Blood

Blood is a body fluid in humans and other animals that delivers necessary substances such as nutrients and oxygen to the cells and transports metabolic waste products away from those same cells.[1]

In vertebrates, it is composed of blood cells suspended in blood plasma. Plasma, which constitutes 55% of blood fluid, is mostly water (92% by volume),[2] and contains proteins, glucose, mineral ions, hormones, carbon dioxide (plasma being the main medium for excretory product transportation), and blood cells themselves. Albumin is the main protein in plasma, and it functions to regulate the colloidal osmotic pressure of blood. The blood cells are mainly red blood cells (also called RBCs or erythrocytes), white blood cells (also called WBCs or leukocytes) and platelets (also called thrombocytes). The most abundant cells in vertebrate blood are red blood cells. These contain hemoglobin, an iron-containing protein, which facilitates oxygen transport by reversibly binding to this respiratory gas and greatly increasing its solubility in blood. In contrast, carbon dioxide is mostly transported extracellularly as bicarbonate ion transported in plasma.

Vertebrate blood is bright red when its hemoglobin is oxygenated and dark red when it is deoxygenated. Some animals, such as crustaceans and mollusks, use hemocyanin to carry oxygen, instead of hemoglobin. Insects and some mollusks use a fluid called hemolymph instead of blood, the difference being that hemolymph is not contained in a closed circulatory system. In most insects, this "blood" does not contain oxygen-carrying molecules such as hemoglobin because their bodies are small enough for their tracheal system to suffice for supplying oxygen.

Jawed vertebrates have an adaptive immune system, based largely on white blood cells. White blood cells help to resist infections and parasites. Platelets are important in the clotting of blood. Arthropods, using hemolymph, have hemocytes as part of their immune system.

Blood is circulated around the body through blood vessels by the pumping action of the heart. In animals with lungs, arterial blood carries oxygen from inhaled air to the tissues of the body, and venous blood carries carbon dioxide, a waste product of metabolism produced by cells, from the tissues to the lungs to be exhaled.

Medical terms related to blood often begin with hemo- or hemato- (also spelled haemo- and haemato-) from the Greek word αἷμα (haima) for "blood". In terms of anatomy and histology, blood is considered a specialized form of connective tissue, given its origin in the bones and the presence of potential molecular fibers in the form of fibrinogen.

Blood
Venous and arterial blood
Venous (darker) and arterial (brighter) blood
Details
Identifiers
Latinhaema
MeSHD001769
TAA12.0.00.009
FMA9670
Anatomical terminology

Functions

1GZX Haemoglobin
Hemoglobin, a globular protein
green = haem (or heme) groups
red & blue = protein subunits
Heme
Heme

Blood performs many important functions within the body, including:

Constituents

In mammals

What's Inside of Blood

Blood accounts for 7% of the human body weight,[3][4] with an average density around 1060 kg/m3, very close to pure water's density of 1000 kg/m3.[5] The average adult has a blood volume of roughly 5 litres (11 US pt),[4] which is composed of plasma and several kinds of cells. These blood cells (which are also called corpuscles or "formed elements") consist of erythrocytes (red blood cells, RBCs), leukocytes (white blood cells), and thrombocytes (platelets). By volume, the red blood cells constitute about 45% of whole blood, the plasma about 54.3%, and white cells about 0.7%.

Whole blood (plasma and cells) exhibits non-Newtonian fluid dynamics. If all human hemoglobin were free in the plasma rather than being contained in RBCs, the circulatory fluid would be too viscous for the cardiovascular system to function effectively.

Krew Frakcjonowana

Human blood fractioned by centrifugation: Plasma (upper, yellow layer), buffy coat (middle, thin white layer) and erythrocyte layer (bottom, red layer) can be seen.

Blutkreislauf

Blood circulation: Red = oxygenated, blue = deoxygenated

Blausen 0425 Formed Elements

Illustration depicting formed elements of blood

Blut-EDTA

Two tubes of EDTA-anticoagulated blood.
Left tube: after standing, the RBCs have settled at the bottom of the tube.
Right tube: Freshly drawn blood

Cells

Red White Blood cells
A scanning electron microscope (SEM) image of a normal red blood cell (left), a platelet (middle), and a white blood cell (right)

One microliter of blood contains:

  • 4.7 to 6.1 million (male), 4.2 to 5.4 million (female) erythrocytes:[6] Red blood cells contain the blood's hemoglobin and distribute oxygen. Mature red blood cells lack a nucleus and organelles in mammals. The red blood cells (together with endothelial vessel cells and other cells) are also marked by glycoproteins that define the different blood types. The proportion of blood occupied by red blood cells is referred to as the hematocrit, and is normally about 45%. The combined surface area of all red blood cells of the human body would be roughly 2,000 times as great as the body's exterior surface.[7]
  • 4,000–11,000 leukocytes:[8] White blood cells are part of the body's immune system; they destroy and remove old or aberrant cells and cellular debris, as well as attack infectious agents (pathogens) and foreign substances. The cancer of leukocytes is called leukemia.
  • 200,000–500,000 thrombocytes:[8] Also called platelets, they take part in blood clotting (coagulation). Fibrin from the coagulation cascade creates a mesh over the platelet plug.
Constitution of normal blood
Parameter Value
Hematocrit

45 ± 7 (38–52%) for males
42 ± 5 (37–47%) for females

pH 7.35–7.45
base excess −3 to +3
PO2 10–13 kPa (80–100 mm Hg)
PCO2 4.8–5.8 kPa (35–45 mm Hg)
HCO3 21–27 mM
Oxygen saturation

Oxygenated: 98–99%
Deoxygenated: 75%

Plasma

About 55% of blood is blood plasma, a fluid that is the blood's liquid medium, which by itself is straw-yellow in color. The blood plasma volume totals of 2.7–3.0 liters (2.8–3.2 quarts) in an average human. It is essentially an aqueous solution containing 92% water, 8% blood plasma proteins, and trace amounts of other materials. Plasma circulates dissolved nutrients, such as glucose, amino acids, and fatty acids (dissolved in the blood or bound to plasma proteins), and removes waste products, such as carbon dioxide, urea, and lactic acid.

Other important components include:

The term serum refers to plasma from which the clotting proteins have been removed. Most of the proteins remaining are albumin and immunoglobulins.

pH values

Blood pH is regulated to stay within the narrow range of 7.35 to 7.45, making it slightly basic.[9][10] Blood that has a pH below 7.35 is too acidic, whereas blood pH above 7.45 is too basic. Blood pH, partial pressure of oxygen (pO2), partial pressure of carbon dioxide (pCO2), and bicarbonate (HCO3) are carefully regulated by a number of homeostatic mechanisms, which exert their influence principally through the respiratory system and the urinary system to control the acid-base balance and respiration. An arterial blood gas test measures these. Plasma also circulates hormones transmitting their messages to various tissues. The list of normal reference ranges for various blood electrolytes is extensive.

In non-mammalian vertebrates

Newbloodm
Vertebrate red blood cell types, measurements in micrometers
Frogrbc1000x
Frog red blood cells magnified 1000 times
Turtlerbc1000x
Turtle red blood cells magnified 1000 times
Chickenrbc1000x
Chicken red blood cells magnified 1000 times
Humanrbc1000x
Human red blood cells magnified 1000 times

Human blood is typical of that of mammals, although the precise details concerning cell numbers, size, protein structure, and so on, vary somewhat between species. In non-mammalian vertebrates, however, there are some key differences:[11]

  • Red blood cells of non-mammalian vertebrates are flattened and ovoid in form, and retain their cell nuclei.
  • There is considerable variation in the types and proportions of white blood cells; for example, acidophils are generally more common than in humans.
  • Platelets are unique to mammals; in other vertebrates, small nucleated, spindle cells called thrombocytes are responsible for blood clotting instead.

Physiology

Cardiovascular system

Diagram of the human heart (cropped)
Circulation of blood through the human heart

Blood is circulated around the body through blood vessels by the pumping action of the heart. In humans, blood is pumped from the strong left ventricle of the heart through arteries to peripheral tissues and returns to the right atrium of the heart through veins. It then enters the right ventricle and is pumped through the pulmonary artery to the lungs and returns to the left atrium through the pulmonary veins. Blood then enters the left ventricle to be circulated again. Arterial blood carries oxygen from inhaled air to all of the cells of the body, and venous blood carries carbon dioxide, a waste product of metabolism by cells, to the lungs to be exhaled. However, one exception includes pulmonary arteries, which contain the most deoxygenated blood in the body, while the pulmonary veins contain oxygenated blood.

Additional return flow may be generated by the movement of skeletal muscles, which can compress veins and push blood through the valves in veins toward the right atrium.

The blood circulation was famously described by William Harvey in 1628.[12]

Production and degradation of blood cells

In vertebrates, the various cells of blood are made in the bone marrow in a process called hematopoiesis, which includes erythropoiesis, the production of red blood cells; and myelopoiesis, the production of white blood cells and platelets. During childhood, almost every human bone produces red blood cells; as adults, red blood cell production is limited to the larger bones: the bodies of the vertebrae, the breastbone (sternum), the ribcage, the pelvic bones, and the bones of the upper arms and legs. In addition, during childhood, the thymus gland, found in the mediastinum, is an important source of T lymphocytes.[13] The proteinaceous component of blood (including clotting proteins) is produced predominantly by the liver, while hormones are produced by the endocrine glands and the watery fraction is regulated by the hypothalamus and maintained by the kidney.

Healthy erythrocytes have a plasma life of about 120 days before they are degraded by the spleen, and the Kupffer cells in the liver. The liver also clears some proteins, lipids, and amino acids. The kidney actively secretes waste products into the urine.

Oxygen transport

Oxyhaemoglobin dissociation curve
Basic hemoglobin saturation curve. It is moved to the right in higher acidity (more dissolved carbon dioxide) and to the left in lower acidity (less dissolved carbon dioxide)

About 98.5% [14] of the oxygen in a sample of arterial blood in a healthy human breathing air at sea-level pressure is chemically combined with the hemoglobin. About 1.5% is physically dissolved in the other blood liquids and not connected to hemoglobin. The hemoglobin molecule is the primary transporter of oxygen in mammals and many other species (for exceptions, see below). Hemoglobin has an oxygen binding capacity between 1.36 and 1.40 ml O2 per gram hemoglobin,[15] which increases the total blood oxygen capacity seventyfold,[16] compared to if oxygen solely were carried by its solubility of 0.03 ml O2 per liter blood per mm Hg partial pressure of oxygen (about 100 mm Hg in arteries).[16]

With the exception of pulmonary and umbilical arteries and their corresponding veins, arteries carry oxygenated blood away from the heart and deliver it to the body via arterioles and capillaries, where the oxygen is consumed; afterwards, venules and veins carry deoxygenated blood back to the heart.

Under normal conditions in adult humans at rest, hemoglobin in blood leaving the lungs is about 98–99% saturated with oxygen, achieving an oxygen delivery between 950 and 1150 ml/min[17] to the body. In a healthy adult at rest, oxygen consumption is approximately 200–250 ml/min,[17] and deoxygenated blood returning to the lungs is still roughly 75%[18][19] (70 to 78%)[17] saturated. Increased oxygen consumption during sustained exercise reduces the oxygen saturation of venous blood, which can reach less than 15% in a trained athlete; although breathing rate and blood flow increase to compensate, oxygen saturation in arterial blood can drop to 95% or less under these conditions.[20] Oxygen saturation this low is considered dangerous in an individual at rest (for instance, during surgery under anesthesia). Sustained hypoxia (oxygenation less than 90%), is dangerous to health, and severe hypoxia (saturations less than 30%) may be rapidly fatal.[21]

A fetus, receiving oxygen via the placenta, is exposed to much lower oxygen pressures (about 21% of the level found in an adult's lungs), so fetuses produce another form of hemoglobin with a much higher affinity for oxygen (hemoglobin F) to function under these conditions.[22]

Carbon dioxide transport

CO2 is carried in blood in three different ways. (The exact percentages vary depending whether it is arterial or venous blood). Most of it (about 70%) is converted to bicarbonate ions HCO
3
by the enzyme carbonic anhydrase in the red blood cells by the reaction CO2 + H2O → H2CO3 → H+ + HCO
3
; about 7% is dissolved in the plasma; and about 23% is bound to hemoglobin as carbamino compounds.[23][24]

Hemoglobin, the main oxygen-carrying molecule in red blood cells, carries both oxygen and carbon dioxide. However, the CO2 bound to hemoglobin does not bind to the same site as oxygen. Instead, it combines with the N-terminal groups on the four globin chains. However, because of allosteric effects on the hemoglobin molecule, the binding of CO2 decreases the amount of oxygen that is bound for a given partial pressure of oxygen. The decreased binding to carbon dioxide in the blood due to increased oxygen levels is known as the Haldane effect, and is important in the transport of carbon dioxide from the tissues to the lungs. A rise in the partial pressure of CO2 or a lower pH will cause offloading of oxygen from hemoglobin, which is known as the Bohr effect.

Transport of hydrogen ions

Some oxyhemoglobin loses oxygen and becomes deoxyhemoglobin. Deoxyhemoglobin binds most of the hydrogen ions as it has a much greater affinity for more hydrogen than does oxyhemoglobin.

Lymphatic system

In mammals, blood is in equilibrium with lymph, which is continuously formed in tissues from blood by capillary ultrafiltration. Lymph is collected by a system of small lymphatic vessels and directed to the thoracic duct, which drains into the left subclavian vein where lymph rejoins the systemic blood circulation.

Thermoregulation

Blood circulation transports heat throughout the body, and adjustments to this flow are an important part of thermoregulation. Increasing blood flow to the surface (e.g., during warm weather or strenuous exercise) causes warmer skin, resulting in faster heat loss. In contrast, when the external temperature is low, blood flow to the extremities and surface of the skin is reduced and to prevent heat loss and is circulated to the important organs of the body, preferentially.

Rate of blood flow

Rate of blood flow varies greatly between different organs. Liver has the most abundant blood supply with an approximate flow of 1350 ml/min. Kidney and brain are the second and the third most supplied organs, with 1100 ml/min and ~700 ml/min, respectively.[25]

Relative rates of blood flow per 100 g of tissue are different, with kidney, adrenal gland and thyroid being the first, second and third most supplied tissues, respectively.[25]

Hydraulic functions

The restriction of blood flow can also be used in specialized tissues to cause engorgement, resulting in an erection of that tissue; examples are the erectile tissue in the penis and clitoris.

Another example of a hydraulic function is the jumping spider, in which blood forced into the legs under pressure causes them to straighten for a powerful jump, without the need for bulky muscular legs.[26]

Invertebrates

In insects, the blood (more properly called hemolymph) is not involved in the transport of oxygen. (Openings called tracheae allow oxygen from the air to diffuse directly to the tissues.) Insect blood moves nutrients to the tissues and removes waste products in an open system.

Other invertebrates use respiratory proteins to increase the oxygen-carrying capacity. Hemoglobin is the most common respiratory protein found in nature. Hemocyanin (blue) contains copper and is found in crustaceans and mollusks. It is thought that tunicates (sea squirts) might use vanabins (proteins containing vanadium) for respiratory pigment (bright-green, blue, or orange).

In many invertebrates, these oxygen-carrying proteins are freely soluble in the blood; in vertebrates they are contained in specialized red blood cells, allowing for a higher concentration of respiratory pigments without increasing viscosity or damaging blood filtering organs like the kidneys.

Giant tube worms have unusual hemoglobins that allow them to live in extraordinary environments. These hemoglobins also carry sulfides normally fatal in other animals.

Color

The coloring matter of blood (hemochrome) is largely due to the protein in the blood responsible for oxygen transport. Different groups of organisms use different proteins.

Hemoglobin

Bleeding finger
Capillary blood from a bleeding finger

Hemoglobin is the principal determinant of the color of blood in vertebrates. Each molecule has four heme groups, and their interaction with various molecules alters the exact color. In vertebrates and other hemoglobin-using creatures, arterial blood and capillary blood are bright red, as oxygen imparts a strong red color to the heme group. Deoxygenated blood is a darker shade of red; this is present in veins, and can be seen during blood donation and when venous blood samples are taken. This is because the spectrum of light absorbed by hemoglobin differs between the oxygenated and deoxygenated states.[27]

Blood in carbon monoxide poisoning is bright red, because carbon monoxide causes the formation of carboxyhemoglobin. In cyanide poisoning, the body cannot utilize oxygen, so the venous blood remains oxygenated, increasing the redness. There are some conditions affecting the heme groups present in hemoglobin that can make the skin appear blue – a symptom called cyanosis. If the heme is oxidized, methemoglobin, which is more brownish and cannot transport oxygen, is formed. In the rare condition sulfhemoglobinemia, arterial hemoglobin is partially oxygenated, and appears dark red with a bluish hue.

Veins close to the surface of the skin appear blue for a variety of reasons. However, the factors that contribute to this alteration of color perception are related to the light-scattering properties of the skin and the processing of visual input by the visual cortex, rather than the actual color of the venous blood.[28]

Skinks in the genus Prasinohaema have green blood due to a buildup of the waste product biliverdin.[29]

Hemocyanin

The blood of most mollusks – including cephalopods and gastropods – as well as some arthropods, such as horseshoe crabs, is blue, as it contains the copper-containing protein hemocyanin at concentrations of about 50 grams per liter.[30] Hemocyanin is colorless when deoxygenated and dark blue when oxygenated. The blood in the circulation of these creatures, which generally live in cold environments with low oxygen tensions, is grey-white to pale yellow,[30] and it turns dark blue when exposed to the oxygen in the air, as seen when they bleed.[30] This is due to change in color of hemocyanin when it is oxidized.[30] Hemocyanin carries oxygen in extracellular fluid, which is in contrast to the intracellular oxygen transport in mammals by hemoglobin in RBCs.[30]

Chlorocruorin

The blood of most annelid worms and some marine polychaetes use chlorocruorin to transport oxygen. It is green in color in dilute solutions.[31]

Hemerythrin

Hemerythrin is used for oxygen transport in the marine invertebrates sipunculids, priapulids, brachiopods, and the annelid worm, magelona. Hemerythrin is violet-pink when oxygenated.[31]

Hemovanadin

The blood of some species of ascidians and tunicates, also known as sea squirts, contains proteins called vanadins. These proteins are based on vanadium, and give the creatures a concentration of vanadium in their bodies 100 times higher than the surrounding sea water. Unlike hemocyanin and hemoglobin, hemovanadin is not an oxygen carrier. When exposed to oxygen, however, vanadins turn a mustard yellow.

Pathology

General medical disorders

  • Disorders of volume
    • Injury can cause blood loss through bleeding.[32] A healthy adult can lose almost 20% of blood volume (1 L) before the first symptom, restlessness, begins, and 40% of volume (2 L) before shock sets in. Thrombocytes are important for blood coagulation and the formation of blood clots, which can stop bleeding. Trauma to the internal organs or bones can cause internal bleeding, which can sometimes be severe.
    • Dehydration can reduce the blood volume by reducing the water content of the blood. This would rarely result in shock (apart from the very severe cases) but may result in orthostatic hypotension and fainting.
  • Disorders of circulation
    • Shock is the ineffective perfusion of tissues, and can be caused by a variety of conditions including blood loss, infection, poor cardiac output.
    • Atherosclerosis reduces the flow of blood through arteries, because atheroma lines arteries and narrows them. Atheroma tends to increase with age, and its progression can be compounded by many causes including smoking, high blood pressure, excess circulating lipids (hyperlipidemia), and diabetes mellitus.
    • Coagulation can form a thrombosis, which can obstruct vessels.
    • Problems with blood composition, the pumping action of the heart, or narrowing of blood vessels can have many consequences including hypoxia (lack of oxygen) of the tissues supplied. The term ischemia refers to tissue that is inadequately perfused with blood, and infarction refers to tissue death (necrosis), which can occur when the blood supply has been blocked (or is very inadequate).

Hematological disorders

  • Anemia
  • Disorders of cell proliferation
  • Disorders of coagulation
    • Hemophilia is a genetic illness that causes dysfunction in one of the blood's clotting mechanisms. This can allow otherwise inconsequential wounds to be life-threatening, but more commonly results in hemarthrosis, or bleeding into joint spaces, which can be crippling.
    • Ineffective or insufficient platelets can also result in coagulopathy (bleeding disorders).
    • Hypercoagulable state (thrombophilia) results from defects in regulation of platelet or clotting factor function, and can cause thrombosis.
  • Infectious disorders of blood
    • Blood is an important vector of infection. HIV, the virus that causes AIDS, is transmitted through contact with blood, semen or other body secretions of an infected person. Hepatitis B and C are transmitted primarily through blood contact. Owing to blood-borne infections, bloodstained objects are treated as a biohazard.
    • Bacterial infection of the blood is bacteremia or sepsis. Viral Infection is viremia. Malaria and trypanosomiasis are blood-borne parasitic infections.

Carbon monoxide poisoning

Substances other than oxygen can bind to hemoglobin; in some cases this can cause irreversible damage to the body. Carbon monoxide, for example, is extremely dangerous when carried to the blood via the lungs by inhalation, because carbon monoxide irreversibly binds to hemoglobin to form carboxyhemoglobin, so that less hemoglobin is free to bind oxygen, and fewer oxygen molecules can be transported throughout the blood. This can cause suffocation insidiously. A fire burning in an enclosed room with poor ventilation presents a very dangerous hazard, since it can create a build-up of carbon monoxide in the air. Some carbon monoxide binds to hemoglobin when smoking tobacco.[34]

Medical treatments

Blood products

Bloodbags
Venous blood collected during blood donation

Blood for transfusion is obtained from human donors by blood donation and stored in a blood bank. There are many different blood types in humans, the ABO blood group system, and the Rhesus blood group system being the most important. Transfusion of blood of an incompatible blood group may cause severe, often fatal, complications, so crossmatching is done to ensure that a compatible blood product is transfused.

Other blood products administered intravenously are platelets, blood plasma, cryoprecipitate, and specific coagulation factor concentrates.

Intravenous administration

Many forms of medication (from antibiotics to chemotherapy) are administered intravenously, as they are not readily or adequately absorbed by the digestive tract.

After severe acute blood loss, liquid preparations, generically known as plasma expanders, can be given intravenously, either solutions of salts (NaCl, KCl, CaCl2 etc.) at physiological concentrations, or colloidal solutions, such as dextrans, human serum albumin, or fresh frozen plasma. In these emergency situations, a plasma expander is a more effective life-saving procedure than a blood transfusion, because the metabolism of transfused red blood cells does not restart immediately after a transfusion.

Bloodletting

In modern evidence-based medicine, bloodletting is used in management of a few rare diseases, including hemochromatosis and polycythemia. However, bloodletting and leeching were common unvalidated interventions used until the 19th century, as many diseases were incorrectly thought to be due to an excess of blood, according to Hippocratic medicine.

Etymology

Jan Janský, 1902
Jan Janský is credited with the first classification of blood into four types (A, B, AB, and O)

According to the Oxford English Dictionary, the word "blood" dates to the oldest English, circa 1000 CE. The word is derived from Middle English, which is derived from the Old English word blōd, which is akin to the Old High German word bluot, meaning blood. The modern German word is (das) Blut.

History

Classical Greek medicine

Fåhræus (a Swedish physician who devised the erythrocyte sedimentation rate) suggested that the Ancient Greek system of humorism, wherein the body was thought to contain four distinct bodily fluids (associated with different temperaments), were based upon the observation of blood clotting in a transparent container. When blood is drawn in a glass container and left undisturbed for about an hour, four different layers can be seen. A dark clot forms at the bottom (the "black bile"). Above the clot is a layer of red blood cells (the "blood"). Above this is a whitish layer of white blood cells (the "phlegm"). The top layer is clear yellow serum (the "yellow bile").[35]

Types

The ABO blood group system was discovered in the year 1900 by Karl Landsteiner. Jan Janský is credited with the first classification of blood into the four types (A, B, AB, and O) in 1907, which remains in use today. In 1907 the first blood transfusion was performed that used the ABO system to predict compatibility.[36] The first non-direct transfusion was performed on March 27, 1914. The Rhesus factor was discovered in 1937.

Cultural and religious beliefs

Due to its importance to life, blood is associated with a large number of beliefs. One of the most basic is the use of blood as a symbol for family relationships through birth/parentage; to be "related by blood" is to be related by ancestry or descendence, rather than marriage. This bears closely to bloodlines, and sayings such as "blood is thicker than water" and "bad blood", as well as "Blood brother".

Blood is given particular emphasis in the Jewish and Christian religions, because Leviticus 17:11 says "the life of a creature is in the blood." This phrase is part of the Levitical law forbidding the drinking of blood or eating meat with the blood still intact instead of being poured off.

Mythic references to blood can sometimes be connected to the life-giving nature of blood, seen in such events as childbirth, as contrasted with the blood of injury or death.

Indigenous Australians

In many indigenous Australian Aboriginal peoples' traditions, ochre (particularly red) and blood, both high in iron content and considered Maban, are applied to the bodies of dancers for ritual. As Lawlor states:

In many Aboriginal rituals and ceremonies, red ochre is rubbed all over the naked bodies of the dancers. In secret, sacred male ceremonies, blood extracted from the veins of the participant's arms is exchanged and rubbed on their bodies. Red ochre is used in similar ways in less-secret ceremonies. Blood is also used to fasten the feathers of birds onto people's bodies. Bird feathers contain a protein that is highly magnetically sensitive.[37]

Lawlor comments that blood employed in this fashion is held by these peoples to attune the dancers to the invisible energetic realm of the Dreamtime. Lawlor then connects these invisible energetic realms and magnetic fields, because iron is magnetic.

European paganism

Among the Germanic tribes, blood was used during their sacrifices; the Blóts. The blood was considered to have the power of its originator, and, after the butchering, the blood was sprinkled on the walls, on the statues of the gods, and on the participants themselves. This act of sprinkling blood was called blóedsian in Old English, and the terminology was borrowed by the Roman Catholic Church becoming to bless and blessing. The Hittite word for blood, ishar was a cognate to words for "oath" and "bond", see Ishara. The Ancient Greeks believed that the blood of the gods, ichor, was a substance that was poisonous to mortals.

As a relic of Germanic Law, the cruentation, an ordeal where the corpse of the victim was supposed to start bleeding in the presence of the murderer, was used until the early 17th century.

Christianity

In Genesis 9:4, God prohibited Noah and his sons from eating blood (see Noahide Law). This command continued to be observed by the Eastern Orthodox.

It is also found in the Bible that when the Angel of Death came around to the Hebrew house that the first-born child would not die if the angel saw lamb's blood wiped across the doorway.

At the Council of Jerusalem, the apostles prohibited certain Christians from consuming blood – this is documented in Acts 15:20 and 29. This chapter specifies a reason (especially in verses 19–21): It was to avoid offending Jews who had become Christians, because the Mosaic Law Code prohibited the practice.

Christ's blood is the means for the atonement of sins. Also, ″… the blood of Jesus Christ his [God] Son cleanseth us from all sin." (1 John 1:7), “… Unto him [God] that loved us, and washed us from our sins in his own blood." (Revelation 1:5), and "And they overcame him (Satan) by the blood of the Lamb [Jesus the Christ], and by the word of their testimony …” (Revelation 12:11).

Some Christian churches, including Roman Catholicism, Eastern Orthodoxy, Oriental Orthodoxy, and the Assyrian Church of the East teach that, when consecrated, the Eucharistic wine actually becomes the blood of Jesus for worshippers to drink. Thus in the consecrated wine, Jesus becomes spiritually and physically present. This teaching is rooted in the Last Supper, as written in the four gospels of the Bible, in which Jesus stated to his disciples that the bread that they ate was his body, and the wine was his blood. "This cup is the new testament in my blood, which is shed for you." (Luke 22:20).

Most forms of Protestantism, especially those of a Wesleyan or Presbyterian lineage, teach that the wine is no more than a symbol of the blood of Christ, who is spiritually but not physically present. Lutheran theology teaches that the body and blood is present together "in, with, and under" the bread and wine of the Eucharistic feast.

Judaism

In Judaism, animal blood may not be consumed even in the smallest quantity (Leviticus 3:17 and elsewhere); this is reflected in Jewish dietary laws (Kashrut). Blood is purged from meat by rinsing and soaking in water (to loosen clots), salting and then rinsing with water again several times.[38] Eggs must also be checked and any blood spots removed before consumption.[39] Although blood from fish is biblically kosher, it is rabbinically forbidden to consume fish blood to avoid the appearance of breaking the Biblical prohibition.[40]

Another ritual involving blood involves the covering of the blood of fowl and game after slaughtering (Leviticus 17:13); the reason given by the Torah is: "Because the life of the animal is [in] its blood" (ibid 17:14). In relation to human beings, Kabbalah expounds on this verse that the animal soul of a person is in the blood, and that physical desires stem from it.

Likewise, the mystical reason for salting temple sacrifices and slaughtered meat is to remove the blood of animal-like passions from the person. By removing the animal's blood, the animal energies and life-force contained in the blood are removed, making the meat fit for human consumption.[41]

Islam

Consumption of food containing blood is forbidden by Islamic dietary laws. This is derived from the statement in the Qur'an, sura Al-Ma'ida (5:3): "Forbidden to you (for food) are: dead meat, blood, the flesh of swine, and that on which has been invoked the name of other than Allah."

Blood is considered unclean, hence there are specific methods to obtain physical and ritual status of cleanliness once bleeding has occurred. Specific rules and prohibitions apply to menstruation, postnatal bleeding and irregular vaginal bleeding. When an animal has been slaughtered, the animal's neck is cut in a way to ensure that the spine is not severed, hence the brain may send commands to the heart to pump blood to it for oxygen. In this way, blood is removed from the body, and the meat is generally now safe to cook and eat. In modern times, blood transfusions are generally not considered against the rules.

Jehovah's Witnesses

Based on their interpretation of scriptures such as Acts 15:28, 29 ("Keep abstaining...from blood."), many Jehovah's Witnesses neither consume blood nor accept transfusions of whole blood or its major components: red blood cells, white blood cells, platelets (thrombocytes), and plasma. Members may personally decide whether they will accept medical procedures that involve their own blood or substances that are further fractionated from the four major components.[42]

East Asian culture

In south East Asian popular culture, it is often said that if a man's nose produces a small flow of blood, he is experiencing sexual desire. This often appears in Chinese-language and Hong Kong films as well as in Japanese and Korean culture parodied in anime, manga, and drama. Characters, mostly males, will often be shown with a nosebleed if they have just seen someone nude or in little clothing, or if they have had an erotic thought or fantasy; this is based on the idea that a male's blood pressure will spike dramatically when aroused.[43]

Vampire legends

Vampires are mythical creatures that drink blood directly for sustenance, usually with a preference for human blood. Cultures all over the world have myths of this kind; for example the 'Nosferatu' legend, a human who achieves damnation and immortality by drinking the blood of others, originates from Eastern European folklore. Ticks, leeches, female mosquitoes, vampire bats, and an assortment of other natural creatures do consume the blood of other animals, but only bats are associated with vampires. This has no relation to vampire bats, which are new world creatures discovered well after the origins of the European myths.

Applications

In the applied sciences

Blood residue can help forensic investigators identify weapons, reconstruct a criminal action, and link suspects to the crime. Through bloodstain pattern analysis, forensic information can also be gained from the spatial distribution of bloodstains.

Blood residue analysis is also a technique used in archeology.

In art

Blood is one of the body fluids that has been used in art.[44] In particular, the performances of Viennese Actionist Hermann Nitsch, Istvan Kantor, Franko B, Lennie Lee, Ron Athey, Yang Zhichao, Lucas Abela and Kira O' Reilly, along with the photography of Andres Serrano, have incorporated blood as a prominent visual element. Marc Quinn has made sculptures using frozen blood, including a cast of his own head made using his own blood.

In genealogy and family history

The term blood is used in genealogical circles to refer to one's ancestry, origins, and ethnic background as in the word bloodline. Other terms where blood is used in a family history sense are blue-blood, royal blood, mixed-blood and blood relative.

See also

References

  1. ^ "Definition of BLOOD". Archived from the original on 23 March 2017. Retrieved 4 March 2017.
  2. ^ The Franklin Institute Inc. "Blood – The Human Heart". Archived from the original on 5 March 2009. Retrieved 19 March 2009.
  3. ^ Alberts, Bruce (2012). "Table 22-1 Blood Cells". Molecular Biology of the Cell. NCBI Bookshelf. Archived from the original on 27 March 2018. Retrieved 1 November 2012.
  4. ^ a b Elert, Glenn (2012). "Volume of Blood in a Human". The Physics Factbook. his students. Archived from the original on 1 November 2012. Retrieved 2012-11-01
  5. ^ Shmukler, Michael (2004). "Density of Blood". The Physics Factbook. Archived from the original on 19 September 2006. Retrieved 4 October 2006.
  6. ^ "Medical Encyclopedia: RBC count". Medline Plus. Archived from the original on 21 October 2007. Retrieved 18 November 2007.
  7. ^ Robert B. Tallitsch; Martini, Frederic; Timmons, Michael J. (2006). Human anatomy (5th ed.). San Francisco: Pearson/Benjamin Cummings. p. 529. ISBN 978-0-8053-7211-3.
  8. ^ a b Ganong, William F. (2003). Review of medical physiology (21 ed.). New York: Lange Medical Books/McGraw-Hill. p. 518. ISBN 978-0-07-121765-1.
  9. ^ Waugh, Anne; Grant, Allison (2007). "2". Anatomy and Physiology in Health and Illness (Tenth ed.). Churchill Livingstone Elsevier. p. 22. ISBN 978-0-443-10102-1.
  10. ^ Acid-Base Regulation and Disorders at Merck Manual of Diagnosis and Therapy Professional Edition
  11. ^ Romer, Alfred Sherwood; Parsons, Thomas S. (1977). The Vertebrate Body. Philadelphia: Holt-Saunders International. pp. 404–406. ISBN 978-0-03-910284-5.
  12. ^ Harvey, William (1628). "Exercitatio Anatomica de Motu Cordis et Sanguinis in Animalibus" (in Latin). Archived from the original on 27 November 2010.
  13. ^ Williams, Peter W.; Gray, Henry David (1989). Gray's anatomy (37th ed.). New York: C. Livingstone. ISBN 978-0-443-02588-4.
  14. ^ Frederic, Martini (2009). Fundamentals of anatomy & physiology. Nath, Judi Lindsley (8th ed.). San Francisco: Pearson/Benjamin Cummings. p. 657. ISBN 978-0321539106. OCLC 173683666.
  15. ^ Dominguez de Villota ED, Ruiz Carmona MT, Rubio JJ, de Andrés S (December 1981). "Equality of the in vivo and in vitro oxygen-binding capacity of hemoglobin in patients with severe respiratory disease". Br J Anaesth. 53 (12): 1325–1328. doi:10.1093/bja/53.12.1325. PMID 7317251.
  16. ^ a b Costanzo, Linda S. (2007). Physiology. Hagerstown, Maryland: Lippincott Williams & Wilkins. ISBN 978-0-7817-7311-9.
  17. ^ a b c Edwards Lifesciences LLC – Normal Hemodynamic Parameters – Adult Archived 10 November 2010 at the Wayback Machine 2009
  18. ^ "Ventilatory Physiology and Endurance". 23 March 2010. Archived from the original on 23 March 2010. Retrieved 4 March 2017.
  19. ^ Transplant Support- Lung, Heart/Lung, Heart MSN groups
  20. ^ Mortensen SP, Dawson EA, Yoshiga CC, et al. (July 2005). "Limitations to systemic and locomotor limb muscle oxygen delivery and uptake during maximal exercise in humans". J. Physiol. 566 (Pt 1): 273–285. doi:10.1113/jphysiol.2005.086025. PMC 1464731. PMID 15860533.
  21. ^ "Blood gas and Saturation measurements". 25 September 2010. Archived from the original on 25 September 2010. Retrieved 4 March 2017.
  22. ^ "Lecture Notes-20". 2 May 1999. Archived from the original on 2 May 1999. Retrieved 4 March 2017.
  23. ^ Martini, Frederic; et al. (2007). Anatomy and Physiology. Rex Bookstore, Inc. p. 643. ISBN 9789712348075. Archived from the original on 1 May 2016.
  24. ^ Vander's Human Physiology reported similar numbers: 60% carried as bicarbonate, 30% bound to hemoglobin as carbaminohemoglobin, and 10% physically dissolved. Widmaier, Eric P.; Raff, Hershel; Strang, Kevin T. (2003). Vander's Human Physiology (9th ed.). McGraw-Hill Education. p. 493 (ch. Respiratory physiology § Transport of carbon dioxide in blood). ISBN 978-0-07-288074-8.
  25. ^ a b Guyton and Hall Textbook of Medical Physiology. Saunders. 2015. p. 204. ISBN 978-1455770052.
  26. ^ "Spiders: circulatory system". Encyclopædia Britannica online. Archived from the original on 12 November 2007. Retrieved 25 November 2007.
  27. ^ Prahl. "Optical Absorption of Hemoglobin". Archived from the original on 5 January 2002. Retrieved 30 December 2012.
  28. ^ Kienle, Alwin; Lothar Lilge; I. Alex Vitkin; Michael S. Patterson; Brian C. Wilson; Raimund Hibst; Rudolf Steiner (1 March 1996). "Why do veins appear blue? A new look at an old question" (PDF). Applied Optics. 35 (7): 1151–1160. Bibcode:1996ApOpt..35.1151K. doi:10.1364/AO.35.001151. PMID 21085227. Archived from the original (PDF) on 10 February 2012.
  29. ^ Austin CC, Perkins SL (2006). "Parasites in a biodiversity hotspot: a survey of hematozoa and a molecular phylogenetic analysis of Plasmodium in New Guinea skinks". J. Parasitol. 92 (4): 770–777. doi:10.1645/GE-693R.1. PMID 16995395.
  30. ^ a b c d e Shuster, Carl N (2004). "Chapter 11: A blue blood: the circulatory system". In Shuster, Carl N Jr; Barlow, Robert B; Brockmann, H. Jane (eds.). The American Horseshoe Crab. Harvard University Press. pp. 276–277. ISBN 978-0-674-01159-5.
  31. ^ a b Carnegie Library of Pittsburgh, The Handy Science Answer Book, p. 465, Visible Ink Press, 2011 ISBN 1578593212.
  32. ^ "Blood – The Human heart". The Franklin Institute. Archived from the original on 5 March 2009. Retrieved 19 March 2009.
  33. ^ "The Role of Red Blood Cells in Anemia". Archived from the original on 18 May 2017. Retrieved 22 May 2017.
  34. ^ Blumenthal, Ivan (2001). "Carbon monoxide poisoning". Journal of the Royal Society of Medicine. 94 (6): 270–272. doi:10.1177/014107680109400604. ISSN 0141-0768. PMC 1281520. PMID 11387414.
  35. ^ Hart GD (December 2001). "Descriptions of blood and blood disorders before the advent of laboratory studies" (PDF). Br. J. Haematol. 115 (4): 719–728. doi:10.1046/j.1365-2141.2001.03130.x. PMID 11843802. Archived from the original (PDF) on 8 July 2011.
  36. ^ http://www.redcrossblood.org/learn-about-blood/history-blood-transfusion
  37. ^ Lawlor, Robert (1991). Voices of the first day: awakening in the Aboriginal dreamtime. Rochester, VT: Inner Traditions International. pp. 102–103. ISBN 978-0-89281-355-1.
  38. ^ Koshering Meat. Archived 16 December 2013 at the Wayback Machine Chabad.org.
  39. ^ Removing the Blood. Archived 16 December 2013 at the Wayback Machine Chabad.org.
  40. ^ Citron, R. Aryeh. All About Kosher Fish. Archived 16 December 2013 at the Wayback Machine Chabad.org.
  41. ^ Schneerson, R. Menachem M. Igrot Kodesh, vol. vii, p. 270.
  42. ^ The Watchtower 15 June 2004, p. 22, "Be Guided by the Living God"
  43. ^ Law of Anime No. 40 a.k.a. Law of Nasal Sanguination at ABCB.com Archived 18 January 2009 at the Wayback Machine, The Anime Cafe.
  44. ^ "Nostalgia" Artwork in blood Archived 8 January 2009 at the Wayback Machine

External links

Anemia

Anemia is a decrease in the total amount of red blood cells (RBCs) or hemoglobin in the blood, or a lowered ability of the blood to carry oxygen. When anemia comes on slowly, the symptoms are often vague and may include feeling tired, weakness, shortness of breath or a poor ability to exercise. Anemia that comes on quickly often has greater symptoms, which may include confusion, feeling like one is going to pass out, loss of consciousness, or increased thirst. Anemia must be significant before a person becomes noticeably pale. Additional symptoms may occur depending on the underlying cause.The three main types of anemia are due to blood loss, decreased red blood cell production, and increased red blood cell breakdown. Causes of blood loss include trauma and gastrointestinal bleeding, among others. Causes of decreased production include iron deficiency, a lack of vitamin B12, thalassemia, and a number of neoplasms of the bone marrow. Causes of increased breakdown include a number of genetic conditions such as sickle cell anemia, infections like malaria, and certain autoimmune diseases. It can also be classified based on the size of red blood cells and amount of hemoglobin in each cell. If the cells are small, it is microcytic anemia. If they are large, it is macrocytic anemia while if they are normal sized, it is normocytic anemia. Diagnosis in men is based on a hemoglobin of less than 130 to 140 g/L (13 to 14 g/dL), while in women, it must be less than 120 to 130 g/L (12 to 13 g/dL). Further testing is then required to determine the cause.Certain groups of individuals, such as pregnant women, benefit from the use of iron pills for prevention. Dietary supplementation, without determining the specific cause, is not recommended. The use of blood transfusions is typically based on a person's signs and symptoms. In those without symptoms, they are not recommended unless hemoglobin levels are less than 60 to 80 g/L (6 to 8 g/dL). These recommendations may also apply to some people with acute bleeding. Erythropoiesis-stimulating medications are only recommended in those with severe anemia.Anemia is the most common blood disorder, affecting about a third of the global population. Iron-deficiency anemia affects nearly 1 billion people. In 2013, anemia due to iron deficiency resulted in about 183,000 deaths – down from 213,000 deaths in 1990. It is more common in women than men, during pregnancy, and in children and the elderly. Anemia increases costs of medical care and lowers a person's productivity through a decreased ability to work. The name is derived from Ancient Greek: ἀναιμία anaimia, meaning "lack of blood", from ἀν- an-, "not" and αἷμα haima, "blood".

Blood pressure

Blood pressure (BP) is the pressure of circulating blood on the walls of blood vessels. Most of this pressure is due to work done by the heart by pumping blood through the circulatory system. Used without further specification, "blood pressure" usually refers to the pressure in large arteries of the systemic circulation. Blood pressure is usually expressed in terms of the systolic pressure (maximum during one heartbeat) over diastolic pressure (minimum in between two heartbeats) and is measured in millimeters of mercury (mmHg), above the surrounding atmospheric pressure.

Blood pressure is one of the vital signs, along with respiratory rate, heart rate, oxygen saturation, and body temperature. Normal resting blood pressure in an adult is approximately 120 millimetres of mercury (16 kPa) systolic, and 80 millimetres of mercury (11 kPa) diastolic, abbreviated "120/80 mmHg". Globally, the average age standardized blood pressure has remained about the same since 1975 to present, at approx. 127/79 mmHg in men and 122/77 mmHg in women.Traditionally, blood pressure was measured non-invasively using ausculation with a mercury-tube sphygmomanometer. Ausculation is still generally considered to be the gold standard of accuracy for non-invasive blood pressure readings in clinic. However, semi-automated methods have become common, largely due to concerns about potential mercury toxicity, although cost, ease of use and applicability to ambulatory blood pressure or home blood pressure measurements have also influenced this trend. Early automated alternatives to mercury-tube sphygmomanometers were often seriously inaccurate, but modern devices validated to international standards achieve average difference between two standardized reading methods of 5 mm Hg or less and a standard deviation of less than 8 mm Hg. Most of these semi-automated methods measure blood pressure using oscillometry.Blood pressure is influenced by cardiac output, total peripheral resistance and arterial stiffness and varies depending on situation, emotional state, activity, and relative health/disease states. In the short term, blood pressure is regulated by baroreceptors which act via the brain to influence nervous and endocrine systems.

Blood pressure that is too low is called hypotension, and pressure that is consistently high is hypertension. Both have many causes and may be of sudden onset or of long duration. Long-term hypertension is a risk factor for many diseases, including heart disease, stroke and kidney failure. Long-term hypertension is more common than long-term hypotension, which is usually only diagnosed when it causes symptoms.

Blood sugar level

The blood sugar level, blood sugar concentration, or blood glucose level is the amount of glucose present in the blood of humans and other animals. Glucose is a simple sugar and approximately 4 grams of glucose are present in the blood of a 70-kilogram (150 lb) human at all times. The body tightly regulates blood glucose levels as a part of metabolic homeostasis. Glucose is stored in skeletal muscle and liver cells in the form of glycogen; in fasted individuals, blood glucose is maintained at a constant level at the expense of glycogen stores in the liver and skeletal muscle.In humans, a blood glucose level of four grams, or about a teaspoon, is critical for normal function in a number of tissues, and the human brain consumes approximately 60% of blood glucose in fasted, sedentary individuals. A persistent elevation in blood glucose leads to glucose toxicity, which contributes to cell dysfunction and the pathology grouped together as complications of diabetes. Glucose can be transported from the intestines or liver to other tissues in the body via the bloodstream. Cellular glucose uptake is primarily regulated by insulin, a hormone produced in the pancreas.Glucose levels are usually lowest in the morning, before the first meal of the day, and rise after meals for an hour or two by a few millimoles.

Blood sugar levels outside the normal range may be an indicator of a medical condition. A persistently high level is referred to as hyperglycemia; low levels are referred to as hypoglycemia. Diabetes mellitus is characterized by persistent hyperglycemia from any of several causes, and is the most prominent disease related to failure of blood sugar regulation. There are different methods of testing and measuring blood sugar levels.

The intake of alcohol causes an initial surge in blood sugar, and later tends to cause levels to fall. Also, certain drugs can increase or decrease glucose levels.

Blood type

A blood type (also called a blood group) is a classification of blood, based on the presence and absence of antibodies and inherited antigenic substances on the surface of red blood cells (RBCs). These antigens may be proteins, carbohydrates, glycoproteins, or glycolipids, depending on the blood group system. Some of these antigens are also present on the surface of other types of cells of various tissues. Several of these red blood cell surface antigens can stem from one allele (or an alternative version of a gene) and collectively form a blood group system. Blood types are inherited and represent contributions from both parents. A total of 36 human blood group systems and 346 antigens are now recognized by the International Society of Blood Transfusion (ISBT). The two most important ones are ABO and the Rh blood group systems; they determine someone's blood type (A, B, AB and O, with +, − or null denoting RhD status) for suitability in blood transfusion.

Blood vessel

The blood vessels are a part of the circulatory system, and microcirculation, that transports blood throughout the human body. These vessels are designed to transport nutrients and oxygen to the tissues of the body. They also take waste and carbon dioxide and carry them away from the tissues and back to the heart. Blood vessels are needed to sustain life as all of the body’s tissues rely on their functionality.There are three major types of blood vessels: the arteries, which carry the blood away from the heart; the capillaries, which enable the actual exchange of water and chemicals between the blood and the tissues; and the veins, which carry blood from the capillaries back toward the heart. The word vascular, meaning relating to the blood vessels, is derived from the Latin vas, meaning vessel. Some structures -- such as cartilage, the epithelium, and the lens and cornea of the eye -- do not contain blood vessels and are labeled avascular.

Bloods

The Bloods, also known as Original Blood Family (OBF), are a primarily African-American street gang founded in Los Angeles, California. The gang is widely known for its rivalry with the Crips. They are identified by the red color worn by their members and by particular gang symbols, including distinctive hand signs.

The Bloods comprise various sub-groups known as "sets" between which significant differences exist such as colors, clothing, operations, and political ideas which may be in open conflict with each other. Since their creation, the Bloods gangs have branched throughout the United States.

Circulatory system

The circulatory system, also called the cardiovascular system or the vascular system, is an organ system that permits blood to circulate and transport nutrients (such as amino acids and electrolytes), oxygen, carbon dioxide, hormones, and blood cells to and from the cells in the body to provide nourishment and help in fighting diseases, stabilize temperature and pH, and maintain homeostasis.

The circulatory system includes the lymphatic system, which circulates lymph. The passage of lymph for example takes much longer than that of blood. Blood is a fluid consisting of plasma, red blood cells, white blood cells, and platelets that is circulated by the heart through the vertebrate vascular system, carrying oxygen and nutrients to and waste materials away from all body tissues. Lymph is essentially recycled excess blood plasma after it has been filtered from the interstitial fluid (between cells) and returned to the lymphatic system. The cardiovascular (from Latin words meaning "heart" and "vessel") system comprises the blood, heart, and blood vessels. The lymph, lymph nodes, and lymph vessels form the lymphatic system, which returns filtered blood plasma from the interstitial fluid (between cells) as lymph.

The circulatory system of the blood is seen as having two components, a systemic circulation and a pulmonary circulation.While humans, as well as other vertebrates, have a closed cardiovascular system (meaning that the blood never leaves the network of arteries, veins and capillaries), some invertebrate groups have an open cardiovascular system. The lymphatic system, on the other hand, is an open system providing an accessory route for excess interstitial fluid to be returned to the blood. The more primitive, diploblastic animal phyla lack circulatory systems.

Many diseases affect the circulatory system. This includes cardiovascular disease, affecting the cardiovascular system, and lymphatic disease affecting the lymphatic system. Cardiologists are medical professionals which specialise in the heart, and cardiothoracic surgeons specialise in operating on the heart and its surrounding areas. Vascular surgeons focus on other parts of the circulatory system.

Coagulation

Coagulation, also known as clotting, is the process by which blood changes from a liquid to a gel, forming a blood clot. It potentially results in hemostasis, the cessation of blood loss from a damaged vessel, followed by repair. The mechanism of coagulation involves activation, adhesion and aggregation of platelets along with deposition and maturation of fibrin. Disorders of coagulation are disease states which can result in bleeding (hemorrhage or bruising) or obstructive clotting (thrombosis).Coagulation begins almost instantly after an injury to the blood vessel has damaged the endothelium lining the blood vessel. Exposure of blood to the subendothelial space initiates two processes: changes in platelets, and the exposure of subendothelial tissue factor to plasma Factor VII, which ultimately leads to fibrin formation. Platelets immediately form a plug at the site of injury; this is called primary hemostasis. Secondary hemostasis occurs simultaneously: Additional coagulation factors or clotting factors beyond Factor VII (listed below) respond in a complex cascade to form fibrin strands, which strengthen the platelet plug.Coagulation is highly conserved throughout biology; in all mammals, coagulation involves both a cellular (platelet) and a protein (coagulation factor) component. The system in humans has been the most extensively researched and is the best understood.

Diabetes mellitus

Diabetes mellitus (DM), commonly known as diabetes, is a group of metabolic disorders characterized by high blood sugar levels over a prolonged period. Symptoms of high blood sugar include frequent urination, increased thirst, and increased hunger. If left untreated, diabetes can cause many complications. Acute complications can include diabetic ketoacidosis, hyperosmolar hyperglycemic state, or death. Serious long-term complications include cardiovascular disease, stroke, chronic kidney disease, foot ulcers, and damage to the eyes.Diabetes is due to either the pancreas not producing enough insulin, or the cells of the body not responding properly to the insulin produced. There are three main types of diabetes mellitus:

Type 1 DM results from the pancreas' failure to produce enough insulin due to loss of beta cells. This form was previously referred to as "insulin-dependent diabetes mellitus" (IDDM) or "juvenile diabetes". The cause is unknown.

Type 2 DM begins with insulin resistance, a condition in which cells fail to respond to insulin properly. As the disease progresses, a lack of insulin may also develop. This form was previously referred to as "non insulin-dependent diabetes mellitus" (NIDDM) or "adult-onset diabetes". The most common cause is a combination of excessive body weight and insufficient exercise.

Gestational diabetes is the third main form, and occurs when pregnant women without a previous history of diabetes develop high blood sugar levels.Prevention and treatment involve maintaining a healthy diet, regular physical exercise, a normal body weight, and avoiding use of tobacco. Control of blood pressure and maintaining proper foot care are important for people with the disease. Type 1 DM must be managed with insulin injections. Type 2 DM may be treated with medications with or without insulin. Insulin and some oral medications can cause low blood sugar. Weight loss surgery in those with obesity is sometimes an effective measure in those with type 2 DM. Gestational diabetes usually resolves after the birth of the baby.As of 2017, an estimated 425 million people had diabetes worldwide, with type 2 DM making up about 90% of the cases. This represents 8.8% of the adult population, with equal rates in both women and men. Trend suggests that rates will continue to rise. Diabetes at least doubles a person's risk of early death. In 2017, diabetes resulted in approximately 3.2 to 5.0 million deaths. The global economic cost of diabetes related health expenditure in 2017 was estimated at US$727 billion. In the United States, diabetes cost nearly US$245 billion in 2012.

Erythropoietin

Erythropoietin (; EPO), also known as hematopoietin or hemopoietin, is a glycoprotein cytokine secreted by the kidney in response to cellular hypoxia; it stimulates red blood cell production (erythropoiesis) in the bone marrow. Low levels of EPO (around 10 mU/mL) are constantly secreted sufficient to compensate for normal red blood cell turnover. Common causes of cellular hypoxia resulting in elevated levels of EPO (up to 10 000 mU/mL) include any anemia, and hypoxemia due to chronic lung disease.

Erythropoietin is produced by interstitial fibroblasts in the kidney in close association with the peritubular capillary and proximal convoluted tubule. It is also produced in perisinusoidal cells in the liver. Liver production predominates in the fetal and perinatal period; renal production predominates in adulthood.

Exogenous erythropoietin, recombinant human erythropoietin (rhEPO) is produced by recombinant DNA technology in cell culture and are collectively called erythropoiesis-stimulating agents (ESA): two examples are epoetin alfa and epoetin beta. ESAs are used in the treatment of anemia in chronic kidney disease, anemia in myelodysplasia, and in anemia from cancer chemotherapy. Risks of therapy include death, myocardial infarction, stroke, venous thromboembolism, and tumor recurrence. Risk increases when EPO treatment raises hemoglobin levels over 11 g/dL to 12 g/dL: this is to be avoided.

rhEPO has been used illicitly as a performance-enhancing drug. It can often be detected in blood, due to slight differences from the endogenous protein; for example, in features of posttranslational modification.

Heart

The heart is a muscular organ in most animals, which pumps blood through the blood vessels of the circulatory system. Blood provides the body with oxygen and nutrients, as well as assisting in the removal of metabolic wastes. In humans, the heart is located between the lungs, in the middle compartment of the chest.In humans, other mammals, and birds, the heart is divided into four chambers: upper left and right atria and lower left and right ventricles. Commonly the right atrium and ventricle are referred together as the right heart and their left counterparts as the left heart. Fish, in contrast, have two chambers, an atrium and a ventricle, while reptiles have three chambers. In a healthy heart blood flows one way through the heart due to heart valves, which prevent backflow. The heart is enclosed in a protective sac, the pericardium, which also contains a small amount of fluid. The wall of the heart is made up of three layers: epicardium, myocardium, and endocardium.The heart pumps blood with a rhythm determined by a group of pacemaking cells in the sinoatrial node. These generate a current that causes contraction of the heart, traveling through the atrioventricular node and along the conduction system of the heart. The heart receives blood low in oxygen from the systemic circulation, which enters the right atrium from the superior and inferior venae cavae and passes to the right ventricle. From here it is pumped into the pulmonary circulation, through the lungs where it receives oxygen and gives off carbon dioxide. Oxygenated blood then returns to the left atrium, passes through the left ventricle and is pumped out through the aorta to the systemic circulation−where the oxygen is used and metabolized to carbon dioxide. The heart beats at a resting rate close to 72 beats per minute. Exercise temporarily increases the rate, but lowers resting heart rate in the long term, and is good for heart health.Cardiovascular diseases (CVD) are the most common cause of death globally as of 2008, accounting for 30% of deaths. Of these more than three quarters are a result of coronary artery disease and stroke. Risk factors include: smoking, being overweight, little exercise, high cholesterol, high blood pressure, and poorly controlled diabetes, among others. Cardiovascular diseases frequently do not have symptoms or may cause chest pain or shortness of breath. Diagnosis of heart disease is often done by the taking of a medical history, listening to the heart-sounds with a stethoscope, ECG, and ultrasound. Specialists who focus on diseases of the heart are called cardiologists, although many specialties of medicine may be involved in treatment.

Hypertension

Hypertension (HTN or HT), also known as high blood pressure (HBP), is a long-term medical condition in which the blood pressure in the arteries is persistently elevated. High blood pressure typically does not cause symptoms. Long-term high blood pressure, however, is a major risk factor for coronary artery disease, stroke, heart failure, atrial fibrillation, peripheral vascular disease, vision loss, chronic kidney disease, and dementia.High blood pressure is classified as either primary (essential) high blood pressure or secondary high blood pressure. About 90–95% of cases are primary, defined as high blood pressure due to nonspecific lifestyle and genetic factors. Lifestyle factors that increase the risk include excess salt in the diet, excess body weight, smoking, and alcohol use. The remaining 5–10% of cases are categorized as secondary high blood pressure, defined as high blood pressure due to an identifiable cause, such as chronic kidney disease, narrowing of the kidney arteries, an endocrine disorder, or the use of birth control pills.Blood pressure is expressed by two measurements, the systolic and diastolic pressures, which are the maximum and minimum pressures, respectively. For most adults, normal blood pressure at rest is within the range of 100–130 millimeters mercury (mmHg) systolic and 60–80 mmHg diastolic. For most adults, high blood pressure is present if the resting blood pressure is persistently at or above 130/80 or 140/90 mmHg. Different numbers apply to children. Ambulatory blood pressure monitoring over a 24-hour period appears more accurate than office-based blood pressure measurement.Lifestyle changes and medications can lower blood pressure and decrease the risk of health complications. Lifestyle changes include weight loss, physical exercise, decreased salt intake, reducing alcohol intake, and a healthy diet. If lifestyle changes are not sufficient then blood pressure medications are used. Up to three medications can control blood pressure in 90% of people. The treatment of moderately high arterial blood pressure (defined as >160/100 mmHg) with medications is associated with an improved life expectancy. The effect of treatment of blood pressure between 130/80 mmHg and 160/100 mmHg is less clear, with some reviews finding benefit and others finding unclear benefit. High blood pressure affects between 16 and 37% of the population globally. In 2010 hypertension was believed to have been a factor in 18% of all deaths (9.4 million globally).

Leukemia

Leukemia, also spelled leukaemia, is a group of blood cancers that usually begin in the bone marrow and result in high numbers of abnormal blood cells. These blood cells are not fully developed and are called blasts or leukemia cells. Symptoms may include bleeding and bruising problems, feeling tired, fever, and an increased risk of infections. These symptoms occur due to a lack of normal blood cells. Diagnosis is typically made by blood tests or bone marrow biopsy.The exact cause of leukemia is unknown. A combination of genetic factors and environmental (non-inherited) factors are believed to play a role. Risk factors include smoking, ionizing radiation, some chemicals (such as benzene), prior chemotherapy, and Down syndrome. People with a family history of leukemia are also at higher risk. There are four main types of leukemia—acute lymphoblastic leukemia (ALL), acute myeloid leukemia (AML), chronic lymphocytic leukemia (CLL) and chronic myeloid leukemia (CML)—as well as a number of less common types. Leukemias and lymphomas both belong to a broader group of tumors that affect the blood, bone marrow, and lymphoid system, known as tumors of the hematopoietic and lymphoid tissues.Treatment may involve some combination of chemotherapy, radiation therapy, targeted therapy, and bone marrow transplant, in addition to supportive care and palliative care as needed. Certain types of leukemia may be managed with watchful waiting. The success of treatment depends on the type of leukemia and the age of the person. Outcomes have improved in the developed world. The average five-year survival rate is 57% in the United States. In children under 15, the five-year survival rate is greater than 60 to 85%, depending on the type of leukemia. In children with acute leukemia who are cancer-free after five years, the cancer is unlikely to return.In 2015, leukemia was present in 2.3 million people and caused 353,500 deaths. In 2012 it newly developed in 352,000 people. It is the most common type of cancer in children, with three quarters of leukemia cases in children being the acute lymphoblastic type. However, about 90% of all leukemias are diagnosed in adults, with AML and CLL being most common in adults. It occurs more commonly in the developed world.

Myocardial infarction

Myocardial infarction (MI), commonly known as a heart attack, occurs when blood flow decreases or stops to a part of the heart, causing damage to the heart muscle. The most common symptom is chest pain or discomfort which may travel into the shoulder, arm, back, neck, or jaw. Often it occurs in the center or left side of the chest and lasts for more than a few minutes. The discomfort may occasionally feel like heartburn. Other symptoms may include shortness of breath, nausea, feeling faint, a cold sweat, or feeling tired. About 30% of people have atypical symptoms. Women more often present without chest pain and instead have neck pain, arm pain, or feel tired. Among those over 75 years old, about 5% have had an MI with little or no history of symptoms. An MI may cause heart failure, an irregular heartbeat, cardiogenic shock, or cardiac arrest.Most MIs occur due to coronary artery disease. Risk factors include high blood pressure, smoking, diabetes, lack of exercise, obesity, high blood cholesterol, poor diet, and excessive alcohol intake, among others. The complete blockage of a coronary artery caused by a rupture of an atherosclerotic plaque is usually the underlying mechanism of an MI. MIs are less commonly caused by coronary artery spasms, which may be due to cocaine, significant emotional stress, and extreme cold, among others. A number of tests are useful to help with diagnosis, including electrocardiograms (ECGs), blood tests, and coronary angiography. An ECG, which is a recording of the heart's electrical activity, may confirm an ST elevation MI (STEMI) if ST elevation is present. Commonly used blood tests include troponin and less often creatine kinase MB.Treatment of an MI is time-critical. Aspirin is an appropriate immediate treatment for a suspected MI. Nitroglycerin or opioids may be used to help with chest pain; however, they do not improve overall outcomes. Supplemental oxygen is recommended in those with low oxygen levels or shortness of breath. In a STEMI, treatments attempt to restore blood flow to the heart, and include percutaneous coronary intervention (PCI), where the arteries are pushed open and may be stented, or thrombolysis, where the blockage is removed using medications. People who have a non-ST elevation myocardial infarction (NSTEMI) are often managed with the blood thinner heparin, with the additional use of PCI in those at high risk. In people with blockages of multiple coronary arteries and diabetes, coronary artery bypass surgery (CABG) may be recommended rather than angioplasty. After an MI, lifestyle modifications, along with long term treatment with aspirin, beta blockers, and statins, are typically recommended.Worldwide, about 15.9 million myocardial infarctions occurred in 2015. More than 3 million people had an ST elevation MI and more than 4 million had an NSTEMI. STEMIs occur about twice as often in men as women. About one million people have an MI each year in the United States. In the developed world the risk of death in those who have had an STEMI is about 10%. Rates of MI for a given age have decreased globally between 1990 and 2010. In 2011, a MI was one of the top five most expensive conditions during inpatient hospitalizations in the US, with a cost of about $11.5 billion for 612,000 hospital stays.

Red blood cell

Red blood cells, also known as RBCs, red cells, red blood corpuscles, haematids, erythroid cells or erythrocytes (from Greek erythros for "red" and kytos for "hollow vessel", with -cyte translated as "cell" in modern usage), are the most common type of blood cell and the vertebrate's principal means of delivering oxygen (O2) to the body tissues—via blood flow through the circulatory system. RBCs take up oxygen in the lungs, or gills of fish, and release it into tissues while squeezing through the body's capillaries.

The cytoplasm of erythrocytes is rich in hemoglobin, an iron-containing biomolecule that can bind oxygen and is responsible for the red color of the cells and the blood. The cell membrane is composed of proteins and lipids, and this structure provides properties essential for physiological cell function such as deformability and stability while traversing the circulatory system and specifically the capillary network.

In humans, mature red blood cells are flexible and oval biconcave disks. They lack a cell nucleus and most organelles, in order to accommodate maximum space for hemoglobin; they can be viewed as sacks of hemoglobin, with a plasma membrane as the sack. Approximately 2.4 million new erythrocytes are produced per second in human adults. The cells develop in the bone marrow and circulate for about 100–120 days in the body before their components are recycled by macrophages. Each circulation takes about 60 seconds (one minute). Approximately a quarter of the cells in the human body are red blood cells. Nearly half of the blood's volume (40% to 45%) is red blood cells.

Packed red blood cells (pRBC) are red blood cells that have been donated, processed, and stored in a blood bank for blood transfusion.

Sepsis

Sepsis is a life-threatening condition that arises when the body's response to infection causes injury to its own tissues and organs. Common signs and symptoms include fever, increased heart rate, increased breathing rate, and confusion. There may also be symptoms related to a specific infection, such as a cough with pneumonia, or painful urination with a kidney infection. In the very young, old, and people with a weakened immune system, there may be no symptoms of a specific infection and the body temperature may be low or normal, rather than high. Severe sepsis is sepsis causing poor organ function or insufficient blood flow. Insufficient blood flow may be evident by low blood pressure, high blood lactate, or low urine output. Septic shock is low blood pressure due to sepsis that does not improve after fluid replacement.Sepsis is caused by an inflammatory immune response triggered by an infection. Most commonly, the infection is bacterial, but it may also be fungal, viral, or protozoan. Common locations for the primary infection include the lungs, brain, urinary tract, skin, and abdominal organs. Risk factors include very young age, older age, a weakened immune system from conditions such as cancer or diabetes, major trauma, or burns. An older method of diagnosis was based on meeting at least two systemic inflammatory response syndrome (SIRS) criteria due to a presumed infection. In 2016, SIRS was replaced with a shortened sequential organ failure assessment score (SOFA score) known as the quick SOFA score (qSOFA) which is two of the following three: increased breathing rate, change in level of consciousness, and low blood pressure. Blood cultures are recommended preferably before antibiotics are started, however, infection of the blood is not required for the diagnosis. Medical imaging should be used to look for the possible location of infection. Other potential causes of similar signs and symptoms include anaphylaxis, adrenal insufficiency, low blood volume, heart failure, and pulmonary embolism.Sepsis is usually treated with intravenous fluids and antibiotics. Typically, antibiotics are given as soon as possible. Often, ongoing care is performed in an intensive care unit. If fluid replacement is not enough to maintain blood pressure, medications that raise blood pressure may be used. Mechanical ventilation and dialysis may be needed to support the function of the lungs and kidneys, respectively. To guide treatment, a central venous catheter and an arterial catheter may be placed for access to the bloodstream. Other measurements such as cardiac output and superior vena cava oxygen saturation may be used. People with sepsis need preventive measures for deep vein thrombosis, stress ulcers and pressure ulcers, unless other conditions prevent such interventions. Some might benefit from tight control of blood sugar levels with insulin. The use of corticosteroids is controversial. Drotrecogin alfa, originally marketed for severe sepsis, has not been found to be helpful, and was withdrawn from sale in 2011.Disease severity partly determines the outcome. The risk of death from sepsis is as high as 30%, from severe sepsis as high as 50%, and from septic shock as high as 80%. The number of cases worldwide is unknown as there is little data from the developing world. Estimates suggest sepsis affects millions of people a year. In the developed world approximately 0.2 to 3 people per 1000 are affected by sepsis yearly, resulting in about a million cases per year in the United States. Rates of disease have been increasing. Sepsis is more common among males than females. The medical condition has been described since the time of Hippocrates. The terms "septicemia" and "blood poisoning" have been used in various ways and are no longer recommended.

Stroke

A stroke is a medical condition in which poor blood flow to the brain results in cell death. There are two main types of stroke: ischemic, due to lack of blood flow, and hemorrhagic, due to bleeding. Both result in parts of the brain not functioning properly. Signs and symptoms of a stroke may include an inability to move or feel on one side of the body, problems understanding or speaking, dizziness, or loss of vision to one side. Signs and symptoms often appear soon after the stroke has occurred. If symptoms last less than one or two hours it is known as a transient ischemic attack (TIA) or mini-stroke. A hemorrhagic stroke may also be associated with a severe headache. The symptoms of a stroke can be permanent. Long-term complications may include pneumonia or loss of bladder control.The main risk factor for stroke is high blood pressure. Other risk factors include tobacco smoking, obesity, high blood cholesterol, diabetes mellitus, a previous TIA, and atrial fibrillation. An ischemic stroke is typically caused by blockage of a blood vessel, though there are also less common causes. A hemorrhagic stroke is caused by either bleeding directly into the brain or into the space between the brain's membranes. Bleeding may occur due to a ruptured brain aneurysm. Diagnosis is typically based on a physical exam and supported by medical imaging such as a CT scan or MRI scan. A CT scan can rule out bleeding, but may not necessarily rule out ischemia, which early on typically does not show up on a CT scan. Other tests such as an electrocardiogram (ECG) and blood tests are done to determine risk factors and rule out other possible causes. Low blood sugar may cause similar symptoms.Prevention includes decreasing risk factors, as well as possibly aspirin, statins, surgery to open up the arteries to the brain in those with problematic narrowing, and warfarin in those with atrial fibrillation. A stroke or TIA often requires emergency care. An ischemic stroke, if detected within three to four and half hours, may be treatable with a medication that can break down the clot. Aspirin should be used. Some hemorrhagic strokes benefit from surgery. Treatment to try to recover lost function is called stroke rehabilitation and ideally takes place in a stroke unit; however, these are not available in much of the world.In 2013 approximately 6.9 million people had an ischemic stroke and 3.4 million people had a hemorrhagic stroke. In 2015 there were about 42.4 million people who had previously had a stroke and were still alive. Between 1990 and 2010 the number of strokes which occurred each year decreased by approximately 10% in the developed world and increased by 10% in the developing world. In 2015, stroke was the second most frequent cause of death after coronary artery disease, accounting for 6.3 million deaths (11% of the total). About 3.0 million deaths resulted from ischemic stroke while 3.3 million deaths resulted from hemorrhagic stroke. About half of people who have had a stroke live less than one year. Overall, two thirds of strokes occurred in those over 65 years old.

True Blood

True Blood is an American dark fantasy horror

television series produced and created by Alan Ball and based on The Southern Vampire Mysteries, a series of novels by Charlaine Harris.

The series revolves around Sookie Stackhouse (Anna Paquin), a half-human, half-fairy waitress living in the rural town of Bon Temps, Louisiana. Two years after the invention of a synthetic blood branded “Tru Blood,” vampires are able to "come out of the coffin" and allow their presence to be known to mankind. Now they are struggling for equal rights and assimilation, while anti-vampire organizations begin to gain power. Sookie's world is turned upside down when she falls in love with 173-year-old vampire Bill Compton (Stephen Moyer) and for the first time must navigate the trials, tribulations, and terrors of intimacy and relationships.The show was broadcast on the premium cable network HBO, in the United States, and was produced by HBO in association with Ball's production company, Your Face Goes Here Entertainment. The series premiered on September 7, 2008 and concluded on August 24, 2014, comprising seven seasons and 80 episodes. The first five seasons received highly positive reviews, and both nominations and wins for several awards, including a Golden Globe and an Emmy.

White blood cell

White blood cells (also called leukocytes or leucocytes and abbreviated as WBCs) 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.All white blood cells have nuclei, which distinguishes them from the other blood cells, the anucleated red blood cells (RBCs) and platelets. Types of white blood cells can be classified in standard ways. Two pairs of broadest categories classify them either by structure (granulocytes or agranulocytes) or by cell lineage (myeloid cells or lymphoid cells). These broadest categories can be further divided into the five main types: neutrophils, eosinophils (acidophiles), basophils, lymphocytes, and monocytes. These types are distinguished by their physical and functional characteristics. Monocytes and neutrophils are phagocytic. Further subtypes can be classified; for example, among lymphocytes, there are B cells, T cells, and NK cells.

The number of leukocytes in the blood is often an indicator of disease, and thus the white blood cell count is an important subset of the complete blood count. The normal white cell count is usually between 4 × 109/L and 1.1 × 1010/L. In the US, this is usually expressed as 4,000 to 11,000 white blood cells per microliter of blood. White blood cells make up approximately 1% of the total blood volume in a healthy adult, making them substantially less numerous than the red blood cells at 40% to 45%. However, this 1% of the blood makes a large difference to health, because immunity depends on it. An increase in the number of leukocytes over the upper limits is called leukocytosis. It is normal when it is part of healthy immune responses, which happen frequently. It is occasionally abnormal, when it is neoplastic or autoimmune in origin. A decrease below the lower limit is called leukopenia. This indicates a weakened immune system.

Main cell types in blood
Myeloid
Other
B cells
Thymocyte
NK cells
Lymphopoiesis
General concepts
Blood group systems /
blood types
Blood products /
blood donation

This page is based on a Wikipedia article written by authors (here).
Text is available under the CC BY-SA 3.0 license; additional terms may apply.
Images, videos and audio are available under their respective licenses.