VENIPUNCTURE

1. INTRODUCTION
VENIPUNCTURE
-the puncture of a vein as part of a medical procedure, typically to withdraw a blood sample or for an
intravenous injection.
-It is done for the purpose of intravenous therapy or diagnosis.
-In radiography venipuncture, it is mainly used to access vein for intravenous CM injection.
-Contrast media are used to improve pictures of the inside of the body produced by x-rays, CT, MRI and
ultrasound.
- Aside from injecting CM, other ways can be done: oral and rectal

2. ANATOMY AND PHYSIOLOGY OF VENIPUNCTURE SITES

THE HEART AND THE CIRCULATION

3 -4L of blood
Heart, Blood vessels and Blood
The Heart and The Circulation

CIRCULATION AND THE VASCULAR SYSTEM

Blood vessels – several tubelike structures which are interconnected, also with the heart.
Heart – large muscle that pumps blood through the vascular system (oxygenated and deoxygenated blood).
Septum – divides the middle into left and right sides
Four chambers: Atria and ventricles (R atrium, R ventricle, L atrium and L ventricle.
Three layers of the heart:
Endocardium – inside layer
Myocardium – middle layer (L ventricle)
Epicardium – outermost
It has two membranes: houses the pericardial fluid (pericardial sac)
Visceral – serous, inner
Parietal - fibrous, outer
Valves – openings in the ventricles from atria
Trapdoors, one direction
Tricuspid valve (R)
Bicuspid valve (L)
Valves that separate the heart from the large arteries:
Aorta
Pulmonary artery
- Keeps the blood from flowing backward into the heart once it has been pumped out
Three types of circulation:
1. CORONARY CIRCULATION
L ventricle > Aorta > Coronary arteries
Two main coronary arteries: L and R
L has more branches and is more muscular and requires a larger blood supply
Once the oxygen is delivered to the heart, deoxygenated blood flows through the coronary veins and is collected in
coronary sinus then flows to the right atrium
2. PULMONARY CIRCULATION
Deoxygenation to oxygenation
R atrium > R ventricle > Pulmonary arteries > Lungs (alveoli ) > Pulmonary veins > L atrium > L ventricle
3. SYSTEMIC CIRCULATION
L atrium > L ventricle >Aorta > Body tissues > Digestive tract > Body’s cells > R atrium > Pulmonary circulation

BLOOD VESSELS
ARTERIES
Transport blood away from the heart
Elastic, muscular and thicker
Oxygenated blood
Aorta – largest artery; transports oxygenated blood from the heart
Arterioles - smaller arteries
Pulse

Prepared by: Ms. Rothessa Mary G. Caringal, RMT

 VENIPUNCTURE
CAPILLARIES
Smallest blood vessels
Most numerous
Connecting points between arterioles and venules
Deliver oxygen to the tissues
Single layer of cells for selective permeability
VEINS
Capillaries when joined together they form venules
Venules when joined together form veins
Superior and inferior vena cava – largest veins and return deoxygenated blood in the R atrium
Deoxygenated
Flows the blood towards the heart
STRUCTURE
Tunica intima – innermost; smooth layer and has the direct contact with the blood
Tunica media – middle; thickest; contracts and relaxes
Tunica adventitia – outer covering; protection and support

VEINS COMMONLY USED IN PHLEBOTOMY

Middle of the arm and in front of the elbow
Antecubital fossa – three most preferred veins in venipuncture
1.Median cubital vein - middle, largest, best-anchored and least moving; Most favored site
2. Cephalic vein – lateral to the MCV and harder to palpate; Second next best site
3. Basilic vein – medial to MCV; easier to palpate but not well anchored; Most difficult to access
*Median nerve and brachial artery
Dorsal arch – back of the hand
- smaller and requires smaller needles such as butterfly needle

COMPOSITION OF BLOOD
Blood and Its Functions
Transports oxygen and nutrients to body’s cells and tissues
Transports hormones to their target area
Eliminates waste materials from the body’s cells
Maintains water balance for body’s cells and tissues
Transports antibodies and protective substances throughout the body
Assist in regulating body temperature
Helps maintain acid base balance
Blood is composed of cellular or formed elements and the liquid portion.
Formed elements: (45%)
RBCs (erythrocytes)
WBCs (leukocytes)
Platelets (thrombocytes)
Liquid portion (55%) : Plasma
Contains mostly of water
straw colored

ERYTHROCYTES
Bone marrow
Most numerous
Biconcave
Flexible
120 days
Hemoglobin
Anemia
LEUKOCYTES
Destroys foreign substances and removes cellular debris
Diapedesis – ability to pass thru capillaries thin walls
Phagocytosis
Stains
Neutrophils
Lymphocytes
Monocytes
Eosinophils
Prepared by: Ms. Rothessa Mary G. Caringal, RMT
 VENIPUNCTURE
Basophils

PLATELETS
Smallest
Anucleated
Fragments of megakaryocytes
Prevents blood loss
Platelet plug

PLASMA & SERUM

Liquid portion
Pale yellow

Water – 90-92%
Nutrients – cholesterol, FA, AA and glucose
Hormones – assist in chemical reactions and allow the body to maintain a constant balance
Electrolytes – Na, K, Cl, Mg, Ca ; regulation of the body’s water
Proteins
Fibrinogen – aids in clotting
Globulins – fight foreign invaders (antibodies)
Albumin – Most abundant; assist in regulating BP
Waste – urea, uric acid, creatinine and xanthine ; product of chemical reactions
Protective substances

Prepared by: Ms. Rothessa Mary G. Caringal, RMT