Table Contents

subject Number Page

Contents 1
Blood 2 -3
Functions 3
Blood Conditions 4-5
Blood Tests 6
Blood Treatments 7
Physiology 8
Circulation of blood through the human heart 8
Cell production and degradation 9
Oxygen transport 10 - 11
Carbon dioxide transport 11
Transport of hydrogen ions 12
Lymphatic system 12
Thermoregulation 12
Rate of flow 12
Hydraulic functions 13
Invertebrates 13
General medical 14
References 15

1
 Blood
Blood is a body fluid in the circulatory system of humans and other
vertebrates that delivers necessary substances such as nutrients and oxygen
to the cells and transports metabolic waste products away from those same
cells.
Blood is composed of blood cells suspended in blood plasma. Plasma,
which constitutes 55% of blood fluid, is mostly water (92% by volume),and
contains proteins, glucose, mineral ions, hormones, carbon dioxide (plasma
being the main medium for excretory product transportation), and blood
cells themselves. Albumin is the main protein in plasma, and it functions to
regulate the colloidal osmotic pressure of blood. The blood cells are mainly
red blood cells (also called RBCs or erythrocytes), white blood cells (also
called WBCs or leukocytes) and platelets (also called thrombocytes). The
most abundant cells in vertebrate blood are red blood cells. These contain
hemoglobin, an iron-containing protein, which facilitates oxygen transport
by reversibly binding to this respiratory gas and greatly increasing its
solubility in blood. In contrast, carbon dioxide is mostly transported
extracellularly as bicarbonate ion transported in plasma.
Vertebrate blood is bright red when its hemoglobin is oxygenated and dark
red when it is deoxygenated. Some animals, such as crustaceans and
mollusks, use hemocyanin to carry oxygen, instead of hemoglobin. Insects
and some mollusks use a fluid called hemolymph instead of blood, the
difference being that hemolymph is not contained in a closed circulatory
system. In most insects, this "blood" does not contain oxygen-carrying
molecules such as hemoglobin because their bodies are small enough for
their tracheal system to suffice for supplying oxygen.
Jawed vertebrates have an adaptive immune system, based largely on white
blood cells. White blood cells help to resist infections and parasites.
Platelets are important in the clotting of blood. Arthropods, using
hemolymph, have hemocytes as part of their immune system.

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Blood is circulated around the body through blood vessels by the pumping
action of the heart. In animals with lungs, arterial blood carries oxygen
from inhaled air to the tissues of the body, and venous blood carries carbon
dioxide, a waste product of metabolism produced by cells, from the tissues
to the lungs to be exhaled.
Medical terms related to blood often begin with hemo- or hemato- (also
spelled haemo- and haemato-) from the Greek word αἷμα (haima) for
"blood". In terms of anatomy and histology, blood is considered a
specialized form of connective tissue, given its origin in the bones and the
presence of potential molecular fibers in the form of fibrinogen.

Functions
Blood performs many important functions within the body, including:

 Supply of oxygen to tissues (bound to hemoglobin, which is carried in

red cells)
 Supply of nutrients such as glucose, amino acids, and fatty acids
(dissolved in the blood or bound to plasma proteins (e.g., blood lipids))
 Removal of waste such as carbon dioxide, urea, and lactic acid
 Immunological functions, including circulation of white blood cells, and
detection of foreign material by antibodies
 Coagulation, the response to a broken blood vessel, the conversion of
blood from a liquid to a semisolid gel to stop bleeding
 Messenger functions, including the transport of hormones and the
signaling of tissue damage
 Regulation of core body temperature
 Hydraulic functions

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 Blood Conditions

 Hemorrhage (bleeding): Blood leaking out of blood vessels may be

obvious, as from a wound penetrating the skin. Internal bleeding (such
as into the intestines, or after a car accident) may not be immediately
apparent.
 Hematoma: A collection of blood inside the body tissues. Internal
bleeding often causes a hematoma.
 Leukemia: A form of blood cancer, in which white blood cells
multiply abnormally and circulate through the blood. The abnormal
white blood cells make getting sick from infections easier than normal.
 Multiple myeloma: A form of blood cancer of plasma cells similar to
leukemia. Anemia, kidney failure and high blood calcium levels are
common in multiple myeloma.
 Lymphoma: A form of blood cancer, in which white blood cells
multiply abnormally inside lymph nodes and other tissues. The
enlarging tissues, and disruption of blood's functions, can eventually
cause organ failure.
 Anemia: An abnormally low number of red blood cells in the blood.
Fatigue and breathlessness can result, although anemia often causes no
noticeable symptoms.
 Hemolytic anemia: Anemia caused by rapid bursting of large numbers
of red blood cells (hemolysis). An immune system malfunction is one
cause.
 Hemochromatosis: A disorder causing excessive levels of iron in the
blood. The iron deposits in the liver, pancreas and other organs,
causing liver problems and diabetes.
 Sickle cell disease: A genetic condition in which red blood cells
periodically lose their proper shape (appearing like sickles, rather than
discs). The deformed blood cells deposit in tissues, causing pain and
organ damage.

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 Bacteremia: Bacterial infection of the blood. Blood infections are
serious, and often require hospitalization and continuous antibiotic
infusion into the veins.
 Malaria: Infection of red blood cells by Plasmodium, a parasite
transmitted by mosquitos. Malaria causes episodic fevers, chills, and
potentially organ damage.
 Thrombocytopenia: Abnormally low numbers of platelets in the blood.
Severe thrombocytopenia may lead to bleeding.
 Leukopenia: Abnormally low numbers of white blood cells in the
blood. Leukopenia can result in difficulty fighting infections.
 Disseminated intravascular coagulation (DIC): An uncontrolled
process of simultaneous bleeding and clotting in very small blood
vessels. DIC usually results from severe infections or cancer.
 Hemophilia: An inherited (genetic) deficiency of certain blood clotting
proteins. Frequent or uncontrolled bleeding can result from
hemophilia.
 Hypercoaguable state: Numerous conditions can result in the blood
being prone to clotting. A heart attack, stroke, or blood clots in the
legs or lungs can result.
 Polycythemia: Abnormally high numbers of red blood cells in the
blood. Polycythemia can result from low blood oxygen levels, or may
occur as a cancer-like condition.
 Deep venous thrombosis (DVT): A blood clot in a deep vein, usually
in the leg. DVTs are dangerous because they may become dislodged
and travel to the lungs, causing a pulmonary embolism (PE).
 Myocardial infarction (MI): Commonly called a heart attack, a
myocardial infarction occurs when a sudden blood clot develops in
one of the coronary arteries, which supply blood to the heart

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 Blood Tests

 Complete blood count: An analysis of the concentration of red blood

cells, white blood cells, and platelets in the blood. Automated cell
counters perform this test.
https://www.webmd.com/a-to-z-guides/complete-blood-count-cbc
 Blood smear: Drops of blood are smeared across a microscope slide, to
be examined by an expert in a lab. Leukemia, anemia, malaria, and
numerous other blood conditions can be identified with a blood smear.
 Blood type: A test for compatibility before receiving a blood transfusion.
The major blood types (A, B, AB, and O) are determined by the protein
markers (antigens) present on the surface of red blood cells.
 Coombs test: A blood test looking for antibodies that could bind to and
destroy red blood cells. Pregnant women and people with anemia may
undergo Coombs testing.
 Blood culture: A blood test looking for infection present in the
bloodstream. If bacteria or other organisms are present, they may
multiply in the tested blood, allowing their identification.
 Mixing study: A blood test to identify the reason for blood being "too
thin" (abnormally resistant to clotting). The patient's blood is mixed in a
tube with normal blood, and the mixed blood's properties may provide a
diagnosis.
 Bone marrow biopsy: A thick needle is inserted into a large bone
(usually in the hip), and bone marrow is drawn out for tests. Bone
marrow biopsy can identify blood conditions that simple blood tests
cannot.

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 Blood Treatments

 Chemotherapy: Medicines that kill cancer cells. Leukemias and

lymphomas are usually treated with chemotherapy.
 Blood transfusion: A blood donor's red blood cells are separated from
their plasma and packed into a small bag. Transfusing the concentrated
red blood cells into a recipient replaces blood loss.
 Platelet transfusion: A blood donor's platelets are separated from the rest
of blood and concentrated into a plastic bag. Platelet transfusion is
generally only performed when platelet counts fall to very low levels.
 Fresh frozen plasma: A blood donor's plasma (liquid blood) is separated
from the blood cells, and frozen for storage. Plasma transfusion can
improve blood clotting and prevent or stop bleeding that's due to clotting
problems.
 Cryoprecipitate: Specific proteins are separated from blood and frozen in
a small volume of liquid. Cryoprecipitate transfusion can replace specific
blood clotting proteins when their levels are low, such as in people with
hemophilia.
 Anticoagulation: Medicines to "thin" the blood and prevent clotting in
people at high risk from blood clots. Heparin, enoxaparin (Lovenox) and
warfarin (Coumadin) are the medicines most often used.
 Antiplatelet drugs: Aspirin and clopidogrel (Plavix) interfere with
platelet function and help prevent blood clots, including those that cause
heart attacks and strokes.
 Antibiotics: Medicines to kill bacteria and parasites can treat blood
infections caused by these organisms.
 Erythropoietin: A hormone produced by the kidney that stimulates red
blood cell production. A manufactured form of erythropoietin can be
given to improve the symptoms of anemia.
 Bloodletting: In people with problems caused by too much blood (such
as from hemochromatosis or polycythemia), occasional controlled
removal of blood may be necessary.
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 Physiology
Circulatory system

Circulation of blood through the human heart

Blood is circulated around the body through blood vessels by the pumping
action of the heart. In humans, blood is pumped from the strong left
ventricle of the heart through arteries to peripheral tissues and returns to the
right atrium of the heart through veins. It then enters the right ventricle and
is pumped through the pulmonary artery to the lungs and returns to the left
atrium through the pulmonary veins. Blood then enters the left ventricle to
be circulated again. Arterial blood carries oxygen from inhaled air to all of
the cells of the body, and venous blood carries carbon dioxide, a waste
product of metabolism by cells, to the lungs to be exhaled. However, one
exception includes pulmonary arteries, which contain the most
deoxygenated blood in the body, while the pulmonary veins contain
oxygenated blood.
Additional return flow may be generated by the movement of skeletal
muscles, which can compress veins and push blood through the valves in
veins toward the right atrium.
The blood circulation was famously described by William Harvey in 1628.

8
 Cell production and degradation
In vertebrates, the various cells of blood are made in the bone marrow in a
process called hematopoiesis, which includes erythropoiesis, the production
of red blood cells; and myelopoiesis, the production of white blood cells
and platelets. During childhood, almost every human bone produces red
blood cells; as adults, red blood cell production is limited to the larger
bones: the bodies of the vertebrae, the breastbone (sternum), the ribcage,
the pelvic bones, and the bones of the upper arms and legs. In addition,
during childhood, the thymus gland, found in the mediastinum, is an
important source of T lymphocytes. The proteinaceous component of blood
(including clotting proteins) is produced predominantly by the liver, while
hormones are produced by the endocrine glands and the watery fraction is
regulated by the hypothalamus and maintained by the kidney.
Healthy erythrocytes have a plasma life of about 120 days before they are
degraded by the spleen, and the Kupffer cells in the liver. The liver also
clears some proteins, lipids, and amino acids. The kidney actively secretes
waste products into the urine.

9
 Oxygen transport

Basic hemoglobin saturation curve. It is moved to the right in higher acidity

(more dissolved carbon dioxide) and to the left in lower acidity (less
dissolved carbon dioxide)
About 98.5% of the oxygen in a sample of arterial blood in a healthy human
breathing air at sea-level pressure is chemically combined with
the hemoglobin. About 1.5% is physically dissolved in the other blood
liquids and not connected to hemoglobin. The hemoglobin molecule is the
primary transporter of oxygen in mammals and many other species (for
exceptions, see below). Hemoglobin has an oxygen binding capacity
between 1.36 and 1.40 ml O2 per gram hemoglobin, which increases the
total blood oxygen capacity seventyfold, compared to if oxygen solely were
carried by its solubility of 0.03 ml O2 per liter blood per mm Hg partial
pressure of oxygen (about 100 mm Hg in arteries) With the exception of
pulmonary and umbilical arteries and their corresponding veins, arteries
carry oxygenated blood away from the heart and deliver it to the body
via arterioles and capillaries, where the oxygen is consumed;
afterwards, venules and veins carry deoxygenated blood back to the heart.
Under normal conditions in adult humans at rest, hemoglobin in blood
leaving the lungs is about 98–99% saturated with oxygen, achieving an
oxygen delivery between 950 and 1150 ml/min to the body. In a healthy
adult at rest, oxygen consumption is approximately 200–250 ml/min, and
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deoxygenated blood returning to the lungs is still roughly 75% (70 to
78%) saturated. Increased oxygen consumption during sustained exercise
reduces the oxygen saturation of venous blood, which can reach less than
15% in a trained athlete; although breathing rate and blood flow increase to
compensate, oxygen saturation in arterial blood can drop to 95% or less
under these conditions. Oxygen saturation this low is considered dangerous
in an individual at rest (for instance, during surgery under anesthesia).
Sustained hypoxia (oxygenation less than 90%), is dangerous to health, and
severe hypoxia (saturations less than 30%) may be rapidly fatal.
A fetus, receiving oxygen via the placenta, is exposed to much lower
oxygen pressures (about 21% of the level found in an adult's lungs), so
fetuses produce another form of hemoglobin with a much higher affinity for
oxygen (hemoglobin F) to function under these conditions.
Carbon dioxide transport
CO2 is carried in blood in three different ways. (The exact percentages vary
depending whether it is arterial or venous blood). Most of it (about 70%) is
converted to bicarbonate ions HCO−
3 by the enzyme carbonic anhydrase in the red blood cells by the reaction

CO2 + H2O → H2CO3 → H+ + HCO−

3; about 7% is dissolved in the plasma; and about 23% is bound to

hemoglobin as carbamino compounds. Hemoglobin, the main oxygen-

carrying molecule in red blood cells, carries both oxygen and carbon
dioxide. However, the CO2 bound to hemoglobin does not bind to the same
site as oxygen. Instead, it combines with the N-terminal groups on the four
globin chains. However, because of allosteric effects on the hemoglobin
molecule, the binding of CO2 decreases the amount of oxygen that is bound
for a given partial pressure of oxygen. The decreased binding to carbon
dioxide in the blood due to increased oxygen levels is known as
the Haldane effect, and is important in the transport of carbon dioxide from
the tissues to the lungs. A rise in the partial pressure of CO2 or a lower pH
will cause offloading of oxygen from hemoglobin, which is known as
the Bohr effect.

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 Transport of hydrogen ions
Some oxyhemoglobin loses oxygen and becomes deoxyhemoglobin.
Deoxyhemoglobin binds most of the hydrogen ions as it has a much greater
affinity for more hydrogen than does oxyhemoglobin.

Lymphatic system
In mammals, blood is in equilibrium with lymph, which is continuously
formed in tissues from blood by capillary ultrafiltration. Lymph is collected
by a system of small lymphatic vessels and directed to the thoracic duct,
which drains into the left subclavian vein, where lymph rejoins the systemic
blood circulation.

Thermoregulation
Blood circulation transports heat throughout the body, and adjustments to
this flow are an important part of thermoregulation. Increasing blood flow
to the surface (e.g., during warm weather or strenuous exercise) causes
warmer skin, resulting in faster heat loss. In contrast, when the external
temperature is low, blood flow to the extremities and surface of the skin is
reduced and to prevent heat loss and is circulated to the important organs of
the body, preferentially.

Rate of flow
Rate of blood flow varies greatly between different organs. Liver has the
most abundant blood supply with an approximate flow of 1350 ml/min.
Kidney and brain are the second and the third most supplied organs, with
1100 ml/min and ~700 ml/min, respectively.
Relative rates of blood flow per 100 g of tissue are different, with kidney,
adrenal gland and thyroid being the first, second and third most supplied
tissues, respectively.
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 Hydraulic functions
The restriction of blood flow can also be used in specialized tissues to cause
engorgement, resulting in an erection of that tissue; examples are
the erectile tissue in the penis and clitoris.
Another example of a hydraulic function is the jumping spider, in which
blood forced into the legs under pressure causes them to straighten for a
powerful jump, without the need for bulky muscular legs.

Invertebrates
In insects, the blood (more properly called hemolymph) is not involved in
the transport of oxygen. (Openings called tracheae allow oxygen from the
air to diffuse directly to the tissues.) Insect blood moves nutrients to the
tissues and removes waste products in an open system.
Other invertebrates use respiratory proteins to increase the oxygen-carrying
capacity. Hemoglobin is the most common respiratory protein found in
nature. Hemocyanin (blue) contains copper and is found
in crustaceans and mollusks. It is thought that tunicates (sea squirts) might
use vanabins (proteins containing vanadium) for respiratory
pigment (bright-green, blue, or orange).
In many invertebrates, these oxygen-carrying proteins are freely soluble in
the blood; in vertebrates they are contained in specialized red blood cells,
allowing for a higher concentration of respiratory pigments without
increasing viscosity or damaging blood filtering organs like the kidneys.
Giant tube worms have unusual hemoglobins that allow them to live in
extraordinary environments. These hemoglobins also carry sulfides
normally fatal in other animals.

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 General medical
 Disorders of volume
 Injury can cause blood loss through bleeding. A healthy adult can lose
almost 20% of blood volume (1 L) before the first symptom,
restlessness, begins, and 40% of volume (2 L) before shock sets
in. Thrombocytes are important for blood coagulation and the formation
of blood clots, which can stop bleeding. Trauma to the internal organs or
bones can cause internal bleeding, which can sometimes be severe.
 Dehydration can reduce the blood volume by reducing the water content
of the blood. This would rarely result in shock (apart from the very
severe cases) but may result in orthostatic hypotension and fainting.

 Disorders of circulation
 Shock is the ineffective perfusion of tissues, and can be caused by a
variety of conditions including blood loss, infection, poor cardiac output.
 Atherosclerosis reduces the flow of blood through arteries, because
atheroma lines arteries and narrows them. Atheroma tends to increase
with age, and its progression can be compounded by many causes
including smoking, high blood pressure, excess circulating lipids
(hyperlipidemia), and diabetes mellitus.
 Coagulation can form a thrombosis, which can obstruct vessels.
 Problems with blood composition, the pumping action of the heart, or
narrowing of blood vessels can have many consequences including
hypoxia (lack of oxygen) of the tissues supplied. The
term ischemia refers to tissue that is inadequately perfused with blood,
and infarction refers to tissue death (necrosis), which can occur when the
blood supply has been blocked (or is very inadequate).

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 References

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Retrieved 1 November 2012.
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