Chapter 14 Circulation and Blood Vessels 2014 2013

Blood Circulation • Major circulatory systems –Cardiopulmonary circulation (blood from Heart lungs heart) –Systemic circulation (blood from Heart tissue/cells heart) © 2014 Cengage Learning. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part.

• Specialized circulatory systems – Coronary circulation (bring Blood from Heart Myocardium) – Portal circulation (takes Blood from Organs of digestion Liver through portal vein) – Fetal circulation (fetus obtaining O 2 & Nutrients from moms blood) © 2014 Cengage Learning. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part.

Cardiopulmonary Circulation • Deoxygenated blood from the heart flows to the lungs, where carbon dioxide is exchanged for oxygen • Oxygenated blood then returns to the heart • Review of blood flow through the heart and lungs • Decrease Erythrocytes=difficulty carrying O 2 © 2014 Cengage Learning. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part.

Cardiopulmonary Circulation © 2014 Cengage Learning. All Rights Reserved. May not be scanned, copied

Systemic Circulation • Circulates nutrients, oxygen, water, and secretions • Carries away waste products • Helps equalize body temperature • Aids in protecting the body from harmful bacteria • The aorta and its branches(largest Artery in body) © 2014 Cengage Learning. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part.

Systemic Circulation © 2014 Cengage Learning. All Rights Reserved. May not be scanned, copied

Coronary Circulation • Brings oxygenated blood to the heart muscle • Right and left branches of the coronary artery • Exchange of oxygen and waste occurs at capillary level • Deoxygenated blood returns through the coronary veins to the coronary sinus © 2014 Cengage Learning. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part.

Portal Circulation • A branch of the general circulation • Veins from the pancreas, stomach, small intestine, colon, and spleen empty their blood into the hepatic portal vein, which goes to the liver © 2014 Cengage Learning. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part.

Portal Circulation © 2014 Cengage Learning. All Rights Reserved. May not be scanned, copied

Portal Circulation • Liver ensures that the blood’s glucose concentration is kept within a relatively narrow range © 2014 Cengage Learning. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part.

Fetal Circulation • Occurs in the unborn baby (fetus) • Fetus obtains oxygen and nutrients from the mother’s blood, not through its own lungs and digestive system • The fetal blood does not mix with the mother’s blood; the exchange of gases, food, and waste occurs through the placenta © 2014 Cengage Learning. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part.

1. Cardiopulmonary circulation A. (blood from Heart lungs heart) B. (blood from Heart tissue/cells heart) C. (bring Blood from Heart Myocardium) D. (takes Blood from Organs of digestion Liver through portal vein) E. (fetus obtaining O 2 & Nutrients from moms blood) © 2014 Cengage Learning. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part.

2. Systemic circulation A. (blood from Heart lungs heart) B. (blood from Heart tissue/cells heart) C. (bring Blood from Heart Myocardium) D. (takes Blood from Organs of digestion Liver through portal vein) E. (fetus obtaining O 2 & Nutrients from moms blood) © 2014 Cengage Learning. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part.

3. Coronary circulation A. (blood from Heart lungs heart) B. (blood from Heart tissue/cells heart) C. (bring Blood from Heart Myocardium) D. (takes Blood from Organs of digestion Liver through portal vein) E. (fetus obtaining O 2 & Nutrients from moms blood) © 2014 Cengage Learning. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part.

4. Fetal circulation A. (blood from Heart lungs heart) B. (blood from Heart tissue/cells heart) C. (bring Blood from Heart Myocardium) D. (takes Blood from Organs of digestion Liver through portal vein) E. (fetus obtaining O 2 & Nutrients from moms blood) © 2014 Cengage Learning. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part.

5. Portal circulation A. (blood from Heart lungs heart) B. (blood from Heart tissue/cells heart) C. (bring Blood from Heart Myocardium) D. (takes Blood from Organs of digestion Liver through portal vein) E. (fetus obtaining O 2 & Nutrients from moms blood) © 2014 Cengage Learning. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part.

Blood Vessels • Arteries (mostly muscular & Elastic) • Capillaries (O 2 & CO 2 exchange) • Veins © 2014 Cengage Learning. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part.

HEMATOLOGIST would tx the following: • Neutrophils & Lymphocytes (are Leukocytes) • Leukemia (tx is chemo/radiation/bone marrow) • Anemia (decreased Iron decreased Hemoglobin decreased energy) • Hemophilia (rare disorder in which your blood doesn't clot normally because it lacks sufficient bloodclotting proteins (clotting factors). If you have hemophilia, you may bleed for a longer time after an injury than you would if your blood clotted normally) © 2014 Cengage Learning. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part.

Plasma… Plasma is the often forgotten component of blood. White blood cells, red blood cells, and platelets are essential to body function, but plasma also plays a crucial, and mostly unrecognized, job, carrying these blood components throughout the body as the fluid in which they travel. – No plasma = dehydrated!!!! © 2014 Cengage Learning. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part.

Arteries-AWAY from Heart • Carry oxygenated blood away from the heart to capillaries (exception – pulmonary arteries) • Layers of the walls – Tunica adventitia or externa – Tunica media – Tunica intima © 2014 Cengage Learning. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part.

Arteries • Aorta leads away from the heart and branches into smaller arteries • Smaller arteries branch into arterioles • Arterioles give rise to the capillaries © 2014 Cengage Learning. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part.

Capillaries • • Smallest blood vessels Can only be seen through a microscope Connect the arterioles and venules Muscle and connective tissue disappear and they become a simple endothelial cell layer © 2014 Cengage Learning. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part.

Capillaries • Selective permeability • Control of blood flow by precapillary sphincters © 2014 Cengage Learning. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part.

Veins-Carry TO the HEART • Carry deoxygenated blood away from the capillaries to the heart • Layers of the walls – Tunica externa – Tunica media – Tunica intima • Walls much thinner than arteries – Do not have to withstand as much pressure © 2014 Cengage Learning. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part.

Veins • Veins have valves so blood flows in one direction – Toward the heart • Largest vein is the vena cavae – Superior vena cavae returns blood from the upper part of the body – Inferior vena cavae returns blood from the lower part of the body © 2014 Cengage Learning. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part.

Venous Return • Valves help keep venous blood moving • Skeletal muscles contract to push venous blood along its path © 2014 Cengage Learning. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part.

Venous Return • Pressure changes occur when we breath, which helps bring venous blood back to the heart • Stationary positioning can decrease flow back to the heart for oxygenation © 2014 Cengage Learning. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part.

FYI: There about 62, 000 miles of blood vessels and if you lay them down end to end, they would encircle the world at least 2. 5 times… © 2014 Cengage Learning. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part.

Blood Pressure • Systolic blood pressure – Heart Contracting (1 st beat heard) • Diastolic blood pressure – Heart Relaxing (Last beat heard) • Pulse pressure – The difference between Systolic & Diastolic • Normal values – 120/80 © 2014 Cengage Learning. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part.

Pulse • Can feel pulsating beat at certain points on the body • Should be the same as the heart rate • Can feel the pulse on the body where the artery is near the surface of the skin and over a bone – These are called pulse points © 2014 Cengage Learning. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part.

Pulse Points • Brachial artery– crook of elbow • Common carotid artery– sternocleidomastoid • Femoral artery – inguinal area/groin area • Dorsalis pedis artery – top of foot below ankle © 2014 Cengage Learning. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part.

Pulse Points • Popliteal artery – Behind Knee • Radial artery – Wrist • Temporal artery • Apical (apex) • Pressure points can be used to stop bleeding distal to the pulse point © 2014 Cengage Learning. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part.

Where are these? ? ? 1. 2. 3. 4. 5. 6. 7. 8. Brachial artery. Common carotid artery. Femoral artery Dorsalis pedis artery Popliteal artery Radial artery Temporal artery Apical (apex) © 2014 Cengage Learning. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part.

Pulse Point Quiz 4. a. Popliteal b. Radial c. Temporal d. Dorsalis pedis e. Femoral a. Carotid b. Brachial c. Apical (apex) 1. 5. 6. 2. 7. 8. 3. © 2014 Cengage Learning. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part.

Congenital Heart Defects • Occur when there is a malformation (development) of the heart during fetal development • Most common symptom – Cyanosis, rapid breathing, decreased circulation • Microscopic surgery – Can correct many congenital heart defects © 2014 Cengage Learning. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part.

Disorders of Circulation and Blood Vessels • Aneurysm – Ballooning of Artery, weakness in the wall • s/s pain, pressure/may have no s/s © 2014 Cengage Learning. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part.

• Arteriosclerosis – Arterial wall thickening (arteries hardening) • Causes elevated b/p • Atherosclerosis – Fat hardening in walls © 2014 Cengage Learning. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part.

Disorders of Circulation and Blood Vessels • Gangrene – Body tissue dies decrease blood supply © 2014 Cengage Learning. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part.

• Phlebitis or thrombophlebitis – Inf. Of vein clotting of blood • s/s edema, pain, redness in leg…tx NWB coumadin • Or IV results…tx warm compresses/motrin © 2014 Cengage Learning. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part.

Disorders of Circulation and Blood Vessels • Embolism – Traveling blood clot pulmonary embolism to lungs • Tx: coumadin © 2014 Cengage Learning. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part.

• Varicose veins – Swollen veins from wt or standing for long periods of time/years • Hemorrhoids – In rectum or anus © 2014 Cengage Learning. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part.

Disorders of Circulation and Blood Vessels • Cerebral hemorrhage – Bleeding from blood vessels in brain caused by arthrosclerosis • Peripheral vascular disease PVD – Block Artery (legs) • s/s pain, cramping © 2014 Cengage Learning. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part.

Disorders of the Blood Vessels • Hypertension “Silent Killer” – Normal – Less than 120/80 – Pre-hypertension – 120 -130/80 -89 • Stage I hypertension – 140 -159/90 -99 • Stage II hypertension – 160 and above/100 and above © 2014 Cengage Learning. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part.

Disorders of the Blood Vessels • White coat hypertension Doctor Office • Hypotension low b/p © 2014 Cengage Learning. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part.

• Transient ischemic attacks (TIAs) – Temp interruption of blood to brain • due to fat stroke like s/s disappear 1 -24 hours 1/3 usually have stroke in future • Cerebral vascular accident (CVA) – Sudden interruption of blood in brain • stroke decreased O 2 brain cells 3 rd leading cause of death in US © 2014 Cengage Learning. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part.

Hypoperfusion • Inadequate flow of blood carrying oxygen to the organs and body systems • Hypoperfused tissue will stop working properly • Main causes of hypoperfusion • Can lead to SHOCK – Increase Resp – Increase Heart Rate/Pulse – Decrease b/p © 2014 Cengage Learning. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part.