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Chapter 3 Blood
Physiology, a textbook used in the "14th Five-Year Plan", summarizes the composition and physical and chemical properties of blood, blood cell physiology, blood coagulation and fibrinolysis, etc.
Edited at 2024-01-16 21:05:43
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Chapter 3 Blood
- bacteria
This is a mind map about bacteria, and its main contents include: overview, morphology, types, structure, reproduction, distribution, application, and expansion. The summary is comprehensive and meticulous, suitable as review materials.
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- Outline
Chapter 3 Blood
Section 1 Composition and physical and chemical properties of blood
Composed of plasma and blood cells suspended in water
Blood composition and blood volume
chemical composition of blood plasma
Water: 91%～92%
Electrolytes: accounting for about 0.9%, function: participating in the formation of plasma crystal osmotic pressure; maintaining acid-base balance and normal excitability of nerves and muscles
plasma proteins
Types: albumin (most), globulin, fibrinogen (three major categories)
Main functions: Formation of plasma colloid osmotic pressure; nutrition; buffering; transportation; immunity; involved in coagulation, anticoagulation, and fibrinolysis
non-protein organic matter
Nitrogenous
Most of them are protein metabolites, which are helpful to understand protein metabolism and renal function.
No nitrogen
Glucose, lipids, ketone bodies, lactic acid
Others: gases, hormones, vitamins, etc.
composition of blood cells
Type: red blood cells (most, about 99%)
Hematocrit
Definition: The percentage of volume occupied by blood cells in the blood
Normal value: 40%~50% for adult men, 37%~48% for women
Meaning: a relative value that reflects the number of red blood cells in the blood
HP
Normal adult blood volume accounts for about 7% to 8% of body weight.
Relatively stable blood volume is a necessary condition for maintaining normal life activities
Physical and chemical properties of blood
plasma osmolality
Osmotic pressure concept
Osmotic pressure: refers to the force of a solution to attract water molecules to pass through a semipermeable membrane per unit area. It is a characteristic of the solution itself.
Osmotic pressure is proportional to the number of solute particles in the solution
The composition of plasma osmotic pressure
Crystal osmotic pressure: formed by crystalline substances in plasma, 80% comes from NaCl
Colloidal osmotic pressure: formed by plasma proteins, mainly albumin
Physiological effects
Plasma crystal osmotic pressure: maintains the balance of water inside and outside cells, and maintains the normal shape and function of blood cells
Plasma colloid osmotic pressure: maintains water balance inside and outside blood vessels and maintains normal blood volume
Isotonic solution and isotonic solution
Isotonic solution: a solution with an osmotic pressure equal to that of plasma
0.9% NaCl solution, 5% glucose solution
Isotonic solution: A solution that maintains the normal shape and size of red blood cells suspended in it
0.9% NaCl solution and 5% glucose solution are both isotonic and isotonic solutions
The 1.9% urea solution is an isotonic solution, but not an isotonic solution (because urea easily passes through the cell membrane and can freely enter the red blood cells, causing the intracellular osmotic pressure to increase, causing the red blood cells to swell and rupture and cause hemolysis)
pH of plasma
Plasma pH remains relatively stable, relying on the buffering system in the blood and the regulation of lung and kidney functions by nerves and body fluids.
blood function
Transport function
Maintain internal homeostasis
immune and defense functions
Section 2 Blood Cell Physiology
red blood cells
Number and shape of red blood cells
Biconcave disc shape, filled with a large amount of hemoglobin
Anemia: The number of red blood cells and hemoglobin concentration in the blood are lower than normal
Physiological properties
Plastic deformability
Definition: When red blood cells circulate in blood vessels and pass through capillaries and sinusoids that are smaller than their diameter, they often twist and deform, and then return to their original shape. This characteristic is called plastic deformation.
is the most important property required for red blood cells to survive
Influencing factors
Cell membrane elasticity: proportional to
The ratio of surface area to volume: directly proportional
Viscosity within red blood cells: inversely proportional
suspension stability
Definition: Red blood cells have the property of being suspended in plasma and not easily sinking
Erythrocyte sedimentation rate: the height of the plasma column in which red blood cells do not sink in the first hour, referred to as erythrocyte sedimentation rate.
The slower the red blood cells sink and the smaller the erythrocyte sedimentation rate, the better their suspension stability.
The cause of accelerated erythrocyte sedimentation rate: depends on changes in plasma components rather than red blood cells themselves
Inhibit red blood cell stacking: albumin, lecithin
Promote red blood cell stacking: globulin, fibrinogen, cholesterol
Osmotic fragility
Definition: The characteristic of red blood cells swelling, rupturing, and hemolysis in hypotonic saline solution
Reflects the resistance of red blood cells to hypotonic saline solution
Newly born red blood cells have low osmotic fragility and are highly resistant to hypotonic solutions and are not easy to rupture; aged red blood cells are more fragile and easy to rupture.
Function
Transport O2 and CO2
Buffers the pH of the blood
generation and regulation
generation process
Generating site
Bone marrow is the main site of hematopoiesis (only in adults)
The development and maturation of red blood cells is a continuous and staged process
Substances required for the production of red blood cells
protein and iron
Basic raw materials for the synthesis of hemoglobin
Iron deficiency anemia caused by iron deficiency, also known as hypochromic microcytic anemia
Vitamin B12 and folic acid
Cofactor that promotes the development and maturation of red blood cells
Intrinsic factor promotes the absorption of vitamin B12: Vitamin B12 is an important coenzyme required for the synthesis of DNA, and is also involved in the conversion and utilization of folic acid; after conversion, folic acid participates in the synthesis of red blood cell DNA
Deficiency causes megaloblastic anemia, also known as macrocytic anemia
Regulation of erythropoiesis
Two regulatory factors regulate the growth of erythroid progenitor cells at two different developmental stages.
Blast Promoting Active (BPA)
Strongly stimulates the proliferation of early erythroid progenitor cells
Erythropoietin (EPO)
Nephrogenesis, promoting the proliferation and differentiation of late erythroid progenitor cells and the maturation of red blood cells
Androgens promote red blood cell production
Thyroid hormones, growth hormone, glucocorticoids, etc. also promote red blood cell production
destruction of red blood cells
The lifespan of red blood cells is about 120 days
leukocyte
Differential counting of white blood cells
granular leukocytes
neutrophils
eosinophils
basophils
agranular leukocytes
monocytes
Lymphocytes
Physiological properties and functions
Physiological properties
Chemotaxis: the tendency to swim toward certain chemicals
Extravasation: penetration through capillary walls into tissue by deformation movement
Phagocytosis: Surrounding foreign matter and swallowing it into the cell
Secretion: Secrete a variety of cytokines
The physiological basis for executing defense functions
granulosa cells
neutrophils
Function: Phagocytosis of bacteria, antigen-antibody complexes, aging and necrotic cells, etc.
On the front line against the invasion of pathogenic microorganisms, especially pyogenic bacteria
Neutrophils phagocytose bacteria and then decompose themselves and die, forming an abscess.
eosinophils
effect
The role of basophil restriction in type I hypersensitivity reactions
Involved in the immune response to worms
Hypersensitivity reactions or certain parasitic infections are often accompanied by an increase in eosinophils
basophils
Effect: Releases a variety of substances, causing symptoms of hypersensitivity reactions
agranular cells
monocytes
After entering the tissue, it transforms into macrophages.
The function of macrophages: engulf and destroy viruses, malaria parasites, fungi and Mycobacterium tuberculosis, etc., and identify and kill tumor cells. Remove denatured proteins, aging and damaged cells and debris, activate the specific immune function of lymphocytes, etc.
Lymphocytes: perform specific immune functions
T lymphocytes: perform cellular immunity
B lymphocytes: perform humoral immunity
Natural killer cells: important executors of the body’s innate immunity
platelets
form
It is a small piece of biologically active cytoplasm that is broken off from mature megakaryocytes in bone marrow. It is biconvex disc-shaped and has no nucleus. It stretches out pseudopods after activation.
Physiological properties
Adhesion: refers to the process of adhesion of platelets to non-platelet surfaces, such as collagen fibers exposed after vascular injury.
Aggregation: the phenomenon of platelets adhering to each other, forming platelet plugs, which is beneficial to hemostasis
Release: The phenomenon in which platelets discharge a variety of stored active substances while adhering and aggregating, participating in functions such as coagulation and hemostasis.
Adsorption: The surface of platelets can adsorb a variety of coagulation factors in plasma, increasing the concentration of local coagulation factors.
Contraction: shrink the blood clot to form a solid hemostatic thrombus, blocking the vascular wound
Physiological function
Maintain the integrity of vascular endothelial cells and support the repair of blood vessel walls
Participate in physiological hemostasis
Physiological hemostasis is defined as the phenomenon in which bleeding caused by broken small blood vessels stops naturally within a few minutes.
Physiological hemostasis process mainly includes three phases
vasoconstriction
platelet thrombosis
Fibrin clot formation
Promote blood clotting
Through multiple links, the coagulation process is greatly accelerated.
Section 3 Blood Coagulation and Fibrinolysis
blood clotting
Definition: The process of blood changing from a flowing liquid state to a stagnant gel state is an important step in physiological hemostasis.
Essence: The process of converting soluble fibrinogen in plasma into insoluble fibrin polymers, intertwining into a network, trapping blood cells, and forming a clot.
serum
Definition: 1 to 2 hours after coagulation, the clot will shrink and release a light yellow liquid.
Difference from plasma: Serum does not contain fibrinogen and some coagulation factors consumed during blood coagulation, but has added chemicals released during coagulation.
Blood coagulation is a series of enzymatic reaction processes in which multiple coagulation factors are enzymatically activated one after another
clotting factor
Refers to substances in plasma and tissues that are directly involved in blood coagulation
blood clotting process
three phases
Formation of prothrombin activator
thrombin formation
fibrin formation
According to the different pathways of prothrombin activator generation, the coagulation process is divided into
Intrinsic coagulation pathway: means that all factors involved in coagulation come from plasma, usually initiated by activation of FXII
Extrinsic coagulation pathway: refers to the coagulation pathway initiated when FIII from outside the blood comes into contact with the blood.
Both pathways generate FXa and then enter the same coagulation process
It is a process of sequential enzymatic activation of a series of coagulation factors. Each enzymatic reaction has an amplification effect.
Ca2 must be involved in the entire process of blood coagulation
anticoagulation system
Anticoagulant effect of vascular endothelium
Vascular endothelial cells secrete a variety of substances and play an important role in preventing the spread of blood coagulation reactions.
Inhibit platelet aggregation
Destroys and inactivates multiple coagulation factors
Degrade fibrin to ensure smooth blood vessels
Fibrin adsorption, blood flow dilution and monocyte-macrophage phagocytosis
Physiological anticoagulant substances
Serine protease inhibitors: the most important of these is antithrombin III
Heparin: It has strong effects in vivo and in vitro. It is the most commonly used anticoagulant in clinical practice.
Anticoagulation mechanism: Enhance the affinity of antithrombin III and coagulation factors; inhibit platelet adhesion and aggregation; enhance the activity of protein C
Protein C system: inactivation of FVa and FVIIIa
Tissue factor pathway inhibitor: extrinsic coagulation pathway inhibitor
Procoagulation and anticoagulation
Use warm saline gauze to compress and stop bleeding
fibrinolytic system
Section 4 Blood Type and Blood Transfusion
blood type
Blood types and red blood cell aggregation
The definition of blood type: refers to the type of specific antigen on the blood cell membrane, usually refers to the type of specific antigen on the red blood cell membrane.
Red blood cell aggregation
Phenomenon: When blood of two different blood types is mixed, red blood cells clump with each other.
Hazards: Blockage of capillaries; hemolysis; damage to renal tubules; hypersensitivity reaction
Essence: Antigen-antibody reaction
Antigen: Specific antigen (agglutinogen) on the red blood cell membrane
Antibodies: Corresponding antibodies (lectins) in plasma/serum
Leukocyte blood group and platelet blood group
red blood cell blood type
ABO blood group system
Classification basis: According to the presence of agglutogen A and agglutogen B on the red blood cell membrane
Antigens and antibodies of the ABO blood group system
Antigen: present on the outer surface of the red blood cell membrane, there are two types: A and B
Antibodies: present in plasma or serum, including anti-A and anti-B
Agglutinogens and Lectins in the ABO Blood Group System
Rh blood group system
Rh blood group system antigens
Rh positive: D antigen is present on the surface of RBCs
Rh negative: no D antigen on RBC surface
Rh blood group system antibodies
Blood transfusion principle
Prerequisite for blood transfusion: ensure that red blood cells do not agglutination
Principle of blood transfusion: blood type is consistent, blood matching is consistent
First, the blood type must be identified
Second, conduct cross-matching experiments in the same blood group system