REVIEW OF ANATOMY AND PHYSIOLOGY BLOOD Blood is considered the essence of life because the uncontrolled loss of it can

result to death. Blood is a type of connective tissue, consisting of cells and cell fragments surrounded by a liquid matrix which circulates through the heart and blood vessels. The cells and cell fragments are formed elements and the liquid is plasma. Blood makes about 8% of total weight of the body. Functions of Blood: >transports gases, nutrients, waste products, and hormones >involve in regulation of homeostasis and the maintenance of PH, body temperature, fluid balance, and electrolyte levels >protects against diseases and blood loss PLASMA Plasma is a pale yellow fluid that accounts for over half of the total blood volume. It consists of 92% water and 8% suspended or dissolved substances such as proteins, ions, nutrients, gases, waste products, and regulatory substances. Plasma volume remains relatively constant. Normally, water intake through the GIT closely matches water loss through the kidneys, lungs, GIT and skin. The suspended and dissolved substances come from the liver, kidneys, intestines, endocrine glands, and immune tissues as spleen FORMED ELEMENTS Cell Type Erythrocytes (RBC) Description Biconcave disk, no nucleus, 78 micrometers in diameter Function Transport oxygen and carbon dioxide Cell Type Leukocytes (WBC):

Neutrophil Description Spherical cell, nucleus with two or more lobes connected by thin filaments, cytoplasmic granules stain a light pink or reddish purple, 12-15 micrometers in diameter Function Phagocytizes microorganism Cell Type Basophil Spherical cell, nucleus, with two indistinct lobes, cytoplasmic granules stain blue-purple, 10-12 micrometers in diameter Releases histamine, which promotes inflammation, and heparin which prevents clot formation Cell Type Eosinophil Spherical cell, nucleus often bilobed, cytoplasmic granules satin orange-red or bright red, 10-12 micrometers in diameter Releases chemical that reduce inflammation, attacks certain worm parasites

Cell Type Lymphocyte Spherical cell with round nucleus, cytoplasm forms a thin ring around the nucleus, 6-8 micrometers in diameter Produces antibodies and other chemicals responsible for destroying microorganisms, responsible for allergic reactions, graft rejection, tumor control, and regulation

PREVENTING BLOOD LOSS When a blood vessel is damaged, blood can leak into other tissues and interfere with thenormal tissue function or blood can be lost from the body. Small amounts of blood from the bodycan be tolerated but new blood must be produced to replace the loss blood. If large amounts ofblood are lost, death can occur. BLOOD CLOTTING Platelet plugs alone are not sufficient to close large tears or cults in blood vessels. When ablood vessel is severely damaged, blood clotting or coagulation results in the formation of a clot.A clot is a network of threadlike protein fibers called fibrin, which traps blood cells, platelets andfluids. The formation of a blood clot depends on a number of proteins found within plasmacalled clotting factors. Normally the clotting factors are inactive and do not cause clotting.Following injury however, the clotting factors are activated to produce a clot. This is a complexprocess involving chemical reactions, but it can be summarized in 3 main stages; the chemicalreactions can be stated in two ways: just as with platelets, the contact of inactive clotting factorswith exposed connective tissue can result in their activation. Chemicals released from injuredtissues can also cause activation of clotting factors. After the initial clotting factors are activated,they in turn activate other clotting factors. A series of reactions results in which each clottingfactor activates the next clotting factor in the series until the clotting factor prothrombin activatoris formed. Prothrombin activator acts on an inactive clotting factor called prothrombin.Prothrombin is converted to its active form called thrombin. Thrombin converts the inactiveclotting factor fibrinogen into its active form, fibrin. The fibrin threads form a network whichtraps blood cells and platelets and forms the clots.

CONTROL OF CLOT FORMATION Without control, clotting would spread from the point of its initiation throughout theentire circulatory system. To prevent unwanted clotting, the blood contains severalanticoagulants which prevent clotting factors from forming clots. Normally there are enoughanticoagulants in the blood to prevent clot formation. At the injury site, however, the stimulationfor activating clotting factors is very strong. So many clotting factors are activated that theanticoagulants no longer can prevent a clot from forming. CLOT RETRACTION AND DISSOLUTION After a clot has formed, it begins to condense into a denser compact structure by aprocess known as clot retraction. Serum, which is plasma without its clotting factors, is squeezedout of the clot during clot retraction. Consolidation of the clot pulls the edges of the damagedvessels together, helping the stop of the flow of blood, reducing the probability of infection andenhancing healing. The damaged vessel is repaired by the movement of fibroblasts into damaged area and the formation of the new connective tissue. In addition, epithelial cells around the wound divide and fill in the torn area. The clot is dissolved by a process called fibrinolysis. An inactive plasma protein calledplasminogen is converted to its active form, which is called plasmin. Thrombin and other clottingfactors activated during clot formation, or tissue plasminogen activator released fromsurrounding tissues, stimulate the conversion of plasminogen to plasmin. Over a period of a fewdays the plasmin slowly breaks down the fibrin.