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ECF (% of total body wt)
ICF?
components of each
ECF (20%)
~ Interstital fluid (15%) 10.5 L
~ Plasma (5%) ~3.5 L
ICF (40%)
~ rbc 2 L
Functions of blood
osmotic balance of ECF
determines movement of fluid
transport wastes & nutrients
inorganic part of plasma?
organic?
inorganic: ions (K, Na, HCO3)
Organic: proteins (albumin), carbs, fats, urea, gases
Erythrocyte production
Where?
Induced by?
~ Bone Marrow
~ Erythropoieten (Kidney -senses hypoxia - releases it, and androgens)
Also influenced by: 
1) granulocyte- macrophage stimulating factor
2) IL-1, 2, 3
3) Insulin Like Growth Factor (IGF)
4) Platelet derived growth factor (PDGF)
PCV? aka?
Rbc lifespan?
rbc lifespan = 120 days
PVC = Packed rbc volume = Hematocrit (Hct) % of blood made up of rbc
Normal Hematocrit values for male? female?
How does it change if dehydrated
Male:  39-49%
Female:  35-45%
Dehydrated = INCREASED % of blood is rbc
MCV?
Mean rbc volume
the volume of an avg rbc ~ 10^-15 L
Macrocytic = lg rbc
Microcytic = sm rbc
MCH?
Mean cell Hemoglobin
-wt of Hb in avg rbc
Range: 27-33 picograms (10^-12g)
*Should be proportionate to MCV
MCHC?
Normal values?
Mean Cell Hb Conc.
~ prop of Hb in packed cell vol (Hct)
Range:  32-36%
Function of RBC?
*Impt Enzyme?
transport O2 & CO2
help in acid/base balance by forming HCO3- *with Carbonic anhydrase.  
Co2 + H2O → HCO3 + H+
RBC count
Male / female
Male: 4.5-5.9 x 106
Female: 4.0-5.2 x 106
WBC count - normal values
4.5-11.0 x103
 or 4,500- 11,000
hemoglobin levels for Male & Female
Males:  13.5-17.5 gm/dL
Females: 12-16 gm/dL
Normal Platelet Values
150 - 350 x 10^3  microL
or  150,000 - 350,000
If a RBC is Macro- or Microcytic? what does this affect?
affects MCV (Mean Cell Volume)

(Larger or Sm rbc)
Hypochromic ?
affects?
Decreased Hb content = pale
Affects:
1) MCH (Mean Cell Hb)
2) MCHC (Mean Cell Hb conc.)
what is the definition of anemia
reduced # of circulating rbc
Hb < 10 gm/dL
3 types of Anemia
1) Iron deficiency
2) Megaloblastic / Pernicious
3) Sickle cell
Iron deficiency anemia
size of rbc?
Color of rbc?
affects what labs?
Iron deficiency anemia = Low Fe - can't make enought Hb = Low Hb
Mycrocytic (small rbc) = DECREASED MCV (mean cell vol)
Hypochromic (pale) = DECREASED MCHC (mean Hb conc)
Megaloblastic / Pernicious Anemia
size of rbc?
color of rbc?  affects what labs?
Pernicious (Macrocytic) Anemia = due to B12 deficency. a maturation defect.
Macrocytic = ↑ MCV (more volume)
Sickle cell anemia
-cause
-what happens to cells in capillaries
Tissue Hypoxia→ Abnormal Hb ppt inside rbc → deforms cell "sickle"
less flexible - can't pass thru capilarries = clog up capillary beds
Lymph
-derived from?
-Function?
- Regulation of Lymph Flow
Interstital fluid
Function: control interstital fluid P & comp
How?  Regulate:
1) conc. of protein in interstital fluid
2) Volume
3) fluid pressure
Maturation of rbc
Reticulocyte count?
1) erythroblast
2) normoblast (nucleated)
3) Reticulocyte (nuclear fragments)
-normal: ~1-2%
-used 2 asses erythropoietic activity
4) Erythrocyte (MATURE!)
rbc indicies? (4)
1) MCV
2) MCH (Mean Cell Hb)
3) MCHC (Mean Cell)
4) RBC distribution width (RDW)
Chloride Shift?
Why is this necessary?
Movement of Cl- to offset Bicarb flux (*In tissues)
 In lungs it is reversed.
Why is this necessary??
polycythemia
too many rbc's
increased RBC
increased Hb
Increased Hct
NORMAL:  MCV, MCH, MCHC
Poikilocytosis
variation in the size of the rbc's
Anisocytosis
variation in shape of rbc's
RBC indicies in Acute blood loss? in chronic blood loss?
????
Acute = low Hct?

Chronic = High retic count
Hct
influenced by what?
dehydrated?  super hydrated?
Hct Influenced by:  fluid status
dehydrated:  Hct HIGH
Hydrated: Hct Lower
Free Hb? does it exsit in plasma? what does this indicate?
Hb NOT Normally in plasma, if it's found = rbc lysis
(bacterial?)

-filtered out by Kidney
B-cells
-where formed?
-migrate where?
-Adult called?
Function
type of immunity
Formed in Bone marrow
Migrate to lymph tissues
Plasma cell = make & secret Ab's

*humoral immunity
Sub-types of T-cells

type of immunity
T-Helper
T-Suppressor
Cytotoxic T-cells
Natural Killer cells
Memory cells

Cell-mediated immunity
3 Pools of Neutrophils

Range
1) Circulating pool
2) Marginal Pool (loosely adhered to endothelial cells - first responders)
3) Marrow Neutrophil reserve (10x amt in circ.)

range: 54-62%
Functions of Neutrophil
Phagocytic in to vacuole
1) metabolic burst (O2 species)
2) Degranulation
Immature neutrophils?
range?
indicative of?
Band cells = Immature neutrophils
Range 0-5%
Monocytes
what they do - where they live
do they move in and out of circulation?
migrate from circ to organ/tissue where they become macrophages
*DO NOT re-enter the circulation
-Long life span 
Range for:
Basophils
Eonsinophils
monocytes
Lymphocytes
Basophils = 0-3 %
Eosinophils = 0-8%
Monocytes = 4-11%
Lymphocytes = 22-44%
Neutrophils = 40-70%
Increase in Neutrophils w/ Increase in Bands indicates?
Increase in Neutrophils w/o an increase in Bands indicates?
Increase in Neutrophils & Bands = "Left Shift" = more widespread, severe bacterial infection

Increase in Neutrophils only (not band cells) = Mild bacterial infection.
Lg Increase in WBC w/majority being granulocytes & many immature forms?
Myelogenous Leukemia C
Increase in lymphocytes (what is this called?) w/atypical lymphocytes indicates?
Viral infection
Increased lymphocytes - "Right Shift"
Atypical Lymphocytes - "Mononucleosis"
increase in eosinophils
parasitic infection (worms!)
Increase In WBC - majority being lymphocytes and also immature forms - indicates?
Lymphocytic Leukemia cond.
Plateletes
-where do they come from?
-Range?
-complete cell?
-memb bound a-nucleare strucutres from Megakaryocytes in bone marrow
*Parts of a cell - NOT a true cell

Range: 150-400 x10^3 / microL   or
150,000 - 400,000
what regulates synthesis of platelets? (2)
1) Thromobpoietin (TPO) - platelets have TPO receptors & if there are enough they bind TPO - less TPO in circ = reduce stimulus to make more
2) IL-3
Life span of platelet?
external memb has what?
stored where?
Life span = 10 days
Half-life = 4 days
external membrane = many glycoprotein receptors

Stored in Spleen
What 2 types of granules do platelets have? contents?
1) α-grannules:
Von-Wildebrand Factor
Platelet fibrinogen
clotting factor V, more...
2) Dense Core grannules: 
ATP, ADP
Serotonin
Ca2+
and more....
Function of Platelets
Coagulation process
1) Release Thromboxane A2 & aggregate @ site of injury → form platelet plug
2) Release Heparin neutralizing factor - enhances clot formation
Albumin function
- Low Albumin - causes....
*driving force for fluid movement = Colloid Osmotic Pressure

Low Albumin = edema
Anion gap?
Normal Values?
Ions that are involved?
difference b/w conc. of major anions & major cations = Anion gap
Na+ & K+  conc. vs. Cl- & HCO3-
(cations greater than anions)
Normal Values: 7-16 mEq/L
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