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Physiology of RBC BDS 2014
Physiology of RBC BDS 2014
Describe the morphological features of RBCs, their normal counts and their
function
Describe the structure of HB molecule, its function and normal concentration
Describe the life cycle of RBCs
Describe the production of new RBCs
Describe the fate of RBCs
Define anemia and outline the different classifications of anemia
List the different blood indices
Describe the physiological effect of anemia
Define polycythemia and outline its classification
References
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2.
ERYTHROCYTES (RBCS)
Non nucleated Biconcave discs
Mean diameter ~7.8
Thickness of 2.5 at the thickest point and 1 or
less in the center.
The average volume of the red blood cell is 90 to
95 3.
It has no mitochondria, or other organelles.
Filled with hemoglobin (Hb), a protein that functions
in gas transport
Cell Membrane
The membrane skeleton is made up of spectrin and is anchored to
the transmembrane protein band 3 by the protein ankyrin
Band 3 is also an important anion exchanger
Erythrocyte Function
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2.
3.
Its small size and biconcave shape provide a huge surface area
relative to volume
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3.
Hemoglobin molecule
Hemoglobin is composed of the protein globin each of which is
bound to a heme group
Globin is made up of 2 and chains,
Each heme group bears an atom of iron,
Each iron can bind to one O2molecule
So each hemoglobin molecule can transport 4 molecules of O2
If you know that there are 250 million molecules of Hb / cell you can imagine how
much oxygen is carried by each RBC
Function of Haemoglobin
optimal conditions
But under normal conditions some hemoglobin exists in forms such as
Methemoglobin (metHb) an oxidized form of hemoglobin that has
an increased affinity for oxygen, resulting in a reduced ability to
release oxygen to tissues
Carboxyhemoglobin (COHb) Combined with CO
The oxygen carrying capacity of hemoglobin when fully saturated with
oxygen binds with 1.34 ml O2/ g Hb.
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Hb4 + 4O2
Hb4O8
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The amount of oxygen physically dissolved in the blood depends on its solubility
and is proportional to partial pressure (Henrys law)
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The first reaction is rate-limiting and is very slow unless catalyzed by the
plasma via a transporter that exchanges one bicarbonate for one chloride ion
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Erythropoiesis
Production of Red Blood Cells
Erythropoiesis
During this reticulocyte stage, the cells pass from the bone marrow into the blood
capillaries by diapedesis
within 1 to 2 days the cell become a mature erythrocyte.
Because of the short life of the reticulocytes, their concentration is normally slightly
less than1%
CONTROL OF ERYTHROPOEISIS
I. Hormonal control
1. Erythropoietin
Anaemia
Hemorrhage
High altitude
Lung disease
Heart failure
Norepinephrine and epinephrine and
several of the prostaglandins stimulate
erythropoietin production.
also stimulates the release of reticulocytes
to the circulation.
Hormonal Controlcont
2. Other hormones
Androgens, Thyroid, cortisol & growth hormones are essential
for normal red cell formation
Androgens e.g. testosterone: increase erythropoiesis through
directly stimulating bone marrow and indirect stimulation of
erythropoietin release .
Thyroid hormones (T3 and T4): stimulate the metabolism
of all body cells including the bone marrow
Glucocorticoids: stimulates the general metabolism of all
cells including the bone marrow.
2. Iron
Essential for the synthesis of Hemoglobin.
Deficiency causes Microcytic, Hypochromic Anemia.
3. B12 (Cyanocobalamine) & Folic Acid:
Deficiency causes Megaloblastic Anemia Or Pernicious
4. Other elements:
Vit C -Iron absorption, Copper, Cobalt, zinc, manganese
Erythrocyte Disorders
Anemia deficiency of hemoglobin in the blood( low
oxygen-carrying capacity)
This can be caused by
i. Decrease number of RBCs
ii. Decrease hemoglobin in the cells
Anemia is a symptom rather than a disease
Blood oxygen levels cannot support normal metabolism
Signs/symptoms include fatigue, paleness, shortness of
breath, and chills
7.
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Hematocrit (PCV)
It is the percentage ratio of RBCs volume
to the total blood volume.
number of RBC
ECF ; Dehydration
MCV =
PCV X 10
RBCs count in millions/ L
Hb content (mg/dL) X 10
MCH =
RBCs count in millions/ L
MCHC =
Hb content (mg/dL)
X 100
PCV
Effect of anemia
The effects of anemia are
mostly on the circulatory
system:
It increases the work load
on the heart.
It is accompanied by
hyperdynamic circulation
and functional murmurs.
It leads to tissue hypoxia
and acute heart failure
Polycythemia
Polycythemia is an abnormal excess of erythrocytes
It increases blood viscosity, causing it to sludge, or flow
sluggishly.
It is classified to:
A. Primary polycythemia
i. Acquired ; Polycythemia vera
ii. Hereditary
B. Secondary polycythemia
High altitude , Smoking , Hypoxemia, Chronic lung
disease ,Sleep apnea.