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BLOOD
 Connective tissue in fluid form

 Fluid of life – carries oxygen from lungs to all parts

of body and carbon-di-oxide from all parts of the body
to the lungs

 Fluid of growth – carries nutritive substances from

the digestive system and hormones from endocrine
gland to all the tissues.

 Fluid of health – protects the body against diseases

and get rid of unwanted substances by
transporting them into excretory organs like kidney.
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 Physical Characteristics of Blood

• Thicker than water

• 8 % of total body weight

• Blood volume
» 70 mL/kg of body weight
» 5 - 6 liters in males
» 4 - 5 liters in females

• Temperature - 100.40F

• pH - 7.35 to 7.45
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 Blood Functions
1. Respiratory
 Transport O2 from lungs to tissues
 Transport CO2 from tissues to lungs

2. Nutrition
 Transport “food” from gut to tissues

3. Excretory
 Transport waste from tissues to kidney (urea,
uric acid)

4. Protective
 White blood cells , antibodies, antitoxins.
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 Blood Functions
5. Regulatory
regulate body temperature
 regulate pH through buffers
 coolant properties of water
 vasodilatation of surface vessels dump heat
 regulate water content of cells by interactions with dissolved
ions and proteins

6. Body Temperature
 Water- high heat capacity, thermal conductivity, heat of
vaporization
 Typical heat generation is 3000 kcal/day

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 Blood composition
 Suspension of cells in plasma (carrier fluid)
45% Cells
55% Plasma
 Cells

Red cells (erythrocytes) 99%

5x106/mL
White cells (leukocytes)
7x103/mL < 1%
Platelets
(thrombocytes)
3x105/mL

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Blood composition

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 Blood Plasma
• Straw colored clear liquid
• Contains 90% water
• 7% plasma proteins
 created in liver
 confined to bloodstream
 albumin
 maintain blood osmotic pressure
 immunoglobulins
 antibodies bind to foreign
substances called antigens
 form antigen-antibody complexes
 fibrinogen
 for clotting
• 2% other substances
 Nutrients, electrolytes, gases, hormones, waste products8
 Functions of plasma proteins
1. Coagulation of blood – Fibrinogen to fibrin

2. Defense mechanism of blood – Immunoglobulins

3. Transport mechanism – α Albumin, β globulin transport

hormones, gases, enzymes, etc.

4. Maintenance of osmotic pressure in blood

5. Acid-base balance

6. Provides viscosity to blood

7. Provides suspension stability of RBC

8. Reserve proteins
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 Formed Elements of Blood
• Red blood cells (R.B.C.)
• White blood cells (W.B.C.)
 granular leukocytes
 neutrophils
 eosinophils
 basophils
 agranular leukocytes
 lymphocytes - T cells, B cells, natural killer cells
(N.K.C)
 monocytes
• Platelets (special cell fragments)

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 Functions of RBC
1. Transport oxygen from lungs to the tissues
(oxyhemoglobin).

2. Transport carbon-di-oxide from tissues to lungs

(carboxyhemoglobin)

3. Hemoglobin acts as a buffer and regulates the

hydrogen ion concentration (acid base balance)

4. Carry the blood group antigens and Rh factor

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 Functions of neutrophils
1. First line of defence against invading micro-
organisms.

2. Powerful and effective killer machine – contains

enzymes like protease, elastase, metalloproteinase,
antibody like substances called defensins.
Defensins – antimicrobial peptides active against bacteria and fungi.

3.Secrete Platelet Aggregation Factor (PAF) –

accelerates the aggregation of platelet during injury
to the blood vessels

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 Functions of eosinophils
Secrete lethal substances at the time of exposure to
foreign proteins/parasites

1. Eosinophill peroxidase – destroy worms, bacteria

and tumor cells.

2. Major basic protein – damage parasites

3. Eosinophill cationic protein (ECP)- destroys

helminths.

4. Eosinophill derived neurotoxin – destroys nerve

fibres (myelinated nerve fibres)
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 Functions of basophils
Basophill granules release some important substances like –

1. Histamine – Acute hypersensitivity reaction- vascular changes,

increase capillary permeability

2. Heparin – prevents intravascular blood clotting

3. Hyaluronic acid – necessary for deposition of ground

substances in basement membrane

4. Proteases – exaggerate inflammation

• Basophill have IgE receptor – hypersensitivity reaction

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 Functions of Platelets
1. Blood clotting

2. Clot retraction

3. Defence mechanism

4. Homeostasis

5. Repair and rupture of blood vessel

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 Gas transport

• Continuous interchange of CO2 and O2

between lungs and tissues.

• Oxygen –
• major e- acceptor
• indispensable for ATP production.
• CO2
• major by product of energy metabolism

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 pH maintenance

• Oxygen release helps to maintain pH in tissues

• Lungs:
– Hb + O2 = HbO2 + H+

• Tissues:
– CO2 forms proton and bicarbonate
– Proton is bound to Hb, when O2 is released
– Bicarbonate leaves RBC

• Cl- / HCO3- interchange - Hamburger effect

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 Hb

• Higher ability of Hb to release O2 but lower

ability to bind O2 - Right shift

• Useful at site of O2 release (tissues)

• higher temperature
• higher 2,3 BPG level
• lower pH (Bohr effect)

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 CO2 transport

1. Bicarbonate formation within RBC and Cl

interchange

2. CO2 dissolved in blood plasma

3. Carbaminohemoglobin formation

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 What is urine?

• Urine is a liquid waste product of

the body secreted by the kidneys by a
process of blood filtration and
excretion through the urethra.

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 Composition
• Urine is a transparent solution that can range
from colorless to amber but is usually a pale
yellow. It is normally odorless but can acquire
strong odors due to bacterial action.

• Urine is an aqueous solution of metabolic wastes

such as urea, dissolved salts, and organic
compounds.

• Most noticeably, ammonia is produced by

breakdown of urea, a major component of urine.
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 Hazards

• Urea is toxic and can be irritating to skin

and eyes.

• High concentrations in the blood can

cause damage to organs of the body.

• Low concentrations of urea such as in

urine are not dangerous.
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 Characteristics

• The typical bright yellow color of urine is

caused by the pigment urochrome as well
as the degradation products of billirubin
and urobillin.

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 Unusual coloration
• Yellowing/light Orange may be caused by removal
of excess vitamin B from the bloodstream.
• Bloody urine is termed hematuria, potentially a sign
of a bladder infection.
• Dark orange to brown urine can be a symptom of
jaundice.
• Black or dark-colored urine is referred to as
melanuria and may be caused by a melanoma.
• Reddish or brown urine may be caused by
porphyria.
• Dark yellow urine is usually indicative of
dehydration. 25
 Turbidity

• Turbid urine may be a symptom of a

bacterial infection.

• and can also be due to crystallization of

salts such as calcium phosphate.

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 pH

 
•The pH of urine can normally vary between
4.5 and 8. (average around 6).

•Strongly acidic or alkaline urine may be

symptomatic of disease.

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 Volume
The amount of urine produced depends on numerous
factors including :
• state of hydration,
• activities,
• environmental factors,
• age, and health.

• In adult human, the average production is about 1 - 2 L

per day.

• Polyuria is a condition of excessive production of urine

(> 2.5 L/day), in contrast to oliguria where < 400 mL are
produced per day, or anuria with a production of < 100
mL per day.
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 Density or specific gravity

• It is the ratio of the weight of a volume of urine to

the weight of the same volume of distilled water
at a constant temperature.

• Normal urine density or specific gravity values

vary between 1.003-1.035 (g.cm-3) , and any
deviations may or may not be associated with
urinary disorders.

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Substances found in normal urine

• Urine is aprox. 95% water.

• The other components of normal urine are

the solutes that are dissolved in the water
component of the urine.

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 Organic molecules

These are electrically neutral and can be

relatively large (compared with the
'simpler' ions).These include:
• Urea
• Creatinine
• Others

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 Urea

• Urea is an organic (i.e. carbon-based)

compound whose chemical formula is: CON2H4
or (NH2)2CO. It is also known as carbamide.

• Urea is derived from ammonia and produced by

the deamination of amino acids. The amount of
urea in urine is related to quantity of dietary
protein.
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 Creatinine

• Creatinine is a normal (healthy) constituent of

blood.

• It is produced mainly as a result of the breakdown

of creatine phosphate in muscle tissue.

• It is usually produced by the body at a fairly

constant rate (which depends on the muscle
mass of the body).

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 Uric acid

• Uric acid is an organic (i.e. carbon-based)

compound whose chemical formula is:
C5H4N4O3.

• Due to its insolubility, uric acid has a

tendency to crystallize, and is a common
part of kidney stones.

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 Other substances/molecules

Example of other substances that may be

found in small amounts in normal urine
include :
• carbohydrates,
• enzymes,
• fatty acids,
• hormones,
• pigments, and mucins (a group of large,
heavily glycosylated proteins found in the
body).

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 Ions

• Sodium (Na+) : Amount in urine varies with diet and

the amount of aldosterone (a steroid hormone) in
the body.

• Potassium (K+) : Amount in urine varies with diet

and the amount of aldosterone (a steroid hormone)
in the body.

• Chloride (Cl-) : Amount in urine varies with dietary

intake (chloride is a part of common salt, NaCl).
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 Continues…
• Magnesium (Mg2+) : Amount in urine varies with diet and the
amount of parathyroid hormone in the body. (Parathyroid hormone
increases the reabsorption of magnesium by the body, which
therefore decreases the quantity of magnesium in urine.)

• Calcium (Ca2+) : Amount in urine varies with diet and the amount of
parathyroid hormone in the body. (Parathyroid hormone increases
the reabsorption of calcium by the body, which therefore decreases
the quantity of calcium in urine.)

• Phosphates (H2PO4-, HPO42-, PO43-) amount in urine varies

with diet and the amount of parathyroid hormone in the body -
parathyroid hormone decreases the quantity of phosphates in
urine.

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Small groups formed from a few different elements

• Ammonium (NH4+) : The amount of ammonia

produced by the kidneys may vary according to
the pH of the blood and tissues in the body.

• Sulphates (SO42-) : Sulphates are derived from

amino acids. The quantity of sulphates excreted
in urine varies according to the quantity and type
of protein in the person's diet.

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What are the abnormal constituents of urine?

Abnormal urine can have:

• Carbohydrates
• Proteins
• ketone bodies
• Blood
• Bile salts
• Fats

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 CARBOHYDRATES

• Physiologically in pregnancy and lactation,

lactose is excreted in pregnant women.
• Pathologically if lactose is excreted in the urine,
then this is due to lactose intolerance.
• Glucose could be excreted in the urine in
Diabetes mellitus, renal glycosuria
• Fructose in essential fructosuria
• Galactose in galactosemia

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 Continues…
•The presence of significant amount of glucose in
urine is called glycosuria (e.g diabetes mellitus,
renal glycosuria)

•The quantity of glucose that appears in the urine

is dependent upon
• - the blood glucose level
• - The rate of glomerular filtration
• - and the degree of tubular reabsorption

•(Usually glucose will not be present in the urine until

the blood level exceeds 160 – 180 mg/dl, which is
the normal renal threshold for glucose ) 41
 PROTEINS

Secretion of proteins in urine is due to:

1- Increase in the permeability of the glomerular
capillaries as in nephrotic syndrome

2- Damage to the capillary membranes as in

glomerulonephritis

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The following proteins can be excreted
abnormally in urine:
•Albumin & Globulin: found in the urine in the
condition called proteinuria, also in nephrotic
syndrome and glomerular nephritis
•Hemoglobin (protein of RBC): excreted in urinay
tract infections
•Myoglobin: excreted due to muscular atrophy

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 KETONE BODIES
Are formed during the catabolism of fatty acids
They are basically three chemicals :
• acetone
• acetoacetic acid
• Beta-hydroxy butaric acid
All the three are the intermediates in lipid metabolism.
Defect in metabolism can lead to presence of ketone
bodies in urine

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 Increased catabolism of fats is due to :
• starvation
• increased fat intake
• decreased carbohydrates in take
• diabetes ketoacidosis

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