Blood Anatomy and Physiology

UPDATED ON OCTOBER 19, 2023

BY MARIANNE BELLEZA, R.N.

Functions of the Blood

Blood is unique; it is the only fluid tissue in the body.

1. Carrier of gases, nutrients, and waste products. Oxygen enters blood in

the lungs and is transported to cells. Carbon dioxide, produced by cells, is
transported in the blood to the lungs, from which it is expelled. Ingested
nutrients, ions, and water are carried by the blood from the digestive tract to
cells, and the waste products of the cells are moved to the kidneys for
elimination.
2. Clot formation. Clotting proteins help stem blood loss when a blood vessel is
injured.
3. Transport of processed molecules. Most substances are produced in one part
of the body and transported in the blood to another part.
4. Protection against foreign substances. Antibodies help protect the body
from pathogens.
5. Transport of regulatory molecules. Various hormones and enzymes that
regulate body processes are carried from one part of the body to another within
the blood.
6. Maintenance of body temperature. Warm blood is transported from the
inside to the surface of the body, where heat is released from the blood.
7. pH and osmosis regulation. Albumin is also an important blood buffer and
contributes to the osmotic pressure of blood, which acts to keep water in the
blood stream.

Components of Blood
Essentially, blood is a complex connective tissue in which living blood cells, the
formed elements, are suspended.

Physical Characteristics and Volume

Blood is a sticky, opaque fluid with a characteristic metallic taste.

• Color. Depending on the amount of oxygen it is carrying, the color

of blood varies from scarlet (oxygen-rich) to a dull red (oxygen-
poor).
• Weight. Blood is heavier than water and about five times thicker, or
more viscous, largely because of its formed elements.
• pH. Blood is slightly alkaline, with a pH between 7.35 and 7.45.
• Temperature. Its temperature (38 degrees Celsius, or 100.4
degrees Fahrenheit) is always slightly higher than body
temperature.
Plasma

Plasma, which is approximately 90 percent water, is the liquid part of the blood.

Fresh Frozen Plasma

• Dissolved substances. Examples of dissolved substances include
nutrients, salts (electrolytes), respiratory gases, hormones, plasma
proteins, and various wastes and products of cell metabolism.
• Plasma proteins. Plasma proteins are the most abundant solutes in
plasma; except for antibodies and protein-based hormones, most
plasma proteins are made by the liver.
• Composition. The composition of plasma varies continuously as
cells remove or add substances to the blood; assuming a healthy
diet, however, the composition of plasma is kept relatively constant
by various homeostatic mechanisms of the body.
Formed Elements
If you observe a stained smear of human blood under a light microscope, you will
see disc-shaped red blood cells, a variety of gaudily stained spherical white blood
cells, and some scattered platelets that look like debris.

Erythrocytes

Erythrocytes, or red blood cells, function primarily to ferry oxygen in blood to all
cells of the body.
• Anucleate. RBCs differ from other blood cells because they are
anucleate, that is, they lack a nucleus; they also contain a very few
organelles.
• Hemoglobin. Hemoglobin, an iron bearing protein, transports the
bulk of oxygen that is carried in the blood.
• Microscopic appearance. Erythrocytes are small, flexible cells
shaped like biconcave discs- flattened discs with depressed centers
on both sides; they look like miniature doughnuts when viewed with
a microscope.
• Number of RBCs. There are normally about 5 million cells per cubic
millimeter of blood; RBCs outnumber WBCs by about 1000 to 1 and
are the major factor contributing to blood viscosity.
• Normal blood. Clinically, normal blood contains 12-18 grams of
hemoglobin per 100 milliliters (ml); the hemoglobin content is
slightly higher in men (13-18 g/dl) than in women (12-16 g/dl).
Leukocytes

Although leukocytes, or white blood cells, are far less numerous than red blood
cells, they are crucial to body defense against disease.

• Number of WBCs. On average, there are 4,000 to 11,000

WBC/mm3 , and they account for less than 1 percent of total body
volume.
• Body defense. Leukocytes form a protective, movable army that
helps defend the body against damage by bacteria, viruses,
parasites, and tumor cells.
• Diapedesis. White blood cells are able to slip into and out of the
blood vessels- a process called diapedesis.
• Positive chemotaxis. In addition, WBCs can locate areas of tissue
damage and infection in the body by responding to certain
chemicals that diffuse from the damaged cells; this capability is
called positive chemotaxis.
• Ameboid motion. Once they have “caught the scent”, the WBCs
move through the tissue spaces by ameboid motion (they form
flowing cytoplasmic extensions that help move them along).
• Leukocytosis. A total WBC count above 11, 000 cells/mm3 is
referred to as leukocytosis.
• Leukopenia. The opposite condition, leukopenia, is an abnormally
low WBC count.
• Granulocytes. Granulocytes are granule-containing WBCs; they have
lobed nuclei, which typically consist of several rounded nuclear areas
connected by thin strands of nuclear material, and
includes neutrophils, eosinophils, and basophils.
• Neutrophils. Neutrophil are the most numerous of the WBCs; they
have a multilobed granules and very fine granules that respond to
acidic and basic stains; neutrophils are avid phagocytes at sites of
acute infection, and are particularly partial to bacteria and fungi.
• Eosinophils. Eosinophils have blue red nucleus that resembles an
old-fashioned telephone receiver and sport coarse, lysosome-like,
brick-red cytoplasmic granules; their number increases rapidly
during allergies and infections by parasitic worms or entering via the
skin.
• Basophils. Basophils, the rarest of the WBCs, contain large,
histamine-containing granules that stain dark blue; histamine is an
inflammatory chemical that makes blood vessels leaky and attracts
other WBCs to the inflammatory site.
• Agranulocytes. The second group of WBCs, the agranulocytes, lack
visible cytoplasmic granules; their nuclei are closer to the norm- that
is, they are spherical; they are spherical, oval, or kidney-shaped; and
they include lymphocytes and monocytes.
• Lymphocytes. Lymphocytes have a large, dark purple nucleus that
occupies most of the cell volume; they tend to take up residence
in lymphatic tissues, where they play an important role in the
immune response.
• Monocytes. Monocytes are the largest of the WBCs; when they
migrate into the tissues, they transform into macrophages with huge
appetites; macrophages are very important in fighting chronic
infections.
• Platelets. Platelets are not cells in the strict sense; they are
fragments of bizarre multinucleate cells called megakaryocytes,
which pinch off thousands of anucleate platelet “pieces” that quickly
seal themselves off from surrounding fluids; platelets are needed for
the clotting process that occurs in plasma when blood vessels are
ruptured or broken.
Hematopoiesis

Blood cell formation, or hematopoiesis, occurs in red bone marrow, or myeloid

tissue.

•Hemocytoblast. All the formed elements arise from a common type

of stem cell, the hemocytoblast.
• Descendants of hemocytoblasts. The hemocytoblast forms two
types of descendants- the lymphoid stem cell, which produces
lymphocytes, and the myeloid stem cell, which can produce all
other classes of formed elements.
Formation of Red Blood Cells

Because they are anucleate, RBCs are unable to synthesize proteins, grow, or
divide.

• Life span. As they age, RBCs become more rigid and begin to
fragment, or fall apart, in 100 to 120 days.
 •Lost RBCs. Lost cells are replaced more or less continuously by the
division of hemocytoblasts in the red bone marrow.
• Immature RBCs. Developing RBCs divide many times and then
begin synthesizing huge amounts of hemoglobin.
• Reticulocyte. Suddenly, when enough hemoglobin has been
accumulated, the nucleus and most organelles are ejected and the
cell collapses inward; the result is the young RBC, called a
reticulocyte because it still contains some rough endoplasmic
reticulum (ER).
• Mature erythrocytes. Within 2 days of release, they have rejected
the remaining ER and have become fully functioning erythrocytes;
the entire developmental process from hemocytoblast to mature
RBC takes 3 to 5 days.
• Erythropoietin. The rate of erythrocyte production is controlled by a
hormone called erythropoietin; normally a small amount of
erythropoietin circulates in the blood at all times, and red blood cells
are formed at a fairly constant rate.
• Control of RBC production. An important point to remember is
that it is not the relative number of RBCS in the blood that controls
RBC production; control is based on their ability to transport enough
oxygen to meet the body’s demands.
Formation of White Blood Cells and Platelets

Like erythrocyte production, the formation of leukocytes and platelets is

stimulated by hormones.

• Colony stimulating factors and interleukins. These colony

stimulating factors and interleukins not only prompt red bone
marrow to turn out leukocytes, but also marshal up an army of WBCs
to ward off attacks by enhancing the ability of mature leukocytes to
protect the body.
• Thrombopoietin. The hormone thrombopoietin accelerates the
production of platelets, but little is known about how that process is
regulated.
Hemostasis
The multistep process of hemostasis begins when a blood vessel is damaged and
connective tissue in the vessel wall is exposed to blood.

• Vascular spasms occur. The immediate response to blood

vessel injury is vasoconstriction, which causes that blood vessel to go
into spasms; the spasms narrow the blood vessel, decreasing blood
loss until clotting can occur.
• Platelet plug forms. Injury to the lining of vessels exposes collage
fibers; platelets adhere to the damaged site and platelet plug forms.
• Coagulation events occur. At the same time, the injured tissues are
releasing tissue factor (TF), a substance that plays an important role
in clotting; PF3, a phospholipid that coats the surfaces of the
platelets, interacts with TF, vitamin K, and other blood clotting
factors; this prothrombin activator converts prothrombin, present
in the plasma, to thrombin, an enzyme; thrombin then joins
 soluble fibrinogen proteins into long, hairlike molecules of
insoluble fibrin, which forms the meshwork that traps RBCs and
forms the basis of the clot; within the hour, the clot begins to retract,
squeezing serum from the mass and pulling the ruptured edges of
the blood vessel closer together.
Blood Groups and Transfusions
As we have seen, blood is vital for transporting substances through the body;
when blood is lost, the blood vessels constrict and the bone marrow steps up
blood cell formation in an attempt to keep the circulation going.

Human Blood Groups

Although whole blood transfusions can save lives, people have different blood
groups, and transfusing incompatible or mismatched blood can be fatal.
• Antigen. An antigen is a substance that the body recognizes as
foreign; it stimulates the immune system to release antibodies or use
other means to mount a defense against it.
• Antibodies. One person’s RBC proteins will be recognized as foreign
if transfused into another person with different RBC antigens; the
“recognizers” are antibodies present in the plasma that attach to
RBCs bearing surface antigens different from those on the patient’s
(blood recipient’s) RBCs.
• Agglutination. Binding of the antibodies causes the foreign RBCs to
clump, a phenomenon called agglutination, which leads to the
clogging of small blood vessels throughout the body.
• ABO blood groups. The ABO blood groups are based on which of
two antigens, type A or type B, a person inherits; absence of both
antigens results in type O blood, presence of both antigens leads
 to type AB, and the presence of either A or B antigen yields type A
or B blood.
• Rh blood groups. The Rh blood groups are so named because one
of the eight Rh antigens (agglutinogen D) was originally identified
in Rhesus monkeys; later the same antigen was discovered in human
beings; most Americans are Rh+ (Rh positive), meaning that their
RBCs carry the Rh antigen.
• Anti-Rh antibodies. Unlike the antibodies of the ABO system, anti-
Rh antibodies are not automatically formed and present in the blood
of Rh- (Rh-negative) individuals.
• Hemolysis. Hemolysis (rupture of RBCs) does not occur with the first
transfusion because it takes time for the body to react and start
making antibodies.
Blood Typing

The importance of determining the blood group of both the donor and the
recipient before blood is transfused is glaringly obvious.

• Blood typing of ABO blood groups. When serum containing anti-A

or anti-B antibodies is added to a blood sample diluted with saline,
agglutination will occur between the antibody and the
corresponding antigen.
• Cross matching. Cross matching involves testing for agglutination
of donor RBCs by the recipient’s serum and of the recipient’s RBCs
by the donor serum;
• Blood typing for Rh factors. Typing for the Rh factors is done in
the same manner as ABO blood typing.