BLOOD

Blood is the specialized fluid connective tissue, which circulates through the heart,
arteries, veins and capillaries carrying nutrient materials and oxygen to body cell and
removing waste products and carbon dioxide.
CHARACTERISTICS /PROPERTIES OF BLOOD
 Bright red (Oxygenated blood).
 Dark red/Purplish (Deoxygenated blood).
 Ph range from 7.35 to 7.45 (Slightly alkaline).
 Slightly warmer than body temperature 100.4 F.
 Typical volume in adult male 5-6 liters.
 Typical volume in adult female 4-5 liters.
 Typically 8% of body weight.
 Osmotic pressure 25mmHg.
 Specific gravity 1.052-1.060.
 Taste:-Salty.
FUNCTIONS OF BLOOD
1. Respiration: - It transports oxygen from the lungs to the tissue and cabondioxide from
tissue to the lungs.
2. Excretion: - It transports metabolic wastes to the lungs, kidney, skin and intestine for
removal.
3. Nutrition: - It transports & absorbs carbohydrates, protein and lipid.
4. It maintains normal acid base balance.
5. Regulation of water balance.
6. It regulates the body temperature.
7. Transport of hormones, vitamins and salt.
8. Transport of various metabolites (Urine, Body fluid, CSF).
9. Defense against infection by the WBC.
10. Coagulation of blood by platelets.
COMPOSITION OF BLOOD
Blood is made up of:
Plasma:-55%
Blood cells:-45%
PLASMA:-55%
Composition of plasma:-
Water: 90-92% of the plasma.
Solids: 8-10% of the plasma.
The solids of plasma are:
 Plasma proteins: - Albumin, Globulin, Fibrinogen, Prothrombin.
 Inorganic salts (Mineral salts):-Sodium, Chloride, Bicarbonate, Potassium,
Magnesium, Phosphorus,iron,calcium,coper,iodine,cobalt,
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 Nutrient materials:-Monosaccharide (glucose), amino acids, fatty acids and glycerol,
vitamins.
 Organic waste materials:-Urea, uric acid, cretinine.
 Hormones: - TSH, T3, T4, Calcitonic, Insuline, Glucagon.Glucocorticoid.
 Enzyme:-Pepsinogen, Amylase, Lipage, Carbonic anhydrase, Protease.
 Antibodies:-Immunoglobulin, IgG, IgM, IgA, IgD, IgE.
 Gases:-oxygen, cabondioxide, nitrogen.
BLOOD CELLS:-45%

Red blood cells (RBC) or White blood cells (WBC) or Platelets or

Erythrocytes Leukocytes Thrombocytes
(4.5-5.5 million/cumm) (4-11000million/cumm) (2-5lakhs/cumm)

Granulocytes Agranulocytes
Neutrophils (45-75%) Monocytes (2-6%)
Eosinophils (1-6%) Lymphocytes (20-30%)
Basophils (0-1%)

T lymphocytes B lymphocytes
RED BLOOD CELLS (RBC)/ERYTHROCYTES
Erythrocytes are the non-nucleated formed elements in the blood. The red colour of these
cells is due to the presence of the colouring matter called haemoglobin. The word erythro
means red and cytes means cells.
Structure of RBC
 Diameter:-7.2µ.
 Thickness:-2.2µ.
 Surface area: 120 square µ.
 Volume:-85-90 cubic µ.
 Shaped:-Normally disc shaped and biconcave (Dumb-bell shaped).
 Mature cells are non-nucleated (no nucleus).
 No mitochondria, only anaerobic respiration.
 Normal count of red blood cell:
In adult males: - 5 millions per cubic millimeter of blood.
Female:-4.5millions/cu mm of blood.
 The average life span of erythrocyte is about 120 days.

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Functions of RBC:-
 Erythrocytes are transport oxygen from the lungs to the tissue.
 Erythrocytes are transport cabondioxide from the tissue to the lungs.
 Haemoglobin in red blood cell also functions as a good buffer .By this action, it
regulates the hydrogen ion concentration and thereby takes part in the maintenance of
acid base balance.
 Red blood cells carry the blood group antigens like A Agglutinogen, B Agglutinogen,
and Rh factor. This helps in determination of blood group and blood transfusion.
HAEMOGLOBIN
Haemoglobin is the colouring matter of red blood cells. It is a chromoprotein forming
95% of dry weight of red blood cells and 30 -40% of wet weight. It contains globin a
protein which conjugated with heme (haemoglobin = hem+globin).
Types of haemoglobin
1. Oxyhaemoglobin: - Oxyhaemoglobin is the combine form of haemoglobin and oxygen
which is found in arterial blood and is the oxygen carried to the body tissues.
2. Methemoglobin: - A compound formed from hemoglobin by the oxidation of its
ferrous iron to ferric iron by injury or toxic substances.
2. Carboxyhaemoglobin: - The Inhaled carbon monoxide combines with haemoglobin
binding more tightly than oxygen and rendering the haemoglobin incapable of
transporting oxygen is known as Carboxyhaemoglobin.
Normal values of haemoglobin
Average hameoglobin contain in blood is 14 – 16 gm%
 In adult male, it is 15gm%
 In adult females, it is 14.5gm%
 Children (Up to 1 year):-11 -13 gm%
 Infants: - 14-19 gm%
Functions of haemoglobin
 It transports respiratory gases (oxygen and carbondioxide).
 It maintenance of acid base balance.
 It reserves iron and proteins.
ERYTHROCYTE DISORDERS
ANAEMIA: - Qualitative and quantitative reduction of red blood cell count, haemoglobin
content and packed cell volume (PCV) is called anaemia.
POLYCYTHEMIA:- Polycythaemia is the disease characterized by excess RBCs count
in the blood. This increases blood viscosity, slows the rate of blood flow and increases
the risk of intravascular clotting, ischaemia and infraction.
WHITE BLOOD CELLS (WBC)/LEUKOCYTES
Leukocytes are the colourless and nucleated formed elements of blood. Leukocytes play
very important role in defense mechanism of body. It depends upon the presence or

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absence of granules in the cytoplasm. Total WBC count (TLC or TC):-4000-
11000/cumm of blood.
Classification of WBC
(i) Granulocytes:-The presence of granules
 Neutrophils
 Eosinophils
 Basophils
(ii) Agranulocytes: - The absence of granules
 Monocytes
 Lymphocytes
Neutrophils
 Neutrophils have fine granules or small granules in the cytoplasm.
 The nucleus is multilobed.
 The diameter of cell is 10-12 microns.
 Normal range: - 50-70%, 3000-6000/cumm of blood.
 Life span of Neutrophils may be 2-5days.

Eosinophils
 Eosinophils have large granules in the cytoplasm.
 The nucleus is bilobed.
 The diameter of the cells varies between 10 and 14 microns.
 Normal range: -2-4%, 150-450 /cumm of blood.
 Life span of Eosinophils: - 7-12 days.

Basophils
 Basophils also have larger granules in the cytoplasm.
 Nucleus is bilobed.
 Diameter of the cell is 8-10 microns.
 Normal range: - 0-1%, 0-100/cumm of blood.
 Life span of Basophils: - 12-15 days.

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Monocytes
 Monocytes are the largest leucocytes with diameter of 14-18 micron.
 The cytoplasm is clear without granules.
 The nucleus is round, oval horse shoe or kidney shaped.
 Normal range: - 2-6%, 200-600/cumm.
 Life span of Monocytes: - 2-5 days.

Lymphocytes
 The lymphocytes also have clear cytoplasm without granules.
 The nucleus is oval or kidney shaped occupying the whole of the cytoplasm.
 the lymphocytes are divided into two types depending upon the size and function:
T-Lymphocytes:-concerned with cellular immunity.
B-Lymphocytes:-concerned with humoral immunity.
 Normal range: - -20-30%, 1500-2700/cumm of blood.
 Life span of lymphocytes: - 1/2-1 day.

FUNCTIONS OF WBCs
1. Protection against infection: - This is done by neutrophils and monocytes which
engulf bacteria. This is process is called phagocytosis.
2. To aid in the repair of injured tissues.
3. To produce immune substances which defense against disease. This is done by
lymphocytes through the synthesis of gamma globulin.
4. Basophils secrete an anticoagulant substance called heparin.
LEUKOCYTE DISORDERS
1. Leukopenia:-Leukopenia is defined as decreased white blood cells (WBC) count. It is
a blood disease in which the number of circulating white blood cells diminishes to a
great extent. Leukopenia usually caused by a decrease in the granulocyte numbers,
particularly the blood neutrophils.
2. Leukocytosis:-Increase in number of circulating WBCs above 1100/mm.It can be
physiological and pathological.
3. Leukaemia:-The leukemia is the condition, which is characterized by abnormal
uncontrolled increased and premature leukocyte count up to 1000000/cumm. It is also
called as blood cancer.
4. Neutrophilia:-Neutrophilia is a condition, characterized by increase in Neutrophils
count.
5. Eosinophilia:-Eosinophilia is a chronic disorder resulting from excessive production
of eosinophils cells.

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6. Basophilia:-Basophilia is a condition characterized by the increase in the basophiles
count.
7. Monocytosis:-Monocytosis is a condition characterized by the increase in the
Monocytes count.
8. Lymphocytosis:-Lymphocytosis is the condition characterized by the increase in the
Lymphocyte count.
PLATELETS/THROMBOCYTES
 Platelets or Thrombocytes are small colourless, nonnucleated and moderately
refractive bodies. These formed elements of blood are considered to be the fragments
of cytoplasm.
 Diameter is 1-4 micron.
 Shaped: - Normally, the platelets are spherical or rod shaped and become oval or disc
shaped when inactive. Sometimes, the platelets are of dumbell, comma, cigar or any
other unusual shape.
 The life span of platelet is 7-14 days.
 The normal range of platelets count is 1.5-4 Lakh/cumm of blood.

Functions of platelets:-
 Platelets are essential part of blood coagulating mechanism.
 They close minute lesions in the walls of blood vessels.
HAEMATOPOIESIS
Haem means blood poiesis means synthesis. The maturation, development, and
formation of blood cells are called haematopoiesis.
Site of blood formation:-
Fetus less than 2 month: - Yolk sac.
2-5 month:-Liver and Spleen (Haepatic phase).
Adult life:-Bone marrow (Myeloid phage).
Stages of haematopoiesis:
 Erythropoiesis
 Leukopoiesis
 Thrombopoiesis
ERYTHROPOIESIS
The formation, maturation and development of red blood cell (erythrocyte) is called
erythropoiesis.
Stages of erythropoiesis:
Bone marrow stem cells

Pronormoblast

Basophilic (Early) normoblast

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 Polychromatic (Intermediate) normoblast

Orthochromatic (Late) normoblast

Reticulocyte

Erythrocyte
The process of development of red blood cells from pluripoment stream cells takes about
7 days. Vitamin B12 and folic acids are required for synthesis of red blood cells. They are
absorbed in the intestine.
CLOTTING OF BLOOD (HAEMOSATSIS)
Clotting of blood is a defence mechanism of the body. It prevents loss of blood from the site of injury.
If a leak develops in blood vessels, a clot is formed and it plugs the leak. This prevents the loss of
blood.
Mechanism of clotting
Clotting of blood occurs in the following stages:
 Thromboplastin is liberated from disintegrated tissues and damaged platelets.
 Thromboplastin converts Prothrombin into thrombin .this occurs in presence of calcium ions.
 The insoluble fibrin forms threads. The formed elements of blood get entangled in this and form
the clot.
Tissues and
Platelets Thromboplastin
Ca++
Prothrombin Thrombin

Fibrinogen fibrin

Blood cells clot

Clotting factors
Coagulation of blood occurs through a series of reactions due to the activation of a group
of substances. Those substances necessary for clotting are called factors. Thirteen factors
are identified.
FACTOR I Fibrinogen
FACTOR II Prothrombin
FACTOR III Thromboplastin
FACTOR IV Calcium
FACTOR V Labile factor (Proaccelerin or accelerator globulin)
FACTOR VI Pretense has not been proved
FACTOR VII Stable factor
FACTOR VIII Antihemophilic factor
FACTOR IX Christmas factor
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FACTOR X Stuart-Prower factor
FACTOR XI Plasma Thromboplastin antedent
FACTOR XII Hegman factor (contact factor)
FACTOR XIII Fibrin stabilizing factor (Fibrinase)
Clotting time
It is the time taken for the clotting of human blood removed from circulation. The
average clotting time varies from 5 to 15 minutes.
DISORDERS OF CLOTTING
1. Haemophilia:-Haemophilia is a bleeding disorder in which clotting time is
prolonged but bleeding time remains normal. It results due to deficiency of clotting
factor either factor VIII of factor IX.
2. Thrombosis:-A blood clot formed within the heart or blood vessels from constitutes
of the blood, obstruction the blood vessel.
BLOOD GROUPS
Blood groups are determined by protein molecules present on the surface of red blood
cells or cell membrane. Discovery of blood groups was done by the Austrian scientist
Karl Landsteiner in 1901.He was honored with Nobel prizes in 1930 for this discovery.
Types of blood group
 ABO system
 RH factors
ABO system
According to this system entire population is divided into four different blood groups.
There are four different groups in this system. They are labeled according to type of
agglutinogen present on red blood cell membrane.
 Persions having “A” agglutinogen are called “A” group Persions.
 Persions having “B” agglutinogen are called “B” group Persions.
 Persions having “A” and “B” agglutinogen are celled “AB” group Persions
 Persions having no agglutinogen called “O” Persions.
Thus there are four blood groups A, B, AB, O.Each agglutinogen is capable of
combining with a specific antibody called agglutinin present in plasma. If particular
agglutinogen is absent in Persions RBCs corresponding agglutinin is present in
plasma.therefor:
 “A” group person has anti –B or beta agglutinins.
 “B” group person has anti- A or alpha agglutinins.
 “AB” group person does not possess agglutinins.
 “O” group person contains alpha and beta both agglutinins in plasma.

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Rhesus factor (Rh factor)
Experiments done by Winer and Levine in 1940 on Indian brown rhesus monkey
describes that antigens present on surface of RBC called Rhesus factor (Rh factor). The
antigen presents on the surface of RBC that is called Rh-positive .If Rh antigen is not
present on the surface of RBC that is called Rh-negative. Rh-positive and Rh-negative
blood group is not mixed with each other. Blood cannot be given to a patient with
different Rh factor.
Purpose of blood grouping
 Blood transfusion: - If the non match blood will transfuse to the patient then there will
be antigen antibody reaction and hemolysis will occur.
 To prevent Hemolytic disease of new born.
 Relationship of blood groups, susceptibility to various diseases.
ERYTHROBLASTOSIS FOETALIS
It is clinical condition, If Rh –ve mother has Rh +ve fetus, at the time of delivery fetal
RBCs enter maternal circulation and cause sensitization leading to formation of
agglutinins against Rh in large quantity. If next time this woman becomes pregnant
and bears Rh +ve fetus, agglutinins can enter from mother to fetus leading to
agglutination of fetal red blood cells and hemolysis. Severe hemolysis in fetus causes
jaundice. To compensate hemolysis more and more number of red blood cells are
needed not only from bone marrow but also from liver and spleen. Now many large
and immature proerythroblastic stage are released in circulation because of this only
disease is called Erythroblastosis fetalis. Ultimately due to excessive hemolysis
anemia occurs and the infant dies because of severe anaemia.

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