252 lines
5.8 KiB
Markdown
252 lines
5.8 KiB
Markdown
# BLOD OCH BLODBILDNING
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<span id="_Toc112582150" class="anchor"></span>**BLOD OCH BLODBILDNING** (kapitel 10; plate 17-20)
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**1. RÖD BENMÄRG** (Fig 10.25)
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Här sker blodbildningen. Finns bland annat i sternum, ryggkotor, höftben. I ett nätverk av retikulära trådar syns retikelceller, omogna celler i myelopoesen, omogna celler i erytropoesen, mogna blodceller, megakaryocyter samt spridda fettceller. Gul benmärg finns i de flesta ben hos vuxna individer, den består framför allt av fettceller.
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*CV18 -tibia*
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**2. BLODBILDNING** (Plate 17-20, Table 10.3; Fig 10.19; 10.22, 10.25)
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Prep. *CV3* -sternalpunktat (May-Grünwald-Giemsa). Detta är ett utstrykspreparat från röd benmärg. Här sker blodbildningen. Finns bland annat i sternum, ryggkotor, höftben. I tabellen beskrivs alla stadier i erytro- och myelopoesen. ==Du skall kunna skilja på celler i erytro- och== ==myelopoesen samt kunna ange ungefärlig mognadsgrad.== Man kan även urskilja de stora ==megakaryocyterna== samt spridda fettceller.
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**3. PERIFERT BLOD** (plate 17-18)
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Prep. *CV1* blodutstryk (May-Grünwald-Giemsa). I perifert blod finns hos en frisk människa enbart mogna blodceller.
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Sammansättning av blodets celler: Celltyp, diameter; ungefärlig mängd:
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**==a) Erytrocyter== = röda blodkroppar**, 7-8 µm, 4-6 x 106/µL
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**b) ==Trombocyter== = blodplättar,** 2-4 µm, 2-5 x 105/µL
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**c) Leukocyter = vita blodkroppar,** totalt 6-10 x 103/µL
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Varav diameter och % -andel:
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**==Granulocyter (polymorfa leukocyter)==**
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**==neutrofil==** 12-16 µm, 60-70 %
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**eosinofil,** 12-16 µm, 2-4 %
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**basofil,** 12-16 µm. 0-1 %
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**==Agranulocyter (mononukleära leukocyter)==**
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**==Lymfocyt==** 7-18 µm 20-30 %. Man ser ej skillnad på B- och T-lymfocyter
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**==Monocyt==** 16-20 µm 3-8%
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<table style="width:96%;">
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<colgroup>
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<col style="width: 21%" />
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<col style="width: 8%" />
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<col style="width: 9%" />
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<col style="width: 12%" />
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<col style="width: 14%" />
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<col style="width: 9%" />
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<col style="width: 9%" />
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<col style="width: 10%" />
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</colgroup>
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<thead>
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<tr>
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<th><strong>Cell</strong></th>
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<th style="text-align: center;"><strong>%</strong></th>
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<th><p><strong>Storlek</strong></p>
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<p><strong>µm</strong></p></th>
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<th><strong>Kärn- form</strong></th>
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<th><strong>Kärn- teckning</strong></th>
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<th><strong>Nukleol</strong></th>
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<th><strong>Cyto- plasma</strong></th>
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<th><strong>Granulae</strong></th>
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</tr>
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</thead>
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<tbody>
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<tr>
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<td><strong>Erytropoes</strong></td>
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<td style="text-align: center;"></td>
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<td></td>
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<td></td>
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<td></td>
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<td></td>
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<td></td>
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<td></td>
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</tr>
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<tr>
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<td>Proerytroblast</td>
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<td style="text-align: center;">0,5</td>
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<td style="text-align: center;">18-30</td>
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<td>rund</td>
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<td>eukromatin</td>
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<td>violetta</td>
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<td>basofil</td>
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<td>saknas</td>
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</tr>
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<tr>
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<td>Basofil erytroblast</td>
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<td style="text-align: center;"></td>
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<td style="text-align: center;">10-15</td>
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<td>rund</td>
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<td>grynig</td>
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<td>saknas</td>
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<td>basofil</td>
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<td>saknas</td>
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</tr>
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<tr>
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<td><p>Polykromatisk</p>
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<p>erytroblast</p></td>
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<td style="text-align: center;"></td>
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<td style="text-align: center;">7-11</td>
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<td>rund</td>
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<td>tät</td>
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<td>saknas</td>
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<td>basofil</td>
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<td></td>
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</tr>
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<tr>
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<td><p>Ortokromatisk</p>
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<p>erytroblast</p></td>
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<td style="text-align: center;"></td>
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<td style="text-align: center;">7-10</td>
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<td>rund</td>
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<td>kompakt</td>
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<td>saknas</td>
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<td>gul-skär</td>
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<td></td>
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</tr>
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<tr>
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<td>Erytrocyt</td>
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<td style="text-align: center;"></td>
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<td style="text-align: center;">7-8</td>
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<td>ej kärna</td>
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<td></td>
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<td></td>
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<td>röd</td>
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<td>saknas</td>
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</tr>
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<tr>
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<td><strong>Myelopoes</strong></td>
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<td style="text-align: center;"></td>
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<td style="text-align: center;"></td>
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<td></td>
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<td></td>
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<td></td>
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<td></td>
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<td></td>
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</tr>
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<tr>
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<td>Myeloblast</td>
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<td style="text-align: center;">0,3 - 4</td>
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<td style="text-align: center;">16-20</td>
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<td>rund</td>
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<td>eukromatin</td>
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<td>ljusblå</td>
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<td>basofil</td>
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<td>enstaka</td>
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</tr>
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<tr>
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<td>Promyelocyt</td>
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<td style="text-align: center;">4</td>
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<td style="text-align: center;">16-25</td>
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<td>rund</td>
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<td>förtätad</td>
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<td>ljusblå</td>
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<td>basofil</td>
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<td>azur</td>
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</tr>
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<tr>
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<td>Myelocyt</td>
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<td style="text-align: center;">12</td>
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<td style="text-align: center;">16-20</td>
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<td>inbuktad</td>
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<td>tät</td>
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<td>saknas</td>
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<td>eusinofil</td>
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<td>diff.</td>
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</tr>
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<tr>
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<td>Metamyelocyt</td>
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<td style="text-align: center;">18</td>
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<td style="text-align: center;">14-18</td>
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<td>njurformad</td>
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<td>tät</td>
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<td>saknas</td>
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<td>grå-skär</td>
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<td>diff.</td>
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</tr>
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<tr>
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<td>Mogna granulocyt</td>
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<td style="text-align: center;"></td>
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<td style="text-align: center;">12-16</td>
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<td>loberad</td>
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<td>tät</td>
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<td>saknas</td>
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<td>grå-skär</td>
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<td>diff.</td>
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</tr>
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<tr>
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<td><strong>Övriga celler</strong></td>
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<td style="text-align: center;"></td>
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<td style="text-align: center;"></td>
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<td></td>
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<td></td>
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<td></td>
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<td></td>
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<td></td>
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</tr>
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<tr>
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<td>Megakaryocyt</td>
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<td style="text-align: center;">0,1</td>
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<td style="text-align: center;">30-100</td>
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<td>oregelb.</td>
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<td>tät</td>
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<td>saknas</td>
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<td>grå-skär</td>
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<td></td>
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</tr>
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<tr>
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<td>Plasmacell</td>
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<td style="text-align: center;">7 - 15</td>
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<td style="text-align: center;"></td>
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<td>hjuleker</td>
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<td>tät</td>
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<td>saknas</td>
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<td>basofil</td>
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<td></td>
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</tr>
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<tr>
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<td>Monocyt</td>
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<td style="text-align: center;"></td>
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<td style="text-align: center;">16-20</td>
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<td>njurformad</td>
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<td>lucker</td>
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<td>saknas</td>
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<td>blågrå</td>
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<td>fin azur</td>
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</tr>
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<tr>
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<td>Stor lymfocyt</td>
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<td style="text-align: center;">14</td>
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<td style="text-align: center;"></td>
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<td>rund</td>
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<td>ganska tät</td>
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<td>saknas</td>
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<td>blågrå</td>
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<td>fåtal azur</td>
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</tr>
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<tr>
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<td>Liten lymfocyt</td>
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<td style="text-align: center;"></td>
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<td style="text-align: center;">7-10</td>
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<td>rund</td>
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<td>tät</td>
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<td>saknas</td>
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<td>blågrå</td>
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<td>(azur)</td>
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</tr>
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</tbody>
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</table>
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