Physiology of the blood

Patophysiology, hematology

Blood: main represenetive of the ECF

Functions: result from physical and chemical properties, morphological properties, universal medium,
contact with all tissues/
Transport of O2, CO2
Transport of nutriens
Transport of final products of metabolism
transport of hormones, vitamines
transport of heat
Defence function – against blood lost, infections
Maintanance of homeostasis – isovolemia, isoionia, isoosmia, isohydria
Mainainance of the blood pressure
Source of informations for interoreceptors: baro, presso, volumo, chemo, osmoreceptors.
Source of informations for phisicians about homeostasis

Blood composition
Blood : plasma
91% water
8% organic substances – proteins: albumins 45 g/l, globulins 25 g/l, fibrinogen 3 g/l. Lipids 10 g/l.
Carbonhydrates 5 mmol/l. Inorganic substances 1%

blood cells: erythrocytes, leukocytes, platelets

General properties of the blood

1. Isovolemia
2. Hematocrit value
3. Viscosity
4. Specific gravity
5. Isoionia
6. Osmotic pressure
7. Acid – Base balance
8. Erythrocytes sedimentation rate

Blood: red, nontransparent, viscous, suspension

1. Blood volume: 5l, 7% of the body weight, 5% from TBF
2.8 l/m2, 83ml /kg
normovolemia
hypovolemia (blood lost) : simple : bleeding
hyperythorcytotic: sweeting, burning
hypervolemia: after work, exersice, high altitude, pregnancy, transfusion, infusion, excess
drinking
Regenaration of blood: daily 50 ml, 3X / Year
Regulation: nervous, hormonal, local
Meassurement: direct (1790), indirect
Measurement of body fluid: distribution principle
Volume = injected amount of substance i.v / concentration of substance in plasma
 Test material must be: nontoxic, mix throughout the compartment, movable only into the
definite compartment, unchanged in the body, easy measured.
Using materials: TBW: deuterium oxide
ECF: inulin, sucrose
Blood: plasma: Evans blue, radioactive, albumin
redcells: radioactive red cells

interstitial fluid = ECF – plasma volume, ICF = TBW – ECF

2. Hematocrit value (PCV)

Volume of the RBC in the total blood volume in 1%
Male: 44 +- 5% (0.44)
Female: 39 +- 4% (0.41)
Dependent on: number of RBC, size of RBC, water content in plasma, place of sampling (arteria, vena,
spleen, kidneys). Importance: RBC–plasma relation, caculation of blood volume, volume of the RBC.
MCHC (mean compulsolar hemoglobin concentration).

3. Viscosity: whole blood: 4-5 X > water

Plasma 2.2 x > water
depend on: number of RBC, size of RBC, water content, proteins content, temprature, blood flow speed

4. Specific gravity: whole blood: 1.062 g/cm3

Er: 1.090
plasma: 1.027
dependent on: number of Er, size of Er, water content, proteins content
5. Ionic composition – isoionia
cations+ : H+, NH4, Na, K
anions-: OH, HCO3, Cl
funcions of ions
1. Physico-chemical: osmotic pressure, pH, solubility
2. biological: K+: heart conductivity
Ca2+: excitability, contractillity, blood clotting, Mg+2: Nervous system, Fe+2: erythrocyte,
I:thyroxine
Regulation: hormonal
6. Blood osmolarity – osmotic pressure – isoosmia
Osmolarity = concentration of osmotically active particles in soulution
Plasma contains: water, ions (NaCl, Ca, Cl), proteins, low mollecular organic substance
(glucose, amino acids, urea)
Osmotic pressure = 700 kPa
- 0.57 C
290 mosmol/l – 96% by electrolytes, 4% by nonelectrolytes, proteins – oncotic pressure (3.3
kPa)
Tonicity = osmolarity of solution relative to the plasma
isotonic solution = 0.9 NaCl – physiological solution
5% glucose
hypotonic, hypertonic solution
Osmotic resistance – osmotic fragility of Er.
Hemolysis – releasing of hemoglobin from Er.
physical – mechanical, thermal, chemical, osmotic, toxical, imunobiological
osmotic fragility: 0.48 – 0.32 % NaCl

7. Acid – Base balance – isohydria

is the maintainance od the H+ concentration in the ECF
pH os the negative logarithm of the hydrogen ion concentration, or hydrogen ion activity
(nmol/l)
arterial plasma: pH7.4 +- 0.05 (40 nmol/l)
compatible with life: pH 7.0-7.7
ICF: pH 6.8-7
Constancy of the pH is maintained by:
Blood, lungs, kidney, liver

buffer systems
1. biocarbons (53%)
2. hemoglobin (35%)
3. proteins (7%)
4. phosphates (5%)

acidosis (acidemia) pH < 7.36 (metabolic, respiratory)

alkalosis (alkemia) pH > 7.43 interstitial fluid: bicarbonates, phosphates
intracellular fluid: proteins, phosphates, bicarbonate
8. Erythrocyte sedimentation rate (FW)
nonspecific method, Fahraeus – Westergreen (1921), used in clinical practice.
Suspension stabillity – sedmentation rate
Male: 3 – 8 mm/ hour, Female: 7 – 2 mm / hour, 2-3 mm/ h at newborn
FW = 3/6 (first hour/ second hour)
dependent on: 1. number of Er: higher number – lower FW
2. size of Er: bigger size – higher FW
3. composition of plasma
proteins: albumins decreases FW
globulin increases FW
fibronogen increases FW
lipids: cholesterol (increases), lecithine (decreases)
4. pH: alkalosis, acidosis
5. funcional state (pregnancy, menstrution) - increase
6. extencive tissue damage (cancer, infract) – increase
7. external temprature – increase

Methods: classic (vertical), quick (45 deg)

Importance: diagnosis, effectivity of therapy, prognosis

Plasma proteins – 75 g/l:

albumins: 45
globulins: 25
fibrinogen: 3-5

Functions
Maintainence of the blood volume (oncotic pressure 3.3 – 4 kPa)
 Transport of vary substances (hormone, vitamins, billrubin, fatty acids, ions medicaments)
Buffering function (pH)
Maintainence of blood suspension stabillity
preventing of the blood loss (clotting)
Immune functions (immune globulins)
Nutritional funcion?

Anorganic substances:
Na+ - 142 mmol/l, K+ - 5 mmol/l
Ca+2 – 2.5 mmol/l, Cl- mmol/l

Red Blood Cells – erythrocytes

biconcave, nonuclear cells, diameter 7.4 um, thickness 1.8-2.1 um

mean corpuscular volume: 86 fl (10 ^-15 l)
surface: 130 um^2

Functions of erythrocytes

transport of o2, co2

transport of substances
Maintainence of pH
metabolism
antibiotic effect (erythrin) ?

Metabolic pecularities of Er
anaerobic glycolysis
2,3 – DPG (diphosphoglycerate) production
high amount of glutathione
methemohlobin reductase
carbonanhydrase

Number of RBC:
Depend on:
Age
Sex
pO2
Physical activity
Functional state of organism