C hapter

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Hematology

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© Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION Outline

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© Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION KEY TERMS

Agglutination: The clumping of red blood cells following a Introduction transfusion reaction. Hematology Agranulocytes: Leukocytes without granular cytoplasm. Red Blood Cells Albumins: The smallest of plasma make up Learning, LLC White Blood Cells© Jones & Bartlett Learning, LLC © proteins; Jonesthey & Bartlett around 60% of these proteins NOT by weight. Platelets FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION Antibodies: Agglutinins; gamma globulin proteins that respond Plasma to specific antigens. Hemostasis Antigens: Agglutinogens; red blood cell surface molecules Serum that react with antibodies from the plasma. Plasma Basophils: Leukocytes fewer granules than Appearance of Serum and Plasma © Jones & Bartlett Learning, LLC © Jonesthat&have Bartlett Learning, LLC eosinophils, which become deep blue in basic stain. Blood Clotting NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION B cells: Lymphocytes that are responsible for humoral Blood Types and Transfusions immunity. Summary Bilirubin: An orange pigment formed from biliverdin that has Critical Thinking potent antioxidant activity; bilirubin is orange and excreted Websites along with biliverdin in the bile. Review Questions

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© Jones & Bartlett Learning, LLC Biliverdin: A green pigment created from decomposing heme, NOT FOR SALE OR which is converted to DISTRIBUTION bilirubin. Coagulation: The formation of a blood clot.

After studying this chapter, readers should be able to: Colony-stimulating factors (CSFs): Glycoproteins that can 1. Distinguish between the formed elements and the cause the proliferation and differentiation of leukocytes. liquid portion of the blood. Embolus: A clot that dislodges or fragments, to be carried 2. Explain the characteristics of red blood cell counts. © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC away in the blood flow. 3. Describe erythropoiesis and the sites of production Eosinophils: Leukocytes with coarse, granules NOTsame-sized FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION of erythropoietin. that appear dark red in acid stain. 4. Distinguish between the five types of white blood Erythropoiesis: The process of developing erythrocytes (red cells and discuss their functions. blood cells), which mostly occurs in the red bone marrow 5. Describe the functions of each of the major (myeloid tissue). components of blood plasma. Erythropoietin: A hormone uses negative feedback LLC to © Jones & Bartlett Learning, LLC © Jones &that Bartlett Learning, 6. Describe the characteristics of platelets and their control the rate of red blood cell formation. NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION functions. Fibrin: Insoluble threads of protein made from the plasma 7. Define hemostasis and explain the mechanisms protein fibrinogen. that help achieve it. Fibrinogen: A plasma protein that is important for blood 8. Explain what prevents the formation of massive coagulation. It is the largest plasma protein. clots throughout the cardiovascular system. Globulins: Antibodies made by the liver or lymphatic tissues © Jones & Bartlett 9. ExplainLearning, blood typingLLC and how it is used to avoid © Jones & Bartlett Learning, LLC that make up around 36% of the plasma proteins. reactions to blood transfusions. NOT FOR SALEadverse OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION 10. Distinguish between a thrombus and an embolus. © Jones and Bartlett Publishers. NOT FOR SALE OR DISTRIBUTION

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CHAPTER 6  Hematology

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© Jones & Bartlett Learning, LLC nitrogenous substances: Amino acids, urea, and NOTNonprotein FOR SALE OR DISTRIBUTION

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uric acid in the plasma. Granulocytes: Leukocytes with granular cytoplasm, including Plasma: The liquid portion of blood. neutrophils, eosinophils, and basophils. Plasma cells: Specialized B cells that form and secrete Hematocrit (HCT): The volume percentage of red blood cells antibodies. in a sample of whole blood. Plasma proteins: The most abundant solutes (dissolved Hematology: The study blood and&blood disorders. ©ofJones Bartlett Learning, LLC © Jones & Bartlett Learning, LLC substances) in the plasma. Hemoglobin: The substance red blood cells that NOT FOR SALE ORofDISTRIBUTION NOT inFOR SALE ORcarries DISTRIBUTION Platelets: Thrombocytes; platelets are cytoplasm fragments oxygen. megakaryocytes that are important in blood clotting. Hemostasis: The stoppage of bleeding. Polymorphonuclear leukocytes: White blood cells with Interleukins: Hormones upon which many of the effects of segmented lobular nuclei, such as neutrophils. leukocytes depend. Prothrombin: An alpha globulin made in the liver that is Leukocytes: White cells; they protect theLLC body against © Jones & blood Bartlett Learning, © Jones & Bartlett Learning, LLC converted to thrombin. disease and develop from hemocytoblasts in red bone NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR Red blood cells (erythrocytes): Those redDISTRIBUTION blood cells that marrow. transport gases, including oxygen. Leukocytosis: A condition of white blood cells exceeding Serotonin: A substance that contracts smooth muscles in 10,000 per cubic millimeter (microliter), indicating an acute blood vessels, reducing blood loss. infection. Serum: The clear, yellowish liquid that remains after clot Leukopenia: A condition of the total white blood cell count © Jones & Bartlett Learning, LLC © Jones & Bartlett LLC and some, but formation; serum is Learning, plasma minus fibrinogen being below 5,000 per cubic millimeter (microliter); this not all, of its clotting factors. NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION signifies conditions such as influenza, AIDS, and others. T cells: Lymphocytes that are responsible for cell-mediated Lymphocytes: Leukocytes with large, round nuclei inside a immunity. thin cytoplasm rim. Thrombin: A substance that causes fibrinogen to be cut into Macrophages: Cells that phagocytize and destroy damaged sections of fibrin and then joined into long threads as part of red blood cells, mostly in the liver and spleen. the clotting process. Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC Mast cells: Connective©tissue cells that, during allergic Thrombocytes: See platelets. reactions, release histamine and heparin. NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION Thrombopoietin: A hormone that causes megakaryocytes to Megakaryocytes: Red bone marrow cells that fragment to develop from hemocytoblasts, resulting in eventual platelet produce platelets. (thrombocyte) formation. Monocytes: Leukocytes that are the largest type of blood Thrombus: A clot that forms abnormally in a vessel. cells, with varied nuclei. Vasospasm: action of muscle contraction in a small blood Natural killer (NK) cells: Lymphocytes responsible © Jones & Bartlett Learning, LLCfor ©AnJones & Bartlett Learning, LLC vessel that occurs after it is cut or broken; this action can immune surveillance; they are important in preventing NOT FOR SALE OR DISTRIBUTION NOT FOR ORvessel. DISTRIBUTION completely close the endsSALE of a severed cancer. White blood cells: See leukocytes. Neutrophils: Leukocytes with small granules that appear light purple in neutral stain; older neutrophils are called segs while younger neutrophils are called bands.

© Jones & Bartlett Learning, LLC © Jones &approximately Bartlett Learning, LLC wastes (see Figure 6–1). An average adult has NOT FOR SALE OR DISTRIBUTION FOR SALE 4 to 6 L of blood. The blood is made upNOT of cells, fragments of OR cells, DISTRIBUTION and dis-

Introduction

solved biochemicals containing nutrients, oxygen, hormones, Hematology and wastes. It helps to distribute body heat and maintain Hematology is the branch of medicine that is concerned with stable interstitial fluid. Blood is actually a connective tissue the study of blood and blood disorders. The blood transports with its cells suspended in a liquid, extracellular matrix. It © Jones & Bartlett Learning, LLC erythro- oxygen, nutrients, © Jones & waste Bartlett Learning, LLC cellular products, and hormones is heavier and thicker than water. Blood contains NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION throughout the body. It is involved in heat distribution, procytes (red blood cells), platelets, and leukocytes (white blood tection against infection, and the regulation of acid–base cells). Red blood cells (RBCs), white blood cells (WBCs), and balances. Hematology is a major component of the clinical platelets are collectively called formed elements. The liquid laboratory. Phlebotomists must be familiar with the composiportion of blood is called plasma. Blood volume represents about 7% of a person’s body weight. tion and normal values of the blood. They must also under© Jones & Bartlett Learning, © Jones & Bartlett LLC Plasma contains water, LLC amino acids, carbohydrates, lipstand common bloodLearning, diseases and conditions. This chapter ids, proteins, electrolytes, vitamins, and cellular examine the structure and functions of the blood, which NOT FOR SALE OR hormones, DISTRIBUTION NOTwill FOR SALE OR DISTRIBUTION © Jones and Bartlett Publishers. NOT FOR SALE OR DISTRIBUTION

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Hematology

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© Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION Withdraw blood

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© Jones & Bartlett Learning, LLC White blood cells NOT FOR SALE OR DISTRIBUTION Red blood cells

Plasma (55% of whole blood)

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White blood cells© andJones & Bartlett Learning, LLC platelets (