Blood Transfusions

• Some of these units ("whole blood") were transfused directly into patients (e.g., to replace blood lost by trauma or during surgery).
• Most were further fractionated into components, including:
  • RBCs. When refrigerated these can be used for up to 42 days.
  • platelets. These must be stored at room temperature and thus can be saved for only 5 days.
  • plasma. This can be frozen and stored for up to a year.

safety of donated blood

A variety of infectious agents can be present in blood.

• viruses (e.g., HIV-1, hepatitis B and C, HTLV, West Nile virus
• bacteria like the spirochete of syphilis
• protozoans like the agents of malaria and babesiosis
• prions (e.g., the agent of variant Crueutzfeldt-Jakob disease)

and could be transmitted to recipients. To minimize these risks,

• donors are questioned about their possible exposure to these agents;
• each unit of blood is tested for a variety of infectious agents.

Most of these tests are performed with enzyme immunoassays (EIA) and detect antibodies against the agents. blood is now also checked for the presence of the RNA of these RNA viruses:

• HIV-1
• hepatitis C
• West Nile virus

• by the so-called nucleic acid-amplification test (NAT).

Normal Chemical Composition of Urine

Urine is an aqueous solution of greater than 95% water, with a minimum of these remaining constituents, in order of decreasing concentration:

Urea 9.3 g/L.

Chloride 1.87 g/L.

Sodium 1.17 g/L.

Potassium 0.750 g/L.

Creatinine 0.670 g/L .

Other dissolved ions, inorganic and organic compounds (proteins, hormones, metabolites).

Urine is sterile until it reaches the urethra, where epithelial cells lining the urethra are colonized by facultatively anaerobic gram-negative rods and cocci. Urea is essentially a processed form of ammonia that is non-toxic to mammals, unlike ammonia, which can be highly toxic. It is processed from ammonia and carbon dioxide in the liver.

Alveolar Ventilation: is the volume of air of new air , entering the alveoli and adjacent gas exchange areas each minute . It equals to multiplying of respiratory rate by ( tidal volume - dead space).
Va = R rate X (TV- DsV)
     = 12 X ( 500-150)
     = 4200 ml of air.

• it's the individual pressure exerted independently by a particular gas within a mixture of gasses. The air we breath is a mixture of gasses: primarily nitrogen, oxygen, & carbon dioxide. So, the air you blow into a balloon creates pressure that causes the balloon to expand (& this pressure is generated as all the molecules of nitrogen, oxygen, & carbon dioxide move about & collide with the walls of the balloon). However, the total pressure generated by the air is due in part to nitrogen, in part to oxygen, & in part to carbon dioxide. That part of the total pressure generated by oxygen is the 'partial pressure' of oxygen, while that generated by carbon dioxide is the 'partial pressure' of carbon dioxide. A gas's partial pressure, therefore, is a measure of how much of that gas is present (e.g., in the blood or alveoli). 
   
• the partial pressure exerted by each gas in a mixture equals the total pressure times the fractional composition of the gas in the mixture. So, given that total atmospheric pressure (at sea level) is about 760 mm Hg and, further, that air is about 21% oxygen, then the partial pressure of oxygen in the air is 0.21 times 760 mm Hg or 160 mm Hg.

Respiration occurs in three steps :
1- Mechanical ventilation : inhaling and exhaling of air between lungs and atmosphere.
2- Gas exchange : between pulmonary alveoli and pulmonary capillaries.
3- Transport of gases from the lung to the peripheral tissues , and from the peripheral tissues back to blood .
These steps are well regulated by neural and chemical regulation.

Respiratory tract is subdivided into upper and lower respiratory tract. The upper respiratory tract involves , nose , oropharynx and nasopharynx , while the lower respiratory tract involves larynx , trachea , bronchi ,and lungs .

Nose fulfills three important functions which are :

1. warming of inhaled air .

b. filtration of air .

c. humidification of air .

Pharynx is a muscular tube , which forms a passageway for air and food .During swallowing the epiglottis closes the larynx and the bolus of food falls in the esophagus .

Larynx is a respiratory organ that connects pharynx with trachea . It is composed of many cartilages and muscles and

vocal cords . Its role in respiration is limited to being a conductive passageway for air .

Trachea is a tube composed of C shaped cartilage rings from anterior side, and of muscle (trachealis muscle ) from its posterior side.The rings prevent trachea from collapsing during the inspiration. 

From  the trachea the bronchi are branched into right and left bronchus ( primary bronchi) , which enter the lung .Then they repeatedly branch into secondary and tertiary bronchi and then into terminal and respiratory broncholes.There are about 23 branching levels from the right and left bronchi to the respiratory bronchioles  , the first upper  17 branching are considered as a part of the conductive zones , while the lower 6 are considered to be respiratory zone. 

The cartilaginous component decreases gradually from the trachea to the bronchioles  . Bronchioles are totally composed of smooth muscles ( no cartilage) . With each branching the diameter of bronchi get smaller , the smallest diameter of respiratory passageways is that of respiratory bronchiole. 

Lungs are evolved by pleura . Pleura is composed of two layers : visceral and parietal .
Between the two layers of pleura , there is a pleural cavity , filled with a fluid that decrease the friction between the visceral and parietal pleura.
 

Respiratory muscles : There are two group of respiratory muscles:

1. Inspiratory muscles : diaphragm and external intercostal muscle ( contract during quiet breathing ) , and accessory inspiratory muscles : scaleni , sternocleidomastoid , internal pectoral muscle , and others( contract during forceful inspiration).
 

2. Expiratory muscles : internal intercostal muscles , and abdominal muscles ( contract during forceful expiration)

The Posterior Lobe

The posterior lobe of the pituitary releases two hormones, both synthesized in the hypothalamus, into the circulation.

• Antidiuretic Hormone (ADH).
  ADH is a peptide of 9 amino acids. It is also known as arginine vasopressin. ADH acts on the collecting ducts of the kidney to facilitate the reabsorption of water into the blood.
  • A deficiency of ADH
    • leads to excessive loss of urine, a condition known as diabetes  nsipidus.
• Oxytocin
  Oxytocin is a peptide of 9 amino acids. Its principal actions are:
  • stimulating contractions of the uterus at the time of birth
  • stimulating release of milk when the baby begins to suckle