department of medical physiology 2nd week semester: winter ... week.pdf · department of medical...

Department of medical physiology2nd week

Semester: winterStudy program: Dental medicineLecture: RNDr. Soňa Grešová, PhD.Department of medical physiologyFaculty of Medicine PJŠU

Department of medical physiology2nd week

1. Blood functions and general blood atributes

2. Blood plasma

3. Red blood cells

4. White blood cells


• 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


• 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 7.35-7.45 (acidemia, alkalosis)

• Specific gravity is 1.062 g/cm3

• 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 1.5-2 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

1. Blood functions and general blood atributesBlood viscosity

1. Blood functions and general blood atributesHematocrit 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


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

1. Blood functions and general blood atributesComposition 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


• Plasma

– other solutes (2%)

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


• Blood: – Plasma (55%)

– Formed elements (45%)

• Formed elements• Erythrocytes (red blood cells)

• Leukocytes (white blood cells)

• Platelets (trombocytes)

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

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

Copyright: Javorka, K., & col. (2001). Lekárska fyziológia. Martin: Vydavateľstvo Osveta.

Price-Jones curve

Cell Lines in Blood Cell Formation (Hematopoiesis)



Cell Lines in Red Blood Cell Formation (Hematopoiesis)

Earlyerythroblasts

Intermediateerythroblasts

Late erythroblasts

Erythropoietin: Hormone to stimulate RBC production

Maturation of RBC –requirement for vitaminB12 (Cyanocobalamin) and Folic Acid


3. Red blood cellsHemoglobin

• Adult hemoglobin A (HbA, 2α a 2β) , (3% HbA2, 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


3. Red blood cellsHemoglobin

• 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 = 140-160 g/L– Women = 120-158 g/L– Total in blood = 800g

• Each gram carries 1.34mL oxygen

• Derivates of hemoglobin- Carbaminohemoglobin (HbCO2)- Oxyhemoglobin (HbO2)- Carboxyhemoglobin (HbCO)- Methemoglobin (Fe3+)


3. Iron transport and metabolism



• 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


1. Chemical mediatorsof inflamation

2. Vasodilatation , blood flow increase- area red and hot

3. Epithelial cellsshrink

4. Fluid licking out –hemoconcentration, blood flow decrease– area is swelling


Cell Lines in Blood Cell Formation (Hematopoiesis)


• Two types of leukocytes– Granulocytes

– Agranulocytes

• Differential WBC Count– Never

– Let

– Monkeys

– Eat

– Bananas



• 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 cellwall), lactofferins, bacteriostatis and bacteriocidal agents, tercialgranules: 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, lungs-

alveolar macrophages, liver – Kupffer cells, spleen-histiocytes, skin-Langerhans cells, kidney-mesengial cells, bones-osteoclast


• 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


• 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


Formation of antibodies and sensitizedlymphocytes


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