Compartment of body fluid
Almost 55% and 60% of the total mass in female and males respectively is made up of body fluids.
The body fluid is present in two compartments does it is divided into two types :-
1. Intracellular fluid (ICF) or crytosol
It is the fluid present within the cell and make up around two third of body fluid.
2. Extracellular fluid (ECF) :-
-it is present outside the cell include the rest of the body fluid.
---. Extracellular fluid :-
• Plasma and interstitial fluid makeup the extracellular fluid.
• The interstitial fluid surrounds the cells while the plasma is found within the body vessels.
• extracellular fluid also include a small volume of lymph and transcellular fluid.
• Interstitial fluid make up around 80% of the ecf and lodges the microscopic spaces between the tissue cell.
• Remaining 20% of ecf is made up of plasma which is the liquid part of blood.
Intracellular Fluid
• fluid account largest volume of the body.
• it includes the fluid present inside all the cell of body.
• it is mainly composed of water which is the main solvent in which significant chemical reaction of the cell take place.
MAINTAINANCE OF FLUID BALANCE
• Water is the only component that makes up 45 to 70% of the total body mass based on age gender of the individual.
• balance of fluid is in the body rinse till to maintain homeostasis.
• fluid balance maintained by the input or output of water.
• kidney play an important role in maintaining homeostasis.
• various factors are involved in maintaining plasma IF and ICF
1. Regulating fluid output.
2. Regulating fluid input and
3. Exchanging fluid between compartments.
BLOOD
• blood is a connective tissue that play a vital role to carry various life processes and protect the body against disease.
• blood is a unique component for every individual as it differ in composition number of cell of each type and hence its function from one individual to another.
• hematology is the branch of medical science concerned with the study of blood blood forming tissue and blood disorders.
COMPOSITION AND FUNCTION OF BLOOD
• around 8% of total body weight in blood adult female 425 litres and male 5 to 6 litres.
• blood is a connective tissue having a liquid matrix with cell and cell fragments.
Two major components of blood are :-
1. Blood plasma clear extracellular fluid.
2. Formed element composed of blood cell and platelets.
Component and function of blood are listed below.
FORMED ELEMENTS (45%)
• it is composed of three principal components.
• red blood cells (4,8-5,4millions)
• platelets (150,000-400,000)
• White blood cell (5000-10,000)
i) Neutrophils (60-70%)
ii) Lymphocytes (20-25%)
iii) Monocytes (3-8%)
iv) Eosinophils (2-4%)
v) Basophils (0.5-1%)
HAEMOPOEISIS / BLOOD FORMATION
• Around 250 billion new RBC is 20 billion new WBC is and 25 million platelets are required for replacing the the aged or dead cell each day.
• formation of blood cells RBC WBC and platelets is termed as haemopoiesis or haematopoiesis and tissue involved in this process are known as haematopoietic tissue.
HAEMPOIETIC TISSUE
• formation of blood cells occur outside the bloodstream and the newly formed shall come into the circulation via diapedesis later WBC.
• bone marrow is the main site of haemopoiesis but in different stage of life it may occur in different tissue at summerised below :-
• in the earlier embryo stage blood cell develop from the mesoderm of the york sac.
• as the foetus gets mature, haemopoiesis starts in liver and spleen.
• From the second month of pregnancy haemopoiesis starts in the bone marrow and continues even after birth.
• Bone marrow is of two types i.e red bone marrow and yellow bone marrow.
• Infant and young children have only Reed bone marrow, but with their growing age, red marrow is replaced with yellow marrow.
ERYTHROPOIESIS
• formation of red blood cell is known as erythropoiesis.
1. first steps involved division of pluripotent stem cell to yield multipotent myeloid progenitor cell.
2. these cells in the presence of growth factor develop into Raipur site colony-forming cell or units.
3. Next step erythropoietin (EPO) along with the other growth factor promote the production of precursor cell known as proerythroblast or pronormoblast.
4. proerythroblast aur pronormoblast give rise to smaller daughter cell by going through a series of cell division.
5. Lastly the cell becomes reticulocytes as their nuclear are lost.
LEUCOPOIESIS
• formation of white blood is known as leukopoiesis
• all the different kind of WBC is obtained from the hematopoietic stem cell in the bone marrow.
• The myeloid progenitor cell forms distant ages giving rise to different WBCS except lymphocyte which originate from the lymphoid progenitor cell.
THROMBOPOIESIS
• formation of platelets are known as thrombopoiesis
• Megakaryoblasts are the precursor cell of platelets.
• Megakaryocytes giant cell having a large irregular nucleus containing DNA in excess amount.
• liver kidney and skeletal muscle secretin hormone known as thrombopoietin.
FORMATION OF HARMOGLOBIN
• hemoglobin HB is a respiratory pigment present in RBC and giving them their red colour.
• it is conjugated protein having 4% hemo and 96% globin protein.
• normal level of hemoglobin in human body.
~ hatesex altitude exercise excitement and adrenaline level affect the HB level in the blood.
1. Normal hemoglobin level in males is 14 to 17gm / 100ml
2. Normal hemoglobin level in females is 12 to 15gm / 100ml
3. Normal hemoglobin level in newly born babies 14.5 to 18.5 gm/100ml.
BLOOD COAGULATION (BLOOD CLOTTING)
• blood coagulation is also known as blood clotting is the process by which blood from its liquid state changes to a gel like consistency.
• blood clotting is the process by which blood forms clots.
• clotting can be divided into three stages.
1. Intrinsic pathway.
2. Extrinsic pathway.
3. Common pathway.
1. Intrinsic pathway
• this pathway is more complex and occur more slowly usually in several minutes.
• Activators are either in direct contact with blood or contained within the blood vessels.
• in endothelial cells are damaged blood comes in direct contact with collagen fibres in the connective tissue around the endothelial of blood vessels.
• Injury to any serial cell cause damage to platelets resulting in release of phospholipid by the platelets.
• phospholipid and Ca2+ participate in the activation of factor x.
2. Extrinsic pathway
• it consists of your steps and occurs rapidly with in a second.
• in this pathway a tissue protein called tissue factor TF.
• it is a complex mixture of lipoprotein and phospholipid released from the surface of damage cell.
• in the presence of CA2+, TF activate factor x.
• once it activate it becomes it combine with factor V in presence of of CA2+ to form active enzyme.
COMMON PATHWAY
• the formation of prothrombinase is the starting point of common pathway.
• in the second stage of blood clotting prothrombinase and calcium catalyzes the conversion of prothrombin to thrombin.
• in the third stage thrombin in presence of calcium convert fibrinogen (soluble) to loose fibrin threads (insoluble).
• tum bin also activates factor XIII which strengthen and stabilizes the fibrin thread into a a sturdy clot.
BLOOD TRANSFUSION
• it is a life saving procedure indicate dead for replacement of blood cells in blood deficiency on use of large amount of blood through bleeding.
• blood transfusion becomes instl in condition like anaemia, hemorrhage, trauma, burns and surgery.
ex- donor is a person who donate the blood and the person who receive the blood is a recipient.
Individual with blood group O are universal donor and individual with blood group AB universal acceptor.
PRECAUTIONS DURING BLOOD TRANSFUSION
~ following precautions should be taken during blood transfusion.
• blood transfusion should be performed only in case of emergency or critical conditions.
• cross matching should always be performed before transfusion.
• blood donors should always be tested for disease which spread via blood
Eg Aids, syphilis etc.
• during the transfusion proper aseptic measure should be taken.
• before the transfusion the label of the blood bottles bag should be checked for name of recipient blood group etc.
• during the transfusion careful watch on recipient is must for 10 to 15 minutes of starting of transfusion.
SIGNIFICANCE OF BLOOD TRANSFUSION
Transfusion is indicated in the following conditions.
1. Blood loss - transfusion blood transfusion is indicated in condition of blood loss like trauma surgery etc.
2. Blood disease - transfusion becomes instead in blood disease like aplastic anaemia, haemophilia clotting defects, leukaemia etc.
3. Acute poisoning - transmission is indicated in case of carbon monoxide poisoning.
4.Hemolytic disease - exchange transfusion is indicated in haemolytic disease of infants.
BLOOD GROUPS
• blood groups are decided by presence or absence of certain red cell antigens present on the surface of RBC membrane.
• the antigens are lipoprotein or glycoprotein.
~ Transfusion
Intracellular is the transfer of whole blood or blood components red blood cell only for blood plasma into blood stream or directly into the red bone marrow.
~ Donor
The person who donate blood is called donor.
~ Recipient
The person who received the blood is called recipient.
In a hemagglutination reaction
a) cell antigen is called as agglutinogen.
b) the antibody involved in the action is called as agglutinin.
There are two main blood group system
1. A-B-O SYSTEM
2. RH SYSTEM
1. A-B-O System
• The ABO blood group is based on two glycolipid antigens called as A and B antigens
• A person whose RBCs display only antigen A has type B blood.
• A person whose RBCs display only antigen B has type B blood.
• A person whose RBCs display both antigen A and B have type AB blood.
• A person whose RBCs display neither antigen A nor B have type O blood.
~~> Hence there are mainly four type of groups :-
• A Group
• B Group
• AB Group
• O Group
Blood group A
• when RBCs are mixed with anti-A and anti-B serum and if agglutination is observed with anti-A then the blood group is A.
• This indicates that antigen-A is present on RBCs and the serum contains anti-B antibodies.
• Blood group A is compatible with group A and group O.
• It is inCompatible with group B and group AB.
Blood group AB
• when RBCs are mixed with anti-A and anti-B serum, and if agglutination is observed with anti-B than the blood group is supposed to be AB.
• this indicates the presence of antigen A and B on RBC and the serum does not have any antigen A and antigen B antibodies.
• AB blood group is compatible with group A, B, AB and group O and therefore people with blood group AB are called as universal recipient because they don't have antigens A and B to attack the donated RBC.
Blood group O
• When RBC are mixed with antigen A and antigen B serum and if aggulation is not observed with either of them then the blood group is O.
• This indicate absence of antigen A and antigen B on RBC and the serum contains both and anti- A and anti- b antibodies.
• Hence people with blood group O are referred to as universal donor.
• Type O people can receive only type of blood.
• They cannot receive blood of type A, B and AB.
2. Rhesus blood group system (Rh factor)
• The Rh blood group is so named because the antigen was discovered in the blood of the rhesus monkey.
• people whose RBC have RH antigen are generated RH positive those who lack RH antigen are designated RH negative.
• normal blood plasma does not contain and antigen-RH antibodies.
• if an average person receive and RH positive blood transfusion the immune system start to make antigen RH antibodies that will remain in the blood.
• if a second transfusion of RH positive blood is given later the previously formed antigen RH antibodies will cause agglutination and hemolysis of the RBC in the donated blood and a severe reaction may occur.
DISORDER OF THE BLOOD
1. Haemophilia :-
• It is the oldest hereditary bleeding disorder.
• It is an inherited deficiency of clotting factor that impairs the body's ability to stop bleeding.
• In severe haemophilia a patient of an experience internal bleeding.
• Two most common type of humour failure are haemophilia a and haemophilia b. Which result due to deficiency of different blood clotting factor.
• the treatment in valves injection of genetically injured clotting factor that prevent prolonged bleeding.
2. Leukemia :-
• it is a form of Cancer that affect the blood forming tissue such as bone marrow and lymphatic organs,this cause a large number of abnormal blood cells to be produced that multiply uncontrollably.
• vacuum relation of cancerous WBC in blood bone marrow interferes with the production of RBC WBC and platelets.
• As a result the oxygen carrying capacity of blood is decreased and an individual is most respectable to infection and blood clotting also is abnormal.
• Treatment vinclude surgery chemotherapy, radiation therapy, immunotherapy, and Vaccine therapy.
3.Sickle cell anemia (SCA)
• SCA is a serious disorder in which the body make sickle shaped red blood cell.
• Sickle shaped means that the red blood cells are shaped like a crescent.
• normal red blood cell are disc-shaped and removed easily through the blood vessels.
• red blood cell contain an iron rich protein called hemoglobin this protein carries oxygen from lungs to the rest of the body.
• sickle cell contain abnormal hemoglobin called sickle hemoglobin or hemoglobin s.
• sickle cells are stuff and sticky.
• they tend to block blood flow in the blood vessels to the limbs and organs.
• at low oxygen concentration in many capillaries hemoglobin molecules combined with each other to form like structure which distort the RBC membrane to form a sickle shaped.
4.Haemolytic disease of the Newborn (HDN)
• It is also called erythroblastosis fetalis.
It is blood disorder that occur when the blood type of the mother and baby are incompatible.
• Pregnant mother to produce red cell antibodies which can cross the placenta and destroy the baby's red cell causing hemolytic disease of the newborn HDN.
• The mother may develop these antibodies if foetal red blood cell across the placenta during pregnancy or delivery.
normally there is no direct contact occur between material and foetal blood while a woman is pregnant.
• The greatest possibility of foetal blood leakage into the material circulation occur at delivery the first born baby usually is not affected.
• If mother is pregnant again her anti- RH antibodies can cross the placenta and enter the bloodstream of the Foetus.
• An injection of antigen RH antibodies called antigen RH gamma globulin can be given to prevent HDN.
IMMUNE SYSTEM :-
• the organ cell involved in the body defence system collectively constituted the immune system.
• the immunological cell can be grouped into two main components.
1. Reticuloendothelial system (mononuclear phagocyte system)
2. Lymphoid component
1. Reticuloendothelial system
Reticuloendothelial system or aur mono nuclear phagocytic system is also known as as tissue macrophage system as it involve the formation of mononuclear phagocyte system.
From the bone marrow the monocytes enter to blood circulation and remain for 3 days and then migrate into the tissue.
in tissue this cell attend maturity develop phagocytic property and finally converts into macrophages.
this tissue macrophages are spread to different part of the body and collectively known as tissue macrophages system or reticuloendothelial system or MPS.
The macrophage of tissue macrophages system are abundantly present at the following sites of the body are.
1. Kupffer cells
2. Spleen.
3. Bone marrow
4. Lymph nodes.
5. Lungs.
6. Connective tissue.
7. Bones.
8. Central nervous system.
Function of mononuclear phagocytic system
1. Participate in inflammation and healing.
2. Participate in defence against the bacteria invading the body tissue.
3. Participate in immune responce and
4. Remove old RBCs, WBCs and Platelets.
2.Lymphoid components
lymphoid component is the part of immune system that include a network of lymphoid organ tissue and product of these cell.
The lymphoid organ can be grouped as follow :-
1. Central or primary lymphoid organs.
i) Thymus
ii) Bursa equivalent ( foetal liver and bone marrow).
2. Peripheral lymphoid organs
i) Lymph nodes
ii) Spleen and
iii) Mucosa - Associated Lymphoi tissue (MALT).
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