Unit G: Hematology

1. Unit G: Hematology Explain the structure of the blood. Analyze the function of the blood. Discuss characteristics and treatments of common blood disorders

2. Assignment • Find in your packet the page titled Blood Anticipation Guide. Read the instructions carefully! Complete.

3. Bell/Payday! • List the functions of the Blood! • Goals: Explain structures of the blood • Analyze the functions of the blood • Discuss characteristics and treatment of common blood disorders

4. Hematology • Average adult = 8-10 pints of blood • Functions: • Transports nutrients, oxygen, cellular waste products, and hormones • Aids in distribution of heat • Regulates acid-base balance • Helps protect against infection

5. Ha! Ha! • Why did the blonde nurse take a red magic marker to work?So she could draw blood!I just had to tell you that one I heard the other day. Funny, even if I am blonde( sometimes)!!

6. Composition: • PLASMA – liquid portion of blood without cellular components • Serum – plasma after a blood clot is formed • Cellular elements are red cells, white cells, and platelets

7. Straw colored, contains – Water Blood proteins Plasma proteins: FIBRONOGEN – necessary for blood clotting, synthesized in the liver ALBUMIN – from the liver, helps maintain blood’s osmotic pressure and volume PROTHROMBIN – a globulin which helps blood coagulate. Vitamin K necessary for prothrombin synthesis. Nutrients Electrolytes Hormones, vitamins, enzymes PLASMA

9. Bell • Complete the 2nd ½ of Blood anticipation guide • List all functions of blood • …when you finish come show me your work!

10. Read page 243 • The first person to write down and show me ( in medical/scientific terms) what do smarties and RBC’s have in common wins a prize!

11. Bell • What % of blood is Plasma? • What % of blood is formed ? • What is in formed?

12. ERYTHROCYTES • Shape = biconcave discs • HEMOGLOBIN – gives red color, heme is iron and globin is protein. • Function = transports oxygen to tissues and carbon dioxide away from cells • Normal – men =14-18 gm, women = 12-16 gm

13. Function of Hemoglobin • Red cells travel through the lungs where • O2 is carried to tissues and released • CO2 picked up and carried back to lungs for exchange

14. Arterial blood – lots of oxygen = bright redOxyhemiglobin-bright red color

15. Venous blood – lots of CO2 = dark crimsonCarbiminohemiglobin-crimson blue

16. What is carbon monoxide poisoning? Hemoglobin readily accepts carbon monoxide - even over the life giving oxygen atoms (as much as 200 times as readily as oxygen) forming a toxic compound known as carboxyhemoglobin (COHb). By replacing oxygen with carbon monoxide in our blood, our bodies poison themselves by cutting off the needed oxygen to our organs and cells, causing various amounts of damage - depending on exposure.

17. red blood cells……….. • ERYTHROPOIESIS • Manufacture of red blood cells • Occurs in bone marrow • Red cells live 120 days • Old cells broken down by the spleen and liver • HEMOLYSIS – rupture or bursting of erythrocyte, can be from a blood transfusion or disease. • Page 148 workbook A. 1, 2, 3, 4, 5

18. Bell • Complete “b” from page 153-154…”I Am the Red Blood Cell” This has been copied and is in your packets!

19. Bell • Page 148-149 workbook A. 1, 2, 3, 4, 5

20. Bell…. • Define the function of a Leukocyte

21. White Blood Cells – LEUKOCYTES • Leukocytes-Defends body from injury and disease • Larger than erythrocytes • 5 types • Normal leukocyte count = 3,200 – 9,800 • Types of White Cells • Neutrophils • Eosinophils • Basophils • Lymphocytes • Monocytes • http://science.howstuffworks.com/immune-system10.htm

22. Leukocytes are divided into two classes: • Granulocytes -grainules • Agrainulocytes withoutgrainules • Classification is due to the presence of cytoplasmic grainules & a reaction of a Wright Stain

23. 1/2/4 discussion…45 second time limit • Granulocytes • Agrainulocytes • Neutrophils • Eosinophils • Basophils • Lymphocytes • Monocytes

24. Granulocytes • - Granulocytes make up 50% to 60% of all leukocytes. Granulocytes are themselves divided into three classes: neutrophils, eosinophils and basophils. • Granulocytes get their name because they contain 30% to 40% of all leukocytes. Lymphocytes come in two classes: B cells (those that mature in bone marrow) and T cells (those that mature in the thymus). • Neutraphils-Immune defense (phagocytosos • Eosinophils- Defense against parasites • Basophils- Inflamatory response. Histamine. Produce HEPARIN – an anticoagulant

25. Agranulocytes2 divisions • Monocyte – Formed in the bone marrow and spleen, Monocytes protect against blood-borne pathogens. Assist in phagocytosis. Move quickly to sites of infection in the tissues. • http://science.howstuffworks.com/immune-system10.htm • Lymphocyte - Lymphocytes make up up 7% or so of all leukocytes. A lymphocyte is a type of white blood cell involved in the human body's immune system. • T-lymphocyte from thymus • B-lymphocyte formed in bone marrow.

26. Erythrocytes-Oxygen and carbon Dioxide trandsport Neutraphils-Immune defense (phagocytosos) Eosinophils- Defense against parasites Basophils- Inflamatory response. Histamine. Produce HEPARIN – an anticoagulant B-lymphocytes-Antibody production T- lymphocytes Cellular Immune response Monocytes-Immune defense (phagocytosos) Platelets-Blood clotting Classes of Blood Cells

27. Bell • Define phagocytosis

28. PHAGOCYTOSIS • – process when white cells surround, engulf, and digest harmful bacteria. .All leukocytes except Lymphocytes can…..

29. DIAPEDESIS • – when white cells LEUKOCYTES move through capillary wall into neighboring tissue.

30. Leukocytes are divided into two classes: • Granulocytes -grainules (Megablasts)-origin Red Bone Marrow • Neutraphils-Immune defense (phagocytosos) Eosinophils- Defense against parasites, increase with alergic reactions .(phagocytosos) • Basophils- Inflamatory response. Histamine. Produce HEPARIN – an anticoagulant Agranulocytes2 divisions 1) Monocyte – Formed in the bone marrow and spleen, Monocytes protect against blood-borne pathogens. Assist in phagocytosis. Move quickly to sites of infection in the tissues. • 2) Lymphocyte - Lymphocytes make up up 7% or so of all leukocytes. A lymphocyte is a type of white blood cell involved in the human body's immune system. • T-lymphocyte from thymus • B-lymphocyte formed in bone marrow.

31. Body’s reaction to chemical or physical trauma PATHOGENIC – disease producing microorganisms can cause inflammation Symptoms – redness, local heat, swelling and pain Why? Bacterial toxins, increased blood flow, collection of plasma in tissues (edema) HISTAMINE increases the blood flow to the injured area INFLAMMATION

32. PUS produced – a combination of dead tissue, dead and living bacteria, dead leukocytes and plasma ABSCESS – pus-filled cavity below the epidermis PYREXIA – increase in body temperature by the hypothalamus – in response to pathogenic invasion LEUKOCYTOSIS – increase in the number of white cells in response to infection LEUKOPENIA – decrease in number of white cells due to chemotherapy or radiation Workbook page 153-154 E,F,G(ck pkt) Worksheet Top ½ “The Blood” Why do we need LEUKOCYTES?? Define @ top of 3rd pg of outline

33. Bell/payday • If you missed any portion of class yesterday, see me! • Complete…..Workbook G page 156-already copied in pkt!

34. Workbook E, F

35. Career exploration(Name of career, Area of speculation, work environment, Academic requirements, Salary range, Educational programs ) • Choose One… • Clinical Laboratory Scientist ( medical technologist ) • Clinical Laboratory Technician ( Med. Lab. Tech) • Phlebotomist • Hematologist • Biomedical Scientist • Any other ideas??

36. Bell • Workbook 149 answer 7 and 8

37. THROMBOCYTES (Platelets) Smallest of solid components of blood Synthesized in red marrow Not cells – fragments of megakaryocytes Necessary for the initiation of the blood clotting process 250,000 to 450,000 per ml.

38. COAGULATION • Cut or injury  platelets and injured tissue release THROMBOPLASTIN  act on PROTHROMBIN in plasma  + Calcium ions converts to THROMBIN  the thrombin acts as an enzyme and changes FIBRINOGEN  FIBRIN creating a mesh that traps red blood cells, platelets and plasma creating a blood clot. • See Transparency

39. Clotting…. ANTICOAGULANTS – prevent blood clotting HEPARIN = antiprothrombin PROTHROMBIN – dependent on Vitamin K W/B H (already in Pkt) Word bank pg 154

40. Complete (worksheet) Functions of Blood Cells • Quick review… • Plasma-Straw colored, contains: Water, Blood proteins • Erythrocytes-Function = transports oxygen to tissues and carbon dioxide away from cells • Leukocytes-Defends body from injury and disease • Platelets- initiation of the blood clotting process

41. Bell • Name the 4 blood types

42. Are you my type? • Four major types of blood- A, B, AB and O • Inherited from parents • Determined by presence or absence of an ANTIGEN on the surface of the red blood cellExample-Type A blood has antigen A • Type O has neither Antigen A or B

43. BLOOD TYPES • ANTIBODY – a protein in the plasma that will inactivate a foreign substance that enters the body. • Someone with type A blood has b antibodies • Someone with type B blood has a antibodies • Someone with type AB blood has no antibodies • Someone with type O blood has a and b antibodies • UNIVERSAL DONOR – O • UNIVERSAL RECIPIENT – AB • See poster

44. Blood Simulated Transfusion Compatibility

45. Step 6: Rinse the Patient cup. Add liquid from Group B to the Patient cup. Step 7: Repeat step 5 using “blood” from the Group B cup. Step 8: Repeat step 6 Step 9: Repeat step 5 using “blood” from the Group AB cup. Step 10: Repeat step 6 Step 11: Repeat step 5 using liquid from the Group O cup Step 12: Which “blood” groups can safely give blood to the patient who had Group B blood? Key..next slideAs Long as liquid does NOT change color=safe! Step 1:   Label paper cups with Group A, Group B, Group AB, Group O. Label The empty cup patient. Step 2:: Fill four cups about 2/3 full with water. Leave the fifth cup empty Step 3: Add red color to cup A, blue to cup B, and equal amounts of red and blue to cup AB; do not add food coloring to cup O Step 4: Pour a small amount of liquid from cup B into Patient cup. Patient now has that type of blood. Step 5: Using a medicine dropper, transfer “blood” from Group A to Patient cup. Did the color change in patient cup? Record your findings as either safe or unsafe.

46. As long as the liquid in the patient cup does not change color the transfussion is safe!

47. Classwork/homework • Blood typing study guide

48. Erythroblastosis fetalis Determining a person's blood type is very important if she becomes pregnant. Blood cells from the unborn baby (fetal red blood cells) can cross over into the mother's bloodstream, especially at delivery. If the mother and her baby have compatible blood types, the crossover does not present any danger. However, if the blood types are incompatible, the mother's immune system manufactures antibodies against the baby's blood.  Usually, this incompatibility is not a factor in a first pregnancy, because few fetal blood cells reach the mother's bloodstream until delivery. The antibodies that form after delivery cannot affect the first child. In later pregnancies, fetuses and babies may be in grave danger. The danger arises from the possibility that the mother's antibodies will attack the fetal red blood cells. If this happens, the fetus or baby can suffer severe health effects and may die.

49. Red cells also may contain Rh factor If you have it, you’re Rh + If you don’t, you’re Rh – Another blood typing system, discovered in 1939, is called the Rh blood group. The Rh comes from Rhesus monkeys on which the tests were first run. About 85% of our population is positive for the Rh factor, and the remainder is Rh-negative. RHO gam given to RH neg . mothers Are you positive???

50. BBLOOD TYPE REVIEW QUESTIONS 1. Mrs. Payne’s blood type is O positive. Her husband’s type is O negative. Her newborn baby’s blood type is O negative. Is there any need for concern with this combination? 2. You hear that your friend has been in a car accident and needs a blood transfusion; you want to donate blood. Your friend has type O+ blood and you have A+ blood. Can yourblood be given to your friend? Explain the reason for your answer. 3. Ms. Pratt is claiming the Mr. X is the father of her child. Ms. Pratt’s blood type is O negative. Her baby boy has type A positive blood. Mr. X’s blood is typed and found to be B positive. Could he be the father of her child? _______ If not, what blood type would the father be expected to have?  4. A patient comes to the doctor’s office. She is pregnant and states she is Rh negative and her husband is Rh positive. She has heard that there may be a problem with the baby. Explain to her about the Rh factor and how this situation is taken care of today. Bottom 1?2 “The Blood”