BLOOD

The average person has 5 to 6 quarts of blood in their circulatory system. Over half of blood is plasma. Plasma is a slightly yellowish fluid that carries hundreds of different substances in solution or suspension. These substances include nutrients, minerals, antibodies, hormones, gases, enzymes, blood clotting proteins, and the waste products of metabolism. Also suspended in plasma are red and white blood cells.

Red blood cells are called erythrocytes. Erythrocytes carry oxygen to and carbon dioxide away from the thirty trillion cells which compose the human body. Mature erythrocytes have no nucleus, so they do not divide as do normal body cells. An erythrocyte will last about 120 days before becoming worn out. It is estimated that erythrocytes are created and die at a rate of 5,000,000 per second. Erythrocytes are formed in the red marrow of bones by a process called erythropoiesis. Erythrocytes are disk-shaped and slightly concave on both sides. They require ATP energy to maintain this shape; for when ATP energy is taken away they become more spherical in shape.

Erythrocytes get there color from an iron pigment called heme. Heme combines with the protein globin to form hemoglobin. Hemoglobin picks up oxygen in the lungs, hold it loosely, and exchange it for carbon dioxide in capillaries which serve cells. In the lungs hemoglobin releases carbon dioxide which we exhale.

White blood cells are called leukocytes, and are much less numerous than erythrocytes. White blood cells are actually colorless, but show up white under microscopic light. Leukocytes are slightly larger than erythrocytes. There are many different types of leukocytes, and they are named for their internal structure, or for the stains which they accept.

Granulocytes have tiny granules which are easily seen when they are stained. These leukocytes are manufactured in the red marrow. Lymphocytes are manufactured in the lymph nodes, spleen and Peyer's Patches of the intestines. A third type, called monocytes, are produced in connective tissue, lymph nodes and the spleen.

Neutrophils are leukocytes which absorb a neutral stain (neither acidic or basic). Eosinophils absorb a rose-colored stain called eosin. Eosin is a stain that is attracted to acids. Basophils adsorb a basic stain known as methylene blue.

The primary function of leukocytes is to eat anything which does not belong in the body. They do this through a process called phagocytosis. Leukocytes gang up on things which don't belong and destroy these invaders. In this process some leukocytes are killed, and remain mixed with the dead invader, and a few live leukocytes, to form what is commonly called pus.

If there is infection in the body the number of leukocytes rises dramatically to fight the infection. Therefore, a high white blood cell count is a sign of infection. Unlike erythrocytes which must go with the flow of blood, leukocytes can move to where they are needed. They move much like an ameba, and can exit the capillaries to fight infection. The membrane of a leukocyte is chemically attracted to the toxins produced by bacteria, and it is this attraction that causes them to move toward the infected area.

Another function of leukocytes is to eat damaged or worn out erythrocytes. This destruction occurs in the spleen, red bone marrow, lymphatic tissue, and the liver. After erythrocytes are eaten, the by-products are recycled to form bile. Since most damaged and worn out erythrocytes are destroyed in the spleen, the spleen is known as the "graveyard for red blood cells."

Also suspended in plasma are blood platelets called thrombocytes. Thrombocytes are about one-fourth the size of erythrocytes and also have no nucleus. Like erythrocytes, thrombocytes are also formed in the red marrow. Platelets help initiate clotting by causing certain plasma contents to coagulate. The word "coagulate" means to change from a liquid to a solid. Thrombocytes release an enzyme called thrombin which causes a plasma protein called fibrogen to form fibrin. Fibrin is a mesh-work of thread which covers the wound and traps blood cells so they can not escape through the wound. Vitamin K is vital to thrombin, and is administered to assist clotting. K is the first letter of the Danish word for coagulation.

Blood does not normally clot in the circulatory system because of the presence of a substance called heparin. If blood does clot in a blood vessel the clot is called a thrombus, and the condition is called thrombosis . Heparin obtained from the lungs of slaughtered animals is used medically to break up a thrombus.

If a clot should develop in the circulatory system the clot may break lose to form an embolus. An embolus is a substance, such as a blood clot, fat globule, air bubble, or clumps of cells--which is swept along in the blood stream until it lodges in a vessel and blocks the flow of blood beyond that point. Such a condition is called an embolism.

While all erythrocytes and most leukocytes are made in the red marrow from mesenchymal stem cells, lymphocytes and monocytes are formed in the lymphatic system. The lymphatic system is sort of a secondary circulation system which functions to return fluids from tissue spaces to the circulatory system. In the lymphatic circulatory system there is no pump, such as a heart, to cause a flow. Instead, the movement and action of muscles causes this fluid to move. Without lymphatic circulation tissue becomes water-logged producing a condition called edema. The lymphatic system also serves to filter blood of bacteria to arrest infection. Along the course of this second circulatory system are the lymph nodes which do this filtering. There are more than a hundred lymph nodes spaced along the lymphatic circulatory system. Lymph nodes manufacture lymphocytes which kill the trapped bacteria.

An antibody is a protein in erythrocytes which becomes modified when it comes in contact with a foreign substance (antigen). An antigen is any substance which will stimulate the production of an antibody. This modification occurs in the antibody-antigen reaction. The end result of this reaction is the production of a leukocyte that will destroy the antigen. This is the key to immunity, as these reactions result in the production of a leukocyte which will immediately kill an invader so that we do not get sick from it. Often viruses or bacteria are killed or weakened and are then injected into the blood stream so that this antibody-antigen reaction occurs. This procedure, called vaccination, allows us to become immune to a bacterial or viral disease. However, the antibody-antigen reaction can also cause allergies and auto-immune diseases.

Immunity includes all of the physiological activities that make it possible for the body to recognize things that do not belong in the body and render the harmless. These foreign invaders include bacteria, viruses, unicellular and multicellular organisms, and toxins (poisons). If such invaders have penetrated skin, escaped being killed by lacrimal glands, sebaceous glands or sweat glands, managed to travel through the mucus which lines passages into the body, they must then be killed by lymphocytes.

All lymphocytes start as stem cells made by the red bone marrow. Those stem cells which travel to the thymus are made into T-lymphocytes. From the thymus they travel to the lymph nodes which becomes their work place. Those stem cells which associate themselves with globulin to form gamma globulin are the B-lymphocytes. As gamma globulin they eat foreign objects circulating in the blood stream.

Human beings are classified as belonging to one of four general blood groups according to the nature of certain protein antigens in plasma and in red blood cells. Because of our inheritance we have different antigens in our blood. Some common antigens have been named A, B and AB. If one's blood lacks these antigens they are blood type O. Other rare factors are M and N. Another is Rh, an antigen first observed in the rhesus monkey. About 85% of people in the United States have the Rh factor in their blood and are designated as being Rh positive (Rh+). The 15% who lack this factor are Rh negative (Rh-). These antigens must be matched when blood is transfused from one person to another.

Group O- is called the universal donor, because type O- lacks all of these antigens. Therefore, anyone can be transfused with O- blood. Group AB+ is called the universal recipient because it contains all of these antigens. A person with blood type AB can receive blood of any type.

When blood is to be transfused from a donor to a recipient these factors in blood must be matched. If transfused blood contains factors which the recipients blood does not have, there occurs a reaction called agglutination. In agglutination there is a clumping of blood cells which inhibits normal blood flow, and damages the kidneys. For this reason blood must be typed, and donor and recipient matched for compatibility.

If the father of a child is Rh+ and the mother is Rh-, the child's blood type will be determined by the random combination of their parent's genes. The gene for Rh+ blood appears to be dominant, and there is a good chance that the child's blood forming organs will begin to manufacture Rh+ blood. Normally, the blood of mother and developing child do not mix; however, bits of the child's blood cells will enter the mother's blood stream as waste products. As the Rh+ antigens from waste products enters the mother's blood stream, she begins to make antibodies to destroy them. In time, usually after the second or third child, the mother's blood will have developed a significant number of antibodies against the child's invading Rh+ antigens. When the mother's blood contains a high number of these antibodies, they invade the body of the fetus and cause the fetus' blood to agglutinate. The result is anemia, which often results in blindness, deafness and mental damage. This condition is called erythroblastosis fetalis, and requires immediate blood transfusions at birth. Erythroblastosis can be fatal. Children born with this condition are often blue in appearance, and are commonly called "blue babies."

About 13% of marriages in the United States pair an Rh+ man with an Rh- woman. However, there has been developed an Anti-Rh serum which prevents erythroblastosis. Before the development of this serum, Rh incompatible couples were advised to have no more than two children, as the third would run a high risk of erythroblastosis. With this serum, such parents can have almost any number of healthy children.

Donating blood is not only good for the recipient, it is good for the donor as well. The giving of blood stimulates the bone marrow. If a healthy person donates a pint of blood, they will regenerate that pint in about four weeks. If they then donate a second pint, they will regenerate that pint in three weeks. If they then give a third pint, they regenerate that third pint in two weeks.

Anemia refers to a lower than normal level of hemoglobin, or to a lower than normal number of erythrocytes. The most common kind of anemia is due to iron deficiency. The most common cause for iron deficiency anemia is a diet deficient of iron. Hemoglobin levels in mature females are slightly lower than in mature males, making females more likely to develop iron deficiency anemia. Iron supplements, in the form of pills, will usually correct this deficiency. The second most likely cause of anemia is chronic blood loss. Blood loss may occur because of bleeding peptic ulcers, hookworms (hookworms feed on erythrocytes), hemorrhoids, and excessive menstrual flow. The symptoms of anemia are pallor (skin which becomes more pale in appearance) and lack of energy. Young people in particular must be careful not to over-dose on iron supplements, as these effects can be permanent, and can be far worse than anemia.

Anemia may also develop from lead poisoning, as lead accumulates in the bone marrow and destroys some blood-forming cells. Diseases such as malaria also cause anemia as the protozoan transmitted by the mosquito feeds on red blood cells. Bacterial toxins can also cause anemia, as many of these toxins destroy red blood cells.

Pernicious anemia is the result of the failure of the red blood cells to mature normally. It is caused by a vitamin B12 deficiency. This results in fewer than normal red blood cells being produced, and the production of very large, mis-shaped red blood cells. It occurs in people over the age of 30, and usually has its onset in the 50's and 60's. Pernicious anemia is usually treated with vitamin B12, and the intrinsic factor, a substance which allows the absorption of this vitamin. The word "pernicious" means deadly. This was true of this form of anemia up until the late 1920's. However, with modern medical understanding and modern treatments, it is seldom life threatening today.

Sickle-cell disease also causes anemia. It is a genetic disease inherited in the recessive manner. In sickle-cell disease, some of the erythrocytes take a sickle-shape because of the distorting effects of an abnormal hemoglobin molecule. These sickle-shaped erythrocytes clog capillaries and veins, causing an impairment of blood flow to organs such as the lungs and nervous system. Severe symptoms occur in "crisis periods" which are more common in spring and fall than other times of the year. In crisis periods there is fever and pain in the arms, legs, heart, or abdomen.

Hemophilia is a sex-linked genetic disorder. In its most common form hemophiliacs have less than one percent of the normal clotting factor in their blood. The numerous bleeding episodes of hemophiliacs often results in anemia.

Leukemia is sometimes called "cancer of the blood." It is a disease of the blood-forming organs in which there is an over-production of leukocytes. Leukemia has many different causes and, there are many forms of leukemia. Some can be easily treated; other are fatal.

In the plasma of blood are dissolved inorganic substances such as: sodium, potassium, chloride, and calcium. The organic portions of plasma include the plasma proteins known as albumins and globulin, as well as the proteins fibrogen and lipoproteins. Plasma also carries enzymes, hormones and vitamins.

Plasma proteins are classed as being either albumins or globulins. These plasma proteins are common in living things. The white of an egg, for example, is primarily composed of albumins. The yolk of an egg is primarily composed of globulins. Plasma albumin functions to control the osmotic pressure of blood. Globulin also helps control osmotic pressure, but it has other functions as well. A part of globulin is gamma globulin, a substance that contains antibodies which protect us from disease. Gamma globulin is made by lymphocytes.

Blood circulates throughout the body in a closed system in which blood is confined in blood vessels. Blood is forced outward from the heart through arteries. The arteries become increasingly smaller as they branch out to body tissue. As they become smaller, they become arterioles. Arterioles then become tubes with only a single layer of thickness. These tubes are called capillaries. Capillaries pass between cells, or layers of cells, bringing blood into immediate contact with the cells. This allows oxygen to be exchanged for carbon dioxide, and nutrients to be exchanged for waste products.

Capillaries then join together to form venules. Venules are small veins and have a larger diameter and thicker walls than do capillaries. Venules become increasingly larger to form veins. Veins return blood to the heart.

While gravity causes the used blood in the veins of the upper body to flow back down to the heart, the veins below the heart rely upon the muscular action of breathing and muscular contractions in the arms and legs to force the used blood back to the heart. These veins also have valves which keep the blood flowing in the direction of the heart. These valves allow blood to flow toward the heart, but close to prevent a backflow.

Varicose veins are swollen, tortuous (crossing), veins which can be seen as bluish cords. Varicose veins most often appear in the legs, and in hemorrhoids. Varicose veins are caused by a failure of the valves in veins to prevent a backflow. The blood which flows back pools in these veins causing them to become large and blue in color. If varicose veins become infected, this infection is called phlebitis. Varicose veins commonly develop in women during pregnancy. Varicose veins can be stripped surgically, obliterated by lasers, or treated with anticoagulants.

Because arteries carry blood that is pumped from the heart, they have more blood pressure than do veins. Arteries and veins are composed of these layers of tissue: the tunica intima, which is composed of endothelial tissue, the tunica media, which is composed of smooth muscle and elastic tissue, and the tunica adventitia, composed of white fibrous connective tissue. However, arteries have an additional layer called the internal elastic membrane which lies between the tunica intima and the tunica media. This extra layer help arteries cope with blood pressure. If, however, there is a weakening of an arterial wall, blood pressure causes a ballooning in this weakened area. This condition is known as an aneurysm. Aneurysms are susceptible to rupture and hemorrhage. The word "hemorrhage means to bleed.

Blood Study Sheet
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