d) • Eosinophils • Plays in allergic reaction and effective against parasitic worms • Normal value is 1% to 4% • Basophils • Nonspecific immune response to inflammation because of role in releasing histamine (vasodilator) • Cytoplasmic granules that contain heparin, serotonin, and histamine • Normal values 0.5% to 1%

  11. Overview of Anatomy and Physiology: -Characteristics of blood • Monocytes • Function similar to neutrophils; circulate in blood stream and move into tissue where they engulf antigens and cell debris • Second to arrive at scene of injury • Useful in removing dead bacteria and cells in recovery stage of acute bacterial infections • Normal value is 2% to 6%

  12. Overview of Anatomy and Physiology: -Characteristics of blood • Lymphocytes • For antibody formation • Two groups: • B cells and T cells • B cells: function to search out, identify and bind with specific antigens • T cells: when exposed to antigen, divide rapidly and produce new T cells that are sensitized to that antigen • Normal values are 20% to 40% • See Table 47-1, pg 1531-1532

  13. Overview of Anatomy and Physiology: -Characteristics of blood • Thrombocytes (platelets) • Smallest cell in the blood • Circular cell fragments, do not have nuclei • Life span of 5 to 9 days • Normal value of 150,000 to 400,000 per cubic mm • Initiate blood clotting and produced in the BM

  14. Overview of Anatomy and Physiology • Hemostasis: • A body process that arrests the flow of blood and prevents hemorrhage • 1. vessel spasm • 2. platelet plug formation • 3. clot formation • Vessel tear, smooth muscle in the walls of vessel causes it to contract • Platelet rush to area and seals it

  15. Overview of Anatomy and Physiology: -Characteristics of blood • Hemostasis • Clot formation • Injury • Hemorrhage • Grouping platelets • Thromboplastin released (reacts along with calcium ions) • Converts prothrombin to thrombin • Links with fibrinogen • Formation of fibrin • Trap RBCs and platelets • Forms clot

  16. Figure 47-2 (From Thibodeau, G.A., Patton, K.T. [2005]. The human body in health and disease. [4th ed.]. St. Louis: Mosby.) Blood clotting.

  17. Overview of Anatomy and Physiology • Blood types (groups) • Determined by the presence or absence of specific antigens on the outer surface of the RBC • Type A • Type B • Type AB • Universal recipient • Type O • Universal donor • In certain types of blood, the Ag on RBCs are accompanied by Ab found in blood plasma

  18. Overview of Anatomy and Physiology • Blood types (groups) • Type A blood: • RBCs contain type A antigen and the plasma contains anti-B antibodies • Type B: • RBCs contain type B antigen and the plasma contains anti-A antibodies • Type AB: • RBCs contain bothe type A and type B antigens, and the plasma contains neither anti-A nor anti-B antibodies • Type O: • RBCs contain neither type A nor type B antigens and plasma contains both anti-A and anti-B

  19. Overview of Anatomy and Physiology • Harmful effects or death result from a blood transfusion if donor’s RBCs become agglutinated by antibodies in recipient’s plasma (fig. 47-3, pg 1534) • Two types of reaction: • Agglutination and hemolyzation • Agglutination • Donor cells clump together because of the antibodies • Occludes arteries resulting to death • Hemolyzation • Antibodies cause RBCs of recipient to rupture, releasing their contents • Can lead to death

  20. Overview of Anatomy and Physiology • Rh factor • Rh antibodies may be located on the surface of the RBC • Rh positive: antibodies are present • Rh negative: antibodies are not present • 85% are Rh +; 15% are Rh – • Rh incompatibility seen commonly in pregnancy • If Rh antibody is present in mother then given IM dose of RhoGAM, a desensitization drug • Enables her to carry next infant without complications

  21. Overview of Anatomy and Physiology • Rh factor • Normally, plasma does not contain Rh antibodies; develop in response to individual’s receiving wrong type of blood • Develop Rh antibodies develop in 2 weeks and remain in the blood • Rh – person receives more Rh + blood , reaction occurs because Rh + antibodies react with donor blood, hemolysis occurs

  22. Overview of Anatomy and Physiology: -Lymphatic System • Consist of lymphatic vessels, lymph fluid and lymph tissue • Functions • Maintenance of fluid balance • Production of lymphocytes • Absorption and transportation of lipids from the intestine to the bloodstream

  23. Overview of Anatomy and Physiology: -Lymphatic System • Lymph and lymph vessels • Lymph is a specialized fluid formed in the tissue spaces transported by way of the lymphatic vessels and reenters the circulatory system • Substances that cannot enter or return through capillary walls, including excess fluid and protein molecules, are returned to blood as lymph

  24. Overview of Anatomy and Physiology: -Lymphatic System • Lymphatic tissue • Lymph nodes • Two functions: 1) filter impurities from lymph; 2) produce lymphocytes (WBCs) • Act as filters, keeping particulate matter such as bacteria from entering bloodstream • Small bean shaped structures appearing in groups • Body contains 500 to 600 nodes • Most numerous in axilla, groin, abdomen, thorax, cervical regions

  25. Overview of Anatomy and Physiology -Lymphatic System • Lymphatic tissue (continued) • Tonsils • Masses of lymphoid tissue embedded in mucous membrane of oral cavity and pharynx • Produce lymphocytes and antibodies • Trap bacteria and become enlarged • Larger in children and begin to atrophy at age 7

  26. Overview of Anatomy and Physiology -Lymphatic System • Lymphatic tissue (continued) • Spleen • Reservoir for blood (1 pint of blood) which can be released during emergencies like hemorrhage in less than 60 seconds • Main functions: • 1) reservoir for blood • 2) forms lymphocytes, monocytes, and plasma cells • 3) destroys worn-out RBCs • 4) removes bacteria by phagocytosis • 5) produce RBCs before birth

  27. Overview of Anatomy and Physiology -Lymphatic System • Lymphatic tissue (continued) • Thymus • Functions in utero (before birth) and a few months after birth to develop immune system • Responsible for development of T lymphocytes of cell-mediated immune response before they migrate to lymph nodes and spleen • Atrophies at puberty and replaced by fat and connective tissue

  28. Figure 47-4 (From Thibodeau, G.A., Patton, K.T. [2003]. Anatomy and physiology. [5th ed.]. St. Louis: Mosby.) Principal organs of the lymphatic system.

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