DARAH

DEPARTEMEN FISIOLOGI
FK USU

Tujuan
1. Mampu memahami fungsi dasar darah

2. Mampu mengenal komponen-komponen

darah dan fungsinya masing-masing

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

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
PLASMA

FORMED
ELEMENTS

is the liquid portion of the blood and

consists primarily of water (92%) and
plasma proteins (7%)
Proteins - albumin, globulins, and
fibrinogen

- solid component of the blood

consisting of erythrocytes,
leukocytes, and platelets

BLOOD =

55% plasma + 45% formed elements

PLASMA DARAH

90 % air

7 % protein : albumin, globulin, fibrinogen,

protrombin

3 % bahan organik : lipid, garam, nutrien,

waste product

FUNGSI TIAP KOMPONEN

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/Plasma Darah

Blood is composed of cellular and non-cellular elements.

If the cellular components are removed: plasma remains.

HEMATOCRIT

Perbandingan sel eritrosit terhadap volume

darah dalam bentuk persentase.
Pria : 42% - 54%
Wanita : 39% - 48%
Ht < = Anemia
Ht > = Polycytemia

SEL-SEL DARAH

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

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

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,

composed of globin (made up of 4 highly
folded 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 carryingHAEM
oxygen
can also combine with carbon dioxide & helps
transport carbon dioxide from the tissues to
the lungs

Each RBC can contain up to 250 million

hemoglobin molecules!

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

SEL DARAH PUTIH (LEUKOSIT)

Mempunyai

inti
Terbagi atas

Jumlah

Normal

: Agranular mononuklear
Granular polimorfonuklear
: 4.000 11.000/mm3
< 4.000 = Leukopenia
> 11.000 = Lekositosis

Leukopoiesis dipengaruhi oleh jenis dan banyaknya

jumlah mikoroorganismeyang masuk ke dalam tubuh

White Blood Cells

Leukocyte

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

bacteria & cell fragments

Cytoplasm

Multi - lobed
nucleus

GRANULOCYTES
2. Eosinophils
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

Cytoplasmic
granules

Bi - lobed
nucleus

GRANULOCYTES
3. Basophils
< 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

Cytoplasmic
granules

Bi - lobed
nucleus

AGRANULOCYTES
1. Lymphocytes
20 - 30% of leukocytes
6 - 9um diameter (small)

Large
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

Rounded
nuclei

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 sumsum tlg
Berperan pada proses pembekuan darah
Jumlah normal : 150.103 450.103
Bila < 150.103
= trombositopenia
> 450.103
= trombositosis

Platelets (or thrombocytes)

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 the
blood by macrophages in the spleen &
liver)

HEMOSTASIS

Adalah penghentian perdarahan dari suatu

pembuluh darah yang rusak
Mekanisme hemostatik dalam keadaan normal
mampu menambal kebocoran dan menghentikan
pengeluaran darah melalui kerusakan kecil di
kapiler, arteriol, dan venulamenjaga agar
kehilangan darah akibat trauma kecil tetap minimum

Perdarahan dari pembuluh darah yang

berukuran sedang atau besar jarang
terjadi 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 secara
bedah

Perdarahan pada vena tidak selalu harus

ditangani dengan cara bedah karena
sering kali dapat dihentikan hanya
denganmeninggikan bagian tubuh yang
berdarah untuk mengurangi efek gravitasi
pada tekanan di vena

HEMOSTASIS
Melibatkan tiga langkah utama:
1. Spasme vaskuler
2. Pembentukan sumbat trombosit
3. Koagulasi darah

Hemostasis -

prevention of blood loss from broken vessel

1 - Vascular spasm - vasoconstriction of

injured vessel due to contraction of smooth
muscle in the wall of the vessel. This
'spasm' may reduce blood flow & blood loss
but will not stop blood loss.

2 - Formation of a platelet plug - platelets

aggregate at the point where a vessel
ruptures. This occurs because platelets are
exposed to collagen (a protein found in the
connective tissure located just outside the
blood vessel). Upon exposure to collagen,
platelets release ADP (adenosine
diphosphate) & thromboxane. These
substances cause the surfaces of nearby
platelets to become sticky and, as 'sticky'
platelets accumulate, a 'plug' forms.

3 Blood coagulation (clotting)

The result of all of this is a clot formed primarily of fibrin
threads (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).

Clot retraction:
"tightening" of clot
contraction of platelets trapped

within clot shrinks fibrin meshwork,

pulling edges of damaged vessel
closer together

Over time (with the amount of

time depending on the amount of

damage), the clot is dissolved and
replaced with normal tissue

GOLONGAN DARAH

Membran sel darah manusia mengandung

bermacam macam antigen golongan darah
atau yang sering disebut aglutinogen
Yang paling penting dan yang paling dikenal
adalah antigen A dan B
Antibodi terhadap aglutinogen sel darah
merah disebut aglutinin

SISTEM ABO

Antigen A dan B diturunkan secara dominan

Dibagi menjadi 4 golongan darah utama yaitu:
- golongan A memp. Antigen A dan mengembangkan
aglutinin-B
- golongan B memp. Antigen B dan mengembangkan
aglutinin-A
- golongan AB memp. Kedua antigen dan tidak
mengembangkan kedua aglutinin (merupakan universal
recipientdapat menerima darah dari siapa saja)
- golongan O tidak memp. Kedua antigen dan
mengembangkan kedua aglutinin (merupakan universal
donordapat memberikan darah kepada siapa saja)

SISTEM Rh

Selain antigen dari sistem ABO ada juga

antigen dari sistem Rh
Seseorang yang memiliki antigen Rh disebut
sebagai Rh+
Seseorang yang tidak memiliki antigen Rh
disebut sebagai RhAntibodi terhadap antigen Rh(aglutinin) tidak
dibawa dari lahir

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

Type O - universal donor, can give blood to anyone

Type AB - universal recipient, can receive blood from
any blood type

Rh system

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