2
Med-Surg Exam 4
1 CHAPTER 30: HEMATOLOGICAL SYSTEM
➢ BONE
MARROW
• Soft material that fills the central core of bones. Although there are two types of bone marrow, yellow (adipose) & red
marrow (hematopoietic)
• It is red bone marrow that actively produces blood cells, in adults the red marrow is primarily found in flat & irregular bones such
as the end of long bones, pelvic bones, vertebrae, sacrum, sternum, ribs, cranial bones, & the scapulae
• All three types of blood cells RBCs, WBCs, & platelets develop from a common hematopoietic stem cell within the bone
marrow
• Bone marrow is stimulated by various factors or cytokines erythroieptin, granulocyte colony stimulating factor, stem cells factor, &
thrombopoietin that cause differentiation of the stem cells into one of the committed hematopoietic cells (e.g. RBC)
➢ FUNCTION OF THE BLOOD
• Blood is a type of connective tissue that performs three major functions; transportation, regulation, & protection. Blood also has two
major components plasma & blood cells. Blood volume is usually 4.7 to 5.5 liters (5 to 6 quarts)
• Transportation: O2 from the lungs to cells, nutrients from gastrointestinal tract to cells, hormones from endocrine
glands to tissue & cells, metabolic waste products from cells to lungs, liver, & kidneys
• Regulation: Fluid & electrolyte balance, acid base balance, body temperature, maintaining intravascular oncotic pressure
• Protection: Maintaining homeostasis of blood coagulation, combating invasion of pathogens & other foreign
substances
,2
➢ PLASMA
• Approximately 55% of blood is plasma, plasma is composed primarily of water, but also contains proteins, electrolytes, gases,
nutrients, & waste
• Plasma protein includes albumin, globulin, & clotting factors, most plasma proteins are produced by the liver except for
antibodies (immunoglobulin) which is produced by plasma cells
• The term serum refers so plasma minus the clotting factors
• Albumin is a protein that helps maintain oncotic pressure in the blood
,2
➢ BLOOD CELLS
• About 45% of blood is composed of elements, or blood cells, the three types of blood cells are erythrocytes (RBC), leukocytes
(WBC), & thrombocytes (platelets). Primary function is oxygen transportation, whereas leukocytes are involved in protecting
the body from infection. Platelets promote blood coagulation.
• Erythrocytes: primary functions of RBCs include transport of gases (oxygen & carbon dioxide) & assistance in
maintaining acid-base balance. Composed of hemoglobin, RBCs are flexible cells with a unique biconcave shape.
• Leukocytes: originate from the stem cells within the bone marrow. Usually has 4,300 to 10,800.
• Granulocytes: Primary function is phagocytosis, a process by which WBCs ingest or engulf any unwanted organism & digest &
kills it.
• Neutrophils: most common type of granulocyte, they are the primary phagocytic cells involves in acute inflammatory
responses, an increase in neutrophils in the blood is a common diagnostic indicator of infection & tissue injury.
• Eosinophils: primary function is to engulf antigen-antibody complexes formed during an allergic response.
• Basophils: if a basophil is stimulated by an antigen or by tissue injury, it responds by releasing substances within the granule, this
in part of the response seen in allergic & inflammatory reactions.
• Lymphocytes: They form the basis of the cellular & humoral responses. There are two subtypes B cells & T cells, T
cells precursors originate in bone marrow, and these cells migrate to the thymus gland for further differentiation unto T
cells. Nature Killer (NK) cells are lymphocytes that do not require prior exposure to antigens to kill virus infected cells &
activate T cells & phagocytes.
• Monocytes: Potent phagocytic cells that ingest small or large masses of matter, such as bacteria, dead cells, tissue
debris, & old or defective RBCs. These cells are only present in the blood for a short time before they migrate into the
tissues & become macrophages.
• Thrombocytes: Primary function is to initiate the clotting process by producing an initial platelet plug in the early
phases of the process. One third of platelets in the body reside in the spleen, typically the lifespan of a platelet is 8 to
11 days. Platelet production is regulated by thrombopoietin, a growth factor that acts on bone marrow to stimulate
platelet production.
, 2
➢ ERYTHROPOIESIS
• The process of RBC production, which is regulated by cellular oxygen requirements & general metabolic activity. Is stimulated by
hypoxia & controlled erythropoietin, a glycoprotein, growth factor synthesized & released primarily in the kidney. The normal life
span of an erythrocytes is 120 days.
➢ HEMOLYSIS
• Destruction of RBCs by monocytes & macrophage removes abnormal, defective, damaged, & old RBCs from circulation. Normally
occurs in the bone marrow, liver, & spleen
Med-Surg Exam 4
1 CHAPTER 30: HEMATOLOGICAL SYSTEM
➢ BONE
MARROW
• Soft material that fills the central core of bones. Although there are two types of bone marrow, yellow (adipose) & red
marrow (hematopoietic)
• It is red bone marrow that actively produces blood cells, in adults the red marrow is primarily found in flat & irregular bones such
as the end of long bones, pelvic bones, vertebrae, sacrum, sternum, ribs, cranial bones, & the scapulae
• All three types of blood cells RBCs, WBCs, & platelets develop from a common hematopoietic stem cell within the bone
marrow
• Bone marrow is stimulated by various factors or cytokines erythroieptin, granulocyte colony stimulating factor, stem cells factor, &
thrombopoietin that cause differentiation of the stem cells into one of the committed hematopoietic cells (e.g. RBC)
➢ FUNCTION OF THE BLOOD
• Blood is a type of connective tissue that performs three major functions; transportation, regulation, & protection. Blood also has two
major components plasma & blood cells. Blood volume is usually 4.7 to 5.5 liters (5 to 6 quarts)
• Transportation: O2 from the lungs to cells, nutrients from gastrointestinal tract to cells, hormones from endocrine
glands to tissue & cells, metabolic waste products from cells to lungs, liver, & kidneys
• Regulation: Fluid & electrolyte balance, acid base balance, body temperature, maintaining intravascular oncotic pressure
• Protection: Maintaining homeostasis of blood coagulation, combating invasion of pathogens & other foreign
substances
,2
➢ PLASMA
• Approximately 55% of blood is plasma, plasma is composed primarily of water, but also contains proteins, electrolytes, gases,
nutrients, & waste
• Plasma protein includes albumin, globulin, & clotting factors, most plasma proteins are produced by the liver except for
antibodies (immunoglobulin) which is produced by plasma cells
• The term serum refers so plasma minus the clotting factors
• Albumin is a protein that helps maintain oncotic pressure in the blood
,2
➢ BLOOD CELLS
• About 45% of blood is composed of elements, or blood cells, the three types of blood cells are erythrocytes (RBC), leukocytes
(WBC), & thrombocytes (platelets). Primary function is oxygen transportation, whereas leukocytes are involved in protecting
the body from infection. Platelets promote blood coagulation.
• Erythrocytes: primary functions of RBCs include transport of gases (oxygen & carbon dioxide) & assistance in
maintaining acid-base balance. Composed of hemoglobin, RBCs are flexible cells with a unique biconcave shape.
• Leukocytes: originate from the stem cells within the bone marrow. Usually has 4,300 to 10,800.
• Granulocytes: Primary function is phagocytosis, a process by which WBCs ingest or engulf any unwanted organism & digest &
kills it.
• Neutrophils: most common type of granulocyte, they are the primary phagocytic cells involves in acute inflammatory
responses, an increase in neutrophils in the blood is a common diagnostic indicator of infection & tissue injury.
• Eosinophils: primary function is to engulf antigen-antibody complexes formed during an allergic response.
• Basophils: if a basophil is stimulated by an antigen or by tissue injury, it responds by releasing substances within the granule, this
in part of the response seen in allergic & inflammatory reactions.
• Lymphocytes: They form the basis of the cellular & humoral responses. There are two subtypes B cells & T cells, T
cells precursors originate in bone marrow, and these cells migrate to the thymus gland for further differentiation unto T
cells. Nature Killer (NK) cells are lymphocytes that do not require prior exposure to antigens to kill virus infected cells &
activate T cells & phagocytes.
• Monocytes: Potent phagocytic cells that ingest small or large masses of matter, such as bacteria, dead cells, tissue
debris, & old or defective RBCs. These cells are only present in the blood for a short time before they migrate into the
tissues & become macrophages.
• Thrombocytes: Primary function is to initiate the clotting process by producing an initial platelet plug in the early
phases of the process. One third of platelets in the body reside in the spleen, typically the lifespan of a platelet is 8 to
11 days. Platelet production is regulated by thrombopoietin, a growth factor that acts on bone marrow to stimulate
platelet production.
, 2
➢ ERYTHROPOIESIS
• The process of RBC production, which is regulated by cellular oxygen requirements & general metabolic activity. Is stimulated by
hypoxia & controlled erythropoietin, a glycoprotein, growth factor synthesized & released primarily in the kidney. The normal life
span of an erythrocytes is 120 days.
➢ HEMOLYSIS
• Destruction of RBCs by monocytes & macrophage removes abnormal, defective, damaged, & old RBCs from circulation. Normally
occurs in the bone marrow, liver, & spleen
