Hematology and Circulatory System

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Hematology and Circulatory System
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STRUCTURE

• Blood
• Heart
• Arteries
• Veins
• Capillaries

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BLOOD

• HEMAT- blood
• -OLOGY the study of
• The average adult has
• 8 10 pints.

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Blood

• One drop of blood contains
• 5 million RBCs
• 250,000-500,000 platelets
• 7,500 WBCs
• Red blood cells live 120 days.
• Make new blood cells 2 million per second!

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Structures of the blood

• Plasma
• Erythrocytes
• Leukocytes
• Thrombocytes

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Plasma

• Straw-colored liquid
• Blood without cellular components
• 55 of the bloods volume
• Water
• Plasma proteins
• Nutrients
• Electrolytes
• Hormones, vitamins, and enzymes
• Waste products

Plasma
Cellular elements
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Plasma proteins

• Fibrinogen - Necessary for
• blood clotting, synthesized in liver
• Albumin - From the liver,
• helps maintain bloods osmotic
• pressure and volume
• Globulin
• Gamma globulin
• Prothrombin - helps blood coagulate. Vitamin K
  necessary for prothrombin synthesis

Plasma
Cellular elements
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ERYTHROCYTES/RBC

• BICONCAVE DISK
• HEMOGLOBIN - Gives red color, heme is iron and
  globin is protein
• Transportation
• Oxygen
• Carbon dioxide
• Arterial blood
• Lots of oxygen
• Bright red
• Venous blood
• Lots of CO2
• Dark crimson

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LEUKOCYTES/WBC

• LARGER THAN ERYTHROCYTES
• FIVE TYPES
• LEUK/O/CYTES
• WHITE CELLS

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LEUKOCYTES

• Agranulocytes-WITHOUT GRANULES
• 1. Lymphocytes- antibody production, cellular
  immune response
• 2.Monocytes- immune defense

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LEUKOCYTES

• Granulocytes- with granules
• 3.Neutrophils-immune response
• 4.Eosinophils-defense against parasites
• 5.Basophils-inflammatory response histamines
  release
• PHAGOCYTOSIS
• Process when white cells surround, engulf, and
  digest harmful bacteria.used by granulocytes and
  monocytes

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THROMBOCYTES/PLATELETS

• Smallest of solid components of blood
• Synthesized in red marrow
• Not cells, composed of fragments of cells
• Necessary for the initiation of the blood
  clotting process

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BLOOD TYPES

• Inherited from parents
• Determined by presence or absence of an antigen
  on the surface of the red blood cell

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Check your knowledge of medical history...

• In 1901, the Austrian immunologist Karl
  Landsteiner discovered that blood may be grouped
  into four main types.
• Based on the reaction that resulted when blood
  from different individuals were mixed.

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BLOOD TYPES

• Someone with type A antigen has B antibodies
• Someone with type B antigen has A antibodies
• Someone with type AB antigen has no antibodies
• Someone with type O antigen has A and B
  antibodies

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RH FACTOR

• Rhesus (Rh) factor is an inherited trait that
  refers to a specific protein found on the surface
  of red blood cells (antigen).
• Blood used in transfusions must match donors for
  Rh status as well as for ABO blood type.

• Although Rh factor doesn't affect the patients
  health, it can affect pregnancy.

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RH FACTOR

• In 1940, the Rh factor was discovered as a result
  of studying Rhesus monkeys.
• When blood from monkeys was injected into rabbits
  and guinea pigs, it clotted.

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BLOOD TYPE YOU TUBE

• https//www.youtube.com/watch?vttjn1jVACk8

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RH FACTOR

• If the blood has the protein, the patient is Rh
  positive.
• If the blood lacks the protein, the patient is Rh
  negative.

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ERYTHROBLASTOSIS FETALIS
If the mom gets pregnant again with another Rh
positive, her anti Rh antibodies will attack the
babys blood, causing ERYTHROBLASTOSIS
FETALIS. RHO Gam will destroy any baby blood
cells in the mom, her immune system wont
produce antibodies.
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HEART

• The heart is a
• double pump.
• It has valves and chambers.
• Can you name some

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HEART
Aorta
Superior vena cava
Pulmonary artery
Aortic semilunar valve
Pulmonary vein
Right atrium
Left atrium
Tricuspid valve
Bicuspid (mitral) valve
Inferior vena cava
Pulmonary semilunar valve
Right ventricle
Left ventricle
Septum
Apex
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LAYERS OF THE HEART
Left atrium
Right atrium
Pericardium
Myocardium
Endocardium
Right ventricle
Left ventricle
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The transportation process

• Compare
• Systemic Circulation
• To
• Cardiopulmonary Circulation

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The transportation process

• Right side
• Superior vena cava
• Inferior vena cava
• Right atrium
• Tricuspid valve
• Right Ventricle
• Pulmonary valve
• Pulmonary artery
• Lungs CO2 and O2 exchange

• Left Side
• Pulmonary vein
• Left atrium
• Bicuspid valve
• Left ventricle
• Aortic valve
• Aorta
• Body

(Schematic of systemic circulation)
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Blood supply to the Heart from CORONARY
ARTERIES Heart Sounds lubb dupp
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ELECTRICAL CONTROL OF HEART CONTRACTIONS

• 1. SA (sino atrial) NODE PACEMAKER
• Located in right atrium
• SA node sends out electrical impulse
• Impulse spreads over atria, making them contract
• Travels to AV Node
• 2. AV (atrio ventricular) NODE
• Conducting cell group between atria and ventricle
• Carries impulse to bundle of His

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• 3. BUNDLE OF HIS
• Conducting fibers in septum
• Divides into R and L branches to network of
  branches in ventricles
• 4. PURKINJE FIBERS
• Impulse shoots along Purkinje fibers causing
  ventricles to contract

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AV bundle or Bundle of HIS
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VESSELS OF THE CIRCULATORY SYSTEM

• ARTERIES
• Carry oxygenated blood away from the heart to the
  capillaries. BRIGHT RED
• Elastic, muscular and thick-walled
• Transport blood under very high pressure
• Arteries gt arterioles gt capillaries

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VESSELS OF THE CIRCULATORY SYSTEM

• VEINS
• Carry deoxygenated blood away from capillaries to
  the heart (NO O2 JUST CO2)
• Veins contain a muscular layer, but less elastic
  and muscular than arteries
• Thin walled veins collapse easily when not filled
  with blood
• Veins have values that permit flow of blood only
  in direction of the heart
• Veins gt Venules gt Capillaries

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STRUCTURES OF THE CIRCULATORY SYSTEM

• CAPILLARIES
• The smallest blood vessels
• Connect arterioles to venules.
• One cell thickmade of endothelial tissue

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• BLOOD PRESSURE
• Surge of blood when heart pumps creates pressure
  against the walls of the arteries
• SYSTOLIC PRESSURE - measured during the
  contraction phase (contraction phase of the
  heart is called systole)
• DIASTOLIC PRESSURE - measured when the ventricles
  are relaxed (relaxation phase is called
  diastole)
• NORMAL- 120/80

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PULSE SITES

• PULSE - alternating expansion and contraction of
  an artery as blood flows through it.
• PULSE SITES Brachial, Carotid, Radial,
  Popliteal, Pedal
• NORMAL- 60 TO 80

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COMMON PULSE SITES
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• DISEASES AND DISORDERS OF THE CIRCULATORY SYSTEM

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DISORDERS

• ANEMIA
• Deficiency in number or
• of red blood cells
• IRON-DEFICENCY ANEMIA
• Usually in women, children and adolescents
• Deficiency of iron in the diet causing in
  sufficient hemoglobin synthesis
• Treat with iron supplements and green, leafy
  vegetables

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• PERNICIOUS ANEMIA
• Caused by deficiency of B12 or intrinsic
  factor (produced by stomach mucosa, necessary for
  absorption of B12)
• Symptoms dyspnea, pallor, fatigue,
  neurologic changes
• Treatment injections of B12
• APLASTIC ANEMIA
• Bone marrow does not produce enough red
  white blood cells
• Caused by drugs or radiation therapy

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• SICKLE CELL ANEMIA
• Chronic blood disease inherited from both
  parents
• Causes the red cells to form in abnormal
  sickle shape
• Sickle cells break easily carry less oxygen
• Occurs primarily in blacks
• Treatment blood transfusion

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• POLYCYTHEMIA
• Too many red blood cells are formed
• May be a temporary condition that occurs at
  high altitude
• EMBOLISM
• Air, blood clot, cancer cells, fat, etc. That
  is carried by the bloodstream until it reaches an
  artery too small for passage
• Also known as a moving blood clot
• THROMBOSIS
• The formation of a blood clot in a blood
  vessel
• The blood clot is a THROMBUS

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• HEMATOMA
• Localized clotted mass of blood found in an
  organ, tissue or space
• Caused by an injury that can cause a blood
  vessel to rupture
• HEMOPHILIA
• Hereditary
• Missing clotting factor
• Blood clots slow or abnormally
• Sex-linked transmitted genetically from
  mother to sons
• Treat with missing clotting factor, avoid
  trauma
• THROMBOCYTOPENIA
• Not enough platelets
• Blood will not clot properly

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• LEUKEMIA
• Malignant condition
• Overproduction of immature white blood cells
• Hinders synthesis of red cells
• SEPTICEMIA
• Presence of pathogens or toxins in the blood

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• Pus- cream colored liquid
• Abscess- pus filed cavity
• Pyrexia- fever
• Leukocytosis-increase in white blood cell count
  (gt10,000 per cubic centimeter)
• Edema-excessive fluid in tissues

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• VARICOSE VEINS-swollen and
• distended blood veins normally found
  superficially in the legs.
• CAUSE excessive pressure on the veins.
  Pregnancy, obesity, long periods of standing.
• PREVENTION
• Wear sunscreen
• Elevate legs when resting
• Wear elastic support stockings
• Eating fiber diets
• Exercise
• Weight control

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• TRANSIENT ISCHEMIC ATTACK (TIA) /STROKE
• THROMBUS GETS STUCK IN ARTERY TO BRAIN

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• PULMONARY EDEMA-
• INCREASE IN FLUID IN THE LUNGS WHICH CAN RESULT
  IN DECREASE IN EXCHANGE IN O2 AND CO2

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• PERIPHERAL VASCULAR DISEASE
• CAUSE PLAQUE BUILDUP, DIABETES CAN CAUSE IT
• S/S PAIN AND CRAMPING
• TX CLEANING OUT PLAGUE

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MYOCARDINAL INFARCTION/HEART ATTACK/MI

• CAUSE DECREASES HEART FLOW TO HEART TISSUE.
• S/S INDIGESTION, HEAVY CRUSHING FEELING IN
  YOUR CHEST, PAIN IN YOUR LEFT ARM, ETC.
• TX CPR, O2, PACEMAKER ETC.

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• MYOCARDIAL INFARCTION

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• MURMURS
• BLOOD IS LEAKING BACKWARDS DUE TO A FAULTY HEART
  VALVE.

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• HEART FAILURE/CHF
• CONGESTED HEART FAILURE
• HIGH BLOOD PRESSURE, HEART IS WORKING TWICE AS
  HARD TO PUSH THE BLOOD AROUND.
• EDEMA(SWELLING)
• FEEL LIKE YOU ARE BEING SUFFICATED/DROWNING

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• ANGINA PECTORIS/CHEST PAIN
• LACK OF O2 TO THE HEART MUSCLE
• WAKE UP CALL
• NITROGLYCERIN/02

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• MYELOMA
• The cause of myeloma is unknown
• SYMPTOMS bruising, low blood counts, pain in you
  bones,
• Treatment High dose chemotherapy
• stem cell infusion - called a stem cell
  transplant is often offered as a best way to
  control multiple myeloma for as long as possible.

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• Arrhythmia-
• irregular heart rate
• BRADYCARDIA
• Slow heart rate (lt60 beats per minute)
• TACHYCARDIA
• Rapid heart rate (gt100 beats per minute)

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• ARTERIOSCLEROSIS
• artery hardening due to age
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  ATHERIOSCLEROSIS
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  due to smoking,
  heredity, stress and lifestyle

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• CORONARY ARTERY DISEASE/CAD
• CAUSED BY INSUFFICIENT BLOOD FLOW TO HEART CAUSED
  BY ATHEROSCLEROSIS.

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• HYPERTENSION/high blood pressure
• What factors influence the development of
  hypertension?
• Diet, sedentary lifestyle, genetics, smoking.
• Treatment exercise, diet change , quit smoking,
  medication
• Why is it called the silent killer?
• Quit taking medication can cause a stroke or
  heart attack.