Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display Chapter 21 Booth, Wallace, and Fitzgerald PowerPoint Presentation.

Chapter 2 1

Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display

Booth, Wallace, and Fitzgerald

PowerPoint PowerPoint ® Presentation to Accompany Presentation to Accompany

Chapter 2

Chapter 2 2


Blood Circulation, Function, and Composition

Chapter 2 3


Learning Outcomes

• Describe circulation and the purpose of the vascular system.

• Discuss three types of circulation.

• List and describe the three layers of blood vessels.

• Identify and describe the structures and functions of the different types of blood vessels.

Upon Completion of this chapter, you should be able to:

Chapter 2 4


Learning Outcomes (cont’d)

• Locate and name the veins most commonly used for phlebotomy procedures.

• List the functions of blood.

• Identify the major components of blood.

• Describe the major functions of red blood cells, white blood cells, and platelets.

Chapter 2 5


• List the different types of white blood cells and give the function of each.

• Differentiate between serum and plasma.

• Define hemostasis and describe the basic coagulation process.

• Describe how ABO and Rh blood types are determined.

Learning Outcomes (cont’d)

Chapter 2 6


The human vascular system consists of approximately 70,000 miles of blood vessels; this could reach from New York to San Francisco about 24 times!!

New York

San

Francis

co

Blood vessels, along with the heart, are responsible for the circulation of blood throughout the body.

Chapter 2 7


Circulation and the Vascular System

• Septum divides the heart into a right and left side

• Has four chambers: • Right and left atrium• Right and left ventricle

• Valves allow blood to pass from the atria to the ventricles

• The pulmonary artery and aorta carry blood away from the heart

Chapter 2 8


• Provides blood supply to the heart• Receives oxygenated blood from the aorta

into the coronary arteries• Coronary veins carry deoxygenated blood to

the right atrium

Coronary Circulation

Click picture for larger view.

Chapter 2 10


Pulmonary circulation occurs when blood that has been used by the cells of the body is returned to the heart and transported to the lungs for gas exchange.

O2 2CO

Exchange of gases

Chapter 2 11


This network of blood vessels carrying oxygenated blood picks up essential nutrients from the digestive tract to deliver to all other cells of the body.

Systemic circulation also removes waste products from the body cells.

Venous Blood Arterial Blood

• Has a larger concentration of carbon dioxide

• Pumped by the heart to the lungs

• Has a larger concentration of oxygen than carbon dioxide

• Pumped by the heart to the body cells

Digestive system

Chapter 2 12


Exchange of oxygen and carbon dioxide in the lungs’ capillaries

O2 and CO2 exchange between capillary beds and body tissues.

Blood rich in oxygen

Blood low in oxygen

Blood moves from the vena cava to the right atrium and ventricle for pulmonary circulation. Blood then moves to the left atrium and ventricle and into the aorta for systemic circulation.

Pulmonary Circulation

Systemic Circulation

Chapter 2 13


Vena Cava

Aorta

Arteries

Arterioles

Capillaries

Venules

VeinsArteries carry blood away from the heart and veins carry blood toward the heart. The capillaries are exchange vessels located between the arterial and venous systems.

Chapter 2 14


Apply Your Knowledge

Identify the four chambers of the heart.

ANSWER: Right atrium, left atrium, right ventricle, and left ventricle

BRAVO!

Chapter 2 15



What is the purpose of pulmonary circulation?

ANSWER: To exchange oxygen and carbon dioxide

Good Job!

Chapter 2 16


Arteries and veins are comprised of three layers of tissue:

• Tunica intima• Innermost,

smooth layer• Tunica media

• Middle, thickest layer

• Tunica adventitia

• Outer coveringCapillaries comprise only one layer of tissue.

Chapter 2 17


• Transport blood away from the heart

• Carry blood under high pressure

• Are elastic, muscular, and thick-walled

• Dilate and constrict, which creates a pulse

• Appear bright red due to high oxygen levels

Chapter 2 18


•Are the smallest blood vessels

•Provide a link from arterioles to venules

•All gas exchange occurs at this level

•Walls are very thin to allow for gas and nutrient exchange

Chapter 2 19


• Carry deoxygenated blood to the heart

• Contain one-way valves

• Store about 65% to 70% of the body’s total blood volume

• Blood appears darker in color

• Blood flows in a slow manner

Chapter 2 20


At a venipuncture site, a vein will feel bouncy and resilient, while an artery will feel firm and pulsate.

In case of an accidental puncturing of an artery, withdraw the needle and apply firm pressure for at least 5 minutes.

Instruct the patient to remain still and notify a nurse to assist in hematoma prevention.

Artery or Vein?

Chapter 2 21


After properly selecting a vein, the phlebotomist must use proper technique and avoid “probing” around at the site.

Accidental puncturing of a nerve could result in a temporary loss of function and constitutes an act of negligence.

Selecting a Vein

Chapter 2 22


The most commonly used veins for venipuncture are located in the antecubital fossa.

1st Choice Median cubital vein

2nd Choice Cephalic vein

3rd Choice Basilic vein

Which vein is BEST for venipuncture?

Chapter 2 23


Dorsal venous arch

Metacarpal plexus

Hand Veins

When the antecubital veins are not accessible, the hand veins may be used for venipuncture.

NOTE:• Hand veins are smaller and less

anchored.• This can be very painful for the

patient.

Chapter 2 24



What are the three layers of tissue that comprise the artery and vein?

ANSWER: Tunica intima, tunica media, tunica adventitia

Great!

Chapter 2 25



Which type of vessel is the smallest, forming the link between arterioles and venules?

ANSWER: Capillaries Bravo!

Chapter 2 26



Which site is the best for performing venipuncture?

ANSWER: Median cubital vein

GREAT!

Chapter 2 27


Liquid Solid

• Plasma, which is a straw-colored fluid comprised mostly of water

• Cellular components, including:

-red blood cells-white blood cells-platelets

Blood, when allowed to stand, will separate into two components:

Chapter 2 28


• Originate in the bone marrow

• Resemble the shape of a doughnut without a hole (biconcave)

• Average lifespan is 120 days

• Normal value = approximately 4.5 to 5 million per cubic millimeter of blood

• Contains an iron-rich protein molecule called hemoglobin

• Responsible for carrying oxygen and removing carbon dioxide from every body cell

Chapter 2 29


Normal Hemoglobin Levels

Male = 14–18 grams/100 mL of blood

Female = 12–16 grams/100 mL of blood

An abnormally low hemoglobin level and/or decrease in the number of red blood cells is called anemia.

Symptoms of Anemia

• Weakness• Headache• Pale skin color• Difficulty breathing

I’m just so tired!

Chapter 2 30


• Also known as white blood cells

• Primarily responsible for destroying foreign substances such as pathogens

• Appear round and white because they lack hemoglobin

• Normal adult has 5,000 to 10,000 white blood cells per cubic millimeter of blood

Types of White Blood Cells

Granulocytes Agranulocytes

• Neutrophils• Eosinophils• Basophils

• Monocytes• Lymphocytes

Chapter 2 31


Granulocytes

Neutrophils• Most numerous of all the WBCs• Main warriors against infection

(phagocytosis)

Eosinophils• Present in a very small quantity• Ingest and destroy foreign proteins• Secrete chemicals to destroy parasites• Increase during allergic reactions and parasitic infections

Basophils• Least common granulocyte• Assist with the inflammatory

process• Release histamine and heparin

Chapter 2 32


Agranulocytes

Monocytes• Largest in size of all the

white blood cells• Primary function is

phagocytosis• Survive for several months• Effective against chronic

infections

Lymphocytes• Assist with the immune

system• Produce antibodies that

destroy pathogens• Aid in controlling allergic

reactions

Quantities of each type of WBC can be determined with a blood test known as a differential.

Chapter 2 33


• Also known as platelets

• Smallest of all the cellular components

• Normal adult has 150,000 to 450,000 per cubic millimeter of blood

• Average lifespan is 9 to 12 days

• Prevent blood loss following an injury

Chapter 2 34


Composition of Plasma

• Water• Nutrients• Hormones• Electrolytes• Proteins• Waste• Protective substances

Serum is the liquid portion of clotted blood.

Centrifugation is a procedure that separates blood into liquid and cellular components.

Chapter 2 35


Immunocompromised Patients

• Require extra measures to be taken in order to prevent infection

• Standard Precautions, hand hygiene and PPE must be used to protect the patient from exposure to harmful organisms

Immunocompromised Patients

Chapter 2 36



What are the two types of white blood cells?

ANSWER: Granulocytes and agranulocytes

Good Job!

Chapter 2 37



What is the primary function of thrombocytes or platelets?

ANSWER: To prevent blood loss following an injury

GREAT!

Chapter 2 38


Following an injury, four events are available to stop the bleeding:

• Vessels decrease in size to stop bleeding in small vessels

• Inner torn layer of the vessels releases chemical signals that call platelets to the site of injury

• Requires the presence of certain clotting factors to form fibrin

Blood Vessel Spasm

1

Platelet Plug Formation

2

Blood Clotting

3

Fibrinolysis

4

• Begins the repair process

Chapter 2 39


I. Blood vessel spasm II. Platelet plug Formation

III. Blood clotting IV. Fibrinolysis

Chapter 2 40


Patients on anticoagulants or those lacking natural clotting ability require close monitoring following venipuncture.

Apply manual pressure for a minimum of 3 to 5 minutes to ensure that bleeding has stopped.

Lack of Clotting Factors

Chapter 2 41



Identify the four events necessary to stop blood flow to an injured site.

ANSWER: Blood vessel spasm, platelet plug formation, blood clotting, fibrinolysis

GOOD JOB!

Chapter 2 42


The blood group system recognizes four blood types:

• Type A, B, AB, and O

• They are distinguished from each other in part by their antigens and antibodies.

• Specific antibodies are found in the serum based on the type of antigen on the surface of the RBC.

Chapter 2 43


Compatibility ChartBlood Type Can Accept From Can Donate To

A

B

AB

O

A, O

B, O

A, B, AB, O

O

A, AB

B, AB

AB

O, A, AB, B

Chapter 2 44


The Rh Factor

Rh-Positive Rh-Negative

Contains the Rh antigen No Rh antigen

Will make antibodies if given Rh-positive blood

Agglutination can occur if given Rh-positive blood

Clinically, it is very important for a female to know her Rh type if she becomes pregnant.

Chapter 2 45


For all “type and cross-match” orders, additional identification is usually required. This may include a signature and identification number as well as initialing the tube and requisition form.

Always follow your facility’s policy

Type and Cross-Match Blood Specimens

Chapter 2 46


Mary is type O and she requires a blood transfusion. Which of the following people can she receive blood from?

John (type AB)

Harry (type B)Kala (type O)

Answer: Kala type O

BRAVO!

Chapter 2 47


Chapter 2 Summary

The vascular system consists of the heart and blood vessels providing for circulation of blood.

Coronary circulation provides blood to the heart, while systemic circulation provides blood to the body.

Blood vessel layers include the tunica intima, tunica media, and tunica adventitia.

Arteries, except the pulmonary artery, carry blood to the body. Veins, except the pulmonary vein, carries blood back to the heart.

Chapter 2 48


Chapter 2 Summary (cont’d)

The three veins most commonly used for phlebotomy are located in the antecubital fossa.

Blood is responsible for transporting oxygen, fluids, hormones, and antibodies and for eliminating waste materials.

The major components of blood include the formed elements and plasma.

RBCs transport oxygen and carbon dioxide; WBCs destroy foreign invaders.

Chapter 2 49


Chapter 2 Summary (cont’d)

WBCs include granulocytes and agranulocytes.

Plasma is the liquid portion of unclotted blood. Serum is the liquid portion of clotted blood.

Hemostasis includes four stages: blood vessel spasm, platelet plug formation, blood clotting, and fibrinolysis.

ABO and Rh types are determined by the antigen found on the RBCs.

Chapter 2 50


END OF CHAPTER 2

Logic is the anatomy of thought.--John Locke

Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display Chapter 21 Booth, Wallace, and Fitzgerald PowerPoint Presentation.

Documents

blood circulation

circulation of blood

mcgrawhill companies

functions of blood

deoxygenated blood

blood rich

blood supply

heart slide