PLENARY DISCUSSION GROUP 14.

1. PLENARY DISCUSSION GROUP 14. GROUP MEMBERS: • Fatimah Putri Az Zahra • Aulia Fash Farabi • Utari Gestini Rahmi • Mustika Febriani Rizona • Fauzul Azhim • Mega Gusti Ayu • Teddy Kurniawan • Vivit Erdina Yunita • Sari Mulyani • Suresh Mariah

2. Pity taro…… This morning, Taro, 16 years complained of abdominal pain and diarrhea for more than ten times since last night. His body felt weak, but Taro felt thirsty, so he kept drinking water. His sister told Taro that not only drinking water, but drinking isotonic drinks so that minerals that come out can also be replaced. Taro also had take anti diarrhea medicine given by her sister.        Although already taking medication and oral rehydration salts, Taro is still suffering from diarrhea, but its frequency has begun to decrease. And unfortunate for Taro, when it would rush to the bathroom because he wants to defecate, Taro slipped, his head banged into the edge of the bath until it wounds and bleeding. Taro cried for help, his sister came and checked the wound in his head. Taro's sister took him to the ICU.       Arriving at the ICU, Taro wound cleaned and stitched, but there is still seeping blood. Taro looked very pale, although the blood that came out a little. Doctors ask about Taro blood type and history of blood clotting disorders. Taro just know his blood type is A, but do not know any history of blood clotting disorders. Taro wounds bandaged and doctors prescribe antibiotics to prevent infection. How do you explain what is experienced by Taro?

3. Scheme limp Anti-diarrhea medicine thirsty Disorders of body fluids isotonic homeostasis Erytrocyte mechanism Hemostasis Rhesus leukocyte blood composition Blood group ABO Impaired blood clotting source trombocyte MNS Lack of platelet Vitamin k hemofili

4. Learning Objective Students are able to explain : • Composition, sources and mechanisms of blood. • Principles of blood transfusion • The mechanism of blood clotting • Homeostasis • Blood classification system • Various kinds of correlation-related clinical disorders of fluid balance • Hemostasis • Cardiovascular system

5. 1)Composition, sources and mechanisms of blood.

6. During formation, the RBC eventually loses its nucleus and leaves the bone marrow as a reticulocyte. RBCs last an average of 120 days in the bloodstream. When RBCs age, they are removed by macrophages in the liver and spleen. A hormone called erythropoietin and low oxygen levels regulate the production of RBCs. Ninety percent of erythropoietin is made in the kidneys. When both kidneys are removed, or when kidney failure is present, that person becomes anemic due to lack of erythropoietin.

7. White blood cells (WBCs), or leukocytes, are a part of the immune system and help our bodies fight infection. They circulate in the blood so that they can be transported to an area where an infection has developed. Most WBCs (neutrophils, eosinophils, basophils and monocytes) are formed in the bone marrow. Neutrophils are the one of the body's main defenses against bacteria. Eosinophils kill parasites and have a role in allergic reactions Basophils are not well understood, but they function in allergic reactions. Monocytes enter the tissue, where they become larger and turn into macrophages

8. 2)Blood Transfusion • Blood transfusion is a medical action aimed at changing the patient's blood loss resulting from accidents, surgery or because of an illness.  • In principle, prior to blood transfusion, blood donors must be check. • And the most important thing is to determine the blood type to match the blood recipient and does not occur agglutination (clotting).  • Because aglutinin have more than one place agglutinin binding then one can attach to two or more red blood cells that differ in the same time that causes red blood cells attached to each other.  • Then these clumps clog arteries throughout system circulation.  • For several hours until the next few days the physical distortion of cells and attack by phagocytic white blood cells that destroy cells and release HB into plasma which is called hemolysis of red blood cells.

9. 3)The mechanism of blood clotting • In response to the rupture of blood vessels or damage to the blood itself, then a series of complex chemical reactions occur in the blood that involves more than a dozen clotting factors, the end result is a prothrombin activator. • Prothrombin activator catalyze the changes between prothrombin  to thrombin • Thrombin worked as an enzyme to convert finrinogen  into à fibrin threads that compose platelets, blood cells and plasma to form a clot.

10. 4)Homeostasis • refers to the resistance or environmental regulation mechanism of dynamic equilibrium in the (body of organisms) are constant. Homeostasis is one of the most important concepts in biology. • There are 2 types  - Equilibrium static Where circumstances in which such change is not take place. - Dynamic equilibrium Where in a constant state of this system is constantly changing although examples such as a pond at the bottom of the waterfall. The organism has two environments, namely: • Outside environment is the environment surrounding the organism as a whole. The organism will live in groups with these organisms (biotic) and objects that are dead (abiotic). • Environment in the dynamic environment within the human body consisting of the fluid that surrounds the community of cells that form the body.

11. 5) The classification system of blood • There are 21 blood group systems to differentiate but is often used is ABO system, the system Rh (rhesus) and MNS systems.  • In blood transfusion, ABO and Rhesus system is very important because it can cause serious problems of blood transfusion or death to patients.  • MNS System rarely involved in the process of blood transfusion reactions but are useful for individual genetic markers.  ABO system • Determined based on the type of antigens found on red blood cells. 

12. Individuals who have the blood type A, the body will produce antibodies B and will aggulunate the blood that have B antigens .Blood group AB has no antibodies and can receive any type of blood transfusion. Blood group O do not have antigen and can donate to everyone but it must receive the blood from O group only since it have A and B antibodies on it. • The system Rh (rhesus) Distinguished by antigen-D, E, F is the integral membrane protein in red blood cells. D is a dominant antigen. - Type: Rh + Rh-(no antigen D) • -Very important in blood transfusions and pregnancy. • -If individuals with Rh- receive a blood transfusion from RH+, his body will produce antibodies and cause lysis of red blood cells. 

13. 6) Various kinds of correlation-related clinical disorders of fluid balance • Anemia • Aplastic Anemia • Megaloblastic anemia • Hemolytic anemia • Leucopenia (agranulocytosis) • Leukemia • Thalassemia

14. 7)Hemostasis • Definition: Prevention of blood loss • When the blood vessel injury or rupture, hemostasis occur in several ways, namely: • Vascular spasm • Blood vessel injury or rupture resulting in vessel walls to contract so that the flow of blood from a ruptured blood vessel is reduced. • The contraction is a result of nerve reflexes, local miogenik spasms, and humoral factors. 2. Platelet plug formation • If the gap injury to the blood vessels are so small it will be closed by a plug of platelets, not by a blood clot. • The mechanism: - When platelets contact with surface vessels are damaged, then the properties of platelets immediately change drastically.  - Platelets swell, its shape becomes irregular with protrusions protruding from its surface, to contract with a strong protein and causes the release of granules containing a variety of active factors, it becomes sticky platelets that attached to collagen fibers, secreting large amounts of ADP, and enzyme-enzyme form thromboxane A 2, which is also secreted into the blood. 

15. 3. Hemostasis plug dissolution by plasmin Normal blood clotting system in a state of dynamic equilibrium and outlines forming fibrin nets continuously. At this stage, there is decomposition of the net fibrinolysis fibrin by plasmin.  4. The mechanism of blood clotting (has explained in the previous LO) 5. Connective tissue growth Is the final process of hemostasis, which will be formed connective tissue, either permanent or scarring tissue. 

16. Control mechanisms in hemostasis: • Primer: mechanisms of vasoconstriction of blood vessels in the small wound. Platelet serotonin release in the wound and prostaglandins that cause muscles to constrict blood vessels to reduce blood loss. • Secondary: mechanisms involving coagulation factors in plasma and platelets with the final goal on a large wound. Thromboplastin from damaged tissue activates protombin (plasma proteins) with the help of calcium ions then form thrombin. Then thrombin alter fibrinogen (soluble) into fibrin (insoluble). Forming fibrin nets that capture red blood cells and clot. • Tertiary: a control mechanism that prevents excessive hemostasis not do fibrinolytic system.

17. 8)Cardiovascular System • The cardiovascular system is an organ system which functions to move substances to and from the cell. These systems also help stabilize body temperature and pH. • There are two types of the cardiovascular system - open circulatory system. - closed circulation system. 3. Components in cardiovascular system is heart,lung, blood and muscle. 4. Is the most important component in the profile of human physiology. 5. Also known as VO2max (defined as the use of oxygen capacity the maximum by the body during the physical conduct activities. 6. Function of the Cardiovascular System is - deliver oxygen and nutrients to every cell in the body through blood by the heart.- Removing the carbon dioxide and waste products of metabolism from every cell in the body-Transporting hormones from endocrine glands to target cells via the blood plasma.- Helping to maintain the temperature in the body.