1. Prof. Mukul Sharma
Medi-Caps University, Indore
Blood and Lymphatic System

2. Body Fluids
• Body Fluids: Liquids within the human body. Also called Bodily fluid, Biofluid.
About 60% (60-67%) of total body weight. Slightly lower in females.
 Intracellular fluid (ICF) is the cytosol within the cell.
 Extracellular fluid is the term for the many fluids that exist in an organism
outside of cells of the organism, but sealed within the body cavities and vessels.
Example: Blood
The ECF is divided into the interstitial fluid which bathes the outside of the cells
and intravascular fluid (i.e., plasma, lymph, and cerebral spinal fluid).
Prof. Mukul Sharma Medi-Caps University, Indore

3. Fluid balance in the Body7
• Compartments for
Body Fluids
1. Intracellular
2. Extracellular
a. Interstitial
b. Plasma
Prof. Mukul Sharma Medi-Caps University, Indore
3
Fig: Fluid Balance 7

4. Blood
Liquid fluid connective tissue and fluid which carry important
nutrients and oxygen to the cells and transport metabolic
waste products away from those same cells.
Composed of following parts:
1. RBC: carry oxygen to the tissues.
2. WBC: fight infections
3. Platelets: Help in clotting of blood.
Prof. Mukul Sharma Medi-Caps University, Indore
Fig: Components of Blood 14

5. Prof. Mukul Sharma Medi-Caps University, Indore
Composition of blood
I. Plasma:
Water (90%)
Protein (8%) a) albumin: osmotic pressure, Globulin: antibody formation and Fibrinogen :Blood
clotting
Hormones and electrolytes
Nutrients :Glucose, amino acids, Triglycerides, Cholesterol
Waste products: Urea, Amino acids, Creatinine, Bilirubin
Gases: CO2, NO2, O2
Ions: Na, K , Cam Mg, Cl, Fe, PO4, H, HCO3, Fe
II. Formed Elements (45%) :
Platelets,
RBCs,
WBCs : Basophils, Neutrophils, Eosinophils, Lymphocytes, Monocytes

6. Prof. Mukul Sharma Medi-Caps University, Indore
Table: Blood cells types with functions 2

7. Functions of Blood
• Transporting oxygen and nutrients to the lungs and tissues.
• Forming blood clots to prevent excess blood loss.
• Carrying cells and antibodies that fight infection.
• Bringing waste products to the kidneys and liver, which filter
and clean the blood.
• Regulating body temperature.
Prof. Mukul Sharma
Medi-Caps University, Indore

8. Hematopoietic
• It is the production of all of the cellular components of blood and blood
plasma. It occurs within the hematopoietic system, which includes organs
and tissues such as the bone marrow, liver, and spleen.
• It is the process through which the body manufactures blood cells.
Prof. Mukul Sharma
Medi-Caps University, Indore
Fig: Hemotopoiesis 14

9. Prof. Mukul Sharma Medi-Caps University, Indore
Fig: Formation of different WBC cells 13

10. Formation of hemoglobin,
• Synthesis of hemoglobin begins in the proerythroblasts and continues
even into the reticulocyte stage of the red blood cells.
• Therefore, when reticulocytes leave the bone marrow and pass into the
blood stream, they continue to form minute quantities of hemoglobin for
another day or so until they become mature erythrocytes.
• First, succinylCoA, formed in the Krebs metabolic cycle, binds with glycine
to form a pyrrole molecule.
• Four pyrroles combine to form protoporphyrin IX, which then combines
with iron to form the heme molecule.
• Finally, each heme molecule combines with a long polypeptide chain, a
globin synthesized by ribosomes, forming a subunit of hemoglobin called a
hemoglobin chain.
Prof. Mukul Sharma
Medi-Caps University, Indore

11. Formation of Hemoglobin
• Each chain has a molecular weight of about 16,000; four of these in turn
bind together loosely to form the whole hemoglobin molecule.
• There are several slight variations in the different subunit hemoglobin
chains, depending on the amino acid composition of the polypeptide
portion. The different types of chains are designated alpha chains, beta
chains, gamma chains, and delta chains.
Normal values:
• In male- 13-18 gm/100 mL of blood sample
• In female: 12-16 gm/100 mL of blood sample
Prof. Mukul Sharma
Medi-Caps University, Indore

12. Prof. Mukul Sharma Medi-Caps University, Indore
Formation of Hemoglobin
1. 2 succinyl-CoA + 2 glycine Pyrrole
2 4 pyrrole Protoporphyrin IX
3 Protoporphyrin IX + Fe ++ heme
4 Heme + Polypeptide Hemoglobin Chain (alpha and beta)
5 2 alpha Chains + 2 beta chains Haemoglobin A

13. Prof. Mukul Sharma Medi-Caps University, Indore
Figure: Structure of hemoglobin1, 2

14. Prof. Mukul Sharma Medi-Caps University, Indore
Fig: Maturation of Erythrocytes 1

15. Rh factors
• The Rh blood group system is a human blood group system. It contains
proteins on the surface of red blood cells.
• It is the second most important blood group system, after the ABO blood
group system.
• The second major blood grouping system is the Rhesus (Rh) system.
• Philip Levine, in 1939, discovered that the sera of most women who gave
birth to infants with hemolytic disease contained an antibody that reacted
with the red cells of the infant and with the red cells of 85% of Caucasians.
• In 1940, Landsteiner and Wiener injected blood from the monkey Macacus
rhesus into rabbits and guinea pigs, and discovered the resulting antibody
agglutinated rhesus (Rh) red cells, which appeared to have the same
specificity as the neonatal antibody.
Prof. Mukul Sharma Medi-Caps University, Indore

16. Rh factors
• The donors whose cells were agglutinated by the antibody to
Rh red cells were termed Rh positive; those whose cells were
not agglutinated were termed Rh negative.
• It is now known that the antibody obtained by Landsteiner and
Wiener reacts with an antigen (LW) is different but is closely
related to the one that is recognized in human hemolytic
disease, but nevertheless the Rh nomenclature is still retained.
• Like the ABO blood types, the Rh factor is an inherited blood
protein, or antigen, on red blood cells.
Prof. Mukul Sharma Medi-Caps University, Indore Fig: Rh factor 1

17. Rh factor and its facts
• The term Rh blood group system refers to the five main Rh
antigens (C, c, D, E, and e) as well as many other less frequent
Rh antigens.
• The terms Rh factor and Rh antigen are similar, and both refer
to the RhD antigen only.
• All of the Rh antigens, antigen D (RhD) is most important.
Prof. Mukul Sharma
Medi-Caps University, Indore

18. 1/23/2021 Prof. Mukul Sharma Medi-Caps University, Indore 18
Fig: Effect of Rh factors in baby 11

19. Transfusion
• Blood transfusions replace blood that is lost through surgery or
injury or provide it if your body is not making blood properly.
• Need a blood transfusion if you have anemia, sickle cell disease,
a bleeding disorder such as hemophilia, or cancer.
• Blood transfusions are low risk, but may have some mild side
effects, like allergic reactions or a fever. These side effects are
usually treatable with medicine.
• It’s important to have the right type of blood transfused.
• There are four blood types. Each can be positive or negative.
Prof. Mukul Sharma Medi-Caps University, Indore

20. Blood Transfusion
• A
• B
• AB
• O
Transfusing the wrong kind of blood can make you sick. Type O
blood is safe for everyone to use. People with this type are
called “universal donors.”
Prof. Mukul Sharma Medi-Caps University, Indore
Figure: Structures of A, B, and O Oligosaccharide Antigens1, 2
Abbreviations: Fuc, fucose; Gal, galactose; GalNAc, N-
acetylgalactosamine; GlcNAc, N-acetylglucosamine.

21. Significance of Transfusion
• Blood transfusions can replace the parts of blood that have
been lost in an injury or during surgery.
• Blood is a vital fluid in your body, and losing too much can be
fatal.
• Transfusions put the different parts of blood back into your
system to keep you healthy.
Prof. Mukul Sharma Medi-Caps University, Indore

22. Blood Grouping
• The term “blood group” refers to the entire blood group system
comprising red blood cell (RBC) antigens whose specificity is
controlled by a series of genes which can be allelic or linked very
closely on the same chromosome.
• “Blood type” refers to a specific pattern of reaction to testing
antisera within a given system.
• Over a period of time, blood groups has evolved to encompass not
only transfusion-related problems but also specific disease
association with RBC surface antigens.
• Karl Landsteiner has been credited for the discovery of ABO blood
group system in 1900.
Prof. Mukul Sharma
Medi-Caps University, Indore

23. Blood grouping
• Serology based on simple but strong scientific reasoning led to
identification of major blood groups such as O, A, and B types,
compatibility testing, and subsequent transfusion practices.
• He was awarded Noble Prize in 1930 for this discovery. His
obituary lists an immense contribution of more than 346
publications.
Prof. Mukul Sharma Medi-Caps University, Indore
Anti A Anti B Blood group
Agglutination No agglutination A group
No agglutination Agglutination B group
Agglutination Agglutination AB group
No agglutination No agglutination O group

24. Prof. Mukul Sharma Medi-Caps University, Indore
Fig: ABO Blood Grouping System 1,2

25. Blood disorders
• Anemia
• Bleeding Disorder
• Hodgkin’s disease
• Leukemia
• Non-hodgkin’s disease
• Therombocythemia
Prof. Mukul Sharma
Medi-Caps University, Indore

26. Blood disorders
• Anemia: Short of RBC.
• Hemophilia- Inherited, serious bleeding disorder leads to uncontrolled
bleeding which can occurs spontaneously and after minor trauma.
• Thrombocythemia- abnormal small number of platelets in the circulating
blood.
• Hemochromatosis- Disorder of iron metabolism characterized by excessive
absorption.
• Hodgkin’s Disease- marked by chronic enlargement of the lymph nodes.
• Leukemia's- Progressive proliferation of abnormal leukocytes.
• Non-Hodgkin’s Lymphoma- Lymphoma other than Hodgkin disease.
Prof. Mukul Sharma
Medi-Caps University, Indore

27. Anemia
Prof. Mukul Sharma Medi-Caps University, Indore
Fig: Anemia Symptoms 10

28. Reticulo-endothelial system.
• Systems of cells which have high phagocytic property.
It consist of following cells.
• Monocytes
• Macrophages
• Fixed tissue macrophages.
Essential component of Immune system.
Eat microbes and toxins from the body.
Prof. Mukul Sharma Medi-Caps University, Indore
Fig: Reticulo endothelial cells in
the human body 9

29. Blood Clotting
3 Major stages:
• Vascular spasm
• Platelet plug formation
• Coagulation
Stages of blood clotting:
Formation of prothrombinase: Intrinsic pathways
Extrinsic pathways
Prothrombin Thrombine (Enzyme)
Fibrinogen(Soluble) Fibrin (Insoluble)
Prof. Mukul Sharma Medi-Caps University, Indore

30. Fig: Mechanisms of coagulation 8
Prof. Mukul Sharma Medi-Caps University, Indore

31. Lymphatic System
Prof. Mukul Sharma Medi-Caps University, Indore

32. Lymphatic System
• Lymphatic system, a subsystem of the circulatory system in
the vertebrate body that consists of a complex network of
vessels, tissues, and organs.
• Lymph is a clear and colorless fluid; the word "lymph" comes from
the Latin word lympha, which means "connected to water”.
• The lymphatic system primarily consists of lymphatic vessels, which
are similar to the veins and capillaries of the circulatory system.
The vessels are connected to lymph nodes, where the lymph is
filtered. The tonsils, adenoids, spleen and thymus are all part of the
lymphatic system.
Prof. Mukul Sharma
Medi-Caps University, Indore

33. Prof. Mukul Sharma Medi-Caps University, Indore
Lymphatic System
•Adenoids
•Tonsils
•Thymus gland
•Appendix
•Payers patches
•Spleen
•Thoracic duct
•Lymphatic Nodes, ducts and
Vessels
•Bone Marrow Fig: Different organs in Lymphatic System6

34. Functions of Lymphatic System
• The primary function of the lymphatic system is to transport lymph, a fluid containing
infection-fighting white blood cells, throughout the body.
• The spleen acts as a blood filter; it controls the amount of red blood cells and blood storage
in the body, and helps to fight infection by producing lymphocytes in blood.
• The thymus is small organ stores immature lymphocytes and prepares them to become
active T cells, which help destroy infected or cancerous cells.
Prof. Mukul Sharma
Medi-Caps University, Indore

35. Functions
• Tonsils are the first line of defense as part of the immune system
• It also helps defend the body against infection by supplying
disease-fighting cells called lymphocytes.
• The lymphatic system helps maintain fluid balance in the body by
collecting excess fluid and particulate matter from tissues and
depositing them in the bloodstream.
Prof. Mukul Sharma Medi-Caps University,
Indore

36. References
1. Grabowski Tortora, “Principles of Anatomy and Physiology”, Palmetto, GA,
U.S.A.
2. Waugh Anne, Grant Allison, Ross & Wilson: Anatomy and physiology in health
& illness 2006, edition 10th, Elsevier publication.
3. Sembulingam K. and Sembulingam P., “Essentials of Medical Physiology”,
Jaypee brothers’ medical publishers, New Delhi.
3. Kathleen J.W. Wilson , “Anatomy and Physiology in Health and Illness”,
Churchill Livingstone, New York.
4. Best and Tailor, “Physiological basis of Medical Practice”, Williams & Wilkins
Co, Riverview, MI USA.
5. Arthur C,Guyton and John.E Hall, “Text book of Medical Physiology”,
Miamisburg, OH, U.S.A.
Prof. Mukul Sharma Medi-Caps University, Indore

37. Wibliography
6. www.Encyclopedia Britannica
7. @Johnwilley and sons.
8. https://images.app.goo.gl/hAzvbos1qQktWdhs9
9. https://images.app.goo.gl/pTVj7QxUfhTz9bSR7
10. www.netmeds.com
11. https://images.app.goo.gl/aJkYH3YTFc7pX6pw8
12. www.buzzle.com
13. https://images.app.goo.gl/CoPtbRh57zE7Lx4X9
14. https://images.app.goo.gl/erWGBkn1Fyc6HLor5
1/23/2021
Prof. Mukul Sharma
Medi-Caps University, Indore
37

38. Thanks