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BLOOD 8% body weight, 5-6 l, transporting medium functions: 1. Respiratory 2. Nutritional 3. Excretoric 4. Homeostatic a) water, ions, pH
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BLOOD 8% body weight, 5-6 l, transporting medium functions: 1. Respiratory 2. Nutritional 3. Excretoric 4. Homeostatic a) water, ions, pH b) temperature - specific heat, conductivity, latent heat 5. Chemical control 6. Immunity Formed elements + plasma hematocrit stability of suspension electrostatic forces proteiny bridges viskosity
Fluid x losses BLOOD – PLASMA – SERUM PLASMA Water Proteins – onkotic pressure, pH, hemostasis, immunity, transport, AMA pool elektroforesis albumin, globulins, fibrinogen, clotting faktors, lipopro- teins, haptoglobins, transferrin Organic substancies – nutriens, vitamins, cholesterol, waste products, hormons Electrolyts – Na, K, Cl, HCO3, PO4, Ca Gases – O2, CO2, N2
ELEMENTS erythrocytes, leukocytes, trombocytes stem cells (resting, proliferating) progenitor colony increase in number of stem cells entering, shortening of the cycle, combination ERYTHROCYTES – lack of nuclei, ribosomes, mitochondria, 95% of dry weight Hb, shape, antigens Erythropoesis - multipotent (pluripotent, totipotent) stem cells unipotent (progenitor) EPO HIF EPO apoptosis of progenitors Ery line proerytroblast basophilic erytroblast (normoblast) Hb synthesis polychromatic erythroblast DNA synthesis restricted ortochromatic erytroblast (NORMOBLAST) Nuclei retikulocyte erythrocyte
Ery formation afinity of Hb O2 2,3 DPG renal aa. lungs O2 CO2 Ox Red Hb liver kidneys Hb concentration HIF EPO plasma volume Ery hormons bone marrow Losses
Hb – 135 –170 g/l A, F, dissociation curve Metabolism Ery -shape, deformability - ion pumps - hem in ferroform - ROS scavanging no mitochondriae glycolysis carboanhydrase GG-6PNAD GSH H2O + CO2 H+ + HCO3- F-6PNADH GSSG F –1,6 P NADG – 3P NADH1,3 DPGdifosfogycerate mutasea 2,3 DPG 3 PGdifosfoglycerate fosfatase
Ery destruction aging membráne rigidity sferocyte CO2 Fe transferrin bilirubin AMA bilirubinglukuronid RES Hb urobilin sterkobilin
ANEMIE hypoplastic, aplastic microcytic hypochromic sideropennic normocytic normochromic thalasemia makrocytic hyperchromic pernicious infiltration of bone marrow drugs hemorrhagic hemolytic acute bleeding intracorpuscular (hereditary, chronic spherocytosis, sicle cell) extracorpuscular (hypersplenism) POLYGLOBULIA
LEUKOCYTES - 7 x 109/l % neutrophils50 – 70 O2 O 2- H2O2 OH eozinophilsí 1 – 4 granulocytes basophils < 1 monocytes 2 – 8 chemotaxis, secretion, adhesion, diapedesis, fagocytosis, ROS (NADPH oxidase, myeloperoxidase), proteases lymfocytes 20 – 40 T - helper/inducer - memory cells - supressors - cytotoxic - K - N K B - plasmatic - memory cells NADPH NADP
TROMBOCYTES 250 x 109/l 2 – 4 u microtubuli, receptors for collagen, actin + myosin, granules (ADP, serotin), α granules (PDGF, PAF) HEMOSTASIS: 1) vessels – vasoconstriction (wall, serotonin, tromboxan A2) 2) platelets - adhesion (receptors, von Willebrandův f.) - change of the shape - aggregation ADP plug granules TXA2 vasokonstriction
3) clotting HMWK, LMWK kinins inflammation complement extrinsic - thromboplastin intrinsic – XII, kallikrein tkáňový aktivátor prothrombin thrombin plasmin plasminogen streptokinase fibrinogen fibrinstabilized fibrin fibrin degradation products Alterations of hemostasis, disseminated intravascular coagulation, consumption coagulopathy