Acid-Base Balance _ Boundless Anatomy and Physiology.pdf -...

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1PHYSIOLOGY OF THE BLOODTOTAL BODY WATERMales: 60 %Females: 50 %Extracellular fluid(ECF) – 20 %, 14 litres1) intravascular (blood-plasma 5%, lymph)2) extravascular – intersticial 15 %Intracellular fluid(ICF) – 40 %, 28 lBLOOD VOLUMEAdults:7% of b.w.-Males:7.7 % b.w., 5.5 l; 70 ml/kg-Females:6.5-7 % (more fat)NormovolemiaHypovolemia:- proportional- hemoconcentration- hemodilutionHypervolemiaMeasurement– methods: direct and indirect (radioisotopes, dyes)BIOPHYSICAL CHARACTERISTICS OF THE BLOOD1)Specific gravityBlood - 1056 (152-1063) kg/m3- plasma 1027- red blood cells 10902) Viscosity- water = 1; blood 4-5.4x moreSyndrome of hyperviscosity – impairment of microcirculation, hypoxia,...3) Hematocrit- the percentage of red blood cells in the whole bloodMales: 0.44±0.05 (44±5 %)Females: 0.39±0.04 (39±4 %)Newborns: 50-60 %
2ERYTHROCYTE SEDIMENTATION RATE (ESR)Blood - suspensionelectrical bilayer: RBC – negative chargesplasma proteins – positive chargesFactors influencing ESR1) Plasma proteins2) RBC count and size3) Lipidemia4) pH of plasmaValues: M: 2-5 mm/hF:3-8 mm/h (less RBC, more fibrinogen)Determination: Fahraeus-Westergreen method (FW) - see practicalsAcceleration of ESR: physiological (gravidity, menstruation)pathological (infect.diseases, tumors, liver diseases,...)RED BLOOD CELLS (RBC)- non-nucleated cells- biconcave discs, diameter 7.2μm, thickness 2.1μm, volume 85 fl, surface 130μm2;surface of all RBC 50x60 mRBC countM: 4.3 – 5.3 x 1012/lF:3.8 – 4.8 x 1012/lNewborns: 7-8 x 1012/lHypererythrocytosis(polycytemia, polyglobulia)count– physical activity, high altitude, hemoconcentrationErythrocytopenia(anemia)cout: physiol.(sucklings), pathologicStructure- water –70% and dry subst.30%membrane, stroma, hemoglobinmembrane:lipid bilayer with proteins (peripheral, integrat.)other substances: hemoglobin, ions (K, Na, Ca), enzymes (40), glutathion, ...Metabolism: RBCs have low metabolic needs1) Embden-Mayerhof pathway (anaerobic - 90 %)2) Hexose-monophosphate shunt (aerobic - 10%)HEMOGLOBINMolecular structure:tetramerM.W.: 64 kDa
3Heme:ferrous protoporphyrin (Fe2+)Globin:4polypeptide chains (HbA: 2 alpha + 2 beta)Quantity of HbM: 135-170 g/lF: 120-160 g/lNewborns: 190, sucklings:110Each gram of Hb can carry 1.34 ml O2one litre of blood cca 200 ml O2Measurement of Hb concentration:spectrophotometry– see practicalsHemoglobin derivatesPhysiological1) OxyHb (+O2)2) DeoxyHb (-O2)3) CarbaminoHb (+CO2)Pathological1) CarboxyHb (+CO)2) MetHb (+OH):Fe2+Fe3+Types of hemoglobin1) Embryonica) Gower I (2 zeta, 2 epsilon)b) Gower II (2 alpha, 2 epsilon)c) Portland (2 zeta, 2 gamma)2) Fetal(2 alpha, 2 gamma)3) Adulta) HbA (2 alpha, 2 beta)b) HbA2– minor component (2 alpha, 2 delta) – up to 2 % - in adultsHEMOLYSISDestruction of the RBC membrane and release of Hb1) Osmotic (hypotonic, hypertonic)2) Physical (temperature, mechanical, radiation)3) Chemical (saponin-see practicals)4) Toxic (cobra venom – hemolysis)5) Immunologic (mismatched transfusion)6) Hereditary (deficiency of G-6PD)
4BLOOD GROUPSSystem AB0AgglutinogensA, B – on membrane of RBCA – acetyl-galactosamineB – D-galactoseH – acetyl-glucosamine – maternal substance6 blood types: A1, A2, B, A1B, A2B, 0(H)Agglutinins

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