Final Q&A 80-119 Flashcards
- Notion of “blood system”. Main blood functions.
———Notion of “blood system”
blood system – a repository blood (which excluded of the total blood flow in blood depots).
1- Peripheral blood located in vessels
2-Blood-forming organs – red bone marrow, spleen, lymph nodes
3-Hemoclastic organs – red bone marrow, spleen, lymph nodes, liver
4-neurohumoral regulation apparatus (mechanisms)
——–Main blood functions.
1. Transport ; of various substance necessary for vital activity of organs and tissuesО2, СО2 nutrients, hormones, proteins, electrolytes, enzymes
2- Respiratory – transport of О2 from the lungs to tissues and СО2 from tissues to lungs.
3-Nutritive – transport of basic nutrients from digestive organs to body tissues.
4-Excretory – transport of intermediate and final products of metabolism (urea, uric acid, ammonia .) and water excesses to organs of their excretion (kidneys, lungs, sweat glands, intestine).
5-Regulatory or humoral – delivery of the hormones, peptides, ions and other substances having regulatory effects on different target cells.
6-Thermoregulatory –blood transports heat from more heated bodies to less heated ones and to bodies of heat transfer, to maintaining its temperature constancy.
7-Protective – participation in immunity (implementing humoral specific and non-specific protection mechanisms) as well as blood coagulation and arrest of bleeding
8-homeostatic function, that is maintenance of internal medium constancy (acid-base balance, water-electrolytic balance and other types of exchange).
this is the main function of the blood
- Peripheral blood. Total amount of blood. Circulating blood volume and its calculating.
– Peripheral blood : is the one that is in blood vessels and depots. Its main parts: plasma and formed elements
-Formed elements :-1. Erythrocytes (red blood cells) = 4.5–5.51012 pieces/liter.
-2. Leukocytes = 4–9109 /liter. -3. Platelets =
-plasma composition :
1. Water (90-92 %).
2. Inorganic compounds. For example, ions and their salts.
3.Organic compounds. For example, organic acids, proteins, etc.
——.Total amount of blood.:
The total amount of blood (circulating and deposited) in the body of an adult human is 6-8% of body weight
—–
the notion of circulating blood volume is used ( CBV ; mass of blood ). CBV is a hemodynamic indicator which represents the total volume of blood that is contained in functioning blood vessels. Сalculating of referenceСalculating of reference CBV: CBV = M*K
М – body weight (kg),
k – coefficient that is equal 70 for men and 60 for women.
CBV, despite its name, does not differentiate blood, which is located in the depot from those one which circulates in vessels, it’s a total blood
- Hematocrit. Serum and its clinical importance.
— hematocrit : its the relationship between plasma and formed elements , A hematocrit is the volume of blood that falls on the share of formed elements. It equals 40-45% and shows the amount of formed elements of the total mass of blood.
———Serum and its clinical importance. :
Blood, devoid of formed elements is called plasma. Plasma without fibrinogen is serum, the main clinical value of which is determined by the presence of antibodies in it.
- Values of a general blood test. Basic parameters of biochemical blood test.
—–general blood test ( common parameters )
Hematocrit = 40-45%
Erythrocytes (male) = 4.0-5.5·1012/l
Erythrocytes (female) = 3.7-4.9·1012/l
Leukocytes = 4.0-9.0·109/l
Platelets = 180-320·109/l
Hemoglobin, Hb (male) = 130-170 g/l
Hemoglobin, Hb (female) = 120-150 g/l
Erythrocyte sedimentation rate, ESR (male) = 1-10 mm/h
Erythrocyte sedimentation rate, ESR (female) = 2-15 mm/h
-----Basic parameters of biochemical blood tests Water =900-920 g/l Total protein Proteins in fractions:=65-85 g/l 1. Albumins=35-50 g/l 2. Globulins=20-30 g/l – α1- globulins=1-3g/l – α2- globulins=5-9g/l – β- globulins=6-9g/l – γ- globulins=8-13g/l 3. Fibrinogen=2-4g/l Total bilirubin =8.5-20.5 мkmol/L VLDL = 0.2-1.5 mmol/L LDL =<4.5 mmol/L HDL=>1.0 mmol/L Triglycerides (lipids)=0.45-2.5 mmol/L Glucose =3.3-5.5 mmol/L Sodium+=135-150 mmol/L Potassium+=3.5-5.0 mmol/L Free calcium2+=1.15-1.3 mmol/L Magnesium2+=0.7-1.2 mmol/L Chlorine–=95-110 mmol/L Hydrogen сarbonate–=20-30 mmol/L Protein anions–=15-20 mmol/L Total calcium =2.25-2.75 mmol/L Free (nonheme) iron=12-32 mcmol/l Copper=11-24 mcmol/l Phosphorus=1-2 mmol/L Ammonia=7-30 mcmol/l (up to 40 mcmol/l) Residual nitrogen =14-28 mmol/L Uric acid=0.15-0.5 mmol/L Creatinine=40-110 mcmol/l
- Osmotic pressure, colloid-osmotic pressure. Iso-, hypo- and hypertonic solutions. Physiological solutions
——–Osmotic pressure
is the force with which a dissolved substance holds or attracts water , creates conditions for transmembrane transport of all other substances; nutrient substances , – inside cells, metabolism products – out, and formed mainly from ions
Osmotic pressure of blood of 7.3-7.6
its function :
1 water-salt metabolism in the body ensures implementation of all other substances exchange,
2 formation of membrane potentials and the course of excitable processes
3 homeostasis maintenance.
——-oncotic (colloid) pressure : formed by proteins (it is much lower – 1/200 of osmotic pressure). its 30 mm Hg
——–
-Isoosmotic solutions used in clinic are called physiological solutions. These are various solutions: 0.9% NaCl, Ringer’s solution, Ringer-Lock’s solution, Tyrode’s solution etc.
-hypotonic solutions :Solutions having a lower osmotic pressure than that of plasma ,They cause an increase in cells size. This is a result of water passage from a solution into a cell
-hypertonic solutions : Solutions having high osmotic pressure
- Specific functions of electrolytes.
- Sodium (Nа+). Its content is more than any others, that is why it creates osmotic pressure.
- Potassium (К+), Magnesium (Мg2+). As well as Са2+, these two ions are not of decisive importance in regulation of plasma osmotic pressure, as their concentration is low. Unlike Са2+ and Nа+ increase of К+ and Мg2+ decrease excitability, causing hyperpolarization of the membrane.
- Hydrocarbonate anion (НСО3–). Its specific function is participation in blood pH regulation. An increase in the content of this ion causes alkalosis of blood, increasing of pH. Lack of НСО3– – leads to acidosis
- Chlorine (Сl–). Chlorine is the most indifferent ion for the organism. Cl– concentration is a non-rigid constant, its content can verify widely without significant effect on vital functions. Therefore, changing Сl– contents turns out to be a “goodly” mechanism for maintaining electroneutrality of plasma (see Gamble rule
- Blood total calcium, hyper- and hypocalcemia
—-normal content of Са2+ in plasma is not too large, that is why even small changes in its concentration can significantly affect these functions. And expressed change in concentration of this ion (less than 1.15 and more than 3.27 mmol/L) can be life-threatening. An organism “will agree” to any regulatory changes to maintain the concentration of Са2+ in the homeostatic ranges. The main depot of Са2+ in a body is the skeletal system
----- hypercalcemia : effects on 1-CNS : irritablity and anxiety , paresthesia's ,seizures , laryngospasm ,bronchospasm 2-CVS : heart failure 3-MSK: Muscles cramps ----- hypocalcemia : effects on 1-CNS :decreases ability to concentrate , increased sleep requirement 2-CVS : arrhythmias , bradycardia 3-MSK: Muscles weakness
- Hydrocarbonate anion and its role in blood pH regulation.
Hydrocarbonate anion (НСО3–). Its specific function is participation in blood pH regulation. An increase in the content of this ion causes alkalosis of blood, increasing of pH. Lack of НСО3– – leads to acidosis.
- Gamble rule and its clinical relevance.
- Gamble rule. Plasma is always electrically neutral, the total charge of cations and anions is equal to 0.
- Plasma electrical neutrality is a rigid constant of homeostasis, only in this case it is possible to maintain normal water-salt balance. This fact has an important clinical relevance.
- Blood pH and its regulation (three main organism’s systems). Acidosis and alkalosis
- the three main mechanasim is 1 - homeostasis or chemical buffer 2- lung 3- kidney ------------ Acidosis and alkalosis In the norm blood рН = 7.35-7.47. More often an average value is named – 7.37. рН of venous blood is 0.02 lower than that of arterial blood. Acidosis – рН is lower than 7.35. Alkalosis – рН is more than 7.47. Acidosis and alkalosis are an immediate risk of loss of life. And рН equal to 6.8 and 7.8 is fatal.
- Types of blood proteins and their common functions. Oncotic blood pressure.
—— Proteins make 65-85 g/l (6-8 %). They are presented by
albumins (35-50 g/l or 3-5 %)
– α1- globulins
– α2- globulins
– β- globulins
– γ- globulins
globulins (20-30 g/l or 2‑3 %)
fibrinogen (2-4 g/l or 0,2-0,4 %).
Blood plasma proteins perform a variety of functions:
1) ensure oncotic pressure;
2) regulate water homeostasis;
3) perform a nutritional function;
4) take part in transport of numerous substances;
5) ensure immune homeostasis;
6) determine blood viscosity and coagulation;
7) maintain acid-base balance (protein buffer).
———-Oncotic blood pressure. :
Oncotic blood pressure – part of osmotic pressure created by plasma proteins. Its value is 25-30 mm Hg , brought about mainly by albumins. Albumins possess a small size, therefore, a large surface area; they are able to attract intensively water. Oncotic pressure plays an important role in regulating water distribution between plasma and tissues.
- Blood proteins specific functions.
—— they are 3
albumins
globulins
fibrinogen
-1- Albumins : low molecular weight proteins of small size, they make about a half of all plasma proteins Lat. albumen – protein . As they are numerous
and this protein on 80% defines plasma oncotic pressure.
Albumins are synthesized in the liver.
-2-(Lat. globulus – ball) – are larger than albumins. Their several fractions are distinguished: alpha ‑, beta- and gamma-globulins
they are formed in the liver, bone marrow, spleen and lymph nodes
function : . A specific function of globulins is transport. Globulin molecules on their surface have active centers with the help of which biochemical or electrostatic bond with substances that are transported is carried out.
α-globulins transport hormones, vitamins, minerals, lipids. For example, a variant of alpha-globulin, binding glucose, is called glycoproteids. About 60% of all plasma glucose circulates in the composition of glycoproteids
β-globulins are involved in transport of phospholipids, cholesterol, steroid hormones, cations of metals. For example, transferrin serves as an agent of copper and iron for the synthesis of red blood cells.
γ-globulins are known as antibodies or immunoglobulins which have five classes: JgA, JgG, JgM, JgD, JgE. They are able to bind with foreign proteins, membrane structures of pathological microorganisms,
- Erythrocytes. Hemoglobin. Its physiological and pathological compounds.
—- Erythrocytes :
-Erythrocytes (red blood cells) are the most numerous formed elements of blood. The blood of males normally contains it is non-rigid homeostatic constant.
-Human erythrocytes are devoid of nucleus their cytoplasm is filled with hemoglobin They have predominantly the form of a bi-concave disk Erythrocytes of this form are called normocytes
- A special form of erythrocytes results in increase in its surface that improves its basic function – respiratory function.
—– Hemoglobin. :
Hemoglobin (Hb) is a special protein that performs
1) respiratory function and 2) maintains blood pH
In men blood contains in average 130-170 g/l in women – 120 -150 g/l.
—— Its physiological and pathological compounds.
– physiological :
1 - oxyhemoglobin (НbО2). = is transport of oxygen and carbon dioxide.
Hemoglobin which bound О2,
- deoxyhemoglobin or reduced hemoglobin (H+Нb). = Hemoglobin which gave away О2
3- carbhemoglobin (НbCО2). = Hemoglobin, coupled with СО2 Connection of hemoglobin with СО2 takes place in capillaries of body tissues. This connection is unstable as well. In the form of this compound 20% of CO2 is transported.
4- myoglobin = located In skeletal and cardiac muscle and its muscle hemoglobin , It plays an important role in supplying oxygen to the working muscles; it can be seen as a depot of O2 in muscles.
5-6 - In a fetus mainly (80%) fetal hemoglobin (HbF) is contained. It has a higher ability to bind oxygen, it has greater affinity to О2 and it gives it away harder. After birth HbF is almost completely replaced by adult hemoglobin (HbA). In erythrocytes of an adult HbA makes 95-98%.
-Pathological:
1)CarboxyHb - HbCO
2) MethaHb -MtHb
- Carboxyhaemoglobin. First aid after carbon monoxide poisoning. Methaemoglobin.
—— carboxyhaemoglobin. its path logical compound of hemoglobin
Normally it does not exist, because there is no CO in atmosphere. HbCO is a stabile compound ,
–Hemoglobin is blocked in it by carbon monoxide and is not capable of transferring oxygen. The affinity of hemoglobin to carbon monoxide is higher than its affinity to oxygen and carbon dioxide, so even a small amount of carbon monoxide in the air is dangerous for life. At this not concentration of carbon monoxide but duration
Even extremely low levels of CO in the air, but with prolonged inhalation of it, such as during sleep, can be lethal.
Carbon monoxide poisoning very often arise in drivers at their long stay in a closed garage with an working car engine. Another common source of CO are woody smoke and fumes
feature of Carbon monoxide poisoning
A feature of carbon monoxide is that it has no smell, so poisoning develops without being noticed. Often the victim is understand of his poisoning, when myorelaxing action (relaxation of skeletal muscles) of CO is manifested
– First Aid
The victim must be taken to “fresh air”. But this is not enough , you can using an oxygenous pillow If it is not available – make artificial ventilation «mouth-to-mouth». At this air will be forced into the victim’s lungs under higher pressure. The partial
pressure of О2 in such air turns out to be larger than normal,
. Due to this some CO get out from compound with hemoglobin. Later, the victim should be taken to the hospital.
- Color indicator. Hemolysis and its types.
——- Color indicator
-The content of hemoglobin in erythrocytes is judged by the colour indicator (CI)
the formula : CI = Hb * 3 / first three figures of Er amount
CI – colour indicator;
Hb – amount of hemoglobin, g/l;
Er – amount of erythrocytes (first three figures).
For example, in norm Hb=166g/l, and Er=5∙1012 /l. Then
CI = 166 * 3 / 510 = 0.98,
In norm CI = 0.75-1.0 or more. Such erythrocytes are - normochromatic erythrocytes.
If CI is less than 0.7, these erythrocytes are - hypochromatic erythrocytes.
When CI is more than 1.1, they speak about - hyperchromatic erythrocytes.
—— Hemolysis and its types.
- Hemolysis : its destruction of the erythrocytes membrane and hemoglobin going out to the blood plasma,At this plasma turns red and becomes transparent “laky blood”.
-types :
1-Osmotic hemolysis:Osmotic hemolysis is possible only in laboratory , as in a whole organism blood under no circumstances can reach such a low hypotonicity
2-Biological hemolysis:It occurs when some substances of animal and vegetable origin (bites of snakes, insects, mushroom poisoning) enter the blood stream.
3-Chemical hemolysis:may be caused by chloroform, ether, solutions of acids and alkali,
4-Temperature (or thermal hemolysis) :occurs at blood freezing/unfreezing as a result of erythrocytes membrane destruction by ice crystals.
5-Mechanical hemolysis : occurs at strong mechanical impacts on blood, for example, while shaking the ampoule with blood,
- Erythrocyte sedimentation rate. Suspension stability of blood and its mechanism. Laboratory clinical importance of its determination.
