Department of medical physiology 2nd week Semester: winter ... week.pdf · Department of medical...
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Department of medical physiology2nd week
Semester: winterStudy program: Dental medicineLecture: RNDr. Soňa Grešová, PhD.Department of medical physiologyFaculty of Medicine PJŠU
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Department of medical physiology2nd week
1. Blood functions and general blood atributes
2. Blood plasma
3. Red blood cells
4. White blood cells
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1. Blood functions and general blood atributes
• Transport of:
– Gases, nutrients, waste products
– Processed molecules
– Regulatory molecules
• Regulation of pH and osmosis
• Maintenance of body temperature
• Protection against foreign substances (specific and unspecific)
• Clot formation
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1. Blood functions and general blood atributes
• Contains cellular and liquid components
• A specialized connective tissue
– Blood cells – formed elements
– Plasma – fluid portion and fibrinogen
• Blood volume
– Males: 5 – 6 liters
– Females: 4 – 5 liters
– Measurement- Evans blue, deuterium oxide (hypovolemia, hypervolemia)
• The pH of blood is about 7.35-7.45 (acidemia, alkalosis)
• Specific gravity is 1.062 g/cm3
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• Blood viscosity is a measure of the resistance of blood to flow. It can be described as the thickness and stickiness of blood
• blood viscosity is 4 to 5.3 times higher then water viscosity• plasma viscosity is 1.5-2 times higher than the viscosity of
water
• viscosity depends the size, number, shape elements, the composition of the plasma, temperature
• Viscosity decrease - eg. Anemia• The increase in viscosity - polycythemia, increased
concentration of plasma proteins
1. Blood functions and general blood atributesBlood viscosity
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1. Blood functions and general blood atributesHematocrit Value
• Hematocrit ratio - % of red blood cell volume to total blood volume.
• Varies depending on number and size of red blood cells, plasma volume, portion or the circulatory system sampled from.
• Hematocrit is slightly greater in venous blood samples.
• Normal Hematocrit:– Men = 44 +/- 5%– Women = 39 +/- 4%– Newborns = 20% higher due to polycythemia
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1. Blood functions and general blood atributes
Erythrocyte Sedimentation• The erythrocyte sedimentation rate (ESR), also called a sedimentation rate or Westergren ESR, is the rate at which
red blood cells sediment in a period of one hour.
• Fahraeus Westergren method• Sedimentation rate depends on:
– Gravity, and resistance of plasma– Number of erythrocytes
• Sedimentation slowed by high number(polycythemia)• Faster sedimentation in anemia
– Size and shape of erythrocytes• Large erythrocytes have higher rate
– Alterations in plasma composition• Fibrinogen and globulin = rise in sed. Rate (pregnancy)• Infections and intoxications can increase rate• Plasma lipids; cholesterol increases, lecithin decreases rate
– Blood pH• Acidosis slows rate, Alkalosis increases rate
– Tissue damage
• Values• Men = 4-6mm first hour, 8mm second hour• Women = 8-10mm first hour, 16mm second hour• Newborn = 0.5mm/hour
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1. Blood functions and general blood atributesComposition of Blood
• Blood: – Plasma (55%)– Formed elements (45%)
• Plasma– Proteins (7%)
• albumins (35 – 50 g/l), • globulins (cca 25 g/l), • fibrinogen (1,5 – 3,5 g/l)
– water (91%)– other solutes (2%)
• Ions• Nutrients:
– glucose (3,05 – 6,4 mmol/l),– bilirubin (< 22,2 mol/l),– lipids (5,7 – 8,2 mmol/l),– Cholesterol (2,8 – 5,2 mmol/l)– free fatty acids (0,15 – 0,71 mmol/l)
• Waste products - urea, uric acid, bilirubin, creatinine, amonia• Gases• Regulatory substances – hormones, antibodies, enzymes
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1. Blood functions and general blood atributesComposition of Blood
• Plasma
– other solutes (2%)
Copyright: Hall, J. E., & Guyton, A. C. (2006). Guyton and Hall textbook of medical physiology. Philadelphia, PA: Saunders Elsevier.
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1. Blood functions and general blood atributesComposition of Blood
• Blood: – Plasma (55%)
– Formed elements (45%)
• Formed elements• Erythrocytes (red blood cells)
• Leukocytes (white blood cells)
• Platelets (trombocytes)
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2. Blood plasma
• Plasma proteins
– Coloid osmotic pressure (oncotic pressure of proteins) = 3.3kPa (25 mmHg)
• Salts
– Osmotic pressure of the blood= 290 mosmol/l
– Physiological isotonic solution = 0.9% NaCl with 5% glucose
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3. Red blood cells• Structure
– Biconcave, anucleate
• Components
– Hemoglobin
– Lipids, ATP, 2,3-DPG, carbonic anhydrase
• Function
– Transport oxygen from lungs to tissues and carbon dioxide from tissues to lungs
• Values- Females: 4,700,000 (±300,000) cells/cubic millimeter
- Males: 5,200,000 (±300,000) cells/cubic millimeter
Copyright: Javorka, K., & col. (2001). Lekárska fyziológia. Martin: Vydavateľstvo Osveta.
Price-Jones curve
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Cell Lines in Blood Cell Formation (Hematopoiesis)
Copyright: Hall, J. E., & Guyton, A. C. (2006). Guyton and Hall textbook of medical physiology. Philadelphia, PA: Saunders Elsevier.
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Copyright: Hall, J. E., & Guyton, A. C. (2006). Guyton and Hall textbook of medical physiology. Philadelphia, PA: Saunders Elsevier.
Cell Lines in Red Blood Cell Formation (Hematopoiesis)
Earlyerythroblasts
Intermediateerythroblasts
Late erythroblasts
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Erythropoietin: Hormone to stimulate RBC production
Maturation of RBC –requirement for vitaminB12 (Cyanocobalamin) and Folic Acid
Copyright: Hall, J. E., & Guyton, A. C. (2006). Guyton and Hall textbook of medical physiology. Philadelphia, PA: Saunders Elsevier.
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3. Red blood cellsHemoglobin
• Adult hemoglobin A (HbA, 2α a 2β) , (3% HbA2, 2α a 2δ)• Embryo hemoglobin E (HbE, Grower I. 2 ζ a 2ε, Grower II. 2α a 2ε,
Portland 2ζ a 2γ) • Fetal hemoglobin (HbF, 2α a 2γ) – between 10 and 32 weeks of
intrauterine development
Copyright: Hall, J. E., & Guyton, A. C. (2006). Guyton and Hall textbook of medical physiology. Philadelphia, PA: Saunders Elsevier.
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3. Red blood cellsHemoglobin
• Consists of: – 4 globin molecules: Transport carbon
dioxide (carbonic anhydrase involved), nitric oxide
– 4 heme molecules: Transport oxygen• Iron is required for oxygen transport
• Effected by altitude, sex, age, hypoxia, physical fitness, disease, ect.
• Normal values:– Men = 140-160 g/L– Women = 120-158 g/L– Total in blood = 800g
• Each gram carries 1.34mL oxygen
• Derivates of hemoglobin- Carbaminohemoglobin (HbCO2)- Oxyhemoglobin (HbO2)- Carboxyhemoglobin (HbCO)- Methemoglobin (Fe3+)
Copyright: Hall, J. E., & Guyton, A. C. (2006). Guyton and Hall textbook of medical physiology. Philadelphia, PA: Saunders Elsevier.
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3. Iron transport and metabolism
Copyright: Hall, J. E., & Guyton, A. C. (2006). Guyton and Hall textbook of medical physiology. Philadelphia, PA: Saunders Elsevier.
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4. White blood cells
• Protect body against microorganisms and remove dead cells and debris
• Movements
– Ameboid: are capable of amoeboid movement
– Diapedesis: are able to penetrate the wall of the capillaries into the tissue
– Chemotaxis: the ability to influence the direction and speed of the leu(bakt.toxins, tissue breakdown products, ....)
– Tigmotaxis: neu - surface activity and ability to adhere on surfaces
– Immunity
– Antigen – Antibody
• Values
4,800 – 11,000/cubic millimeter
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4. White blood cells
1. Chemical mediatorsof inflamation
2. Vasodilatation , blood flow increase- area red and hot
3. Epithelial cellsshrink
4. Fluid licking out –hemoconcentration, blood flow decrease– area is swelling
Copyright: Hall, J. E., & Guyton, A. C. (2006). Guyton and Hall textbook of medical physiology. Philadelphia, PA: Saunders Elsevier.
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Cell Lines in Blood Cell Formation (Hematopoiesis)
Copyright: Hall, J. E., & Guyton, A. C. (2006). Guyton and Hall textbook of medical physiology. Philadelphia, PA: Saunders Elsevier.
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• Two types of leukocytes– Granulocytes
– Agranulocytes
• Differential WBC Count– Never
– Let
– Monkeys
– Eat
– Bananas
4. White blood cells
Copyright: Hall, J. E., & Guyton, A. C. (2006). Guyton and Hall textbook of medical physiology. Philadelphia, PA: Saunders Elsevier.
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• Neutrophils and macrophages are active phagocytes
– Attracted by chemotaxis
• Neutrophils respond most quickly to tissue damage by bacteria– Primary granules: strong oxidants (MPO-myeloperoxidase),
defensins (such as Ig), secondary granules: lysozymes (bacterial cellwall), lactofferins, bacteriostatis and bacteriocidal agents, tercialgranules: collagenase, hyaluronidase (break down collagens)
• Monocytes take longer to arrive but arrive in larger numbers and destroy more microbes– Enlarge and differentiate into macrophages (CNS-microglia, lungs-
alveolar macrophages, liver – Kupffer cells, spleen-histiocytes, skin-Langerhans cells, kidney-mesengial cells, bones-osteoclast
4. White blood cells
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• Basophila leave capillaries and release granules containing heparin, histamine and serotonin, at sites of inflammation– Intensify inflammatory reaction
– Involved in hypersensitivity reactions (allergies)
• Eosinophils leave capillaries and enter tissue fluid– Release histaminase (reduce inflamation),
phagocytize antigen-antibody complexes and effective against certain parasitic worms
4. White blood cells
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• Lymphocytes are the major soldiers of the immune system
– B cells – destroying bacteria and inactivating their toxins
– T cells – attack viruses, fungi, transplanted cells, cancer cells and some bacteria
– Natural Killer (NK) cells – attack a wide variety of infectious microbes and certain tumor cells
4. White blood cells
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Formation of antibodies and sensitizedlymphocytes
Copyright: Hall, J. E., & Guyton, A. C. (2006). Guyton and Hall textbook of medical physiology. Philadelphia, PA: Saunders Elsevier.