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Chapter 2
PowerPoint ® Presentation to Accompany
Booth, Wallace, and Fitzgerald
Chapter 2
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Blood Circulation,
Function, and Composition
Chapter 2
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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
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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.
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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
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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.
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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
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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.
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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
CO
2
Exchange of gases
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Digestive system
Systemic circulation
also removes waste
products from the body
cells.
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.
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
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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.
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Aorta
Arteries
Arterioles
Capillaries
Venules
Veins
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.
Vena Cava
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Apply Your Knowledge
Identify the four chambers of the
heart.
ANSWER: Right atrium, left atrium, right
ventricle, and left ventricle
BRAVO!
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Apply Your Knowledge
What is the purpose of pulmonary
circulation?
ANSWER: To exchange oxygen and
carbon dioxide
Good Job!
Chapter 2
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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.
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• 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
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• 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
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• 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
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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
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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.
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The most commonly used
veins for venipuncture are
located in the antecubital
fossa.
Which vein is BEST for venipuncture?
1st Choice
Median cubital vein
2nd Choice
Cephalic vein
3rd Choice
Basilic vein
Chapter 2
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Hand Veins
Metacarpal plexus
Dorsal venous
arch
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.
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Apply Your Knowledge
What are the three layers of tissue
that comprise the artery and vein?
ANSWER: Tunica intima, tunica media,
tunica adventitia
Great!
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Apply Your Knowledge
Which type of vessel is the smallest,
forming the link between arterioles and
venules?
ANSWER: Capillaries
Chapter 2
Bravo!
25
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Apply Your Knowledge
Which site is the best for performing
venipuncture?
ANSWER: Median cubital vein
GREAT!
Chapter 2
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Blood, when allowed to stand, will
separate into two components:
Liquid
• Plasma, which is a strawcolored fluid comprised
mostly of water
Solid
-red blood cells
• Cellular
components, -white blood cells
-platelets
including:
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• 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
Chapter 2
• Contains an iron-rich
protein molecule called
hemoglobin
• Responsible for carrying
oxygen and removing
carbon dioxide from
every body cell
28
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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
An abnormally low hemoglobin
level and/or decrease in the
number of red blood cells is called
anemia.
Chapter 2
•
•
•
•
Weakness
Headache
Pale skin color
Difficulty breathing
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• Also known as white blood cells
Types of 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
Granulocytes
Agranulocytes
• Neutrophils
• Eosinophils
• Basophils
• Monocytes
• Lymphocytes
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Granulocytes
Basophils
Neutrophils
• 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
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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.
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• 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
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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.
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Immunocompromised Patients
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
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Apply Your Knowledge
What are the two types of white
blood cells?
ANSWER: Granulocytes and
agranulocytes
Good Job!
Chapter 2
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Apply Your Knowledge
What is the primary function of
thrombocytes or platelets?
ANSWER: To prevent blood loss
following an injury
GREAT!
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Following an injury, four events are available to stop the
bleeding:
2
1
Blood Vessel Spasm
• Vessels decrease
in size to stop
bleeding in small
vessels
3
Platelet Plug Formation
• Inner torn layer of the vessels
releases chemical signals that call
platelets to the site of injury
4
Blood Clotting
• Requires the presence of certain
clotting factors to form fibrin
Chapter 2
Fibrinolysis
• Begins the repair
process
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I. Blood vessel spasm
III. Blood clotting
II. Platelet plug Formation
Chapter 2
IV. Fibrinolysis
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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.
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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!
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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.
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Compatibility Chart
Blood Type
Can Accept From
Can Donate To
A
A, O
A, AB
B
B, O
B, AB
AB
A, B, AB, O
AB
O
O
O, A, AB, B
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The Rh Factor
Rh-Positive
Rh-Negative
Contains the Rh antigen
No Rh antigen
Clinically, it is very
important for a female
to know her Rh type if
she becomes pregnant.
Chapter 2
Will make antibodies
if given Rh-positive
blood
Agglutination can
occur if given Rhpositive blood
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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
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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)
Answer: Kala type O
Chapter 2
Kala (type O)
BRAVO!
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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
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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
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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
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END OF CHAPTER 2
Logic is the anatomy of thought.
--John Locke
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