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Chapter 2
PowerPoint ® Presentation to Accompany

Booth, Wallace, and Fitzgerald

Chapter 2 1
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Blood Circulation,
Function, and Composition

Chapter 2 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 3
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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.

Chapter 2 4
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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 5
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o
n cisc

N
a

ew
S ran

Y
The human vascular system F

or
k
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 6
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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

Chapter 2 7
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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.

Chapter 2 8
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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 Chapter 2 10

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This network of blood vessels carrying

oxygenated blood picks up essential
Digestive system nutrients from the digestive tract to
deliver to all other cells of the body.

Venous Blood Arterial Blood

• Has a larger • Has a larger
concentration of concentration of
Systemic circulation carbon dioxide oxygen than carbon
also removes waste • Pumped by the dioxide
products from the body heart to the lungs • Pumped by the heart to
cells. the body cells
Chapter 2 11
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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.
Chapter 2 12
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Aorta

Arteries

Arterioles

Capillaries

Venules
Arteries carry blood away from the heart and veins carry
Veins blood toward the heart. The capillaries are exchange
vessels located between the arterial and venous systems.
Vena Cava
Chapter 2 13
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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!

Chapter 2 14
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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 15
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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.

Chapter 2 16
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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

Chapter 2 17
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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 19
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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 20
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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.
Chapter 2 21
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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 22
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Hand Veins

Dorsal venous Metacarpal plexus

arch

When the antecubital veins are not accessible,

the hand veins may be used for venipuncture.
• Hand veins are smaller and less anchored.
NOTE:
• This can be very painful for the patient.

Chapter 2 23
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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 Bravo!

Chapter 2 25
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Apply Your Knowledge

Which site is the best for performing

venipuncture?

ANSWER: Median cubital vein

GREAT!

Chapter 2 26
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Blood, when allowed to stand, will

separate into two components:

Liquid Solid

• Plasma, which is a straw- • Cellular -red blood cells

colored fluid comprised components, -white blood cells
mostly of water including: -platelets
Chapter 2 27
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• Originate in the bone marrow

• Resemble the shape of a

doughnut without a hole • Contains an iron-rich
(biconcave) protein molecule called
hemoglobin
• Average lifespan is 120 days
• Responsible for carrying
• Normal value = approximately oxygen and removing
4.5 to 5 million per cubic carbon dioxide from
millimeter of blood every body cell
Chapter 2 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 • Weakness
level and/or decrease in the • Headache
number of red blood cells is called • Pale skin color
anemia.
• Difficulty breathing
Chapter 2 29
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• Also known as white blood cells

Types of White Blood Cells
• Primarily responsible for
destroying foreign substances
such as pathogens
Granulocytes Agranulocytes
• Appear round and white because
• Neutrophils • Monocytes
they lack hemoglobin
• Eosinophils • Lymphocytes
• Normal adult has 5,000 to • Basophils
10,000 white blood cells per
cubic millimeter of blood

Chapter 2 30
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Granulocytes

Neutrophils Basophils
• Most numerous of all the WBCs • Least common granulocyte
• Main warriors against infection • Assist with the inflammatory
(phagocytosis) 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 31
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Agranulocytes

Monocytes Lymphocytes
• Largest in size of all the • Assist with the immune
white blood cells system
• Primary function is • Produce antibodies that
phagocytosis destroy pathogens
• Survive for several months • Aid in controlling allergic
• Effective against chronic reactions
infections

Quantities of each type of WBC can be determined

with a blood test known as a differential.
Chapter 2 32
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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

Chapter 2 33
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Composition of Plasma
• Water
• Nutrients
• Hormones
• Electrolytes
• Proteins
• Waste
• Protective substances Centrifugation is a
procedure that separates
Serum is the liquid portion blood into liquid and
of clotted blood. cellular components.
Chapter 2 34
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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

Chapter 2 35
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Apply Your Knowledge

What are the two types of white

blood cells?

ANSWER: Granulocytes and

agranulocytes
Good Job!

Chapter 2 36
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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!

Chapter 2 37
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Following an injury, four events are available to stop the

bleeding:
1 2
Blood Vessel Spasm Platelet Plug Formation
• Vessels decrease • Inner torn layer of the vessels
in size to stop releases chemical signals that call
bleeding in platelets to the site of injury
small vessels
3 4
Blood Clotting Fibrinolysis
• Requires the presence of certain • Begins the repair
clotting factors to form fibrin process

Chapter 2 38
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I. Blood vessel spasm II. Platelet plug Formation

III. Blood clotting IV. Fibrinolysis

Chapter 2 39
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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.
Chapter 2 40
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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!

Chapter 2 41
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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.
Chapter 2 42
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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
Chapter 2 43
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The Rh Factor

Rh-Positive Rh-Negative

Contains the Rh antigen No Rh antigen

Will make antibodies

Clinically, it is very if given Rh-positive
important for a female blood
to know her Rh type if
she becomes pregnant. Agglutination can
occur if given Rh-
positive blood
Chapter 2 44
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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

Chapter 2 45
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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)
Kala (type O)
Answer: Kala type O
Chapter 2 BRAVO! 46
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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 47
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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 48
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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 49
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END OF CHAPTER 2

Logic is the anatomy of thought.

--John Locke

Chapter 2 50