Understanding Blood and Its Functions

all right class so welcome back after spring break here we are with chapter 11. it's a chapter on blood where we'll talk about kind of what makes up blood and why is it important um yes druid i just got your message i'll respond to you after this but yeah we can work that out for sure so as we go through this chapter this is what i told these guys before kind of an introductory chapter as we start to talk about the cardiovascular system which are is your heart and arteries and veins that carry the blood but first we kind of focus on blood itself because blood has a lot of unique functions that are really important for the body some of the functions are blood of blood are it transports all of your oxygen and carbon dioxide to the various tissues that need it and then it gets rid of carbon dioxide from all of your cells as a way to getting rid of that waste product it transports all nutrients all other waste products that could be ions it transports processed molecules it transports regulatory molecules your blood regulates your ph levels in the body um it helps with osmosis so the diffusion of water into and out of blood uh your blood helps to maintain body temperature so your blood vessels itself will constrict or dilate to allow blood flow to various parts of the body that influence your body temperature and your blood um provides protection against foreign substances within your blood you have the red blood cells but you also have white blood cells which are part of your body's immune system uh that help fight off all infection viruses bacteria and blood has what we call platelets within it to help with forming clots which are very helpful if you damage a blood vessel and you start to bleed for your blood to be able to clot to stop the exit of blood into the surrounding tissues so what is blood made of um it's mostly plasma so about 55 of your blood is this kind of liquid that surrounds the blood cells and we call that liquid the plasma it's mostly made up of water but there are proteins um and other solutes within that plasma so kind of within our composition of blood we have plasma which is kind of the water-based material and then we have the formed elements which include all of the cells the different cells in your blood and that makes up about 45 of let's say a blood sample all the cells the cell fragments these cells include erythrocytes which are red blood cells and then leukocytes are white blood cells and thrombocytes are the cells that will go on to kind of break apart to form the platelets which help in blood clotting so that is what makes up your blood um some of the proteins in the blood itself or specifically in the plasma are albumin globulins and fibrinogen and these proteins are really important again for different functions so here we have albumin which makes up more than half of the proteins in your plasma and that helps to maintain the balance of the blood violence helps your immune system and fibrinogen helps to create different fibers to help with clot formation so those are some of the proteins in your plasma many of you have probably gotten a blood sample taken um through venipuncture or many of you have might even know how to do this if you're trained in phlebotomy um so taking a blood sample what they are looking for are cell numbers in your blood or dif other substances to help determine if you have some sort of disease or disorder so when they initially take the blood out of the cubital vein kind of in the elbow they'll take it and it'll just be a vial and then what they do is they centrifuge that blood sample down that means they spin it extremely quickly and when you centrifuge or spin the blood sample very quickly the blood will kind of separate into natural layers all the formed elements which are all of the blood cells sink to the bottom of the sample because they're a lot denser the plasma which again is made up of mostly water floats to the top and remember in plasma you know we have mostly water but we also have proteins and other solutes you can see some of those listed there the buffy coat is kind of this um like a white color kind of separation that kind of separates the plasma from the formed elements um within this buffy coat you can see um i guess they don't really list what is in the buffy coat you have platelets and white blood cells within the buffy coat um so within that buffy coat are all of your platelets which help with blood clots and then your white blood cells and the white blood cells we you have five different types of white blood cells neutrophils lymphocytes monocytes acenophylls and basophils and these five different types of white blood cells each have a specific function to help your immune system so to help fight off infections so let's say a virus gets into your blood um one of these five white blood cells has the specific function to either eat up that virus to fight it off to try to degrade it so five different types of white blood cells and they each have a different function to help protect your body against anything foreign that could enter the tissue and the blood and then way at the bottom we have the red blood cells they're the densest so they stink to the bottom and that makes up the majority of the formed elements your red blood cells so that's the composition of blood so again medical professionals they take your blood sample they spin it down and then they're able to determine you know what are your glucose levels what are other ion levels what are your neutral lymphocyte monocyte levels specific levels of these white blood cells can tell if your body's fighting off an infection usually your white blood cell counts are elevated um if there is a problem because it means your body's trying to fight off an infection so really interesting there a lot you can tell just from taking a blood sample and that's usually what they do first if you you're at the doctor and they don't know what's wrong with you they take a sample of your blood hematopoiesis so hematopoiesis is a long name for the process that produces formed elements specifically the blood cells so in the fetus in the womb hematopoiesis occurs in several different types of tissues the liver the thymus the spleen your lymph nodes and the red bone marrow but then after birth and through you know childhood adulthood hematopoiesis the ability to form new blood cells is confined mainly to your red bone marrow which is inside your bones but some of your white cells are produced in different lymphatic tissues throughout the body uh hematopoiesis is very interesting because all of your formed elements of blood whether it's a white blood cell a thrombocyte a red blood cell they're all derived from a single population of cell a stem cell called a hemocytoblast so all your different blood cells kind of come from one stem cell and then they will differentiate to give rise to all the different cell lines each of which will end in a particular type of cell formed and this just shows you if we're looking here this is the stem cell of your blood cells your formed elements the hematocytoblast so all of your blood cells will start as a hematocytoblast then they'll either go down the myeloid stem stem cell line or the lymphoid stem line and if it's in the myeloid stem line it will eventually differentiate into what you see down here a red blood cell a platelet basophil acenophyll neutrophil and monocyte which are these again are four types of white blood cells and then if it kind of differentiates down the lymphoid stem cell line it just becomes a lymphocyte which is your fifth type of white blood cell so it's kind of interesting how all of your red blood cells all kind of start as one stem cell and then they will differentiate into all these different types through hematopoiesis which is just the development of these different blood cells erythrocytes so the stem site always means cell and erythro means red so erythrocyte is a red blood cell we often you'll often see that abbreviated as rbc um it's kind of a disc shaped cell with very thick edges so you'll notice there's kind of like an indentation on both sides of these cells so it kind of has the shape of a donut but without the center out it's just indented on both sides red blood cells do not have a nucleus so during development the nucleus is lost they live for about 120 days in your bloodstream and their primary function is to transport oxygen to tissues so because it doesn't have a nucleus it just leaves extra space in the red blood cell to transport all this oxygen to all the tissues that desperately need oxygen so those are red blood cells and this is a scanning electron microscope image so if that means it's zoomed in on a blood sample at about 2600 times magnified and blood samples normally are filled up with red blood cells um if you see something that has like a jagged edge it is a different color that's a white blood cell and anything smaller would be a platelet which again helps with um climbing their blood hemoglobin this is how oxygen gets transported in your red blood cells hemoglobin is a type of protein it's the main component of your erythrocytes and hemoglobin is what transports oxygen that's the only thing one of the few things you remember from today i'm just trying to get that in your head hemoglobin transports oxygen it's made up of globin proteins attached to a heme molecule in the center and each heme contains an iron atom and this iron atom is what will bind to oxygen so oxygen binds to the iron that's kind of at the center of this hemoglobin molecule if we have a hemoglobin with oxygen attached we call it oxyhemoglobin and hemoglobin that does not have oxygen attached is called deoxyhemoglobin so these this is the hemoglobin molecule it's a protein that's made up of four different globin kind of chains you can see here these different chains um one two three four so this is hemoglobin um you can see at the center of each chain is this heme group and this heme group is what we kind of zoom in it has an iron center and that's what the oxygen attaches to so really simply put because we have four kind of chains we have four heme groups and again each heme group can attach to one oxygen molecule so what this means is that one hemoglobin and i'm going to abbreviate hemoglobin as hb one hemoglobin can hold for transport up to four oxygen molecules because each oxygen gets attached to each one of these four chains so that is hemoglobin the reason why red blood cells can transport oxygen how are erythrocytes produced so we talked about how your red blood cells can only live for about 120 days which is what about four months in um in the body so your bodies need to constantly be producing more red blood cells if you have a decreased oxygen level your kidneys will increase production of a hormone called urethral pollutant and erythropoietin tells the red bone marrow to stimulate the production of more erythrocytes red blood cells and increased erythrocytes causing increase in your blood oxygen levels and this is why athletes train at higher elevations because there's they're kind of tricking their bodies into creating more red blood cells because they're at a higher elevation their body thinks they have decreased oxygen levels so athletes who train at higher elevations their bodies are producing more red blood cells so then when that athlete goes back down to sea level they have a ton of red blood cells so their red blood cells in turn will carry more oxygen to their muscle tissues that need it for their athletic event so red blood cell production let's say you have a decrease in blood oxygen your kidneys will produce production of this hormone called erythropoietin which tells the red bone marrow in your bones to produce more red blood cells more red blood cells means more oxygen in your blood because red blood cells carry oxygen what happens to old erythrocytes so where do they go and what happens to old hemoglobin old red blood cells are removed from their blood by a cell called a macrophage in the spleen in the liver so what a macrophage does is it kind of breaks down red blood cells into the component parts hemoglobin is broken down globin which makes up the chains of hemoglobin is broken down into the specific amino acids that created it the iron is recycled to be used for more hemoglobin production in the future and the heme group is converted to bilirubin bilirubin is actually taken up by your liver and then um produced or kind of changed into bile and released in the small intestine and bile is important um to help digest your fats in your small intestines so your body is very good at recycling and you're using different parts of hemoglobin and your red blood cells when they're broken down so this just takes you through the steps of hemoglobin breakdown i don't think you need to know specific steps um but in general you know where does this occur so hemoglobin so you have you know damaged red blood cells that are too old or they've been damaged by something else they get taken to the spleen in the liver where all damaged red blood cells go and then they get broken apart the hemoglobin gets kind of broken into its component heme groups globin groups globin groups get broken down into their individual amino acids the heme group gets converted into bilirubin and bilirubin is kind of taken back to the liver where it's transferred or kind of changed into bile and bile is what the liver secretes into your small intestine to help with digestion um any other bilirubin derivatives or waste products can also be taken to the kidney for processing um iron could be taken to the spleen iron will be taken back into the bone marrow to be used again and recycled and more red blood cell production so that's just a little bit how we break down hemoglobin and we use the components of it so we talked about red blood cells now we're going to go on and talk about our leukocytes and another word for a leukocyte is a white blood cell and we often abbreviate this wbc so leukocytes are white blood cells they do not have hemoglobin because they're not transporting oxygen they're much larger than erythrocytes so if you look at a sample of blood and get this involved you'll see different samples of blood under a microscope so they'll be much larger than your red blood cells they will contain a nucleus and the big functions of leukocytes are to fight off all infections and remove any dead cells and other debris that are in your blood by phagocytosis which kind of means eating eating them up so those are leukocytes we have two kind of classes of leukocytes they're either granulocytes or a granulocytes and granulocytes contain specific kind of granules or specks in them and there's three types of the granulocytes we have neutrophils acinophils and basophils so underneath the microscope when you're looking at a granulocyte you can see kind of specks for these tiny granules in them neutrophils are the most common and they remain in your blood about 10 to 12 hours and then they move to tissues and they are phagocytes which means they help eat up and get rid of any extra debris that your body might need to get rid of so those are neutrophils the most common acinophils help to reduce inflammation they help to destroy parasites in the body and basophils are the least common leukocytes and heparin which help aid also in the inflammatory response as well so those are the three types of granulocytes and then i told you you have five total types of leukocytes so the other class of leukocyte is that a granulocyte means they do not have granules so when looking under a microscope these type of leukocytes will look kind of smooth in one of these little specks of extra material in them the monocyte is the largest sized white blood cell and it will produce macrophages again which will help eat up or get rid of anything foreign a lymphocyte is a part of an immune response and lymphocytes are very important because they go on and produce several different types of cells specifically t cells and b cells which have very specific functions to help fight off infection and lymphocytes are also important because they lead to the production of the antibodies which are very important in your body antibodies are little proteins that help also help destroy anything foreign that might have entered into the body so lymphocytes are kind of have a lot of functions to them because they will go on and create even more types of cells so underneath the microscope here are different types of cells the tops three are our granulocytes neutrophils basophils and acetophylls and then the bottom two are a granulocytes the monocytes in the lymphocytes and we'll go over you know a little bit more in lab what they look like and what how you can tell the difference between between all five they all kind of differentiate nuclei so some have a nucleus that has lobes to them um some are just kind of very circular in shape others stain a particular color always so in lab we'll go over kind of how to differentiate the different types of leukocytes too and then platelets are kind of our third type of formed element in your blood and platelets are my new various fragments of cells each scene of a small amount of cytoplasm surrounded by a cell membrane and they're produced in red bone marrow from a large cell called a megakaryocyte and what happens is small fragments kind of break off of the megakaryocytes and those are what are our platelets and platelets help to play a very important role in preventing blood loss by helping with blood clotting so if the blood in the blood vessel is damaged let's say you're cutting vegetables and you accidentally slice your finger you're cutting through blood vessels in your fingers so that is how the blood comes to the surface and it starts to leak out what platelets do is they'll try to form a clot at that place of damage to try to stop blood from leaking out blood can also leak into other tissues inside the body and that's you know internal bleeding can disrupt normal function as well and blood that is lost if there's a significant amount of blood loss that must be produced or replaced by producing more blood cells or by a transfusion and this is how our bodies try to prevent blood loss if there is some sort of damage to a blood vessel you know from a little cut or split during your skin to a more you know a bigger damage to the body itself vascular there's kind of three main steps that occur that the body goes through to help prevent blood loss vascular spasm means temporary constriction of a blood vessel so the blood vessel that's damaged will try to constrict to try to decrease the amount of blood that's flowing through it a platelet plug is when platelets nothing okay all right guys give me a second [Music] it's back now okay okay now that you guys hear me okay thanks for letting me know i'm not sure what happened let me check my internet real quick from my internet just kind of okay so how long have you not been able to hear me for the best you know thanks for letting me know guys i think my internet i just got a message that was unstable so let me know if it goes away again okay so vascular spasm is just an immediate but temporary constriction of your blood vessel usually in an artery um where the smooth muscle constricts the wall of the blood vessel so that it closes off the vessel so it stops the flow of blood through it um a vascular spasm usually chemicals released by the cells will help stimulate the vascular spasm um these specific chemicals will be released when the blood vessel wall is damaged and the platelets can also stimulate a vascular spasm the platelet plug formation is kind of our next step to help maintain integrity and to try to stop blood from leaving the formation of what we call a platelet plug is a series of steps but everything kind of happens at the same time platelets will stick to exposed collagen on the damaged blood vessel walls the platelets kind of come to the area of damage stick to the blood vessel wall and after they kind of stick to that collagen in the damaged blood vessel while they become activated they change shape and they release chemicals to kind of keep calling all their platelet friends to continue coming to that area of damage in what we call platelet aggregation we're adding more and more platelets to the area of damage but we're also adding um fibrinogen protein which helps to form bridges between fibrinogen receptors on the platelets and this these fibrinogen they produce all the fibers that kind of form what we call a platelet plug and i think i have a picture here you know the formation of a platelet plug these steps kind of all happen at the same time and again you know for your exam i don't think you need to know the specifics of these series of steps but it's just good to know how your body stops blood loss from occurring so we have a damaged blood vessel wall here so you see exposed collagen and you can see how the platelets are kind of attaching to the exposed collagen fibrinogen comes in and binds and kind of connects platelets together via these fibrinogen receptors so it forms fibers that are connecting the platelets together and this is what forms the plug of platelets to try to stop blood loss from occurring again this isn't very you know this is like slicing your finger if you're cutting vegetables um you know if you are in a serious accident where i don't know i don't know i'm trying to think of you know something like this severs off your arm um a platelet plug formation will not stop that blood loss so this is four times smaller from smaller accidents blood clotting then so blood can be transformed from a liquid to a gel and this is a good thing to help in damaged blood vessels to try to get your blood to clot this is a bad thing if your blood can't break up these clots and these clots could travel to your heart to produce a blockage in your arteries blood clots can travel to your lungs to produce a blockage in some of the arteries in your lungs or blood clots can travel to the brain to produce a blockage in the brain so in general you know blood clots are good because they're supposed to stop blood from leaking into surrounding tissues but you can have too many blood clots and that can lead to problems too okay so the ability to change blood from a liquid to a gel this creates a clot and a clot is a network of proteins called fibrin that can trap blood cells and fluid and a clot depends on clotting factors which are different proteins in the plasma they are activated following an injury so when your body gets injured they send out these clotting factors um they're made in the liver and they require vitamin k and clotting factors will go and tell your blood cells to produce a clot to try to keep damage from getting worse here are the steps in clot formation and again knowing these specific steps i don't think you'll be required to know all specifics but when your blood vessel is injured this causes inactive clotting factors to become activated due to exposed connective tissue what that means is when you cut through blood vessel while you're exposing connective tissue so that will release kind of this activation of these clotting factors or the release of a protein called thromboplastin prothrombinase a clotting factor is formed and acts upon the prothrombin prothrombin gets added to thrombin thrombin activates fibrinogen um into its active form of fibrin and fibrin forms these network of fibers that traps blood to clot it up so those are the steps in clot formation we have a lot of activating of different proteins to produce a clot so you know it starts with an injury to a blood vessel because again any cut any significant damage would you know cut through a blood vessel so that would cause a leakage of blood either externally or internally injury to a vessel um expose this connective tissue and this is a big step because then when that connected tissue is exposed it releases chemicals that will activate clotting factors specifically prothrombinase that activates prothrombin into thrombin which activates vibration into fibrin to help form the blood clots so steps in clot formation we just have a variety of steps activating different proteins to eventually form our plot which is what we want we do have to control the formation of clots because as i told you in the beginning you know if you have too many clots they could spread throughout the body and again the three worst places for plots to spread are your hearts your lungs or your brain anything that disrupts blood flow to those three major organs is not good so we have anti-coagulants which help to prevent clots from forming or controlling their spread or getting rid of clots after they've formed and done their job so you have natural anticoagulants in your body heparin and antithrombin that makes sense because throbbing was the protein that was used to activate clots so an anti-thrombin would get rid of them the injury causes enough clotting factors to be activated so that anticoagulants can't work in that particular area of the body so you know you should never be worried that oh no i hope my blood clots you know i just got my arm cut off it you know your that injury will kind of override any action of your body's anticoagulants what happens when we're done with the clot well the clot will retract it will condense serum in the plasma is squeezed out of it so it's kind of made a little bit smaller and as the clot retracts that'll also help to enhance the healing fibro fat or fibrinolysis lysis means the splitting apart something so this literally means the splitting apart of that fibrin clot or the dissolving plasminogen which is a plasma protein helps to break down that clot made of fibrin so here's fibrinolysis which is again the lysis of fibrin or the dissolve or splitting apart of that clot and those are the steps shown there okay so now we get into okay sage question patient is on an anticoagulant does the first two happen spasm [Music] that's a good question yeah anticoagulation drugs um specifically i think just help with the clotting preventing clots so if there is some sort of damage um yeah spasm and plug formation would still occur you know if you know you might have relatives on um you know coumadin warfarin those are very common anti-glycogens my dad has been on coumadin for years i think since he was like 45 not the healthiest guy but now he is um you know he has to be just very careful to get cut because when he cuts he just bleeds because he's on this anticoagulant but that's a good question sage i would assume the anticoagulant therapy or drug would just affect the clotting okay let me take a little sip of water because now we're gonna get into another kind of topic that's a little um it's very interesting but it can be a little misleading or confusing this is blood grouping or blood typing we're going to keep it as simple as we can so this is you know everyone has a blood type and your blood type is very important if you're ever needing a transfusion or wanting to donate blood you never want to mix blood types and we'll talk about why that is bad um and again i would encourage you guys i'm just going to put a shout out here if you this if anatomy and physiology is really interesting to you i would encourage you to continue to take um anatomy 150 and 151 at crafting or somewhere else or look into there's a lot of healthcare field options and you don't have to be a nurse or a doctor you can be a phlebotomist you can read ecg's um just the healthcare field in general opens up a lot of opportunities for different um just jobs so this is interesting to you um keep taking classes on it and ask questions okay so blood grouping [Music] we include this in blood and we talk about it right after injury or surgery because if you lost a lot of blood you'll probably need a blood transfusion transfusion reactions can be what we call agglutination reactions and these are bad transfusion reactions if the blood agglutinates that means it's clumping together and that usually happens if you've received the wrong blood type your blood actually attacks the um the transfusion the blood that it received and it clumps your blood cells together and we'll talk about that but that's called agglutination the clumping of blood cells and that's bad if your blood cells are clumping together it means they're they can't really go to do what they're supposed to do talk about what an antigen is antigens are molecules or proteins on the surface of your red blood cells your erythrocytes and the type of antigens that you have on the surface of your red blood cells determine your blood type so i'm type a blood so all of my red blood cells have the a antigen this protein or molecule on the surface an antibody is a protein that's found in the plasma so remember when we talked about a blood sample you know the plasma is the liquid portion of your blood and um you know your red blood cells are part of the cell portion of your blood so antigens will be on the surface of your red blood cells but antibodies are only found in the plasma and antibodies will always be a special protein that fights off an antigen that your body doesn't want so for example i'm type a blood so i have the a antigen on the surface of my red blood cells and i have the anti-b antibody in my plasma so my plasma carries antibodies against the b antigen because my body doesn't need the b antigen it will just mean the a and then blood groups these are named according to their antigen so again your blood type is named for what antigen is on the surface you can be blood type a you can be blood type b you can be a b so if you're type a b you have both types of antigens on the surface of your cells or you can be really special you can be type o which there's a lot of us who are type o actually o positive is one of the most popular blood types um and if your type o and i say this in the best way but type o blood cells have no antigen so think of this picture of an o and picture it like a cell and there's just no antigens on the surface so type o blood doesn't have any antigens on its surface but we are going to go over this in detail so your blood types this is the blood system and i know some of you are thinking well i'm positive or negative where does that come in we're going to get to that too but let's just talk about a b a v and o let's just talk about that first so in our blood grouping system there's two types of antigens that can appear on the surface of your red blood cells you can have the type a antigen on your red blood cells or you can have the type b antigen on your red blood cells where you can have both so type a blood that's what i am has the type a antigens type b blood has b antigens on the surface of their red blood cells and your type a b if you have both a and b antigens and again type o their red blood cells have nothing so type o blood does not have a does not have b antigen you kind of have this like naked red blood cell if your type o the types of antigens found on the surface of your red blood cells are all genetically determined so this is passed down from your mom and dad your blood type um there's a specific kind of a genetic order that you can determine you know what are the chances that again you could pass on your blood type to your kids too so then antibodies so again your antigens are found on the surface of your red blood cell that's what's that is what gives you your blood type and then we all have most of us have antibodies against the antigens and they're present in the plasma of the blood so for example i am type a blood so my plasma contains anti-b antibodies what that means is these are little proteins antibodies are proteins that will fight off and get really upset if they see the antigen in my blood because i'm type a blood my plasma has anti-b antibodies and they act against the type b antigens if you're type b blood you will have anti a antibodies in your plasma so type b blood the surface of your red blood cells has the b antigen and in your plasma you'll have antibodies that will fight off against the a antigen so you always produce antibodies that are the opposite of what you have because you want to fight off antigens that your body doesn't need type a b blood is unique in that remember if you have if your type a b blood you have a and b antigen on the surface of your cells so because you have both types of antigens on the surface of your red blood cells your plasma is not going to contain any antibody and that makes sense so if you're some of you are probably type a b in here so you have both types of antigens on the surface of your cells because you have both types of antigens your plasma is not going to create an antibody that is going to attack its own antigens so if you're type a b you don't need antibodies that are against a or against b because your type a b type a b blood because you guys have both types of antigens you don't have any antibodies you can accept blood from anybody because you don't have any antibodies in your plasma that could potentially fight off a blood transfusion so if you are type a b blood specifically a b negative we'll talk about the negative and positive i promise um that's called the universal recipient because you're able to accept blood from anybody type o blood is also unique remember type o blood are our naked blood cells they do not have any antigens on the surface but since there are no antigens on the surface of their blood cells type o blood plasma has both antibodies in it because it can produce anti a and anti b antibodies against both antigens this makes type o blood people they can only accept blood from other old people because they have both antibodies in their plasma that could potentially fight or you know fight off other blood types you know type o blood we often call as the universal donor of blood because when you donate blood to someone if it's not an emergency situation you'll donate pure blood cells to somebody so they separate out the plasma so if you donate type o red blood cells to somebody you're just giving someone these naked blood cells so you can give type o blood to type a type b type a b because typo blood doesn't have any antigens on the surface so no antibodies will be able to attack type o blood type o blood does have antibodies itself but when you again donate blood they usually separate out the red blood cells from the plasma unless it's an emergency situation where they give you a whole blood transfusion so in caucasian so throughout different races um you know there for some reason there's a distribution of different types of blood and you can read that through here um you know in general if you look at it whether regardless of your race if you look at all the people in the world the majority the main majority is this type o so many people are typo and i would say if you guys know your blood type in our class many of you would be typo most likely o positive um and then type a is usually the next runner up for that okay so this is just a good kind of picture representation of what i just talked about and this might you know if you're a visual learner this probably will help a lot more if you understand what i just spent the last 10 minutes talking about but this shows you your red blood cells and the different antigens on the surface whether your type a type b type a b or type o and what i like about this picture is it shows you the different shapes so the shape of the type a antigen let's say is circle and let's say the shape of the type b antigen is triangular so what happens is your type a blood has the a antigen and then in the plasma it produces antibodies that have the shape that it can kind of grab hold of the b antigen when it's trying to kind of attack it and cause an agglutination reaction which is the clumpy and we'll talk about what that is if you're type b blood if you look at the second column you have the you have a antigen b on your surface of your red blood cells and in your plasma you create and antibodies and antibodies actually look like this they're a y-shaped protein and the anti-a antibody has a receptor site to grab hold of an a antigen if it ever comes in contact with type a blood what these antibodies do is they actually grab hold of the antigens that they're trying to fight off and when they grab hold of those antigens they clump up your red blood cells together and that's what causes an agglutination reaction which is a bad transfusion reaction when you mix type a and take b blood these antibodies go to work they grab hold of the antigens and they cause this clumping and again that agglutination the clumping that is what is a bad transfusion type a b blood you notice that it has both types of antigens on the surface so again i like the visual representation here because if you are in type a b in blood this is what your red blood cells look like so look here your plasma doesn't produce any antibodies because you don't want your plasma producing these little y-shaped villains that are going to cause clumping of your own red blood cells so type a b blood again if you're type a b you can accept blood from anybody because you don't have antibodies that is your body won't fight off any blood that it's given and then type o blood remember we have a naked red blood cell no antigens on the surface but we do have both types of antibodies present so we have both antibodies present in type o people but no antigens so again type o people they can donate their red blood cells to any one of the other blood types because again usually in a blood donation they separate the plasma from the blood but if you're type o you must only receive blood from other type o people because of this because your plasma has antibodies so if you accept type a blood from somebody who's type a you'll have an anti-a antibody that'll cause agglutination so type o people need blood from other type of people so this is what the agglutination is so let's say you have a type a blood of the donor um and you have an anti the antibody you're type a blood of the recipient so again we're kind of donating type a blood to a type a recipient the antibodies in the type a blood recipient and i'll use myself as an example i have anti-b antibodies so i don't my antibodies only fight off against b so we don't have agglutination because the antibodies that i have if i receive blood from another type a person my antibodies do not fit with the type with the a antigen so there's no clumping there's no agglutination i can safely receive blood from other type a donors this is where agglutination occurs let's say we have a type a blood of a donor but it's donating to someone who's type b remember if you're type b you have the b antigen on your the surface of your red blood cells but you have the anti a antibody in your plasma so if you donate type a blood to a type b recipient the anti-a antibodies which are shown here can reach up and kind of grab hold of the antigens on that donor blood and when they do that they clump the red blood cells together and that is called agglutination and that is a bad transfusion when you mix you know non-compatible blood types to kept together it causes an illumination reaction is everyone with me so far can you also hear me hopefully okay so this is just a chart that talks about blood donor and recipients according to blood types um type o's are universal donors because they have no antigens on them that just means that you're giving again naked red blood cells to everyone so you know agglutination reactions require an antigen on the surface to grab a hold of to cause clumping but if you're donating these naked red blood cells no agglutination will ever occur because there's no antigens for the antibodies to grab hold of type a blood can receive other a or other o blood because o is the universal donor type b blood people can receive either b or o blood type a b blood is known as the universal recipient because remember type a b blood um doesn't have any antibodies in the plasma so if you're type a b you're kind of lucky because you'll always have blood that's able to be given to you but type o can only receive from other type of now we'll get to the positive and negative because i know many of you know what i'm positive or negative and where does this come in it makes it a little trickier but not much really simply the positive and negative that gives you so i'm a positive you might be being negative or you might be a b positive or o negative the idea that you are positive or negative on the end of your blood type that just means you have an extra antigen called an ra antigen so it would be the same way as if we had labeled it like in a different letter but for some reason they just call it positive or negative negative you're positive if you have this extra antigen on the surface of your red blood cells and you're negative if you do not have that um most of us are positive so again if i were to pull all of you guys i would say most of us will be b positives a positive a b positive or o positive so it just means we have an extra antigen on the surface of our red blood cells antibodies it's this antigen is different though because if you have this um you know positive antigen you'll only produce antibodies if the rh negative person is exposed to rh positive blood for example by transfusion or from mother to fetus so for example we'll go over why this is important in pregnancy but you can only develop antibodies against this antigen if you're actually exposed to the blood so that's the difference you know if you're a b you will naturally have antibodies against the opposite antigen that's not in your blood but if you are um rh negative or rh positive you'll only produce those antibodies against the rh antigen if you're exposed to that blood and you'll be exposed to this rh antigen either by a transfusion reaction or in a pregnancy and this is where there's some problems that can be caused in pregnancy and you know they'll always ask and test your blood type in pregnancy so let's say the mom is rh negative and you know again this doesn't happen often because we just said that most of the population is arch positive so this doesn't happen often but when it does it can be very it can be life-threatening to the fetus so if a mother is rh negative and the fetus is rh positive the mother can be exposed to the rh positive blood of that fetus when it leaks through the placenta and mixes with your mug with the mother's blood so this is in cases of the first pregnancy the mom is rh negative the fetus is rh positive some of the fetal blood can leak through the placenta into the mother's blood and the first time that this occurs the mother's blood produces antibodies against that rh antigen it doesn't affect the first fetus or the first baby when it's born because um fetal blood can move across the placenta into the mother's blood but these antibodies then that will be produced in the mom's plasma those antibodies that they cannot move back in um so this is the first time this occurs it won't affect the first pregnancy but it could affect subsequent pregnancies and we'll talk about that any repeated mixing of blood could cause a reaction and this is what we cause hemolytic disease of a newborn so this condition occurs when a mother produces these anti-rh antibodies after it's been exposed to that fetal blood and this you know it usually even doesn't happen during pregnancy i should say that at the birth of the baby that's when the blood usually mixes so at the birth of that first baby the mom can produce these antibodies against that rh factor um but for subsequent pregnancies this rh negative mother will now have this antibody in it that could cross the placenta and cause agglutination and actually cause hemolysis of fetal erythrocytes meaning it can split apart the red blood cells in that fetus and that can be fatal to the fetus it can be prevented if we kind of pump rhogam into the mom which contains antibodies against the rh antigen itself so it can be treated but it is a condition that's always watched out for in pregnancy and again if you're a visual learner this just describes these steps with it so here we have um fetal rh positive red blood in maternal circulation um the placental tissue which again you know the mixing of blood in pregnancies usually only occurs right before or during delivery so the rh positive red blood cells from the fetus can enter the mom circulation through when the placenta tears for example and the mother then in this first pregnancy will be sensitized to that rh antigen and now produce rh antibodies so again because this usually happens after delivery the fetus is not affected in the first pregnancy but now in subsequent pregnancies which is what this shows now you have the mom who has the antibodies against this rh antigen so that when blood mixes her antibodies could attack the fetal red blood cells and cause them to clump or even because fetal cells are a little different it might even cause them to break apart and that's called hemolysis so that's hemolytic disease with a newborn it can be fatal it is treated you just that's why they always ask and they take your blood sample so that's how i know what my blood type is because i've gone through pregnancies before um i don't think my husband even knows what his blood type is i should probably figure that out so that is blood typing and we talked a little bit about the positive and negative you're just positive if you have that extra rh antigen and you're negative if you don't have it it does come into play with donation of blood but only to the point where you know if you are rh positive you'll only produce an antibody against that rh factor if you're exposed um to the antigen it well if you're ever exposed to it and we'll finish up this lecture and then we'll be done here in a couple minutes talking about how blood tests can be used as a diagnostic tool so this is when you get a blood sample taken a complete blood count describes information such as total red blood cell count hemoglobin count hematocrit which is the percentage of total blood volume composed of red blood cells and white blood cell count hemoglobin itself determines the amount of hemoglobin and the amount of oxygen which might be in the blood so the hemoglobin count could indicate you know if it's very low that could indicate that the person is anemic their oxygen levels are them so usually with a hematocrit which again is the percentage of total blood volume exposed to red blood cells they can take a little withdrawn blood sample um usually just a prick and then they're able to kind of see this hematocrit's scale which is the percentage of red blood cells um male versus females males usually have a little more higher hematocrit than females mean they have a higher percentage of red blood cells in their sample prothrombin time is another diagnostic blood test and i go through these because i think there might be a question on your lecture exam understanding what these different blood tests mean prothrombin time is the time it takes for your blood to begin clotting so they're able to determine that from a blood test usually 9 to 12 seconds your blood white cell count is the total number of light blood cells again if this is elevated and they take your white blood cell account and they count your neutrophils axenophiles vasophiles and any indication or heightened activity of one of those cells usually indicates your body is fighting off an infection so here are normal white blood cell counts and again the percentage of each different kinds of leukocytes is shown normally you have again the majority we talked about are your neutrophils next in line are your lymphocytes and the rarest white blood cell are your laser fills but again if you have a if your diagnostic blood test shows an increase in any of these areas it usually indicates your body's fighting an infection a white blood cell disorder leukopenia so the suffix pedia always means small so this means a lower white blood cell count it can be caused by radiation so usually chemotherapy radiation um even a tumor or an infection could decrease your white blood cells or could increase them you could have leukocytosis which is a high white blood cell count this could also be caused by an infection or leukemia which is a cancer of your white blood cells so i'll go ahead and stop us there where

all right class so welcome back after spring break here we are with chapter 11. it's a chapter on blood where we'll talk about kind of what makes up blood and why is it important um yes druid i just got your message i'll respond to you after this but yeah we can work that out for sure so as we go through this chapter this is what i told these guys before kind of an introductory chapter as we start to talk about the cardiovascular system which are is your heart and arteries and veins that carry the blood but first we kind of focus on blood itself because blood has a lot of unique functions that are really important for the body some of the functions are blood of blood are it transports all of your oxygen and carbon dioxide to the various tissues that need it and then it gets rid of carbon dioxide from all of your cells as a way to getting rid of that waste product it transports all nutrients all other waste products that could be ions it transports processed molecules it transports regulatory molecules your blood regulates your ph levels in the body um it helps with osmosis so the diffusion of water into and out of blood uh your blood helps to maintain body temperature so your blood vessels itself will constrict or dilate to allow blood flow to various parts of the body that influence your body temperature and your blood um provides protection against foreign substances within your blood you have the red blood cells but you also have white blood cells which are part of your body's immune system uh that help fight off all infection viruses bacteria and blood has what we call platelets within it to help with forming clots which are very helpful if you damage a blood vessel and you start to bleed for your blood to be able to clot to stop the exit of blood into the surrounding tissues so what is blood made of um it's mostly plasma so about 55 of your blood is this kind of liquid that surrounds the blood cells and we call that liquid the plasma it's mostly made up of water but there are proteins um and other solutes within that plasma so kind of within our composition of blood we have plasma which is kind of the water-based material and then we have the formed elements which include all of the cells the different cells in your blood and that makes up about 45 of let's say a blood sample all the cells the cell fragments these cells include erythrocytes which are red blood cells and then leukocytes are white blood cells and thrombocytes are the cells that will go on to kind of break apart to form the platelets which help in blood clotting so that is what makes up your blood um some of the proteins in the blood itself or specifically in the plasma are albumin globulins and fibrinogen and these proteins are really important again for different functions so here we have albumin which makes up more than half of the proteins in your plasma and that helps to maintain the balance of the blood violence helps your immune system and fibrinogen helps to create different fibers to help with clot formation so those are some of the proteins in your plasma many of you have probably gotten a blood sample taken um through venipuncture or many of you have might even know how to do this if you're trained in phlebotomy um so taking a blood sample what they are looking for are cell numbers in your blood or dif other substances to help determine if you have some sort of disease or disorder so when they initially take the blood out of the cubital vein kind of in the elbow they'll take it and it'll just be a vial and then what they do is they centrifuge that blood sample down that means they spin it extremely quickly and when you centrifuge or spin the blood sample very quickly the blood will kind of separate into natural layers all the formed elements which are all of the blood cells sink to the bottom of the sample because they're a lot denser the plasma which again is made up of mostly water floats to the top and remember in plasma you know we have mostly water but we also have proteins and other solutes you can see some of those listed there the buffy coat is kind of this um like a white color kind of separation that kind of separates the plasma from the formed elements um within this buffy coat you can see um i guess they don't really list what is in the buffy coat you have platelets and white blood cells within the buffy coat um so within that buffy coat are all of your platelets which help with blood clots and then your white blood cells and the white blood cells we you have five different types of white blood cells neutrophils lymphocytes monocytes acenophylls and basophils and these five different types of white blood cells each have a specific function to help your immune system so to help fight off infections so let's say a virus gets into your blood um one of these five white blood cells has the specific function to either eat up that virus to fight it off to try to degrade it so five different types of white blood cells and they each have a different function to help protect your body against anything foreign that could enter the tissue and the blood and then way at the bottom we have the red blood cells they're the densest so they stink to the bottom and that makes up the majority of the formed elements your red blood cells so that's the composition of blood so again medical professionals they take your blood sample they spin it down and then they're able to determine you know what are your glucose levels what are other ion levels what are your neutral lymphocyte monocyte levels specific levels of these white blood cells can tell if your body's fighting off an infection usually your white blood cell counts are elevated um if there is a problem because it means your body's trying to fight off an infection so really interesting there a lot you can tell just from taking a blood sample and that's usually what they do first if you you're at the doctor and they don't know what's wrong with you they take a sample of your blood hematopoiesis so hematopoiesis is a long name for the process that produces formed elements specifically the blood cells so in the fetus in the womb hematopoiesis occurs in several different types of tissues the liver the thymus the spleen your lymph nodes and the red bone marrow but then after birth and through you know childhood adulthood hematopoiesis the ability to form new blood cells is confined mainly to your red bone marrow which is inside your bones but some of your white cells are produced in different lymphatic tissues throughout the body uh hematopoiesis is very interesting because all of your formed elements of blood whether it's a white blood cell a thrombocyte a red blood cell they're all derived from a single population of cell a stem cell called a hemocytoblast so all your different blood cells kind of come from one stem cell and then they will differentiate to give rise to all the different cell lines each of which will end in a particular type of cell formed and this just shows you if we're looking here this is the stem cell of your blood cells your formed elements the hematocytoblast so all of your blood cells will start as a hematocytoblast then they'll either go down the myeloid stem stem cell line or the lymphoid stem line and if it's in the myeloid stem line it will eventually differentiate into what you see down here a red blood cell a platelet basophil acenophyll neutrophil and monocyte which are these again are four types of white blood cells and then if it kind of differentiates down the lymphoid stem cell line it just becomes a lymphocyte which is your fifth type of white blood cell so it's kind of interesting how all of your red blood cells all kind of start as one stem cell and then they will differentiate into all these different types through hematopoiesis which is just the development of these different blood cells erythrocytes so the stem site always means cell and erythro means red so erythrocyte is a red blood cell we often you'll often see that abbreviated as rbc um it's kind of a disc shaped cell with very thick edges so you'll notice there's kind of like an indentation on both sides of these cells so it kind of has the shape of a donut but without the center out it's just indented on both sides red blood cells do not have a nucleus so during development the nucleus is lost they live for about 120 days in your bloodstream and their primary function is to transport oxygen to tissues so because it doesn't have a nucleus it just leaves extra space in the red blood cell to transport all this oxygen to all the tissues that desperately need oxygen so those are red blood cells and this is a scanning electron microscope image so if that means it's zoomed in on a blood sample at about 2600 times magnified and blood samples normally are filled up with red blood cells um if you see something that has like a jagged edge it is a different color that's a white blood cell and anything smaller would be a platelet which again helps with um climbing their blood hemoglobin this is how oxygen gets transported in your red blood cells hemoglobin is a type of protein it's the main component of your erythrocytes and hemoglobin is what transports oxygen that's the only thing one of the few things you remember from today i'm just trying to get that in your head hemoglobin transports oxygen it's made up of globin proteins attached to a heme molecule in the center and each heme contains an iron atom and this iron atom is what will bind to oxygen so oxygen binds to the iron that's kind of at the center of this hemoglobin molecule if we have a hemoglobin with oxygen attached we call it oxyhemoglobin and hemoglobin that does not have oxygen attached is called deoxyhemoglobin so these this is the hemoglobin molecule it's a protein that's made up of four different globin kind of chains you can see here these different chains um one two three four so this is hemoglobin um you can see at the center of each chain is this heme group and this heme group is what we kind of zoom in it has an iron center and that's what the oxygen attaches to so really simply put because we have four kind of chains we have four heme groups and again each heme group can attach to one oxygen molecule so what this means is that one hemoglobin and i'm going to abbreviate hemoglobin as hb one hemoglobin can hold for transport up to four oxygen molecules because each oxygen gets attached to each one of these four chains so that is hemoglobin the reason why red blood cells can transport oxygen how are erythrocytes produced so we talked about how your red blood cells can only live for about 120 days which is what about four months in um in the body so your bodies need to constantly be producing more red blood cells if you have a decreased oxygen level your kidneys will increase production of a hormone called urethral pollutant and erythropoietin tells the red bone marrow to stimulate the production of more erythrocytes red blood cells and increased erythrocytes causing increase in your blood oxygen levels and this is why athletes train at higher elevations because there's they're kind of tricking their bodies into creating more red blood cells because they're at a higher elevation their body thinks they have decreased oxygen levels so athletes who train at higher elevations their bodies are producing more red blood cells so then when that athlete goes back down to sea level they have a ton of red blood cells so their red blood cells in turn will carry more oxygen to their muscle tissues that need it for their athletic event so red blood cell production let's say you have a decrease in blood oxygen your kidneys will produce production of this hormone called erythropoietin which tells the red bone marrow in your bones to produce more red blood cells more red blood cells means more oxygen in your blood because red blood cells carry oxygen what happens to old erythrocytes so where do they go and what happens to old hemoglobin old red blood cells are removed from their blood by a cell called a macrophage in the spleen in the liver so what a macrophage does is it kind of breaks down red blood cells into the component parts hemoglobin is broken down globin which makes up the chains of hemoglobin is broken down into the specific amino acids that created it the iron is recycled to be used for more hemoglobin production in the future and the heme group is converted to bilirubin bilirubin is actually taken up by your liver and then um produced or kind of changed into bile and released in the small intestine and bile is important um to help digest your fats in your small intestines so your body is very good at recycling and you're using different parts of hemoglobin and your red blood cells when they're broken down so this just takes you through the steps of hemoglobin breakdown i don't think you need to know specific steps um but in general you know where does this occur so hemoglobin so you have you know damaged red blood cells that are too old or they've been damaged by something else they get taken to the spleen in the liver where all damaged red blood cells go and then they get broken apart the hemoglobin gets kind of broken into its component heme groups globin groups globin groups get broken down into their individual amino acids the heme group gets converted into bilirubin and bilirubin is kind of taken back to the liver where it's transferred or kind of changed into bile and bile is what the liver secretes into your small intestine to help with digestion um any other bilirubin derivatives or waste products can also be taken to the kidney for processing um iron could be taken to the spleen iron will be taken back into the bone marrow to be used again and recycled and more red blood cell production so that's just a little bit how we break down hemoglobin and we use the components of it so we talked about red blood cells now we're going to go on and talk about our leukocytes and another word for a leukocyte is a white blood cell and we often abbreviate this wbc so leukocytes are white blood cells they do not have hemoglobin because they're not transporting oxygen they're much larger than erythrocytes so if you look at a sample of blood and get this involved you'll see different samples of blood under a microscope so they'll be much larger than your red blood cells they will contain a nucleus and the big functions of leukocytes are to fight off all infections and remove any dead cells and other debris that are in your blood by phagocytosis which kind of means eating eating them up so those are leukocytes we have two kind of classes of leukocytes they're either granulocytes or a granulocytes and granulocytes contain specific kind of granules or specks in them and there's three types of the granulocytes we have neutrophils acinophils and basophils so underneath the microscope when you're looking at a granulocyte you can see kind of specks for these tiny granules in them neutrophils are the most common and they remain in your blood about 10 to 12 hours and then they move to tissues and they are phagocytes which means they help eat up and get rid of any extra debris that your body might need to get rid of so those are neutrophils the most common acinophils help to reduce inflammation they help to destroy parasites in the body and basophils are the least common leukocytes and heparin which help aid also in the inflammatory response as well so those are the three types of granulocytes and then i told you you have five total types of leukocytes so the other class of leukocyte is that a granulocyte means they do not have granules so when looking under a microscope these type of leukocytes will look kind of smooth in one of these little specks of extra material in them the monocyte is the largest sized white blood cell and it will produce macrophages again which will help eat up or get rid of anything foreign a lymphocyte is a part of an immune response and lymphocytes are very important because they go on and produce several different types of cells specifically t cells and b cells which have very specific functions to help fight off infection and lymphocytes are also important because they lead to the production of the antibodies which are very important in your body antibodies are little proteins that help also help destroy anything foreign that might have entered into the body so lymphocytes are kind of have a lot of functions to them because they will go on and create even more types of cells so underneath the microscope here are different types of cells the tops three are our granulocytes neutrophils basophils and acetophylls and then the bottom two are a granulocytes the monocytes in the lymphocytes and we'll go over you know a little bit more in lab what they look like and what how you can tell the difference between between all five they all kind of differentiate nuclei so some have a nucleus that has lobes to them um some are just kind of very circular in shape others stain a particular color always so in lab we'll go over kind of how to differentiate the different types of leukocytes too and then platelets are kind of our third type of formed element in your blood and platelets are my new various fragments of cells each scene of a small amount of cytoplasm surrounded by a cell membrane and they're produced in red bone marrow from a large cell called a megakaryocyte and what happens is small fragments kind of break off of the megakaryocytes and those are what are our platelets and platelets help to play a very important role in preventing blood loss by helping with blood clotting so if the blood in the blood vessel is damaged let's say you're cutting vegetables and you accidentally slice your finger you're cutting through blood vessels in your fingers so that is how the blood comes to the surface and it starts to leak out what platelets do is they'll try to form a clot at that place of damage to try to stop blood from leaking out blood can also leak into other tissues inside the body and that's you know internal bleeding can disrupt normal function as well and blood that is lost if there's a significant amount of blood loss that must be produced or replaced by producing more blood cells or by a transfusion and this is how our bodies try to prevent blood loss if there is some sort of damage to a blood vessel you know from a little cut or split during your skin to a more you know a bigger damage to the body itself vascular there's kind of three main steps that occur that the body goes through to help prevent blood loss vascular spasm means temporary constriction of a blood vessel so the blood vessel that's damaged will try to constrict to try to decrease the amount of blood that's flowing through it a platelet plug is when platelets nothing okay all right guys give me a second [Music] it's back now okay okay now that you guys hear me okay thanks for letting me know i'm not sure what happened let me check my internet real quick from my internet just kind of okay so how long have you not been able to hear me for the best you know thanks for letting me know guys i think my internet i just got a message that was unstable so let me know if it goes away again okay so vascular spasm is just an immediate but temporary constriction of your blood vessel usually in an artery um where the smooth muscle constricts the wall of the blood vessel so that it closes off the vessel so it stops the flow of blood through it um a vascular spasm usually chemicals released by the cells will help stimulate the vascular spasm um these specific chemicals will be released when the blood vessel wall is damaged and the platelets can also stimulate a vascular spasm the platelet plug formation is kind of our next step to help maintain integrity and to try to stop blood from leaving the formation of what we call a platelet plug is a series of steps but everything kind of happens at the same time platelets will stick to exposed collagen on the damaged blood vessel walls the platelets kind of come to the area of damage stick to the blood vessel wall and after they kind of stick to that collagen in the damaged blood vessel while they become activated they change shape and they release chemicals to kind of keep calling all their platelet friends to continue coming to that area of damage in what we call platelet aggregation we're adding more and more platelets to the area of damage but we're also adding um fibrinogen protein which helps to form bridges between fibrinogen receptors on the platelets and this these fibrinogen they produce all the fibers that kind of form what we call a platelet plug and i think i have a picture here you know the formation of a platelet plug these steps kind of all happen at the same time and again you know for your exam i don't think you need to know the specifics of these series of steps but it's just good to know how your body stops blood loss from occurring so we have a damaged blood vessel wall here so you see exposed collagen and you can see how the platelets are kind of attaching to the exposed collagen fibrinogen comes in and binds and kind of connects platelets together via these fibrinogen receptors so it forms fibers that are connecting the platelets together and this is what forms the plug of platelets to try to stop blood loss from occurring again this isn't very you know this is like slicing your finger if you're cutting vegetables um you know if you are in a serious accident where i don't know i don't know i'm trying to think of you know something like this severs off your arm um a platelet plug formation will not stop that blood loss so this is four times smaller from smaller accidents blood clotting then so blood can be transformed from a liquid to a gel and this is a good thing to help in damaged blood vessels to try to get your blood to clot this is a bad thing if your blood can't break up these clots and these clots could travel to your heart to produce a blockage in your arteries blood clots can travel to your lungs to produce a blockage in some of the arteries in your lungs or blood clots can travel to the brain to produce a blockage in the brain so in general you know blood clots are good because they're supposed to stop blood from leaking into surrounding tissues but you can have too many blood clots and that can lead to problems too okay so the ability to change blood from a liquid to a gel this creates a clot and a clot is a network of proteins called fibrin that can trap blood cells and fluid and a clot depends on clotting factors which are different proteins in the plasma they are activated following an injury so when your body gets injured they send out these clotting factors um they're made in the liver and they require vitamin k and clotting factors will go and tell your blood cells to produce a clot to try to keep damage from getting worse here are the steps in clot formation and again knowing these specific steps i don't think you'll be required to know all specifics but when your blood vessel is injured this causes inactive clotting factors to become activated due to exposed connective tissue what that means is when you cut through blood vessel while you're exposing connective tissue so that will release kind of this activation of these clotting factors or the release of a protein called thromboplastin prothrombinase a clotting factor is formed and acts upon the prothrombin prothrombin gets added to thrombin thrombin activates fibrinogen um into its active form of fibrin and fibrin forms these network of fibers that traps blood to clot it up so those are the steps in clot formation we have a lot of activating of different proteins to produce a clot so you know it starts with an injury to a blood vessel because again any cut any significant damage would you know cut through a blood vessel so that would cause a leakage of blood either externally or internally injury to a vessel um expose this connective tissue and this is a big step because then when that connected tissue is exposed it releases chemicals that will activate clotting factors specifically prothrombinase that activates prothrombin into thrombin which activates vibration into fibrin to help form the blood clots so steps in clot formation we just have a variety of steps activating different proteins to eventually form our plot which is what we want we do have to control the formation of clots because as i told you in the beginning you know if you have too many clots they could spread throughout the body and again the three worst places for plots to spread are your hearts your lungs or your brain anything that disrupts blood flow to those three major organs is not good so we have anti-coagulants which help to prevent clots from forming or controlling their spread or getting rid of clots after they've formed and done their job so you have natural anticoagulants in your body heparin and antithrombin that makes sense because throbbing was the protein that was used to activate clots so an anti-thrombin would get rid of them the injury causes enough clotting factors to be activated so that anticoagulants can't work in that particular area of the body so you know you should never be worried that oh no i hope my blood clots you know i just got my arm cut off it you know your that injury will kind of override any action of your body's anticoagulants what happens when we're done with the clot well the clot will retract it will condense serum in the plasma is squeezed out of it so it's kind of made a little bit smaller and as the clot retracts that'll also help to enhance the healing fibro fat or fibrinolysis lysis means the splitting apart something so this literally means the splitting apart of that fibrin clot or the dissolving plasminogen which is a plasma protein helps to break down that clot made of fibrin so here's fibrinolysis which is again the lysis of fibrin or the dissolve or splitting apart of that clot and those are the steps shown there okay so now we get into okay sage question patient is on an anticoagulant does the first two happen spasm [Music] that's a good question yeah anticoagulation drugs um specifically i think just help with the clotting preventing clots so if there is some sort of damage um yeah spasm and plug formation would still occur you know if you know you might have relatives on um you know coumadin warfarin those are very common anti-glycogens my dad has been on coumadin for years i think since he was like 45 not the healthiest guy but now he is um you know he has to be just very careful to get cut because when he cuts he just bleeds because he's on this anticoagulant but that's a good question sage i would assume the anticoagulant therapy or drug would just affect the clotting okay let me take a little sip of water because now we're gonna get into another kind of topic that's a little um it's very interesting but it can be a little misleading or confusing this is blood grouping or blood typing we're going to keep it as simple as we can so this is you know everyone has a blood type and your blood type is very important if you're ever needing a transfusion or wanting to donate blood you never want to mix blood types and we'll talk about why that is bad um and again i would encourage you guys i'm just going to put a shout out here if you this if anatomy and physiology is really interesting to you i would encourage you to continue to take um anatomy 150 and 151 at crafting or somewhere else or look into there's a lot of healthcare field options and you don't have to be a nurse or a doctor you can be a phlebotomist you can read ecg's um just the healthcare field in general opens up a lot of opportunities for different um just jobs so this is interesting to you um keep taking classes on it and ask questions okay so blood grouping [Music] we include this in blood and we talk about it right after injury or surgery because if you lost a lot of blood you'll probably need a blood transfusion transfusion reactions can be what we call agglutination reactions and these are bad transfusion reactions if the blood agglutinates that means it's clumping together and that usually happens if you've received the wrong blood type your blood actually attacks the um the transfusion the blood that it received and it clumps your blood cells together and we'll talk about that but that's called agglutination the clumping of blood cells and that's bad if your blood cells are clumping together it means they're they can't really go to do what they're supposed to do talk about what an antigen is antigens are molecules or proteins on the surface of your red blood cells your erythrocytes and the type of antigens that you have on the surface of your red blood cells determine your blood type so i'm type a blood so all of my red blood cells have the a antigen this protein or molecule on the surface an antibody is a protein that's found in the plasma so remember when we talked about a blood sample you know the plasma is the liquid portion of your blood and um you know your red blood cells are part of the cell portion of your blood so antigens will be on the surface of your red blood cells but antibodies are only found in the plasma and antibodies will always be a special protein that fights off an antigen that your body doesn't want so for example i'm type a blood so i have the a antigen on the surface of my red blood cells and i have the anti-b antibody in my plasma so my plasma carries antibodies against the b antigen because my body doesn't need the b antigen it will just mean the a and then blood groups these are named according to their antigen so again your blood type is named for what antigen is on the surface you can be blood type a you can be blood type b you can be a b so if you're type a b you have both types of antigens on the surface of your cells or you can be really special you can be type o which there's a lot of us who are type o actually o positive is one of the most popular blood types um and if your type o and i say this in the best way but type o blood cells have no antigen so think of this picture of an o and picture it like a cell and there's just no antigens on the surface so type o blood doesn't have any antigens on its surface but we are going to go over this in detail so your blood types this is the blood system and i know some of you are thinking well i'm positive or negative where does that come in we're going to get to that too but let's just talk about a b a v and o let's just talk about that first so in our blood grouping system there's two types of antigens that can appear on the surface of your red blood cells you can have the type a antigen on your red blood cells or you can have the type b antigen on your red blood cells where you can have both so type a blood that's what i am has the type a antigens type b blood has b antigens on the surface of their red blood cells and your type a b if you have both a and b antigens and again type o their red blood cells have nothing so type o blood does not have a does not have b antigen you kind of have this like naked red blood cell if your type o the types of antigens found on the surface of your red blood cells are all genetically determined so this is passed down from your mom and dad your blood type um there's a specific kind of a genetic order that you can determine you know what are the chances that again you could pass on your blood type to your kids too so then antibodies so again your antigens are found on the surface of your red blood cell that's what's that is what gives you your blood type and then we all have most of us have antibodies against the antigens and they're present in the plasma of the blood so for example i am type a blood so my plasma contains anti-b antibodies what that means is these are little proteins antibodies are proteins that will fight off and get really upset if they see the antigen in my blood because i'm type a blood my plasma has anti-b antibodies and they act against the type b antigens if you're type b blood you will have anti a antibodies in your plasma so type b blood the surface of your red blood cells has the b antigen and in your plasma you'll have antibodies that will fight off against the a antigen so you always produce antibodies that are the opposite of what you have because you want to fight off antigens that your body doesn't need type a b blood is unique in that remember if you have if your type a b blood you have a and b antigen on the surface of your cells so because you have both types of antigens on the surface of your red blood cells your plasma is not going to contain any antibody and that makes sense so if you're some of you are probably type a b in here so you have both types of antigens on the surface of your cells because you have both types of antigens your plasma is not going to create an antibody that is going to attack its own antigens so if you're type a b you don't need antibodies that are against a or against b because your type a b type a b blood because you guys have both types of antigens you don't have any antibodies you can accept blood from anybody because you don't have any antibodies in your plasma that could potentially fight off a blood transfusion so if you are type a b blood specifically a b negative we'll talk about the negative and positive i promise um that's called the universal recipient because you're able to accept blood from anybody type o blood is also unique remember type o blood are our naked blood cells they do not have any antigens on the surface but since there are no antigens on the surface of their blood cells type o blood plasma has both antibodies in it because it can produce anti a and anti b antibodies against both antigens this makes type o blood people they can only accept blood from other old people because they have both antibodies in their plasma that could potentially fight or you know fight off other blood types you know type o blood we often call as the universal donor of blood because when you donate blood to someone if it's not an emergency situation you'll donate pure blood cells to somebody so they separate out the plasma so if you donate type o red blood cells to somebody you're just giving someone these naked blood cells so you can give type o blood to type a type b type a b because typo blood doesn't have any antigens on the surface so no antibodies will be able to attack type o blood type o blood does have antibodies itself but when you again donate blood they usually separate out the red blood cells from the plasma unless it's an emergency situation where they give you a whole blood transfusion so in caucasian so throughout different races um you know there for some reason there's a distribution of different types of blood and you can read that through here um you know in general if you look at it whether regardless of your race if you look at all the people in the world the majority the main majority is this type o so many people are typo and i would say if you guys know your blood type in our class many of you would be typo most likely o positive um and then type a is usually the next runner up for that okay so this is just a good kind of picture representation of what i just talked about and this might you know if you're a visual learner this probably will help a lot more if you understand what i just spent the last 10 minutes talking about but this shows you your red blood cells and the different antigens on the surface whether your type a type b type a b or type o and what i like about this picture is it shows you the different shapes so the shape of the type a antigen let's say is circle and let's say the shape of the type b antigen is triangular so what happens is your type a blood has the a antigen and then in the plasma it produces antibodies that have the shape that it can kind of grab hold of the b antigen when it's trying to kind of attack it and cause an agglutination reaction which is the clumpy and we'll talk about what that is if you're type b blood if you look at the second column you have the you have a antigen b on your surface of your red blood cells and in your plasma you create and antibodies and antibodies actually look like this they're a y-shaped protein and the anti-a antibody has a receptor site to grab hold of an a antigen if it ever comes in contact with type a blood what these antibodies do is they actually grab hold of the antigens that they're trying to fight off and when they grab hold of those antigens they clump up your red blood cells together and that's what causes an agglutination reaction which is a bad transfusion reaction when you mix type a and take b blood these antibodies go to work they grab hold of the antigens and they cause this clumping and again that agglutination the clumping that is what is a bad transfusion type a b blood you notice that it has both types of antigens on the surface so again i like the visual representation here because if you are in type a b in blood this is what your red blood cells look like so look here your plasma doesn't produce any antibodies because you don't want your plasma producing these little y-shaped villains that are going to cause clumping of your own red blood cells so type a b blood again if you're type a b you can accept blood from anybody because you don't have antibodies that is your body won't fight off any blood that it's given and then type o blood remember we have a naked red blood cell no antigens on the surface but we do have both types of antibodies present so we have both antibodies present in type o people but no antigens so again type o people they can donate their red blood cells to any one of the other blood types because again usually in a blood donation they separate the plasma from the blood but if you're type o you must only receive blood from other type o people because of this because your plasma has antibodies so if you accept type a blood from somebody who's type a you'll have an anti-a antibody that'll cause agglutination so type o people need blood from other type of people so this is what the agglutination is so let's say you have a type a blood of the donor um and you have an anti the antibody you're type a blood of the recipient so again we're kind of donating type a blood to a type a recipient the antibodies in the type a blood recipient and i'll use myself as an example i have anti-b antibodies so i don't my antibodies only fight off against b so we don't have agglutination because the antibodies that i have if i receive blood from another type a person my antibodies do not fit with the type with the a antigen so there's no clumping there's no agglutination i can safely receive blood from other type a donors this is where agglutination occurs let's say we have a type a blood of a donor but it's donating to someone who's type b remember if you're type b you have the b antigen on your the surface of your red blood cells but you have the anti a antibody in your plasma so if you donate type a blood to a type b recipient the anti-a antibodies which are shown here can reach up and kind of grab hold of the antigens on that donor blood and when they do that they clump the red blood cells together and that is called agglutination and that is a bad transfusion when you mix you know non-compatible blood types to kept together it causes an illumination reaction is everyone with me so far can you also hear me hopefully okay so this is just a chart that talks about blood donor and recipients according to  blood types um type o's are universal donors because they have no antigens on them that just means that you're giving again naked red blood cells to everyone so you know agglutination reactions require an antigen on the surface to grab a hold of to cause clumping but if you're donating these naked red blood cells no agglutination will ever occur because there's no antigens for the antibodies to grab hold of type a blood can receive other a or other o blood because o is the universal donor type b blood people can receive either b or o blood type a b blood is known as the universal recipient because remember type a b blood um doesn't have any antibodies in the plasma so if you're type a b you're kind of lucky because you'll always have blood that's able to be given to you but type o can only receive from other type of now we'll get to the positive and negative because i know many of you know what i'm positive or negative and where does this come in it makes it a little trickier but not much really simply the positive and negative that gives you so i'm a positive you might be being negative or you might be a b positive or o negative the idea that you are positive or negative on the end of your blood type that just means you have an extra antigen called an ra antigen so it would be the same way as if we had labeled it like in a different letter but for some reason they just call it positive or negative negative you're positive if you have this extra antigen on the surface of your red blood cells and you're negative if you do not have that um most of us are positive so again if i were to pull all of you guys i would say most of us will be b positives a positive a b positive or o positive so it just means we have an extra antigen on the surface of our red blood cells antibodies it's this antigen is different though because if you have this um you know positive antigen you'll only produce antibodies if the rh negative person is exposed to rh positive blood for example by transfusion or from mother to fetus so for example we'll go over why this is important in pregnancy but you can only develop antibodies against this antigen if you're actually exposed to the blood so that's the difference you know if you're a b you will naturally have antibodies against the opposite antigen that's not in your blood but if you are um rh negative or rh positive you'll only produce those antibodies against the rh antigen if you're exposed to that blood and you'll be exposed to this rh antigen either by a transfusion reaction or in a pregnancy and this is where there's some problems that can be caused in pregnancy and you know they'll always ask and test your blood type in pregnancy so let's say the mom is rh negative and you know again this doesn't happen often because we just said that most of the population is arch positive so this doesn't happen often but when it does it can be very it can be life-threatening to the fetus so if a mother is rh negative and the fetus is rh positive the mother can be exposed to the rh positive blood of that fetus when it leaks through the placenta and mixes with your mug with the mother's blood so this is in cases of the first pregnancy the mom is rh negative the fetus is rh positive some of the fetal blood can leak through the placenta into the mother's blood and the first time that this occurs the mother's blood produces antibodies against that rh antigen it doesn't affect the first fetus or the first baby when it's born because um fetal blood can move across the placenta into the mother's blood but these antibodies then that will be produced in the mom's plasma those antibodies that they cannot move back in um so this is the first time this occurs it won't affect the first pregnancy but it could affect subsequent pregnancies and we'll talk about that any repeated mixing of blood could cause a reaction and this is what we cause hemolytic disease of a newborn so this condition occurs when a mother produces these anti-rh antibodies after it's been exposed to that fetal blood and this you know it usually even doesn't happen during pregnancy i should say that at the birth of the baby that's when the blood usually mixes so at the birth of that first baby the mom can produce these antibodies against that rh factor um but for subsequent pregnancies this rh negative mother will now have this antibody in it that could cross the placenta and cause agglutination and actually cause hemolysis of fetal erythrocytes meaning it can split apart the red blood cells in that fetus and that can be fatal to the fetus it can be prevented if we kind of pump rhogam into the mom which contains antibodies against the rh antigen itself so it can be treated but it is a condition that's always watched out for in pregnancy and again if you're a visual learner this just describes these steps with it so here we have um fetal rh positive red blood in maternal circulation um the placental tissue which again you know the mixing of blood in pregnancies usually only occurs right before or during delivery so the rh positive red blood cells from the fetus can enter the mom circulation through when the placenta tears for example and the mother then in this first pregnancy will be sensitized to that rh antigen and now produce rh antibodies so again because this usually happens after delivery the fetus is not affected in the first pregnancy but now in subsequent pregnancies which is what this shows now you have the mom who has the antibodies against this rh antigen so that when blood mixes her antibodies could attack the fetal red blood cells and cause them to clump or even because fetal cells are a little different it might even cause them to break apart and that's called hemolysis so that's hemolytic disease with a newborn it can be fatal it is treated you just that's why they always ask and they take your blood sample so that's how i know what my blood type is because i've gone through pregnancies before um i don't think my husband even knows what his blood type is i should probably figure that out so that is blood typing and we talked a little bit about the positive and negative you're just positive if you have that extra rh antigen and you're negative if you don't have it it does come into play with donation of blood but only to the point where you know if you are rh positive you'll only produce an antibody against that rh factor if you're exposed um to the antigen it well if you're ever exposed to it and we'll finish up this lecture and then we'll be done here in a couple minutes talking about how blood tests can be used as a diagnostic tool so this is when you get a blood sample taken a complete blood count describes information such as total red blood cell count hemoglobin count hematocrit which is the percentage of total blood volume composed of red blood cells and white blood cell count hemoglobin itself determines the amount of hemoglobin and the amount of oxygen which might be in the blood so the hemoglobin count could indicate you know if it's very low that could indicate that the person is anemic their oxygen levels are them so usually with a hematocrit which again is the percentage of total blood volume exposed to red blood cells they can take a little withdrawn blood sample um usually just a prick and then they're able to kind of see this hematocrit's scale which is the percentage of red blood cells um male versus females males usually have a little more higher hematocrit than females mean they have a higher percentage of red blood cells in their sample prothrombin time is another diagnostic blood test and i go through these because i think there might be a question on your lecture exam understanding what these different blood tests mean prothrombin time is the time it takes for your blood to begin clotting so they're able to determine that from a blood test usually 9 to 12 seconds your blood white cell count is the total number of light blood cells again if this is elevated and they take your white blood cell account and they count your neutrophils axenophiles vasophiles and any indication or heightened activity of one of those cells usually indicates your body is fighting off an infection so here are normal white blood cell counts and again the percentage of each different kinds of leukocytes is shown normally you have again the majority we talked about are your neutrophils next in line are your lymphocytes and the rarest white blood cell are your laser fills but again if you have a if your diagnostic blood test shows an increase in any of these areas it usually indicates your body's fighting an infection a white blood cell disorder leukopenia so the suffix pedia always means small so this means a lower white blood cell count it can be caused by radiation so usually chemotherapy radiation um even a tumor or an infection could decrease your white blood cells or could increase them you could have leukocytosis which is a high white blood cell count this could also be caused by an infection or leukemia which is a cancer of your white blood cells so i'll go ahead and stop us there where

Transcript for:Understanding Blood and Its Functions

Transcript for:
Understanding Blood and Its Functions