Blood

• red blood cells (erythrocytes) 45%
• white blood cells (leukocytes) <1%
• Platelets <1%
• plasma 55%

• 55%
• 90-92% water
• electrlytes/ glucose
• clotting factors
• plasma proteins 
• _{albumin-transport fatty substances}
• _glubulins
• fibrinogen-blood clotting

• albumin (liver)-osmotic pressure of plasma and carrier
• globulin(liver & lymphoid tissue)- clotting, enymes, antibodies and carriers 
• fibrinogen(liver)- need for blood clotting
• transferrin- iron transport

• lymphocytes-body immune system
• monocytes-evolve into macrophages which kill of bacteria
• neutrophils-phagocytes, first to move to point of inlfammation in an infection (chemotaxis)
• eosinophils-killing bacteria and parsites
• basophils- response to allergic symptoms, and contain vasodilator histamine which promotes blood flow

platelets

• megakaryocytes
• erythrocytes
• monocytes
• granulocytes

• red blood cells
• megakaryocytes

5-6 litres

• 5000-10,000/mm³(mcl)
• lifespan 13-20 days

• specific immunity
• T-cells and B-cells
• 20-40%

• macrphages(big eaters)
• 2-8%

• phagocytes
• 50-70%

• allergic reactions/ worms 
• 1-4%

• histamine- runny nose, eyes. Stops entry of other pathogens
• <1%

• 4.2-5.4 million/ mm³ (mcl)
• lifespan= 120days 
• _{2 million per sec}

• 150,000-350,000
• lifespan= 5-9 days
• 5,000-10,000/ megakaryocyte

• males: 13.5-17.5 g/dL
• females: 12-16 g/dL

• ratio of RBC's to total blood volume
• males: 40-54%
• females: 37-47%

• lymph nodes
• bone marrow- cell production
• liver- prothrombin and fibrinogen for blood clotting
• spleen- lymphocytes, plasma cells, and antibodies

• erythropoietin- horomone that trigger red cell production
• w/o this not proper cell formation
• folic acid, B12- need for proper cell division
• iron- bind O₂ and make hemoglobin

low blood O₂ in kidney cause secretion of erythropoietin which stimulates erythropoiesis by bone marrow.  This increases RBC's, increase O_2. This help relieve intial erythropoietin secretion.

• no nucleus
• flexible
• more SA, more diffusion and more flexible
• when red blood cell old can lose felixibility and get stuck in capillaries which can cause problems

• cell shape changes with osmolarity of plasma
•  hyoptonic- more water in cell
• isotonic- same # of particles in solution and cell
• hypertonic - crenated shrivel cell
• water move to outside

• liver
• spleen

• 1,iron from diet
• 2. iron absorbed
• 3.transferrin transport Fe in plasma
• 4. liver store excess iron as ferritin
• 5. bone marrow use Fe to make hemoglobin
• 6. spleen converts to bilirubin
• 7.liver metabolize bilirubin and excrete in bile
• 8.bilirubin excreted in urine

• decrease O₂
• decrease RBC count
• dreace Hb
• decrease Hct
• iron defiency, folic acid deficiency, pernicious, hemolytic, sickle cell, aplastic

• pallor
• fatigue
• shortness breath
• headache
• irritability
• fast HR

• low Fe-> low Hb-> decrease cell size (RBC count normal)
• casues:
• _{blood loss- lose iron that want to recycle}
• _{low dietry intake}
• microcytic cells
• _{low hct}
• _{low hb}
• Treatment
• _{increase iron intake}

• need folic acid for maturation RBC/ DNA production
• causes:
• _{poor diet}
• _{over cooked vegetables}
• _{alchohol= decrease folic acid}
• Treatment
• _{increase folic acid intake}
• _{green and yellow vegetables; citrus fruits}

• not enough absorption vit B12
• B₁₂ needed for cell division
• Macrocytic cells:
• _{Low RBC count}
• _{Hct and Hb normal}
• _{RBC big in size}
• Treatment:
• monthly injection vit B₁₂

• destruction RBC
• _{antigen-antibody reaction, immune disorder}
• _{jaundice- yellow skin and eyes}
• Treatment:
• _{exchange tanfusion/ splenectomy}

• hereditary
• sickle shape RBC
• _{doesnt travel smotthly through vessels}
• no cure

• bone marrow cannot produce blood components
• casues:
• _chemotherapy
• _radiation
• _viruses 
• _toxins

• polycythemia (primary, secondary, relative)
• symptoms:
• red skin and mucous membranes
• bloodshot eyes
• increased blood volume and pressure
• enlarged spleen

• bone marrow tumor
• increase RBC b/c increase sensitivity to Epo

• high levels erythropoietin cause high level RBC
• RBC abnormal structure
• not enough oxygen cause high Epo
• ex: kidney tumor-> increase Epo-> increase RBC

• increase in Hct= less plasma so increase RBC volume
• number red blood cell normal
• ex dehydration
• danger include
• decreased oxygen 
• decreased blood flow
• increased clotting
• treatment= blood doping

• 45%=normal
• 30%=anemia
• 70%=polycythemia
• 70%=dehydration

• leukocytopenia
• leukocytosis
• neutropenia
• mononucleosis
• leukemia

• decrease WBC
• weaken immune system

• increase WBC
• normal response to small infections

• decrease neutrophils
• _{increase risk for bacterial and fungal infections}
• destruction neutrophils
• _{cancer therapy}
• _{rheumatoid arthritis ( inflammation joint surrounding tissue)}

• increase monocytes
• symptoms:
• _{fatigue, sore throat swollen glands}
• treatment:
• _{rest, analgesics( painkillers)}

• cancer
• increase immature leukocytes
• acute or chronic
• myelegenous=affecting bone marrow
• lymphocyte= affect lymph nodes 

• anemia 
• fatigue
• headache
• sore throat
• bleeding mucous membranes
• bone and joint pain
• enlarged lymph nodes, liver and spleen

• stopping bleeding
• 3mechanisms:
• _{vascular spasm-vasoconstriction}
• _{platelet plug}
• _coagulation

• clot formation (intrinsic)
• clot reaction
• clot destruction

• get sticky and adhere to collagen
• activated platelets secrete chemotaxins
• _{-ADP,serotonin and thrombaxane A2}
• attract other paltelets
• _{activate and aggregate}

• 1.collagen bind and activate platelet
• 2.release of platelet factors
• 3.factors attract platelet
• 4.platelet go into platelet plug

• prostacyclin
• _{prevent platelet aggregation}
• Nitric Oxide
• _vasodilator

Inhibit thrombaxane->decrease activation platelet->decrease clotting-> can cause heart attacks

• clotting factors-in the liver
• platelet factor- if dont have it can bruise easily
• clotting cofactor
• plasma calcium- dont have calcium slow down clotting

• shorter
• faster 
• less fibrin

• longer 
• slower
• more fibrin

• tissue factor pathway inhibitor
• _{slows extrinsic pathway}
• Protein C
• _{activated by thrombin}
• _{slow down both pathways}
• Antithrombin
• _{secreted by undamaged endothhelium}
• _{inactivates thrombin}
• Heparin, coumadin
• _{inhibit platelets}
• _{turn of blood formation and intrinsic/extrinsic pathways}

• break down of clot after healing
• secrete tPA(tissue plasminogen activator)- this comes from liver to convert to plasmin to make active and break down the clot

• hemophelia
• thrombocytopenia
• disseminated intravascular coagulation

• hereditary bleeding disorder common among males
• lack protein for clot formation
• symptoms:
• _nosebleeds
• _bruising
• _{lots bleeding}
• treatment:_{blood transfusion, clotting proteins}

• low platelet-> no platelet plug-> no coagulation
• know if you have this by platlelt vcount and bleeding time
• symptoms:
• _{abnormal bleeding}
• _{petechiae- small purple spot on skin from damaged blood vessel}
• _{ecchymoses-bruising} 
• _hematuria

• avoid tissue trauma
• vitamin K
• transfusion of platelets
• splenectomy

• abnormal clotting followed by abnormal bleeding
• followed by major trauma(surgery, complicated child birth)
• multiple clots in capillaries
• symptoms:
• _{Petechiae/ ecchymosis}
• _hematoma
• _{hematuria/ hematamesis}
• _{GI bleeding}

• Heparin
• platelets