blood,clotting factors, blood pressure, blood group,blood transfusion,blood vessel of the body.

1. Blood anatomy and
physiology
Soilan Chandro Das
RN,BSN,BSMMU

2. Blood Definition
It is basically connective tissue in fluid form. It is called as
the fluid of life, as it carries oxygen from lungs to all parts
of the body and carbondioxide from all parts of the body
to the lungs.
Volume: In new born-450 ml
Normal healthy male adult-5-6L
pH: Slightly alkaline 7.4
Specific Gravity: Total blood- 1.052-1.061
Viscosity: 5 times more than water
COMPOSITION OF BLOOD:
• Plasma
• Formed Elements or Blood cells

3. Blood Cells
 RED BLLOD CELLS
 WHITE BLOOD CELLS
 THROMBOCYTES
PLASMA
 Plasma is the straw colored liquid component of blood.
 It contains 90-92% 0f water and 8-9% of solids.
 These solids are the organic and inorganic substances.
 The removal of coagulation factors from plasma leaves a fluid similar to interstitial fluid,
known as serum.
SERUM
 Within 45 minutes of clot formation serum oozes out of the clot
 It is different from plasma only by the action of fibrinogen
 Serum = Plasma – Fibrinogen
plasma proteins
Proteins that are present in blood plasma and have many different functionalities, such as
Role in blood coagulation, the transport of various biochemical (lipids, hormones etc.) in
the circulatory system to the regulation of the osmotic pressure, helping maintain the
balance of fluid and electrolyte levels in the body.

5. FUNCTIONS OF BLOOD
 Nutrient supply
 Respiratory Function ( O2 and CO2}
 Excretory Function
 Transport Of Hormones And Enzymes
 Regulation of Acid-Base Balance
 Regulation of body Temperature
 Storage Function
 Defensive function
 Protection against blood loss through clotting factors .
RED BLOOD CELLS
RBCs also called as erythrocytes are non nucleated formed elements of the blood. There red color is
due to hemoglobin. All blood cells, including red and white, are produced in red bone marrow. On
average, one ounce, or 100 billion blood cells, are made each day.
NORMAL VALUES: Male-Male: 4.35-5.65 trillion cells/L, Female: 3.92-5.13 trillion cells/L
Functions: Transport oxygen from the lung to tissue cells and carbon dioxide from tissue cells to the
lung.
Life span of R.B.Cs
Average life span of RBCs is about 120 days. They are destroyed in reticuloendothelial system. When
cell became older the cell membrane became fragile. Destruction occurs mostly in capillaries of
spleen.

6. Hemoglobin
Hemoglobin -: It is composed of the protein globin (a polypeptide), and the pigment heme.
The hemoglobin has the ability to combine with oxygen is due to the four iron atoms
associated with each heme group within the molecule.
Hemoglobin content:
Average Hb content of blood is= 14-16gm/dl.
Varies with age and gender.
 In adult males-14-16gm%
 In adult females-12-14.5gm%

7. White Blood Cells
White blood cells (also called leukocytes or leucocytes and abbreviated as WBCs) Colorless and
nucleated formed elements of blood. Comparatively large in size and lesser in number. Play a role in
defense mechanism of body. White blood cells are the cells of the immune system that are involved in
protecting the body against both infectious disease and foreign invaders. All white blood cells are
produced and derived from multipotent cells in the bone marrow known as hematopoietic stem cells.
Leukocytes are found throughout the body, including the blood and lymphatic system. The lifespan of
white blood cells ranges from 13 to 20 days,
Classifications of WBC:
White blood cells, or leukocytes, are classified into two main groups: granulocytes and nongranulocytes
(also known as agranulocytes).
Normal values for total WBC and differential in adult males and females are:
Total WBC: 4,500 - 10,000
Granulocytes (or polymorphonuclears)
Neutrophils (or segs): 50 - 70% relative value (2500-7000 absolute value)
Eosinophils: 1 - 3% relative value (100-300 absolute value)
Basophils: 0.4% - 1% relative value (40-100 absolute value)
Agranulocytes (or mononuclears)
Lymphocytes: 25 - 35% relative value (1700-3500 absolute value)
Moncytes: 4 - 6% relative value (200-600 absolute value)

8. Functions of wbc
WBC's also called Leukocytes , they are one of the three types of cells present in
blood.There main function in the body is to protect body from pathogens and other
disease causing agent.A rise in their no. than normal could mean a disease causing agent
in the body.There are five types of W.B.C's.
1.Monocytes. They have a longer lifespan than many white blood cells and help to break
down bacteria.
2.Lymphocytes: They create antibodies to defend against bacteria, viruses, and other
potentially harmful invaders.
3.Neutrophils: Phagocytosis : Neutrophils and Monocytes engulf the foreign bodies by
means of phagocytosis.They kill and digest bacteria and fungi. They are the most
numerous type of white blood cell and your first line of defense when infection strikes.
4.Basophils: These small cells appear to sound an alarm when infectious agents invade
your blood. They secrete chemicals such as histamine, a marker of allergic disease, that
help control the body's immune response.
5.Eosinophils: They attack and kill parasites, destroy cancer cells, and help with allergic
responses.

9. Platelets:
Platelets are tiny blood cell fragments that help your body form clots to stop bleeding. If one
of your blood vessels gets damaged, it sends out signals that are picked up by platelets. The
platelets then rush to the site of damage and form a plug, or clot, to repair the damage.The
process of spreading across the surface of a damaged blood vessel to stop bleeding is called
adhesion—when platelets get to the site of the injury, they grow sticky tentacles that help
them adhere. They also send out chemical signals to attract more platelets to pile onto the
clot in a process called aggregation.
A normal platelet count is 150,000 to 450,000 platelets per microliter of blood.
Functions of platelets:
The main function of platelets is the maintenance of
hemostasis.
•Repair of ruptured blood vessels
• Clot retraction
• Procoagulant
• Inflammation
•Role in defense mechanism.

10. Complet Blood Count (CBC)
•WBC (white blood cell) (TLC)4,300 and 11,000 cells per cubic millimeter (cmm).
•RBC (red blood cell) ranges between 4.2 to 5.9 million cells per cmm.
•Hemoglobin (Hbg) 13 to 18 grams per deciliter (one-hundredth of a liter) for men and 12
to 16 grams per deciliter for women.
•Hematocrit (Hct) 45%-52% for men and 37%-48% for women.
•Mean corpuscular volume (MCV) ranges between 80 to 100 femtoliters (a fraction of one-
millionth of a liter).
•Mean corpuscular hemoglobin (MCH) ranges between 27 to 32 picograms (a small
fraction of a gram).
•Mean corpuscular hemoglobin concentration (MCHC) ranges between 32%-36%.
•Red cell distribution width (RDW) ranges between 11 to 15.
•Platelet count ranges between 150,000 to 400,000 per cmm.
•Mean platelet volume (MPV). The normal range is between 6 to 12 femtoliters.

11. Hemostasis: Spontaneous arrest of bleeding from small vessels by physiological process is
known as hemostasis.
Events of Hemostasis:
 Vascular Spasm
 Formation of platelet plug
 Blood coagulation
 Fibrous of organization or dissolution of blood clot.
Vascular spasm: Immediately after blood vessel is cut or ruptured. The wall of the vessel
contract, this phenomenon is known as Vascular spasm.
Platelet plug: Accumulation of platelet is very small vascular hole.
Blood Coagulation: The process of conversion of small fibrinogen into insoluble fibrin thread
is known blood coagulation.
Clotting Factors: Several plasma protein in the blood which play major role in the clotting
process are called blood clotting factors.
Synthesis in liver
Vitamin K dependent: II, VII, IX, X
Blood Clotting

13. Blood Clotting Process

14. Blood pressure: The blood pressure is the pressure of the blood within the arteries. It
is produced primarily by the contraction of the heart muscle.
Normal Range-120/80mmHg
Types of blood pressure:
1. Systolic pressure –(100-140) mmHg, Avrage-120 mmHg
2. Diastolic pressure—(60-90) mmHg, Avrage-80 mmHg
3. Pules pressure—(30-40)mmHg, Avrage-40 mmHg, (Systolic – Diastolic=pules
pressure)
4. Mean pressure—(78-98) mmHg, (Diastolic -
1
3
(pulse pressure)
Heart Rate: 60-99b/min. Avg.72 b/min.
Tachycardia: Heart rate 100 or above 100 b/min.
Bradycardia: Heart rate below 60 b/min.

15. Blood Group
Transfusion: is the transfer of blood or blood components from one
individual to another.
Infusion: is the introduction of fluid other than blood, for example:
saline solution or glucose solution.
Blood Group: is determined by the antigens (agglutinogens) on the
surface of RBCs.
Antibodies (agglutinins) can bind to RBC antigens, resulting in
agglutination (clumping) or hemolysis (rupture) of RBCs
Blood Groups: ABO and Rh
Antigen: A substance that the immune system perceives as being
foreign or dangerous. The body combats an antigen with the
production of an antibody.
Antibody: An antibody, also known as an immunoglobin, is a Y-shaped
protein secreted by certain types of white blood cells which have the
ability to identify pathogens (infective agents) such as viruses,bacteria
and foreign substances in the blood .

16. ABO Blood Typing

17. Rh blood group system
Rh blood group system, system for classifying blood
groups according to the presence or absence of the Rh D
antigen, often called the Rh factor, on the cell membranes
of the red blood cells (erythrocytes). The designation Rh
is derived from the use of the blood of rhesus monkeys in
the basic test for determining the presence of the Rh
antigen in human blood. The Rh blood group system was
discovered in 1940 by Karl Landsteiner and A.S. Weiner.
Since that time a number of distinct Rh antigens have
been identified, but the first and most common one,
called Rh D, causes the most severe immune reaction and
is the primary determinant of the Rh trait

18. Blood Transfusion
Universal donor group O, Universal Receiver group AB.
If the wrong blood type is used, the person’s own immune system immediately
attacks the donor’s blood and causes clots and RBC destruction that can lead to
total kidney failure and death.

19. Blood Transfusion
Indication
Blood Group with Rh
Screening & Cross Matching
Blood Order
Medication
Open I/v Chanel (18G green canula)
 Transfused the blood 5 to 10 drops/min in first 10 min.
Health education to the patient or patient party
After 10 min if any reaction not occur start the blood
25 to 30 drops/min.
Finished the 3 to 4 hours

20. Screening Test
WHO recommends that all blood donations be
screened for evidence of infection prior to the
release of the blood and its components for
clinical or manufacturing use. Screening of all
blood donations should be mandatory for HIV,
hepatitis B and C and syphilis.
The donated blood should also be tested for
ABO and RhD to ensure the safety and
compatibility of the transfusion for the patient.

21. Blood transfusion reaction
 Itching with redness
 High fever
 Chills
 Shivering
 shortness of breath
 Change Skin color
 back pain
 dark urine
 fainting or dizziness
 flank pain
 skin flushing
N.B. If any reaction occur stop transfusion, call your senior or doctor.

22. Hazards of Blood transfusion
Early :
 ABO incompatibility reaction – can be rapidly fatal
 Fluid overload, pulmonary oedema
 Febrile reactions, urticarial reactions, occasionally life
threatening respiratory failure
 Bacterial and malerial infection
Late:
 Rh D and other antibody sensitisation
 Delayed transfusion reaction
 Viral infection: Hepatitis B, C, HIV
 Prion infection
 Iron overload: cardiac, hepatic and endocrine damage

23. Blood vessels
The blood vessels are the components of the circulatory system that
transports blood throughout the human body. These vessels transport blood cells,
nutrients, and oxygen to the tissues of the body. They also take waste and carbon
dioxide away from the tissues. Blood vessels are needed to sustain life, because all of
the body’s tissues rely on their functionality.
Types
There are various kinds of blood vessels:
 Arteries
 Elastic arteries
 Distributing arteries
 Arterioles
 Capillaries (the smallest blood vessels)
 Venules
 Veins
Large collecting vessels, such as the subclavian vein, the jugular vein, the renal vein
and the iliac vein.
Venae cavae (the two largest veins, carry blood into the heart).

26. Sites of pules

27. Thanks to all
Have any question ?