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Booth, Wallace, and Fitzgerald

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1 Booth, Wallace, and Fitzgerald
Chapter 2 PowerPoint ® Presentation to Accompany Phlebotomy for Health Care Personnel Booth, Wallace, and Fitzgerald Chapter 2

2 Blood Circulation, Function, and Composition
Chapter 2

3 Learning Outcomes Upon Completion of this chapter, you should be able to: 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. 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 Learning Outcomes (cont’d)
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. Chapter 2

6 Introduction San Francisco New York 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!! 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 Click picture for larger view.
Coronary Circulation 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 Click picture for larger view. Chapter 2

9 Coronary Circulation Click to return to previous slide. Chapter 2

10 Pulmonary Circulation
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. O 2 CO Exchange of gases Chapter 2

11 Systemic Circulation 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. Digestive system 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 Systemic circulation also removes waste products from the body cells. Chapter 2

12 Pulmonary Circulation
Systemic and Pulmonary Circulation Exchange of oxygen and carbon dioxide in the lungs’ capillaries Pulmonary Circulation 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. Systemic Circulation O2 and CO2 exchange between capillary beds and body tissues. Chapter 2

13 Circulation of Blood Aorta Arteries Arterioles Capillaries Venules
Arteries 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. Veins Vena Cava 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 Apply Your Knowledge Good Job!
What is the purpose of pulmonary circulation? ANSWER: To exchange oxygen and carbon dioxide Good Job! Chapter 2

16 Blood Vessels Arteries and veins are comprised of three layers of tissue: Tunica intima Innermost, smooth layer Tunica media Middle, thickest layer Tunica adventitia Outer covering Capillaries comprise only one layer of tissue. Chapter 2

17 Arteries 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 Please add figure 2-5 on page 37. Chapter 2

18 Capillaries 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 Veins 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 Artery or Vein? 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. Chapter 2

21 Selecting a Vein 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. Chapter 2

22 Primary Veins Used For Phlebotomy Which vein is BEST for venipuncture?
The most commonly used veins for venipuncture are located in the antecubital fossa. Which vein is BEST for venipuncture? 1st Choice Median cubital vein Cephalic vein 2nd Choice Basilic vein 3rd Choice Chapter 2

23 Other Sites for Venipuncture
Hand Veins Dorsal venous arch Metacarpal plexus When the antecubital veins are not accessible, the hand veins may be used for venipuncture. Hand veins are smaller and less anchored. This can be very painful for the patient. NOTE: Chapter 2

24 Apply Your Knowledge Great!
What are the three layers of tissue that comprise the artery and vein? ANSWER: Tunica intima, tunica media, tunica adventitia Great! Chapter 2

25 Apply Your Knowledge Which type of vessel is the smallest, forming the link between arterioles and venules? ANSWER: Capillaries Bravo! Chapter 2

26 Apply Your Knowledge Which site is the best for performing venipuncture? ANSWER: Median cubital vein GREAT! Chapter 2

27 Blood and Blood Components
Blood, when allowed to stand, will separate into two components: Liquid Solid Plasma, which is a straw-colored fluid comprised mostly of water Cellular components, including: -red blood cells -white blood cells -platelets Chapter 2

28 Erythrocytes 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 Erythrocytes I’m just so tired! Normal Hemoglobin Levels
Male = 14–18 grams/100 mL of blood Female = 12–16 grams/100 mL of blood Symptoms of Anemia Weakness Headache Pale skin color Difficulty breathing An abnormally low hemoglobin level and/or decrease in the number of red blood cells is called anemia. Chapter 2

30 Leukocytes Types of White Blood Cells Granulocytes Agranulocytes
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 Basophils Neutrophils Eosinophils
Most numerous of all the WBCs Main warriors against infection (phagocytosis) Least common granulocyte Assist with the inflammatory process Release histamine and heparin Eosinophils Present in a very small quantity Ingest and destroy foreign proteins Secrete chemicals to destroy parasites Increase during allergic reactions and parasitic infections Chapter 2

32 Agranulocytes Monocytes Lymphocytes
Largest in size of all the white blood cells Primary function is phagocytosis Survive for several months Effective against chronic infections 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 Thrombocytes 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 Liquid Component (Plasma)
Composition of Plasma Water Nutrients Hormones Electrolytes Proteins Waste Protective substances Centrifugation is a procedure that separates blood into liquid and cellular components. Serum is the liquid portion of clotted blood. 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 Chapter 2

36 Apply Your Knowledge Good Job!
What are the two types of white blood cells? ANSWER: Granulocytes and agranulocytes Good Job! Chapter 2

37 Apply Your Knowledge What is the primary function of thrombocytes or platelets? ANSWER: To prevent blood loss following an injury GREAT! Chapter 2

38 Hemostasis and Blood Coagulation
Following an injury, four events are available to stop the bleeding: Blood Vessel Spasm 1 Platelet Plug Formation 2 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 Blood Clotting 3 Fibrinolysis 4 Requires the presence of certain clotting factors to form fibrin Begins the repair process Chapter 2

39 Hemostasis and Blood Coagulation
I. Blood vessel spasm II. Platelet plug Formation III. Blood clotting IV. Fibrinolysis Chapter 2

40 Lack of Clotting Factors
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. Chapter 2

41 Apply Your Knowledge 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 ABO and Rh Blood Types 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 ABO and Rh Blood Types Compatibility Chart A B AB O A, O B, O
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 Type and Cross-Match Blood Specimens
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 Chapter 2

46 Apply Your Knowledge Answer: Kala type O
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 Logic is the anatomy of thought. --John Locke
END OF CHAPTER 2 Logic is the anatomy of thought. --John Locke Chapter 2

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