BLOOD

8% body weight, 5-6 l, transporting medium

functions: 1. Respiratory

2. Nutritional

3. Excretoric

4. Homeostatic a) water, ions, pH

b) temperature - specific heat, conductivity, latent heat

5. Chemical control

6. Immunity

Formed elements + plasma

hematocrit

stability of suspension electrostatic forces

proteiny bridges

viskosity

Fluid x lossesBLOOD – PLASMA – SERUM

PLASMA

Water

Proteins – onkotic pressure, pH, hemostasis, immunity, transport, AMA pool elektroforesis albumin, globulins, fibrinogen, clotting faktors, lipopro- teins, haptoglobins, transferrin

Organic substancies – nutriens, vitamins, cholesterol, waste products, hormons

Electrolyts – Na, K, Cl, HCO3, PO4, Ca

Gases – O2, CO2, N2

ELEMENTS

erythrocytes, leukocytes, trombocytes

stem cells (resting, proliferating) progenitor colony

increase in number of stem cells entering, shortening of the cycle, combination

ERYTHROCYTES – lack of nuclei, ribosomes, mitochondria, 95% of dry weight Hb, shape, antigens

Erythropoesis - multipotent (pluripotent, totipotent) stem cells

unipotent (progenitor)

EPO HIF EPO apoptosis of progenitors Ery line

proerytroblast

basophilic erytroblast (normoblast) Hb synthesis

polychromatic erythroblast DNA synthesis restricted

ortochromatic erytroblast (NORMOBLAST) Nuclei

retikulocyte

erythrocyte

Ery formation

liver kidneys

HIFEPO

bone marrow

Ery

Hb concentration

plasma volume

Ox Red Hb lungs

O2

CO2

afinity of Hb O2

2,3 DPG

renal aa.

hormonsLosses

Hb – 135 –170 g/l

A, F, dissociation curve

Metabolism Ery - shape, deformability

- ion pumps

- hem in ferroform

- ROS scavanging

no mitochondriae glycolysis carboanhydrase

G G-6P NAD GSH H2O + CO2 H+ + HCO3-

F-6P NADH GSSG

F –1,6 P

NAD G – 3P

NADH 1,3 DPG difosfogycerate mutasea

2,3 DPG

3 PG difosfoglycerate fosfatase

Ery destruction

aging membráne rigidity sferocyte

CO2

Fe

transferrin bilirubin

AMA

RESHb

bilirubinglukuronid

urobilin

sterkobilin

ANEMIE

hypoplastic, aplastic microcytic hypochromic

sideropennic normocytic normochromic

thalasemia makrocytic hyperchromic

pernicious

infiltration of bone marrow

drugs

hemorrhagic hemolytic

acute bleeding intracorpuscular (hereditary,

chronic spherocytosis, sicle cell)

extracorpuscular (hypersplenism)

POLYGLOBULIA

LEUKOCYTES - 7 x 109/l

%

neutrophils 50 – 70 O2 O 2- H2O2 OH

eozinophilsí 1 – 4 granulocytes

basophils < 1

monocytes 2 – 8

chemotaxis, secretion, adhesion, diapedesis, fagocytosis, ROS (NADPH oxidase, myeloperoxidase), proteases

lymfocytes 20 – 40

T - helper/inducer - memory cells

- supressors

- cytotoxic - K

- N K

B - plasmatic - memory cells

NADPH NADP

TROMBOCYTES 250 x 109/l 2 – 4 u

microtubuli, receptors for collagen, actin + myosin, granules (ADP, serotin),

α granules (PDGF, PAF)

HEMOSTASIS: 1) vessels – vasoconstriction (wall, serotonin, tromboxan A2)

2) platelets - adhesion (receptors, von Willebrandův f.)

- change of the shape

- aggregation

ADP plug

granules TXA2

vasokonstriction

3) clotting

HMWK, LMWK kinins

inflammation

complement

extrinsic - thromboplastin intrinsic – XII, kallikrein

tkáňový aktivátor

prothrombin thrombin plasmin plasminogen

streptokinase

fibrinogen fibrin stabilized fibrin

fibrin degradation products

Alterations of hemostasis, disseminated intravascular coagulation, consumption coagulopathy