Blood PDF

BLOOD Functions: 1. Transport of gases, nutrients, waste products, processed and regulatory molecules 2. Regulation of pH and osmosis 3. Maintenance of body temperature 4. Protection against foreign substances 5. Clot formation Composition of Blood: ​ Plasma ​ 55% of total blood ​ Pale, yell...

BLOOD Functions: 1. Transport of gases, nutrients, waste products, processed and regulatory molecules 2. Regulation of pH and osmosis 3. Maintenance of body temperature 4. Protection against foreign substances 5. Clot formation Composition of Blood: ​ Plasma ​ 55% of total blood ​ Pale, yellow liquid surrounding cells ​ 91% water, 7% proteins, and 2% others Formed elements: (Solid Structures) ​ 45% of total blood ​ Cells and Cell fragments ​ Erythrocytes (RBCs), Leukocytes (WBCs), Thrombocytes (Platelets) PLASMA PROTEINS 1. Albumin ​ 58% of plasma proteins ​ Helps maintain water balance (osmotic pressure) 2. Globulins ​ 38% of blood proteins ​ Helps immune system 3. Fibrinogen (Fiber) ​ 4% of blood proteins ​ Aids in clot formation ​ Activation of clotting factors results from conversion of fibrinogen to “fibrin” ​ Fibrin, threadlike protein responsible for blood clots PLASMA VS SERUM Plasma ​ Liquid portion of unclotted blood ​ Albumin, Globulin, and Fibrinogen ​ Obtained by using anticoagulant Serum ​ Liquid portion of clotted blood  ​ Consists of albumin and globulin only ​ Plasma without the clotting factors HEMATOPOIESIS ​ Process the produces formed elements ​ In the fetus, it occurs in several tissues such as liver, thymus, spleen, lymph nodes, and red bone marrow ​ After birth, it occurs primarily on the red bone marrow, but some white blood cells are produced in lymphatic tissues ​ All formed elements of blood derived from a single population of cells called “Hemocytoblasts” (stem cell) ○​ They differentiate to give rise to different cell lines: ​ “Myeloid” stem cell ​ “Lymphoid” stem cell (Matures only into Lymphocytes) ERYTHROCYTES (Red blood Cells/ RBCs) ​ Disk-shaped with thick edges/bio concave disk (thicker than the center) ○​ The increases the RBC’s surface area thus allowing gases to move in and out rapidly out of that cell ​ Nucleus and most organelles lost during development (to have more space for hemoglobin to have more areas to carry oxygen) ​ Lives for 120 days (males) and 110 days (Females) ​ Unable to divide ​ Transports oxygen from lungs to tissues HEMOGLOBIN ​ Main component of erythrocytes (RBC’s) constituting one-third of RBC’s volume ​ Transports 98.5% of oxygen in the body and Carbon dioxide for excretion ○​ Remaining 1.5% is dissolved in plasma ○​ Oxygenated: Bright red ○​ Deoxygenated: Dark red ​ Each hemoglobin molecule consists of 4 protein chains (globin) and 4 heme groups ​ Each “globin” protein is bound to one “heme” molecule (red pigmented molecule) ○​ Each “heme” contains one iron atom (necessary for function of hemoglobin) ​ Oxyhemoglobin ○​ Hemoglobin with oxygen attached ​ Carboxyhemoglobin ○​ Hemoglobin with carbon monoxide attached ​ Carbon monoxide ○​ Helps transport Carbon dioxide from tissues to lungs (Oxygen transport is accomplished by hemoglobin) ○​ Gas produced by incomplete combustion of hydrocarbons (gasoline) ○​ Binds to iron in hemoglobin 210x more readily than oxygen and does not tend to unbind which makes hemoglobin bound to carbon monoxide no longer capable of transporting oxygen  ○​ Nausea, headache, unconsciousness, and death are possible consequences of prolonged exposure to carbon monoxide. PRODUCTION OF ERYTHROCYTES 1.​ Decreased blood Oxygen levels causing kidneys to increase production of hormone erythropoietin 2.​ Erythropoietin stimulates red bone marrow to produce more erythrocytes 3.​ Increased erythrocytes cause an increase blood oxygen levels FATE OF OLD ERYTHROCYTES AND HEMOGLOBIN 1.​ Old/abnormal/damaged RBCs are removed from blood by macrophages in the spleen and liver. 2.​ Hemoglobin is broken down. 3.​ Globin is broken down into amino acids. 4.​ Hemoglobin’s iron is recycled. 5.​ Heme is converted to bilirubin (yellow pigment molecule and can be deposited to other tissues resulting in “jaundice”, yellowish color to the skin/abnormal functioning of liver). 6.​ Bilirubin is taken up by the liver and released into the small intestine as part of bile. LEUKOCYTES (White Blood Cells/ WBCs) ​ Lacks hemoglobin ​ Larger than erythrocytes (RBCs) ​ Contains a nucleus ​ Can leave the blood and travel by “ameboid” (movement through tissues) ​ Fights off infections ​ Removes dead cells and debris by “phagocytosis” Types of Leukocytes 1.​ Granulocytes - contains large cytoplasmic granules/specific granules ​ Neutrophils ○​ Lilac granules (2-4 lobes) ○​ Stains with both acidic and basic dyes ○​ Most common type of WBC ○​ Remains in blood for 10-12 hours then moves to tissues ○​ Phagocytes (engulfs other materials) ○​ Increased in bacterial infection/acute disease ○​ Dead neutrophils accumulates as “pus” at sites of infection ​ Eosinophils ○​ Orange-red granules (2 lobes) ○​ Stains bright red with “eosin”, an acidic stain ○​ Increased in cases of parasitic infection and allergies ○​ Destroys parasites ○​ Reduces inflammation ​ Basophils ○​ Least common ○​ Contains large cytoplasmic granules that stain blue/purple with basic dyes ○​ Increased in cases of allergies ○​ Releases “histamine” (inflammation), “heparin” (prevents formation of clots)  2.​ Agranulocytes - Very small granules or no specific granules that cannot be easily seen by the light microscope. ​ Lymphocytes ○​ Immune response ○​ Increased in viral infection ○​ Several different types (T cells and B cells) ○​ Leads to production of antibodies ​ Monocytes ○​ Largest size of WBCs ○​ Increased in cases of chronic infection ○​ Produces “macrophages” (Phagocytizes bacteria, dead cells and etc) PLATELETS ​ Minute fragments of cells, consisting of small amount of cytoplasm surrounded by a cell membrane ​ Produced in the red bone marrow from large cells called “megakaryocytes” ○​ Small fragments of these cells break off and enter the blood as “platelets” ​ Plays an important role in preventing blood loss BLOOD LOSS ​ When blood vessels are damaged, blood can leak into other tissues and disrupt normal function ​ Blood that is lost must be replaced by new blood or production of new blood by transfusion HEMOSTASIS - Prevents blood loss by: 1.​ Vascular spasm ​ Temporary constriction of blood vessels (smooth muscle contraction) ​ Stimulated by chemicals (thromboxanes and endothelin) 2.​ Platelet Plug Formation ​ Accumulation of platelets sealing a small break in a blood vessel ​ Maintains the integrity of damaged blood vessels ​ First step - Platelet adhesion (Platelets stick to exposed collagen) ​ Second Step - Platelet release reaction (Activates, change shapes, releases chemical thromboxane and ADP) ​ Third step - Platelet aggregation (Fibrinogen forms bridges) 3.​ Blood Clotting (Coagulation) ​ Blood can be transformed from liquid to gel ○​ Clot - network of thread-like proteins called “fibrin” (traps blood cells and fluid ​ Depends on clotting factors ​ Clotting Factors: ○​ Proteins in plasma ○​ Only activated following injury ○​ Made in liver ○​ Requires vitamin K Steps in Clot Formation Injury → Clotting factors activated → Prothrombinase (clotting factor) formed and acts upon → Prothrombin → switch to active form Fibrin → Forms a network that traps blood (clots) Clot Formation Control -​ Clots need to be controlled so they don’t spread throughout the body Anticoagulants ​ Prevents clot from forming ​ Heparin and antithrombin (Inactivates thrombin) After site of injury has fully healed, two things happen; ​ Clot Retraction ○​ Condensing/shrinking of clot ○​ Serum in plasma is squeezed out of clot ○​ Helps enhance healing ​ Fibrinolysis ○​ Dissolving of clot ○​ Plasminogen (inactive form) is converted to Plasmin (active form) which will break down clot (fibrin) BLOOD GROUPING * Injury or surgery can lead to blood transfusion, where either transfusion or infusion is called for 1.​ Transfusion - Transfer of blood components from one individual to another 2.​ Infusion - Introduction of fluid other than blood such as saline or glucose solution, into the blood *Early attempts to transfuse blood were often unsuccessful, resulting to; ​ Transfusions reactions ○​ Clumping of blood cells and clotting within blood vessels ○​ Caused by interactions between antigens and antibodies ○​ Antibodies can bind to red blood cell antigens, resulting in agglutination (clumping of cells) or hemolysis (rupture of red blood cells) ​ Antigens - molecules on surface of red blood cells/erythrocytes ○​ Blood groups are determined by antigens on surface of red blood cells ​ Antibodies - proteins in plasma, binds to specific antigens ABO Blood Groups ANTIGENS There are two types of antigen that may appear on the surface of red blood cells; 1.​ Type A antigen - Type A and Type AB blood has these antigen 2.​ Type B antigen - Type B and Type AB blood has these antigen a.​ Type O blood has neither A or B antigen b.​ Type of antigens found on surface of red blood cells are genetically determined ANTIBODIES Antibodies against the antigens are usually present in the plasma of blood 1.​ Type A blood - Has Anti-B antibodies (acts against type B antigens) 2.​ Type B blood - Has Anti-A antibodies (acts against type A antigens) 3.​ Type AB blood - Has neither Anti A or Anti B antibodies  4.​ Type O blood - Has both Anti A and Anti B antibodies Blood donor and recipient according to ABO Blood types ​ Type O are universal donors because they have no antigens ​ Type A can receive blood from A and O blood ​ Type B can receive blood from B and O blood ​ Type AB are universal recipients and can receive from A, B, AB, and O blood ​ Type O can only receive blood from O RH Blood Groups ​ Rh positive means you have Rh antigens ​ 95 - 85% of the population is Rh+ ​ Antibodies only develop if an Rh-person is exposed to Rh+ blood by transfusion or from mother to fetus RH Incompatibility (Hemolytic Disease of Newborn) ​ Destruction of red blood cells in the fetus or newborn, caused by antibodies produced in the Rh-negative mother acting on the Rh-positive blood of the fetus or newborn ​ Occurs when the mother is Rh-negative and the fetus is Rh-positive. Once the fetal blood leaks through the placenta and mixes with the mother’s blood, the mother becomes sensitized to the Rh antigen. The mother produces anti-Rh antibodies that cross the placenta and cause agglutination and hemolysis of fetal red blood cells ​ Mother’s first pregnancy usually there is no problem Prevention of HDN ​ Rh-negative mother is injected with Rho(D) immune globulin (contains antibodies against Rh antigens ○​ Can be given during pregnancy, before and immediately after delivery, misscarriage, or abortion DIAGNOSTIC BLOOD TEST A.​ Blood Typing - Determines ABO and Rh blood groups of a blood sample B.​ Crossmatch - Donor’s blood cells are mixed with recipient's serum, and donor’s serum is mixed with the recipient’s cells C.​ Complete Blood Count (CBC) - provides information such as RBC count, hemoglobin, hematocrit, and WBC count a.​ Red Blood Cell count i.​ Usually performed with a machine but can be done manually ii.​ Normal values: Male 4.6-6.2 million per ul of blood, Female 4.2-54 million per ul of blood iii.​ Erythrocytosis - overabundance of red blood cells b.​ White blood cell count i.​ Measures total number of white blood cells in blood ii.​ Normal values 5000-9000 WBC/ul of blood iii.​ Leukopenia - lower than normal WBC iv.​ Leukocytosis - Abnormally high WBC c.​ Hemoglobin i.​ Determines amount of hemoglobin in blood  ii.​ Indicates anemia (abnormally low hemoglobin measurement) iii.​ 14-18 g/100 ml of blood (Males) iv.​ 12-16 g per 100 ml of blood (Females) d.​ Hematocrit i.​ Percentage of total blood volume composed of RBC ii.​ Males (40-52%) and Females (38-48%) e.​ Differential white blood count i.​ Determines percentage of each 5 kinds of leukocytes 1.​ Neutrophils - 60-70% 2.​ Lymphocytes - 20-25% 3.​ Monocytes - 3-8% 4.​ Eosinophils - 2-4% 5.​ Basophils - 0.5% f.​ Clotting i.​ Can be assessed by the platelet count and the prothrombin time measurement. 1.​ Platelet count - 250,000 - 400,000 platelets/ul 2.​ Thrombocytopenia - Platelet count is greatly reduced, resulting in chronic bleeding through small vessels and capillaries Clotting Disorders and Infectious Diseases of the Blood 1.​ Von willebrand disease a.​ Most common inherited bleeding disorder b.​ Platelet plug formation and the contribution of activated platelets to blood clotting are impaired c.​ Treatments are injection of von willebrand factor or drugs that can increase von willebrand factor levels of blood 2.​ Hemophilia a.​ Genetic disorder where clotting is abnormal or absent b.​ Can result from deficiency or dysfunction of a clotting factor c.​ Most often a sex-linked trait occurs almost exclusively in males 3.​ Septicemia (blood poisoning) a.​ Spread of microorganisms and their toxins by blood often from medical procedures 4.​ Malaria a.​ Caused by a protozoan introduced into blood by Anopheles mosquito; symptoms include chills and fever produced by toxins released when the protozoan causes red blood cells to rupture 5.​ Infectious mononucleosis a.​ Caused by Epstein-Barr virus, which infects salivary glands and lymphocytes; symptoms include fever, sore throat, and swollen lymph nodes, all probably produced by the immune system response to infected lymphocytes 6.​ Acquired immunodeficiency syndrome (AIDS) a.​ Caused by human immunodeficiency virus (HIV), which infects lymphocytes and suppresses immune system HEART Functions: ​ Generates blood pressure ​ Routes blood ​ Ensures one-way flow ​ Regulates blood supply Characteristics: ​ Shaped like a blunt cone ​ Size of a closed fist and weighs 250g (females) and 300g (males), decreases in size after age 65, especially in physically inactive people ​ Located in the mediastinum between the two pleural cavities that surround the lungs ​ Base - Larger, flat part at the opposite end of the heart ○​ Located deep/behind the sternum extending to the level of the second intercostal space ○​ Directed posteriorly and slightly superiorly ​ Apex - Blunt, rounded point of the heart ○​ Directed to the left ○​ Directed anteriorly and slightly inferiorly ○​ Behind the 5th and 6th ribs at the 5th intercostal space HEART COVERING The heart lies in the pericardial cavity* Pericardial cavity - formed by the “pericardium/pericardial sac” (A sac that anchors and protects the heart) Pericardium/Pericardial sac ​ Anchors and protects the heart ​ Keeps the heart contained in the chest cavity ​ Prevents heart from over expanding when blood volume increases ​ Limits heart motion ​ Consists of two layers: ○​ Fibrous Pericardium - tough, fibrous connective tissue outer layer ○​ Serous Pericardium - inner layer of flat epithelial cells, with thin layer of connective tissue and composed of two parts: ​ Parietal Pericardium - lines the fibrous pericardium ​ Visceral Pericardium (Epicardium) - covers the heart surface and smooth outer surface and below it is the: ​ Myocardium - thick middle layer of composed of cardiac muscle cells ○​ Responsible for contraction of heart chambers ​ Endocardium - Smooth inner layer of heart chambers ○​ Allows blood to move more easily ○​ Trabeculae carneae - surfaces of interior walls of the ventricles modified by ridges and columns of cardiac muscles ​ Pericardial cavity - located between the visceral and parietal pericardium ​ Filled with Pericardial fluid ○​ Which reduces friction as the heart moves within the pericardium ○​ It is produced by the serous pericardium EXTERNAL ANATOMY 4 Chambers: 1. 2 Atria - receiving chambers of the heart - functions primary as reservoirs, where blood returning from veins collects before entering ventricles -​ Left atrium - Receives blood returning to the heart from pulmonary veins -​ Right atrium - Receives blood returning to the heart from superior, inferior vena cava and coronary sinus -​ Interatrial septum - Separates the right and left atria Located at the base of the heart 2. 2 Ventricles - Major pumping/discharging chambers of the heart -​ Right Ventricle - Receives blood from the right atrium and pumps it to pulmonary artery -​ Left Ventricle - Receives blood from left atrium and pumps it to the aorta -​ Interventricular septum - Separates left and right ventricles -​ Papillary muscles - Each ventricle contains cone-shaped, muscular pillars -​ Chordae tendineae - thin, strong connective tissue strings attaching to papillary muscles to the free margins of the cups of the atrioventricular valves Extends from the base of the heart towards the apex Coronary Sulcus ​ Separates atria from ventricles Interventricular sulci ​ Separates right and left ventricles ○​ Anterior Interventricular sulci -on the anterior surface of the heart ○​ Posterior Interventricular sulci - on the posterior surface of the heart Heart valves (4 in number) ​ Flap-like structures ensuring one-way flow of blood 1.​ Atrioventricular valves - Located between atria and ventricles a.​ Mitral/Bicuspid valve - located between left atrium and left ventricle i.​ Prevents backflow of blood as it is pumped from the left atrium to the the left ventricle b.​ Tricuspid valve - located between right atrium and left ventricle i.​ Prevents backflow of blood as it is pumped from the right atrium to the right ventricle 2.​ Semilunar valve a.​ Aortic semilunar valve - located between the left ventricle and aorta i.​ Prevents backflow of blood as it is pumped from the left ventricle to the aorta b.​ Pulmonary semilunar valve - located between right ventricle and pulmonary artery i.​ Prevents backflow of blood as it is pumped from right ventricle to pulmonary artery BLOOD SUPPLY TO THE HEART 1.​ Coronary arteries a.​ Supply blood to the wall of the heart b.​ Originates from base of the aorta, just above the aortic semilunar valves ​ Left coronary artery - originates on left side of the aorta, has 3 major branches: ○​ Circumflex artery ○​ Left marginal artery ○​ Anterior interventricular artery ​ Right coronary artery - originates on the right side of the aorta, has two branches: ○​ Right marginal artery ○​ Posterior interventricular artery 2.​ Cardiac veins - drain blood from the cardiac muscles, and are nearly parallel to coronary arteries a.​ Drains blood into the coronary sinus ACTION POTENTIALS IN CARDIAC MUSCLE ​ Changes in the permeability of the cell membrane produce action potentials ​ Action potentials in cardiac muscle are prolonged compared to skeletal muscles and have a: ○​ Depolarization phase (Na+) ○​ Plateau phase (period of slow repolarization) (Ca2+) ○​ Repolarization phase (K+) ​ Prolonged action potential in cardiac muscle ensures that contraction and relaxation occurs and prevents tetany ​ Refractory period - period of time, in which the cardiac cell is unable to initiate another action potential for some duration of time CONDUCTION SYSTEM OF HEART ​ Contraction of atria and ventricles by cardiac muscle cells ​ Made up of sinoatrial node, atrioventricular node, atrioventricular bundle, right and left bundle branches, purkinje fibers ​ Sinoatrial node (SA node) ○​ Produces action potentials that are propagated over the atria to the AV node ○​ Functions as the heart’s pacemaker ○​ Located in the upper wall of the atrium ○​ Has larger number of Ca2+ channels ○​ If unable to function, the atrioventricular node (AV node) becomes the pacemaker ○​ Ectopic beat - action potential originating in other areas of the heart other than SA node ​ Atrioventricular node (AV node) and Atrioventricular bundle ○​ Conducts action potentials to the ventricles ​ Right and Left bundle branches ○​ Conducts action potentials from the atrioventricular bundle through Purkinje fibers to the ventricular muscle ELECTROCARDIOGRAM ​ Record of electrical events (not mechanical events) within the heart ​ Normal ecg contains: ○​ P wave (atrial depolarization) ○​ Qrs complex (ventricular depolarization) ○​ T wave (ventricular repolarization) ​ PQ interval (PR Interval because Q wave is very small) ○​ Time beginning of the P wave and beginning of the QRS complex ○​ Atria contracts and begins to relax ○​ End of interval, ventricles begin to depolarize ​ QT interval ○​ extends from the beginning of the QRS complex to the end of the T wave and represents the length of time required for ventricular depolarization and repolarization CARDIAC CYCLE ​ Right and left halves of the heart can be viewed as two separate pumps ​ Repetitive pumping process that begins with the onset of cardiac muscle contraction and ends with beginning of the next contraction ​ Atria - primer pumps, complete the filling of ventricles with blood ​ Ventricles - power pumps, produces the major forces that causes blood to flow through the pulmonary and systemic circulations ​ Blood moves from high pressure to low pressure ​ Pressure changes are responsible for blood movement ​ Cardiac muscle contractions produce pressure changes within heart chambers Systole vs Diastole ​ Atrial Systole - Contraction of the two aorta (Semilunar valves closed, AV valves open) ​ Ventricular Systole - Contraction of the two ventricles (All valves closed) ​ Atrial diastole - Relaxation of the two aorta ​ Ventricular Diastole - Relaxation of the ventricles (Semilunar valves open then closes, AV valves closed) HEART SOUNDS ​ Stethoscope - originally developed to listen to sounds of the lungs and heart but can now be used to listen to other sounds of the body as well ​ Two main heart sounds: ○​ Lubb ​ Lower pitch than the second, occurs at beginning of ventricular systole (closure of AV valves) ○​ Dupp ​ Occurs at beginning of ventricular diastole (closure of semilunar valves) ○​ Murmurs ​ Abnormal heart sounds (result of faulty valves) REGULATION OF HEART FUNCTION 1.​ Cardiac output (CO) a.​ Volume of blood pumped by either ventricle of the heart each minute b.​ Slightly more than 5 L/min c.​ Co = SV X HR 2.​ Stroke volume a.​ Volume of blood pumped per ventricle each time the heart contracts b.​ 70 ml/neat 3.​ Heart rate a.​ Number of times the heart contracts each minute b.​ 72 beats/min Intrinsic Regulation of Heart ​ Regulation mechanisms within the heart ​ Results from the heart’s normal functional characteristics ​ Venous return ○​ Amount of blood that returns to the heart ​ Preload ○​ The degree to which the ventricular wall are stretch towards the end of the diastole ○​ Starling’s law of heart ​ Relationship between stroke volume and preload ​ Venous return is proportional to cardiac output ​ Afterload ○​ Pressure against which the ventricles pumps the most blood Extrinsic Regulation of Heart ​ Mechanisms external to the heart ​ Sympathetic stimulation increases stroke volume and heart rate, parasympathetic stimulation decreases heart rate ​ Includes nervous and chemical regulations ○​ Nervous Regulation: Baroreceptor reflex ​ Baroreceptors ​ Stretch receptors monitoring blood pressure in aorta and the wall of internal carotid arteries  ​ Baroreceptor reflex ​ Mechanism of the nervous system regulating heart function ○​ Chemical Regulation: Chemoreceptor reflex ​ Chemicals can affect heart rate and stroke volume ​ Epinephrine and norepinephrine from adrenal medulla can increase heart rate and stroke volume INFLAMMATION OF HEART TISSUES 1.​ Endocarditis - Inflammation of the endocardium 2.​ Pericarditis - Inflammation of the Pericardium 3.​ Cardiomyopathy - Disease of the myocardium of unknown cause or occurring secondarily to other disease; results in weakened cardiac muscle, causing all chambers of the heart to enlarge; may eventually lead to congestive heart failure 4.​ Rheumatic heart disease - Results from a streptococcal infection in young people; toxin produced by the bacteria can cause rheumatic fever several weeks after the infection that can result in rheumatic endocarditis REDUCED BLOOD FLOW TO CARDIAC MUSCLE 1.​ Coronary heart disease - reduces the amount of blood the coronary arteries can deliver to the myocardium 2.​ Coronary thrombosis - Blood clot formation in a coronary artery 3.​ Myocardial infarction (heart attack) - Damaged cardiac muscle tissue resulting from lack of blood flow to the myocardium CONGENITAL HEART DISEASE 1.​ Septal defect - Hole in the septum between the left and right sides of the heart, allowing blood to flow from one side of the heart to the other and greatly reducing the heart’s pumping effectiveness. 2.​ Patent ductus arteriosus - Ductus arteriosus fails to close after birth, allowing blood to flow from the aorta to the pulmonary trunk under a higher pressure, which damages the lungs; also, the left ventricle must work harder to maintain adequate systemic pressure 3.​ Stenosis of the heart valve - Narrowed opening through one or more of the heart valves; aortic or pulmonary semilunar stenosis increases the heart’s workload 4.​ Cyanosis - Symptom of inadequate heart function in babies with congenital heart disease; (Appears blue because of low oxygen levels in the blood) Heart procedures ​ Angioplasty - Procedure that opens blocked blood vessels ​ Stent - Structures inserted to keep vessels open and relieve obstruction ​ Bypass - Procedure that reroutes blood away from blocked arteries