Darah
Plasma
 Bagian cair dari darah
 mengandung:







Water
Proteins
Hormones
Nutrients
Electrolytes
Respiratory Gases
Wastes
Plasma Protein
Mengandung:
 Albumin (60%)
 Globulin (36%)
(Antibodi & protein
transport)
 Clotting Proteins Plasma
(4%)
 Enzyme &
Hormon
Hematocrit
 Persen dari
formed elements
 Normal Hematocrit berkisar 45%,
tergantung gender
Hematocrit
Formed Elements –
(komponen sel darah)
 Erythrocytes
(RBCs)
 Platelets
 Leucocytes
(WBCs)
250,000500,000/mm3
4 - 6 million/mm3
Granulocyte - Neutrophil
 Nucleus3 sampai 6 lobus
 Cytoplasmic granules fine, both basic &
acidic
 Memfagositosis bakteria & beberapa fungi
 Diproduksi oleh sumsum tulang oleh
myeloblast
Granulocyte - Eosinophil
 Nucleus bilobed (2 lobus)
 Cytoplasmic granules kasar & acidic
(red/orange)
 Membunuh parasit cacing & immune complexes
 Produced in bone marrow by myeloblasts
Granulocyte - Basophil
 Nucleus berlobus- berbentuk huruf U or S Cytoplasmic
granules besar -(purplish/black)
 Menyebabkan vasodilatasi dgn melepaskan
histamindiproduksi oleh sumsum tulang dgn
myeloblast
Agranulocyte - Lymphocyte
 Nucleus spherical-fills half or more of cell
 No visible granules in cytoplasm
 B lymphocytes - Humoral Immunity (antibodies)
 T lymphocytes - Cellular Immunity
 Produced in lymphatic tissues
Agranulocyte - Monocyte
 Nucleus U or kidney shaped -fills half or
more of cell
 No visible cytoplasmic granules
 Differentiate into macrophages in tissues.
 Provide defense against viruses &
intracellular bacteria in chronic infections.
 Activate lymphocytes
 Produced by monoblasts in lymphatic
 Platelet factors - React with Calcium
(Ca2+) & other clotting factors in the
plasma to initiate clot formation.
• Thromboplastin - a lipid (Tissue Factor) released from injured cell
membranes which accelerates the clotting process.
• Lipids released from damaged cell membranes such as
thromboplastin having a localized effect are called Prostaglandins.
 Platelet factors - React with Calcium
(Ca2+) & other clotting factors in the
plasma to initiate clot formation.
• Thromboplastin - a lipid (Tissue Factor) released from injured cell
membranes which accelerates the clotting process.
• Lipids released from damaged cell membranes such as
thromboplastin having a localized effect are called Prostaglandins.
 Platelet factors, Ca2+ & other clotting factors
in plasma initiate clot formation
• A plasma protein (Prothrombin) is converted by
prothrombin activator into an enzyme Thrombin.
 Thrombin converts the plasma protein
Fibrinogen into the insoluble protein
Fibrin.
 Fibrin forms a mesh which glues the platelets
& RBCs together to form the clot.
Factors Affecting Clot
Formation
 Vitamin K - Required by liver to
produce prothrombin & several other
clotting factors.
 Calcium - Necessary for prothrombin
conversion into thrombin &
fibrinogen conversion into fibrin.
 Thromboplastin - Speeds up clot
formation from 3 - 6 minutes to 15
seconds.
Factors Affecting Clot
Formation
 Heparin - A natural anticoagulant
which prevents clot formation by
inhibiting thrombin formation.
 Sodium Citrate - An agent used on
glassware & instruments to prevent
coagulation by tying up Calcium.
 Plasmin (Fibrinolysin) - Breaks down
clots by dissolving the fibrin after the
clot is no longer needed.
Anemia - reduced O2
carrying capacity of the
blood
 Insufficient number of RBCs:
Hemorrhagic - due to blood loss associated with an injury,
undiagnosed bleeding ulcer, etc.
Hemolytic - due to blood loss due to transfusion reactions &
certain bacterial and parasite infections.
Aplastic - due to destruction or inhibition of red marrow by
drugs, ionizing radiation or certain bacterial toxins.
Anemia - reduced O2
carrying capacity of the
blood
 Insufficient hemoglobin content in
RBCs:
Iron Deficiency - inadequate intake or absorption of iron.
Pernicious - dietary deficiency of Vitamin B12 or inadequate
production of intrinsic factor for absorption of Vitamin B12.
Anemia - reduced O2
carrying capacity of the
blood
 Abnormal hemoglobin in RBCs:
Sickle Cell - one amino acid in the 287 forming the beta
chains is wrong.
In low O2 conditions the beta chains form stiff rods which
cause RBCs to sickle blocking small vessels.
Other Blood Related
Disturbances
 Polycythemia - abnormally high
number of RBCs (8 - 11 million/mm3).
Increases blood viscosity & blood
pressure.
 Cause - most often the result of bone
marrow cancer.
 Lecuopenia - abnormally low number
of WBCs (less than 5,000/mm3).
 Cause - drugs, steroids & anti-cancer
agents.
Other Blood Related
Disturbances
 Leukemia - abnormally high numbers
of immature WBCs that are mitotic &
unspecialized.
 Named according to abnormal WBC
type involved
 Myelocytic - derived from myeloblasts
(chronic)
 Lymphocytic - involves lymphocytes
(acute)
Intrinsic Cardiac Conduction
System
Approximately 1% of cardiac muscle cells are
autorhythmic rather than contractile
75/min
40-60/min
30/min
Intrinsic Conduction System
Function: initiate & distribute impulses so
heart depolarizes & contracts in orderly
manner from atria to ventricles.
SA node
AV node
Bundle of His
Bundle Branches
Purkinje fibers