1. Introduction Physiology is the study of the living things
Introduction Physiology is the study of the living things. (from Greek physis = nature; logos= study physiology is concerned with the way the human body works. It is the study of the functions of systems and organs. Organs consist of tissues which are formed of cells

2. Blood A vital fluid which circulates within cardiovascular system.
The total blood volume is about 5600ml in a 70 kg man( 8% of body weight).
It is composed of two main parts
-plasma 55%
-cellular elements 45%.....RBC’s, WBC’s and platelets

3. Blood 55% Plasma Erythrocytes Leucocytes - Inorganic substances Na, cl
- Water
- Inorganic substances Na, cl
-Organic substances
plasma proteins
plasma lipids
glucose &amino acids
45 % blood elements
Erythrocytes
Leucocytes
Platelets

4. Function of the blood
Transport function
e.g. glucose, oxygen, carbon dioxide, hormones,……….
Defensive function
e.g. white blood cells
Hemostatic function
stoppage of bleeding after injury
Homeostatic function
what’s homeostasis?

5. Homeostasis maintenance of constant conditions in the internal environment

6. Site of hematopoiesis…..
in fetus Liver & spleen
in adult Bone marrow

7. Plasma It is a yellow clear fluid composed of Water 90%
Inorganic substances – 0.9% Na+ , Cl- , HCO3
Organic substances 9.1%
-plasma proteins
-lipids…triglycerides, cholesterol & fatty acids
-other organic substances glucose, amino acids, vitamins, enzymes, waste products
4 Blood gases O2 , CO2 .

8. Plasma Proteins albumin globulins (α, β & γ) prothrombin fibrinogen
-Concentration…… 7 gm \dl
-Site of formation…..?
….liver ( albumin, fibrinogen,prothrombin & 50% of globulins)
….lymphocytes (gamma globulin)
-albumin/globulin ratio ??

9. Albumin-globulin ratio ( A/G Ratio)
Normal A/G ratio 1.2 – 1.6
It is decreased in
1- liver diseases…… decreased albumin production
2- renal diseases…..albumin is lost in urine

10. Functions of plasma proteins
Osmotic function…….albumin ( oncotic pressure)
Defensive function……. γ globulins
Blood clotting…..prothrombin and fibrinogen
Blood viscosity………. fibrinogen
Buffer function
Capillary function
transport function…( hormones, metals, drugs…..)

11. Red Blood Corpuscles Erythrocytes / RBC’s
Biconcave discs
count … million /mm3
structure
-semipermeable membrane
-hemoglobin ( content and function)
-no nucleus
Life span … days

12. Hem…..iron containing porphyrin derivatives
Hemoglobin( Hb)
Hem…..iron containing porphyrin derivatives
Globin…protein part formed of 4 polypeptide chains
Hb A …..2 α & 2 β (96- 98% of Hb in adult)
Hb A2 ….2 α & 2 δ ( 2.5 % of adult Hb)
Hb F ….2 α & 2 γ ( Hb of fetus-more affinity to O2 )
Function of Hb
1- transport oxygen from lungs to tissues & carbon dioxide from tissues to the lungs
2- buffering action

13. Erythropoiesis Definition…formation of new RBC’s Site in fetus Liver & spleen in adult Bone marrow

14. Factors affecting erythropoiesis
Oxygen supply to the tissues
decreased oxygen…….erythropoietin….increased RBC
(erythropoietin hormone ? )
2. Healthy bone marrow (erythropoiesis in adult)
3- healthy liver ( why ? )
storage of Fe, Vit B12, erythropoiesis in fetus
4. Diet……iron, vitaminC, vitamin B12 and folic acid
- iron…………………….hemoglobin formation
- Vit B12 & folic acid……DNA synthesis & cell division
- proteins……………..…globin formation
5. Hormones
androgen, thyroid & glucocorticoid hormones stimulates erythropoiesis

16. Erythropoietin Glycoprotein hormone
Hypoxia is the main stimulus for its secretion
In adult 85% is formed by the kidney and 15% is formed by the liver
It Stimulates all steps of erythropoiesis and increases the production of RBCs

17. Hypoxia, cobalt salts, androgens (testosterone), catecholamines, corticosteroids, growth hormone, and thyroxin.
production of proerythroblast from the stem cells.
Increasing the speed of conversion of one step to the other in the erythroblastic stages.
It accelerates the synthesis of Hb.
Erytheropiotin is a glycoprotein which is normally present in the plasma in low concentration, has a half-life of about 5h. It is produced by the action of an enzyme called renal erytheropiotic factor ( erythergenin) on a circulating plasma protein formed by the liver, erytheropiotin may be secreted directly by the kidneys (From renal glomerular epithelial cells), also about % of the erytheropiotin is formed by the liver.
Erytheropiotin stimulate the bone marrow to produce RBCs through convergen of stem cells to pro-erythroblasts. It stimulates synthesis of RNA and protein in red cell precursors, increasing their rate of mitosis and their maturation time.
Erythropoietin 17

18. Iron
Gastric HCl & vitamin C reduce iron from ferric state to ferrous state
Iron is absorbed in upper small intestine
Iron is found in Hb, myoglobin & ferritin ( storage frorm)
Folic acid
Essential for DNA synthesis & cell division
Vitamin B12
Essential for DNA synthesis, cell division & metabolism of myelin sheath
It unites with intrinsic factor from the stomach then absorbed from terminal ileum
Deficiency-----macrocytic anemia & neurological symptoms
Treatment by injection of vit B12

19. Anemia It is a decrease in number of RBCs, hemoglobin content or both.
normal RBCs count…… million/ mm3
normal Hb content…… gm/ dl
Types
1- normocytic normochromic anemia
hemorrhage, hemolytic anemia & bone marrow depression (aplastic
anemia)
2-microcytic hypochromic anemia
iron deficiency( decreased iron intake &absorption –chronic blood loss)
3- macrocytic hyperchromic anemia
vit B112 deficiency absent intrinsic factor, disease of lower ileum, decreased storage in liver disease
folic acid deficiency decreased intake, disease of small intestine ,cytotoxic drugs

20. Pernicious anemia
autoimmune disease of elderly women
Macrocytic anemia and nervous manifestations
caused by absence of HCL & intrinsic factor
Polycythemia
Increased number of RBC’s
Primary polycythemia ( Polycythemia Vera)
Increased RBC’s, WBCs & platelets
Secondary polycythemia
Increased RBCs in hypoxia