А. Los, O. A. Obukhova icon

А. Los, O. A. Obukhova

НазваА. Los, O. A. Obukhova
Розмір0.66 Mb.
  1   2   3   4   5   6   7   8   9   ...   12




V.Yu. Garbuzova, L.А. Los, O.A. Obukhova


Educational book

Is recommended by the Central methodological study

with higher education the Ministry of Health of Ukraine


Sumy State University


UDK 612.1

BBK 67.9 (4УКР) я7



Shevchuk V.G. – doctor of medical sciences, professor;

Samokhvalov V.G. – doctor of medical sciences, professor;

Mischenko I.V. - doctor of medical sciences, professor

Is recommended by the Central methodological study with higher education

the Ministry of Health of Ukraine as educational book

for students of higher education IV level accreditation

(letter № 23-01-25/114 from 28.10.2009)

Garbuzova V.Yu.,

G72 Physiology of the blood: educational book / V.Yu. Garbuzova, L.А. Los,

O.A. Obukhova – Sumy: Publisher SumSU. – 2010. – 165 p.

ISBN 978-966-657-272-4

This teaching aid described in the tutorial material for self-preparing students to practical classes in physiology from the “Physiology of the blood”. Each theme contains basic information theoretic question to self, test questions and problems.
For students of institutions of the III - IV level of accreditation.

У навчальному посібнику викладений матеріал для самостійної підготовки студентів до практичних занять з фізіології з розділу “Фізіологія крові”. До кожної теми наведені основні теоретичні відомості, питання до самопідготовки, тестові питання і задачі.

Для студентів вищих медичних закладів III – IV рівнів акредитації.






Chapter 1 Physical and Chemical Properties of the Blood…..


Chapter 2 Physiologies of Erythrocytes………………………


Chapter 3 Blood groups……………………………………....


Chapter 4 Protective functions of the blood. Leucocytes…….


Chapter 5 Haemostasis……………………………………......


PRACTICAL WORKS…………………………………….....


Appendix I……………………………………………………


Appendix II…………………………………………………..



Blood is used to transport substances and together with lymph and intercellular fluid belongs to the internal medium of the organism. With the help of well regulated constant content and properties of it, the internal medium provides comparably independent existent of the organism in conditions of the environment. Compounds of internal medium have common and differential physical and chemical properties. They can affect each other, and their state depends on activities of various systems of the organism.

System of the blood is the variety of executive organs (blood, which is circulated and stored; organs of blood formation and blood degradation) and mechanisms of regulation (nervous and humoral), activity of which is directed on keeping the adequate changes of blood compounds to provide adaptive reactions.

Blood participates in transport of substances, helps the excretion of metabolic products, it provides protection from antigens and non-protein factors, affects the regulation of different functions of the organism.

Chapter “Physiology of the blood” is important in preparing the medical doctor of any specialty, because the state of internal medium describes all processes in organism, which characterize homeostasis, homeokinesis and adaptive reactions when changes in internal medium and co-operation of the organism with the environment.

Teach chapter “Physiology of the blood” is necessary for learning the next chapters of physiology and other subjects, for example pathological physiology and all clinical medically-specified subjects.


  • To know the definition of blood system, mechanisms of its regulation based on analysis of homeostasis parameters: blood volumes, acid-base balance, osmotic pressure, quantity and quality content of blood plasma and formed elements of the blood.

  • To know physiological laws of functions of blood system: respiratory, transport and protection.

  • To know physiological laws of functions of keeping the liquid consistency of the blood and development of hemostasis when damage of blood vessels.

  • To make conclusions about the state of physiological functions of the organism, which perform with the help of the blood system, based on quality and quantity showings: hematocrit, number of erythrocytes, hemoglobin, leucocytes, thrombocytes, leukogram, color index, erythrocyte sedimentation rate (ESR), time of erythrocytes coagulation, duration of bleeding.

  • To analyze maturing changes of blood consistence, function and mechanisms of regulation.

  • To explain the physiological basis of examination methods of functions of the blood system: quantity of formed blood cells, hemoglobin, ESR, osmotic resistance of erythrocytes, duration of bleeding, time of blood clotting, definition of blood group in ABO and CDE.

CHAPTER 1 Physical and Chemical Properties of the Blood

Blood is one of many functional systems of the organism. Together with nervous system blood unties organs in entire organism. At the same time they define the term – proper blood system or physiological blood system (PBS).

The contents of PBS are:

  1. Peripheral blood.

  2. Organs or blood formation and blood degradation.

  3. Mechanisms of nervous and humoral regulation of blood content.

Functions of the Blood

Functions of the blood are important and various. Practically all of them are associated with the circulation of the blood in blood vessels. That is why the main function of the blood is transport function. There are several types of it:

  1. Respiratory function (transport of gases: O2 from the lungs to tissues, CO2 from tissues to the lungs).

  2. Trophic function (transport of nutrients from gastro-intestinal tract and other organs to all the tissues of the organism).

  3. Excretory function (transport of metabolic products to the excretory organs).

  4. Regulatory function (transport of hormones and biologically active substances from endocrine glands to aim-organs).

  5. Protective function (transport of phagocytes and immunoglobulins).

  6. Thermoregulatory function (transport of heat from organs that maintain warmness – liver and other internal organs to the skin).

Besides, pathogenic factors are transported with blood: microorganisms, toxins, tumor cells. Transport of the last one will lead to the development of metastasis of malignant tumor.

Except the transport function, blood plays an important role in maintaining homeostatic features of the organism. That is why the second important function of the blood is homeostatic function. There are several types of it:

  1. Maintenance of the constant chemical content and physical properties of the blood (osmotic pressure, pH, temperature, concentration of ions and other).

  2. Maintenance of the constant volume of the circulating blood.

  3. Maintenance of the antigenic homeostasis.

The third, important function of the blood is creative function. Macromolecules, which are transported with blood, perform intercellular information transferring, which provides regulation of intracellular processes of protein synthesis, keeping the level of cell differentiation, renovation and maintenance of tissue structure.

^ Content and Quantity of the Blood

Peripheral blood – is the blood, which circulates in vessels and it is stored.

The volume of circulating blood (VCB) is 6-8% of body weight of adult human or 70 – 75 ml/kg of the body weight (approximately 4 – 6 liters).

VCB is an important physiological constant. VCB depends on:

  1. Age (VCB of the newborn is 10% of the body weight and only in the period of pubescence it decreases to the level of the adult).

  2. Sex (men – 7-8%, women – 6-7% of the body weight).

  3. Functional state of the organism (physically trained have higher VCB, sportsmen can have up to 10%).

Normal VCB value is normovolemia, increased VCB – hypervolemia, decreased VCB – hypovolemia.

Peripheral blood consists of plasma (55 – 60%) and formed elements (40 – 45%) fig. 1.1.

Percentage volume of the formed elements is called hematocrit. In normal state hematocrit value is HV almost completely depends on the quantity of erythrocytes in the blood, because its volume is nearly 99% of the volume of all formed elements of the blood. Only in some forms of leucosis, due to development of anemia and increase in quantity of circulating leucocytes, the part of the last ones in hematocrit value increases.

^ HV = (Red Cell Volume  Total blood Volume)  100

Hematocrit is defined by Wintrobe method. 2 ml of the blood is put in special centrifugal glass, then add anticoagulant to it and turn it for 10 minutes with 1000 turns per minute. Blood cells, mass of which is higher than plasma will settle down in the bottom. Due to plasma are lighter in weight than erythrocytes, they will form thin white layer between erythrocytes and plasma.





Figure. 1.1 – Compaund of the blood

Other method for determination of haemotocrite value is microtechique: Blood sample is withdrawn in a heparinized capillary glass tube of small size. Both ends are waxed. The tube is put with other similar tubes in a special centrifuge and rotated for few minutes. The tube is then removed after separation of red cells from plasma and put on a special scale to read the haematocrite value.

Hematocrit value depends on:

  1. sex (men – 44% - 46%, women – 41% - 43%);

  2. age (newborns have 20% higher, than women; children – 10% higher);

  3. life conditions (due to adaptation to the mountain country, hematocrit can increase);

  4. HV is greater in venous than arterial blood (due to chloride shift phenomenon) and in large, than in small vessels.

The increase of hematocrit can lead to increase of blood stickness and that means to increase of the load on heart, disorders of blood circulation.

^ Changes in haemotocrite value (HV)

1) HV is increased in:

a) polycythaemia: due to increased number of R. B. Cs as in high altitude and in the newly born infants;

b) dehydration: due to decreased plasma volume as in severe vomiting and diarrhea.

2) HV is decreased in:

a) anemias: due to decreased R. B. Cs. count;

b) Overhydration: as in renal diseases or after intravenous infusion of large amounts of fluids (fig. 1.2).

Uses of haemotocrite value:

  1. diagnosis of anaemias;

2) determination of blood volume and renal blood flow;

3) calculation of certain blood indices;

4) follow up of cases of shock.

Functional importance of blood plasma components

Figure 1.2 – Haematocrit in the normal person and partients with anaemia and polycythaemia

Main components of blood plasma are:

  • Water (91%);

  • Proteins (8%);

  • Electrolytes (0,9%).

Importance of Water

  1. Water medium, in which substances and blood cells are dissolved.

  2. Water defines VCB.

  3. It is needed to perform the exchange of the substances between blood and intercellular fluid.

  4. It affects reological properties of the blood (for example, stickness).

  5. Due to high thermal capacity it performs transport of heat.

Importance of Proteins

  1. Transport function. There are special spots in the molecule of protein, which are able to bind inorganic substances (for example, ions, water) and organic substances (for example, hormones, biologically active substances) and to transport them. Binding of this substances to proteins provides:

  1. Keeping small molecules in bloodstream when blood is passing through kidneys.

  2. Predicts its destructing by blood enzymes.

There are specific and non-specific transport proteins. Not-specific – are able to bind different substances and transport those (most of albumins transport hormones, calcium). Specific – transport only one kind of substances. For example, cerulloplasmin – ions of cuprum (Cu), transferrin – ions of iron (Fe), haptoglobulin – bilirubin.

  1. ^ Trophic function. Proteins are the source of amino acids,

which with peripheral tissues, are used for the formation of proper, specified for the organ proteins. Proteins are the source of energy. When breaking down 1 g of protein in the organism 4,1 kkal.

Trophic function of proteins is used clinically when disorder of natural way of nourishment, in parenteral nourishment, when protein suspensions are injected in bloodstream.

  1. ^ Enzymatic function. There are a lot of protein-enzymes into the plasma. There are secretory and indicatory (cellular) enzymes. Secretory enzymes are synthesized in liver and are excreted in the blood plasma, where they perform their function. Typical representatives of this group are protein-enzymes of blood clotting. Indicatory enzymes are entering the blood from other organs. Their activity is not high. In conditions of pathological states, enzymes are taken from cells into the blood and its activity increases, which indicate the level of lesion. That’s why quantitative definition of blood enzymes is one of the available laboratory methods of diagnostics. For example, activity of AlAt (alaninaminotransferase) increases during liver sickness. Activity of AsAt (aspartateaminotransferase) increases up to 20 times during myocardial infarction. Activity of lactatedehydrogenase increases during myocardial infarction, hepatitis, myopathy, tumors, and leucosis.

  2. Participating hemostasis. Proteins comprise biochemical systems of blood plasma, which provides hemostasis, namely:

  • Blood clotting system;

  • Anticoagulatory system;

  • Fibrinolytic system;

  • Kallikrein-kinine system.

  1. Participating in maintaining pH of the blood. Proteins form protein buffer. In acidic medium, they work as bases, binding acids; in base, they react like acids, binding bases. This property of the proteins is called amphoteric. Mostly buffer properties belong to carboxyl groups and amino groups. Plasma proteins are responsible for 15% of the buffering capacity of the blood and carriage of CO2.

  • Protein – NH2 +CO2  NHCOOC (Carbamino protein);

  • Proteinic acid: Na proteinate buffer:

a) Na proteinate +H2CO 3  NaHCO3 + Proteinic acid.

b) Na proteinate + lactic acid  Na lactate + Proteinic acid.

Lactic acid (strong acid) is converted to proteinic acid (weak acid).

  1. Maintenance of the reological properties of the blood, namely its stickness. When increase in protein quantity, stickness increases, when decrease in protein quantity, stickness decreases.

  2. Proteins are the source of biologically active substances.

For example, kinins and angiotensin.

  1. Protective function. Proteins participate in non-specific and specific protection of the organism. Non-specific protection is represented by complement system proteins, interferons, orosomucoid and viruses’ inhibitors. Specific – by antibodies: congenital (agglutinins) and acquired.

  2. Making creative connections. Proteins participate transferring of the information, which affects genetic apparatus of cells, provides growth, development and differentiation of tissues. For example, proteins are growth factor of nervous tissue, erythropoietin etc.

  3. Capillary Permeability. Plasma proteins close the pores in the cement substance (between the endothelial cells) of the capillary wall. Hypoproteinaemia increases the capillary permeability.

  4. Creation of oncotic. (colloid-osmotic) pressure

Ponc= 25 – 30 mmHg. 80% of oncotic pressure is made by albumins (molecule of albumin has small size and in volume of plasma, its quantity is the highest).

Role of oncotic pressure in redistribution of water in the organism (fig. 1.3):

C a p i l l a r y

Arterial part Venous part

Рhbp = 32,5 mmHg Рhbp = 17,5 mmHg

Рobp = 25 mmHg Рobp = 25 mmHg

Filtration Reabsorbtion

I n t e r c e l l u l a r l i q u i d

Рhp = 3 mmHg Рhp = 3 mmHg

Рop = 4,5 mmHg Рop = 4,5 mmHg

Figure 1.3 – Redistribution of water in the capillaries

Wall of capillaries is permeable to small molecules and water. That is why osmotic pressure in blood plasma and in intercellular liquid is almost equal. Big molecules, first of all protein molecules, can not pass through the capillary wall. That’s why there is gradient of protein concentration (oncotic pressure gradient - Ponc) between plasma and intercellular liquid. Ponc inside capillary is higher than in intercellular liquid. Hydrostatic pressure – pressure of the liquid on the capillary wall (from one side blood is making pressure on capillary wall, from other side – intercellular liquid), it also plays important role in redistribution of the water. Hydrostatic pressure of the blood is higher, than hydrostatic pressure of intercellular liquid.

Water exchange occurs in two ways:

  1. filtration (transition of the water from the capillary to the tissue);

  2. reabsorbtion (transition of the water from the tissue to the capillary).

The direction of the water movement is defined by the filtrative pressure (Pf).

Pf = (Phbp + Pop) – (Php + Pobp)

Phbp – hydrostatic pressure of the blood;

Pop – oncotic pressure of the intercellular liquid;

Php – hydrostatic pressure of the intercellular liquid;

Pobp – oncotic pressure of the blood.

If Pf >0 – filtration occurs.

If Pf <0 – reabsorbtion occurs.

Increasing of the Phbp and Pop leads to filtration, increasing of the Php and Pobp leads to reabsorbtion.

In the arterial end of the capillary:

Pf = (32,5 + 4,5) – (25 + 3) = 9 mmHg – filtration occurs, water is transited to the tissue.

As the blood passes in the capillary, in the result of transition of the water to the tissue, hydrostatic pressure decreases. In the middle of the capillary Pf = 0 and water transition stops.

In the venous end of the capillary:

Pf = (17,5 + 4,5) – (25 + 3) = - 6 mmHg – reabsorbtion occurs, water passes into the capillary.

At the beginning of the capillary approximately 0,5% of blood plasma passes to the tissues. Pf in the arterial part of the capillary (Pf = 9 mmHg) is higher than in the venous part (Pf = - 6 mmHg), that is why the bloodstream returns not the whole 100% of the liquid, but nearly 90%. 10% are excreted through the lymphatic vessels.

This pressure values may vary in different organs and it depends on organ activity. Described mechanism of filtration – reabsorbtion is called Starling’s mechanism.

Changes in any of the parameters may cause disorder in filtration and reabsorbtion correlation.

For example, the decrease in protein concentration in blood plasma will lead to the decrease of the reabsorbtion, delay of the water in intercellular medium and development of the intercellular oedema. This can happen during starvation (cachexy oedemas); when pathological processes in kidneys, in the consequence of which proteinuria can occur and loss of proteins (nephrotic oedemas); when disorder in albumin synthesis by liver (hepatic oedemas); when allergic and inflammatory processes, when there is the increase of vessel wall permeability and other plasma proteins are leaving to the intercellular space (membranogenic oedemas) and other.

  1   2   3   4   5   6   7   8   9   ...   12


А. Los, O. A. Obukhova iconА. Los, O. A. Obukhova
У навчальному посібнику викладений матеріал для самостійної підготовки студентів до практичних занять з фізіології з розділу “Фізіологія...
А. Los, O. A. Obukhova iconПредставлення інтернаціональних конкурсів та програм Гете-інституту та Міністерства Закордонних Справ Німеччини Вперед! – Перші кроки викладання німецької (Los geht's!
Вперед! – Перші кроки викладання німецької (Los geht's! – Erste Unterrichtsschritte auf Deutsch)
Додайте кнопку на своєму сайті:

База даних захищена авторським правом ©zavantag.com 2000-2013
При копіюванні матеріалу обов'язкове зазначення активного посилання відкритою для індексації.
звернутися до адміністрації