Blood
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Dr. Amal M. Moustafa, , Department of Histology & Cytology
Dr. Amal M. Moustafa, , Department of Histology & Cytology
The <strong>Blood</strong><br />
Dr. Amal M. Moustafa, , Department of Histology & Cytology
• Definition:-<br />
The <strong>Blood</strong><br />
• It is the viscid fluid, present in the closed<br />
circulatory system.<br />
• Contents:<br />
1-blood cells:<br />
• They form about 45% of the blood volume.<br />
• The <strong>Blood</strong> cells are:-<br />
– a- Red cells (erythrocytes).<br />
– b- White cells (leukocytes).<br />
– c- <strong>Blood</strong> platelets (thrombocytes).<br />
2-Plasma: it forms 55% of the blood volume.<br />
Dr. Amal M. Moustafa, , Department of Histology & Cytology
The <strong>Blood</strong> Cells<br />
Dr. Amal M. Moustafa, , Department of Histology & Cytology
RED BLOOD CORPUSCLES (RBCS)<br />
Erythrocytes<br />
• A- Shape of RBCs:-<br />
• They are rounded, biconcave<br />
disc shape.<br />
• In slow blood stream and in blood<br />
film they adhere together forming<br />
“Rouleaux” due to high surface<br />
tension.<br />
• B- Size:-<br />
• Normal diameter:<br />
• 6-9 um<br />
• (average 7.5 um).<br />
Dr. Amal M. Moustafa, , Department of Histology & Cytology
C- Colour:-<br />
• Fresh, single RBC is greenish<br />
yellow due to minimal HB.<br />
• A drop of blood appears red as<br />
it contains large number of<br />
RBCs.<br />
• In stained sections, RBCs with<br />
normal HB appear acidophilic<br />
with pale centre<br />
(normochromic).<br />
• D- Number:-<br />
• In males: 5 - 5.5 million /mm3.<br />
• In females: 4.5 - 5 million<br />
/mm3.(due to loss of blood<br />
during menstruation and<br />
depression of bone marrow by<br />
female sex hormones).<br />
Dr. Amal M. Moustafa, , Department of Histology & Cytology
E- Structure of RBCs:-<br />
• They are non nucleated cells (now called corpuscles).<br />
• They have no organoids but filled with HB.<br />
• They are surrounded by cell membrane, which is plastic and has selective<br />
permeability.<br />
• They contain important enzymes e.g. carbonic anhydrase enzyme.<br />
• Adaptation of RBCs to its function:-<br />
• Its biconcave shape increases surface area for more gas<br />
exchange.<br />
• Absence of nuclei and cell organoids allows more space to HB<br />
for gas exchange.<br />
• Carbonic anhydrase enzyme plays an important role in<br />
transportation of CO2 from tissues to the lung.<br />
• Selective permeability of the cell membrane allows easy<br />
exchange of oxygen and CO2 but not HB.<br />
• Plastic cell membrane allows RBCs to be squeezed in narrow<br />
vessels, then regain its normal shape in wide vessels thus<br />
prevent their rupture.<br />
Dr. Amal M. Moustafa, , Department of Histology & Cytology
LEUCOCYTES (WBCS)<br />
• - :Definition<br />
• They are true nucleated cells having cell<br />
organoids, cell inclusions, but no hemoglobin.<br />
• :Colour<br />
• Single WBC is colourless (leucocyte) but when<br />
aggregated, they appear white (WBCs).<br />
• :Number. 4000-11000/mm 3<br />
Dr. Amal M. Moustafa, , Department of Histology & Cytology
Classification of leucocytes:<br />
-1-Granular leucocytes:- 2- Non-granular:-<br />
a- Neutrophils. a- Lymphocytes.<br />
b- Eosinophils. b- Monocytes.<br />
• c- Basophils.<br />
Dr. Amal M. Moustafa, , Department of Histology & Cytology
Neutrophils<br />
(leucocytes polymorphonuclear)<br />
• Percentage: 60-75% of total leucocytes.<br />
• Shape: spherical<br />
• Size: 10-12 um.<br />
• Nucleus:-<br />
• Single, dark stained and segmented (2-5<br />
segments connected by fine chromatin threads.<br />
• About 60% of female nuetrophils have Barr<br />
bodies attached to their nuclei.<br />
• Cytoplasm:- contains fine neutrophilic<br />
granules.<br />
Dr. Amal M. Moustafa, , Department of Histology & Cytology
E/M:<br />
• Few mitochondria and<br />
• endoplasmic reticulum.<br />
• Two types of granules are present:-<br />
• Specific granules:<br />
• Numerous & small in size.<br />
• Contain bacteriostatic and bactericidal substances.<br />
• Azurophilic granules:<br />
• Few in number & large in size.<br />
• Contain hydrolytic enzymes (lysosomes).<br />
• Life span: 1- 4 days.<br />
Dr. Amal M. Moustafa, , Department of Histology & Cytology
Function:-<br />
• Defense against microorganisms.<br />
• When microorganism invades the surrounding tissue,<br />
the neutrophils migrate from the capillaries and<br />
phagocytose it (so called microphages).<br />
• They also secrete proteolytic enzymes.<br />
• During infections, they stimulate the bone marrow to<br />
produce more leucocytes (neutrophilia).<br />
• They attract monocytes to the infected area.<br />
• Precipitate in pus formation.<br />
• They secrete trephone substances, that help in<br />
healing of wounds.<br />
Dr. Amal M. Moustafa, , Department of Histology & Cytology
Eosinophils<br />
• Percentage: 2- 5% of total leucocytes.<br />
• Shape: spherical<br />
• Size: 12-15 um.<br />
• Nucleus: Bilobed “horse shoe-shaped”.<br />
• Cytoplasm: contains acidophilic refractile<br />
granules.<br />
• E/M:<br />
• Few mitochondria, rER, and Golgi.<br />
• Coarse ellipsoid granules, with electron dense<br />
crystalloid core in the centre.<br />
• These granules contain histaminase and<br />
sulphatase enzyme.<br />
• Life span: 8-12 days.<br />
Dr. Amal M. Moustafa, , Department of Histology & Cytology
Function:-<br />
1-In allergic conditions, the mast<br />
cells attract eosinophils to the site<br />
of allergy to perform anti-allergic<br />
action through:<br />
2-They can phagocytose the<br />
antigen-antibody complex.<br />
3-They secrete histaminase and<br />
sulphatase enzymes which<br />
destroy histamine and sulphate<br />
substances of allergy.<br />
Dr. Amal M. Moustafa, , Department of Histology & Cytology
Basophils<br />
• Percentage: ½ - ١ % of .total leucocytes<br />
• Shape: spherical<br />
• Size: -١٠- ١٢ .um<br />
• Nucleus: .Large and irregular<br />
• -:Cytoplasm<br />
• Filled with large basophilic granules.<br />
• These granules can be stained metachromatic .<br />
• They also stained with Giemsa stain.<br />
• E/M<br />
• They contain coarse electron dense granules.<br />
• These granules contain histamine and heparin.<br />
• Life span ١٥-١٠ : .days<br />
• -:Function<br />
• They produce heparin and histamine during allergy.<br />
• They have minimal phagocytic activity.<br />
• They release eosinophil chemotactic factor.<br />
Dr. Amal M. Moustafa, , Department of Histology & Cytology
Lymphocytes<br />
Non granular leucocytes<br />
Percentage: 25-30%.<br />
• Classification :<br />
•<br />
1-Small sized lymphocytes:<br />
4-7 um.<br />
2-Medium sized lymphocytes: 7-10 um.<br />
3-Large sized lymphocytes:<br />
10-15 um.<br />
• Lymphocytes found in the blood are mainly<br />
small and medium sized, while the lymphoid<br />
organs contain the three types.<br />
Dr. Amal M. Moustafa, , Department of Histology & Cytology
Large or medium-sized lymphocytes<br />
• Percentage: 5-10%.<br />
• Size: ١٠ - ١٢ um .<br />
• Nucleus:<br />
.indented<br />
Large, pale and<br />
• Cytoplasm: abundant, more<br />
.basophilic and non granular<br />
• E / M - :<br />
• The cytoplasm contains<br />
polyribosomes, numerous<br />
mitochondria, large Golgi and<br />
lysosomes.<br />
Dr. Amal M. Moustafa, , Department of Histology & Cytology
Small Lymphocytes<br />
• Percentage: 15-20%.<br />
• Shape: spherical.<br />
• Size: 6-8 um.<br />
• Nucleus:-<br />
• Central, round and dark stained.<br />
• Surrounded by a thin rim of cytoplasm.<br />
• Cytoplasm:- few in amount & pale<br />
basophilic.<br />
• E/M:-<br />
• They have few ribosomes, few<br />
mitochondria, a very small Golgi and few<br />
azurophilic granules.<br />
• Classification:-<br />
• B. lymphocytes.<br />
• T. lymphocytes .<br />
Dr. Amal M. Moustafa, , Department of Histology & Cytology
B-<br />
lymphocytes<br />
• :Development<br />
• U.M.C in the bone marrow colony forming cells … lymphoblast . B… .lymphocyte . B<br />
• Percentage: 30% .lymphcytes<br />
• Types:<br />
• B.lymphocytes of humoral immunity.<br />
• B.memory cells.<br />
• :Life span .3months<br />
• Function<br />
• 1- Humoral immunity:<br />
• When exposed to antigen, they are activated into medium sized lymphocytes.<br />
• Some of the active cells are differentiated into plasma cells which produce<br />
antibodies.<br />
• This is called primary immune response.<br />
2- Secondary response (B memory cells):<br />
• Some of the active cells are not changed into plasma cells but remain as memory<br />
cells.<br />
• When exposed to the same antigen again, they produce more rapid and more<br />
extensive humoral immune response.<br />
Dr. Amal M. Moustafa, , Department of Histology & Cytology
T. Lymphocytes<br />
• Development:<br />
• UMC in the bone marrow colony<br />
forming cells which migrate to the<br />
thymus gland where they develop into<br />
T.lymphocytes (thymus dependent).<br />
• :Percentage<br />
• ٧٠ % of small lymphocytes<br />
• :Life span .years<br />
• :Types<br />
• T. killer cells: produce cytotoxic<br />
substances.<br />
• T. memory cells<br />
• T. helper cells.<br />
• T. suppressor cells.<br />
• Lymphokines secreting cells.<br />
Dr. Amal M. Moustafa, , Department of Histology & Cytology
T. Lymphocytes<br />
Function: •<br />
• Cell mediated immunity:-<br />
• When exposed to cellular antigen, the T-lymphocytes are activated and<br />
come in contact with the antigen.<br />
• They secrete cytotoxic substance to destroy it.<br />
• Graft rejection cells in organ transplantation:<br />
• .(by cell mediated immunity)<br />
• T-memory cells:<br />
• Some of the activated T-cells remain in the body as memory cells, that<br />
can attack the same antigen after a long period of time.<br />
• T-helper cells:-<br />
• T-lymphocytes, can help the B-lymphocytes to be activated by the<br />
antigen.<br />
• .٥ Se cretion of lymphokines:<br />
• Interferon: antiviral.<br />
• Colony stimulating factor: stimulate bone marrow cells.<br />
• Macrophage factor: antibacterial.<br />
• ٦ . They act as macrophage attracting cells .<br />
Dr. Amal M. Moustafa, , Department of Histology & Cytology
Classification of lymphocytes<br />
Development:<br />
Percentage :<br />
Life span<br />
Function :<br />
Types :<br />
B. lymphocytes<br />
In bone marrow<br />
30%<br />
٣months<br />
Humoral immunity<br />
T. lymphocytes<br />
In the thymus<br />
٧٠ %<br />
years<br />
Cell mediated<br />
immunity<br />
Dr. Amal M. Moustafa, , Department of Histology & Cytology
Monocytes<br />
• Percentage : 3-8%.<br />
• Size : ١٥ um .<br />
• Nucleus : .large, pale and kidney shaped<br />
• ytoplasmC: .abundant and appears pale blue *<br />
• .<br />
• M/E -:<br />
• Many microvilli and pinocytotic vesicles near the cell surface.<br />
• Few cell organelles, small Golgi and azurophilic granules<br />
(lysosomes).<br />
• Life Span 3 Days<br />
• Function -:<br />
• Monocytes can penetrate through capillaries and venules to<br />
reach the C.T. where they can be transformed into<br />
macrophages.<br />
Dr. Amal M. Moustafa, , Department of Histology & Cytology
PLATELETS (THROMBOCYTES)<br />
Dr. Amal M. Moustafa, , Department of Histology & Cytology
PLATELETS (THROMBOCYTES)<br />
• : Definition<br />
• They are fragments of cytoplasm covered with<br />
membrane but have no nucleus (not true cells).<br />
• Origin : .in the red bone marrow megakaryocytes<br />
• Size : 2 - 4 .m<br />
• Shape : .oval or rounded discs<br />
• Number: ١٥٠٫٠٠٠ - ٤٠٠٫٠٠٠ / mm3.<br />
• L / M :<br />
• Appear as oval or rounded non nucleated discs.<br />
• Their outer part appears transparent and pale blue<br />
(called hyalomere).<br />
• Their central part contains dark stained granules<br />
(called granulomere).<br />
Dr. Amal M. Moustafa, , Department of Histology & Cytology
E/M:<br />
1-Cell membrane:-<br />
Irregular and covered with<br />
a thick cell coat.<br />
2- Hyalomere:- contains<br />
Tubules & vesicles invaginated<br />
from the cell membrane.<br />
Actin-like mirofilaments and<br />
microtubules to maintain the<br />
ovoid shape of the platelet.<br />
3- Granulomere: (chromomere): Contains:-<br />
Alpha granules: contain fibrinogen.<br />
Beta granules: mitochondria .<br />
Delta granules: contains serotonin, ATP, ADP and calcium.<br />
Lambda granules: lysosomes.<br />
Glycogen granules.<br />
Dr. Amal M. Moustafa, , Department of Histology & Cytology
Life span:<br />
١٠-٥<br />
days .<br />
• Function -:<br />
• Stop bleeding (haemostasis) through :<br />
1-Secretion of serotonin vasconstriction<br />
.decrease blood loss<br />
2-The platelets adhere to the inner wall of the<br />
injured blood vessels forming platelet<br />
aggregation or white thrombus.<br />
3-Then, they secrete thromboblastin change<br />
into thrombin prothrombin change<br />
attract RBCs fibrinogen into fibrin network<br />
which )coagulation(to form red thrombus<br />
.close blood vessels and stop bleeding<br />
Dr. Amal M. Moustafa, , Department of Histology & Cytology
Number<br />
RBCs<br />
Neutrophils<br />
Anaemia or<br />
:(oligocythemia)<br />
Neutropenia:<br />
Polycythaemia<br />
Neutrophilia:<br />
Eosinophils<br />
Basophils<br />
Lymphocytes<br />
Eosinopenia:<br />
Eosinophilia:<br />
Basophilia:<br />
Lymphocytosis:<br />
Monocytes<br />
Platelet<br />
Thrompocytopenia<br />
Monocytosis:<br />
Dr. Amal M. Moustafa, , Department of Histology & Cytology
• 1- Anaemia or oligocythemia<br />
• Decease in number is<br />
caused by:-<br />
• A ،Deficiency of iron -<br />
B.vit12 .proteins، copper ،<br />
• - b Defect in bone marrow<br />
aplastic .anaemia<br />
• - c Haemorrhage<br />
haemorrhagic anaemia .<br />
• - d haemolytic<br />
.anaemia<br />
Haemolysis<br />
• Causes of haemolysis<br />
are -:<br />
• Incompatible blood<br />
transfusion.<br />
• Acids and alkalies.<br />
• Bacterial toxins and viruses.<br />
• Snake venom.<br />
• Hypotonic solutions and fat<br />
solvents.<br />
• 2- Polycythaemia<br />
Haemoconcentration):<br />
• The actual number of RBCs does<br />
not increase but the volume of<br />
plasma is reduced.<br />
• Occurs in cases of dehydration<br />
due to vomiting, diarrhea or<br />
polyuria.<br />
• -b Compensatory<br />
polycythaemia :<br />
• There is actual increase in<br />
production of RBCs from bone<br />
marrow.<br />
• Occurs as compensatory to<br />
hypoxia as in:-<br />
• The foetus due to intrauterine<br />
anoxia.<br />
• High attitude in low O2.<br />
• Severe muscular exercise<br />
.٢need for O<br />
• Congenital heart diseases mixed<br />
.blood<br />
• Chronic lung conditions impaired<br />
.oxygenation of blood<br />
Dr. Amal M. Moustafa, , Department of Histology & Cytology
• Neutropenia:<br />
• It is a decrease of<br />
neutrophils below<br />
60%.<br />
• It occurs in:<br />
• , Influenza, measles<br />
starvation, severe<br />
poisoning, chronic<br />
Typhoid .eg infections<br />
.TB &<br />
Neutrophilia:<br />
• It is an increase<br />
of neutrophils<br />
above 75%.<br />
• It occurs in:<br />
–Pyogenic<br />
infections: e.g.<br />
tonsilitis,<br />
appendicitis<br />
–Myocardial<br />
infarction.<br />
•<br />
Dr. Amal M. Moustafa, , Department of Histology & Cytology
• Eosinophilia:<br />
Allergic diseases.<br />
Parasitic : infections e.g.<br />
bilharziasis.<br />
•<br />
E osinopenia :<br />
It occurs after:-<br />
Prolonged steroid<br />
therapy.<br />
• Basophilia<br />
Allergic diseases.<br />
Parasitic diseases.<br />
Liver cirrhosis.<br />
• Lymphocytosis:<br />
• Whooping cough.<br />
• TB.<br />
• Syphilis.<br />
• Glandular fever<br />
• Monocytosis:<br />
• Malaria.<br />
• Typhus.<br />
• TB.<br />
• Syphilis.<br />
• Glandular fever.<br />
Dr. Amal M. Moustafa, , Department of Histology & Cytology
Dr. Amal M. Moustafa, , Department of Histology & Cytology
<strong>Blood</strong><br />
Practical Cession<br />
Dr. Amal M. Moustafa, , Department of Histology & Cytology
PLATELETS<br />
RBCs<br />
Dr. Amal M. Moustafa, , Department of Histology & Cytology
Neutrophils.<br />
Dr. Amal M. Moustafa, , Department of Histology & Cytology
Dr. Amal M. Moustafa, , Department of Histology & Cytology
Dr. Amal M. Moustafa, , Department of Histology & Cytology
Dr. Amal M. Moustafa, , Department of Histology & Cytology
Dr. Amal M. Moustafa, , Department of Histology & Cytology
Dr. Amal M. Moustafa, , Department of Histology & Cytology