Physiology objectives exam 1

what percent of body weight is total blood volume

7%

how many kg are in a liter when talking about blood

about one kg is equal to one liter

if a person weights 100 kg how much blood in volume do they have

7 liters

how much of a persons body weight is due to plasma

4%

if a person weighs 100 kg how much plasma volume do they have

4 liters

what percent of a persons weight is due to RBCs

3%

if a person weighs 100 kg how much of their weight is due to RBCs

3 liters

what is serum osmolality

the concentration of dissolved particles (solutes) in the blood serum, which determines how water moves in the body

what is the serum osmolality (actual number)

275-295 mOsm/kg

in milliosmoles per kilogram

pH of blood

7.35-7.45

3 components of blood apparent following centrifugation

top layer - plasma - 55% of volume

middle layer- buffy coat containing WBC and platelets - less than 1%

bottom layer - RBCs, hematocrit- 45% of volume

whole blood

contains RBC, WBC, platelets and plasma

plasma

The liquid portion of blood that contains water, proteins, electrolytes, nutrients, and clotting factors.

serum

The liquid portion left after blood has clotted, so it does not contain most clotting factors.

plasma without clotting factors

two major roles of albumin

major contributor to colloid osmotic pressure and carrier of hydrophobic substances

how is albumin a major contributor to colloid osmotic pressure

helps regulate distribution of water between intravascular and extravascular spaces

is abundant in the blood and cannot easily cross capillary walls, so it pulls water into the bloodstream and helps keep fluid in the blood vessels.

importance of albumin being a carrier of hydrophobic substances

binds and transports water-insoluble molecules, such as fatty acids, hormones, and some drugs, through the bloodstream.

It is important because hydrophobic substances cannot dissolve well in blood, so albumin allows them to be transported safely through the bloodstream to where they are needed or removed.

importance of albumin’s size and charge

negatively charged and larger

large size and negative charge help keep it inside blood vessels, where it maintains colloid osmotic pressure and prevents excessive fluid from leaving the bloodstream.

its charge allows it to bind many substances, including hydrophobic molecules, hormones, fatty acids, and drugs, and transport them through the blood

explain the association of liver disease with hypoalbuminemia

the liver is responsible for producing albumin, so impaired liver function leads to decreased albumin production.

what are the 5 major groups of serum proteins

albumins

alpha1

alpha2

beta

gamma-globulins

alpha-1 globulins

transport proteins and acute-phase proteins

alpha-2 globulins

acute-phase and transport proteins

beta

transport proteins, complement, and immune proteins

gamma globulins

mainly antibodies (immunoglobulins)

how are serum globulins identified

according to their differences in their charge density that affects how they move in an electric field, SPEP- serum protein electrophoresis

more negative the further they move

what group of serum proteins moves the furthest on a serum protein electrophoresis

albumins

what group of serum proteins moves the second furthest on a serum protein electrophoresis

alpha 1

what group of serum proteins moves the third furthest on a serum protein electrophoresis

alpha 2

what group of serum proteins moves the 4th furthest on a serum protein electrophoresis

beta

what group of serum proteins moves the least furthest on a serum protein electrophoresis

gamma

what is a regular serum electrophoresis of albumin look like

furthest

narrow

tall

what is a regular serum electrophoresis of alpha 1 look like

2nd furthest

shortest, not particularly narrow or wide

what is a regular serum electrophoresis of alpha 2 look like

3rd furthest

slightly narrower and taller than alpha-1

what is a regular serum electrophoresis of beta look like

4th furthest

taller (sameish as alpha-2) than alpha-1 but not particularly wide or narrow

what is a regular serum electrophoresis of gamma look like

least furthest

second tallest (not by a lot)

widest (not by a lot)

what does the height of a serum protein electrophoresis mean

the amount of protein there is in the sample

what does the width of serum protein electrophoresis mean

narrow- more similar

wider- less similar

if gamma is too high and narrow in a serum protein electrophoresis what is the likely cause

malignancy of immunoglobulin producing cells so too many immunoglobulins are being produced

if gamma is too broad in a serum protein electrophoresis what is the likely cause

theres too many types of immunoglobulins which can be due to chronic inflammation, infection, or autoimmune disease

if alpha-1 is too short in a serum protein electrophoresis what is the likely cause

not enough alpha one is being produced by the liver maybe due to mutation

if gamma is non-existent in a serum protein electrophoresis what is the likely cause

immunoglobulins are not being produced maybe due to an immune deficiency

if albumin is low and the alpha 2 is high in a serum protein electrophoresis what is the likely cause

kidney disease

the diseased kidneys lose a lot of albumin in the urine, but alpha 2 is large enough that it stays in the blood, causing the alpha 2 region to increase.

if albumin is high in a serum protein electrophoresis what is the likely cause

dehydration - You lose water from the blood, but the amount of albumin stays about the same so the albumin becomes more concentrated

if albumin is low in a serum protein electrophoresis what is the likely cause

liver disease- not making it

kidney disease- losing it

malnutrition decreases production

if alpha 1 is high in a serum protein electrophoresis what is the likely cause

acute inflammation because alpha 1 proteins are acute-phase proteins that increase during inflammation.

if alpha 2 is low in a serum protein electrophoresis what is the likely cause

liver disease- decreases production

if beta is low in a serum protein electrophoresis what is the likely cause

liver disease, malnutrition, or low levels of transferrin and other beta proteins.

if beta is high in a serum protein electrophoresis what is the likely cause

can be caused by iron-deficiency anemia, because transferrin (a major beta protein) increases when the body needs more iron.

hemoglobin

within RBCs

carries oxygen

measure of most important characteristic of blood, ability to carry oxygen

hematocrit

measurement of RBCs so can also can quickly and easily assess hemoglobin content

mean corpuscular volume

the size of RBCs

helps identify the cause of RBC abnormalites

types of mean corpuscular volumes

low- microcytosis

high- macrocytosis

microcytosis

anemias due to iron deficiency because low/ not enough hemoglobin so smaller cell

macrocytosis

anemia due B12 or folate deficiency

larger cell because cell keeps growing while waiting on B12 or folate

red blood cell distribution width

RDW

measure of variation in cell sizes

addresses wheether there is a single population of relatively uniform cells

hemoglobin amount in males

13-17 g/dL

hemoglobin amount in females

12-15 g/dL

hematocrit percentage of blood in males

40-52%

hematocrit percentage in females

36-47%

MCV (mean corpuscular volume) reference range

<80 fL → microcytic

80–100 fL → normocytic

>100 fL → macrocytic

why does the viscosity of blood matter

it helps determine the resistance to flow in vessels

viscous blood can increase systemic vascular resistant which increases the after load on the heart and sludging which can lead to thrombosis and CNS effects

thin blood increases cardiac output

what factor is blood viscosity most effect by

hematocrit

polycythemia

an increase of RBC (hematocrit) and creates viscous blood

where are blood cells made in adults

blood cells are primarily made in the red bone marrow in flat bones (cranial bones, ribs, sternum and ilia), vertebrae, and proximal ends of long bones

erythropoietin (EPO)

a hormone produced primarily by the kidney in response to lowered tissue oxygenation

stimulate erythrocyte production

identify factors that can increase EPO

factors that decrease renal tissue oxygen delivery stimulate EPO release

characteristics of RBC and how they help them do their job

they are anucleate, biconcave discs with a central pallor

there shape increases surface area for gas exchange and allows them to be deformable to ease passage through capillaries

how large is the central pallor of RBC

1/3 to ½ of its diameter

life expectancy of RBCs

100-120 days

Explain the role of carbonic anhydrase in RBC’s

has an important role in transport of CO2 and buffering of H+

rapidly converts CO₂ + H₂O ↔ carbonic acid (H₂CO₃) ↔ H⁺ + HCO₃⁻, allowing red blood cells to efficiently transport CO₂ from tissues to the lungs for exhalation.

Explain the role of G6PD in RBC’s

prevents oxidation of Hb proteins

protects RBCs from oxidative damage by producing NADPH, which helps maintain glutathione in its protective form and prevents damage to hemoglobin and the RBC membrane.

Explain what happens to RBC’s in G6PD deficiency

G6PD deficiency leads to deficient amounts of glutathione so hemoglobin denatures and creates Heinz bodes, the cell membrane is damaged, and lysis occurs and potentially hemolytic anemia.

how is G6PD deficiency inherited

an X-linked recessive genetic disorder

woman have two X’s so one X having it just means carrier

men have one X so having it means expressing it

identify the populations in whom G6PD is most common

men of African, Asian, and Mediterranean descent

believed to provide some protection against malaria

reticulocytes

are newly formed RBCs released into circulation

how do reticulocytes differ from mature RBC’s

they are distinguishable for about 1 day

they are slightly larger and slightly bluish (polychromatic)

what is a retic count

the percent of all RBC’s that are retics

is an indicator of erythropoietic activity

Reticulocyte % = (Number of reticulocytes ÷ Total number of RBCs) × 100

corrected retic count

corrects for an increased retic count resulting from lowering number of mature RBCs rather from an increase in retics

adjusts the reticulocyte percentage for the patient’s low hematocrit to show whether the bone marrow is appropriately producing new RBCs

tells us how much your bone marrow is doing

High retic → high corrected retic → increased RBC production.

corrected retic count formula

corrected retic count = retic count x HCT/normal HCT

normal HCT

45%

low corrected retic count

is usually caused by iron/B12/folate deficiency, kidney disease, or bone marrow disorders, because the bone marrow cannot produce enough new RBCs to compensate for the anemia.

high corrected reticulocyte count in anemia

is usually caused by blood loss or hemolysis (such as from G6PD deficiency, sickle cell disease, autoimmune destruction, or certain infections), because the bone marrow increases RBC production to replace the cells that were lost or destroyed.

normal corrected reticulocyte count

0.5-1.5%

hemoglobin function

to transport oxygen from the lungs to tissues and carry some carbon dioxide from tissues back to the lungs.

HbA

(hemoglobin A) is the normal, most common type of hemoglobin in healthy adults, made of 2 alpha (α) and 2 beta (β) chains (α₂β₂). It makes up about 95–98% of adult hemoglobin.

identify the 4 most important locations where heme-containing compounds are found in the body

Hemoglobin

Myoglobin

Cytochrome c

Cytochrome P450

myoglobin

in muscle; involved in oxygen transport/storage.

cytochrome c

electron transport chain in ATP synthesis in mitochondria

cytochrome P450

durg detoxification in the liver

what substance inhibits heme formation

lead inhibits synthesis of heme formation

porphyria

are inherited or acquired defects of enzymes of heme synthesis mainly causing skin or nervous system issues due to accumulation of intermediates in the heme synthesis pathway

a defect in the enzymes that make heme causing heme intermediate build up

oxyhemoglobin

O2 binds to this form in the lungs

hemoglobin with oxygen (O₂) bound to it, formed primarily in the lungs and transported in the blood to deliver oxygen to tissues

carboxyhemoglobin

results from the binding of CO to hemoglobin

CO binds 200x more avidly than O2 and decreases tissue release of O2 that is bound causing tissue hypoxia

makes blood a bright cherry red color

carboaminoglobin

Hemoglobin binding to CO2 in the tissues where O2 is released and helps in transfer of CO2 to lungs

CO2 binds to globin chain, not iron

is hemoglobin with carbon dioxide (CO₂) bound to the globin portion of hemoglobin, helping transport CO₂ from the tissues to the lungs.

methemoglobin

is hemoglobin in which the iron has been oxidized from Fe²⁺ to Fe³⁺, so it cannot bind oxygen

anemia

decreased effective erythropoiesis

identify the 3 basic mechanisms by which disorders may cause anemia

decreased production

increased destruction

bleeding

what a specific things that cause anemia

nutrient deficiency

inherited defects

inhibitors

drugs or toxins

lack of EPO

what specific things lead to decreased production of RBC anemia

B12, folic acid, and iron deficiency

anemia of chronic disease

B12 and folic acid deficiency anemia

they are needed for the production of bases for DNA needed in cell division

limits cell division while they are able to continue to enlarge and fill up with Hb

cells are large but fewer in number

creates macrocytic anemia