Exam #2: Physiology of Blood Flashcards
Describe the composition of blood, both generally & specifically.
Generally, blood is 7-8% of total body weight & on average there are ~5 L of blood in the human body.
Specifically, roughly 42% of blood is composed of the formed elements, 58% is plasma, and there is a small fraction called the buffy coat.
What is the buffy coat?
WBCs
Platelets
Describe the general composition of plasma.
Plasma is 92% water; the remaining 8% is composed of: - Proteins
- Other solutes
What are the proteins in plasma?
Albumin
Globulin
Fibrinogen
Regulatory proteins
What are the other solutes?
Ions/ electrolytes
Nutrients
Respiratory gases
Waste products
What are the formed elements in blood?
RBCs
Platelets
WBCs
List the WBCs & identify their relative abundance.
Neutrophils (60-70%) Basophils (0.5 - 1%) Eosinophils (2-4%) Monocytes (3-8%) Lymphocytes (25-33%)
What is the difference between plasma and serum?
Serum is plasma without fibrinogen & other clotting factors
What are the major positive charges in plasma? Which are routinely measured?
*Na+
*K+
Mg++
Ca++
Only Na+ & K+ are routinely measured in blood tests.
What is a miliequivalent?
A mole of a substance multiplied by the charge of that substance.
What is the major negative charges in plasma? Which of these are routinely measured in blood tests?
Albumin *Cl- *HCO3- HPO4- SO2-- Lactate Citrate
Cl- & HCO3- are routinely measured in blood tests.
What is an anion gap? What is a normal anion gap?
The concentration & charge of the measured cations is larger than the concentration & charge of anions. This difference is referred to as the anion gap.
A normal anion gap is 8-16 mEq/L
*Note that the anion gap represents the unmeasured anions
How is anion gap used clinically?
Increased anion gap is used in the diagnosis of metabolic acidosis because of:
- Increases in unmeasured organic anions (e.g. ketoacids)
- Decreased bicarbonate (HCO3-) that builds to elevated H+ during acidosis
BOTH increase the anion gap b/c bicarbonate is a measured anion
How does hypoalbuminemia affect the anion gap?
Hypoalbuminemia decreases in anion gap. Why?
- Albumin is an unmeasured anion
- Decreased levels of albumin lead to compensatory retention of the measured anions (HCO3- & Cl-)
- A higher measured concentration of anions= lower anion gap
What is an osmole?
Moles of solute times the number of ions or particles upon its dissociation in solution
E.g. 1 mmol/L NaCl= 2mOsm/L (Na+ & Cl- = x2)
What is the osmolality equation?
Osmoles of solute/kg solvent
What is the normal reference range for the osmolality of blood?
292.6 mOsm/Kg H20
How does the osmolality of the plasma compared to the osmolality of the interstitial fluid? What is the net effect of this difference?
The osmolality of plasma is higher than the osmolality of the interstitial fluid because albumin is too large to cross the capillary membrane. This difference drives water into the vasculature
What is albumin? What are the functions of albumin?
- Albumin is a plasma protein (anion, most abundant–58%–plasma protein)
- Responsible for 70-80% of colloid osmotic pressure, or oncotic pressure, that drive water into the vasculature
- Transporter in the blood (important for drugs)
Clinically, what does hypoalbuminemia lead to?
Edema
- Note that the causes of hypoalbuminemia are generally three-fold:
1) Decreased synthesis
2) Increased volume distribution
3) Increased excretion & degradation
What are the important globulin proteins in plasma?
Gamma-globulin
Transferrin
Haptoglobin
What is the function of gamma-globin?
Gamma-globulins are antibodies involved in immunity