BLOOD VESSELS AND BLOOD

CIRCULATIONChapter 15

Objectives Identify and Clarify the differences between the 5 types of Blood

Vessels Compare and Contrast the Pulmonary and Systemic Circuits List the aortic sections and it’s branches Define anastomosis and describe it’s function and provide examples Compare and Contrast Superficial and Deep Veins and provide

examples of each Name main vessels that drain into the Superior and Inferior Vena Cava Define venous sinus and give examples Give structure and function of Hepatic Portal System Describe forces that affect capillary wall exchange Describe factors regulating blood flow Define pulse and give factors affecting pulse rate and blood pressure Explain how blood pressure can be controlled Give reasons why hypertension should be controlled and list other

disorders that involve blood vessels Describe first aid for hemorrhage Name the 4 types of shock Utilize word anatomy

ReviewTake time to review Chapter 13 to clarifythe importance and functions of blood, the components of blood and blood disorders.

Also, review Chapter 14 to bring together what you know about the heart, it’s relationship with blood, and how these apply to the disease process.

Bringing it all together:Blood is pumped through vessels by the heart during circulation to the entire body

Blood Vessels

Arteries

Arterioles

Venules

Veins

Circuits

PULMONARY SYSTEMIC

Pulmonary trunk and its arterial branches carry blood from RV to lungs

Capillaries in lungs where gases are exchanged

Pulmonary veins carry blood to LA

Aorta receives blood from LV and branches systemically to arteries carrying blood to tissues

Capillaries everywhere in body that exchange materials such as gases, waste and nutrients

Systemic veins carry blood from body to RA

Pulmonary arteries carry blood LOW in

oxygen to lungsPulmonary veins

carry blood HIGH in oxygen to LA

Aorta

4 Main Sections

- Ascending - Aortic Arch

- Thoracic

- Abdominal

Branches of Aorta

• Ascending Aorta: Left and Right Coronary Arteries

• Aortic Arch: Brachiocephalic, Right Subclavian, and Right Common Carotid Left Common Carotid and Left Subclavian

• Thoracic Aorta: Chest Wall, Esophagus, Bronchi and Intercostals

• Abdominal Aorta: (Unpaired) Celiac Trunk, Left Gastric Artery, Splenic Artery, Hepatic Artery, Superior and Inferior Mesenteric Arteries

(Paired) Phrenic, Suprarenal, Renal, Ovarian, Testicular, and Lumbar Arteries

Real Life!! 72 year old female presents to the ED with c/o right flank

pain since she woke this morning and some pain with urination. Denies nausea, vomiting or abdominal pain. Pt is worked up with basic labs, IVP and given NSAID pain medications.

After a few minutes, pt states she is pain-free and is noted to be joking and laughing with family. She is in a hurry to leave to attend a family reunion. After physician receives negative UA and IVP, patient is discharged home.Several hours later, family finds patient unresponsive in bathroom floor at home. 911 is called and pt is transported to hospital, CPR in progress. Pt does not survive.

Autopsy later revealed ruptured abdominal aortic aneurysm.

Definitions….

Anastomosis – The union and communication between two vessels

This enables blood to flow to areas by more than one route. Important when injury occurs.

Examples: circle of Willis, superficial palmar arch, and mesenteric arch.

Veins

DEEP SUPERFICIAL

Deep veins tend to run parallel to arteries and typically share the same name.

Extremity deep veins include: Femoral, Iliac, Brachial, Axillary, and Subclavian veins.

Deep veins of the head and neck include: Jugular and Brachiocephalic veins

Superficial veins are found near the surface of the body. Most important are found in the extremities.

Upper extremities include: Cephalic, Basilic, and Median Cubital veins.

The lower extremities include: Saphenous veins.

Superior and Inferior Vena Cava

Superior : Drains the head, neck, upper extremities and chest. Main vessels: Azygos veins

Inferior: Drains the areas below the diaphragm. Main vessels: Iliac, Testicular, Ovarian, Renal and Suprarenal, Hepatic veins. Also, the unpaired Hepatic Portal vein

Definitions…

Venous Sinus – A large channel that drains deoxygenated blood. It does not have the structure of a vein, but rather an opening or space.

Examples: Coronary sinus in the heart

and Cranial Venous Sinuses in the skull.

The Hepatic Portal System In a portal system,

blood circulates through a 2nd capillary bed that is usually in another organ. It provides a detour from the path of venous return and transports substances from one organ to another directly. The Hepatic Portal System carries blood from the abdominal organs to the liver.

Capillary Exchange

Forces driving capillary exchange :Diffusion, Blood Pressure and

Osmotic Pressure

Blood Flow

There are different factors that regulate blood flow in the human body. These include:

Vasodilation

Vasoconstriction

Precapillary Sphincter

Skeletal Muscle Contraction

Valves

Breathing

Real Life!!

High school band member standing in formation, waiting to perform, passes out and is rushed to the hospital by EMS.

Upon arrival to the ED, the 17 year old patient is awake, alert

and has no complaints. VS are stable and routine tests are ordered.

During physician exam, the student admits to locking knees while standing. Patient reports feeling hot, dizzy, seeing black spots and then remembers arriving at hospital.

Why do you think this happened and what could be done to prevent it? Explain.

Definitions.… Pulse is the force of ventricular

contraction that causes a wave of increased pressure that can be felt in arteries near the surface of the body.

By compressing the artery against a

bone, the pulse can be easily felt. This is most commonly done at the wrist.

Factors that affect pulse rate: Small body frame, muscular activity and stress.

Blood Pressure Factors affecting B/P

Cardiac Output

Peripheral Resistance

• Heart Rate• Stroke Volume

• Vessel Diameter• Elasticity• Viscosity• Volume

Blood Pressure = Cardiac Output x Peripheral Resistance

Blood Pressure Measurement

Blood pressure is obtained by using an instrument called a sphygmomanometer. This is a blood pressure cuff!!

The Blood Pressure Cuff measures two variables:

- Systolic Pressure (Heart Contraction)

- Diastolic Pressure (Heart Relaxation)

Once the cuff is on, pressure is increaseduntil brachial artery is compressed, then provider listens with a stethoscope for pulsations.

Blood Pressure and Hypertension

Hypertension is defined as high blood pressure. Untreated Hypertension can lead to:

Weaken vessels leading to rupture

Enlarged heart due to increased pumping

Kidney damage

Artherosclerosis

Causes:

Stress or exertionKidney DiseaseEndocrine DisordersArterial DiseaseAdrenal Tumors

Hyper

tensio

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Blood Vessel Disorders• Arteriosclerosis(Causing Heart Disease, Blood Clots, and Stroke)

• Aneurysm(Caused by weakness in vessel wall)

Hemorrhage

• Control Bleeding with Direct Pressure

• Elevate extremity above heart level

• If needed, compress artery on bone near injury. Common pressure points :

Facial Artery

Temporal Artery

Common Carotid Artery

Subclavian Artery

Brachial Artery

Femoral Artery

Shock

When related to hemodynamics, or circulating blood, shock refers to a life-threatening condition where body tissues are not being adequately perfused due to decreased blood flow.

The four most common forms of shock include:

• Cardiogenic • Septic• Hypovolemic• Anaphylactic

Word Anatomy

Review word anatomy at end of chapter to help you use word parts to quickly recognize and know the meaning behind medical terms, not only about blood vessels and circulation, but all terms in the healthcare field that you will come in contact with.

What does all this mean to me as a nurse???

Being in healthcare offers many opportunities as a nurse and plenty of choices when it comes to jobs and specialties.

Regardless of where you choose to work and what kind of patients you THINK you will see…….there are medical conditions you will see over andover throughout your career.

Study hard and do well on your tests, but arm yourself with the knowledgeyou need to apply what you’ve learned in the clinical setting. In regards to blood vessels and circulation, here are some common things you willencounter:

CAD Atherosclerosis Hypo/Hypertension DVT Thrombophlebitis Aneurysm