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8/10/2019 Darah Farmasi

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DARAH

DEPARTEMEN FISIOLOGI

FK USU


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Tujuan

1. Mampu memahami fungsi dasar darah

2. Mampu mengenal komponen-komponen

darah dan fungsinya masing-masing


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Fungsi Darah

Distribusi

O2, CO2, nutrisi, hormon, waste product/sisa

metabolisme

Regulasi

Body temperature, pH

Proteksi

Melindungi tubuh dari kehilangan cairan

Melindungi tubuh dari infeksi


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DARAH

Merupakan jaringan tubuh

Volume 6 8 % BB

To

38o

C, pH 7,35

7,45 Terdiri dari plasma darah dan komponen

padat


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Components of Blood

LOOD=

55% plasma + 45% formed elements

is the liquid portion of the blood and

consists primarily of water (92 ) and

plasma proteins (7 )

Proteins - albumin, globulins, and

fibrinogen

FORMED

ELEMENTS

- solid component of the blood

consisting of erythrocytes,

leukocytes, and platelets

PLASMA


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PLASMA DARAH

90 % air

7 % protein : albumin, globulin, fibrinogen,

protrombin

3 % bahan organik : lipid, garam, nutrien,

waste product


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FUNGSI TIAP KOMPONEN

Air

Protrombin

Fibrinogen Albumin

Globulin


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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 redblood cells.

About 55% of the bloodis plasma and about 45%

are cells( males generally havinga higher percentage of cells than females).

If the percentage of cells

becomes too low the person

is said to have anemia.

Hematocrit


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Blood Plasma/Plasma Darah

Blood is composed of cellular and non-cellular elements.

If the cellular components are removed: plasma remains.


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HEMATOCRIT

Perbandingan sel eritrosit terhadap volume

darah dalam bentuk persentase.

Pria : 42% - 54%

Wanita : 39% - 48%

Ht < = Anemia

Ht > = Polycytemia


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SEL-SEL DARAH

Sel darah merah (eritrosit)

fs : 99% mengangkut O2 dari paru keseluruh tubuh dan CO2 dari jaringantubuh ke paru.

Sel darah putih (leukosit)

fs : Melindungi tubuh dari infeksi dan

kanker Platelet (trombosit)

fs : Pembekuan darah


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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.

Pembentukan eritosit juga dipengaruhi oleh vit B12,asam folat , ferum, testosteron


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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.


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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


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Red blood cellsRegulation of Erythropoiesis


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Erythropoiesis= formation of

erythrocytes the body must produce about 2.5 million new RBCs

every second

in adults, erythropoiesisoccurs mainly in the marrowof 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 bycells in the kidneys

kidney cells release the hormone erythropoietin into theblood

erythropoietin stimulates erythropoiesis by the bone

marrow
http://www.psbc.org/education/hematology/blood/made.htmhttp://www.psbc.org/education/hematology/blood/made.htmhttp://www.psbc.org/education/hematology/blood/made.htmhttp://www231.pair.com/grpulse/gp/medill/wblood.htmlhttp://www231.pair.com/grpulse/gp/medill/wblood.htmlhttp://www.psbc.org/education/hematology/blood/made.htmhttp://www.psbc.org/education/hematology/blood/made.htmhttp://www.psbc.org/education/hematology/blood/made.htmhttp://www.psbc.org/education/hematology/blood/made.htm


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Red blood cellsHaemoglobin

Haemoglobin is a molecule specialised for transport of oxygen,

HAEM

composed of globin (made up of 4 highlyfolded polypeptide chains) + 4 heme groups

(with iron) each molecule can carry 4 molecules of

oxygen

called oxyhemoglobin when carrying oxygen &called reduced hemoglobin when not carryingoxygen

can also combine with carbon dioxide & helpstransport carbon dioxide from the tissues tothe lungs
http://www.chemistry.wustl.edu/EduDev/LabTutorials/Hemoglobin/MetalComplexinBlood.htmlhttp://www.chemistry.wustl.edu/EduDev/LabTutorials/Hemoglobin/MetalComplexinBlood.html


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Each RBC can contain up to 250 million

hemoglobin molecules!

Jumlah Hb normal ; 12 14 g/dl (wanita), 13 16 g/dl (pria)


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SEL DARAH PUTIH (LEUKOSIT)

Mempunyai intiTerbagi atas : Agranular mononuklear

Granular polimorfonuklear

Jumlah Normal : 4.000 11.000/mm3

< 4.000 = Leukopenia

> 11.000 = Lekositosis

Leukopoiesis dipengaruhi oleh jenis dan banyaknya

jumlah mikoroorganismeyang masuk ke dalam tubuh


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Lymphocyte

Monocyte

Eosinophil

Basophil

Neutrophil

GranulocyteAgranulocyte

Leukocyte

White Blood Cells


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GRANULOCYTES

1. Neutrophils

40 - 75% of leukocytes

10 - 14um diameter

Exhibit multi - lobed nucleiCytoplasm lightly stippled with

indistinct granules

- represents large lysosomes

Active phagocytes that ingest

bacteria & cell fragmentsMulti - lobed

nucleus

CytoplasmErythrocyte


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10 - 14um diameter

Bilobed nucleus

Abundant large ovoid granules

- stain bright red with eosin

Phagocytes that ingestantibody + antigen complexes

Release histaminase that

inhibits inflammation

GRANULOCYTES

2. Eosinophils Bi - lobednucleus

Cytoplasmic

granules


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< 1% of leukocytes

10 - 16um diameter

U- or S-shaped bi-lobednucleus

large blue cytoplasmic

granules

- exhibit basophilicstaining

Granules contain materials

that mediate inflammation

- eg. histamine

GRANULOCYTES

3. BasophilsBi - lobed

nucleus

Cytoplasmic

granules


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6 - 9um diameter (small)

9 - 15um diameter (large - 3%)

Round, densely stained nuclei

Pale non-granular cytoplasm

Small lymphocytes have

relatively little cytoplasm

- attack pathogens & regulate

immune responses

Large lymphocytes make

antibodies

AGRANULOCYTES

1. Lymphocytes

Small

Large

Rounded

nuclei


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14 - 24um diameter

Large, often indented, nuclei

Abundant grey-blue cytoplasm with

fine granules

Cytoplasmic vacuoles often evident

Highly motileDifferentiate into macrophages

which phagocytose

pathogens & dead tissue

AGRANULOCYTES

2. Monocytes


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TROMBOSIT (PLATELET)

Mempunyai inti

Umur 7 10 hari

Dibentuk oleh megakaryosit di sumsum tlg

Berperan pada proses pembekuan darah Jumlah normal : 150.103450.103

Bila < 150.103 = trombositopenia

> 450.103

= trombositosis


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Small cell fragments

Possess granules

2.5 to 5 x 105/mm3(250,000 -500.000

per cubic millimeter )

Produced by megakaryocytes in

marrow.

Regulated by thrombopoietin.

Contain granules.

Role in clotting

remain functional for about 7 - 10 days(after which they are removed from theblood by macrophages in the spleen &liver)

Platelets (orthrombocytes)
http://www.psbc.org/education/hematology/blood/platelets.htmhttp://www.psbc.org/education/hematology/blood/platelets.htm


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HEMOSTASIS

Adalah penghentian perdarahan dari suatu

pembuluh darah yang rusak

Mekanisme hemostatik dalam keadaan normal

mampu menambal kebocoran dan menghentikanpengeluaran darah melalui kerusakan kecil di

kapiler, arteriol, dan venulamenjaga agar

kehilangan darah akibat trauma kecil tetap minimum


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Perdarahan dari pembuluh darah yang

berukuran sedang atau besar jarangterjadi biasanya tidak dapat dihentikan

oleh mekanisme hemostatik

Perdarahan pada arteri biasanya harus

dibantu dengan penekanan external

dengan kekuatan yang lebih besar dari

tekanan arteri itu sendiri kemudian

pembuluh darah yang robek ditutup secarabedah


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Perdarahan pada vena tidak selalu harus

ditangani dengan cara bedah karenasering kali dapat dihentikan hanya

denganmeninggikan bagian tubuh yang

berdarah untuk mengurangi efek gravitasi

pada tekanan di vena


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HEMOSTASIS

Melibatkan tiga langkah utama:

1. Spasme vaskuler

2. Pembentukan sumbat trombosit3. Koagulasi darah


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Hemostasis- prevention of blood loss from broken vessel 1 - Vascular spasm - vasoconstrictionofinjured vessel due to contraction of smooth

muscle in the wall of the vessel. This'spasm' may reduce blood flow & blood lossbut will not stop blood loss.

2 - Formation of a platelet plug- plateletsaggregate at the point where a vesselruptures. This occurs because platelets areexposed to collagen (a protein found in theconnective tissure located just outside theblood vessel). Upon exposure to collagen,platelets release ADP (adenosine

diphosphate) & thromboxane. Thesesubstances cause the surfaces of nearbyplatelets to become sticky and, as 'sticky'platelets accumulate, a 'plug' forms.
http://www.residentnet.com/private/vasc_res.htmhttp://www.platelet-research.org/htm/function_hemo.htmhttp://www.residentnet.com/private/coag2.htmhttp://www.residentnet.com/private/coag2.htmhttp://www.residentnet.com/private/coag2.htmhttp://www.platelet-research.org/htm/function_hemo.htmhttp://www.residentnet.com/private/vasc_res.htm


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3 Blood coagulation (clotting)

The result of all of this is a clot-

formed primarily of fibrinthreads (or polymers), but also

including blood cells &

platelets.

Blood clots in the right places

prevent the loss of blood from

ruptured vessels, but in the

wrong place can cause

problems such as a stroke

(see below under

inappropriate clotting).
http://www.residentnet.com/private/clot.htmhttp://www.residentnet.com/private/clot.htm


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Clot retraction:

"tightening" of clot

contraction of platelets trappedwithin clot shrinks fibrin meshwork,

pulling edges of damaged vessel

closer together

Over time (with the amount oftime depending on the amount of

damage), the clot is dissolved and

replaced with normal tissue


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GOLONGAN DARAH

Membran sel darah manusia mengandungbermacam macam antigen golongan darahatau yang sering disebut aglutinogen

Yang paling penting dan yang paling dikenaladalah antigen A dan B

Antibodi terhadap aglutinogen sel darahmerah disebut aglutinin


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SISTEM ABO Antigen A dan B diturunkan secara dominan

Dibagi menjadi 4 golongan darah utama yaitu:- golongan Amemp. Antigen A dan mengembangkanaglutinin-B

- golongan Bmemp. Antigen B dan mengembangkanaglutinin-A

- golongan ABmemp. Kedua antigen dan tidakmengembangkan kedua aglutinin (merupakan universalrecipientdapat menerima darah dari siapa saja)

- golongan Otidak memp. Kedua antigen danmengembangkan kedua aglutinin (merupakan universal

donor

dapatmemberikan darah kepada siapa saja)


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SISTEM Rh

Selain antigen dari sistem ABO ada jugaantigen dari sistem Rh

Seseorang yang memiliki antigen Rh disebut

sebagai Rh+ Seseorang yang tidak memiliki antigen Rh

disebut sebagai Rh-

Antibodi terhadap antigen Rh(aglutinin) tidakdibawa dari lahir


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Blood Groups - Typing

Blood is typed into groups depending upon thetype of agglutinogens (antigens) present onthe red blood cell surface

The plasma may contain geneticallydetermined agglutinins or antibodies againstthe blood group antigens that they DO NOThave

The ABO and Rh system are based uponantigen-antibody type responses


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Blood Typing

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

Type O - un iversal donor,can give blood to anyone

Type AB - un iversal recipient, can receive blood fromany blood type

ABO system -

Rh system


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Rh system individuals whose 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

Hemolytic Disease of the Newborn

Only in Rh- mothers and an Rh+ child, after

exposure.

RhoGam -medication given to prevent

sensitization of Rh- mother

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