Blood and its
protective functions
Conception of blood system
Blood system is blood, which consists of
1) blood, which is moving through the vessels,
2) blood forming organs,
3) blood destroying organs,
4) storage of blood,
5) apparatus for regulation
Blood functions
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1) respiratory (carries oxygen, carbon dioxide),
2) transport of nutririve elements, products of
metabolism, hormones and waste materials,
3) thermoregulation,
4) maintaining the acid-base balance of the tissues,
5) supporting of oncotic and osmotic pressure,
6) help to form a clot,
7) plays an important part in protecting the body from
bacteria and other organism that can cause disease or
other abnormal conditions.
Blood volume, notion of blood reserve
The amount of blood in the body has been
measured in various ways. Naturally the
volume of blood can be expected to vary with
the size of the body. It has been estimated at
1/20 to 1/13 of the body weight or 6-8 %. The
blood depo (storage) are liver – 30 %;
subcutaneus tissue – 20 %; spleen – 1,5-2,5 %
Composition of blood
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The liquid portion of circulating blood is
called the plasma. The red cells, white cells,
and blood platelets float in this liquid
medium.
Plasma: water - 92 %, solids - 8 %;
inorganic chemicals: sodium, calcium,
potassium, magnesium, chloride, bicarbonate,
phosphate, sulfate; organic chemicals:
proteins: serum albumin, serum globulin,
fibrinogen;
nonprotein
nitrogenous
substances: urea, uric acid, creatine,
creatinine, ammonium salts, amino acids;
nonnitrogenous substances: glucose, fats,
cholesterol, hormones, gases: oxygen, carbon
dioxide, nitrogen.
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Functional meaning of plasma protein
The blood plasma include serum albumin, serum globulin,
and fibrinogen.
Food proteins are absorbed as amino acids and transported to the
tissues as such. Fibrinogen is formed in the liver, and most other
plasma proteins are thought to be formed there also.
Serum globulin is concerned with antibody formation – the
reaction of the blood to toxins formed by bacteria or to foreign
proteins introduced into the blood.
Fibrinogen is essential to the clotting mechanism.
Quantity of erythrocytes
In men – 4,0-5,1•1012/L; in women – 3,7-4,7•1012/L. The quantity
of erythrocytes may be increase – in pregnancy, in physical
training, mental work, in newborn or decrease; and decrease –
only in pathology.
Functions of erythrocytes
The primary function of the erythrocytes is to carry oxygen to
the tissue.
Development of erythrocytes
Common progenitor cell – uncommited stem cell – commited
stem cell – erythroblast – pronormoblast – early (basophilic)
normoblast – intermidiate (polychromatorhylic) normoblast –
late (eosinophilic) normoblast – reticulocyte – erythrocyte.
Regulation of erythropoiesis
Coused by erythropoietins, which produced in kidneys and
macrophagal system. Thyroid, epinephrine and male sex
hormons increase quantity of erythrocytes and female sex
hormones decrease its.
Hemoglobin
Erythrocytes derive their colour from a complex protein
called hemoglobin. This substance is composed of a pigment,
heme, containing iron, and the protein glohin. Hemoglobin
has the power to attract oxygen molecules and to hold them
in a loose chemical combination known as oxyhemoglobin. It
is said, therefore, to have a chemical affinity for oxygen.
Myoglobin
Hem is also part of the structure of myoglobin, an oxygenbinding pigment found in red (slow) muscles and in the
respiratory enzyme cytochrome c. Porphyrins other than that
found in hem play a role in the pathogenesis of a number of
metabolic diseases (congenital and acquired porphyria, etc.)
It may be the reserve pigments, which give the tissue oxygen
in a small oxygen condition.
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Quantity and chemical structure of hemoglobin
In man – 130-160 g/L; in woman – 120-140 g/L. It
consists of four folded polypeptide chains of amino
acid units. The four chains form the globin, or
protein, part of the molecule. In addition there are
four atoms of iron, each associated with a pigment, or
heme, group of atoms. The heme group provides the
red colour of the blood and also its oxygencombining ability. The iron atoms are bivalent or in
the ferrous state. There are 2 pairs of polypeptides in
each hemoglobin molecule, 2 of the subunits
containing one type of polypeptide and 2 containing
another. In normal adult human hemoglobin (HbA),
the 2 types of polypeptide are called the a, and the 
chains.
Methods of definitition
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gasometric – definition of gases, such as O2,
colorimetric – definition of colour substances,
ironmetric – definition of iron concentration.
Function of leukocytes
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1. Protective
2. Transport
3. Metabolic
4. Regenerator
Lymphocytes
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Physiological role of Tlymphocytes (There are
receptors to antigens on the
membrane of T-lymphocytes,
which helps to distinguish
genetic heterologous
substances.)
Functional significance of Blymphocytes (B-lymphocytes
syntheses the immunoglobulins
such as IgM, IgN, IgA, IgG, IgB,
IgE.)
Neutrophils
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The neutrophils seek out, ingest, and kill
bacteria and have been called the body‘s first
line of defense against bacterial infections. The
average half-life of a neutrophil in the
circulation is 6 hours. Many of the neutrophils
enter the tissues; they first adhere to the
endothelium and then insinuate themselves
through the walls of the capillaries between
endothelial cells by a process called diapedesis.
Many of those that leave the circulation enter
the gastrointestinal tract and are lost from the
body. When bacteria invade the body, the bone
marrow is stimulated to produce and release
large numbers of neutrophils. Phagocytosis
refers to the ability of neutrophils to ingest
bacteria or other foreign bodies. They contain
protein-digesting enzymes.
Eosinophils
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These cells make up only 0,5 to 5 percent of the total number
of white cells in the blood, but in the tissues they can
congregate in considerable numbers. There is a rise in the
number of eosinophils in some cases of allergy, possibly in
response to toxic substances released by the allergic reaction.
The eosinophils attack some parasites, and they inactivate
mediators released from mast cells during allergic reactions.
EOSINOPHILS
Basophils
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Basophils constitute only 0,5 percent of the white
cells of the blood. Basophils in the blood are said to
contain histamine and a heparinlike substance.
Histamine dilates capillaries and often permits fluid
to move through the capillary wall into the tissues:
heparin is an anticoaguiant of the blood. Apparently
tissue basophils become the mast cells of the tissues.
The large granules of mast cells are thought to store
enzymes. The basophils contain histamine and
heparin, but their role in the maintenance of normal
balance between the clotting and anticlotting systems
is uncertain.
Basophil
System of mononucleares phagocytes
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These is the system, which connect the cells with one nucleus, it has
common origin from red bone marrow, common function of high specific
phagocytosis.
It origines from promonocytes of red bone marrow. Tissue monocytes
named macrophage. There are many macrophages in different organs. The
macrophage of lungs named alveolar macrophages of lungs, the
macrophage of spleen named free or fixed macrophages of spleen, the
macrophage of liver named Kupffer cells, the macrophage of skin named
Langergans cells, the macrophage of brain named microglia etc.
It has the function of high specific phagocytosis.
The monocytes are actively phagocytic and contain peroxidase and
lysosomal enzymes. The macrophages migrate in response to chemotactic
stimuli and engulf and kill bacteria by processes that are generally similar
to those occurring in neutrophils. They also play a key role in cellular
immunity because proliferation of T-lymphocytes requires that they come
in physical contact with macrophages that have taken up and processed
antigen.
Monocyte
Quantity of leukocytes and their
changes
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White cells are nucleated and somewhat variable in
size and shape. Their numbering is 4-9•Giga per
liter. The number of lymphocytes are – 18-37 %,
monocytes – 3-11 %,
eosinophils –0,5-5 %,
basophils – 0-1 %,
juvenile neutrophile – 0-1 %,
relating to stab (rod-shaped) neutrophil – 1-6 %,
segmented neutrophil – 47-72 %.
The number of leukocytes may increase or
decrease.
Physiological role of T-lymphocytes
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1. Immune memory.
2. Anti viruses immunity.
3. Anti tissue immunity.
4. Regulate phagocytosis.
 Function of В-lymphocytes
1. Immune memory.
2. Specific immunity. B-lymphocytes syntheses the
immunoglobulins such as IgM, IgN, IgA, IgG, IgB,
IgE.
System of mononucleares
phagocytes
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These is the system, which common the cells
with one nucleus,
common origin from red bone marrow,
common function of high specific
phagocytosis
The index of nuclear’s changing of
neutrophyls, it interpretation
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NCN=(M+J+S1)/S2, where
M – myelocytes,
J– juvenile,
S1 – stab neutrophils,
S2 – segmented neutrophils
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Norm is 0,06-0,09
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Hemostasis system
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Hemostasis is the physiologic system, which
support the blood in the fluid condition and
prevent bloodless.
Hemostasis system vital necessary and
functionally connect with the cardiovascular,
digestive, breathing, endocrine and other
systems.
The components of hemostasis
system
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The components of hemostasis are
- wall of the vessels,
- blood cells – platelets, erythrocytes, leukocytes,
- enzymes and nonenzymes components of plasma –
clotting and anticlotting substances, fibrinolytic
components.
There are 2 kinds of hemostasis: vessel-platelets
(primary) and coagulative (secondary).
Platelets
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Properties and function of platelets
Quantity of platelets is 180-320 G/L.
Diameter of platelets is 1-4 micrometers, thickness – 0,5-0,75
micrometers.
They are the little peace of megakaryocytes cytoplasm (from
one megacariocytes may develop few hundred of platelets).
Platelets circulates in blood from 5 to 11 days and than
destroyed in liver, lungs, spleen by the cells of macrophages
system. Formation is regulated by thrombopoietin.
Their granules contain serotonin, Ca2+, enzymes, ADP, and
platelet-derived growth factor (PDGF)
Platelets function in the clotting mechanism by forming a
temporary plug that helps seal breaks in blood vessels
Platelets not involved in clotting are kept inactive by Nitric
Oxide (NO) and prostaglandins.
Platelets
Activated platelets
Function of platelets are:
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1. haemostatic function – platelets produce substances, which
are secure the hemostasis.
2. Angiotrophic function – provide trophy of endotheliocytes
of vessel wall, support structure and functions of micro
vessels. These function is realize by adhesion of platelets to
endotheliocytes and injection the enzymes into the
endotheliocytes. For one day near 35 G/l of platelets do this
function.
3. Transport function – transfer the enzymes, ADP, serotonin
and other.
4. Phagocytes function – the contain of platelets help to kill
viruses and antigens bodies.
5. Regeneratory function – platelets have the growth factor,
which help to grow the endothelial and muscles cells which
are present in the vessel wall.
Stages of vessel-platelets hemostasis
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1. Shorting spasm of the vessels – vascular spasm duration to 1
minute is caused by catecholamines and other enzymes.
Diameter of vessels decrease on ½-⅓. Mechanism of it
development determine by secretion of serotonin and
thromboxan A2 from platelets and epinephrine from ending of
sympathetic nerves.
2. Adhesion of platelets – activation of platelets and stick it to
the place of defect in vessel wall.
3. Reverse aggregation of platelets – the thrombus which are
formed may make way for plasma.
4. Unreverse aggregation of platelets – the thrombus which are
formed can not may make way for plasma.
5. Retraction of platelets plug – decrease the size of plug, pack
down the plug.
Primary haemostasis
Investigation of vessel-platelets hemostasis
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1. Calculation of the platelets quantity 180-320
G/l.
2. Determination of duration of capillary
bleeding after Duke’s method – to 3 minute in
norm.
3. Sample of fragility of capillary – to 10
petechias in norm in a round with diameter 5
centimeters.
Coagulative (secondary) hemostasis.
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Characteristics of clotting factors
There are 12 clotting factors:
I – fibrinogen;
II – prothrombine;
III – thromboplastin of tissue;
IV – ions of calcium;
V – proaccelerin;
VII – proconvertin;
VIII – antihemophylic factor A;
IX – Christmas factor or antihemofilic factor B;
X – Stuart-Prower factor or prothrombinase;
XI – plasma thromboplastin antecedent;
XII – Hageman factor;
XIII – fibrin stabilizing factor.
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Some of them are enzymes – II, VII, IX, X, XI,
XII,XIII; other are not – I, III, IV, V, VIII. The
vitamin K is necessary for the functional
activity of II, VII, IX, X factors.
Vitamin K (produced by bacteria in the colon)
stimulates the production of prothrombin by
the liver.
Blood clot
Regulation of the clotting mechanisms
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Increase of clotting names hypercoagulation, decrease
– hypocoagulation. Hypercoagulation may be in a
stress cases. It depends on epinephrine, which
concentration increased in the cases of stress.
Epinephrine increase from the vessels walls factors
from which produced prothrombinase. In cases of big
concentration epinephrine should activate XII factor
in a bloodstream. It divides fats and fat acids, which
have
prothrombinase
activity.
After
the
hypercoagulation stage may be secondary
hypocoagulation.
Coagulogram
-Time of clotting by Ly-Wait – 5-10 minutes;
- Time of plasma recalcification – 60-120 seconds;
- Thrombotest – IV, V, VI degree;
- Thromboplastin time – 12-15 seconds;
- Thromboplastin index – 80-105 %;
- Concentration of fibrinogen – 2-4 g/L;
- Tolerance of plasma to heparin – 6-11 minutes;
- Heparin time – 50-60 seconds;
- Fibrinolysis – 15-20 %.
Anticoagulative mechanisms. Fibrinolysis.
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The primary anticoagulants are
antithrombin III (the most important anticoagulant in
the blood);
heparin (originally found in the liver, by large
basophilic cells in tissues of various organs. Heparin
reduces the ability of the blood to clot by blocking the
change of prothrombin to thrombin. It can also be
used to aid in reducing clots in cases in which internal
clotting has already occurred. Heparin form complex
with antithrombin-III. Activate nonenzyme
fibrinolysis.);
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alpha-2-macroglobulin (Alpha-2-macroglobulin is a
similar to antithrombin-heparin cofactor in that it
combines with the proteolytic coagulation factors. Its
activity is not accelerated by heparin. Its function is
mainly to act as a binding agent for the coagulation
factors and prevent their proteolytic action until they
can be destroyed in various ways. It a faint inhibitor
of thrombin, connect with plasmin),
alpha-1-antitripsin (Alpha-1-antitripsin inhibits
thrombin activity, IXa, XIa, XIIa factors, plasmin and
kallilrein),
protein C (Protein C inhibits VIIIa, Va factors. It
activity depend of thrombin and vitamin K
concentration).
Functionation of secondary anticlotting
substances
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Primary anticoagulants are produce and
present all time in plasma and secondary
anticoagulants form in a case of blood clotting.
They are antithrombin-I or fibrin and products
of fibrinolysis or products of fibrinogen
degradation. Fibrin is sorbs and inactivates
thrombin and Xa factor. Products of
fibrinolysis inactivate ending stage of clotting,
IXa factor, platelets' aggregation.
Fibrinolysis
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Clot dissolved by activity of plasmin, an enzyme
which hydrolyzes fibrin
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