Blood Plasma and Serum Composition
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1
What is plasma?
Whole blood minus cells.
2
What is serum?
Plasma minus clotting proteins.
3
How is serum obtained?
Allow whole blood to clot, remove the clot and collect the remaining fluid.
4
Does serum contain coagulation factors?
No, serum does not contain coagulation factors.
5
What percentage of plasma consists of water?
91%.
6
What percentage of plasma consists of solids?
9%.
7
What percentage of plasma consists of inorganic substances?
1%.
8
What percentage of plasma consists of organic substances?
8%.
9
What are the inorganic constituents of plasma?
Na⁺, K⁺, Fe²⁺, Ca²⁺, Mg²⁺, Fe³⁺, Cl⁻, Cu²⁺, HCO₃⁻ and phosphate ions.
10
What are the organic constituents of plasma?
Plasma proteins and about 1% other substances.
11
What is the normal total plasma protein concentration?
6.0–8.0 g/100 ml.
12
Where are albumin, α-globulin and β-globulin synthesised?
Liver.
13
Which cells produce γ-globulins?
B lymphocytes.
14
Where are B lymphocytes involved in γ-globulin production found?
Lymph nodes and bone marrow.
15
What is the normal albumin concentration in plasma?
4–5 g/100 ml.
16
What is the normal globulin concentration in plasma?
2–3 g/100 ml.
17
What is the normal fibrinogen concentration in plasma?
0.3 g/100 ml.
18
Which plasma protein is the most abundant?
Albumin.
19
What is the main function of albumin in maintaining fluid balance?
Generation of plasma colloid osmotic pressure (oncotic pressure).
20
Why do plasma proteins generate oncotic pressure?
Most capillary walls are relatively impermeable to plasma proteins.
21
What is the approximate oncotic pressure exerted by plasma proteins?
25 mmHg.
22
In which direction does plasma oncotic pressure pull water?
Into the blood.
23
What percentage of blood buffering capacity is contributed by plasma proteins?
15%.
24
What is the buffering function of plasma proteins?
Maintain blood pH.
25
Which plasma proteins act as nonspecific carriers?
Albumin and α-globulin.
26
Which protein transports cortisol?
Corticosteroid-binding globulin (transcortin).
27
Which protein transports thyroxine?
Thyroxine-binding globulin.
28
Which plasma protein transports unconjugated bilirubin?
Albumin.
29
Which plasma protein transports free fatty acids?
Albumin.
30
Which plasma protein transports iron and copper?
Plasma globulins, including α-globulins.
31
Which plasma proteins transport various drugs?
Albumin and α-globulins.
32
Which plasma protein fraction provides immune defence?
γ-globulins.
33
What are γ-globulins also known as?
Immunoglobulins or antibodies.
34
Which immunoglobulin classes are found in γ-globulins?
IgG, IgA, IgM, IgD and IgE.
35
Which plasma proteins are involved in blood clotting?
Fibrinogen and prothrombin.
36
What is the main function of α-globulins?
Transport proteins.
37
What is the main function of γ-globulins?
Defence through immunoglobulins (antibodies).
38
What is the main function of β-globulins according to the lecture?
Coagulation factors.
39
What is capillary hydrostatic pressure?
The pressure exerted by blood against the capillary wall.
40
What is the symbol for capillary hydrostatic pressure?
\$P_c\$.
41
What is the direction of capillary hydrostatic pressure?
Outward force favouring filtration.
42
What is the normal capillary hydrostatic pressure at the arterial end?
30–37 mmHg.
43
What is the normal capillary hydrostatic pressure at the venous end?
10–17 mmHg.
44
What determines capillary hydrostatic pressure?
Both arterial and venous pressures.
45
Which pressure affects capillary hydrostatic pressure more: arterial or venous pressure?
Venous pressure.
46
How does capillary hydrostatic pressure change along the capillary?
It generally declines from the arterial to the venous end.
47
Why does capillary hydrostatic pressure decline along the capillary?
Because of fluid filtration.
48
Where is capillary hydrostatic pressure highest?
Arteriolar end of the capillary.
49
Where is capillary hydrostatic pressure lowest?
Venous end of the capillary.
50
Which capillaries are an exception to the normal decline in capillary hydrostatic pressure?
Glomerular capillaries.
51
What is interstitial hydrostatic pressure?
The hydrostatic pressure exerted by interstitial fluid.
52
What are the symbols for interstitial hydrostatic pressure?
\$P_i\$ or \$P_\$.
53
What is the direction of interstitial hydrostatic pressure?
It opposes filtration.
54
What is the normal value of interstitial hydrostatic pressure?
Nearly zero or slightly negative (−3 mmHg).
55
What is colloid osmotic pressure also known as?
Oncotic pressure.
56
What is blood colloid osmotic pressure?
The osmotic pressure exerted by plasma proteins in capillary blood.
57
What is the symbol for capillary colloid osmotic pressure?
\$\pi_c\$.
58
What is the direction of capillary colloid osmotic pressure?
Inward force opposing filtration.
59
What is the normal capillary colloid osmotic pressure?
25–28 mmHg.
60
What determines capillary colloid osmotic pressure?
Protein concentration of capillary blood.
61
What happens to capillary oncotic pressure when plasma protein concentration increases?
It increases.
62
What happens to filtration when plasma protein concentration increases?
Filtration decreases.
63
What happens to capillary oncotic pressure when plasma protein concentration decreases?
It decreases.
64
What happens to filtration when plasma protein concentration decreases?
Filtration increases.
65
What is interstitial colloid osmotic pressure also known as?
Interstitial oncotic pressure.
66
What are the symbols for interstitial colloid osmotic pressure?
\$\pi_\$ or \$\pi_i\$.
67
What is the direction of interstitial colloid osmotic pressure?
It favours filtration.
68
What determines interstitial colloid osmotic pressure?
Interstitial fluid protein concentration.
69
Why is interstitial oncotic pressure normally low?
There is little protein loss from capillaries into the interstitial fluid.
70
What is the normal significance of interstitial oncotic pressure?
It is usually negligible.
71
What does the osmotic pressure gradient \$(\pi_c-\pi_i)\$ usually equal?
Capillary oncotic pressure.
72
What is the normal capillary oncotic pressure used in Starling's forces calculations?
25 mmHg.
73
Which plasma protein contributes approximately 80% of capillary oncotic pressure?
Albumin.
74
What are Starling's forces?
Forces that drive fluid exchange through capillary walls.
75
Why are Starling's forces essential?
To maintain normal plasma volume.
76
What determines fluid transfer across capillary walls?
The relative balance between hydrostatic and osmotic pressures in capillary plasma and interstitial space.
77
What happens when plasma colloids are lost?
More fluid moves from the vasculature into the interstitial space.
78
What is the capillary fluid shift mechanism?
Exchange of fluid across the capillary membrane between blood and interstitial fluid.
79
What pressures drive capillary fluid movement?
The sum of hydrostatic and effective osmotic pressures.
80
What is the effective osmotic pressure contributed by plasma proteins called?
Colloid osmotic pressure or oncotic pressure.
81
What does a positive net filtration pressure indicate?
Fluid is filtered out of the capillary.
82
What does a negative net filtration pressure indicate?
Fluid is absorbed into the capillary.
83
What is the formula for net filtration pressure (NFP)?
\$NFP=(P_c-P_i)-(\pi_c-\pi_i)\$.
84
Which four pressures determine net filtration pressure?
Capillary hydrostatic, interstitial hydrostatic, capillary colloid osmotic and interstitial colloid osmotic pressures.
85
What is the capillary hydrostatic pressure at the arterial end in the given example?
35 mmHg.
86
What is the capillary oncotic pressure at the arterial end in the given example?
25 mmHg.
87
What is the interstitial hydrostatic pressure in the arterial-end example?
−3 mmHg.
88
What is the interstitial oncotic pressure in the arterial-end example?
0 mmHg.
89
What is the NFP at the arterial end in the given example?
+13 mmHg.
90
What happens to fluid at the arterial end when NFP is +13 mmHg?
Fluid is filtered out of the capillary.
91
What is the capillary hydrostatic pressure at the venous end in the given example?
15 mmHg.
92
What is the capillary oncotic pressure at the venous end in the given example?
25 mmHg.
93
What is the interstitial hydrostatic pressure in the venous-end example?
−3 mmHg.
94
What is the interstitial oncotic pressure in the venous-end example?
0 mmHg.
95
What is the NFP at the venous end in the given example?
−7 mmHg.
96
What happens to fluid at the venous end when NFP is −7 mmHg?
Fluid is absorbed into the capillary.
97
Which pressure dominates at the arterial end of the capillary?
Hydrostatic pressure.
98
Which pressure dominates at the venous end of the capillary?
Oncotic pressure.
99
In which direction does fluid move at the arterial end?
Out of the capillary into the interstitial space.
100
In which direction does fluid move at the venous end?
Into the capillary from the interstitial space.
101
What is the NFP driving fluid movement out of the capillary at the arterial end?
+13 mmHg.
102
What is the NFP driving fluid movement into the capillary at the venous end?
−7 mmHg.
103
Which capillaries are more permeable: arterial or venous capillaries?
Venous capillaries.
104
Why is less absorption pressure required at the venous end?
Venous capillaries are more permeable.
105
What fraction of interstitial fluid is absorbed at the venous end?
9/10 (90%).
106
What happens to the remaining 1/10 of interstitial fluid?
It enters the lymphatics as lymph.
107
What is lymph?
Interstitial fluid that enters the lymphatics.
108
How does the protein content of lymph compare with plasma?
Lymph has a lower protein content than plasma.
109
How does the protein content of lymph compare with interstitial fluid?
It is comparable to interstitial fluid.
110
What do lymphatics transport from tissue spaces back to the blood?
Proteins.
111
What is the first major function of lymph?
Return interstitial fluid to blood vessels.
112
What happens to excess fluid filtered from capillaries?
It enters the lymphatics.
113
How does lymph maintain blood volume?
By returning excess interstitial fluid to the blood vessels.
114
Which immune cells are present within lymph nodes?
Mononuclear phagocytes, including macrophages and monocytes.
115
What is the function of macrophages and monocytes in lymph nodes?
Phagocytosis of bacteria.
116
Where are lymphocytes formed according to the lecture?
Lymph nodes.
117
Which lymphocytes are involved in antibody formation?
Activated B lymphocytes.
118
What type of immunity involves antibody formation by activated B lymphocytes?
Acquired immunity.
119
Which substances are transported by the lymphatic system?
Fats, proteins and blood cells.
120
Which fat-soluble vitamins are transported by lymphatics?
Fat-soluble vitamins.
121
Which other lipid substances are transported by lymphatics?
Cholesterol, monoglycerides and long-chain fatty acids.
122
Where are fat-soluble vitamins and absorbed lipids transported from?
Intestine.
123
Where are absorbed fat-soluble vitamins and lipids transported to?
Blood.
124
Why is protein returned to blood vessels through lymphatics?
To maintain plasma oncotic pressure.
125
Which blood cells are transported to lymph nodes by lymphatics?
RBCs and WBCs, including lymphocytes.
126
What microorganisms are transported by lymphatics to nearby lymph nodes?
Bacteria.
127
What happens when capillary filtration exceeds reabsorption?
Fluid accumulates in the interstitial space, causing oedema.
128
How does the lymphatic system prevent excessive interstitial fluid accumulation?
It removes excess fluid from the interstitium and returns it to the intravascular compartment.
129
What is the equation for normal fluid balance?
\$Filtration=Reabsorption+Lymphatic\ Flow\$.
130
What is oedema?
Excess accumulation of fluid in the interstitial space.
131
What are the four major factors precipitating oedema?
Increased capillary hydrostatic pressure, decreased plasma oncotic pressure, increased capillary permeability and lymphatic obstruction.
132
How does increased capillary hydrostatic pressure cause oedema?
It increases fluid filtration out of capillaries.
133
What conditions can increase capillary hydrostatic pressure?
Elevated venous pressure due to gravitational forces, heart failure or venous obstruction.
134
How does decreased plasma oncotic pressure cause oedema?
It reduces fluid reabsorption into capillaries.
135
What condition can cause decreased plasma oncotic pressure?
Hypoproteinemia during malnutrition.
136
What is hypoproteinemia?
Decreased plasma protein concentration.
137
How does increased capillary permeability cause oedema?
It allows more fluid and proteins to leak into the interstitial space.
138
Which inflammatory mediators increase capillary permeability?
Histamine and bradykinin.
139
What conditions can damage capillary structural integrity and increase permeability?
Tissue trauma, burns and severe inflammation.
140
How does lymphatic obstruction cause oedema?
It impairs drainage of interstitial fluid.
141
What condition can cause lymphatic obstruction?
Filariasis.
142
What is lymphatic filariasis commonly associated with?
Elephantiasis (kaki gajah).
143
What happens to interstitial fluid volume in oedema?
It increases beyond the capacity of lymphatics to maintain normal volume.
144
What is impaired lymphatic drainage?
Inability of lymphatics to adequately maintain interstitial fluid volume.
145
Which mechanisms can contribute to oedema formation?
Increased capillary hydrostatic pressure, decreased capillary oncotic pressure, improper lymphatic drainage and capillary wall damage.
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