2 курс / Нормальная физиология / Учебное_пособие_по_физиологии_крови_Авдеева_Е_В_,_Репалова_Н_В_
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Государственное бюджетное образовательное учреждение высшего профессионального образования
«Курский государственный медицинский университет» Министерства здравоохранения Российской Федерации
КАФЕДРА НОРМАЛЬНОЙ ФИЗИОЛОГИИ
УЧЕБНОЕ ПОСОБИЕ ПО ФИЗИОЛОГИИ КРОВИ
(для студентов международного факультета)
Курск – 2016
УДК 612.19075.8) |
Печатается по решению |
ББК 52.52я73 |
редакционно-издательского |
А18 |
совета ГБОУ ВПО КГМУ |
|
Минздрава России |
Е.В. Авдеева. Учебное пособие по физиологии крови (для студентов международного факультета) / Е.В. Авдеева, Н.В. Репалова. – Курск, 2016. – 108 с.
Рецензенты:
профессор кафедры биологической химии, доктор биологических наук
М.Ю. Смахтин,
профессор кафедры патофизиологии, доктор медицинских наук
И.И. Бобынцев.
Учебно-методическое пособие по физиологии крови способствует повышению уровня самоподготовки студентов. Данное пособие содержит теоретические основы тем раздела «Кровь», описание лабораторных работ в соответствии с утвержденными рабочими программами по предмету для студентов международного факультета, полный перечень вопросов и тестовых задач для самоконтроля, перечень ситуационных задач.
ISBN 978-5-7487-1942-1 |
ББК 52.52я73 |
Коллектив авторов, КГМУ, 2016
ГБОУ ВПО КГМУ Минздрава России, 2016
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STATE BUDGETARY EDUCATIONAL ESTABLISHMENT OF
HIGHER VOCATIONAL EDUCATION
«KURSK STATE MEDICAL UNIVERSITY»
THE MINISTRY OF HEALTH OF THE RUSSIAN FEDERATION
DEPARTMENT OF NORMAL PHYSIOLOGY
TUTORIAL IN THE PHYSIOLOGY
OF BLOOD
(for the students of the international faculty)
KURSK – 2016
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УДК 612.1(075.8) |
Printed according to the |
ББК 52.52.я73 |
decision of the Editorial – |
А18 |
publishing council |
|
of Kursk State Medical |
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University |
E.V. Avdeyeva. Tutorial in the physiology of blood (for the students of the international faculty) / E.V. Avdeyeva, N.V. Repalova. – Kursk, 2016. – 108 p.
Editors: Avdeyeva E.V.
ScD in Biology, professor of the department of normal physiology
Reviewers:
Repalova N.V.
PhD in Biology, associate professor of the department of normal physiology
professor |
of the department of biological chemistry, ScD in Biology, |
M.Yu. Smakhtin, |
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professor |
of the department of pathophysiology, ScD in Medicine, |
I.I. Bobyntsev.
The tutorial in physiology of blood facilitates the improvement of students’ selfpreparation work. The given tutorial contains theoretical basis for the topics of the chapter “Blood”, the description of laboratory works in accordance with approved educational programs on the discipline for international students as well as a complete set of questions and test tasks for self-control and the list of situational problems.
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WHEN PROCEEDING WITH THE PHYSIOLOGY OF BLOOD STUDY, BECOME THOROUGHLY FAMILIAR WITH THE STRUCTURE OF THE GIVEN EDUCATIONAL SUPPORT.
Tasks for self-study.
Each of the 4 sections is made up of:
1.Motivational directive;
2.Aim and tasks formulation for the section study, questions on each theme for self-control which are necessary for the theme assimilation;
3.Questions and exercises for self-control, descriptions of laboratory works carried out during practical classes;
4.List of literature necessary for the discipline study.
MOTIVATIONAL DIRECTIVES show the importance of the given theme for following themes understanding in the course of normal physiology, for related disciplines and training of qualified specialists as well.
AIMS AND TASKS OF THE THEME STUDY determine the final result which is to be achieved as a result of self-study and work during practical classes.
QUESTIONS AND TESTS FOR SELF-STUDY for each theme are to help to identify and understand the most essential learning material.
QUESTIONS AND EXERCISES FOR SELF-CONTROL are to help to apply theoretical knowledge in specific situations, as close as possible to clinical ones.
The educational support includes the description of laboratory works that will be carried out during practical classes. They are to help in better understanding of the discipline’s theoretical material and are to become the basis for the development of practical skills provided by the 3d generation FSES (Federal State Educational Standard) in the course of normal physiology.
Textbooks and lecture notes are required in the process of preparation to each theme.
APPROXIMATE BASIS FOR STUDENTS’ ACTIONS DURING
SELF-STUDY
The main aim of self-study is to acquire new knowledge and include it into your vocabulary.
Type of action |
Mode of action |
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1. Study of the theme material. |
1. Become thoroughly familiar with the tasks for |
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self-study and for practical classes. |
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2. Study the textbook material and lecture notes, |
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and, if necessary, get more extensive and profound |
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knowledge through additional sources. In the |
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process of studying a student should: |
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a) duplicate on paper schemes, diagrams and |
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formulas; |
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b) having read and thought over all the learning |
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materials, repeat aloud its most essential |
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provisions; |
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c) again, from memory draw schemes, reflexes, |
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diagrams and formulas to illustrate the basic |
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contents of the material studied; |
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g) understand the relationship of the studied |
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processes, as well as their biological and |
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physiological value. |
2. Self-control of learning |
1. Carefully read the question or the statement of |
materials understanding. |
the problem and understand their essence. |
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2. Clearly formulate an answer, denoting the |
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process of the problem solution meanwhile writing |
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the necessary stages of solution, explaining the |
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processes going on and drawing diagrams and |
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schemes. |
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3. If you fail to answer some questions or solve |
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problems, refresh the theme through the textbook |
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and lecture notes again. Once again try to analyze |
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the corresponding material and try to find the |
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correct answer or solution. |
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3. Fulfillment of written tasks |
1. Become familiar with the requirements to the |
(problems). |
task and think the method of its fulfillment over. |
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2. Draw a rough sketch and specify details. |
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3. Make a final version of the fulfilled problem in |
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a special notebook. |
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4. Preparation to carrying out |
1. Become thoroughly familiar with the |
laboratory works in |
description of laboratory works and get a clear idea |
forthcoming practical class. |
of the principle of their fulfillment. |
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2. Rewrite in a laboratory notebook the principle |
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and basic stages of laboratory works performance, |
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and also recommended forms of experimental |
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records. |
APPROXIMATE BASIS FOR STUDENTS ACTION IN THE CLASS
In laboratory studies it is necessary to learn how to use knowledge acquired during self-study, to obtain new information for specific tasks (problems) solution. It is achieved in the process of laboratory work performance, teacher-students interview on the most complex issues of the theme and tasks (problems) solution.
Type of action |
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Mode of action |
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1. Laboratory works |
1. |
Fulfill laboratory work following the instructions. |
performance. |
2. |
Compare the obtained data with presented |
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theoretical information and give them an all-round |
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explanation. |
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3. |
Draw conclusions resulting from the laboratory |
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works and their theoretical comprehension. |
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4. |
Present the results of laboratory works to the |
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teacher. |
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5. |
Fill in the forms of experimental records. Write |
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down conclusions and their explanations. Give the |
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laboratory works notebook to the teacher to sign. |
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2. Teacher-students |
1. Answer the teacher’s questions. |
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interview. |
2. Listen to other students’ answers very attentively. |
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3. |
Ask questions with the aim to get a clear |
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understanding of most difficult questions. |
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4. |
Actively participate in discussions organized by |
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the teacher. |
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3. Problems (tasks) |
1. Solve the problem proposed by the teacher. |
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solution. |
2. Compare the given answers with existing |
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theoretical knowledge and give them an explanation. |
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3. |
Draw conclusions and generalizations resulting |
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from the problem solution and theoretical |
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understanding. |
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4. |
Write down the problems (tasks) solution, |
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conclusions, generalizations and explanations of the |
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obtained results in a special notebook. |
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At the seminars it is necessary to master the most difficult for understanding themes of the course. It is conducted in the form of interview or discussion with an active involvement of the entire group and teacher’s participation.
In concluding sessions the level of the course sections mastering is checked. It is achieved by means of program check methods, interviews, problems (tasks) solutions. Simultaneously with the control of mastering learning material the teacher makes necessary corrections.
FUNCTIONS OF BLOOD. RED BLOOD CELLS
TOPIC MOTIVATION
Blood is a part of the inner medium of an organism and plays a great role in keeping homeostasis. Its relatively constant quantitative characteristics are important indices of an organism’s condition and it is used for diagnostic purposes. Knowledge of blood functions, its components, and skills to correctly estimate the results of clinical analysis are obligatory for a doctor of any specialization.
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PURPOSE OF SELF-PREPARATION
After self-preparation to the topic material, a student should know: the notion about blood as a system, characteristics of blood functions; characteristic of erythrocytes and hemoglobin functions. A student should also know the methods of: calculation of erythrocytes quantity, hemoglobin quantity and blood color index.
PLAN OF THE TOPIC STUDY
1.Internal environment of the organism. Blood as a portion of the internal environment.
2.Blood as a system.
3.Functions of the blood.
4.The total amount of blood in the body. Haemopoietic organs.
5.Composition of blood. Blood hematocrit.
6.Red blood cells.
a)Production of red blood cells.
b)Regulation of red blood cells production.
c)Calculation of red blood cells.
d)Destruction of red blood cells.
e)Erythrocytosis, erythropenia, anemias.
7.Hemoglobin.
a)Structure of hemoglobin molecule.
b)Calculation of hemoglobin quantity in blood.
c)Physiological and toxic compounds of hemoglobin.
d)Absolute and relative hemoglobin contents in blood.
8.Color index of blood.
a)Calculation of color index of blood.
b)Physiological significance of color index.
THE ISSUES YOU SHOULD PAY ATTENTION TO
1. Blood composition.
Blood is a circulating tissue composed of fluid plasma and cells (red blood cells, white blood cells, platelets). Anatomically, blood is considered a connective tissue, due to its origin in the bones and its function. Total blood volume makes up about 6-8 percent of the body’s weight. A 70-kilogram person will accordingly have 5 to 6 litres of blood.
Blood is made of two parts:
Plasma which makes up 55% of blood volume.
Formed cellular elements (red and white blood cells, and platelets) which combine to make the remaining 45% of blood volume (fig. 1).
Plasma is made up of 90% water, 7-8% soluble proteins (albumin maintains bloods osmotic integrity, others clot, etc), 1% carbon-dioxide, and 1% elements in transit. One percent of plasma is salt, which helps with the pH of blood.
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Fig. 1. Blood composition.
The largest group of solutes in plasma contains three important proteins to be discussed. They are: albumins, globulins, and clotting proteins.
Albumins are the most common group of proteins in plasma and consist of nearly two-thirds of them (60-80%). They are produced in the liver.
The main function of albumins is to maintain the osmotic balance between blood and tissue fluids and it is called colloid osmotic pressure. In addition, albumins assist in transport of different materials, such as vitamins and certain molecules and drugs (e.g. bilirubin, fatty acids, and penicillin).
Globulins are a diverse group of proteins, designated into three groups: gamma, alpha, and beta. Their main function is to transport various substances in the blood. Gamma globulins assist the body's immune system in defense against infections and illnesses.
Clotting proteins are mainly produced in the liver as well. There are at least 12 substances, known as "clotting factors" that participate in the clotting process.
One important clotting protein that is a part of this group is fibrinogen – one of the main components in the formation of blood clots. In response to tissue damage, fibrinogen makes fibrin threads, which serve as adhesive in binding platelets, red blood cells, and other molecules together, to stop blood flow.
Hematocrit: the percentage of total blood volume that blood cells occupy. Normal value male: 40-50%
female: 37-48% newborn: 55% (fig. 2).
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Fig. 2. Hematocrit.
Hematocrit value depends on: sex, age, life conditions.
The increase of hematocrit can lead to increase of blood stickness and that means the heart works with the increased load, disorders of blood circulation.
Hematocrit value is increased in: polycythaemia, dehydration.
Hematocrit value is decreased in: anemias, overhydration.
Uses of haemotocrite value: diagnosis of anaemias; determination of blood volume and renal blood flow; calculation of certain blood indices; follow up of shock.
2. The main functions of blood: 2.1. Transportation.
Blood is responsible for transporting oxygen and carbon dioxide important nutrients and materials to and from the cells and molecules that make up our body. It is also tasked with the job of collecting metabolic waste from up and down the body and take it to the kidneys for excretion. Blood also has to perform the task of delivering the nutrients and glucose generated by the organs of the digestive system to the other parts of the body including the liver. In addition to these tasks, blood also has to carry out the transportation of hormones produced by the glands of the endocrine system.
2.2. Protection.
Blood performs the important task of protecting the body from the threat of infections and disease causing bacteria. The white blood cells found in blood are responsible for safeguarding different organs of the body by producing antibodies and proteins which are capable of fighting off and killing the germs and viruses that can
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