THE PHYSIOLOGY OF BLOOD

AN INTRODUCTION AND OVERVIEW By Dr.M.ANTHONY DAVID, MD.

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WHAT IS BLOOD?

IT IS A LIQUID CONNECTIVE TISSUE IN AN AVERAGE 70 Kg MAN:

100 Trillion cells O! "#ic# $% &rillions 're Re( )loo( Cells* T#e '+er'ge ,loo( +ol-.e is % / 0 l&s I& is ro-g#l1 72 o! &#e &o&'l ,o(1 "eig#&
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HEMATOL OGY: TH E S TU DY OF B LOOD MAD E POSSIBLE BY MIC ROSCOPY

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THE COMPOSITION OF BLOOD PLASMA

The Liqui ! P"#$%#!

W#&er, &he $'"(e)& The $'"u&e!

Pr'&ei)$!

BLOOD PLASMA

A"*u%i) G"'*u"i)$!+ Fi*ri)',e) N#. /. C#.. Ure# G"u-'$e Li0i $

WATER SOLUTES

E"e-&r'"y&e$!

PROTEINS ELECTRO -LYTES ORGANIC MOLECULES 4

Or,#)i- %'"e-u"e$

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THE FORMED ELEMENT! CELLS

BLOOD CELLS

ERYTHROCYTES

LEUCOCYTES

THROMBOCYTES

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BLOOD: COMPOSITION

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FUNCTIONS OF BLOOD

NUTRITIVE RESPIRATORY EXCRETORY BODY DEFENCE: IMMUNITY TRANSPORT:

HORMONES VITAMINS DRUGS

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BLOOD!TRANSPORTING HORMONE MOLECULES

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OXYGEN & CO2 TRANSPORT

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FUNCTIONS OF BLOOD

HOMEOSTATIC FUNCTION:

ACID BASE BALANCE. ELECTROLYTE BALANCE. HEMOSTASIS. THERMOREGULATION.

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WHAT IS BLOOD VOLUME1

The &'&#" #%'u)& '2 *"'' i) -ir-u"#&i') 0"u$ &he #%'u)& '2 *"'' i) &he re$er('ir$ -')$&i&u&e$ &he 3B"'' V'"u%e4 The #(er#,e # u"& 56 7, %#) h#$ # *"'' ('"u%e '2 8 &' 9 "i&re$.

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E:PRESSION OF BLOOD VOLUME

U$u#""y B"'' V'"u%e i$ e;0re$$e i) "i&er$. I& -#) #"$' *e e;0re$$e i) re"#&i') &' *' y <ei,h&.

I& i$ 5= B' y Wei,h&

A)'&her <#y &' e;0re$$ i& i$ i) &er%$ '2 B' y Sur2#-e Are#.

Wh'"e B"'' P"#$%#

! >.? L&$@M> ! A.8 L&$@M>

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METHODS OF MEASURING BLOOD VOLUME

IN HUMANS! ONLY INDIRECT METHODS DYE DILUTION TECHNIUE! PRINCIPLE!

I)Be-&i') '2 # 7)'<) ('"u%e '2 )') &';i- $u*$&#)-e i)&' &he -ir-u"#&i'). Me#$uri), &he i"u&i') '2 &hi$ i)Be-&e ye #2&er $'%e &i%e. Thi$ ,i(e$ u$ &he P"#$%# ('"u%e.
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DYE DILUTION TECHNICUE

VA D VOLUME CA D CONCENTRATION OF DYE

V> D VOLUME C> D CONC. OF DYE

VA : C A D V > : C > OR V> D VA : C A D A%'u)& '2 Dye i)Be-&e C> C')-. O2 &he ye i) &he P"#$%#
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HEMATOCRIT EPCVF
The ('"u%e '2 ery&hr'-y&e$ i) &he <h'"e *"'' e;0re$$e i) 0er-e)&#,e i$ &he He%#&'-ri&. Thi$ i$ #"$' -#""e #$ P#-7e Ce"" V'"u%e 'r PCV. Thi$ i$ e&er%i)e *y &he Wi)&r'*eG$ &u*e, u$i), # Ce)&ri2u,e.

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HEMATOCRIT

A %i;&ure '2 *"'' #) 'u*"e ';#"#&e E/ H NHIF i$ &#7e) u0&' A66 %#r7 i) &he Wi)&r'*eG$ &u*e. The &u*e i$ 0"#-e i) &he -e)&ri2u,e. I& i$ r'&#&e #& J,666 r0% 2'r J6 %i)u&e$. The He%#&'-ri& i$ &he) re# '22 &he &u*e. B"'' V'"u%e D P"#$%# V'"u%e : A66 NOMAD:2005: BP: INTROVERVIEW 16 A66 K PCV

HEMATOCRIT

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BLOOD VOLUME! PHYSIOLOGICAL VARIATIONS AGE SE: TEMPERATUR E BODY WEIGHT BODY SURFACE

PREGNANCY E:ERCISE POSTURE HYPO:IA EMOTIONS

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BLOOD VOLUME L AGE

AGE AT BIRTH 9 M')&h$ A ye#r >yr$ 9 %')&h$ I ye#r$ 5 ye#r$ A6 ye#r$ ADULTS BLOOD VOLUME i) Li&er$ 6.J 6.8 6.5 A.6 A.J A.5 >.8EGir"$FM J.> EB'y$F 8 EMe)F I.8 EW'%e)F

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BLOOD VOLUME! PHYSIOLOGICAL VARIATIONS

A. SE:!

M#"e$ h#(e %'re *"'' ('"u%e &h#) 2e%#"e$. A-u&e e;0'$ure &' -'" -#u$e$ re u-&i') i) *"'' ('"u%e ue &' P"#$%# <#&er "'$$ &' &i$$ue$.
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>. TEMPERATURE!

BLOOD VOLUME! PHYSIOLOGICAL VARIATIONS

J. BODY WEIGHT! I& i$ u$u#""y 5= '2 &he B' y Wei,h&. I. BODY SURFACE AREA! >.? L&$@Squ#re Me&er$ '2 BSA

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BLOOD VOLUME! PHYSIOLOGICAL VARIATIONS

8. PREGNANCY!

I)-re#$e$ *y >6 H J6= ue &' %#$$ '2 2e&u$. Vi,'r'u$ e;er-i$e -#u$e$ #) i)-re#$e. Ch#),i), 2r'% "yi), '<) &' ere-&.
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9. E:ERCISE!

5. POSTURE!

BLOOD VOLUME! PHYSIOLOGICAL VARIATIONS

?. HYPO:IA!

See) i) Hi,h #"&i&u e$. Ery&hr'-y&e$ S' B"'' ('"u%e. E;-i&e%e)& -#u$e$ #) i)-re#$e i) &he B"'' ('"u%e.
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N. EMOTIONS!

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BLOOD VOLUME! PATHOLOGICAL VARIATIONS

DECREASE IN BLOOD VOLUME IS HYPOVOLEMIA. CAUSES! A. BLOOD LOSS! >. SHOC/! Cru$hi), I)Bury C#r i',e)i Neur',e)i P$y-h',e)i-.

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HYPOVOLEMIA! CAUSES E-')& F

J. HEMOLYSIS!

Mi$%#&-he &r#)$2u$i') S)#7e *i&e B"#-7 <#&er 2e(er He%'rrh#,iP"#,ue$@De),ue Me#$"e$

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HYPOVOLEMIA! CAUSES E-')& F

I. DEHYDRATION!

Di#rrh'e# Ch'"er# G#$&r'e)&eri&i$ Bur)$ Hy0ere%e$i$.

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HYPOVOLEMIA! CAUSES E-')& F

8. ANEMIA!

De-re#$e RBC ('"u%e P"#$%# %#y i)-re#$e. B"'' ('"u%e 0er *' y <ei,h& e-re#$e$ &h'u,h B"'' ('"u%e 0er BSA %#y *e )'r%#". De-re#$e i) B"'' ('"u%e.

9. OBESITY!

5. HYPOTHYROIDISM EMY:EDEMAF!

?. ACUTE COLD! De-re#$e$ *"'' ('"u%e. NOMAD:2005: BP: INTROVERVIEW

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TREATMENT FOR BLOOD LOSS

TRANSFUSION OF WHOLE BLOOD OF THE SAME BLOOD GROUP L TYPE. INFUSION OF PLASMA INFUSION OF DE:TRAN OR NORMAL SALINE.

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HEMOPOIESIS L ERYTHROPOIESIS
By Dr. M.Anthony David.MD.

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HEMOPOIESIS! INTRO

Hemo: Referring to blood cells Poiesis: The development or production of The word Hemopoiesis refers to the production & development of all the blood cells:

"egins in the #$th wee% of life in the fetus & continues in the red bone marrow till death!
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Erythrocytes: Erythropoiesis eucocytes: eucopoiesis Thrombocytes: Thrombopoiesis!

STEM CELL THEORY

&ll blood cells are produced by the bone marrow! They come from a single class of primitive mother cells called as: P 'R(P)TE*T +TE, -E +! These cells give rise to blood cells of:

,yeloid series: -ells arising mainly from the bone marrow! ymphoid series: cells arising from lymphoid tissues!
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PROGENITOR CELLS

-ommitted stem cells lose their capacity for self.renewal! They become irreversibly committed! These cells are termed as Progenitor cells They are regulated by certain hormones or substances so that they can:

Proliferate 'ndergo ,aturation!

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BLOOD CELLS! DEVELOPMENT

PROG ENI TOR CE LL S

LY MPHO ID PRO MEGA MYELO BLA ST MONOBL AST CE LLS NORMOBL AST KA RYO BL AST

LYMP HO CY TESERYTHROCYTESTH ROMB OCY TES GRANUL OCYTE S MONOCYTE S

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ERYTHROPOIESIS! SITES@PHASES

INTRA UT ER INE LIF E:

INTRAVASC UL AR PH ASE : Up to 3 rd mo nt o! Intr " U t# r$ n# L$!#%

End ot #&$"& '#&& ( ) ) ) RBC(

HEPATI C P HAS E : 3 rd t o * t mo nt IU L
L$ +#r , Sp &## n nR BC( !rom M #(# n' -m"& '#&& (%

MYEL OI D PH ASE : Fr om * t m ont o! IUL on."r d(%

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ERYTHROPOIESIS: SITES/PHASES contd.

P)+T *&T&

-H( 0RE*:

(/E:

Predominantly Red "one ,arrow of s%eleton:

&1ial & &ppendicular!

&0' T+:

Red "one ,arrow of &1ial +%eleton!

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ERYTHROPOIESIS
PROERYTHROBLAST BASOPHILIC ERYTHROBLAST POLYCHROMAT OPHILIC ERYTHROBL AST ORTHOCHROMATIC ERYTHROBLAST

RETICULOCYTE

MATURE ERYTHROCYTES
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FACTORS REGULATING ERYTHROPOIESIS

+(*2 E ,)+T (,P)RT&*T RE2' &T)R: T(++'E )342E*&T()* "'R+T PR),)T(*2 &-T(5(T4 ER4THR)P)(ET(* (R)* 5(T&,(*+:

5itamin "6# /olic &cid

,(+-E

&*E)'+
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ERYTHROPOIETIN

A ormon# p ro d/'#d 0- t # K$ dn #-% No. "d"-( " +"$&"0& # " ( S-n t #t $' Epo $# t$ In'r# "( #( t # n /m0# r o! :

N/'& #"t# d p r#'/r (o r( $ n t # m "r ro .% R#t $'/& o'-t# ( , M"t/r # Er -t ro'-t# ( $ n t # 0&ood %

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VITAMINS

B 12 : C-" no'o 0" &" m$ n# , Fo& $' A' $d:

I( "&(o '"& &#d E3 tr $n($ ' F"'to r o! C" (t&# % N##d( t # Intr $n($ ' F"'to r !rom t # G"(tr$ ' 4 /$ '# !or "0 (o rpt$ on ! rom S m"& & Int# (t$ n#% D# !$'$#n'- '"/(# ( P#r n$'$o/( 56 #n I F $( m$ (($ n78 o r M# 7"& o0 &"(t$ ' An #m$ "% St$ m/&"t #( Er -t rop o$#($( I( !o/n d $n m#"t , d$"r - prod /'t(%
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IRON

E((# nt$" & ! or t # (-nt # ($ ( o ! H#m o7 &o 0$n % D#! $'$# n'- '" /(# ( M$'ro' -t$ '9 H-po' ro m$' A n#m$ "% D#! $'$# n'- '" /(# ( t # ' ommon# (t t-p # o ! An#m $" %

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