1

THE PHYSIOLOGY
OF BLOOD
Objectives

1. BODY FLUIDS

2. HOMEOSTASIS

3. BLOOD

4. Practical tasks

HEMATOCRIT
ERYTHROCYTE SEDIMENTATION RATE
HEMOLYSES
BODY FLUIDS
WATER IN WATER OUT TOTAL BODY WATER
Oral Dose 2000 ml Kidney Excretes 2000 ml 40 LITERS (57% - 60% OF
Metabolism 500 ml Insensible 500 ml TOTAL BODY WEIGHT)
Total 2500 ml Total 2500 ml – Newborns 75%
- Obese individuals 45%

P
T
l The 60-40-20 Rule:
r
a
a
s 60 % of body weight is
ISF, 10 n
40% x 70 kg = 28 L water m water
L s
a
,
, 40% of body weight is
1
4 intracellular fluid- ICF
L
L
Extracellular 20% of body weight is
Intracellular Water =40%
=20% extracellular fluid - ECF
Total Body Water = 60% of weight

The ECF volume is proportional to the total Na content.

 SALT IS ESSENTIAL FOR LIVING

ICT

ECT

But healthy adult requires an intake

of less than ten grammes of salt per day.
 Exchange Processes Between
Fluid Compartments
• The movement of water and electrolytes between fluid compartments takes
place by a variety of processes:

• DIFFUSION
• FILTRATION
• ACTIVE TRANSPORT
• OSMOSIS

Movement of water and electrolytes occurs through membranes and

cell walls:
The permeability of membranes is controlled by the size of the "pores"
or "holes".The size of the pores can be changed in response to
pressure and hormones.
Some membranes selectively allow passage of certain ions or molecules and
exclude all others.
A semi-permeable membrane allows only water through it
 DIFFUSION
• Net flux (amount of movement) is proportional to
the concentration difference and the permeability
of any barrier like a membrane.

• Substances can cross membranes by diffusion if

they can dissolve in the oily interior of the
membrane (hydrophobic)

• Diffusion can occur through tight junctions or

within bulk solutions.

• Diffusion of water down its concentration

gradient is called osmosis.
• Diffusion of water down its
concentration gradient is called
OSMOSIS OSMOSIS
• Semipermeable membrane does not
allow hydrophilic ions to be transported
down the concentration gradient

• OSMOSIS is the net diffusion of water

across the membrane to balance the
osmotic pressure

• ISOTONIC solution has the same

osmotic pressure as plasma
0.9 % solution of NaCl
5.0 % glucose solution

• HYPOTONIC solution has lower total

concentration of osmotically active
solutes

• HYPERTONIC solution has higher total

concentration of solutes
 DIFFUSION OF WATER DOWN ITS
CONCENTRATION GRADIENT - OSMOSIS

SHRINKAGE - CRENATION HEMOLYSIS – CELL BURSTS

 ERYTHROCYTE OSMOTIC RESISTANCE
A 70 kg male has a body fluid
osmolality of 290 mOsm/kg water.

Two solutions are isosmotic when

they have the same number of dissolved
particles, regardless of how much water
would flow across a given membrane
barrier.

In contrast, two solutions are isotonic

when they would cause no water movement
across a membrane barrier, regardless
of how many particles are dissolved.

THE CAPABILITY OF THE RED BLOOD CELLS TO RESIST HYPOTONIC

ENVIRONMENT (see the manual)
MINIMAL OSMOTIC RESISTANCE
MAXIMAL OSMOTIC RESISTANCE
PLASMA - Extracellular liquid part of blood tissue
SERUM = plasma without the clotting factors

Composition:
• Mostly water 90%
• Plasma proteins 7%
• Albumins hold water in the blood by way of osmosis,
• Globulins include immunoglobulins (Ig) --antibodies-- for immunity
• Fibrinogen is a protein needed for blood clotting

• Other solutes:
• Ions such as Na+, Cl-, K+, Ca++, H+, HCO3-, and others,
• Nutrients such as glucose, fatty acids, amino acids,
• Waste products such as lactic acid from anaerobic respiration, urea
from breakdown of amino acids used in cellular respiration yellowish
pigments from breakdown of hemoglobin (from old red blood cells)
• Gases such as CO2 and O2
• Regulatory substances such as hormones, prostaglandins, clotting
factors
BLOOD
Blood density or specific gravity - 1.050 g/ml

COMPOSITION:

PLASMA
BLOOD CORPUSCULES:
• RED BLOOD CELLS – ERYTHROCYTES
• WHITE BLOOD CELLS –LEUKOCYTES
• PLATELLETS – THROMBOCYTES

FUNCTION:

TRANSPORT – NUTRIENTS, WARMTH, GASSES

PROTECTION- BLOOD LOSS, ILLNESS,
 HOMEOSTASIS
STATE OF EQUILIBRIUM OF THE INTERNAL
ENVIRONMENT OF THE BODY THAT IS MAINTAINED
BY DYNAMIC PROCESSES OF FEEDBACK AND
REGULATION = DYNAMIC EQUILIBRIUM
THE CAPABILITY TO MAINTAIN THE STABLEINTERNAL ENVIRONMENT IN SPITE
OF CHANGES IN EXTERNAL ENVIRONMENT

PARAMETERS:
• ISOVOLEMIA – cca 5 liters of blood in circulation
• ISOTHERMIA – 37 degrees of Celsius body core temp.
• ISOHYDRIA – 1
pH = Log --------
H+
• ISOTONIA
• ISOOSMIA
VENOUS BLOOD SAMPLING

• Blood is drawn from a vein, usually from the inside of the elbow – FOSSA
CUBITI or the back of the hand. The site is cleaned with germ-killing
medicine (antiseptic). The trainee wraps an elastic band around the upper
arm to apply pressure to the area and make the vein swell with blood.
• The trainee gently inserts a needle into the vein. The blood collects into a
tube attached to the needle. The elastic band is removed from your arm.
• Once the blood has been collected, the needle is removed, and the
puncture site is covered to stop any bleeding.

CAPILLARY BLOOD SAMPLING

• An automatic sharp tool called a lancet may be used to puncture the skin
and make it bleed. The blood collects into a small glass tube called a
pipette, or onto a slide or test strip. A bandage may be placed over the area
if there is any bleeding.
 ERYTHROCYTE (ERY)
SEDIMENTATION RATE
It is a nonspecific screening test that indirectly measures how much inflammation
is in the body. This test can be used to monitor inflammatory or cancerous diseases.
It is a screening test, which means it cannot be used to diagnose a specific disorder.

Blood is the suspension of erythrocytes

and other blood corpuscles
Blood circulation and normal amount
of ERY help to maintain suspension
stability of the blood
By abnormal states the suspension
stability is decreased and the ERY
settle down according to gravitation
They aggregate without breaking
This is called SEDIMENTTION
 ERYTHROCYTE
SEDIMENTATION RATE
Quick method:
Venous blood is drawn into the test tube treated
with anticlotting substance (Ca citrate)
0,4 ml of Ca Citrate
1.6 ml of venous blood
empty the syringe to the small vessel
Slope the measuring device
Wait for 7 minutes and read the mm of settled ERY
Slope down again and read the mm of settled ERY

NORMAL ESR VALUES (Westergren Method)

Male up to 15 mm/hr (>15 is elevated) fasting = 3-7 mm/1 hour
Female up to 20 mm/hr (>20 is elevated) fasting = 7-12 mm/1hour
Child up to 10 mm/hr (>10 is elevated)
Seniors up to 30 mm/hr (>30mm/hr is elevated)
Newborn: 0 to 2 mm/hr
Neonatal to puberty: 3 to 13 mm/hr
 ERYTHROCYTE
SEDIMENTATION RATE
An increased ESR rate may be due to: SEX DIFFERENCES IN ESR
Anemia
Kidney diseases
Inflammatory diseases, such as
rheumatoid arthritis
Pregnancy
Infection and high levels of Ig
Blood cancers, such as leukemia and
lymphoma
Cancers that have spread (metastasized)

Lower-than-normal levels occur with:

Congestive heart failure
Hyperviscosity
Hypofibrinogenemia (decreased fibrinogen levels)
Low plasma protein (due to liver or kidney disease)
Polycythemia
HEMATOCRIT
PACKED CORPUSCLE VOLUME - PCV

CAPILLARY BLOOD IS TAKEN FROM

THE 4TH FINGERTIP OF THE
NONWRITING HAND AFTER
DESINFECTION
THE CAPILAY IS ATTACHED TO THE
BLOOD DROP
THE FREE SIDE IS SEALED BY THE
FIRE
THEN PLACED INTO THE CENTRIFUGE

3 MINUTES
14000 RATES PER MINUTE
HEMATOCRIT
PLACE THE CENTRIFUGED SAMPLE TO THE
STAND AND COUNT THE PERCENTAGE OF
PACKED RBC IN RELATION TO THE WHOLE BLOOD

NORMAL HEMATOCRIT VALUES

Male: 47±5%
Female: 42±5%

Child: variable by age (newborns = 49-54%)

Seniors: values may be significantly decreased
 HEMATOCRIT
Decreased hematocrit indicates:
Anemia (shortage of red blood cells)
vitamin or mineral deficiencies, recent bleeding, cirrhosis of the liver,
and malignancies.
Pregnancy usually causes slightly decreased hematocrit (extra fluid in the blood)

Increased hematocrit indicates:

Dehydration (with adequate fluid intake, the hematocrit returns to normal)
Polycythemia vera (excess of red blood cells)
(usually the cause sis the compensation for inadequate lung function)
Living at high altitudes (body’s response to the decreased oxygen
available at these heights)

This test is used to evaluate also:

response to treatment of anemia or polycythemias,
blood transfusion decisions for severe symptomatic anemias, and
the effectiveness of those transfusions.
 HEMATOCRIT

Write your own hematocrit value to the protocols