Gg Flashcards
Types of fluid
Extracellular
Intracellular
Tramscellualr: synovial, peritomeal, pericardial fluid -1-2l
What dose total water depemd om
Obesity, age, genser
Woken have lover becauuse more fat
With age and obesity er have lower water
Water of fetus , newbkrms and young adults
Fetus 90
Newborn: 78-86
Young adults: 55-60
total body water
Total body water: Radioactive water/heavy water/antipyrin
- Mixes with the total body water.
ECF
ECF: Disperse but do not traverse the cell membrane.
- Radioactive Na+ and Cl- (some entry into cells - over-estimated)
- Inulin (lack distribution - low estimate)
plasma volume
Plasma volume: substances that stay in the vascular system.
- Albumin with radioactive iodine or Evans blue (binds easily with plasma proteins
blood volume
Blood volume:
- Directly: inject RBCs with radioactive markers and measure radioactivity of blood.
- Indirectly: blood volume = plasma volume/1-hematocrit
volume of blood in people
Volume:
Adults: 7% of bw
- Males: 7.7%
- Females: 6.5-7% (higher % of fat - less total body water)
Newborns: 70-100ml/kg of bw.
Fetus: 125 ml/kg bw.
measurment of blood volume
Direct: Welcker’s method
- Bleeding the animal, washing out the vessels, extracting Hb still in the tissues = 7.7%
Indirect: indicator-dilution principle
normovolemia
hypovolemia
hypervolemia
Normovolemia: 5.5l
Hypovolemia:
1. Proportional: equivalent loss of plasma and blood cells.
2. Disproportional:
- Hemoconcentration: loss of plasma, not blood cells.
o Dehydration: Sweating, diarrhea, vomiting.
- Hemodilution: (decrease Ht value): loss of blood cells, not plasma.
o Bleeding: loss of plasma + ery - more rapid replacement of plasma than ery.
o Anemia: lower amount of RBC, same amount of plasma.
Hypervolemia:
- Drinking enormous amount of water.
- Excessive transfusion
specific gravity and values
Specific gravity: ratio of density of a substance to the density of a reference substance (H2O)
Water: 1000kg/m3
Blood: 1056 kg/m3
- Plasma: 1027 kg/m3
- RBC: 1090 kg/m3
Newborns have higher SG - have higher amount of RBC.
hemotocrit and values
Hematocrit: % of RBC in the blood.
Determined by centrifuging blood in hematocrit tubes until the cells become packed tightly in the bottom of the tubes.
- Males: 44 +/- 5%
o Testosterone stimulates RBC production.
- Females: 39 +/- 4%
- Newborns: 50-60%
o Intrauterine development is rather hypoxic - need more carriers for oxygen.
hyperviscosity and symptons
Hyperviscosity:
- Increased hematocrit causes increased viscosity.
o Increase in circulating RBCs
o Decreased blood volume (dehydration) - nurse asks you to drink before blood taking
- Ery derformability - high flexability causes low viscosity (young have higher fleixibility than old)
- Ery aggregation: tendency of RBC to attract each other and stick together.
Symptoms: impaired transit through the microcirculatory system.
- Hypoxia: O2 and nutrients don’t arrive to tissue.
- Bleeding
- Vision defects.
- Neurological manifestations.
RBC dia, thickness, and volume
Mean diameter: 7.2m +/-0.5
Thickness: 2.1m +/- 0.5
Average volume: 10-15 l.
compostion of RBC
Structure: non-nucleated with biconcave disc.
- Water + dry substance
- Membrane, skeleton, hemoglobin.
Shape makes the surface larger for oxygen diffusion.
RBC membrane: lipid bilayer
Membrane lipids = 3 types
- Phospholipids
- Cholesterol (45%)
- Glycolipids (5%)
Membrane proteins
- Spectrin, actin
- Ankyrin (fixation of the cytoskelet)on
Other substances in RBC
- Intracellular ions: K+, Na+, CA2+
- Eynzymes: Carbonanhydrase (buffer system)
- ATPase, protein kinases, cAMP, AA, glutathione
- Hemoglobin.
count of rbc
Count:
M: 4.3-5.3 x 1012/l
- Testosterone stimulates production of ery (directly - BM, indirectly - erythropoietin).
F: 3.8-4.8 1012/l
Newborns: 7-8 x 1012/l
- Intrauterine development is rather hypoxic - need more carriers for oxygen.
Sucklings: 3-3.5 x 1012/l: lowest period - nutrition and iron deficiency.
- Sources from mother start to decrease around 1 year.
- Have to start to compensate for it themselves.
hypereryhtorsis/polycetyemia/polyglobulin
^RBC
Hypererythrocytosis: Increased circulating RBC or decreased plasma.
Physiological: newborns, physical activity, high altitude.
Pathological: polycythemia
- Diseases associated with hypoxemia
- Renal diseases: kidneys produce erythropoietin.
- Iatrogenic: excessive transfusion of RBC.
o Doping EPO.
metabolsim of rbc
embden mayerhof and PPP
eryhtopenia
Erythrocytopenia: anemia
Physiological: Sucklings
Pathological: iron and B12 deficiency.
ESR+ factors
= physiological characteristic of blood.
Rate at which red blood cells sediment and separates from plasma in 1 hour.
Helmholt’s bilayer: form of suspension - blood remains for along time in suspension form.
- Negative electrical charge on RBCs surface = forces holding the ery dispersed in plasma.
- Positive electrical charge of blood plasma.
Sedimentation in aggregate form - “rouleaux”
Factors:
- Size and count of RBC:
o Decreased: accelerates ESR
o Increased: decelerates ESR.
- Plasma proteins:
o Globulins + fibrinogen accelerates.
o Albumin: decelerates.
- Concentration of lipids: increases
- pH of blood plasma: alkalosis increases
Female have higher values - less RBC, more fibrinogen.
ESR values
Values:
M: 2-5mm/h
F: 3-8 mm/h
- Female have higher values - less RBC, more fibrinogen.
Physiological - acceleration: pregnancy, menstruation.
Pathological - infectious disease, tumors, liver disease.
method of ESR
Method: Fahraeus-Westergreen method
After 2 hours the amount of Ery sedimentation should not exceed double of the first ESR value.
- Normal value does not eliminate presence of illness.
- Abnormal value confirms presence of pathological process.
Have to use anticoagulant - if the blood clots we cant make sedimentation.
Combined with examination of CRP
- Protein of acute phase of inflammation (increases >1000x during inflammation).
HB in adults
fetus
embryonic
Types:
Adults:
- HbA: 2α,2β
- HbA2: 2α,2δ- 2%
Fetal:
- HbF: 2α,2γ
Embryonic:
- Gower 1: 4ε
- Gower 2: 2α,2ε
- Portland: 2zeta,2γ
values of Hb
Values: 1g of Hb can carry 1.34ml of O2 🡪 1L of blood 200ml O2.
M: 160g/l
F: 140g/l
Newborns: 190g/l
measurment of HB
Measurement: estimation of Hb concentration.
Spectrophotometric:
1. Hemolysis of cell: destruction of RBC membrane resulting in release of Hb.
- Osmotic pressure: hypotonic, hypertonic solution.
- Physical influences: temperature >50°C, radiation (UV, X-ray)
- Chemicals: lipid solvent, saponine, acids.
- Toxic: cobra venom, phosphatidases.
- Immunologic: antigen-antibody hemolysis
- Hereditary: deficiency of enzyme G6PDH.
2. Determine light absorption during its transition through the transformed solution of blood (g/l or curve)
hb derivates
Hb derivates:
Physiological:
- Oxyhemoglobin (+O2)
- Deoxyhemoglobin (-O2): no oxygen carried - oxygen was released to tissue.
- Carbaminohemoglobin (+CO2): reacts with amino groups of globin.
Pathological: cannot bind O2.
- Carboxyhemoglobin (+CO): Hb has much higher affinity to CO than O2.
o CO poisioning.
o Oxygen treatment.
- Methemoglobin (+OH-): heme iron is oxidized to Fe3+
o Chemicals: NO, nitrates
WBC coun
Count: less than RBC - no considerable gender difference.
Adults: 4-10x109/l
Newborns: 15-17 x109/l
Diurnal rhythm: morning - decreased count
- Best to take the blood sample in the morning.
leukocytosis and leukopenia
Leukocytosis: increased count
- Physiological: after feeding, physical effort, gravidity, menstruation.
- Pathological: inflammation.
- Leukemia: high production of immature WBC
Leukopenia: decreased count
- Physiological: fasting, cold environment.
- Pathological: decreased production of BM (stop - death in 3-6 days).
arneth count
Arneth count: tells us how the BM is working.
- High% of young neu 🡪 left shift (infection, malignant tumor)
- High% of old neu 🡪 right shift (vit. B12 deficiency, liver disease).
Hynek: total sum of 100 neutrophils nuclei lobes (220-270
functions ot WBC
ameboid motion, chemoticis, tigmotaxis, diapedesis, pahocutosis, prevention of blood coagulaiton
eryhtropoiesis value + reg
Erythropoiesis: 3,5 x 1011/day
Regulation:
- Neural: hypothalamus
- Humeral:
o Specific: erythropoietin (kidneys)
o Non-specific: testosteron, thyroxin, GH, corticoid, estrogen.
granulopoiesis: value + reg
Granulopoiesis: 50-100 billion/day
Regulation:
- Specific: colony stimulating factor
o G-CSF (mo, endo, fibrobl)
o GM-CSF (mo, endo, fibrobl, T)
o M-CSF (mo, endo, fibrobl, T)
- Non-specific: bacterial endotoxins (via CSF)
Immunohormones: IL: 2,4,5,9
thrombipoesis : value + reg
Thrombopoesis: 1011/day
Regulation:
- Thrombopoietin: produced by liver and kidneys.
- Feedback through metabolites and degradation products.
- GM-CSF, IL-3 (stimulate colonies of megakaryocytes).
platelets structure
Originate from megakaryoctyes.
Structure:
- Round/oval disc, no nucleus, granulated cytoplasm.
- Small (1/10 of ery volume).
- Dia : 2,4 mm
- Thick: 0,5-1mm
- Vol: 4-8fl
- Lifetime: 8-12 days
platelet clotting factors
Platelet clotting factors:
N.1 (plasmatic f. 5): Proaccelarin: prothrombin 🡪 thrombin.
N.2 beta-thromboglobulin fibrinogen 🡪 fibrin.
N.3: Phospholipid-thromboplastic f: prothrombin 🡪 thrombin.
N.4 anti-heparin factor.
N.5 platelet fibrinogen.
