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Anatomy and Physiology of Systems Involved BLOOD

Blood composes of different other substances. It consists of a liquid portion called plasma and a solid portion that includes red blood cells, white blood cells, and platelets. About 8% of our total body weight is blood and blood volume varies by age and body composition. Blood is a complex fluid in which a variety of RBCs white blood cells and platelets are suspended in plasma. Its main functions involve supplying cells with oxygen from the lungs and absorbed nutrients from the GI tract, removing waste products from tissues to the kindneys, skin, and lungs for excretion, transporting hormones from their origin in the endocrine glands to their targets in other parts og the body, protecting the body from dangerous microorganisms, promoting hemostasis, and regulating body temperature by heat transfer Blood composition

Plasma, which is the liquid portion of the blood is one of the three major body fluids. It is composed of 92% water, 7% proteins, and less than 1% nutrients, metabolic wastes, respiratory gases, enzymes, hormones clotting factors, and inorganic salts. It contains the serum albumin and gamma-globulin which contribute to colloidal osmotic pressure. Red Blood cells or erythrocytes are the blood components that carry oxygen to the cells and help transport carbon dioxide back to the lungs. Packed with each RBC are about 200 to 300 million molecules of hemoglobin. Each molecule of hemoglobin is composed of four proteins chains (globin). Production of RBC or erythropoiesis is to produce in the red bone marrow. These cells only have a lifespan of 105 to 120 days and as they age, they become increasingly fragile and will eventually rupture. White blood cells or leukocytes on the other hand are the cells that protect the system from disease causing organisms that enters the body. They develop from hemotopoetic stem cells in response to hormones, much as red blood cells form from precursors upon stimulation form erythropoietin. Normally there are five types of WBC circulating in the blood. These types can be categorized as granulocytes or agranulocytes. Granulocytes which includes neutrophils, eosinopils, and basophils are WBCs that contains a granular cytoplasm while the agranulocytes which includes monocytes and lymphocytes are WBCs that contains no cytoplasmic granules.

Plateletes or thrombocytes which are also found in the blood which help close breaks in damaged blodd vessels and initiate formation of blood clots. A normal blood may contain 140 thousand to 350 thousand/mm3 of thrombocytes. These cell fragments are surrounded by a cell membrane and contains granule having a diameter of 2-5 micrometers. They are also developed from hematopoetic stem cells in response to the hormone thrombopoietin.
HEMOSTASIS

The term hemostasis refers to the stoppage of blood flow. The normal process of hemostasis is regulated by a complex array of activators and inhibitors that maintain blood fluidity and prevent blood from leaving the vascular compartment. Hemostasis is normal when it seals a blood vessel to prevent blood loss and hemorrhage. It is abnormal when it causes inappropriate blood clotting or when clotting is insufficient to stop the flow of blood from the vascular compartment. Disorders of hemostasis fall into two main categories: the inappropriate formation of clots within the vascular system ( i.e., thrombosis) and the failure of blood to clot in response to an appropriate stimulus (i.e., bleeding). Hemostasis is divided into five stages: (1) vessel spasm, (2) formation of the platelet plug, (3) blood coagulation or development of an insoluble fibrin clot, (4) clot retraction, and (5) clot dissolution Formation Of The Platelet Plug in

The platelet plug, the second line of defense, is initiated as platelets come contact with the vessel wall. Tiny breaks in the vessel wall are often sealed with the platelet plug rather than a blood clot . Platelets, also called thrombocytes, are large fragments from the cytoplasm bone marrow cells called megakaryocytes. They are enclosed in a membrane but have no nucleus and cannot reproduce. Although they lack a nucleus, they have many of the characteristics of a whole cell. They have mitochondria and enzyme systems capable of producing adenosine triphosphate (ATP) and

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adenosine diphosphate (ADP), and they have the enzymes needed for synthesis of prostaglandins, which are required for their function in hemostasis. The newly formed platelets that are released from the bone marrow spend up to 8 hours in the spleen before they are released into the blood. Platelet production is controlled by a protein called thrombopoietin that causes proliferation and maturation of megakaryocytes. The sources of thrombopoietin include the liver, kidney, smooth muscle, and bone marrow. Its production and release are regulated by the number of platelets in the circulation. Platelet plug formation involves adhesion and aggregation of platelets. Platelets are attracted to a damaged vessel wall, become activated, and change from smooth disks to spiny spheres, exposing receptors on their surfaces. Platelet adhesion requires a protein molecule called von Willebrand factor (vWF). This factor is produced by the endothelial cells of blood vessels and circulates in the blood as a carrier protein for coagulation factor VIII. Adhesion to the vessel subendothelial layer occurs when the platelet receptor binds to vWF at the injury site, linking the platelet to exposed collagen fibers. Platelet aggregation occurs soon after adhesion. It is mediated by the secretion of the contents of the platelet granules. The release of the dense body contents is particularly important because calcium is required for the coagulation component of hemostasis, and ADP is a mediator of platelet aggregation. ADP release also facilitates the release of ADP from other platelets, leading to amplification of the aggregation process. Besides ADP, platelets also secrete the vasoconstrictor prostaglandin TXA2, which is an important stimulus for platelet aggregation. The combined actions of ADP and TXA2 lead to the buildup of the enlarging platelet aggregate, which becomes the primary hemostatic plug. Stabilization of the platelet plug occurs as the coagulation pathway is activated on the platelet surface and fibrinogen is converted to fibrin, thereby creating a fibrin meshwork that cements the platelets and other blood components together. The primary aggregation and formation of the platelet plug is reversible up to the point at which the coagulation cascade has been activated and the platelets have been irreversibly fused together by the fibrin meshwork. The platelet membrane plays an important role in platelet adhesion and the coagulation process. It has a coat of glycoproteins on its surface that control interactions with the vessel endothelium. Platelets normally avoid adherence to the endothelium but interact with injured areas of the vessel wall and the deeper exposed collagen.

Blood Coagulation

The coagulation cascade is the third component of the hemostatic process. It is a stepwise process resulting in the conversion of the soluble plasma protein, fibrinogen, into fibrin. The Insoluble fibrin strands create a meshwork that cements platelets and other blood components together to form the clot. The coagulation process results from the activation of what has traditionally been designated the intrinsic or the extrinsic pathways. The intrinsic pathway, which is a relatively slow process, begins in the blood itself. The extrinsic pathway, which is a much faster process, begins with trauma to the blood vessel or surrounding tissues and the release of tissue factor. The terminal steps in both pathways are the same: the activation of factor X and the conversion of prothrombin to thrombin. Thrombin then acts as an enzyme to convert fibrinogen to fibrin, the material that stabilizes a clot. Both pathways are needed for normal hemostasis, and many interrelations exist between them. Each system is activated when blood passes out of the vascular system. The intrinsic system is activated as blood comes in contact with collagen in the injured vessel wall; the extrinsic system is activated when blood is exposed to tissue extracts. Bleeding, when it occurs because of defects in the extrinsic system, usually is not as severe as that which results from defects in the intrinsic pathway.

Cardiovascular System
The cardiovascular or circulatory system is responsible primarily with the movement of blood in the body. It also plays an important role in the maintenance of homeostasis, immune response and the transport of fluids. It is composed of tubes that serve as passage of fluids to and away from the heart and the different components of blood. Arteries are the vessels that transport fluids away from the heart. Arteries carry oxygenated blood. In the past they were found to be empty on dead people thus give the name. From the words Aer= hollow Tereo= to carry. The hollow center is called the lumen. It is made up of three main layers. The tunica externa as the outermost layer, tunica media as the middle layer and tunica intima as the inner layer. The structure of the arteries gives them two special properties----- elasticity and contractility. As the ventricles of the heart start to eject blood, the arteries expand to accommodate the extra blood. Then as the ventricles start to relax, the elastic recoil of the arteries forces blood onward. The contractility of the artery comes from the smooth muscles arranged longitudinally and the rings around the lumen. These muscles are stimulated by the sympathetic nervous system to cause vasoconstriction and vasodilation. The microscopic capillaries are the smallest blood vessels. Their exceedingly thin walls consist of a thin tunica intima. They are found near everybody cell and are distributed according to oxygen demands. The primary function of the capillary is to permit nutrient, waste, and gas exchange between the blood and the tissue cells. This exchange occurs only in capillary wall since the other blood vessels have thick walls presenting a great barrier for exchange. Veins are composed essentially of the same three coats as arteries, but they have variations in thickness. Despite the difference the vein is still able adapt to the changes volume. By the time blood leaves the capillaries and flows into the vein, its pressure I s greatly decreased. This decrease in pressure is what caused its difference from the artery. Some veins have valves to prevent backflow of unoxygenated blood due to the decrease in pressure.

The blood is a connective tissue suspended in a liquid matrix called plasma. Suspended also in this matrix are formed elements------ cells and cell fragments. Plasma is a straw colored liquid that consists of mostly water (91.5%) and a variety of dissolved substances (nutrients, wastes, enzymes, hormones, respiratory gases, and ions). Formed elements are red blood cells (erythrocytes), white blood cells (leukocytes), and platelets (thrombocytes). Plasma consists about 55% of whole blood and 45 % formed elements. Seven % of the dissolved components in blood plasma are proteins. Some proteins in plasma are also found elsewhere in the body. However, those confined in blood are called blood proteins. These proteins are important in the maintenance of osmotic pressure, which is important in total body fluid balance.