1.

Overview of blood

Blood is a bodily fluid denser than water. Blood is slightly alkaline and It has
measurement of pH between 7.35 and 7.45 [1] and normally at the temperature of 38
°C (100.4 °F). 8% of body weight consists of blood. Blood is a highly specialized
tissue composed of many different kinds of components produced in bone marrow.
Four of the most important ones are red cells, white cells, platelets, and plasma.
Figure 1 [] bloew shows the composition of blood

Figure 1 Composition of Blood [

- Red blood cells, or erythrocytes, are relatively large microscopic cells without
nuclei. These cells normally make up 40-50% of the total blood volume. They
transport oxygen from the lungs to all of the living tissues of the body and carry away
carbon dioxide [2] [3].

- White blood cells, or leukocytes, (shown in fig 2[4]), exist in variable numbers and
types but make up a very small part of blood's volume - normally only about 1%.
Some white cells (lymphocytes) provide a physiological defense against infection by
seeking out microscopic parasites and destroying them [4] [5]. - Plasma is the
relatively clear liquid medium which carries the red cells, white cells, and platelets.
Most of our blood's volume is made up of plasma. About 95% of it consists of water
that is as salty as the oceans. As the heart pumps blood to cells throughout the body,
the plasma brings them nourishment and removes the waste products of metabolism
[3].

- Platelets, or thrombocytes, are cells that clot blood at the site of wounds. They are
fragments of multinucleated cells called megakaryocytes, which rupture, releasing
thousands of "pieces" that quickly seal the leak in the blood vessel. Plasma is the
relatively clear liquid medium which carries the red cells, white cells, and platelets.
Most of our blood's volume is made up of plasma. As the heart pumps blood to cells
throughout the body, the plasma brings them nourishment and removes the waste
products of metabolism [3].

Other Blood Components includes Chemical substances, including; fat,

carbohydrates, proteins, hormone, Gases, including; oxygen, carbon dioxide, and
nitrogen.
2. FUNCTIONS OF BLOOD FLOW

There are various functions of blood. Blood mainly functions as a transport. It transports
nutrients such as amino acids, glucose, vitamins minerals and lipids to various tissue cells
for utilization. Blood also helps in the transportation of waste products of metabolism
such as urea, uric acid, etc from tissues where there are produced to the kidney for
excretion. The Red Blood Cell, which is a cellular part of the blood help to transport
respiratory gases such as oxygen from the lungs to actively metabolizing tissues.
Hormones secreted by the endocrine glands are transported to target organs via the blood.
The White Blood cells help to protect out body against foreign agents such as bacteria
and viruses. The blood helps in the evenly distribution of heat generated by actively
metabolizing tissues such as the liver and muscles to cooler parts of the body. The plasma
proteins help to maintain the pH of the body fluid. The oncotic pressure of the plasma
proteins helps to control the exchange of fluids between the capillaries and the tissues.
Besides, it helps the temperature regulation by altering the blood flow through the skin
3.STRUCTURE OF BLOOD FLOW

Figure 3 (a)

In the figure 3(a) [7] shown above, Blood flows through the lungs by way of pulmonary
circulation. Oxygen is added, and carbon dioxide is removed. The oxygenated blood
flows to all the cells of the body by way of systemic circulation. The cells remove the
oxygen and add carbon dioxide to it. The blood flows back to the lungs, and the process
repeats itself.

Systemic Circulation

Arteries carry blood from the heart, and they make up the arterial system. Veins
carry blood back to the heart, and they make up the venous system. Systemic circulation
begins with the largest artery, the aorta, which receives all the blood the heart pumps out.
The aorta branches into many smaller arteries. The arteries take the blood to the organs.
Upon entering an organ, an artery branches into smaller arteries, which branch into even
smaller ones called arterioles. The arterioles branch into capillaries, completing the tree
of blood vessels. From the capillaries, the blood can reach the cells of the organ. The
blood is then carried back to the heart by way of the venous system. Similar to the arterial
system, the venous system contains small vessels, venules, which branch together to
make veins. In the upper section of the body, the blood flows from the veins into the
superior vena cava. In the lower section of the body, the blood flows from the veins into
the inferior vena cava. These two vessels unite to return the blood to the right heart. This
completes systemic circulation [8].

Pulmonary Circulation

Pulmonary circulation works in very much the same way as systemic circulation. Blood

exits the right heart through the pulmonary trunk, which branches into pulmonary

arteries. Blood enters the lungs through the pulmonary arteries, and pulmonary capillaries

provide for the exchange of carbon dioxide and oxygen [9] [10]. Once the blood is

oxygenated, it flows to the left heart through progressively larger venules and veins until

it reaches the pulmonary veins. The pulmonary veins are responsible for returning the

blood to the left heart. This concludes pulmonary circulation[9].

4. Regulation of blood flow

Tissues and organs within the body are able to intrinsically regulate, to varying
degree, their own blood supply in order to meet their metabolic and functional needs.
This is termed local or intrinsic regulation of blood flow. everal mechanisms are
responsible for local blood flow regulation. Some mechanisms originate from within
blood vessels (e.g., myogenic and endothelial factors), whereas others originate from
the surrounding tissue. The tissue mechanisms are linked to tissue metabolism or
other biochemical pathways (e.g., arachidonic acid metabolites, histamine and
bradykinin). Local regulatory mechanisms act independently of extrinsic control
mechanisms such as sympathetic nerves and circulating hormones. Therefore, they
can be demonstrated in isolated, perfused organs having no neural or hormonal
influences. Ultimately, the balance between local regulatory mechanisms and
extrinsic factors in vivo determines the vascular tone and therefore the blood flow
within the tissue.

There are 3 types of blood regulation:

- auto regulation
- active hyperemia
- reactive hyperemia

4.1 Auto Regulation

Auto regulation is a manifestation of local blood flow regulation. It is defined as the

intrinsic ability of an organ to maintain a constant blood flow despite changes in
perfusion pressure. For example, if perfusion pressure is decreased to an organ (e.g.,
by partially occluding the arterial supply to the organ), blood flow initially falls, then
returns toward normal levels over the next few minutes. This auto regulatory
response occurs in the absence of neural and hormonal influences and therefore is
intrinsic to the organ. When perfusion pressure (arterial minus venous pressure, PA-
PV) initially decreases, blood flow (F) falls because of the following relationship
between pressure, flow and resistance:
 ………………………………………………………………(Eq1)

When blood flow falls, arterial resistance (R) falls as the resistance vessels (small arteries
and arterioles) dilate. Many studies suggest that that metabolic, myogenic and endothelial
mechanism is responsible for these vasodilatations. As resistance decreases, blood flow
increases despite the presence of reduced perfusion pressure.

4.2 Active Hyperemia

Active hyperemia is the increase in organ blood flow (hyperemia) that is associated with
increased metabolic activity of an organ or tissue. An example of active hyperemia is the
increase in blood flow that accompanies muscle contraction, which is also called exercise
or functional hyperemia in skeletal muscle [12]. Blood flow increases because the
increased oxygen consumption of during muscle contraction stimulates the production of
vasoactive substances that dilate the resistance vessels in the skeletal muscle [11]. Other
examples include the increase in gastrointestinal blood flow during digestion of food, the
increase in coronary blood flow when heart rate is increased, and the increase in cerebral
blood flow associated with increased neuronal activity in the brain.

4.3 Reactive hyperemia

Reactive hyperemia is the transient increase in organ blood flow that
occurs following a brief period of ischemia (e.g., arterial occlusion).
Reactive hyperemia occurs following the removal of a tourniquet,
unclamping an artery during surgery, or restoring flow to a coronary
artery after recanalization (reopening a closed artery using an
angioplasty balloon or clot dissolving drug)[12] .In general, the ability
of an organ to display reactive hyperemia is similar to its ability to
display autoregulation..
Reference:

[1]. Wikipedia (no date) The Free encyclopedia

http://en.wikipedia.org/wiki/Blood

[2] ]. Wikipedia (no date) The Free encyclopedia

http://en.wikipedia.org/wiki/Red_blood_cell

[3] http://users.rcn.com/jkimball.ma.ultranet/BiologyPages/B/Blood.html#RBCs

[4] http://faculty.weber.edu/nokazaki/Human_Biology/Chp%207-blood.htm

[5] http://www.fi.edu/learn/heart/blood/white.html

[6] http://library.thinkquest.org/C0115080/?c=wbc

[7] http://www.arrowvale.worcs.sch.uk/sportscollege/images/sport/body/circulation.gif

[8] http://www.fi.edu/learn/heart/systems/systemic.html

[9] http://www.fi.edu/learn/heart/systems/pulmonary.html

[10] http://users.rcn.com/jkimball.ma.ultranet/BiologyPages/C/Circulation.html

[11] http://www.answers.com/topic/active-hyperemia

[12] http://www.wisegeek.com/what-is-hyperemia.htm

[13] http://www.anaesthetist.com/physiol/basics/autoreg/Findex.htm#index.htm
[14] http://en.wikipedia.org/wiki/Autoregulation