I. Anatomy of the Systemic Circulation A. Comparison of Arteries, Capillaries, and Veins (Microscopic Structure) 1. Tunics (Layers) of the Vessel

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1 I. Anatomy of the Systemic Circulation A. Comparison of Arteries, Capillaries, and Veins (Microscopic Structure) 1. Tunics (Layers) of the Vessel Wall a. Tunica externa (adventitia) 1) Areolar or Fibrous Connective Tissue b. Tunica media 1) Elastic Fibers Elasticity 2) Smooth Muscle Contractility a) Sympathetic Nervous System 3) Collagen Fibers Strength c. Tunica intima (interna) 1) Endothelium 2) Internal Elastic Membrane in arteries only

2 2. Histological Differences in Vessels a. Arteries 1) Elastic Arteries 2) Muscular Arteries b. Arterioles c. Capillaries d. Venules e. Veins 1) Valves 2) Skeletal muscle pump 3) Pressure changes from breathing 3. Lumen 4. Clinical Application: Arteriosclerosis a. Focal Calcification Calcium in Tunica media b. Atherosclerosis Lipid deposits in Tunica media 1) Atherosclerotic Plaque c. Balloon Angioplasty d. Stent

3 B. Arteries of the Head, Neck, and Upper Limb 1. Aorta a. Ascending Aorta 1) Right & Left Coronary Arteries Cardiac Circulation b. Aortic Arch c. Descending Aorta 1) Thoracic Aorta a) Intercostal Arteries Paired b) Superior Phrenic Arteries Paired c) Bronchials Multiple, Unpaired d) Pericardials Multiple, Unpaired e) Esophageals Multiple, Unpaired f) Mediastinals Multiple, Unpaired 2) Abdominal Aorta more later 2. Branches of the Aortic Arch a. Brachiocephalic Trunk (Innominate Artery) 1) Right Common Carotid Artery Right Side of Head 2) Right Subclavian Artery Right Arm a) Right Vertebral Artery b. Left Common Carotid Artery * Left Side of Head c. Left Subclavian Artery Left Arm 1) Left Vertebral Artery

4 3. Branches of the Subclavian Arteries Symmetrical a. Axillary Artery b. Brachial Artery 1) Radial Artery 2) Ulnar Artery 3) Superficial Palmar Arch Arterial Anastomoses connects Radial & Ulnar Arteries 4) Deep Palmar Arch Arterial Anastomoses connects Radial & Ulnar Arteries a) Digital Arteries branch from Superficial & Deep Palmar Arches 4. Branches of the Common Carotid Arteries Symmetrical a. External Carotid Artery 1) Facial Artery 2) Maxillary Artery 3) Superficial Temporal Artery b. Right Internal Carotid Artery 1) Carotid Sinus Baroreceptor for blood pressure 2) Ophthalmic Artery 3) Anterior Cerebral Artery part of the Cerebral Arterial Circle (Circle of Willis) 4) Middle Cerebral Artery

5 5. Cerebral Arterial Circle (Circle of Willis) - Anastomose a. Basilar Artery Forms from Right & Left Vertebral Artery Fusion 1) Branches into a) Right & Left Posterior Cerebral Arteries b) Right & Left Posterior Communicating Arteries joins back of the circle with front of the circle b. Right & Left Anterior Cerebral Arteries 1) Joined by a) Anterior Communicating Artery forms front of the circle

6 C. Arteries of the Abdominopelvic Cavity and Lower Limb 1. Abdominal Aorta a. Three Branches of the Celiac Trunk Unpaired 1) Common Hepatic Artery Branch to a) Hepatic Artery Proper b) Gastroduodenal Artery c) Cystic Artery d) Right Gastric Artery e) Right Gastroepiploic Artery f) Superior Pancreaticoduodenal Artery 2) Left Gastric Artery 3) Splenic Artery a) Left Gastroepiploic Artery b) Pancreatic Artery

7 b. Mesenteric Arteries Unpaired 1) Superior Mesenteric Artery a) Inferior Pancreaticoduodenal Artery b) Middle Colic Artery c) Right Colic Artery d) Ileocolic Artery e) Intestinal Arteries 2) Inferior Mesenteric Artery a) Left Colic Artery b) Sigmoid Artery c) Rectal Artery

8 c. Major Paired Abdominal Arteries (Right & Left) 1) Inferior Phrenic Arteries 2) Adrenal (Suprarenal) Arteries 3) Renal Arteries 4) Gonadal Arteries (Please Note: this is a general not a specific name) a) Testicular Artery (Specific name) b) Ovarian Artery (Specific name) 5) Lumbar Arteries Segmental

9 d. Branches of the Common Iliac Arteries* Supply Pelvis and Lower Limb Symmetrical 1) External Iliac Arteries (Right and Left) a) Femoral Arteries 1] Deep Femoral Arteries Branch a] Medial Femoral Circumflex b] Lateral Femoral Circumflex 2] Popliteal Arteries a] Anterior Tibial Arteries 1} Dorsalis pedis 2} Dorsal Arch b] Posterior Tibial Arteries 1} Fibular (Peroneal) a} Medial Plantar Arch b} Lateral Plantar Arch c] Arterial Anastomoses connects arches with Tibial & Fibular Arteries 2) Internal Iliac Arteries (Right and Left) a) Superior Gluteal Arteries b) Internal Pudendal Arteries c) Obturator Arteries d) Lateral Sacral Arteries

10 D. Veins of the Head, Neck, and Upper Limbs 1. Jugular Veins Drain the Head into Brachiocephalic Veins which join to form the Superior Vena Cava a. Internal Jugular Veins (Right and Left) 1) Superior Sagittal Sinus 2) Transverse Sinus 3) Sigmoid Sinus b. External Jugular Veins (Right and Left) Superficial 1) Join Subclavian Veins (Right and Left) c. Joining the Brachiocephalic Veins (Right and Left) 1) Vertebral Veins (Right and Left) 2) Internal Thoracic Vein (Unpaired) drains into the Left Brachiocephalic Vein

11 2. Veins that Drain the Upper Limb into Subclavian Veins a. Axillary Veins (Right and Left) 1) Brachial Veins a) Radial Veins b) Ulnar Veins c) Palmar Venous Arches drain into radial and ulnar veins and into superficial veins 1] Digital Veins 2) Basilic Veins superficial medial side b. Cephalic Veins superficial lateral side 1) Median Cubital Veins Connects to Basilic Veins Venous Anastomoses 2) Median Antebrachial Veins network may also drain into Basilic Veins

12 E. Veins of the Abdominopelvic Cavity and Lower Limb Empty into the Inferior Vena Cava 1. Veins of the Abdomen a. Lumbar Veins b. Gonadal Veins Right, drains into Inferior Vena Cava 1) Testicular Veins a) Left Drains into Left Renal Vein 2) Ovarian Veins a) Left Drains into Left Renal Vein c. Renal Veins (Right and Left) d. Adrenal (Suprarenal) Veins Right drains into Inferior Vena Cava 1) Left Drains into Left Renal Vein e. Hepatic Veins (Right and Left) f. Phrenic Veins (Right and Left)

13 2. Hepatic Portal Vein (System) Special Circulation a. Superior Mesenteric Vein 1) Pancreaticoduodenal Vein 2) Middle Colic Vein 3) Right Colic Vein 4) Ileocolic Vein 5) Intestinal Vein b. Splenic Vein 1) Left Gastroepiploic Vein 2) Right Gastroepiploic Vein 3) Pancreatic Vein c. Inferior Mesenteric Vein 1) Left Colic Vein 2) Sigmoid Vein 3) Superior Rectal Vein d. Also Joining 1) Right & Left Gastric Veins

14 3. Veins of the Lower Limb Common Iliac Veins (Right and Left) a. Internal Iliac Veins 1) Superior Gluteal Veins 2) Internal Pudendal Veins 3) Obturator Veins 4) Lateral Sacral Veins b. External Iliac Veins 1) Femoral Veins a) Deep Femoral Veins 2) Popliteal Veins a) Anterior Tibial Veins b) Posterior Tibial Veins 1] Plantar Venous Arch c) Fibular (Peroneal) Veins d) Venous Anastomoses interconnect Tibial and Fibular Veins & superficial e) Small Saphenous Veins superficial 3) Great Saphenous Veins medial superficial a) Dorsal Venous Arch connects to Small Saphenous Vein

15 F. Fetal Circulation 1. Placenta a. Umbilical Vein (Ligamentum teres or Round Ligament) Carries Oxygenated Blood 1) Ductus venosus (Ligamentum venosum) a) From Liver to Inferior Vena Cava 2) Foramen ovale (Fossa ovalis) 3) Ductus arteriosus (Ligamentum arteriosum) b. Umbilical Arteries (Medial Umbilical Ligaments) Carry Deoxygenated Blood

16 G. Special Circulations 1. Pulmonary Circulation a. Pulmonary Trunk 1) Pulmonary Arteries Carry Deoxygenated Blood a) Lobar Arteries (3 Right & 2 Left) 1] Pulmonary Capillaries b. Bronchial Arteries Not Part of Pulmonary Circulation Provide Lung Tissue Itself with Blood c. Pulmonary Veins Carry Oxygenated Blood 1) Usually 2 Right & 2 Left (3 5 Vessels) 2. Azygous System Drains into Superior Vena Cava a. Azygous Vein drains Right Intercostal Veins 1) Hemiazygos Vein Continuation of Left Ascending Lumbar Vein drains lower Left Intercostals Vein 2) Accessory Hemiazygous Vein Drains upper Left Intercostal Veins