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Phlebotomy:
A Competency-Based
Approach
Booth and Mundt
5-2
Chapter 5:
The Cardiovascular System
McGraw-Hill
©2013 by McGraw-Hill Education. All rights reserved.
5-3
Upon completion of this chapter, you should
be able to:
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.
McGraw-Hill
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5-4
Upon completion of this chapter, you should
be able to:
Define hemostasis and describe the basic coagulation
process.
Describe how ABO and Rh blood types are
determined.
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5-5
The Heart and Circulation
(LO 5.1)
Average adult
8 to 12 pints of blood
70,000 miles of blood vessels
Phlebotomist must understand
Blood composition
How blood is transported
Locations of blood vessels
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5-6
Structure of the Heart
(LO 5.1)
Heart chambers
Right atrium
Right ventricle
Left atrium
Left ventricle
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5-7
Layers of the Heart (LO 5.1)
Endocardium
Myocardium
Epicardium
Visceral
Parietal
Pericardial
fluid
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5-8
Types of Circulation
(LO 5.1)
Coronary
Provides blood supply to the heart muscle
Pulmonary
Sends deoxygenated blood to lungs for
oxygenation
Sends oxygenated blood back to heart
Systemic
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Sends oxygenated blood throughout the
body
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5-9
Circulation of Blood
(LO 5.1)
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5-10
Circulation of Blood
(LO 5.1)
Arterial blood
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Larger concentration
of oxygen
Pumped by the heart
to the body cells
Venous blood
Larger concentration
of carbon dioxide
Pumped by the heart
to the lungs
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5-11
Apply Your Knowledge
(LO 5.1)
What is the purpose of pulmonary
circulation?
Answer: To exchange oxygen and carbon
dioxide.
BRAVO!
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5-12
Structure of Blood Vessels
(LO 5.2)
Valve
Tunica intima
Tunica media
Tunica
adventitia
Artery
McGraw-Hill
Vein
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5-13
Types of Blood Vessels
(LO 5.2)
Arteries
Carry blood away from the heart
Capillaries
Link arterioles to venules
Carry out gas exchange
Veins
McGraw-Hill
Carry blood toward the heart
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5-14
Apply Your Knowledge
(LO 5.2)
What are the three layers of tissue
that comprise the arteries and veins?
Answer: Tunica intima, tunica media, and
tunica adventitia.
Great!
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5-15
Veins for Phlebotomy
(LO 5.3)
Cephalic vein
Basilic vein
Median cubital
vein
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Basilic vein
branch
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5-16
Veins for Phlebotomy (cont.)
(LO 5.3)
Dorsal venous
arch
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Metacarpal
plexus
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5-17
Apply Your Knowledge
(LO 5.3)
Which site is generally the best for
performing venipuncture?
Answer: Median cubital vein.
GREAT!
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5-18
Composition of Blood (LO 5.4)
Formed elements
(cellular component)
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Red blood cells
White blood cells
Platelets
Plasma (liquid
component)
Water
Solutes (dissolved
chemicals)
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5-19
Erythrocytes (RBCs) (LO 5.5)
Originate in bone marrow
Biconcave
Lifespan 120 days
Contain hemoglobin
Deliver oxygen to cells
Remove carbon dioxide
from cells
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5-20
Leukocytes (WBCs) (LO 5.5)
Not confined to
vascular spaces
Diapedesis
Responsible for
phagocytosis
Round and clear
(when not stained)
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5-21
WBCs: Neutrophils (LO 5.5)
Most numerous
Nucleus has 3 or 4 lobes
Perform phagocytosis
Count increases during
bacterial infection or
inflammation
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5-22
WBCs: Eosinophils (LO 5.5)
Nucleus is bilobed
Perform phagocytosis
Destroy parasites
Count increases during
allergic reactions and
parasitic infections
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5-23
WBCs: Basophils (LO 5.5)
Nucleus usually bilobed
Release histamine
Release heparin
Produce vasodilator
Count increases with
chronic inflammation
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5-24
WBCs: Monocytes (LO 5.5)
Largest type of WBC
Single, kidney-shaped
nucleus
Perform phagocytosis
Count increases
with chronic infections
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5-25
WBCs: Lymphocytes (LO 5.5)
Single, round nucleus
Two types
B-cell lymphocytes
T-cell lymphocytes
Count increases during
viral infections
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5-26
Thrombocytes (Platelets) (LO 5.5)
Smallest formed element
Fragments of
megakaryocytes
Life span 9 to 12 days
Help prevent blood loss
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5-27
Plasma (LO 5.5)
Pale yellow liquid
Mostly water
Contains several
important solutes
Different from serum
Plasma
Buffy coat
Red blood
cells
Centrifuged, unclotted blood
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5-28
Apply Your Knowledge
(LO 5.5)
What is the primary function of
thrombocytes?
Answer: To prevent blood loss following
an injury.
GREAT!
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5-29
Hemostasis (LO 5.6)
Stops the flow of blood from injury
Involves for major events
Blood vessel spasm
Platelet plug formation
Coagulation
Fibrinolysis
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5-30
Blood Vessel Spasm (LO 5.6)
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5-31
Platelet Plug Formation (LO 5.6)
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5-32
Coagulation (LO 5.6)
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5-33
Coagulation: Clotting Cascade
(LO 5.6)
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5-34
Coagulation: Fibrin
Generation Detail (LO 5.6)
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
D
D
E
E
D
D
Fibrin
clot
D
D
E
D
XIIIa
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5-35
Fibrinolysis (LO 5.6)
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5-36
Fibrinolysis (LO 5.6)
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5-37
Apply Your Knowledge
(LO 5.6)
Identify the four events of hemostasis.
Answer: Blood vessel spasm, platelet plug
formation, coagulation, and fibrinolysis.
GOOD JOB!
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5-38
ABO Blood Types (LO 5.7)
Based on antigens
and antibodies
Four types
Type A
Type B
Type AB
Type O
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5-39
ABO Blood Types (cont.)
(LO 5.7)
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5-40
ABO Blood Types (cont.)
(LO 5.7)
Blood type A
Blood type B
Blood type AB
Blood type O
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5-41
ABO Compatibility Chart
(LO 5.7)
Blood
Type
Can Accept Cells
From
Can Donate Cells To
A
B
A, O
B, O
A, AB
B, AB
AB
O
A, B, AB, O
O
AB
O, A, B, AB
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5-42
Rh Factor
(LO 5.7)
Rh positive
Rh negative
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Preventing Transfusion
Reactions (LO 5.7)
5-43
Always use two
patient identifiers
Label blood and
blood products
accurately
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5-44
Apply Your Knowledge
(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!
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5-45
Chapter 5 Summary
The vascular system consists of a
network of vessels that, along with the
heart, provides for circulation of the
blood.
The three types of circulation are
coronary, pulmonary, and systemic.
Blood vessels have three layers: tunica
intima, tunica media, and tunica
adventitia.
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5-46
Chapter 5 Summary (cont.)
All arteries except the pulmonary artery
carry oxygenated blood to the body.
All veins except the pulmonary veins
carry deoxygenated blood to the heart.
The five types of blood vessels are
arteries, arterioles, capillaries, venules,
and veins.
Capillaries link arterioles and venules
and allow for gas exchange.
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5-47
Chapter 5 Summary (cont.)
The veins most commonly used for
phlebotomy are the median cubital,
cephalic, and basilic veins in the
antecubital fossa.
Blood transports oxygen, nutrients,
antibodies, and hormones to cells;
removes wastes from cells; and
maintains water balance.
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5-48
Chapter 5 Summary (cont.)
The major components of blood are the
formed elements (erythrocytes,
leukocytes, and platelets) and plasma.
White blood cells include neutrophils,
eosinophils, basophils, monocytes, and
lymphocytes.
Platelets are essential for clotting.
Plasma is the liquid portion of
uncoagulated blood.
McGraw-Hill
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5-49
Chapter 5 Summary (cont.)
Hemostasis includes blood vessel
spasm, platelet plug formation,
coagulation, and fibrinolysis.
ABO and Rh blood types are determined
by the type of antigen found on the red
blood cells.
McGraw-Hill
©2013 by McGraw-Hill Education. All rights reserved.