Power Point Presentation to Accompany Phlebotomy A CompetencyBased

Power. Point ® Presentation to Accompany Phlebotomy: A Competency-Based Approach Booth and Mundt

5 -2 Chapter 5: The Cardiovascular System Mc. Graw-Hill © 2013 by Mc. Graw-Hill

5 -3 Upon completion of this chapter, you should be able to: l l l Mc. Graw-Hill Describe circulation and the purpose of the vascular system. Identify and describe the structures and functions of the different types of blood vessels. Locate and name the veins most commonly used for phlebotomy procedures. Identify the major components of blood. Describe the major function of red blood cells, white blood cells, and platelets. © 2013 by Mc. Graw-Hill Education. All rights reserved.

5 -4 Upon completion of this chapter, you should be able to: Define hemostasis and describe the basic coagulation process. l Describe how ABO and Rh blood types are determined. l Mc. Graw-Hill © 2013 by Mc. Graw-Hill Education. All rights reserved.

The Heart and Circulation 5 -5 (LO 5. 1) l Average adult 8 to 12 pints of blood l 70, 000 miles of blood vessels l l Phlebotomist must understand Blood composition l How blood is transported l Locations of blood vessels l Mc. Graw-Hill © 2013 by Mc. Graw-Hill Education. All rights reserved.

Structure of the Heart 5 -6 (LO 5. 1) l Heart chambers Right atrium

5 -7 Layers of the Heart (LO 5. 1) l Endocardium l Myocardium l

5 -8 Types of Circulation (LO 5. 1) l Coronary l Provides blood supply to the heart muscle l Pulmonary Sends deoxygenated blood to lungs for oxygenation l Sends oxygenated blood back to heart l l Systemic l Mc. Graw-Hill Sends oxygenated blood throughout the body © 2013 by Mc. Graw-Hill Education. All rights reserved.

Circulation of Blood 5 -9 (LO 5. 1) Mc. Graw-Hill © 2013 by Mc.

5 -10 Circulation of Blood (LO 5. 1) l Arterial blood l l Mc. Graw-Hill Larger concentration of oxygen Pumped by the heart to the body cells l Venous blood l l Larger concentration of carbon dioxide Pumped by the heart to the lungs © 2013 by Mc. Graw-Hill Education. All rights reserved.

5 -11 Apply Your Knowledge (LO 5. 1) What is the purpose of pulmonary circulation? Answer: To exchange oxygen and carbon dioxide. BRAVO! Mc. Graw-Hill © 2013 by Mc. Graw-Hill Education. All rights reserved.

Structure of Blood Vessels 5 -12 (LO 5. 2) Valve Tunica intima Tunica media

Types of Blood Vessels 5 -13 (LO 5. 2) l Arteries l Carry blood away from the heart l Capillaries Link arterioles to venules l Carry out gas exchange l l Veins l Mc. Graw-Hill Carry blood toward the heart © 2013 by Mc. Graw-Hill Education. All rights reserved.

5 -14 Apply Your Knowledge (LO 5. 2) What are three layers of tissue that comprise the arteries and veins? Answer: Tunica intima, tunica media, and tunica adventitia. Great! Mc. Graw-Hill © 2013 by Mc. Graw-Hill Education. All rights reserved.

Veins for Phlebotomy 5 -15 (LO 5. 3) Cephalic vein Basilic vein Median cubital

Veins for Phlebotomy (cont. ) 5 -16 (LO 5. 3) Dorsal venous arch Mc.

5 -17 Apply Your Knowledge (LO 5. 3) Which site is generally the best for performing venipuncture? Answer: Median cubital vein. GREAT! Mc. Graw-Hill © 2013 by Mc. Graw-Hill Education. All rights reserved.

5 -18 Composition of Blood (LO 5. 4) l Formed elements (cellular component) l l l Mc. Graw-Hill Red blood cells White blood cells Platelets l Plasma (liquid component) l l Water Solutes (dissolved chemicals) © 2013 by Mc. Graw-Hill Education. All rights reserved.

5 -19 Erythrocytes (RBCs) (LO 5. 5) l Originate in bone marrow l Biconcave l Lifespan 120 days l Contain hemoglobin l Deliver oxygen to cells l Remove carbon dioxide from cells Mc. Graw-Hill © 2013 by Mc. Graw-Hill Education. All rights reserved.

5 -20 Leukocytes (WBCs) (LO 5. 5) l Not confined to vascular spaces l Diapedesis l Responsible for phagocytosis l Round and clear (when not stained) Mc. Graw-Hill © 2013 by Mc. Graw-Hill Education. All rights reserved.

5 -21 WBCs: Neutrophils (LO 5. 5) l Most numerous l Nucleus has 3 or 4 lobes l Perform phagocytosis l Count increases during bacterial infection or inflammation Mc. Graw-Hill © 2013 by Mc. Graw-Hill Education. All rights reserved.

5 -22 WBCs: Eosinophils (LO 5. 5) l Nucleus is bilobed l Perform phagocytosis l Destroy parasites l Count increases during allergic reactions and parasitic infections Mc. Graw-Hill © 2013 by Mc. Graw-Hill Education. All rights reserved.

5 -23 WBCs: Basophils (LO 5. 5) l Nucleus usually bilobed l Release histamine l Release heparin l Produce vasodilator l Count increases with chronic inflammation Mc. Graw-Hill © 2013 by Mc. Graw-Hill Education. All rights reserved.

5 -24 WBCs: Monocytes (LO 5. 5) l Largest type of WBC l Single, kidney-shaped nucleus l Perform phagocytosis l Count increases with chronic infections Mc. Graw-Hill © 2013 by Mc. Graw-Hill Education. All rights reserved.

5 -25 WBCs: Lymphocytes (LO 5. 5) l Single, round nucleus l Two types B-cell lymphocytes l T-cell lymphocytes l l Count increases during viral infections Mc. Graw-Hill © 2013 by Mc. Graw-Hill Education. All rights reserved.

5 -26 Thrombocytes (Platelets) (LO 5. 5) l Smallest formed element l Fragments of megakaryocytes l Life span 9 to 12 days l Help prevent blood loss Mc. Graw-Hill © 2013 by Mc. Graw-Hill Education. All rights reserved.

5 -27 Plasma (LO 5. 5) l Pale yellow liquid l Mostly water l Contains several important solutes l Different from serum Plasma Buffy coat Red blood cells Centrifuged, unclotted blood Mc. Graw-Hill © 2013 by Mc. Graw-Hill Education. All rights reserved.

5 -28 Apply Your Knowledge (LO 5. 5) What is the primary function of thrombocytes? Answer: To prevent blood loss following an injury. GREAT! Mc. Graw-Hill © 2013 by Mc. Graw-Hill Education. All rights reserved.

5 -29 Hemostasis (LO 5. 6) l Stops the flow of blood from injury l Involves for major events Blood vessel spasm l Platelet plug formation l Coagulation l Fibrinolysis l Mc. Graw-Hill © 2013 by Mc. Graw-Hill Education. All rights reserved.

5 -30 Blood Vessel Spasm (LO 5. 6) Mc. Graw-Hill © 2013 by Mc.

5 -31 Platelet Plug Formation (LO 5. 6) Mc. Graw-Hill © 2013 by Mc.

5 -32 Coagulation (LO 5. 6) Mc. Graw-Hill © 2013 by Mc. Graw-Hill Education.

Coagulation: Clotting Cascade 5 -33 (LO 5. 6) Mc. Graw-Hill © 2013 by Mc.

Coagulation: Fibrin Generation Detail (LO 5. 6) 5 -34 AA B B E D D D Fibrinogen (I) D D E D Fibrin monomer E D D E E Fibrin polymer D E D D E E D D Fibrin clot D D E D XIIIa Mc. Graw-Hill © 2013 by Mc. Graw-Hill Education. All rights reserved.

5 -35 Fibrinolysis (LO 5. 6) Mc. Graw-Hill © 2013 by Mc. Graw-Hill Education.

5 -36 Fibrinolysis (LO 5. 6) Mc. Graw-Hill © 2013 by Mc. Graw-Hill Education.

Apply Your Knowledge 5 -37 (LO 5. 6) Identify the four events of hemostasis. Answer: Blood vessel spasm, platelet plug formation, coagulation, and fibrinolysis. GOOD JOB! Mc. Graw-Hill © 2013 by Mc. Graw-Hill Education. All rights reserved.

5 -38 ABO Blood Types (LO 5. 7) l Based on antigens and antibodies

ABO Blood Types (cont. ) 5 -39 (LO 5. 7) Mc. Graw-Hill © 2013

ABO Blood Types (cont. ) 5 -40 (LO 5. 7) Blood type A Blood

ABO Compatibility Chart 5 -41 (LO 5. 7) Blood Type A B AB O Mc. Graw-Hill Can Accept Cells From A, O B, O A, B, AB, O O Can Donate Cells To A, AB B, AB AB O, A, B, AB © 2013 by Mc. Graw-Hill Education. All rights reserved.

Rh Factor 5 -42 (LO 5. 7) Rh positive Rh negative Mc. Graw-Hill ©

Preventing Transfusion Reactions (LO 5. 7) 5 -43 l Always use two patient identifiers

Apply Your Knowledge 5 -44 (LO 5. 7) Mary has blood type O and requires a transfusion. What blood type must be used in her transfusion? Answer: Type O. BRAVO! Mc. Graw-Hill © 2013 by Mc. Graw-Hill Education. All rights reserved.

5 -45 Chapter 5 Summary l The vascular system consists of a network of vessels that, along with the heart, provides for circulation of the blood. l The three types of circulation are coronary, pulmonary, and systemic. l Blood vessels have three layers: tunica intima, tunica media, and tunica adventitia. Mc. Graw-Hill © 2013 by Mc. Graw-Hill Education. All rights reserved.

5 -46 Chapter 5 Summary (cont. ) l All arteries except the pulmonary artery carry oxygenated blood to the body. l All veins except the pulmonary veins carry deoxygenated blood to the heart. l The five types of blood vessels are arteries, arterioles, capillaries, venules, and veins. l Capillaries link arterioles and venules and allow for gas exchange. Mc. Graw-Hill © 2013 by Mc. Graw-Hill Education. All rights reserved.

5 -47 Chapter 5 Summary (cont. ) l The veins most commonly used for phlebotomy are the median cubital, cephalic, and basilic veins in the antecubital fossa. l Blood transports oxygen, nutrients, antibodies, and hormones to cells; removes wastes from cells; and maintains water balance. Mc. Graw-Hill © 2013 by Mc. Graw-Hill Education. All rights reserved.

5 -48 Chapter 5 Summary (cont. ) l The major components of blood are the formed elements (erythrocytes, leukocytes, and platelets) and plasma. l White blood cells include neutrophils, eosinophils, basophils, monocytes, and lymphocytes. l Platelets are essential for clotting. l Plasma is the liquid portion of uncoagulated blood. Mc. Graw-Hill © 2013 by Mc. Graw-Hill Education. All rights reserved.

5 -49 Chapter 5 Summary (cont. ) l Hemostasis includes blood vessel spasm, platelet plug formation, coagulation, and fibrinolysis. l ABO and Rh blood types are determined by the type of antigen found on the red blood cells. Mc. Graw-Hill © 2013 by Mc. Graw-Hill Education. All rights reserved.