PMLS MIDTERMS

• Blood vessels


  • Veins
  • Arteries
  • Capillaries
• Arteries


  • Send blood from the heart
  • High pressure
  • Narrow lumen
  • Thick wall
  • Three wall layers (tunica adventitia, tunica media, tunica intima)
  • Large amounts of muscle and elastic fibers
  • No valves
• Veins


  • Send blood to the heart
  • Low pressure
  • Wide lumen
  • Thin wall
  • Three wall layers (tunica adventitia, tunica media, tunica intima)
  • Small amounts of muscle and elastic fibers
  • Have valves
• Capillaries


  • Site of material exchange within tissues
  • Extremely narrow lumen
  • Extremely thin wall
  • Only one wall layer (tunica intima)
  • No muscle or elastic fibers
  • No valves
• Veins of the antecubital fossa

  • Median Cubital Vein
  • Basilic Vein
  • Cephalic Vein
• Blood vessel extractions


  • Arterial - 90 degrees arterial puncture
  • Vein - ETS, Butterfly or Syringe method
  • Capillary - Capillary puncture
• Structures of the heart

  • Chambers (Two Atria, Two Ventricles)
  • Heart Valves (Atrioventricular Valves, Semilunar Valves)
  • Blood Vessels (Vena cavae, Pulmonary artery, Pulmonary vein, Aorta)
• Pathway of blood through the heart

  1. Deoxygenated blood from body enters right atrium

  2. Passes through tricuspid valve to right ventricle

  3. Pumped through pulmonary semilunar valve to pulmonary trunk and lungs

  4. Oxygenated blood returns to left atrium

  5. Passes through bicuspid/mitral valve to left ventricle

  6. Pumped through aortic semilunar valve to aorta and body
• Cardiac cycle


  The contraction and relaxation phase of the cardiac muscle that occurs in one heartbeat
• Phases of the cardiac cycle

  • Atrial systole
  • Ventricular systole
  • Diastole
• Steps in the cardiac cycle

  1. SA node initiates heartbeat

  2. AV node receives electrical impulse, atria contract

  3. Impulse travels to AV bundle and Purkinje fibers, ventricles contract

  4. Cycle repeats
• Heart rate


  Number of times the heart beats per minute (normal 60-80 bpm)
• Pulse rate


  Number of times the arteries create a noticeable pulse as a result of heart contraction
• Blood pressure

  Force of blood moving through the blood vessels, measured with a sphygmomanometer and stethoscope
• Blood is the body's main fluid for transporting nutrients, waste, gases, and hormones
• Components of blood


  • Plasma (55%)
  • Red blood cells (45%)
  • White blood cells and platelets (<1%)
• Plasma


  The liquid portion of blood, 91% water and 9% dissolved substances
• Formed elements of blood

  • Erythrocytes (red blood cells)
  • Leukocytes (white blood cells)
  • Thrombocytes (platelets)
• Erythrocytes (red blood cells)


  • Biconcave disks
  • 7.2 microns in diameter
  • Contain hemoglobin to transport oxygen and carbon dioxide
  • Life span 120±20 days
  • Normal values: Male 4.5-6.5 x 10^12/L, Female 3.5-5.5 x 10^12/L
• Leukocytes (white blood cells)


  • Provide immunity by producing antibodies and destroying pathogens
  • Divided into granulocytes and agranulocytes
  • Normal value: 4-11 x 10^9/L
• Granulocytes


  • Neutrophils
  • Eosinophils
  • Basophils
• Neutrophils


  • Nucleus 2-5 lobes, fine cytoplasmic granules
  • 10-12 micrometers in diameter
  • Help destroy bacteria
  • First phagocytic cell to respond to antigens
  • Lifespan 8 hours, produced daily in bone marrow
  • Predominant cells in pus
• Eosinophils


  • Cytoplasmic granules stain red-orange, nucleus 2 lobes
  • Responsible for combating parasitic infections and controlling allergy/asthma mechanisms
• Basophils


  • Least common WBC
  • Cytoplasm contains large purple-black granules
  • Release histamine and heparin
• Agranulocytes


  • Lymphocytes
  • Monocytes
• Lymphocytes


  • Second most numerous leukocytes
  • Large round purple nucleus with sky-blue cytoplasm
  • Increases in viral infections
  • Types: B-cells, T-cells, Natural Killer cells
• Monocytes


  • Largest circulating leukocytes
  • Powerful phagocytes
  • Fine blue-gray cytoplasm with vacuoles and irregular nucleus
  • Tissue monocyte is a macrophage
  • Increases in intracellular infections and tuberculosis
• Thrombocytes (platelets)


  • Small, irregularly shaped disks
  • Formed from megakaryocytes in bone marrow
  • Life span 9-12 days
  • Normal value: 140,000-440,000/uL
  • Play vital role in blood clotting
• Formation of blood


  1. Hematopoiesis - formation and development of blood cells

  2. In adults, cells produced in bone marrow

  3. Some WBCs produced in lymphatic tissue

  4. Blood cells need nutrients like iron, folic acid, vitamin B12

  5. All blood cells come from hematopoietic stem cells
• Composition of blood


  • Plasma (55%)
  • Red blood cells (45%)
  • White blood cells and platelets (<1%)
• Plasma is 90% water and 10% proteins, lipids, carbohydrates, etc.
• Routine venipuncture


  Collection of blood samples according to standard procedures and policies
• Key terms for routine venipuncture

  • Antecubital
  • Basilic vein
  • Cephalic vein
  • Edematous
  • Hematoma
  • Hemoconcentration
  • Lymphostasis
  • Median cubital vein
  • Routine collection
  • Stat
  • Thrombosed
  • Timed collection
• Venipuncture procedure


  1. Prioritize orders (stat, timed, ASAP, routine)

  2. Review collection requisition

  3. Greet patient and introduce yourself
• review the collection order for the name of the patient, the test(s) ordered, the collection priority, and additional collection instructions or comments
• Being prepared beforehand will establish an atmosphere of confidence
• Checking the collection tray or work area and the patient's room

  1. Check for appropriate equipment

  2. Check for special comments on the collection order

  3. Check for posted instructions in the patient's room
• Being alert to special considerations concerning the patient's condition


  • Helps you be more sensitive to the patient's needs
  • Allows you to appear more professional and well-prepared
• Interacting with the patient


  1. Greet the patient with a pleasant tone of voice and a smile

  2. Introduce yourself by first name

  3. State your purpose in being in the patient's room

  4. Attempt to wake the patient up before continuing if they are sleeping

  5. Instruct the patient to direct questions about the tests to the physician

  6. Address an unconscious patient the same as if they were awake
• Absolute identification of the patient


  • Mandatory for every collection
  • Ensures accurate identification of the patient and blood samples
  • Failure to do so may result in serious consequences for the patient