Department of medical physiology 2 nd week

Transcription

1 Department of medical physiology 2 nd week Semester: winter Study program: Dental medicine Lecture: RNDr. Soňa Grešová, PhD. Department of medical physiology Faculty of Medicine PJŠU

2 Department of medical physiology 2 nd week 1. Blood functions and general blood atributes 2. Blood plasma 3. Red blood cells 4. White blood cells

3 1. Blood functions and general blood atributes Transport of: Gases, nutrients, waste products Processed molecules Regulatory molecules Regulation of ph and osmosis Maintenance of body temperature Protection against foreign substances (specific and unspecific) Clot formation

4 1. Blood functions and general blood atributes Contains cellular and liquid components A specialized connective tissue Blood cells formed elements Plasma fluid portion and fibrinogen Blood volume Males: 5 6 liters Females: 4 5 liters Measurement- Evans blue, deuterium oxide (hypovolemia, hypervolemia) The ph of blood is about (acidemia, alkalosis) Specific gravity is g/cm3

5 1. Blood functions and general blood atributes Blood viscosity Blood viscosity is a measure of the resistance of blood to flow. It can be described as the thickness and stickiness of blood blood viscosity is 4 to 5.3 times higher then water viscosity plasma viscosity is times higher than the viscosity of water viscosity depends the size, number, shape elements, the composition of the plasma, temperature Viscosity decrease - eg. Anemia The increase in viscosity - polycythemia, increased concentration of plasma proteins

6 1. Blood functions and general blood atributes Hematocrit Value Hematocrit ratio - % of red blood cell volume to total blood volume. Varies depending on number and size of red blood cells, plasma volume, portion or the circulatory system sampled from. Hematocrit is slightly greater in venous blood samples. Normal Hematocrit: Men = 44 +/- 5% Women = 39 +/- 4% Newborns = 20% higher due to polycythemia

7 1. Blood functions and general blood atributes Erythrocyte Sedimentation The erythrocyte sedimentation rate (ESR), also called a sedimentation rate or Westergren ESR, is the rate at which red blood cells sediment in a period of one hour. Fahraeus Westergren method Sedimentation rate depends on: Gravity, and resistance of plasma Number of erythrocytes Sedimentation slowed by high number(polycythemia) Faster sedimentation in anemia Size and shape of erythrocytes Large erythrocytes have higher rate Alterations in plasma composition Fibrinogen and globulin = rise in sed. Rate (pregnancy) Infections and intoxications can increase rate Plasma lipids; cholesterol increases, lecithin decreases rate Blood ph Acidosis slows rate, Alkalosis increases rate Tissue damage Values Men = 4-6mm first hour, 8mm second hour Women = 8-10mm first hour, 16mm second hour Newborn = 0.5mm/hour

8 1. Blood functions and general blood atributes Composition of Blood Blood: Plasma (55%) Formed elements (45%) Plasma Proteins (7%) albumins (35 50 g/l), globulins (cca 25 g/l), fibrinogen (1,5 3,5 g/l) water (91%) other solutes (2%) Ions Nutrients: glucose (3,05 6,4 mmol/l), bilirubin (< 22,2 mol/l), lipids (5,7 8,2 mmol/l), Cholesterol (2,8 5,2 mmol/l) free fatty acids (0,15 0,71 mmol/l) Waste products - urea, uric acid, bilirubin, creatinine, amonia Gases Regulatory substances hormones, antibodies, enzymes

9 1. Blood functions and general blood atributes Composition of Blood Plasma other solutes (2%) Copyright: Hall, J. E., & Guyton, A. C. (2006). Guyton and Hall textbook of medical physiology. Philadelphia, PA: Saunders Elsevier.

10 1. Blood functions and general blood atributes Composition of Blood Blood: Plasma (55%) Formed elements (45%) Formed elements Erythrocytes (red blood cells) Leukocytes (white blood cells) Platelets (trombocytes)

11 2. Blood plasma Plasma proteins Coloid osmotic pressure (oncotic pressure of proteins) = 3.3kPa (25 mmhg) Salts Osmotic pressure of the blood= 290 mosmol/l Physiological isotonic solution = 0.9% NaCl with 5% glucose

12 3. Red blood cells Structure Biconcave, anucleate Components Hemoglobin Lipids, ATP, 2,3-DPG, carbonic anhydrase Function Transport oxygen from lungs to tissues and carbon dioxide from tissues to lungs Values - Females: 4,700,000 (±300,000) cells/cubic millimeter - Males: 5,200,000 (±300,000) cells/cubic millimeter Price-Jones curve Copyright: Javorka, K., & col. (2001). Lekárska fyziológia. Martin: Vydavateľstvo Osveta.

13 Cell Lines in Blood Cell Formation (Hematopoiesis) Copyright: Hall, J. E., & Guyton, A. C. (2006). Guyton and Hall textbook of medical physiology. Philadelphia, PA: Saunders Elsevier.

14 Cell Lines in Red Blood Cell Formation (Hematopoiesis) Early erythroblasts Intermediate erythroblasts Late erythroblasts Copyright: Hall, J. E., & Guyton, A. C. (2006). Guyton and Hall textbook of medical physiology. Philadelphia, PA: Saunders Elsevier.

15 Erythropoietin: Hormone to stimulate RBC production Maturation of RBC requirement for vitamin B 12 (Cyanocobalamin) and Folic Acid Copyright: Hall, J. E., & Guyton, A. C. (2006). Guyton and Hall textbook of medical physiology. Philadelphia, PA: Saunders Elsevier.

16 3. Red blood cells Hemoglobin Copyright: Hall, J. E., & Guyton, A. C. (2006). Guyton and Hall textbook of medical physiology. Philadelphia, PA: Saunders Elsevier. Adult hemoglobin A (HbA, 2α a 2β), (3% HbA 2, 2α a 2δ) Embryo hemoglobin E (HbE, Grower I. 2 ζ a 2ε, Grower II. 2α a 2ε, Portland 2ζ a 2γ) Fetal hemoglobin (HbF, 2α a 2γ) between 10 and 32 weeks of intrauterine development

17 Consists of: 4 globin molecules: Transport carbon dioxide (carbonic anhydrase involved), nitric oxide 4 heme molecules: Transport oxygen Iron is required for oxygen transport Effected by altitude, sex, age, hypoxia, physical fitness, disease, ect. Normal values: Men = g/l Women = g/l Total in blood = 800g Each gram carries 1.34mL oxygen Derivates of hemoglobin - Carbaminohemoglobin (HbCO2) - Oxyhemoglobin (HbO2) - Carboxyhemoglobin (HbCO) - Methemoglobin (Fe3+) 3. Red blood cells Hemoglobin Copyright: Hall, J. E., & Guyton, A. C. (2006). Guyton and Hall textbook of medical physiology. Philadelphia, PA: Saunders Elsevier.

18 3. Iron transport and metabolism Copyright: Hall, J. E., & Guyton, A. C. (2006). Guyton and Hall textbook of medical physiology. Philadelphia, PA: Saunders Elsevier.

19 4. White blood cells Protect body against microorganisms and remove dead cells and debris Movements Ameboid: are capable of amoeboid movement Diapedesis: are able to penetrate the wall of the capillaries into the tissue Chemotaxis: the ability to influence the direction and speed of the leu (bakt.toxins, tissue breakdown products,...) Tigmotaxis: neu - surface activity and ability to adhere on surfaces Immunity Antigen Antibody Values 4,800 11,000/cubic millimeter

20 1. Chemical mediators of inflamation 2. Vasodilatation, blood flow increase - area red and hot 3. Epithelial cells shrink 4. Fluid licking out hemoconcentration, blood flow decrease area is swelling 4. White blood cells Copyright: Hall, J. E., & Guyton, A. C. (2006). Guyton and Hall textbook of medical physiology. Philadelphia, PA: Saunders Elsevier.

21 Cell Lines in Blood Cell Formation (Hematopoiesis) Copyright: Hall, J. E., & Guyton, A. C. (2006). Guyton and Hall textbook of medical physiology. Philadelphia, PA: Saunders Elsevier.

22 4. White blood cells Two types of leukocytes Granulocytes Agranulocytes Differential WBC Count Never Let Monkeys Eat Bananas Copyright: Hall, J. E., & Guyton, A. C. (2006). Guyton and Hall textbook of medical physiology. Philadelphia, PA: Saunders Elsevier.

23 4. White blood cells Neutrophils and macrophages are active phagocytes Attracted by chemotaxis Neutrophils respond most quickly to tissue damage by bacteria Primary granules: strong oxidants (MPO-myeloperoxidase), defensins (such as Ig), secondary granules: lysozymes (bacterial cell wall), lactofferins, bacteriostatis and bacteriocidal agents, tercial granules: collagenase, hyaluronidase (break down collagens) Monocytes take longer to arrive but arrive in larger numbers and destroy more microbes Enlarge and differentiate into macrophages (CNS-microglia, lungsalveolar macrophages, liver Kupffer cells, spleen-histiocytes, skin- Langerhans cells, kidney-mesengial cells, bones-osteoclast

24 4. White blood cells Basophila leave capillaries and release granules containing heparin, histamine and serotonin, at sites of inflammation Intensify inflammatory reaction Involved in hypersensitivity reactions (allergies) Eosinophils leave capillaries and enter tissue fluid Release histaminase (reduce inflamation), phagocytize antigen-antibody complexes and effective against certain parasitic worms

25 4. White blood cells Lymphocytes are the major soldiers of the immune system B cells destroying bacteria and inactivating their toxins T cells attack viruses, fungi, transplanted cells, cancer cells and some bacteria Natural Killer (NK) cells attack a wide variety of infectious microbes and certain tumor cells

26 Formation of antibodies and sensitized lymphocytes Copyright: Hall, J. E., & Guyton, A. C. (2006). Guyton and Hall textbook of medical physiology. Philadelphia, PA: Saunders Elsevier.