- Produced in the kidneys.
- Stimulates Production or RBCs
Blood cell formation begins when?
2 Weeks after conception.
Blood cell formation begins where?
Mesenchymal Cells (blood islands in the yolk sac)
3 Phases of blood cell production
3 Layers of cells that develope in the blastocyst stage of the zygote.
- Central Cells
Undifferentiated stem cells differentiate into primitive erythroblasts.
Gives rise to blood islands.
Flatten to become blood vessels.
Detach and enter primitive plasma to become undifferentiated stem cells.
Hepatic stage begins when?
- Primitive Erythroblasts migrate to liver.
- Peaks during 3rd month.
- Primitive cells disappear by 4th month.
RBC production continues in liver until when?
At 6th month red bone marrow is primary site of hematopoiesis.
Newborn's and children's bone marrow is?
By Adulthood red bone marrow is?
Only in the axial skeleton.
Loss of RBCs decreases?
P O2 receptors in the brain stem stimulates.
Kidneys to release erythropoietin.
Pluripotential Stem Cell (uncomitted)
Erythropoiesis Maturation Stages
- Reticulocyte (nucleated red)
RBC Formation Time Tables
- Bone Marrow 3 days
- Spleen 1-3 Days (reticulocytes)
- Circulation 120 days (erythrocytes)
RBC Values below normal.
RBC Values above normal.
Mean Cell Volume (Cell Size)
Mean Cell Hemoglobin ( Cell Color )
Ratio of HGB to cell size (color)
- Red Cell Distribution Width
- Cell size variation
Normal RBC size
- 6-8 microns
- About the size of the nucleus of a small lymph.
- Less than 6 microns
- Less than 80fl
Microcytic Anemia Causes
- Iron deficiency Anemia
- Chronic Blood Loss
- Greater than 8 microns
- Greater than 100fl
- WNL = 0-5 / 10 oil
- 1+ = 6-15 / 10oil
- 2+ = 15-30 / 10oil
- 3+ = > 30 / 10 oil
Variation in RBC color
- Fe Deficiency Anemia
- Anemia Associated with leukemia
- Some Hemoglobinopathies (Thalassemias)
- Poikilocytosis (spherocytes, target , helmet)
- Hereditary Spherocytosis.
- Autoimmune Hemolytic Anemia
- Hemoglobinopathies (sickle cells, target cells)
- Take on target shape when slide dries.
- Too much cell membrane for the HGB.
- Associated with ABN.
- HGB and chronic liver cells.
- Shistocyte precursor.
- Fracture of cells metabolic injury or toxicity.
Ascociated with hemolytic anemia and heretitary spreocytosis.
- WNL 0-2 / 10 oil
- 1+ 2-3 / 10 oil
- 2+ 3-4 / 10 oil
- 3+ >4 / 10 oil
Tear Drop cell
- Results from "squeezing" through spleen
- Oval Egg Shaped
- Assoc with hereditary elliptocytosis.
- Fishmouth cell
- Chronic Liver Disease
- Cell deformed with irregular spiny projection.
- Connot revert to normal cell.
- Denotes serious pathological condition.
Echinocytes or Burr Cells
- Regular distribution of spiny projections.
- Can revert back to normal cell
- Crenated: Artifact from slide drying too fast.
- Deformed Cell appears half moon or spindle shaped.
- Appears to have 2 or more spicules.
- Irregularly Shaped RBC fragment with jagged pointed projections.
- Due to mechanical trauma or RBC defect
- RBC stacks or rolls
- May be an Artifact from not preparing slide soon enough after placing blood on slide.
- May be due to high concentration abnormal proteins or fibrinogen.
- Associated with multiple myelomas and macroglobulinemias.
Poikilocytosis Grading (sickle, sperocytes, acanthocytes, rouleaux)
- WNL Never Normal
- 1+ 1-5 / 10 oil
- 2+ 6-15 / 10 oil
- 3+ >15 / 10 oil
Poikilocytosis Grading (lesser Shapes)
- WNL 0-1 Normal
- 1+ 2-5 / 10 oil
- 2+ 6-15 / 10 oil
- 3+ >15 / 10 oil
- Fine dark blue Granules
- Only Found in smear not circulation
- PPT Ribosomes & RNA
Howell Jolly Bodies
- Round densly staining purple granules.
- Ussually 1-2 seen off center.
- Remnant of Nucleus DNA
- Post Splenectomy and Hemolytic Anemias
- 1-2 Small Dense Blue Purple Granulesat periphery of cell.
- IRON Deposits
- Sideroblastic Anemias & Post Splenectomy
- Lead Poisoning
- twisted or figure 8 shape
Stimulates production of