Chapter 22. The Cardiovascular System. Vessels and Circulation. Lecture Presentation by Steven Bassett Southeast Community College

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1 Chapter 22 The Cardiovascular System Vessels and Circulation Lecture Presentation by Steven Bassett Southeast Community College

2 Introduction There are two groups of blood vessels Pulmonary circuit Blood goes to and from the lungs Systemic circuit Blood goes to the rest of the body and back to the heart Blood goes to both circuits at the same time with each heartbeat

3 Histological Organization of Blood Vessels The walls of the vessels consist of three layers The layered walls give the vessels tremendous strength The vessel walls are thick The walls themselves are supplied with blood These blood vessels are called vasa vasorum

4 Histological Organization of Blood Vessels Characteristics of the Three Layers Intima (innermost layer) Also called tunica intima Makes up the endothelium of the vessel Media (middle layer) Also called tunica media Consists of smooth muscle Involved in vasoconstriction and vasodilation Adventitia (outermost layer) Also called tunica adventitia Fibers of the adventitia anchor the blood vessels

5 Figure 22.1 The Structure of Blood Vessels (4 of 8) Histological Comparison of Arteries and Veins Adventitia AV bundle Adventitia Media Intima Smooth muscle Lumen of vein Media Intima The internal elastic membrane is a network of elastic fibers located between the intima and the media. Smooth muscle The media is separated from the adventitia by the external elastic membrane, a band of elastic tissue. Lumen of artery Endothelium Endothelium ARTERY Elastic fiber Artery and Vein LM 60 VEIN

6 Histological Organization of Blood Vessels Distinguishing Arteries from Veins Most arteries and veins run parallel to each other Arteries carry blood away from the heart Veins carry blood toward the heart Walls of arteries are thicker than veins Arteries maintain their circular shape and veins typically collapse when cut Endothelial lining of arteries have pleated folds endothelial lining of veins do not

7 Figure 22.1 The Structure of Blood Vessels (2 of 8) Structural Differences between Arteries and Veins VEINS ARTERIES Start 7 Large Vein Large veins include the superior and inferior venae cavae (also termed the great veins) and their tributaries within the abdominopelvic and thoracic cavities. Elastic Artery 1 The walls of elastic arteries, such as the aorta and brachiocephalic arteries, are not very thick relative to the vessel diameter, but they are extremely resilient. The media of these vessels contains relatively few smooth muscle cells and a high density of elastic fibers. Adventitia Media Endothelium Intima Internal elastic layer Endothelium Media Adventitia Intima 6 Medium-Sized Vein Medium-sized veins, such as the radial and ulnar veins, range from 2 to 9 mm in internal diameter and correspond in general size to muscular arteries. In these veins the media is thin, and it contains relatively few smooth muscle cells. Muscular Artery 2 A typical muscular artery has a diameter of approximately 4 mm (0.15 in.). Muscular arteries, such as the radial and ulnar arteries, have a thicker media with a greater percentage of smooth muscle cells than elastic arteries. Adventitia Media Endothelium Intima Adventitia Media Endothelium Intima 5 Venule Venules, the smallest veins, collect blood from capillaries. They vary widely in diameter and character, and the small venules are both innumerable and unnamed. The smallest venules resemble expanded capillaries, and venules smaller than 50 m in total diameter lack a media altogether. Adventitia Endothelium Arteriole 3 Arterioles have an average diameter of about 30 m. They are considerably smaller than muscular arteries, and they are both innumerable and unnamed. Arterioles have a poorly defined adventitia, and the media consists of scattered smooth muscle cells that may not form a complete layer. Smooth muscle cells Endothelium Basal lamina Fenestrated capillaries are capillaries that contain windows, or pores in their walls, due to an incomplete or perforated endothelial lining. 4 Fenestrated Capillary Pores Endothelial cells Basal lamina Capillaries Continuous Capillary Endothelial cells Basal lamina Continuous capillaries are found in most regions of the body. In these capillaries the endothelium is a complete lining, and the endothelial cells are connected by tight junctions and desmosomes.

8 Histological Organization of Blood Vessels Arteries As blood leaves the heart, it travels through: Elastic arteries Muscular arteries Arterioles

9 Histological Organization of Blood Vessels Elastic Arteries Large vessels up to 2.5 cm in diameter Very resilient Examples are: Aorta Brachiocephalic Pulmonary trunk Common carotid Subclavian Common iliac

10 Figure 22.1 The Structure of Blood Vessels (2 of 8) Structural Differences between Arteries and Veins VEINS ARTERIES Start 7 Large Vein Large veins include the superior and inferior venae cavae (also termed the great veins) and their tributaries within the abdominopelvic and thoracic cavities. Elastic Artery 1 The walls of elastic arteries, such as the aorta and brachiocephalic arteries, are not very thick relative to the vessel diameter, but they are extremely resilient. The media of these vessels contains relatively few smooth muscle cells and a high density of elastic fibers. Adventitia Media Endothelium Intima Internal elastic layer Endothelium Media Adventitia Intima 6 Medium-Sized Vein Medium-sized veins, such as the radial and ulnar veins, range from 2 to 9 mm in internal diameter and correspond in general size to muscular arteries. In these veins the media is thin, and it contains relatively few smooth muscle cells. Muscular Artery 2 A typical muscular artery has a diameter of approximately 4 mm (0.15 in.). Muscular arteries, such as the radial and ulnar arteries, have a thicker media with a greater percentage of smooth muscle cells than elastic arteries. Adventitia Media Endothelium Intima Adventitia Media Endothelium Intima 5 Venule Venules, the smallest veins, collect blood from capillaries. They vary widely in diameter and character, and the small venules are both innumerable and unnamed. The smallest venules resemble expanded capillaries, and venules smaller than 50 m in total diameter lack a media altogether. Adventitia Endothelium Arteriole 3 Arterioles have an average diameter of about 30 m. They are considerably smaller than muscular arteries, and they are both innumerable and unnamed. Arterioles have a poorly defined adventitia, and the media consists of scattered smooth muscle cells that may not form a complete layer. Smooth muscle cells Endothelium Basal lamina Fenestrated capillaries are capillaries that contain windows, or pores in their walls, due to an incomplete or perforated endothelial lining. 4 Fenestrated Capillary Pores Endothelial cells Basal lamina Capillaries Continuous Capillary Endothelial cells Basal lamina Continuous capillaries are found in most regions of the body. In these capillaries the endothelium is a complete lining, and the endothelial cells are connected by tight junctions and desmosomes.

11 Histological Organization of Blood Vessels Muscular Arteries Medium-sized arteries up to 0.4 cm diameter Examples are: Radial and ulnar External carotid Brachial Femoral Mesenteric

12 Figure 22.1 The Structure of Blood Vessels (2 of 8) Structural Differences between Arteries and Veins VEINS ARTERIES Start 7 Large Vein Large veins include the superior and inferior venae cavae (also termed the great veins) and their tributaries within the abdominopelvic and thoracic cavities. Elastic Artery 1 The walls of elastic arteries, such as the aorta and brachiocephalic arteries, are not very thick relative to the vessel diameter, but they are extremely resilient. The media of these vessels contains relatively few smooth muscle cells and a high density of elastic fibers. Adventitia Media Endothelium Intima Internal elastic layer Endothelium Media Adventitia Intima 6 Medium-Sized Vein Medium-sized veins, such as the radial and ulnar veins, range from 2 to 9 mm in internal diameter and correspond in general size to muscular arteries. In these veins the media is thin, and it contains relatively few smooth muscle cells. Muscular Artery 2 A typical muscular artery has a diameter of approximately 4 mm (0.15 in.). Muscular arteries, such as the radial and ulnar arteries, have a thicker media with a greater percentage of smooth muscle cells than elastic arteries. Adventitia Media Endothelium Intima Adventitia Media Endothelium Intima 5 Venule Venules, the smallest veins, collect blood from capillaries. They vary widely in diameter and character, and the small venules are both innumerable and unnamed. The smallest venules resemble expanded capillaries, and venules smaller than 50 m in total diameter lack a media altogether. Adventitia Endothelium Arteriole 3 Arterioles have an average diameter of about 30 m. They are considerably smaller than muscular arteries, and they are both innumerable and unnamed. Arterioles have a poorly defined adventitia, and the media consists of scattered smooth muscle cells that may not form a complete layer. Smooth muscle cells Endothelium Basal lamina Fenestrated capillaries are capillaries that contain windows, or pores in their walls, due to an incomplete or perforated endothelial lining. 4 Fenestrated Capillary Pores Endothelial cells Basal lamina Capillaries Continuous Capillary Endothelial cells Basal lamina Continuous capillaries are found in most regions of the body. In these capillaries the endothelium is a complete lining, and the endothelial cells are connected by tight junctions and desmosomes.

13 Histological Organization of Blood Vessels Arterioles Small arteries around 30 microns in diameter Poorly defined adventitia Control blood flow between arteries and capillaries

14 Figure 22.1 The Structure of Blood Vessels (2 of 8) Structural Differences between Arteries and Veins VEINS ARTERIES Start 7 Large Vein Large veins include the superior and inferior venae cavae (also termed the great veins) and their tributaries within the abdominopelvic and thoracic cavities. Elastic Artery 1 The walls of elastic arteries, such as the aorta and brachiocephalic arteries, are not very thick relative to the vessel diameter, but they are extremely resilient. The media of these vessels contains relatively few smooth muscle cells and a high density of elastic fibers. Adventitia Media Endothelium Intima Internal elastic layer Endothelium Media Adventitia Intima 6 Medium-Sized Vein Medium-sized veins, such as the radial and ulnar veins, range from 2 to 9 mm in internal diameter and correspond in general size to muscular arteries. In these veins the media is thin, and it contains relatively few smooth muscle cells. Muscular Artery 2 A typical muscular artery has a diameter of approximately 4 mm (0.15 in.). Muscular arteries, such as the radial and ulnar arteries, have a thicker media with a greater percentage of smooth muscle cells than elastic arteries. Adventitia Media Endothelium Intima Adventitia Media Endothelium Intima 5 Venule Venules, the smallest veins, collect blood from capillaries. They vary widely in diameter and character, and the small venules are both innumerable and unnamed. The smallest venules resemble expanded capillaries, and venules smaller than 50 m in total diameter lack a media altogether. Adventitia Endothelium Arteriole 3 Arterioles have an average diameter of about 30 m. They are considerably smaller than muscular arteries, and they are both innumerable and unnamed. Arterioles have a poorly defined adventitia, and the media consists of scattered smooth muscle cells that may not form a complete layer. Smooth muscle cells Endothelium Basal lamina Fenestrated capillaries are capillaries that contain windows, or pores in their walls, due to an incomplete or perforated endothelial lining. 4 Fenestrated Capillary Pores Endothelial cells Basal lamina Capillaries Continuous Capillary Endothelial cells Basal lamina Continuous capillaries are found in most regions of the body. In these capillaries the endothelium is a complete lining, and the endothelial cells are connected by tight junctions and desmosomes.

15 Histological Organization of Blood Vessels Capillaries Smallest of all vessels Most delicate of all vessels Walls are thin enough to permit exchange of gases between the blood and the interstitial fluid The diameter is about 8 microns A red blood cell diameter is also about 8 microns

16 Histological Organization of Blood Vessels Types of Capillaries Continuous Endothelial lining is complete Fenestrated Endothelial lining is not complete These capillaries have pores in their lining

17 Figure 22.2ab Structure of Capillaries and Sinusoids Basal lamina Endothelial cell Nucleus Endosomes Endosomes Fenestrations, or pores Basal lamina Boundary between endothelial cells Boundary between endothelial cells Basal lamina a This diagrammatic view of a continuous capillary shows the structure of its wall. b This diagrammatic view of a fenestrated capillary details the structure of the wall.

18 Histological Organization of Blood Vessels Capillaries (continued) There are four mechanisms regarding the passage of material across the walls of capillaries Material can diffuse across the endothelial lining Material can diffuse through gaps between adjacent cells of the lining Material can diffuse through pores Material can move via endocytosis

19 Histological Organization of Blood Vessels Capillary Beds Capillaries do not function as individual units Capillaries form an interconnected network of capillaries (capillary beds) The capillary bed consists of vessels connecting arterioles with venules There are precapillary sphincters involved in regulating blood flow through the capillaries

20 Figure 22.3a Organization of a Capillary Bed Smooth muscle cells Arteriole Collateral arteries Vein Venule Metarterioles Thoroughfare channel Capillaries Section of precapillary sphincter Small venule Precapillary sphincters a Arteriovenous anastomosis Basic organization of a typical capillary bed. The pattern of blood flow changes continually in response to regional alterations in tissue oxygen demand. KEY Consistent blood flow Variable blood flow

21 Histological Organization of Blood Vessels Capillary Beds (continued) In areas such as the brain, heart, and stomach, a continuous, rich flow of blood is required In these areas, more than one artery supplies a specific area These arteries (collateral arteries) typically fuse forming an arterial anastomosis If one arteriole is blocked, the other one will supply blood to the capillary bed

22 Histological Organization of Blood Vessels Capillary Beds (continued) In areas such as the joints or visceral organs, blood flow through some vessels may be hindered due to body movement In order to accommodate this, there must be a direct connection between arterioles and venules This direct connection is called an arteriovenous anastomosis

23 Figure 22.3a Organization of a Capillary Bed Smooth muscle cells Arteriole Collateral arteries Vein Venule Metarterioles Thoroughfare channel Capillaries Section of precapillary sphincter Small venule Precapillary sphincters a Arteriovenous anastomosis Basic organization of a typical capillary bed. The pattern of blood flow changes continually in response to regional alterations in tissue oxygen demand. KEY Consistent blood flow Variable blood flow

24 Histological Organization of Blood Vessels Veins Veins collect blood from tissues and return the blood to the heart As blood leaves the tissue and travels to the heart, it travels through the following vessels: Capillary beds Capillaries Venules Medium-sized veins Large veins

25 Histological Organization of Blood Vessels Venules Smallest of the veins Collect blood from the capillaries Lack or have thin tunica media

26 Figure 22.1 The Structure of Blood Vessels (2 of 8) Structural Differences between Arteries and Veins VEINS ARTERIES Start 7 Large Vein Large veins include the superior and inferior venae cavae (also termed the great veins) and their tributaries within the abdominopelvic and thoracic cavities. Elastic Artery 1 The walls of elastic arteries, such as the aorta and brachiocephalic arteries, are not very thick relative to the vessel diameter, but they are extremely resilient. The media of these vessels contains relatively few smooth muscle cells and a high density of elastic fibers. Adventitia Media Endothelium Intima Internal elastic layer Endothelium Media Adventitia Intima 6 Medium-Sized Vein Medium-sized veins, such as the radial and ulnar veins, range from 2 to 9 mm in internal diameter and correspond in general size to muscular arteries. In these veins the media is thin, and it contains relatively few smooth muscle cells. Muscular Artery 2 A typical muscular artery has a diameter of approximately 4 mm (0.15 in.). Muscular arteries, such as the radial and ulnar arteries, have a thicker media with a greater percentage of smooth muscle cells than elastic arteries. Adventitia Media Endothelium Intima Adventitia Media Endothelium Intima 5 Venule Venules, the smallest veins, collect blood from capillaries. They vary widely in diameter and character, and the small venules are both innumerable and unnamed. The smallest venules resemble expanded capillaries, and venules smaller than 50 m in total diameter lack a media altogether. Adventitia Endothelium Arteriole 3 Arterioles have an average diameter of about 30 m. They are considerably smaller than muscular arteries, and they are both innumerable and unnamed. Arterioles have a poorly defined adventitia, and the media consists of scattered smooth muscle cells that may not form a complete layer. Smooth muscle cells Endothelium Basal lamina Fenestrated capillaries are capillaries that contain windows, or pores in their walls, due to an incomplete or perforated endothelial lining. 4 Fenestrated Capillary Pores Endothelial cells Basal lamina Capillaries Continuous Capillary Endothelial cells Basal lamina Continuous capillaries are found in most regions of the body. In these capillaries the endothelium is a complete lining, and the endothelial cells are connected by tight junctions and desmosomes.

27 Histological Organization of Blood Vessels Medium-Sized Veins The adventitia (tunica externa) is the largest of the layers Contains elastic fibers

28 Figure 22.1 The Structure of Blood Vessels (2 of 8) Structural Differences between Arteries and Veins VEINS ARTERIES Start 7 Large Vein Large veins include the superior and inferior venae cavae (also termed the great veins) and their tributaries within the abdominopelvic and thoracic cavities. Elastic Artery 1 The walls of elastic arteries, such as the aorta and brachiocephalic arteries, are not very thick relative to the vessel diameter, but they are extremely resilient. The media of these vessels contains relatively few smooth muscle cells and a high density of elastic fibers. Adventitia Media Endothelium Intima Internal elastic layer Endothelium Media Adventitia Intima 6 Medium-Sized Vein Medium-sized veins, such as the radial and ulnar veins, range from 2 to 9 mm in internal diameter and correspond in general size to muscular arteries. In these veins the media is thin, and it contains relatively few smooth muscle cells. Muscular Artery 2 A typical muscular artery has a diameter of approximately 4 mm (0.15 in.). Muscular arteries, such as the radial and ulnar arteries, have a thicker media with a greater percentage of smooth muscle cells than elastic arteries. Adventitia Media Endothelium Intima Adventitia Media Endothelium Intima 5 Venule Venules, the smallest veins, collect blood from capillaries. They vary widely in diameter and character, and the small venules are both innumerable and unnamed. The smallest venules resemble expanded capillaries, and venules smaller than 50 m in total diameter lack a media altogether. Adventitia Endothelium Arteriole 3 Arterioles have an average diameter of about 30 m. They are considerably smaller than muscular arteries, and they are both innumerable and unnamed. Arterioles have a poorly defined adventitia, and the media consists of scattered smooth muscle cells that may not form a complete layer. Smooth muscle cells Endothelium Basal lamina Fenestrated capillaries are capillaries that contain windows, or pores in their walls, due to an incomplete or perforated endothelial lining. 4 Fenestrated Capillary Pores Endothelial cells Basal lamina Capillaries Continuous Capillary Endothelial cells Basal lamina Continuous capillaries are found in most regions of the body. In these capillaries the endothelium is a complete lining, and the endothelial cells are connected by tight junctions and desmosomes.

29 Histological Organization of Blood Vessels Large Veins All three layers are relatively thick Examples of large veins are: Superior vena cava Inferior vena cava

30 Figure 22.1 The Structure of Blood Vessels (2 of 8) Structural Differences between Arteries and Veins VEINS ARTERIES Start 7 Large Vein Large veins include the superior and inferior venae cavae (also termed the great veins) and their tributaries within the abdominopelvic and thoracic cavities. Elastic Artery 1 The walls of elastic arteries, such as the aorta and brachiocephalic arteries, are not very thick relative to the vessel diameter, but they are extremely resilient. The media of these vessels contains relatively few smooth muscle cells and a high density of elastic fibers. Adventitia Media Endothelium Intima Internal elastic layer Endothelium Media Adventitia Intima 6 Medium-Sized Vein Medium-sized veins, such as the radial and ulnar veins, range from 2 to 9 mm in internal diameter and correspond in general size to muscular arteries. In these veins the media is thin, and it contains relatively few smooth muscle cells. Muscular Artery 2 A typical muscular artery has a diameter of approximately 4 mm (0.15 in.). Muscular arteries, such as the radial and ulnar arteries, have a thicker media with a greater percentage of smooth muscle cells than elastic arteries. Adventitia Media Endothelium Intima Adventitia Media Endothelium Intima 5 Venule Venules, the smallest veins, collect blood from capillaries. They vary widely in diameter and character, and the small venules are both innumerable and unnamed. The smallest venules resemble expanded capillaries, and venules smaller than 50 m in total diameter lack a media altogether. Adventitia Endothelium Arteriole 3 Arterioles have an average diameter of about 30 m. They are considerably smaller than muscular arteries, and they are both innumerable and unnamed. Arterioles have a poorly defined adventitia, and the media consists of scattered smooth muscle cells that may not form a complete layer. Smooth muscle cells Endothelium Basal lamina Fenestrated capillaries are capillaries that contain windows, or pores in their walls, due to an incomplete or perforated endothelial lining. 4 Fenestrated Capillary Pores Endothelial cells Basal lamina Capillaries Continuous Capillary Endothelial cells Basal lamina Continuous capillaries are found in most regions of the body. In these capillaries the endothelium is a complete lining, and the endothelial cells are connected by tight junctions and desmosomes.

31 Histological Organization of Blood Vessels Venous Valves Blood in the veins returning to the heart from the lower extremities has to go against gravity To assist in this process, many veins have valves (venous valves) These valves compartmentalize the blood in the veins thus acting as one-way valves Valves prevent backflow of blood

32 Figure 22.4 Function of Valves in the Venous System Valve closed Valve opens above contracting muscle Valve closed Valve closes below contracting muscle

33 Histological Organization of Blood Vessels Blood in the veins from the lower extremities has to ascend to the heart Blood in the veins returning to the heart from the lower extremities has to go against gravity The skeletal muscles of the legs help to propel the blood back to the heart Changes in thoracic pressure helps to move the blood through the venae cavae back to the heart

34 The Distribution of Blood The total blood volume is distributed unevenly within the vessels of the body Arteries and capillaries contain percent of the volume Veins contain percent of the volume Veins are more distensible than arteries Based on blood pressure, a vein can expand about 8 times as much as a parallel artery

35 Figure 22.5 The Distribution of Blood in the Cardiovascular System Large veins 18% Large venous networks (liver, bone marrow, skin) 21% Venules and medium-sized veins 25%

36 Blood Vessel Distribution Blood vessels can be divided into two circuits Pulmonary circuit Composed of arteries and veins that transport blood between the heart and the lungs Arteries and veins travel relatively short distances Systemic circuit Composed of arteries and veins that transport oxygenated blood between the heart and all other tissues Arteries and veins travel longer distances

37 Blood Vessel Distribution There are functional and structural differences between the vessels in the two circuits Blood pressure in the pulmonary circuit is lower than in the systemic circuit Walls of the pulmonary arteries are thinner than the walls of systemic arteries

38 Blood Vessel Distribution Vessel Distribution Functional patterns of the pulmonary and systemic circuits The distribution of arteries and veins is the same on the left side of the body as it is on the right side of the body except for the venae cavae and the aorta A single vessel will have different names according to specific anatomical boundaries Arteries and veins often anastomose

39 The Pulmonary Circuit Blood on the right side of the heart is on its way through the pulmonary circuit Deoxygenated blood leaves the heart by passing through the pulmonary valve Enters the pulmonary trunk Enters the left and right pulmonary arteries Blood arrives at the lungs to drop off carbon dioxide and pick up oxygen Oxygenated blood returns to the heart via the pulmonary veins Blood enters the left atrium of the heart

40 Figure 22.6 An Overview of the General Pattern of Circulation Brain Upper limbs Pulmonary circuit (arteries) Pulmonary circuit (veins) Lungs Systemic circuit (veins) RA Right ventricle LA Left ventricle Systemic circuit (arteries) Kidneys Spleen Liver Digestive organs Gonads Lower limbs

41 Figure 22.7a The Pulmonary Circuit Trachea Ascending aorta Superior vena cava Aortic arch Pulmonary trunk Right lung Right pulmonary arteries Left lung Left pulmonary arteries Left pulmonary veins Right pulmonary veins Alveolus Capillary Inferior vena cava Descending aorta CO 2 O 2 a Anatomy of the pulmonary circuit. Blue arrows indicate the flow of oxygen-poor blood; red arrows indicate the flow of oxygen-rich blood. The breakout shows the alveoli of the lung and the routes of gas diffusion into and out of the bloodstream across the walls of the alveolar capillaries.

42 Systemic Arteries Blood on the left side of the heart is on its way through the system circulation Oxygenated blood leaves the heart by passing through the aortic valve Enters the ascending aorta At the base of the ascending aorta are the branches of the coronary vessels Enters the aortic arch From the aortic arch, blood branches into numerous vessels

43 Figure 22.6 An Overview of the General Pattern of Circulation Brain Upper limbs Pulmonary circuit (arteries) Pulmonary circuit (veins) Lungs Systemic circuit (veins) RA Right ventricle LA Left ventricle Systemic circuit (arteries) Kidneys Spleen Liver Digestive organs Gonads Lower limbs

44 Systemic Arteries Blood in the aortic arch branches into the following vessels: Brachiocephalic trunk Then the right common carotid and right subclavian arteries Left common carotid artery Left subclavian artery Descending aorta

45 Figure 22.8 An Overview of the Systemic Arterial System Vertebral Brachiocephalic trunk Right subclavian Aortic arch Ascending aorta Celiac trunk Brachial Radial Ulnar Right common carotid Left common carotid Left subclavian Axillary Pulmonary trunk Descending aorta Diaphragm Renal Superior mesenteric Gonadal Inferior mesenteric Common iliac Internal iliac Palmar arches External iliac Popliteal Deep femoral Femoral Descending genicular Posterior tibial Anterior tibial Fibular Dorsalis pedis Plantar arch

46 Systemic Arteries The Ascending Aorta Begins at the aortic valve Left and right coronary arteries branch off the base of the ascending aorta Aortic arch Forms an arch going toward the left and posterior side of the heart Branching off the aortic arch are three elastic arteries

47 Systemic Arteries Branches of the Aortic Arch Brachiocephalic trunk Gives rise to the right common carotid artery And gives rise to the right subclavian artery, which supplies blood to the right side of the head and brain and to the right subclavian artery (supplies blood to the right arm) Left common carotid artery Supplies blood to the left side of the head and brain Left subclavian artery Supplies blood to the left arm

48 Figure 22.9 Aortic Angiogram Right common carotid artery Thyrocervical trunk Right subclavian artery Left common carotid artery Brachiocephalic trunk Internal thoracic artery Ascending aorta Left subclavian artery Aortic arch Descending aorta

49 Systemic Arteries The Subclavian Arteries The subclavian arteries Continue to form the axillary arteries Prior to forming the axillary arteries, the subclavians form three branches: Thyrocervical trunk Supplies muscles of the neck, head, and upper back Internal thoracic artery Supplies the pericardium and anterior wall of the chest Vertebral artery Supplies the brain and spinal cord

50 Figure 22.19a Major Veins of the Head and Neck Superior sagittal sinus Superficial cerebral veins Great cerebral Straight sinus Petrosal sinuses Right transverse sinus Occipital sinus Inferior sagittal sinus Temporal Deep cerebral Cavernous sinus Maxillary Facial Sigmoid sinus Occipital Vertebral External jugular Internal jugular Right subclavian Axillary Clavicle Right brachiocephalic Left brachiocephalic Superior vena cava Internal thoracic a An oblique lateral view of the head and neck showing the major superficial and deep veins.

51 Systemic Arteries The Flow of Blood from the Subclavians to the Arms Axillary artery Brachial artery Radial and ulnar arteries Arteries anastomose at the wrist forming the superficial palmar arch and deep palmar arch

52 Figure 22.10a Arteries of the Chest and Upper Limb a Anterior view of the arteries of the chest and upper limb Right thyrocervical trunk Right vertebral Right common carotid See Figure Left common carotid Left subclavian Right subclavian Brachiocephalic trunk Right internal thoracic Right Right thyrocervical Right common trunk vertebral carotid Left common carotid Aortic arch Right axillary Thoracoacromial Lateral thoracic Left subclavian Ascending aorta Anterior humeral circumflex Posterior humeral circumflex Thoracic aorta Subscapular Left ventricle Deep brachial Intercostals Right brachial Superior ulnar collateral Abdominal aorta Right radial Right ulnar Inferior ulnar collateral Anterior ulnar recurrent Posterior ulnar recurrent Anterior interosseous Deep palmar arch Superficial palmar arch Digital arteries

53 Figure 22.10bc Arteries of the Chest and Upper Limb b Anterior view of the right axillary region dissected to show blood vessels and nerves in this region Posterior cord of brachial plexus Axillary artery Deep brachial artery Brachial artery Clavicle (cut and removed) Medial trunk of brachial plexus Right subclavian artery Subscapular artery Pectoralis major muscle (cut and reflected) Biceps brachii muscle Median nerve Serratus anterior muscle Brachial artery Biceps brachii muscle Brachial artery Inferior ulnar collateral artery Brachioradialis muscle Ulnar artery Flexor carpi radialis muscle Radial artery Ulnar artery c Anterior view of the right forearm dissected to show the main arteries Superficial palmar arch

54 Systemic Arteries The Carotid Arteries and the Blood Supply to the Brain The common carotids ascend the neck Divide to form the internal carotids and external carotids The carotid sinus is at the base of the internal carotid artery consisting of baroreceptors and chemoreceptors

55 Figure 22.12a Arteries of the Neck and Head Superficial temporal Cerebral arterial circle Carotid canal Posterior cerebral Basilar Occipital Internal carotid Vertebral Inferior thyroid Thyrocervical trunk Transverse cervical Anterior cerebral Middle cerebral Ophthalmic Maxillary Facial Lingual External carotid Carotid sinus Common carotid Suprascapular Subclavian Axillary Internal thoracic Second rib Brachiocephalic trunk a General circulation pattern of arteries supplying the neck and superficial structures of the head; this is an oblique lateral view from the right side.

56 Systemic Arteries The Internal and External Carotid Arteries External carotids Supply the neck and outside of the skull Branches to form: Lingual artery Facial artery Occipital artery Superficial temporal artery

57 Figure 22.12a Arteries of the Neck and Head Superficial temporal Cerebral arterial circle Carotid canal Posterior cerebral Basilar Occipital Internal carotid Vertebral Inferior thyroid Thyrocervical trunk Transverse cervical Anterior cerebral Middle cerebral Ophthalmic Maxillary Facial Lingual External carotid Carotid sinus Common carotid Suprascapular Subclavian Axillary Internal thoracic Second rib Brachiocephalic trunk a General circulation pattern of arteries supplying the neck and superficial structures of the head; this is an oblique lateral view from the right side.

58 Systemic Arteries The Internal and External Carotid Arteries Internal carotids Enter the skull to deliver blood to the brain Branches to form: Ophthalmic artery (supplies the eyes) Anterior cerebral artery (supplies frontal and parietal lobes of the brain) Middle cerebral artery (supplies the midbrain and lateral surfaces of the brain)

59 Systemic Arteries Blood Supply to the Brain Blood in the vertebral arteries reaches the brain via: Left and right vertebral arteries fuse to form the basilar artery Basilar artery branches many times in the area of the pons Basilar artery eventually forms the vessels of the cerebral arterial circle (circle of Willis)

60 Figure 22.19a Major Veins of the Head and Neck Superior sagittal sinus Superficial cerebral veins Great cerebral Straight sinus Petrosal sinuses Right transverse sinus Occipital sinus Inferior sagittal sinus Temporal Deep cerebral Cavernous sinus Maxillary Facial Sigmoid sinus Occipital Vertebral External jugular Internal jugular Right subclavian Axillary Clavicle Right brachiocephalic Left brachiocephalic Superior vena cava Internal thoracic a An oblique lateral view of the head and neck showing the major superficial and deep veins.

61 Figure 22.19b Major Veins of the Head and Neck Superior sagittal sinus (cut) Roots of superior cerebral Middle cerebral Cavernous sinus Pontal Petrosal sinuses Internal jugular Inferior cerebrals Inferior cerebellars Sigmoid sinus Straight sinus Occipital sinus Transverse sinus Confluence of sinuses b An inferior view of the brain showing the major veins. Compare with the arterial supply to the brain shown in Figure 22.13a.

62 Systemic Arteries The Descending Aorta A continuation of the aortic arch Divided into thoracic aorta and abdominal aorta at the diaphragm area

63 Figure Major Arteries of the Trunk Vertebral Thyrocervical trunk Brachiocephalic trunk Aortic arch Internal thoracic Common carotid Left subclavian Axillary Bronchial Esophageal Mediastinal Pericardial THORACIC AORTA Intercostal Superior phrenic Inferior phrenic Diaphragm Common hepatic Suprarenal Renal Lumbar Right common iliac External iliac Internal iliac Inferior mesenteric Terminal segment of the aorta Median sacral Celiac trunk Left gastric Splenic Superior mesenteric ABDOMINAL AORTA Gonadal

64 Systemic Arteries The Thoracic Aorta Branches to form the following vessels: Bronchial arteries Pericardial arteries Mediastinal arteries Esophageal arteries Intercostal arteries Superior phrenic arteries

65 Figure Major Arteries of the Trunk Vertebral Thyrocervical trunk Brachiocephalic trunk Aortic arch Internal thoracic Common carotid Left subclavian Axillary Bronchial Esophageal Mediastinal Pericardial THORACIC AORTA Intercostal Superior phrenic Inferior phrenic Diaphragm Common hepatic Suprarenal Renal Lumbar Right common iliac External iliac Internal iliac Inferior mesenteric Terminal segment of the aorta Median sacral Celiac trunk Left gastric Splenic Superior mesenteric ABDOMINAL AORTA Gonadal

66 Systemic Arteries The Abdominal Aorta Branches to form the following vessels: Celiac trunk Superior mesenteric artery Inferior mesenteric artery Inferior phrenic arteries Suprarenal arteries Renal arteries Gonadal arteries Lumbar arteries Right and left common iliac arteries

67 Figure Major Arteries of the Trunk Vertebral Thyrocervical trunk Brachiocephalic trunk Aortic arch Internal thoracic Common carotid Left subclavian Axillary Bronchial Esophageal Mediastinal Pericardial THORACIC AORTA Intercostal Superior phrenic Inferior phrenic Diaphragm Common hepatic Suprarenal Renal Lumbar Right common iliac External iliac Internal iliac Inferior mesenteric Terminal segment of the aorta Median sacral Celiac trunk Left gastric Splenic Superior mesenteric ABDOMINAL AORTA Gonadal

68 Systemic Arteries The Celiac Trunk Supplies the following organs: Liver Stomach Esophagus Gallbladder Duodenum Pancreas Spleen

69 Systemic Arteries The Celiac Trunk Branches to form the left gastric artery Supplies the stomach Branches to form the splenic artery Supplies the spleen Branches to form the left gastroepiploic artery to supply the stomach Branches to form the pancreatic arteries to supply the pancreas

70 Systemic Arteries The Celiac Trunk Branches to form the common hepatic artery Branches to form: Hepatic artery proper Supplies the liver Right gastric artery Supplies the stomach Cystic artery Supplies the gallbladder Gastroduodenal artery Supplies the duodenum

71 Figure 22.15a Arteries of the Abdomen Inferior vena cava THORACIC AORTA Celiac trunk Common hepatic Liver Stomach ABDOMINAL AORTA Hepatic artery proper Cystic Gastroduodenal Right gastric Left gastric Splenic Spleen Right gastroepiploic Superior mesenteric Left gastroepiploic Superior pancreaticoduodenal Duodenal Inferior pancreaticoduodenal Middle colic (cut) Ascending colon Right colic Ileocolic Intestinal Right external iliac Right internal iliac Pancreas Small intestine Sigmoid colon Rectum Pancreatic Inferior mesenteric Left colic Sigmoid Left common iliac Rectal a Major arteries supplying the abdominal viscera

72 Systemic Arteries Superior Mesenteric Artery Branches to supply Pancreas Inferior pancreaticoduodenal artery Duodenum Inferior pancreaticoduodenal artery Small intestine Intestinal arteries Large intestine Right colic artery Middle colic artery Ileocolic arteries

73 Figure 22.15a Arteries of the Abdomen Inferior vena cava THORACIC AORTA Celiac trunk Common hepatic Liver Stomach ABDOMINAL AORTA Hepatic artery proper Cystic Gastroduodenal Right gastric Left gastric Splenic Spleen Right gastroepiploic Superior mesenteric Left gastroepiploic Superior pancreaticoduodenal Duodenal Inferior pancreaticoduodenal Middle colic (cut) Ascending colon Right colic Ileocolic Intestinal Right external iliac Right internal iliac Pancreas Small intestine Sigmoid colon Rectum Pancreatic Inferior mesenteric Left colic Sigmoid Left common iliac Rectal a Major arteries supplying the abdominal viscera

74 Systemic Arteries Inferior Mesenteric Artery Branches to supply Terminal portion of the large intestine Left colic artery Sigmoid arteries Rectum Rectal arteries

75 Figure 22.15a Arteries of the Abdomen Inferior vena cava THORACIC AORTA Celiac trunk Common hepatic Liver Stomach ABDOMINAL AORTA Hepatic artery proper Cystic Gastroduodenal Right gastric Left gastric Splenic Spleen Right gastroepiploic Superior mesenteric Left gastroepiploic Superior pancreaticoduodenal Duodenal Inferior pancreaticoduodenal Middle colic (cut) Ascending colon Right colic Ileocolic Intestinal Right external iliac Right internal iliac Pancreas Small intestine Sigmoid colon Rectum Pancreatic Inferior mesenteric Left colic Sigmoid Left common iliac Rectal a Major arteries supplying the abdominal viscera

76 Systemic Arteries Five paired arteries branch off the descending aorta Inferior phrenic arteries Suprarenal arteries Renal arteries Gonadal arteries Lumbar arteries

77 Systemic Arteries The five paired arteries supply: Inferior phrenic arteries Supply inferior portion of esophagus and diaphragm Suprarenal arteries Supply the suprarenal glands Renal arteries Supply the right and left kidneys

78 Systemic Arteries The five paired arteries supply (continued) Gonadal arteries Supply testes, scrotum, ovaries, uterine tubes, uterus Lumbar arteries Supply vertebrae, spinal cord, abdominal wall

79 Figure Major Arteries of the Trunk Vertebral Thyrocervical trunk Brachiocephalic trunk Aortic arch Internal thoracic Common carotid Left subclavian Axillary Bronchial Esophageal Mediastinal Pericardial THORACIC AORTA Intercostal Superior phrenic Inferior phrenic Diaphragm Common hepatic Suprarenal Renal Lumbar Right common iliac External iliac Internal iliac Inferior mesenteric Terminal segment of the aorta Median sacral Celiac trunk Left gastric Splenic Superior mesenteric ABDOMINAL AORTA Gonadal

80 Systemic Arteries Arteries of the Pelvis and Lower Limbs The descending aorta branches to form: The common iliac arteries branch to form: The internal iliac artery (supplies the urinary bladder, walls of the pelvis, external genitalia, and the medial side of the thigh) The external iliac artery (supplies blood to the legs)

81 Figure 22.8 An Overview of the Systemic Arterial System Vertebral Brachiocephalic trunk Right subclavian Aortic arch Ascending aorta Celiac trunk Brachial Radial Ulnar Right common carotid Left common carotid Left subclavian Axillary Pulmonary trunk Descending aorta Diaphragm Renal Superior mesenteric Gonadal Inferior mesenteric Common iliac Internal iliac Palmar arches External iliac Popliteal Deep femoral Femoral Descending genicular Posterior tibial Anterior tibial Fibular Dorsalis pedis Plantar arch

82 Systemic Arteries Arteries of the Thigh and Leg External iliac arteries form the: Deep femoral artery Femoral artery Continues to form the popliteal artery The popliteal bifurcates to form anterior tibial and posterior tibial arteries The posterior tibial artery gives rise the fibular artery

83 Figure 22.16a Major Arteries of the Lower Limb, Part I Iliolumbar Superior gluteal Inguinal ligament Deep femoral Lateral femoral circumflex Common iliac Internal iliac External iliac Lateral sacral Internal pudendal Obturator Medial femoral circumflex Femoral Popliteal Descending genicular Posterior tibial Anterior tibial Fibular Dorsalis pedis Lateral plantar Dorsal arch Medial plantar Plantar arch a Anterior view of the arteries supplying the right lower limb

84 Figure Major Arteries of the Lower Limb, Part II Superior gluteal Right external iliac (see Fig ) Femoral (see Fig ) Thigh Deep femoral (see Fig ) Hip joint, femoral head, deep muscles of the thigh Medial femoral circumflex Adductor and obturator muscles, hip joint Lateral femoral circumflex Quadriceps muscles, hip and knee joints Descending genicular Skin of leg; knee joint Popliteal Leg and foot Posterior tibial Anterior tibial Fibular Connected by anastomoses of dorsalis pedis, dorsal arch, and plantar arch, which supply distal portions of the foot and the toes Posterior view of the arteries supplying the right lower limb

85 Systemic Arteries Arteries of the Foot The anterior tibial artery forms: Dorsalis pedis artery The posterior tibial artery forms: Medial and lateral plantar arteries

86 Systemic Veins Systemic Veins Veins collect blood from the body tissues and return it to the heart Blood returns to the heart from the lower extremities Via the inferior vena cava to the right atrium Blood returns to the heart from the upper extremities Via the superior vena cava to the right atrium Blood returns to the heart from the lungs Via the pulmonary veins to the left atrium

87 Figure 22.7a The Pulmonary Circuit Trachea Ascending aorta Superior vena cava Aortic arch Pulmonary trunk Right lung Right pulmonary arteries Left lung Left pulmonary arteries Left pulmonary veins Right pulmonary veins Alveolus Capillary Inferior vena cava Descending aorta CO 2 O 2 a Anatomy of the pulmonary circuit. Blue arrows indicate the flow of oxygen-poor blood; red arrows indicate the flow of oxygen-rich blood. The breakout shows the alveoli of the lung and the routes of gas diffusion into and out of the bloodstream across the walls of the alveolar capillaries.

88 Figure An Overview of the Systemic Venous System Vertebral External jugular Subclavian Axillary Cephalic Brachial Basilic Hepatic Median cubital Radial Median antebrachial Ulnar Palmar venous arches Digital Great saphenous Deep femoral Femoral Internal jugular Brachiocephalic Superior vena cava Intercostal Inferior vena cava Renal Gonadal Lumbar Left and right common iliac External iliac Internal iliac Popliteal Small saphenous Fibular Posterior tibial Anterior tibial Dorsal venous arch Plantar venous arch KEY Superficial veins Deep veins

89 Systemic Veins The Superior Vena Cava All veins drain into the superior vena cava and the inferior vena cava except: Cardiac veins Superior vena cava receives blood from: The head The neck The chest The shoulders The upper limbs

90 Systemic Veins Venous Return from the Cranium The superficial cerebral veins drain into: Superior and inferior sagittal sinuses Petrosal sinuses Occipital sinus Left and right transverse sinuses Straight sinus Venous blood from the cranium drains into the internal jugular veins, which drain into the brachiocephalic veins

91 Figure 22.19a Major Veins of the Head and Neck Superior sagittal sinus Superficial cerebral veins Great cerebral Straight sinus Petrosal sinuses Right transverse sinus Occipital sinus Inferior sagittal sinus Temporal Deep cerebral Cavernous sinus Maxillary Facial Sigmoid sinus Occipital Vertebral External jugular Internal jugular Right subclavian Axillary Clavicle Right brachiocephalic Left brachiocephalic Superior vena cava Internal thoracic a An oblique lateral view of the head and neck showing the major superficial and deep veins.

92 Systemic Veins Venous Return from the Cranium (continued) Venous blood from the posterior skull and the cervical spinal cord drain into: The vertebral veins Drain into brachiocephalic veins

93 Figure 22.19b Major Veins of the Head and Neck Superior sagittal sinus (cut) Roots of superior cerebral Middle cerebral Cavernous sinus Pontal Petrosal sinuses Internal jugular Inferior cerebrals Inferior cerebellars Sigmoid sinus Straight sinus Occipital sinus Transverse sinus Confluence of sinuses b An inferior view of the brain showing the major veins. Compare with the arterial supply to the brain shown in Figure 22.13a.

94 Systemic Veins Superficial Veins of the Head and Neck Veins from the head converge to form the: Temporal vein Drains into the external jugular vein then into the subclavian vein Maxillary veins Drain into the external jugular vein then into the subclavian veins Facial vein Drains into the internal jugular vein then into the subclavian veins

95 Figure 22.19a Major Veins of the Head and Neck Superior sagittal sinus Superficial cerebral veins Great cerebral Straight sinus Petrosal sinuses Right transverse sinus Occipital sinus Inferior sagittal sinus Temporal Deep cerebral Cavernous sinus Maxillary Facial Sigmoid sinus Occipital Vertebral External jugular Internal jugular Right subclavian Axillary Clavicle Right brachiocephalic Left brachiocephalic Superior vena cava Internal thoracic a An oblique lateral view of the head and neck showing the major superficial and deep veins.

96 Systemic Veins Venous Return from the Upper Limb Blood returns to the heart from the hands in the following sequence Digital veins Superficial and deep palmar veins The superficial palmar veins drain into the cephalic vein Subclavian vein Brachiocephalic vein Superior vena cava Right atrium

97 Figure The Venous Drainage of the Trunk and Upper Limb SUPERIOR VENA CAVA Mediastinal Esophageal Azygos Internal thoracic Hepatic Vertebral Internal jugular External jugular Subclavian Highest intercostal Brachiocephalic Axillary Cephalic Accessory hemiazygos Hemiazygos Brachial Intercostal INFERIOR VENA CAVA Basilic Phrenic Renal Gonadal Suprarenal KEY Superficial veins Deep veins Lumbar Median cubital Common iliac Internal iliac External iliac Median sacral Basilic Cephalic Anterior interosseous Radial Median antebrachial Ulnar Palmar venous arches Digital

98 Systemic Veins Venous Return from the Upper Limb Blood can also return to the heart from the hands in the following sequence The superficial palmar veins drain into the cephalic vein Median cubital vein Basilic vein Axillary vein Subclavian vein Brachiocephalic vein Superior vena cava Right atrium

99 Figure The Venous Drainage of the Trunk and Upper Limb SUPERIOR VENA CAVA Mediastinal Esophageal Azygos Internal thoracic Hepatic Vertebral Internal jugular External jugular Subclavian Highest intercostal Brachiocephalic Axillary Cephalic Accessory hemiazygos Hemiazygos Brachial Intercostal INFERIOR VENA CAVA Basilic Phrenic Renal Gonadal Suprarenal KEY Superficial veins Deep veins Lumbar Median cubital Common iliac Internal iliac External iliac Median sacral Basilic Cephalic Anterior interosseous Radial Median antebrachial Ulnar Palmar venous arches Digital

100 Systemic Veins Venous Return from the Upper Limb Blood can also return to the heart from the hands in the following sequence The superficial palmar veins drain into the basilic vein Axillary vein Subclavian vein Brachiocephalic vein Superior vena cava Right atrium

101 Figure The Venous Drainage of the Trunk and Upper Limb SUPERIOR VENA CAVA Mediastinal Esophageal Azygos Internal thoracic Hepatic Vertebral Internal jugular External jugular Subclavian Highest intercostal Brachiocephalic Axillary Cephalic Accessory hemiazygos Hemiazygos Brachial Intercostal INFERIOR VENA CAVA Basilic Phrenic Renal Gonadal Suprarenal KEY Superficial veins Deep veins Lumbar Median cubital Common iliac Internal iliac External iliac Median sacral Basilic Cephalic Anterior interosseous Radial Median antebrachial Ulnar Palmar venous arches Digital

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