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By Dr. Mudassar Ali Roomi (MBBS, M. Phil)

Assistant Professor Physiology

Physiology of Blood
Definition: Blood is a specialized connective tissue in which there is a liquid intercellular substance known as plasma and formed elements. It circulates in a closed system of blood vessels and chambers of heart by pumping of heart. Formed elements:
Red blood cells-Erythrocytes White blood cells-Leucocytes Platelets- Thrombocytes

Functions of Blood
1- Transport function:
A-Respiratory function: Haemoglobin the respiratory pigment present in the Red Blood Cells (RBCS) .It increases oxygen carrying capacity of blood.O2 & CO2. B-Nutritive function: glucose, amino acids, fatty acids, vitamins, minerals & water. C- Excretory function: Urea, uric acid, creatinine through kidney. Bile pigments through liver. CO2 through lungs. D:Distribution function: Hormones & hormone binding proteins towards target tissues & organs. E: Temperature regulation: Heat produced in active tissues in the body core is brought to the skin and lungs. It is regulated by the amount of blood flow to these areas. The water in plasma has
i) High specific heat-can absorb large amount of heat. ii) High thermal conductivity-distribute heat. iii) High heat of evaporation-heat loss.

Temperature regulation

2- Regulatory function:
a) Maintenance of ionic balance and internal environments b/w cells &ICF b) Maintenance of water balance b/w interstitial, intracellular and vascular compartments. c) Maintenance of acid base equilibrium. hemoglobin , plasma proteins are buffers. Bicarbonate buffer system. d) Regulation of blood volume- Haemostasis (homeostasis). Excessive blood loss is prevented by clotting of blood (clot formation) by clotting factors and platelets.

3- Defensive function:
Neutrophils and monocytes: Phagocytosis of dead tissues invading micro-organisms. T lymphocytes: Cellular immunity B lymphocytes & plasma cells: Humoral immunity (antibodies). Eosinophils: Phagocytosis of allergic complex

4-Functions due to plasma proteins:

Proteins exert osmotic pressure (28 mmHg) and contribute to dynamic distribution of water b/w blood, lymph and intracellular fluids. Transport function Nutritive function Buffer function Precursor of active substances Hormones Blood clotting factors Immunity antibodies

Composition of blood
Plasma---52-55% Formed elements (hematocrit)---45-48% pH 7.35-7.45, Plasma
Liquid 90-92% Solids 8-10%

Inorganic constituents in plasma:

138--- 142 mEq/L Na+ 4.5---5.5 mEq/L K+ 4.2---4.5 mEq/L Ca++ 1.2---1.5 mEq/L Mg++ 103 mEq/L Cl25-27 mEq/L HCO3Phosphate 1-4 mEq/L 1 mEq/L SO4

Organic constituents of plasma

A-Plasma proteins: 6.5-7.5 gm/dl
Albumin 4.5gm/dl Globulin 2.5gm/dl Fibrinogen 100---300mg/dl Prothrombin 10---20mg/dl Urea 15-40mg/dl, Uric acid 4-8mg/dl, Creatinine 0.2---1.2mg/dl, Amino acids 40mg/dl Xanthine, hypoxanthine

B-Non-protein nitrogenous substances: 28-48mg/dl

Organic constituents of plasma

C-Nutritive substances in plasma:
Glucose 100mg/dl lipids 450---500mg/dl
Fatty acids 200-400mg/dl Cholestrol 150-250mg/dl Triglycerides 100-150mg/dl Very Low Density Lipoprotien (VLDL) Low Density Lipoprotien (LDL) High Density Lipoprotien (HDL)

D-Coloured substances
Bilirubin 0.3---1mg/dl Carotene

E-Other substances
Hormones, enzymes, vitamins,minerals, Metabolites (Lactic acid, Ketone bodies)

Plasma proteins
60% 0f total Plasma Proteins 4.55.7gm/dl Mol.wt 69000 Water soluble Heat co-aguable Precipitated by fully saturated solution of (NH4)2SO4. MCQ Produced by liver cells. MCQ Responsible for 2/3rd plasma colloidal osmotic pressure (oncotic pressure). MCQ

30% 0f total Plasma Proteins 1.52.5gm/dl Mol. Wt.= 80,000---200,000 Types 1, 2 , , Insoluble in water but soluble in dilute salt solution It is precipitated with half saturation of (NH4)2SO4 Mainly transport function and immunity Mostly produced by liver, but noy -globulins

electrophoretic separates the types of globulins:

1----carries thyroxine 2----- carries copper (Ceruloplasmin), erythropoietin, prothrombin ---lipoprteins carry lipid, steroids, cholestrol. --- produced by lymphocytes and plasma cells. Provides Immunity. Called immunoglobulins include IgG (75%), IgA, IgM, IgE, IgD. Also include blood group antibodies.

Fibrinogen (Clotting factor I)

5% of total plasma proteins. 300mg/dl Mol. Wt.= 330, 000 Produced by the liver It is changed to Fibrin during blood coagulation process. Difference between plasma and serum?

Prothrombin (Clotting factor II)

Serum = Plasma-(fibrinogen+ other clotting factors). 20mg/dl Mol. Wt.= 68, 700 Produced by liver in presence of Vitamin K. its level in blood decreases in liver disease. In its deficiency prothrombin time is increased. It is changed to thrombin in coagulation.

Functions of plasma proteins

1-Proteins exert osmotic pressure and contribute to dynamic distribution of water b/w blood and interstitial fluids. With protein conc. 7.5 gm/dl albumin exerts 70% (2/3rd) of total osmotic pressure. MCQ Regulate filtrationabsorption of fluid across the capillary membrane.

2-Proteins perform transport functions: Albumin----carries bilirubin, calcium, fatty acids, steroids and drugs etc. *** 1-globulin---- carries thyroxin, polysaccharides (glyco proteins) 2-globulin----- carries copper (Ceruloplasmin), erythropoietin, prothrombin -globulins:
Lipoproteins carry lipid, steroids and cholestrol. Transferrin carries iron (Fe). MCQ

3-Proteins perform hemostatic functions:

Prothrombin (factor II), fibrinogen, blood clotting factors V, VII, VIII, IX, X, XI, XII and XIII are proteins which take part in clotting of blood. Factors II, VII, IX , X are vitamin K dependent factors which are synthesized in liver. MCQ

4-Proteins perform nutritive functions: are in a state of dynamic equilibrium with cellular proteins. Undergo constant breakdown to supply raw material to body tissues & constantly being replenished by synthesis of new plasma proteins.

5-Proteins perform immune functions:

Immunoglobulins ( globulins) provide resistance against infections (antigen antibody reactions). Chemically these are glycoproteins of mol. Wt= 150, 000 -1000,000.

6-plasma Proteins perform buffer functions:

At body pH 7.4 act as anions and accept H+ ions. 1/6th of total buffering capacity of blood is due to plasma proteins.

7-Plasma Proteins are precursors of active substances: e.g.

Kininogens---- Kinins Angiotensinogen--- Angiotensin Erythropoietinogen---Erythrpoieotin

8-Plasma Proteins resposible for viscosity of plasma and blood pressure:

normal viscosity of blood is 1.05-1.06

9-Plasma Proteins include proteins of inflammation: Gamma globulins Complement system Acute phase proteins
C reactive proteins (CRP) Fibrinogen Haptoglobins

10-Plasma Proteins include various enzymes e.g.

amylase, transaminase, dehydrogenase, lipase, phosphatase. These enzymes have diagnostic value e.g. Lactate dehydrogenase (LDH) increases in heart attack/myocardial infarction (MI).