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Darah: Dr. Yetty Machrina Bagian Fisiologi FK Usu
Darah: Dr. Yetty Machrina Bagian Fisiologi FK Usu
Distribusi
oxygen, CO2, nutrien, hormone, waste
product/sisa metabolisme
Regulasi
Body temperature, pH
Proteksi
Melindungi tubuh dari kehilangan cairan
Melindungi tubuh dari infeksi
DARAH
Merupakan jaringan tubuh
Volume 6 – 8 % BB
To 38oC, pH 7,35 – 7,45
Terdiri dari plasma darah dan komponen
padat
Components of Blood
is the liquid portion of the blood and
PLASMA consists primarily of water (92%) and
plasma proteins (7%)
Proteins - albumin, globulins, and
fibrinogen
BLOOD =
55% plasma + 45% formed elements
PLASMA DARAH
90 % air
Air
Protrombin
Fibrinogen
Albumin
Globulin
Hematocrit
When whole blood is spun
down in a centrifuge is
seperates into three distinct
components: plasma, white
blood cells combined with
the platelets, and the red
blood cells.
About 55% of the blood
is plasma and about 45%
are cells –( males generally having
a higher percentage of cells than females).
If the percentage of cells
becomes too low the person
is said to have anemia.
Blood Plasma
Blood is composed of cellular and non-cellular elements.
If the cellular components are removed: plasma remains.
HEMATOCRIT
Ht < = Anemia
Ht > = Polycytemia, perembesan
plasma,dehydrasi (polisitemia relatif)
KOMPONEN ELEMEN
Sel darah merah (eritrosit
fs : 99% mengangkut O2 dari paru ke
seluruh tubuh dan CO2 dari jaringan
tubuh ke paru.
Sel darah putih (leukosit)
fs : Melindungi tubuh dari infeksi dan
kanker
Platelet (trombosit)
fs : Pembekuan darah
SEL ERITROSIT
• Bentuk cakram, biconcave dengan bagian tepi
lebih tebal.
• diameter : 7m
• Umur : 120 hari
• Jumlah normal : 5. 106 / mm3
• Dibentuk di red bone marrow, dihancurkan/
dirombak di hati dan limpa
• Eritropoeisis dipengaruhi oleh eritropoeitin hormon.
• Pembentukan eritosit juga dipengaruhi oleh vit B12,
AA , ferum, testosteron
Here is a picture of some blood - most all the cells you
see are erythrocytes - probably the easiest cell to identify
in all anatomy and physiology.
Each RBC can contain up to 250 million
hemoglobin molecules!
Erythrocytes have a bi-concave disc shape - they look like donuts - their
shape optimizes their ability to carry oxygen
Red blood cells
Regulation of Erythropoiesis
Erythropoiesis = formation of
erythrocytes
the body must produce about 2.5 million new RBCs every
second
in adults, erythropoiesis occurs mainly in the marrow of
the sternum, ribs, vertebral processes, and skull bones
begins with a cell called a hemocytoblast or stem cell (below)
rate is regulated by oxygen levels:
hypoxia (lower than normal oxygen levels) is detected by
cells in the kidneys
kidney cells release the hormone erythropoietin into the
blood
erythropoietin stimulates erythropoiesis by the bone
marrow
Red blood cells
Haemoglobin
Haemoglobin is a molecule specialised for transport of oxygen,
1. Nutrional Anemia
2. Hemolitik Anemia
3. Defisiensi Anemia
4. Renal Anemia
5. Aplastik Anemia
6. Pernicious Anemia
Sickle Cell Anemia
POLYCYTHEMIA
Jika erytrosit > 5.106
Dibagi atas : Polisitemia primer ( P. vera )
Polisitemia sekunder
Polisitemia primer
Ht dapat mencapai 70% - 80%
Viskositas menjadi lebih besar (5 -7x normal)
sehingga aliran darah menjadi lambat. O2 carry
menurun.
Viskositas TPRBPKerja jantung
Polistemia sekunder
Merupakan mekanisme adaptif yang diinduksi
oleh eritropoeitin untuk meningkatkan kapasitas
darah mengangkut O2 sebagai respon terhadap
penurunan penyaluran O2 ke jaringan yang
berkepanjangan.
Pada orang yang tinggal di dataran tinggi
Penderita penyakit paru kronik atau gagal
jantung
Eritrosit naik 6.106 – 8. 106
SEL DARAH PUTIH (LEUKOSIT)
Mempunyai inti
Terbagi atas : Agranular leucocyte
Granular leucocyte
Agranulocyte Granulocyte
Monocyte Basophil
Lymphocyte Eosinophil Neutrophil
GRANULOCYTES
1. Neutrophils
• 40 - 75% of leukocytes
• 10 - 14um diameter
• Exhibit multi - lobed nuclei
• Cytoplasm lightly stippled with
indistinct granules
- represents large lysosomes
Erythrocyte
• Active phagocytes that ingest
Cytoplasm Multi - lobed
bacteria & cell fragments nucleus
GRANULOCYTES
2. Eosinophils Bi - lobed
Cytoplasmic
nucleus
granules
• 1 - 6% of leukocytes
• 10 - 14um diameter
• Bilobed nucleus
• Abundant large ovoid granules
- stain bright red with eosin
• Phagocytes that ingest
antibody + antigen complexes
• Release histaminase that
inhibits inflammation
GRANULOCYTES
Cytoplasmic Bi - lobed
granules
3. Basophils nucleus
• < 1% of leukocytes
• 10 - 16um diameter
• U- or S-shaped bi-lobed
nucleus
• large blue cytoplasmic
granules
- exhibit basophilic
staining
• Granules contain materials
that mediate inflammation
- eg. histamine
AGRANULOCYTES
1. Lymphocytes
Large
• 20 - 30% of leukocytes Small
• 6 - 9um diameter (small)
• 9 - 15um diameter (large - 3%)
• Round, densely stained nuclei
• Pale non-granular cytoplasm
Rounded
• Small lymphocytes have nuclei
relatively little cytoplasm
- attack pathogens & regulate
immune responses
• Large lymphocytes make
antibodies
AGRANULOCYTES
2. Monocytes
• 2 - 10% of leukocytes
• 14 - 24um diameter
• Large, often indented, nuclei
• Abundant grey-blue cytoplasm with
fine granules
• Cytoplasmic vacuoles often evident
• Highly motile
• Differentiate into macrophages
which phagocytose
pathogens & dead tissue
TROMBOSIT (PLATELET)
Mempunyai inti
Umur 7 – 10 hari
Dibentuk oleh megakaryosit di sstlg
Berperan pada proses pembekuan darah
Jumlah normal : 150.103 – 450.103
Bila < 150.103 = trombositopenia
> 450.103 = trombositosi
Platelets (or thrombocytes)
1. Extrinsic pathway
2. Intrinsic pathway
3. Common pathway
EXTRINSIC PATHWAY
When tissue or endothelial cells are damaged they release tissue factor, which combines
with two clotting factors to make the enzyme tissue thromboplastin
INTRINSIC PATHWAY
The common pathway begins once either of the two types of thromboplastin are formed.
When this happens, prothrombin is converted into the enzyme thrombin. Thrombin then
takes the final step in the coagulation process by converting fibrinogen into fibrin.
Blood Groups - Typing
Blood is typed into groups depending upon the
type of agglutinogens (antigens) present on the
red blood cell surface
The plasma may contain genetically determined
agglutinins or antibodies against the blood group
antigens that they DO NOT have
The ABO and Rh system are based upon antigen-
antibody type responses
Blood Typing
ABO system -
•people who posses the A antigen on the RBC surface are type A;
•if you posses the B antigen you are blood type B;
• if both A and B are present you are type AB;
• if neither A or B antigens are present, your blood type is O
Rh system
Rh system –
individualswhose red blood cells possess the Rh
antigen are Rh+ (Approx 85%)
Antibodies against Rh antigens are not present
at birth but are stimulated by exposure