The vascular system

❖ The vascular system is the loop consisting of a

network of blood vessels through which blood is
circulated to the rest of the body.

❖ There are two divisions to this system, the

Pulmonary Circulation and the Systemic
Circulation.
Pulmonary Circulation
❖ Transports deoxygenated blood from the right ventricle of the heart to
the lungs to remove carbon dioxide and pick up oxygen
❖ After gas exchange, blood is carried back to left atrium of the heart

Systemic Circulation
❖ Transports oxygenated blood and nutrients from the left ventricle of the
heart to the body cells and then returning to the right atrium of the
heart with blood carrying carbon dioxide and other waste products of
metabolism from the cells.
 CARDIOVASCULAR
SYSTEM

HEART VASCULAR SYSTEM

Arteries Veins Capillaries

Arteries
These are blood vessels that carry blood away from the heart.

Veins Systemic arteries

Pulmonary arteries
Arterioles
Aorta

Capillaries
Arteries
These are blood vessels that carry blood away from the heart.

Veins
These are blood vessels that return blood to the heart.

Capillaries Pulmonary vein

Venules
Vena cava
Great saphenous veins
Arteries
These are blood vessels that carry blood away from the heart.

Veins
These are blood vessels that return blood to the heart.

Capillaries
Where the exchange of gases and various substances and movement of blood
takes place.
 ARTERIES VEINS
Carry blood from the heart Carry blood to the heart
Carry oxygenated blood (bright red) Carry deoxygenated blood (dark red)
Have elastic walls that expand with Thin walls/less elastic
surge of blood
No valves With valves
Has pulse No pulse
Blood vessel structure
❖ Layers – the blood vessels are composed of three main layers:
✓ Tunica adventitia (outer connective tissue)
✓ Tunica media (middle, muscle and elastic fiber)
✓ Tunica intima (inner, endothelial cell)

❖ Lumen – space inside the blood vessel through which the blood flows

❖ Valves – found in veins; these are thin membranous leaflets that prevent
the backflow of blood
 Disorders of the vascular system
❖ Aneurysm – localized dilation or bulging in the wall of a blood vessel (artery)
❖ Arteriosclerosis – thickening, hardening, and loss of elasticity of artery walls
❖ Atherosclerosis – form of arteriosclerosis involving thickening of the intima of the artery
due the buildup of plaque (lipid–calcium deposits)
❖ Embolus – a blood clot, part of a blood clot, or other mass circulating the bloodstream
❖ Embolism – obstruction of a blood vessel due to an embolus
❖ Hemorrhoids – swollen veins in the part of the anus
❖ Phlebitis – inflammation of the vein
❖ Thrombus – a blood clot in a blood vessel or organ
❖ Varicose veins (varices) – swollen, knotted superficial veins
 Diagnostic tests
❖D-dimer
❖Fibrin degradation products (FDP)
❖Prothrombin time (PT)
❖Partial thromboplastin time
(PTT/APTT)

❖ Triglycerides
❖ Lipoproteins
 Phlebotomy-related vascular anatomy
❖ Antecubital fossa, also called the
elbow pit, is the triangular area on the
anterior of the elbow, which is the site
of major veins
✓ First-choice location for routine
venipuncture
✓ Where antecubital veins are
located
 Phlebotomy-related
vascular anatomy
H-shaped antecubital vein arrangement
occurs in about 70% of the population
✓ Median cubital – preferred site; easiest
to access and least painful for the patient
✓ Cephalic – second choice; harder to
palpate but is usually better when
drawing blood from an obese patient
✓ Basilic – last choice; it is not well
anchored and punctures on this vein are
more painful
 Phlebotomy-related
vascular anatomy
M-shaped antecubital veins are the
intermediate antebrachial veins
✓ Median vein – intermediate
antebrachial vein; first-choice; safest
and less painful
✓ Median Cephalic – intermediate
cephalic vein; second choice; less likely
to roll
✓ Median Basilic – intermediate basilic
vein; last choice; more painful
 Phlebotomy-related
vascular anatomy
❖ Other arm and hand veins are used only if
the antecubital veins are not accessible.

❖ The veins at the back of the hand that can

be used are smaller, so using them may be
very painful.

❖ Take note that the underside of the wrist is

never used as a venipuncture site.
 Phlebotomy-related
vascular anatomy
❖ Leg, ankle, and foot veins must not be
used in venipuncture without the
permission of a physician due to
complication such as thrombosis and
phlebitis
❖ Arteries are not used for routine blood
collection and are limited to the collection
of arterial blood gas.
❖ Special training is needed and the
procedure is risky for the patient.
Avoid sites with edematous arms, arms in casts; arms
with IVs, cannulas, fistulas, extensive scarring such as
burns, or hematomas, arms on the side of mastectomy;
birthmarks/moles, tattoo)

To locate the site that will

give the best blood return.