Blood Composition and Regulation

• The cardiovascular system is comprised of the Heart, blood vessels, and blood
• Its primary function is transportation

Circulatory System Components

• The circulatory system includes both the cardiovascular and lymphatic systems
• The cardiovascular system consists of the heart and blood vessels
• The lymphatic system includes lymphatic vessels, lymph nodes, and lymphoid organs

Cardiovascular Functions and Components

• Transportation is a key function, carrying respiratory gases, nutrient and excretory molecules
• Erythrocytes transport O2, while bicarbonate carries CO2
• Plasma transports nutrients and protein carriers, and also excretory molecules
• Regulation includes hormonal transport via plasma and protein carriers, and temperature via blood vessels
• Protection includes clotting via platelets and plasma clotting factors, plus immunity via leukocytes

Blood Function

• Blood's primary role is to transport respiratory gases, nutrients to cells, and eliminate metabolic waste
• It also transports hormones to cells
• Blood helps regulate pH between 7.35 and 7.45
• It regulates osmolality via electrolyte and water balance
• Important for temperature regulation via blood flow
• Crucial for protection from fluid loss via clotting
• Protects the body from pathogens via white blood cells

Blood Composition and Balance

• Blood is a fluid connective tissue
• Plasma is the matrix of blood and mostly water
• Balance between cells and plasma is important for flow

Composition of Whole Blood

• Total blood volume is about 5 liters
• Plasma constitutes about 55% of the blood volume
• Water and dissolved solutes are components of plasma
• Formed elements: Erythrocytes, Leukocytes, and Platelets
• Hematocrit is the ratio of formed elements to plasma; should be about 45%

Plasma Composition

• Plasma: 46- 63%
• Plasma protiens 7%
• Other solutes 1%
• Water 92%
• Plasma contains water, eletrolytes, nutrients (lipids, carbohydrates, and amino acids) and waste

Plasma and pH Levels

• pH balance is critical for proteins, plasma membrane function
• Lungs and kidneys control pH
• The buffer system primarily uses bicarbonate ions

Hematocrit Measurement

• Hematocrit measures the amount of formed elements in total blood volume
• A normal hematocrit should be ~45% or less
• Hematocrit components: plasma, buffy coat, and RBCs

Plasma Makeup

• Water makes up 90% of plasma
• Ions make up about 0.9% of plasma
• Proteins contribute 8%
• 1.1%: Hormones, enzymes, antibodies, metabolites
• Plasma makeup differences from extracellular fluid includes a higher concentratio of O2, lower concetration of CO2, and a higher protein content

Plasma and Blood pressure maintenance

• Water balance is critical for blood pressure
• Na+ is the major solute in plasma
• Increased Na+ concentration creates creates osmotic issues, which are regulated by osmoreceptors in the hypothalmus
• This increases osmolality which leads to drinking and a release of ADH where the kidneys can retain water

Plasma Proteins

• The role of plasma proteins include intravascular osmotic effect
• Maintain the viscosity of plasma
• Allow insoluble substances transport around the body to bind to protein molecules
• Act as protein reserve for the body
• Enable clotting
• Trigger inflammatory responses
• Produce Antibodies
• Maintainenance of acid base balance

Plasma Proteins: Types and Functions

• Albumin constitutes 60% of plasma; it maintains osmotic effect, viscosity
• Globulins make up 36% of plasma
• Alpha and Beta are made by the liver and transport substances
• Gamma are made by lymphocytes, antibodies
• Fibrinogen: 4%; important for clotting

Plasma Function

• Maintain blood pressure and volume
• Transport respiratory gases, nutrients, and insoluble hormones
• Transports wastes
• Balances electrolytes and pH
• Important for immune system function via complement proteins and antibodies
• The plasma triggers infammatory responses
• Enanbles Clotting

Formed Elements of Blood

• Includes: erythrocytes, leukocytes, and platelets

Erythrocytes

• Erythrocytes are red blood cells (rbcs)
• Biconcave discs, without a nucleous or mitochondria
• They rely on anaerobic respiration
• They have a short life span
• Contain hemoglobin

Erythrocytes: Formation and Function

• Biconcave discs create high surface area for gas exchange
• The shape of erythrocytes are maintained by cytoskeletal network (mostly spectrin)
• Flexible for fitting through capillaries

Hemoglobin Information

• Hemoglobin is the erythrocytes major solute content
• A normal value in infants: 14-20 g/100 ml, males: 13-18 g/100 ml and females: 12-16 g/100 ml
• Hemoglobin has an Iron group (heme) bound to the protein globin
• Two alpha and beta subunits, each carrying one oxygen molecule, 1 RBC can carry 1 billion O2 molecules
• Binds O2 in high PO2 and pH neutral environments (lungs)
• Releases O2 in low PO2, acidic pH environments tissues
• Deoxyhemoglobin in the tissues

Oxygen Binding and Unloading

• Oxyhemoglobin has unique 3D shape, has high affinity for O2
• Reduced (deoxyhemoglobin) also has unique shape, reduced affinity for O2
• The change in shape determines the ability to attach 02

ABO and Rh Blood Groups

• Gene expression of antigenic proteins located on chromosome number 9
• Type A: has only A antigen; either IAIA or IAi
• Type B: contains only B antigen; either IBIB or IBi
• Type AB: expresses both A and B antigen; IAIB
• Type O: expresses neither A nor B antigen; ii

ABO Characteristics

• Characteristics include surface antigens, the presence of antibodies in plasma, and the existence of compatible blood types
• AB is the universal receiver whereas O is the universal donor

Rh Blood Type

• Blood is typed using Anti-A, Anti-B, and -Anti D (antibody against the Rh protein)
• The Rh gene is dominant with no atibodies in the plasma against it
• An Rh mother may make antibodies against Rh+ if exposed to it
• These antibodies can cross the placenta, causing anemia in the fetus

Aggultination Reaction

• Antibodies produced against alternate antigen without prior exposure
• Causes RBCs to stick together

Blood Donations

• Blood is used for trauma/accidents, obstetrics, orthopedics and surgical procedures
• Donated blood may treat medical problems (heart, liver, kidney etc) and anemia
• Blood is donated to cancer patients and treat blood disease

Life Cycle of Red Blood Cells

• Formation occurs bone marrow under the influence of erythropoietin from JG apparatus
• The Erythroblast becomes a reticulocyte and ejects nucleus
• A mature RBC circulates and eventually begins to degrade
• RBC have a life span: ~ 120 days
• They are unable to repair or replace

Life Cycle of RBCs: Post Spleen

• Flexibility is lost, and Hgb begins to degenerate
• The cell gets tapped in spleen
• It then gets phagocytized by splenic macrophages, bound to protein complexes
• Heme groups contain a poisonous iron that binds to transport protein called transferrin and recycled
• The remainder of the heme molecule is degraded to bilirubin which then travels to the liver
• Protein degrades down into amino acids and lastly pigment os excreted and broken down

Atypical Red Blood Cell Shapes

• RBC shape is not used as a diagnostic on its own can be an artifact
• A large number of abnormal shapes is an indicator of an underlying cause or pathology such as changes in pH
• Other underlying causes includes iron deficiency such as anemia, sickle cell anemia or uremia

Formed Elements: WBCs

• Leukocytes are white blood cells with an amoeboid shape
• They defend against infection by phagocytosis
• Producing antibodies (immunoglobulins)
• Producing antitoxins, chemical signals and or cytotoxic compounds

Two Types of Leukocytes

• Granular leukocytes have short life span of 12 hours to 3 days (Neutrophils 54-64%, eosinophils, basophils and mast cells)
• Agranular leukocytes have a longer lifespan, 100 - 300 days (Lymphocytes 25-33% and Monocytes

Granular Leukocytes Function

• Neutrophils phagocytize pathogens
• Release defensive compounds
• Demonstrate little affinity for eosinic or hematoxylin stain (neutral)
• Have lobes in nucleus with polymorphonuclear leukocytes (PMNs)

Granular Leukocytes: Eosinophil

• Phagocytize antigen-antibody complex
• Secrete enzymes to dissolve clots
• Important for parasitic infection
• Affinity for eosin stain

Granular Leukocytes Basophil

• Has a Bilobar nucleus
• Plays role in inflammatory response
• Releases histamine (vasodilation), serotonin (inflammation)
• Heparin (anticoagulant), LTC4 (LTC4)
• Affinity for hematoxylin stain (blue)

Granular Leukocytes Mast Cell

• Include round nuclei
• Affinity for hematoxylin (blue)
• Involved with Inflammatory response
• Released histamine, heparin, LTC4
• Releases tryptase and PGD2
• Stimulation (IgE, Allergins)

Agranular Leukocytes: Lymphocytes

• Responsible for specific immunity
• No granules in cytoplasm, small rim of cytoplasm
• B cells: antibody mediated immunity-antibody production
• T cells: cell mediated immunity-attack other cells

Agranular Leukocytes: Monocyte

• Largest leukocyte
• Phagocytic and activated by macrophages

Formed Elements: Thrombocytes

• Platelets or thrombocytes: Fragments of megakaryocytes
• These are critical for clotting
• Function for about 5-9 days
• Release seretonin and form mass of clot, no nucleus and amoeboid

Hematopiesis, Blood Cell Production

• Includes the formation of all formed elements from multipotent hematopoietic stem cells (hormones)
• Myeloid stem cells produce megakaryoblast, erythroblast, myeloblast and monoblast
• Lymphoid stem cells: Lymphoblast, Natural killer cells, Lymphocytes (T cells, B cells)

Steps of Hematopiesis

• First stem cells will go through cell division and some are saved for remain
• The rest are converted into progenitor myeloid and and lymphoid stem cells which begin the process of blood cell formation
• Myelod cells include the formation of different leukocytes, erythrocytes, and megakarocytes
• Lymphoid progenitors form B lymphocytes, a T lymphocytes as well as natural killer cells

Hematopoiesis, Myeloid

• Myeloblast
• Differentiates into granulocytes (neutrophils, eosinophils, basophils), stimulated by cytokines and interleukins
• Monoblast
• Differentiates into monocytes, cytokines and interleukins
• Megakaryoblasts differentiate into megakaryocytes that form platelets when stimulated by thrombopoietin
• For formation of erythrocytes, the cells need a signal of erythropoietin

Erythropoiesis, Red Blood Cell Formation

• RBCs develop within myeloid tissue
• Stimulated by hormone erythropoietin (kidneys)

Triggers for the Erythropoiesis

• When the RBC count has been reduced for one of many reasons the erythropoiesis is triggerd
• Can begin from blood lose, RBC distruction or from decressed production from erythropoietine
• Can be induced by having insufficient hemaglobin typically in cases of anemia from different causes -Reduced [O2] that can occurs when some one is at high altittute or due illness

Erythropoiesis Regulation

• Kidneys secrete erythropoietin when O2 levels are low from less rbcs increased oxygen at high altitude as well as different lung diseases
• This will bind to receptors in hematopoietic and lead to erythroblast then normoblast cells lose nuclei and become reticulocyte after a 3 day process

Dietary requirments for the Hematopoiesis

• The body needs ammino acids for the production as well as lipids and carbohydrates.

Role of Hormones

• Megakaryoblast Differentiates into megakaryocytes
• The hormonal signal is thrombopoietin, and it can differentiate between granulocytes: Neutrophils, Eosinophils, and Basophils

Hematopoiesis, lymphoid

• The hormonal signal is complicated, cytokines, interleukins, as well as activated B cells that will become plasma and T cells which will undergo further differentiation in the Thymus

Leukopoiesis

• Leukopoiesis describes the formations of leukocytes
• Takes place in either the myeloid and lymphoid tissue depending one the type
• For B cells it to have differentiation they need cytokines such as Multipotent growth factor-1 and multiple types of interleukos
• The formation of neutrophil is stimulated via Granulocyte colony stimulating factor as well as Granulocyte-monocyte colony stimulating.

Platelet Production

• Platelets form for the fragmentation of megakaryocytes
• Clotting takes 5-9 Days when serotonin and the clot are used to hold it together

Hemostasis, Clotting

• There are three mechanisms involved in making a clot
• Involves Vasoconstriction which leads to smooth muscles cells contracting
• A Platelet Plug will then be form
• The Production of a web of fibrin will then lead to coagulation

Functions of Platelets

• If there is no damage the body will use prostacyclin to repelled unwanted blood clots
• Damage requires exposure of the subendothelial connective tissue collagen
• After the von Willebrand factor, hormone Platelets attach and perform Degranulation

Coagulation Cascade

• After a primary hemostasis activates, the body responds with blood and fibrin
• Will convert Fibrinogen
• Clot will the be cause thanks to blood deposition ( Secondary hemostasis)

Clotting Cascade Review

• Blood is made stable through the formation of a platelet plug that lead to a conversion with a sequence of enzamatic event using fibrogen as an effective lynchpin

Production of Blood Clots

• Blood will clot thanks to platelet which need Fibrin
• In Arteries the blood is moving to fast the stop red blood cells

Fibrin Forms in Two Main Methods

• No fuhrer chemicals needed to create blood clot
• The tissue can be the initiator such as after getting damaged

Coagulation Factors

• Made up of several factors which each perform a function
• These proteins have the function of making several steps for the deposition

Conversion of Fibrinogen

• Surface must allow the formation of fibrin to occur, with the factors including Haggen and fibrin to be activated to keep it there
• Then the last phases will need to allow the common phase to trigger

Activation of Fibrinogen: Blood

• Use several elements to allow blood clots to begin, as well as tissue cells that cause fibrin and thrombine formation

Factor Regluating Hemostasis System

• The body needs to inhibit the positive feedback response (Positive because it causes even more activity)
• The enzemes Protein Inhibits help with this process
• Antho thrombin will then to stop further ezimatic production The Tissue will then be able to perform acton while prostacyclin to limit blood from flowing

Healing of Body Wounds

• The blood will be reabsorb and the body can get back to working form
• The body might not however fully reobsorbe blood (For internal)

Clot Dissolution

• The body will then use plamin which is forned thanks to factor XII to disolve and disaper blood clots

Intrinsic and Extrinsic pathways

• The two pathways which create blood
• These can be prevented with proper medicines

Clotting Prevention

• Several medications are designed to stop coagulation of the blood to prevent strokes

Basic Diagnostic Testing

• Complete Blood Count (CBC): -RBCs -WBCs -Clotting proteins -Fe Levels -B12 leves

• Basic Metobolism Pannel (BMP or CMP): -Glucose -Electrolyte levels -Waste product levels

• Lipid pannel

• Creatine Kinase and Troponin levels check for Myocardial inforcsionts

• Prothombrin and TSH levels

Classifying Abnormal Bloods

• Blood pathology happens due to different illnesses and desease that cause issues to hemobalance

The Heart as a Double Pump

• Double pump with four chambers
• Two atria with interatrial septum
• Two ventricles with interventricular septum
• Valves ensure their one-way flow
• Pulmonary and systemic circulation

Location of the Human Heart.

-The position within the chest is located obliquely in the middle mediastinum

• In front of thoracic vertebrae (5-8) 2/3 lies to the left of midsagittal line Located at the 5th intercostal and the Base at the 3rd sternochondral (clenched fist for size)

Pericardium

• Surrounds the heart
• Viseral covering
• Parietal covering
• Anchors the the heart and prevents Stretching. Serous membrane to minimize friction

Cardiac function

-Pericardal cavity can cause issues -Fluid around the heart -Caused by inflamatory response -Can be fatal

Structual support of cardaic muscles

• Myocardium
• Syncytium of cardiac muscles
• Endocardium

Myocardium structual aspects

A striated muscle

• Short
• Branched
• Requires aerobic conditions
• Myoglobin
• Mitochondria
• Involuntary Muscles
• Desmose
• Gap-Junctions

Hisology of muscles

Structal integrity

• Desmosomes Current transmission:
• Gap Junction

Structural Properties of Myofibers

• Stabilize valves and muscles. Support Muscles
• Allow the body to distrube forces during contraction

Pulmanary Circuit

• Gas exchange is required to allow the blood to get oxygen

Circulatory Pathways

Four chambers Four valves Pulmonary Gas exchange Systemic Somatic vessels

How is blood pumped

Pumonary valve

• Right atrium, ventricle Systemic cicuat
• Left atrium, ventricle

Exteneral Anatomy

Aorta Superior vena cava

Anterior and lateral heart position Borders with the left and right side Anterior and posterior All must interact to allow function

Heart: Superfical Anatomy Location, Anterior

"Start in the right or you're wrong"

• Right atrium/ventricle
• Superior vena cava/Coronary sulcus, /artery
• Pulmonary trunk/Ligamentum arteriosum Left atrium
• Left pulmonary artery &veins
• Ascending aorta

Superfical Anatomy: Prosterior Side

• Right atrium / Coronary sinus, sulcus
• Superior/Inferior vena cava
• Pulmoanry trunk/artery - Ventrical
• Left Vein

Cardio cell structure

• Pectinate right and cononary can be used for proper function
• Septum
• Inter arterial
• Coronary sinus and valves for semi lunner function

Basic Function

• Ventricle : valves and vessels provide function to the muscular regions of the heart

Heart Sound Production

Valves use pressure to allow the body to function

• Will use gradient to preform process
• Semilunar valves right pulmonare an left atrial
• Use gradients
• Pulmonary, RSL (Right, Semilunear)

Ventrical Pressures

Valves must close and will function depending on the side

• This can be caused by abnormal vessel pressure, heart function and other components

Valvular heart disease

• Can depend on sound that can indicate pshychiological reasonings some of the times
• Heart has the capability of using "Murmers"; indicate issues

Valves structure during Murmurs

• Inssuicient
• Stenosis Valve: Stenosis
• Valve that fails to open completely.
• High pitched sound or click Valve: Insufficienc Valve that dont close A.k.a. regurtitation Swishing sound

Basic Systic vs Diastoile

Valve move blood all depending on a change depending on blood pressure with respect to the gradient that its undergonig There will be valves that close to allow the pressure to push blood to other regions. The Arota the vessels and the vessels the gradient of blood cell

Normal

"Lub Dub System" with respect blood moving to the atria

Normal and Inital

Inial is a form of Atria Contraction

• The process ends with both Atira getting blood

Conduction

Can be broken down to the system to be the Sinotrial (Sa) node The heart to function as -70 bpm to be the ideal amount

• Conduation and bachmens bundle is required and need function in and of
• The Aritorvertical then will go second which allows 60bpm to be function
• This will then have the His bundle to flow to the fiber and can help with the amount of output for the heart

Pcaemakers with Conduction

• Use unstable potential to operate +20

• Need depolarization

• 40 to operate

• --Ca2+ All due to membrane gradient Reptolitization Negative action and potiton thanks to Ca++

• Influx

Heart Inso

• They need to be function or else something will go wrond : Na2+

• These properties work in a time gradient and this will cause a the cells to reporolize

Action Protentail

• Cells need pace makers to function their own cell to produce power.
• 200 will be lost to repolistion and also a cahhnel for slow reaction on an EC
• This needs rapid reaction

Ca2+ Action

Openes the channel in the salcoremna and alow hear to repisond

Basic Function

• Cells are designed to have a refractory and contraction to occur
• Must have no summation

Valve action

• The pressure is how the valves close to make lub and dub sounds to allow all process to function.

Cornoinal Action

Artery: This causes for the vessel function, for the right side, its the marginal and Postventrical

Blood Functioning

Anestomosis; and the cardiac function the blood must go to and from the heart

Muconation

• The cells can change and be affected thanks to aerobic states and changes in the area.

• Can go into phases like Angenious and necrois and even more.

Ishiemia cause

• From several reasons

• Plaqe Rupture

• MI 1

• Vaso and Endothelial

• Type 2

• Atheos

• Type 2

• --Demanding Imabalance

• Type 2 Can be found with ecp with changes in ST and more

Histology:

• Tissue can conduct so ECG will have a altered changes

Clitrical testing

"CBC, BMP, lipid, ekg and some tiome stress testing"

Heart

• These issues can create problems
• Patten Forman Ovale
• These vessel mix blood at heart

Deasea

These conditions increase blood from aorta

• Tretalory Fallot
• Cresendo changes and sound.

Explore the regulation of blood pH and the composition of blood components. This quiz covers hematocrit levels, plasma composition, and the roles of hormones like erythropoietin and thrombopoietin in blood cell production. Also includes the differentiation process of erythroblasts.