01.Blood & Body Fluids 2011 MBBS

7/31/2019 01.Blood & Body Fluids 2011 MBBS

1/70

Dr.Kishan.K MBBS,MDAssistant professor


2/70

TOPICS TO BE COVERED1. Body fluid compartments2. Principle of estimation3. Introduction to blood4. Functions of blood5. Components of blood6. Blood as a part of body fluids

7. Functions of individual components inbrief


3/70

Evolution of blood With evolution, multicellular

organisms developed and tubules

developed to carry sea water toeach cell.

Open system with evolution becamea closed one and sea water

entrapped within the body


4/70

Evolution of blood This entrapped fluid underwent many

modifications & transformed BLOOD

With Further evolution each cell wasfurnished with a small private sea of its

own

This is interstitial fluid or extracellular fluid ; called milieu interior coined by Claude Bernard.


5/70

Body Fluids ECF should be constantly replenished by

having a set of tubules and capillaries.

Fluid in the capillaries is in constantmotion because of pumping of the heart .

Capillaries exchange their materials withexternal environment at few points forfresh supply of nutrients and disposal ofwaste--- lungs, kidneys, GIT.


6/70

Body Fluids Aim of the different systems is to achieve

constancy in characteristics of ECF Homeostasis .( Maintenance of a relativelystable internal environment)

Essential for survival and function of all cells Each cell contributes to its maintenance Disease, by and large, is a failure of

homeostasis


7/70

Digestive, respiratory, excretory,blood and cardiovascular systemscontribute directly to homeostasis;

Endocrine, nervous system co-ordinatethe activity of all other systems.


8/70

8

Systems contribute directly to homeostasisSystems


9/70

9

Body Systems


10/70

Body Fluids Total body water - 45-75% of body weight . In young men - 55-60% of the body weight. In young women - 45-50% of body weight.

In children -70-75% of body weight. Significance of body fluid:1. To maintain homeostasis2. In transport mechanism3. In metabolic reactions4. In texture of tissue

5. In temperature regulation


11/70

11


12/70

12

FLUID COMPARTMENTS

EXTRA CELLUARFLUID

INTRA CELLULARFLUID

INTERSTITIALFLUIDPLASMA

TRANSCELLULARFLUID

CSFIntra ocularPleural

PeritonealSynovial

Digestive Secretions


13/70


14/70

TBW


15/70

15


16/70

16

VOLUME OF BODY FLUIDS IN 70 kg MAN

TOTAL VOLUME42 L

INTRA CELLUAR FLUID28 L (ROUGHLY 2/3 OF TBW)

EXTRA CELLULAR FLUID

14 L (ROUGHLY 1/3 OF TBW)

PLASMA4 L (ROUGHLY OF ECF)


17/70

Composition of ECF & ICF


18/70

Measurement of volume of body fluids:

By indicator dilution or dye dilution method. Dilution principle: Ficks principle says

The final concentration of thesubstance in a solution depends uponthe volume of the solvent in which itdissolves


19/70

Example: if 25 mg of glucose are

added to an unknown volume ofdistilled water and the finalconcentration of glucose after mixingis 0.05 mg/ml, then the volume ofsolvent is ???


20/70

Quantity of fluid in the compartment ismeasured by the following formula:

V=------M

C

V- Volume of the fluid in the compartmentM- Total quantity of marker substance injected

C- con. of the marker substance in the samplefluid


21/70

This method is used to measure theECF volume, plasma volumeand thevolume of total body water.

Correction factor

Amt of sub injected --Amt of sub excretedVolume = ------------------------------------

Concentration of substance in sample of fluid


22/70

Characteristics of the marker substances:

1. It must be non toxic2. It must mix with the fluidcompartment within reasonable time

3. It should not be excreted rapidly4. It should be excreted from the body

completely within reasonable time5. It should not change the color of the

body fluid6. It should not alter the volume of body

luid


23/70

Marker substances used To measure T B W:

Deuterium oxide, Tritium oxide, Antipyrine

To measure E C F:

Radioactive sodium, chloride, bromide, sulfateNon-metabolizable saccharides likeinuline,mannitol.

To measure plasma volumeRadioactive iodine(131I)

Evans blue (T -1824)


24/70

OsmosisOsmosis: Is movement of water molecules from aregion of its higher concentration to the region of itslower concentration through a semipermiable membrane.

O i I h f


25/70

Osmotic pressure : Is the amount of pressurerequired to stop osmosis completely. Itsdetermined by the number of particles per unit

volume of fluidOsmolality: Its expressed as number ofparticles per kilogram of solution.

Osmolarity: expressed as number of particlesper liter of solution.


26/70

Blood

Described as a specialized tissue with liquid intercellular substance (Plasma) and formed elements (RBC,WBC &platelets)

Physical properties of blood Colour- Red opaque liquid Volume- 5-6 liters

pH-7.4 Specific gravity- 1.052-1.062 Viscosity- 4-5 times of water


27/70

Functions of blood

1. Respiratory function2. Nutritive function3. Excretory function4. Transport of Hormones and enzymes5. Regulation of water balance6. Regulation of acid base balance7. Regulation of body temperature

8. Storage function9. Defensive function10.Regulation of blood pressure11.Coagulation


28/70

Composition of Blood


29/70


30/70

Serum Serum is the fluid part of the blood after

clotting.

Serum = plasma -- clotting factors &fibrinogen


31/70

Composition of Blood


32/70

TOPICS COVERED TILL NOW1. Body fluid compartments

2. Principle of estimation3. Introduction to blood4. Functions of blood5. Components of blood6. Functions of individual components in

brief


33/70

Contents of plasma

91% water9% solids-

1% inorganic molecules-Na+,Ca2+,K+,Cl-,I-,etc8% organic substances

1% other substances- NPN substances,sugar, fats, enzymes, hormones7% plasma proteins- 6.4-8.4gm%


34/70


35/70

Plasma proteins Types & Normal values :Total proteins : 7.3gm% (6.4 to 8.3gm%)

Serum albumin: 3-5gm%(55%)Serum globulin: 2-3gm% (38%)Fibrinogen: 0.3gm% (7%)Prothrombin: 40mg%


36/70

Characteristics of plasmaproteins

Serum albumin- Mol wt- 69000,

Made up of single polypeptide chain;

Each molecule is ellipsoid in shape.

It is synthesized in liver

Pre-albumin helps in the transport ofThyroid hormones


37/70

Serum globulin (38%)

Mol wt-90,000to1,50,000. It is also mixture of several globulin 13% -globulin,14% - globulins,11%

- globulins Glycoproteins Lipoproteins

Transferrin Ceruloplasmins Haptoglobins.(Hb)


38/70

Globulins continued---

Prothrombin - globulins in nature MW-68,000-Helps in blood clotting

Fibrinogen Is globulin in nature,MW-4,00,000-helps in

bloodclotting


39/70

origin of plasma proteins: In Embryo: The Mesenchymal cells

In Adults-All the fractions are producedmainly in liver,

sources of globulin are disintegrated blood cellreticulo-endothelial systemGeneral tissue cells andLymphoid nodules


40/70

Albumin: Globulin R atio Serum albumin: globulin ratio is

1.7:1.0

The ratio may be reversed in liverdisease where albumin formation isdecreased and kidney diseases where

albumin is excreted


41/70

Synthesis of proteins

After depletion of plasma proteins, itcomes back to normal level in about14 days. The plasma proteins getcompletely used up and replaced everyfourteen days.

Fibrinogen is regenerated first,followed by globulin and last isalbumin.


42/70

Separation of plasmaproteins

The most commonly used method iselectrophoresis.


43/70

Because the plasma proteins formcharged molecules in solution , if anelectric field is applied, from the line ofapplication, the proteins move eithertowards negative or positive pole of anelectrical field and at different

velocity.


44/70

Electrophoresis

44

h d f f


45/70

Methods of Separation ofplasma proteins

1. Electrophoresis2.Precipitation -22% sodium sulphate

solution-Globulin is precipitated3.salting out method-sodium chloride4.ultra centrifugation-depending on

their density5.Immunoelectrophoretic method


46/70

Plasmapheresis

Is an experiment done to demonstratethe relation of diet to plasma proteins--- WhipplesStandard plasma depleted dog

Whole blood is withdrawn & cellssuspended in same volume of ringerlocke solution is re-injected

l h


47/70

47

PlasmapheresisIf repeated daily, leads to progressivereduction in the plasma proteins

This process is continued till plasmaprotein falls after the exhaust of proteinreserves to below 4gm%

Standard diet is given to the dog-rate ofprotein formation is constant

l h i


48/70

48

PlasmapheresisProtein in the cells are of 3 types

1. Fixed or indispensable cell proteins.

2. Dispensable reserve proteins(skeletalmuscle & glands)

3. Labile reserve proteins(in liver, tissuemacrophage)


49/70

49

Variations in plasma proteinconcentration

Decrease - Hemorrhage, Severe proteinmalnutrition, Liver diseases

Increase - dehydration, Diabetesinsipidus

F i f l i


50/70

50

Functions of plasma proteins:

1. Maintains colloidal osmotic pressure2. Role in acid base regulation3. Maintains viscosity and blood pressure4. Role in erythrocyte sedimentation rate

(ESR)5. Essential for blood clotting---Fibrinogen

6. Acts as a protein reserve7. Role in defense mechanism of body8. Help transport of certain substances

9. Synthesis of trephones


51/70

51

Maintains colloidal osmotic pressure of bloodNormal colloidal osmotic pressure-28 mm

Hg. Oncotic pressure

80% is contributed by albumin

higher concentrationlow molecular weight

20% is due to other plasma proteins.

Maintainence colloidal osmotic pressure of


52/70

52

Maintainence colloidal osmotic pressure ofblood

Colloidal osmotic pressure (COP) is essential for

maintenance of fluid volume in intra vascularcompartment and interstitial spaces (tissuespaces)Helps in the exchange of fluid at tissue level


53/70

53

Structural details of capillary

Starlings Forces


54/70

54

Starling s Forces Rate of filtration at any point along the capillary

depends on the balance of different forces called as Starling Forces

1.Hydrostatic pressure The pressure exerted on the walls of capillaries . At the arterial end of capillary - 30 mm Hg. At the venous end of capillary - 10 mm Hg

Hydrostatic pressure of the capillary out-drivingforce


55/70

55

Starlings Forces 2.Interstitial fluid pressure -3mmHg

Negative- outward force3.Interstitial colloidal osmotic pressure-

outward force--- 8mm Hg4.Colloidal osmotic pressure- inward

force- 28 mm HgCOP remains 28 mm Hg throughout thelength of capillary ( impermeable toplasma proteins).

Starling Forces


56/70

56

Starling Forces Arterial end

mmHg Capillary Pressure 30 Negative interstitial fluid

pressure -3 Interstitial colloidal osmotic

pressure 8 Total outward force 41 Plasma Colloidal pressure

(inward ) 28

Outward 41 Inward 28

Net outward force 13

Venous endmmHg

Capillary Pressure 10 Negative interstitial fluid

pressure -3 Interstitial colloidal osmotic

pressure 8 Total outward force 21

Plasma Colloidal pressure(inward ) 28

Inward 28Outward 21

Net inward force 7


57/70

57

arterial end -- out-driving force (41mm0fHg ) is stronger than the in-driving force (colloidal osmotic pressure-28mmHg ).

Net difference of pressure - 13 mm Hgand is directed outwards fluid goes out from the intra vascular

compartment to interstitial spaces.


58/70

58

Venous end the hydrostatic pressure - 10mm Hg

0utward driving force is 21mmHg &inward driving force is 28mmHg 7 mm Hg and is directed inward

Fluid that has gone out at the arterialend returns to capillaries from tissuespaces.


59/70

59

At arterial end net outward force of 13mm Hg- Filtration pressure

At venous end net inward force of 7 mmHg- Reabsorption pressure

The Reabsorption pressure is considerablyless than the Filtration pressure


60/70

60

Venous end of the capillaries more

permeable than the arterial endLess pressure is required to cause theinward movement

Nine tenths of fluid is returned -- venousends.One tenth of fluid remains in the

interstitial spaces-----tissue fluid orinterstitial fluid


61/70

61

The remaining one part of fluid in tissuespaces with the leaked proteins will enter

the lymphatic vessels and is now known aslymph.Drain into the circulatory system.

Effectively no extra fluid is allowed to getaccumulated in tissue spaces and thereby

edema is prevented


62/70

62

If the tissue fluid is allowed toaccumulate, it decreases blood volume &it also results in swelling of that part ofthe body (edema).

Edema


63/70

63

Edema.By definition, fluid accumulation in interstitialspaces is known as edema .Decreased concentration of plasma proteinsespecially that of albumin fraction.

Some of the common conditions in which edemaoccurs are:

a.Protein malnutrition.

b.Liver diseases.c.Kidney diseases.d.Cardiac diseases

2 Role in acid base regulation


64/70

64

2.Role in acid base regulation Plasma proteins act as buffers.

Their buffering capacity is 1/6th (about15%-16%) of total buffering capacity ofblood.

They are amphoteric in nature i.e. behave asacids or bases depending on the conditionsand thereby maintain theblood pH at 7.4, by

accepting or rejecting H+.

3.Role in viscosity and blood pressure


65/70

65


Blood is 4- 5 times more viscous thanwater Viscosity of blood-both cells and

plasma proteins contribute Viscosity is dependent on shape, size

& number proteins.



66/70

66


o The resistance to the flow of fluidthrough a capillary depends on theviscosity of fluid

o Pressure=Flow X Resistance Itdetermines the peripheral resistanceof the blood flow

Concerned with erythrocyte


67/70

67

Concerned with erythrocytesedimentation rate (ESR):

Rouleaux----- Piling up ofRBCs one above the other

Globulin & Fibrinogen of theplasma accelerates rouleauxformation



68/70

68


1. Maintains colloidal osmotic pressure of blood2. Role in acid base regulation3. Maintains viscosity and blood pressure4. Essential for blood clotting---Fibrinogen

5. Role in erythrocyte sedimentation rate (ESR)6. Acts as a protein reserve7. Role in defense mechanism of body

8. Help transport of certain substances in blood9. Synthesis of trephones

9.Synthesis of trephones


69/70

69

y p

9.Leucocytes can manufacture few

substances called Trephones or Carrelfrom plasma proteins, which help inthe nutrition of tissues.


70/70

NEXT CLASS

RED BLOOD CELLS

01.Blood & Body Fluids 2011 MBBS

Documents

Transcript of 01.Blood & Body Fluids 2011 MBBS