A slide for 200L students on the general properties, functions and components of the blood.

1. COURSE OBJECTIVES
BODY FLUIDS
I.To be able to describe total body water (TBW)
and its relationship with age, sex and Fat.
II.Name different Body fluid compartment, Osmotic
composition of each compartments, principles of
water movement between body compartments.
III.Water Balance and regulation of body Water.
1

2. BLOOD
• General Properties of Blood and its functions.
• Erythropoiesis and function of red blood cells
• Leucopoiesis and function of white blood cells
• Blood groups
• Hemostasis.
2

3. • The maintenance of a relatively constant
volume and a stable composition of the
body fluids is essential for homeostasis
• Water and its dissolved constituents make
up the bulk of your body, and determine
the nature of nearly every physiological
process.
3

4. • In most individuals, approximately 60% of
the total weight is water. This percentage
varies between 50% and 70%, with the
exact value primarily dependent on a
person's fat content.
• Since fat has very low water, individuals
with more fat will have a lower overall
percentage of body weight as water.
4

5. Body water is divided into that located inside cells and
that located outside cells.
• Intracellular fluid (ICF). Approximately 40% of body weight.
This is approximately 28 L in a 70 Kg man.
• Extracellular fluid (ECF). Approximately 20% of body
weight.
The two principal extracellular fluid compartments are plasma
and the interstitial space (the space between the cells that
makes up organs).
In addition, there is extracellular water located in bone and
dense connective tissue, and transcellular water in
secretions such as digestive secretions, intraocular fluid,
cerebrospinal fluid, sweat, and synovial fluid.
5

6. 40% x 70 kg = 28 L water ISF, 10 L
P
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The 60-40-20 Rule:
60 % of body weight is water
40% of body weight is intracellular
fluids
20% of body weight is extracellular
fluid
Intracellular Water =40% Extracellular=20%
Total Body Water = 60% of weight
6

7. • TBW as percentage in relation to sex an
age
AGE MALE FEMALE
• Newborn 80% 75%
• 1-9 75 65
• 10-16 60 60
• 17-39 60 50
• 40-59 55 47
• 60 above 50 45
7

8. Electrolyte
Plasma, (mEq/L)
[molarity]
Plasma Water
(mEq/L) [molality]
Interstitial
Fluid (mEq/L)
Intracellular Fluid
(mEq/L)
Cations:
Sodium 142 153 145 10
Potassium 4 4.3 4 160
Calcium 5 5.4 5 2
Magnesium 2 2.2 2 26
Total Cations: 153 165 156 198
Anions:
Chloride 101 108.5 114 3
Bicarbonate 27 29 31 10
Phosphate 2 2.2 2 100
Sulphate 1 1 1 20
Organic Acid 6 6.5 7
Protein 16 17 1 65
Total Anions: 153 165 156 198
8

9. MEASUREMENT OF BODY
FLUID COMPARTMENTS
• Volumes of various body fluid compartment cannot be
measured directly but estimated
DILUTIONS method.
• These methods utilizes marker indicator substances that
distribute in a specific body fluid compartment, making
allowance for marker loss during period of distribution
(e.g. in urine).
• If X is the marker
Volume of compartment = (Mass of X administered -
Mass of X lost) / Conc. of X in the compartment.
9

10. • Which is based on the principle of
conservation of mass. This means that the
total mass of a substance after dispersion
in the fluid compartment will be the same
as the total mass injected into the
compartment
10

11. • Small amount of dye or other substance
contained in the syringe is injected into a
chamber, and the substance is allowed to
disperse throughout the chamber until it
becomes mixed in equal concentrations in
all areas.
• If none of the substance leaks out of the
compartment, the total mass of substance
in the compartment (Volume B
Concentration B) will equal the total mass
of the substance injected (Volume A
Concentration A). 11

12. PROPERTIES OF MARKERS
• Must be non-toxic.
• Must be measurable.
• Must have no effect on the distribution of
water or other substances in the body.
• Must be unchanged in the b0dy.
• Must be confined to the space being
measured.
• Must not be metabolized in the body.
12

13. • MARKER substances ‘used to measure the B.F. compartments:
• TB"': Deuterium oxide (D20), Tritium oxide. intravenously diffuse
rapidly and evenly through the entire body water including the trans-
cellular components.
• - The drug aminopyrine is also used.
• ECF: (1) radioisotopes of selected ions (Na+, cr, Br-, and S03
2-
thiosulphate).
•
These tend to over estimate the ECF because they enter it to
various extents.
• (2) Non-metabolizable saccharides inulin, Mannitol, Raffinose). They
tend to underestimate the ECF vol. because they do not readily
distribute through out the entire ECF.
• PLASMA:
• Isotopes of albumin e.g 1131_ albumin (radio-iodinated
• serum albumin. RISA)
• Evans blue or T1824.
• Indirectly by measuring RBCV using RBC tagged with radioisotopes
of 51Cr or isotopes of iron and phosphorus (59Fe or 32P).
13

14. • MEASUREMENT OF BODY FLUID
COMPARTMENTS
• The measurement of body fluid compartments is
based on the definition of concentration in a
well-mixed compartment:
– In measuring body fluid compartments, it is necessary
to correct for any substance that is excreted during
the time it takes for the injected substance to
distribute itself in the compartment of interest.
Solving the corrected version of the equation for
volume of distribution yields:
14

15. – To measure the volume of a compartment, one
must have a substance that distributes itself only in
the volume of the compartment of interest.
Volumes for compartments where no such
substance exists may be determined by subtraction.
• Total Body Water (TBW). Deuterated water (D2O),
tritiated water (THO), and antipyrine are commonly used.
• Extracellular Fluid Volume (ECFV). Labeled inulin,
• sucrose, mannitol and sulfate are commonly used.
• Plasma Volume (PV). Radiolabeled albumin or Evans
Blue Dye (which binds to albumin) are commonly used.
• Intracellular Fluid Volume (ICFV). Measured by subtraction
• Interstitial Fluid Volume (ISFV). Measured by subtraction:
15

16. Extracellular vs Intracellular Fluids
Extracellular - high Na+ and high Cl-
2.Intracellular - low Na+ and low Cl-
D.Fluid Movement between Compartments
1. plasma -> interstitial -> plasma &
lymphatics
2. Oxygen, glucose -> into cells
3. Carbon Dioxide, nitrogenous wastes-> out
of cells
4.4. ECF <====> ICF depends on NaCl in the
ECF 16

17. RELATION BETWEEN MOLES AND OSMOLES
• The total number of particles in a solution
is measured in osmoles.
1 osmole = 1 mole (6.02 X 1023)
1 mole of glucose in 1 liter = 1osm/L
NaCl dissociates into two ions = 2osm/L
Na2SO4 dissociates into 3 ions = 3 0sm/L
In body fluids, the term milliosmole (mosm) =
1/1000 osmole is commonly used.
17

18. Osmolality and Osmolarity
• The osmolal concentration of a solution is
called osmolality when the concentration is
expressed as osmoles per kilogram of
water.
• While the osmolal concentration of a
solution is called osmolarity when it is
expressed in osmoles per liter of solution
• Body fluids are usually expressed in liters
of fluid rather than kgs of water.
18

19. Relation between Osmotic Pressure and
Osmolarity
• The osmotic pressure of a solution is directly
proportional to the concentration of osmotically
active particles in that solution.
• E.g I molecule of albumin with a m.w of 70,000
has same osmotic pressure with one molecule of
glucose with a m.w of 180.
• NaCl has twice the osmotic effect of either
albumin or glucose.
• OSMOTIC PRESSURE = CRT
C= concentration of solutes
R= ideal gas constant
T= temperature 19

20. Osmolarity of body Fluids
• 80% of the total osmolarity of the interstitial fluid and
plasma is due to sodium and chloride ions
• In the intracellular fluid 50% of the osmolarity is due
to potassium ion.
• The slight difference btw the plasma and interstitial fluid
is caused by the osmotic effects of plasma proteins
(about 20mmHg greater pressure in the capillaries than
in the surrounding interstitial fluid)
• Corrected Osmolal activities is due to inter ionic and
intermolecular attraction and repulsion from one
molecule to the next which could decrease or increase
osmotic activity
20

21. 21
Osmolar substances in extracellular and intracellular fluids
Plasma(mosm/L H20) Interstitial (mosm/L H20) Intracellular (mosm/L H20)
Na+ 142 139 14
K+ 4.2 4.0 140
Ca2+ 1.3 1.2 0
Mg+ 0.8 0.7 20
Cl- 108 108 4
HCO3
- 24 28.3 10
HPO4
-,H2PO4
- 2 2 11
SO4
- 0.5 0.5 1
Phosphocreatinine carnosine 45
Amino acids 2 2 8
Creatinine 0.2 0.2 9
Lactate 1.2 1.2 1.5
Adenosine triphosphate 5
Hexose monophosphate 3.7
Glucose 5.6 5.6 4
Protein 1.2 0.2 4
Urea 4 4 4
Others 4.8 3.9 10
Total mosm/L 301.8 300.8 301.2
Corrected osmolar activity (mOsm/L) 282.0 281.0 281.0
Total osmotic pressure at 37OC(mm Hg) 5443 5423 5423

22. Isotonic, hypotonic and
hypertonic solutions
• If a cell is placed in a solution of impermeant solutes
having an osmolarity of 282 mOsm/L, the cells will
not shrink or swell because the water concentration
in the intracellular and extracellular fluids is equal
and the solutes cannot enter or leave the cell. Such a
solution is said to be isotonic because it neither
shrinks nor swells the cells.
• Examples of isotonic solutions include a 0.9 per cent
solution of sodium chloride or a 5 per cent glucose
solution
22

23. • If a cell is placed into a hypotonic solution that
has a lower concentration of impermeant solutes
(less than 282 mOsm/L), water will diffuse into
the cell, causing it to swell; water will continue to
diffuse into the cell, diluting the intracellular fluid
while also concentrating the extracellular fluid
until both solutions have about the same
osmolarity.
• Solutions of sodium chloride with a
concentration of less than 0.9 per cent are
hypotonic and cause cells to swell.
23

24. • If a cell is placed in a hypertonic solution
having a higher concentration of impermeant
solutes, water will flow out of the cell into the
extracellular fluid, concentrating the intracellular
fluid and diluting the extracellular fluid.
• In this case, the cell will shrink until the two
concentrations become equal. Sodium chloride
solutions of greater than 0.9 per cent are
hypertonic
24

25. II. Water Balance
A. Overview of Water Balance
INTAKE
• Ingested water 1600mls
• Food intake 700mls
• Water from metabolism 200mls
OUTPUT
• Urinary loss 1500ml
• GIT (feaces) 200mls
Insensible water loss
• Respiration 300mls
• Skin 500mls
25

26. • The average water loss by diffusion
through the skin is about 300 to 400
ml/day.
• This loss is minimized by the cholesterol-
filled cornified layer of the skin, which
provides a barrier against excessive loss
by diffusion.
• In a patient with burns, the rate of
evaporation can increase as much as 10-
fold, to 3 to 5 L/day. 26

27. D.Disorders of Water Balance
1. dehydration - water loss > water intake
such as in: bleeding, burns, sweating,and
 diuretics.
2. hypotonic hydration - too much water or
Na+
3. edema - accumulation of water in
interstitial space
27

28. III. REGULATION OF SODIUM (NA+) BALANCE
A. Sodium (Na+) - 90% of solutes in the ECF; most
important and prevalent of all electrolytes
B. Aldosterone - released by adrenal cortex (renin-
angiotensin)
1. released in response to:
a.decrease in blood pressure
b.decreased osmolality of filtrate
c. sympathetic stimulation of juxtoglomerular cells
function - increase Na+ reabsorption at distal tubule
water will follow if ADH makes the distal tubule
permeable to water
28

29. D. Antidiuretic Hormone (ADH)
 released from the posterior pituitary
 responds to osmoreceptors in the
hypothalamus
a. decrease in osmo of ECF  decreased
release of ADH  less permeability of distal
tubule to water  more water released into
urine
b. increase in osmo of ECF  increased
release of ADH  more permeability of distal
tubule to water  less water released into
urine
29

30. The blood
Plasma
The Formed Elements
- Erythrocytes
- Human Blood Groups
- Leukocytes
- Hemostasis
30

31. 31

32. 1) Plasma
2) The Formed Elements
(blood cells/cell fragments)
Composition of the Blood
32

33. Hematocrit
RBCs as percent of total blood
volume
- Female: 37%-48%
- male: 45%-52%
100%
33

34. 34
Characteristics of Blood
1. bright red (oxygenated)
2. dark red/purplish (unoxygenated)
3. much more dense than pure water
4. pH range from 7.35 to 7.45 (slightly
alkaline)
5. slightly warmer than body
temperature 100.4 F
6. typical volume in adult male 5-6
liters
7. typical volume in adult female 4-5
liters
8. typically 8% of body weight

35. 35
Major Functions of Blood
Distribution & Transport
a. oxygen from lungs to body cells
b. carbon dioxide from body cells to
lungs
c. nutrients from GI tract to body cells
d. nitrogenous wastes from body cells to
kidneys
e. hormones from glands to body cells

36. 36
Regulation (maintenance of homeostasis)
a. maintenance of normal body pH
i. blood proteins (albumin) & bicarbonate
b. maintenance of circulatory/interstitial fluid electrolytes
aid blood proteins (albumin)
c. maintenance of temperature (blushed skin)
Protection
a. platelets and proteins "seal" vessel damage
protection from foreign material & infections
i. leukocytes, antibodies, complement proteins

37. Hemoglobin
Female: 12-16 g/100 ml
male: 13-18 g/100 ml
Mean RBC count
Female: 4.8 million/l
male: 5.4 million/l
Platelet counts 130,000-360,000/l
Total WBC counts 4,000-11,000/l
General Properties of Whole Blood (continued)
37

38. Plasma
38

39. Water 92% by weight
Proteins Total 6-9 g/100 ml
Albumin 60% of total plasma protein
Globulin 36% of total plasma protein
Fibrinogen 4% of total plasma protein
Enzymes of diagnostic value trace
Glucose (dextrose) 70-110 mg/100 ml
Amino acid 33-51 mg/100 ml
Lactic acid 6-16 mg/100 ml
Composition of Plasma
39

40. Total lipid 450-850 mg/100 ml
Cholesterol 120-220 mg/100 ml
Fatty acids 190-420 mg/100 ml
High-density lipoprotein (HDL) 30-80 mg/100 ml
Low-density lipoprotein (LDL) 62-185 mg/100 ml
Neutral Fats (triglycerides) 40-150 mg/100 ml
Phospholipids 6-12 mg/100 ml
Composition of Plasma (continued)
40

41. Iron 50-150 g/100 ml
Vitamins (A, B, C, D, E, K) Trace amount
Electrolytes
Sodium 135-145 mEq/L
Potassium 3.5-5.0 mEq/L
Magnesium 1.3-2.1 mEq/L
Calcium 9.2-10.4 mEq/L
Chloride 90-106 mEq/L
Bicarbonate 23.1-26.7 mEq/L
Phosphate 1.4-2.7 mEq/L
Sulfate 0.6-1.2 mEq/L
Composition of Plasma (continued)
41

42. Nitrogenous Wastes
Ammonia 0.02-0.09 mg/100 ml
Urea 8-25 mg/100 ml
Creatine 0.2-0.8 mg/100 ml
Creatinine 0.6-1.5 mg/100 ml
Uric acid 1.5-8.0 mg/100 ml
Bilirubin 0-1.0 mg/100 ml
Respiratory gases (O2, CO2, and N2)
Composition of Plasma (continued)
42

43. plasma serum
clotting proteins
(fibrin)
43

44. The Formed Elements
(Blood Cells)
44

45. Formed elements include:
Erythrocytes (red blood cells, RBCs)
Platelets (cellular fragments)
Leukocytes (white blood cells, WBCs)
Granulocytes
Agranulocytes
Neutrophils
Eosinophils
Basophils
Lymphocytes
Monocytes
45

46. 46

47. Erythrocytes (Red Blood Cells, RBCs)
Appearance:
- biconcave disc shape, which
is suited for gas exchange. The
shape is flexible so that RBCs
can pass though the smallest
blood vessels, i.e., capillaries.
47

48. • Structure:
• Primary cell content is hemoglobin, the
protein that binds oxygen and carbon
dioxide.
• no nucleus nor mitochondria
Hemoglobin consists of :
globin and heme pigment
48

49. Functions of Erythrocytes
• Primary Function
– Transport oxygen from the lung to tissue
cells
– and carbon dioxide from tissue cells to the
lung
• Buffer blood pH
49

50. Production of Erythrocytes
Hematopoiesis
refers to whole blood cell
production.
Erythropoiesis
refers specifically to red
blood cell production.
All blood cells, including red and white,
are produced in red bone marrow.
On average, one ounce, or 100 billion
blood cells, are made each day.
50

51. 51
All of blood cells
including red and
white arise from the
same type of stem
cell, the
hematopoietic stem
cell or hemocytoblast

52. 52
Erythropoiesis
Erythrocytes are produced throughout whole life to
replace dead cells.

53. All of blood cells including red and white arise from
the same type of stem cell, the hematopoietic
stem cell or hemocytoblast
Erythrocytes are produced throughout whole life
to replace dead cells.
• regulated by renal oxygen content.
• - Erythropoietin, a glycoprotein hormone, is
produced by renal cells in response to a
decreased renal blood O2 content.
• - Erythropoietin stimulates erythrocyte
production in the red bone marrow.
53

54. • Dietary Requirements for Erythropoiesis
– Iron
– vitamin B12
– folic acid
54

55. Read up Assignments
• Describe the Physiological disturbances
leading to Jaundice
• Describe the Physiological disturbances
leading to the various types of Anemia
55

56. BLOOD GROUPS
56

57. Blood type is determined by
Agglutinogens
• are specific
glycoproteins on red
blood cell membranes.
• All RBCs in an
individual carry the same
specific type of
agglutinogens.
57

58. ABO Blood Groups
Type A: RBCs carry agglutinogen A.
Type B: RBCs carry agglutinogen B.
Type O: RBCs carry no A nor B agglutinogens.
Type AB: RBCs carry both A and B agglutinogens.
58

59. Agglutinins
- are preformed antibodies in plasma
- bind to agglutinogens that are not
carried by host RBCs
- cause agglutination --- aggregation
and lysis of incompatible RBCs.
B
B
B
B
B
B
B
B
B
B
B
B
B
B B
B
B
Agglutinin B
59

60. Blood Type Agglutinogen
(on RBC)
Agglutinin
(in Plasma)
A A B
B B A
O A & B
AB A & B
Summary of ABO Blood Groups
60

61. Rh positive
- RBCs contain Rh agglutinogens.
Rh Blood Groups
Classify blood groups based on Rh agglutinogens
other than A/B agglutinogens (C,D,E, c,d,e)
A
A
A
Rh
A
Rh
Rh
Rh
About 85 per cent of all white people are Rh positive and 15 per cent, Rh negative. In
American blacks, the percentage of Rh-positives is about 95, whereas in African blacks, it is
virtually 100 per cent.
61

62. Born with severe anemia
Treatment:
use anti-Rh  globulin to mask Rh agglutinogens 62

63. Leukocytes (WBCs) Count
4,000-11,000 / L
• Function of Leukocytes:
• defense against diseases
Leukocytes form a mobile army that helps protect the
body from damage by bacteria, viruses, parasites,
toxins and tumor cells.
Life span:
• - several hours to several days for the majority
• - many years for a few memory cells
63

64. III. General Structure and Function
1. protection from microbes, parasites, toxins,
cancer
2. 1% of blood volume; 4-11,000 per cubic
mm blood
3. diapedesis - can "slip between" capillary
wall
4. amoeboid motion - movement through the
body
64

65. General Structure and Function
5. chemotaxis - moving in direction of a
chemical
6. leukocytosis - increased "white blood
cell count" in response to bacterial/viral
infection
7. granulocytes - contain membrane-
bound granules (neutrophils,
eosinophils, basophils)
8. agranulocytes - NO membrane-bound
granules (lymphocytes, monocytes)
65

66. Neutrophils
• 40%-70% WBCs
• Nucleus multilobed
• - Duration of development: 6-9 days
• - Life Span: 6 hours to a few days
• - Function: phagocytize bacteria
66

67. Eosinophils
• 1%-4% WBCs
• Nucleus bilobed
• - Development:6-9 days
• Life Span: 8-12 days
• Function:
– 1) Kill parasitic worms
– 2) destroy antigen-antibody complexes
– 3) inactivate some inflammatory chemical of allergy
67

68. Basophils
• 0.5% WBCs
• Nucleus lobed
• - Development: 3-7 days
• - Life Span: a few hours to a few days
• - Function:
– 1) Release histamine and other mediators of
inflammation
– 2) contain heparin, an anticoagulant
68

69. Lymphocytes
• T cells and B cells
• 20%-45% WBCs
• Nucleus spherical or indented
• - Development: days to weeks
• - Life Span: hours to years
• Function
– Mount immune response by direct cell attack (T cells)
or via antibodies (B cells)
69

70. • Monocytes4%-8% WBCs
• Nucleus U-shaped
• - Development: 2-3 days
• - Life Span: months
• Function:
– Phagocytosis
– develop into macrophages in tissues
70

71. - Hemostasis refers to the stoppage of
bleeding.
Hemostatsis = Homeostasis
Maintaining balance
Three phases occur in rapid sequence.
71

72. 1) vascular spasms
2) platelet plug formation
3) blood clotting /
coagulation
72

73. PPlatelets
Platelets are not cells but cytoplasmic fragments of
extraordinarily large (up to 60 m in diameter) cells
called megakaryocytes.
Normal Platelet Count: 130,000 – 400,000/l
73

74. • Function of Platelets
• 1) Secrete vasoconstrictors that cause vascular spasms
in broken vessels
• 2) Form temporary platelet plugs to stop bleeding
• 3) Secrete chemicals that attract neutrophils and
monocytes to sites of inflammation
• 4) Secrete growth factors that stimulate mitosis in
fibroblasts and smooth muscle and help maintain the
linings of blood vessels
• 5) Dissolve blood clots that have outlast their usefulness
74

75. Coagulation (Clotting)
• Many clotting factors in plasma are involved in clotting.
• These factors are inactive in the blood.
• They are activated when:
– blood vessel is broken, or
– blood flow slows down.
• The sequential activation (reaction cascade) of the
clotting factors finally leads to the formation of fibrin
meshwork.
• - Blood cells are trapped in fibrin meshwork to form a
hard clot.
75

76. Fibrinogen Fibrin Fibrin
Polymer
soluble monomer Insoluble filaments
76

77. 77

78. END
78