Phlebotomy Textbook - Chapter 7

What are the three main functions of the lymphatic system?

1. Maintain fluid balance in the tissues by filtering blood and lymph fluid. 2. Provide a defense and immunity against disease through the lymphocytes. 3. Distribute nutrients and hormones into the bloodstream, remove waste, and absorb fats and other substances from the digestive tract.

How many times does the average heart beat per minute?

60-80 beats per minute

Anticoagulant

A chemical agent present in a blood collecting tube to prevent clotting so that the cells can easily be analyzed; an anticoagulated blood sample can also be separated by centrifugation into the cells and the liquid plasma portion.

Define hypoxia

A condition where any region of the body that is deprived of blood and O2 soon becomes oxygen deficient, and the tissues may die within minutes.

Define tachycardia

A fast heart rate

Define bradycardia

A slow heart rate

Random Fact #7

About 30 liters of fluid pass from the blood to the tissue spaces each day

Arterial bleeding is characterized by:

Arterial blood is bright red in color (due to high O2 content), and since the pressure is higher in arteries, bleeding is usually quicker, more abundant, and in spurts (with each heartbeat). Arterial bleeding is the hardest to control

Random Fact #1

Because the lungs are close to the heart, and the pulmonary arteries and veins are short and wide, the right ventricle does not need to pump very hard to propel blood through the pulmonary circuit. Thus, the heart wall of the right ventricle is relatively thin. On the other hand, the left ventricle must push blood around the systemic circuit, which covers the entire body. As a result, the left ventricle has a thick, muscular wall and a powerful contraction.

capillary bleeding

Capillary bleeding occurs slowly and evenly because of the smaller size of the vessels and the low pressure within the vessels. It is usually considered minor and is easily controlled with slight pressure or sometimes bleeding stops without intervention. Capillary blood is a color between the bright red of arterial blood and the dark red of venous blood.

Random Fact #2

Children have faster heart rates than adults, and highly trained athletes have slower rates because more blood can be pumped with each beat. Normally, during exercise, the pulse is faster to supply muscles with more blood. During and after meals, it also beats faster to pump blood to the digestive system. During a fever, the heart pumps more blood to the skin surface to release heat. When one is sleeping, the heart rate is slower. Remember that heart rate responses are designed to maintain the body's homeostasis

Plasma specimen

Contains anticoagulant Unclotted cellular components collect at the bottom Liquid portion (plasma) is straw colored (stays at the top) If the specimen is centrifuged or allowed to settle, the RBCs (the heaviest) will sink to the bottom of the tube. The WBCs and platelets form a thin white layer above the RBCs, called the buffy coat.

Serum specimen

Does not contain anticoagulant Cellular components form clots at the bottom (99% are RBCs) Liquid portion (serum) is clear or straw colored If a blood specimen is allowed to clot, the resulting liquid portion is serum (also straw-colored) plus blood cells meshed in a fibrin clot. Serum contains essentially the same chemical constituents as plasma, except the clotting factors (e.g., fibrinogen) and the blood cells are contained within the fibrin clot

Arterial Bleeding Treatment

During a venipuncture procedure, if a health care worker accidentally punctures an artery instead of a vein, he or she should follow immediate steps to terminate the procedure, call for assistance, and apply pressure to the site. Accidental incidents such as this should be reported to a supervisor immediately.

Random Fact #5

Human bodies contain approximately 5 quarts (4.73 liters) of whole blood, which is composed of water, solutes (dissolved substances), and cells. Males = 5-6 liters Women = 4-5 liters 9 pound new born's blood volume is equivalent to 12 ounce soda can 60 pound child's blood volume is equivalent to one 2 liter soda bottle 125 pound adult's blood volume is equivalent to two 2 liter soda bottles

Define arrhythmia

Irregularities in the heartbeat pattern, pulse, or rhythm

Define thrombocytopenia

Low platelet count

Coagulation phase

Many specific coagulation factors (includ-ing fibrinogen, clotting factors, and calcium, Ca) are released and interact to form a fibrin meshwork, or blood clot. This clot seals off the damaged portion of the vessel. it is divided into two systems: intrinsic and extrinsic. All coagulation fac-tors required for the intrinsic system are contained in the blood, whereas the extrin-sic factors are stimulated when tissue dam-age occurs.

Vascular phase

Once a blood vessel is injured, a rapid constric-tion of the vessel (vasoconstriction) decreases the blood flow to the surrounding vascular bed.

Viens

Page 225 Blood is carried toward the heart by the veins (afferent vessels) the blood in veins flows against gravity in many areas of the body these vessels have one-way valves and rely on weak muscular action to move blood cells along in the vein. All veins (except the pulmonary veins) contain deoxygenated blood. Veins appear bluish in color under the skin and have thinner walls than arterie

cappilaries

Page 225 may be so small in diameter as to allow only one blood cell to pass through at any given time They are the only vessels that permit the exchange or flow of gases (O2 and CO2), fluids, and molecules between the blood and surrounding tissues. Capillaries do not work independently but are a part of an interconnected network. Each arteriole ends in dozens of capillaries (capillary bed) that eventually feed back into a venule (when gas/nutrient exchange has been completed). Blood in the capillary bed is a mixture of arterial and venous blood

Platelets

Platelets (thrombocytes) are much smaller than other blood cells in circulation Platelets help in the clotting process by transporting needed chemicals for clotting, forming a temporary patch or plug to slow blood loss, and contracting after the blood clot has formed. Their lifespan is 9-12 days. Abnormalities in the quality or quantity of platelets result in bleeding disorders, which are detected in the laboratory using the bleed-ing time tests for assessing platelet quality, and the platelet count for assessing the quantity of platelets in the blood.

Platelet phase

Platelets degranulate, clump together, and adhere to the injured vessel in order to form a plug and inhibit bleeding. Remember that some drugs like aspirin can interfere with platelet aggregation and thus, slow down the clotting process.

atrial fibrillation (AF or A-fib).

Rapid and irregular rhythm

RBC facts

Red blood cells measure about 7 micrometers in diameter with a thickness of 2 micrometers The lifespan of red blood cells is approximately 120 days in the circulating bloodstream

edema

Swelling that results if more than 3 liters were retained in the body's tissue instead of filtering back into the bloodstream

Plasma

The liquid portion of blood and lymph It transports and is composed of water and solutes, which include nutrients such as glucose, amino acids, fats, meta-bolic wastes (urea, uric acid, creatinine, and lactic acid), respiratory gases (O2 and CO2), regulatory substances (hormones, enzymes), electrolytes (sodium, potassium, calcium, and chloride), clotting substances such as fibrinogen and Factor VIII, and protective substances (antibodies).

Random Fact #4

The median cubital vein or median vein are most often the best for venipuncture because they are generally the largest and closest to the surface of the skin, have a layer of antecubital fossa under-neath to protect the deeper arteries, nerves, and bones, and are usually the best-anchored vein. median cubital vein, then cephalic (thumb side), then basilic (pinky side)

What is a deferential?

The morphological characteristics of WBCs and RBCs are observed by using special laboratory staining techniques, which can be per-formed manually or by using specialized instrumentation and/or microscopic analysis. This is called a differential.

Random Fact #6

The normal range of blood pH is narrow and slightly basic, from 7.35 to 7.45. In acidosis, carbon dioxide (CO2) and organic acids build up in the blood, causing it to become acidic

The plasma portion of blood contains

The plasma portion contains approximately 92% water and 8% solutes. Solutes include proteins, such as albumin (maintains water balance in blood); fibrinogen (for blood clotting); metabolites, such as lipids; glucose; nitrogen wastes; amino acids; and ions, such as sodium (Na), potassium (K), calcium (Ca), magnesium (Mg), and chloride (Cl).

Random fact #3

This intricate system travels to every inch and millimeter of the human body through repeatedly branching vessels that get smaller and smaller as they move away from the heart (arteries) and then get larger again as they return toward the heart (veins).

Clot retraction

This occurs when the bleeding has stopped. The entire clot retracts to heal torn edges by bringing them closer together.

Blood flow through the heart

To begin, the right atrium of the heart receives O2 poor blood from two large veins: the superior vena cava and the inferior vena cava. The superior vena cava brings blood from the head, neck, arms, and chest; the inferior vena cava carries blood from the rest of the trunk and the legs. Once the blood enters the right atrium, it passes through the heart valve (right atrioventricular, or tricuspid, valve) into the right ventricle. When blood exits the right ventricle, it begins the pulmonary circuit—it enters the right and left pulmonary arteries. These vessels branch into smaller arterioles and capillaries within the lungs, where gaseous exchange occurs (O2 is picked up and CO2 is released). From the respiratory capillaries, blood flows into the left and right pulmonary veins and then into the left atrium. The left atrium also has a valve (left atrioventricular, bicuspid, or mitral valve). Blood flows through the mitral valve into the left ventricle. When blood exits the left ventricle, it passes through the aortic semilunar valve and into the systemic circuit by means of the ascending and descending aorta. The systemic circuit carries blood to the tissues of the body. The right side of the heart pumps O2 poor blood to the lungs to pick up more O2; the left side pumps O2 rich blood toward the legs, head, and organs.

cross-match testing (or type and cross)

To prevent adverse reactions, physicians request cross-match test-ing (or type and cross), which involves establishing a patient's blood type, then exposing a blood donor's blood to the patient's (recipient's) blood. This procedure detects incompatibility and cross-reactivity. In addition to ABO and Rh, at least 48 possible cross-reactions can occur because of numerous antigens on the blood cells and antibodies in sera

Functions of blood

Transportation, distribution of nutrients, regulation and hemostasis. Page 231

What are the phases of the hemostatic process?

Vascular phase Platelet phase Coagulation phase Clot retraction Fibrinolysis the hemostatic process (clotting response) repairs the break and stops the hemorrhage by forming a plug or blood clot

venous bleeding

Venous blood is dark red in color (because it lacks O2), and bleeding occurs in a steady flow. In normal, healthy adults, venous bleeding is easy to stop by simply applying pressure because venous pressure is lower than arterial pressure.

Fibrinolysis

When the final repair and regeneration of the injured vessel occurs, the clot slowly begins to break up (lysis) and dissolve as other cells carry out fur-ther repair. The entire process is fast, elaborate, self-sustaining, and remarkable

Hemostasis

a complex series of processes in which platelets, plasma, and coagulation fac-tors interact to control bleeding or clot formation at one site on the body while at the same time maintaining systemic circulating blood in the liquid state. It enables the human body to retain blood in the vascular system by preventing blood loss

Anemia

a deficiency in RBCs or hemoglobin. There are many types of anemia, but basically they occur due to: ■ The body not making enough RBCs ■ Bleeding (including excessive venipunctures) causing too much blood loss ■ Destruction of RBCs

cardiovascular system is a

a transport network that affects every part of the body. To maintain homeostasis, the cardiovascular system pro-vides for the rapid transport of water, nutrients, electrolytes, hormones, enzymes, anti-bodies, cells, and gases to all cells. In addition, it contributes to body defenses and the coagulation process and controls body temperature.

Which type of blood cell is responsible for gas exchange in the circulating blood? a. Red blood cells b. White blood cells c. Platelets d. Macrophages

a.

Whole blood consists mostly of which of the following? a. Water b. Solutes c. Cells d. Tissue

a.

Whole blood is composed of

approximately 3 quarts (2.84 liters), or about 55-60%, of plasma and 2 quarts (1.89 liters), or about 40-45%, of cells. Thus, if a blood specimen is withdrawn into a test tube from a vein and centrifuged, about 55% will be plasma, the clear, light yellow liquid portion, and 45% will be formed elements, or cells (RBC, WBC, and Platelets

The liquid portion of a blood specimen (without an anticoagulant) is called: a. plasma b. serum c. cellular components d. oxygenated blood

b.

Which type of bleeding is easiest to control? a. Venous b. Capillary c. Arterial d. Systolic

b.

Which type of blood cell is responsible for defense and immunity? a. Red blood cells b. White blood cells c. Platelets d. Macrophages

b.

The pulmonary circuit

blood flow from the heart to the lungs and back to the heart again. It carries blood with low oxygen away from the heart to the lungs to get oxygen, then back to the heart again.

Troponin tests are used to assess: a. RBC size b. WBC counts c. heart damage d. thrombus formation

c.

Which of the following is the preferred vein for venipuncture procedures? a. Popliteal b. Brachial c. Median cubital d. Cephalic

c.

The most common blood type is: a. A b. B c. AB d. O

d

Which blood test includes WBC and RBC counts, hemoglobin, and hematocrit? a. PTT b. Hgb, Hct c. Blood typing d. CBC

d.

Which of the following is the region of the body containing lymph nodes? a. Upper torso b. Lower torso c. Around the heart d. Throughout the body

d.

How many chambers does the heart have?

four

lymphatic system

has a close and interrelated connection with the cardiovascular system. It consists of lymph (fluid), lymphocytes, lymph vessels, lymph nodes, tonsils, the spleen, bone marrow, and the thymus gland. Lymphatic organs contain lymphocytes, macrophages, and other cells that provide immunity and protection against infections from microorganisms

Arteries

highly oxygenated vessels that carry blood away from the heart (efferent vessels). They branch into smaller vessels, called arterioles, and into capillaries. Arteries appear brighter red in color, are oxygen-rich, have thicker elastic walls than veins do, and have a pulse.

palpitation

relates to a fast or irregular heartbeat.

Homeostasis

relates to a normal steady-state condition

hemostasis

relates to blood clotting at the site of an injury while maintaining blood flow in other parts of the body. (The opposite of hemostasis is the term hemorrhage, which means excessive or uncontrolled bleeding.)

palpation

relates to touching or feeling (a vein).

Why are heart valves positioned between each atrium and ventricle?

so that blood can flow in one direction only, thereby preventing backflow. If a valve malfunctions, blood flows backward and a heart murmur results.

cardiovascular refers to

the cardiac (heart) muscle, the vascular system (network of blood vessels that includes veins, arteries, and capillaries), and the circulating blood.

Define Blood Pressure

the force of blood pushing against the walls of the blood vessels Blood pressure increases during ventricular systole and decreases during ventricular diastole. Blood pressure not only forces blood through vessels, but also pushes it against the walls of the vessels like air in a balloon. Therefore, it can be measured by how force-fully it presses against vascular walls.

How many ventricles does the heart have?

the interventricular septum divides the two ventricles

The systemic circuit

the oxygen-rich blood flow to all body regions except the lungs. It carries blood away from the heart through the aorta to all parts of the body.

How do the arteries of the pulmonary circuit differ from that of the systemic circuit?

the pulmonary arteries carry deoxygenated blood (oxygen-poor or low oxygen levels). They are considered arteries because they carry blood away from the heart.

How many atria does the heart have?

there are two atria that are separated by the interatrial septum (wall)

The cardiac cycle refers to

to one complete contraction and relaxation, or pump, or heartbeat, and many processes occur during each beat

Whole blood definition

used in the context of a blood donation whereby voluntary blood donors give blood for transfusion into patients who need it. The whole blood is collected in a donor bag containing an anticoagulant. This whole blood specimen can later be divided into blood components for more targeted transfusion of the products (red blood cells; fresh frozen plasma [FFP]; plasma; and plasma derivatives such as albumin, immune globulin, Factor IX concentrates, cryopre-cipated antihemophilic factor [AHF]; and platelets).

What are the three kinds of blood vessels exist in the human body?

■ Arteries (the aorta is the largest artery) ■ Veins (are about 1 inch wide) ■ Capillaries (the smallest vessels)

Function of the veins

■ Blood is transported from peripheral tissues back to the heart and lungs ■ Large veins branch into venules in the peripheral tissues ■ Deoxygenated blood is carried back to the lungs to release carbon dioxide ■ Carry blood that is normally dark red in color ■ Have thinner walls than arteries; walls appear bluish ■ Valves prevent the backflow of blood ■ Are located both deep and superficially (close to the surface of the skin)

Function of the capillaries

■ Connect arterioles with venules via microscopic vessels ■ Oxygen and carbon dioxide, nutrients, and fluids in tissue capillaries are exchanged ■ Waste products from tissue cells are passed into capillary blood, then onto removal from the body ■ Carry blood that is a mixture of arterial blood and venous blood

What are the three primary components of the cardiovascular system?

■ Heart ■ Circulating blood ■ Blood vessels (the circulatory system)

Function of the circulating blood

■ Oxygen and carbon dioxide, nutrients, and fluids are transported by circulating blood ■ Waste products are removed ■ Nutrients are disbursed ■ Regulates body temperature and electrolytes ■ Regulates the blood-clotting system ■ Transport of blood cells for life-sustaining functions

Function of the arteries

■ Transport blood from the right and left chambers of the heart to the entire body ■ Large arteries branch into arterioles the farther they are from the heart ■ Carry oxygenated blood that is bright red in color ■ Have thicker elastic walls than veins do ■ Have a pulse ■ Are located deep in muscles/tissues

Function of the heart

■Muscular organ about the size of an adult's closed first ■ The arteries and veins for the heart itself are the coronary arteries/veins, located on the outer surface of the heart. Blood for all other regions of the body flows inside or through the heart. ■ Contractions push blood throughout the body ■ The average heart beats 60-80 times per minute