Blood Physiology Professor A.M.A Abdel Gader MD, PhD, FRCP (Lond., Edin), FRSH (London) Professor of Physiology, College of Medicine - PowerPoint PPT Presentation

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Blood Physiology Professor A.M.A Abdel Gader MD, PhD, FRCP (Lond., Edin), FRSH (London) Professor of Physiology, College of Medicine

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Blood Physiology Professor A.M.A Abdel Gader MD, PhD, FRCP (Lond., Edin), FRSH (London) Professor of Physiology, College of Medicine & The Blood Bank, King Khalid ... – PowerPoint PPT presentation

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Title: Blood Physiology Professor A.M.A Abdel Gader MD, PhD, FRCP (Lond., Edin), FRSH (London) Professor of Physiology, College of Medicine


1
Blood PhysiologyProfessor A.M.A Abdel GaderMD,
PhD, FRCP (Lond., Edin), FRSH (London)Professor
of Physiology, College of Medicine The Blood
Bank, King Khalid University Hospital King Saud
UniversityRiyadh
2
BLOOD
3
Lecture 1 2Topic Red Blood Cells (RBCs)
  • Composition functions of the Blood
  • Morphological Features of RBCs.
  • Production of RBCs
  • Regulation of production of RBCs
  • Nutritional substances need for RBC production
  • Haemoglobin
  • (Iron metabolism)

4
Sites of blood formation
  • Adults.. Bone Marrow
  • (Flat bones)
  • Children . Bone Marrow
  • (Flat long bones)
  • Before Birth . Bone Marrow
  • Liver spleen,lymph nodes
  • Fetus 1st 4 months Yalk Sac

5
Production of RBC-cont.
6
Monophyletic theory of cell formation
Red blood cells
7
Genesis of RBC
8
Hematopoiesis
(17.9)
9
Erythropoiesis, (Formation/genesis of RBC)
  • Growth factors (inducers)
  • Control growth and maturation of stem cells
  • Interleukin-3
  • Erythropoeitin
  • Granulocyte stimulating factor (GSF)

10
Production of Erythrocytes Erythropoiesis
Figure 17.5
11
Erythropoiesis, (Formation/genesis of RBC)
  • Stages of RBC development
  • Pluripotential haemopoietic STEM CELL
  • Committed Stem cell
  • Proerthroblast
  • early, intermediate and late normoblast
  • Reticulocytes
  • Erythrocytes

12
Maturation Sequence
13
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14
Stages of differentiation of RBC
15
Features of the maturation process of RBC
  1. Reduction in size
  2. Disappearance of the nucleus
  3. Acquisition of haemoglobin

16
Lecture 1 2Topic Red Blood Cells (RBCs)
  • Composition functions of the Blood
  • Morphological Features of RBCs.
  • Production of RBCs
  • Regulation of production of RBCs
  • Nutritional substances need for RBC production
  • Haemoglobin
  • (Iron metabolism)

17
  • Control of Erythropoiesis

18
Control of Erythropoiesis
  • Erythropoiesis is stimulated by erythropoietin
    hormone
  • Stimulated by
  • Hypoxia (low oxygen)
  • Anaemia
  • Hemorrhage
  • High altitude
  • Lung disease
  • Heart failure

19
Role of the kidneys in RBC formation
20
Tissue oxygenation and RBC formation
21
Control of erythropoiesis Cont.
  • Erythropoietin
  • glycoprotein
  • 90 from kidneys 10 liver
  • Stimulates the growth of
  • early RBC-committed stem cells
  • Can be measured in plasma urine
  • High level of erythropoietin
  • anemia
  • High altitude
  • Heart failure

22
Maturation Times
23
Control of erythropoiesis cont.
  • Other hormones
  • Androgens, Thyroid, cortisol growth hormones
    are essential for red cell formation
  • Deficiencies of any one of these hormones results
    in anaemia

24
Control of erythropoiesis
25
Erythropoitein- Mechanism of production of
  • Hypoxia, (blood loss)
  • ?
  • Blood O2 levels
  • ?
  • Tissue (kidney) hypoxia
  • ?
  • ? Production of erythropoietin
  • ?
  • ? plasma erythropoietin
  • ?
  • Stimulation of erythrocytes production
  • ?
  • ? Erythrocyte production

26
Lecture 1 2Topic Red Blood Cells (RBCs)
  • Composition functions of the Blood
  • Morphological Features of RBCs.
  • Production of RBCs
  • Regulation of production of RBCs
  • Nutritional substances need for RBC production
  • Haemoglobin
  • (Iron metabolism)

27
Nutritional requirements for RBC formation
  • Amino acid
  • HemoGlobin
  • Iron
  • HemoGlobin
  • Deficiency ? small cells
  • (microcytic anaemia )

28
Nutritional requirements for RBC formation cont.
  • 3. Vitamins
  • Vit B12 and Folic acid
  • Synthesis of nucleoprotein DNA
  • Deficiency ? macrocytes
  • megaloblastic (large) anemia
  • Vit C
  • Iron absorption

29
Production of Erythrocytes Erythropoiesis
Figure 17.5
30
Vitamin B12 Folic acid
  • Important for cell division and maturation
  • Deficiency of Vit. B12 gt Red cells are abnormally
    large (macrocytes)
  • Deficiency leads
  • Macrocytic (megaloblastic) anaemia
  • Dietary source meat, milk, liver, fat, green
    vegetables

31
Vitamin B12
  • Absorption of VB12 needs intrinsic factor
    secreted by parietal cells of stomach
  • VB12 intrinsic factor is absorbed in the
    terminal ileum
  • Deficiency arise from
  • Inadequate intake
  • Deficient intrinsic factors
  • Pernicious anaemia

32
Nutritional requirements for RBC formation cont.
  • Essential elements
  • Copper, Cobalt, zinc, manganese, nickel
  • Cobalt ? Erythropoietin

33
ANAEMIAS
  • Definiation
  • Decrease number of RBC
  • Decrease Hb
  • Symptoms
  • Tired, Fatigue, short of breath,
  • (pallor, tachycardia)

34
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35
Causes of anaemia
  • 1. Blood Loss
  • acute? accident
  • Chronic ? ulcer, worm
  • 2. Decrease RBC production
  • Nutritional causes
  • Iron ? microcytic anaemia
  • VB12 Folic acid ? megaloblastic anaemia
  • Bone marrow destruction by cancer, radiation,
    drugs ? Aplastic anaemia.
  • 3. Haemolytic ? excessive destruction
  • Abnormal Hb (sickle cells)
  • Incompatible blood transfusion

36
  • The most common cause for a hypochromic
    microcytic anemia is iron deficiency. The most
    common nutritional deficiency is lack of dietary
    iron. Thus, iron deficiency anemia is common.
    Persons most at risk are children and women in
    reproductive years (from menstrual blood loss and
    from pregnancy).

37
The most common cause for a hypochromic
microcytic anemia is iron deficiency. The most
common nutritional deficiency is lack of dietary
iron. Thus, iron deficiency anemia is common.
Persons most at risk are children and women in
reproductive years (from menstrual blood loss and
from pregnancy)
38
Macrocytic anemia
The RBC are almost as large as the lymphocyte.
Note the hypersegmented neurotrophil. There are
fewer RBCs.
39
The RBC's here are smaller than normal and have
an increased zone of central pallor. This is
indicative of a hypochromic (less hemoglobin in
each RBC) microcytic (smaller size of each RBC)
anemia. There is also increased anisocytosis
(variation in size) and poikilocytosis (variation
in shape).
40
Macrocytic anemia
Note the hypersegmented neurotrophil and also
that the RBC are almost as large as the
lymphocyte. Finally, note that there are fewer
RBCs.
41
Polycythemia
  • Increased number of RBC
  • Types
  • True or absolute
  • Primary (polycythemia rubra vera) uncontrolled
    RBC production
  • Secondary to hypoxia high altitude, chronic
    respiratory or cardiac disease
  • Relative
  • Haemoconcentration
  • loss of body fluid in vomiting, diarrhea, sweating
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