Physiology of Blood

Composition of blood

Blood is composed of

Plasma and

Formed elements
1. Blood plasma

complex non-cellular fluid surrounding

formed elements.
It is the extracellular fluid or environment
of the blood cells.
 Blood Plasma components

1. Proteins e.g.
-albumin for transport of other substances and drugs
-globulins (α-globulin and β-globulin) serve as carriers of
lipids and steroids hormones
-fibrinogen which is required for blood clotting (serum is
the fluid that lacks fibrinogen and therefore cannot clot)
 Plasma components

2. Ions that serve as electrolytes e.g.

Major ions - Sodium, chloride, and bicarbonate
ions.
Trace ions – magnesium, copper, iron, potassium
and zinc
3. Metabolites,wastes and hormones e.g. carbon
dioxide, drugs, urea etc.
1.Formed elements (blood cells)

These are the actual cellular components of

blood (special connective tissue)

 a. erythrocytes - red blood cells

 b. leukocytes - white blood cells
 c. platelets - cell fragments for clotting
 Separation of blood components
(centrifuge)

VOLUME LAYER

1. clear/yellowish -PLASMA 55% top

2. thin/whitish buffy coat - <1% middle

LEUKOCYTES & PLATELETS

3. reddish mass - ERYTHROCYTES 45% bottom

 Characteristics of Blood

 1. bright red (oxygenated)

 2. dark red/purplish (unoxygenated)
 3. much more dense than pure water
 4. pH range from 7.35 to 7.45 (slightly alkaline)
 5. slightly warmer than body temperature
 6. typical volume in adult male 5-6 liters
 7. typical volume in adult female 4-5 liters
 8. typically 8% of body weight

 General Functions of Blood

 1. Distribution & Transport

 a. oxygen from lungs to body cells

 b. carbon dioxide from body cells to lungs
 c. nutrients from GI tract to body cells
 d.nitrogenous wastes from body cells to kidneys
 e.hormones from glands to body cells
2. Regulation (maintenance of homeostasis)

 a. maintenance of normal body pH

 b. blood proteins (albumin) & bicarbonate ions
 c. maintenance of circulatory/interstitial fluid
 d. electrolytes aid blood proteins (albumin)
 e. maintenance of temperature
 3. Protection

 a. platelets and proteins "seal" vessel damage

 b. protection from foreign material & infections
 c. leukocytes, antibodies, complement proteins
Erythrocytes (red blood cells; RBCs)

 A. Structure
 1. 7.5 µm diameter; 2.0 µm thick
 2. biconcave disk shape; ideal for gas exchange
 3. mature cells are anucleate (no nucleus)
 4. very few organelles; mainly a hemoglobin carrier
 -hemoglobin – 33% of cell mass; carries oxygen
 5. no mitochondria; only anaerobic respiration
 6. ratio erythrocytes : leukocytes = 800 :1
 7. red blood cell count: # cells per cubic millimeter
- normal male count - 5.1 to 5.8 million
- normal female count - 4.3 to 5.2 million
 Hemoglobin and oxygen transport

hemoglobin - large molecules with globin and hemes

globin - complex protein with 4 polypeptides (2 alpha and 2 beta polypeptides)

heme group - IRON containing pigment; site to which oxygen binds

Each polypeptide has one heme group; each heme carries one O 2

normal hemoglobin levels (grams/l00 ml blood)

i. infants 14-20 grams/l00 ml
ii. adult female 12-16 grams/100 ml
iii. adult male 13-18 grams/l00 ml
Oxygen transport
2. states of hemoglobin

 a. oxyhemoglobin - when oxygen is bound to IRON

 b. deoxyhemoglobin - no oxygen bound to IRON
 c.
carbaminohemoglobin - when carbon dioxide
bound (to polypeptide chain)
 Methemoglobin: unusual hemoglobin: an altered
form of hemoglobin that cannot bind oxygen,
produced by some poisons or by a genetic disorder
 Hematopoiesis and Erythropoiesis

Hematopoiesis (hemopoiesis) - the maturation, development and formation of

blood cells
• Hematopoiesis occurs in red bone marrow (myeloid tissue) -in blood
sinusoids which connect with capillaries; mainly in axial skeleton and
heads of femur & humerus
• hemocytoblast (stem cell) - the mitotic precursor to blood cells
before differentiation
• differentiation - maturing cell becomes "committed" to being certain
type of blood cell
Life span of RBCs

 hemocytoblast -> reticulocyte 3-5 DAYS

 reticulocyte -> ERYTHROCYTE 2 DAYS (in
blood)
 ERYTHROCYTE lifespan 100-120 DAYS

 Erythrocytes are primarily destroyed by macrophages

in the spleen
Regulation of erythropoiesis

 Productionof RBCs requires both internal

and external blood-forming factors.

 Internal factors – erythropoietin

 External factors – Iron, Vitamin B12, Folic

acid.
 Erythropoietin
 A hormone produced from the kidney, released through blood into the bone marrow

 Eythropoietin has receptors in the bone marrow. When erythropoietin binds to these
receptors in the bone marrow, hematopoiesis increases.

 FACTORS THAT STIMULATE INCREASE IN ERYTHROPOIETIN RELEASE

 1. Less RBCs from bleeding (injury, surgery etc.
 2. Less RBCs from excess RBC destruction (hemolysis,- infection -malaria, drugs etc.)
 3. Low oxygen levels (high altitude, illness)
 4. Increased oxygen demand (exercise)
 Testosterone can also mildly stimulate production of RBCs in humans
 IRON
 Iron – is needed for hemoglobin to carry oxygen
 65% of Fe in body is in hemoglobin
 liver and spleen store most excess Fe bound to
ferritin and hemosiderin
 Fe in blood is bound to transferrin
 daily Fe loss: 0.9 mg men and 1.7 mg women
 v. women also lose Fe during menstrual flow
Vit B12 and Folic acid

 B-complex Vitamins - Vitamin B12 and Folic Acid are

essential for DNA synthesis in early mitotic divisions
leading to erythrocytes
 Erythrocyte Disorders (Anemias & Polycythemias)

 Anemias - a decrease in the circulating RBC mass OR Hb

content
Signs and symptoms of anaemia

 Patients with Hb less than 7G/dl will have symptoms of

 tissue hypoxia( fatigue, headache, dyspnea, pallor,
angina, tachycardia, visual impairment, hepatic and or
splenic enlargement, bone tenderness, neurologic
symptoms.

01/09/2023 27
 Characterization of anaemia
 Based on size and haemoglobin content
1. Hypochromic , microcytic -anaemia due to smaller-
size RBCs(defective) with low Hb, caused by iron
deficiency
2. Macrocytic anaemia - RBCs sizes are larger than
normal(dyscrasias) and are fewer in number. This is
caused by Vit B12 and Folic acid deficiency)
3. Normochromic, normocytic anaemia - fewer normal-
sized RBCs, each with normal Hb content(this is
usually due to haemolysis) 01/09/2023 28

4. Mixed picture
 Causes of anaemia
 Deficiency of nutrients necessary for haemopoiesis e.g.

i. Iron,
ii.folic acid,
iii.vitamin B12 :pernicious anaemia is anaemia caused by lack of
intrinsic factorwhich is needed for Vit B 12 absorption)
iv.or due to Thalassemia- easily ruptured RBCs (Greek &
Italian genetic link)

01/09/2023 29
 Depression of the bone marrow, caused by:
 toxins (e.g. drugs used in chemotherapy)
 radiation therapy
 diseases of the bone marrow of unknown origin (e.g.
idiopathic aplastic anaemia, leukaemias)
 reduced production of, or responsiveness to
erythropoietin (e.g. chronic renal failure, rheumatoid
arthritis, AIDS).
 Excessive destruction of red blood cells (i.e.
haemolytic anaemia);
 this has many causes, including
 haemoglobinopathies (such as sickle cell anaemia),
 adverse reactions to drugs, and
 inappropriate immune reactions.
Treatment of anaemia

Iron
Folic acid
Vit B12
Erythropoietin
 Polycythemia
 Excess RBC count, causes thickening of the blood
 Hematocrit may jump to 80%
 high altitude (normal); or too much erythropoietin release
 blood doping in athletes - RBCs previously withdrawn are
transfused before an event; more RBCs, more oxygen delivery to
the body
 LEUKOCYTES OR WHITE BLOOD CELLS
(WBCs)
GENERAL CHARACTERISTICS AND FUNCTIONS

 1. protection from microbes, parasites, toxins, cancer

 2. 1% of blood volume; 4-11,000 per cubic mm blood
 3. diapedesis - can "slip between" capillary wall
 4. amoeboid motion - movement through the body
 5. chemotaxis - moving in direction of a chemical
 6. leukocytosis - increased "white blood cell count" in response to bacterial/viral infection
 7. granulocytes - contain membrane-bound granules (neutrophils, eosinophils, basophils)
 8. agranulocytes - NO membrane-bound granules (lymphocytes, monocytes)
 Granulocytes

 Granules in cytoplasm which can be stained with

Wright's Stain;
 bilobar nuclei;
 10-14 micron diameter;
 all are phagocytic cells (engulf material)
 neutrophils

 Also known as polymorphonuclear leukocytes

Polymorphonuclear - many-lobed nuclei

 Most numerous WBC

 Basophilic (blue) & acidophilic (red)
 They possess defensins - antibiotic-like proteins
(granules)
 Cause lysis of infecting bacteria/fungi
 HIGH neutrophil count is an indicative of likely infection
IMMUNE RESPONSE TO INFECTION
Eosinophils
 lead attack against parasitic worms
 only 1-4% of all leukocytes
 two-lobed, purplish nuclei
 acidophilic (red) granules with digestive enzymes
 phagocytose antigens & antigen/antibody complex
 inactivate chemicals released during allergies
 Basophils

 release Histamine which causes inflammation, vasodilation, attraction of WBCs

 RAREST of all leukocytes (0.5%)
 deep purple U or S shaped nucleus
 basophilic (blue) granules with HISTAMINE
 related to "mast cells" of connective tissue (BOTH release Histamine)
 antihistamine - blocks the action of Histamine in response to infection or allergic
antigen
 Agranulocytes - WBCs without granules in cytoplasm –
Lymphocytes and Monocytes

 1. lymphocytes - two types of lymphocytes

T lymphocytes - (thymus) respond against virus

infected cells and tumor cells
B lymphocytes - (bone) differentiate into
different "plasma cells" which each produce
antibodies against different antigens
 Characteristics of lymphocytes

 Lymphocytes are primarily in lymphoid tissues

 Have very large basophilic (purple) nucleus
 small lymphocytes in blood (5-8 microns)
 larger lymphocytes in lymph organs (10-17 mic)
2.monocytes –
differentiate to become macrophages;
serious appetites for infectious microbes
largest of all leukocytes (18 microns)
dark purple, kidney shaped nucleus