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PowerPoint® Lecture Slides prepared by Janice Meeking, Mount Royal College
C H A P T E R 18
The Cardiovascular System: Blood Vessels: Part B
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MAJOR BLOOD VESSELS
Pulmonary and Systemic Circulations
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Circulatory Pathways
1. Pulmonary circulation
• Loop from heart to lungs
2. Systemic circulation
• Long loop from heart to body
• Arteries: away from heart
• Veins: towards heart
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Arteries vs Veins
Arteries
• Arteries run deep
• Distinct pathways
Veins
• Veins can be superficial
• Interconnected pathways
• Brain & digestive systems
• Unique venous drainage
• O2 rich blood shown in red
• O2 poor blood shown in blue
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PULMONARY CIRCULATION
“Lungs”
Arteries low in oxygen
Veins high in oxygen
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Pulmonary Circulation
• Exits the R.V. into the pulmonary trunk
• Pulmonary trunk branches:
• R. pulmonary artery
• L. pulmonary artery
• Pulm. arteries branch into lobar arteries
• Lobar arteries form arterioles then pulmonary capillaries
• Air exchange in the capillaries
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Pulmonary Circulation
• From air sacs, pulm. capillaries form venules
• Venules form two pulmonary veins
• R. pulmonary veins (2x)
• L. pulmonary veins (2x)
• The four veins empty into Left atrium
Copyright © 2011 Pearson Education, Inc. Figure 18.19a
R. pulmon-ary veins (2x)
Pulmonarytrunk
Pulmonary capillariesof the R. lung
Pulmonary capillariesof the L. lung
R. pulmonaryartery
L. pulmonaryartery
Tosystemic circulation
L. pulmonaryVeins (2x)
(a) Schematic flowchart.
Fromsystemiccirculation
RA
RV LV
LA
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SYSTEMIC CIRCULATION
Blood flow to major organs and regions of the body
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Naming Major Arteries
1. Body region
2. Organ served
3. Bone followed
• Veins often take name of artery
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The Aorta
• Receives blood directly from left ventricle
• Largest artery
Four regions
1. Ascending aorta
2. Aortic arch
3. Thoracic aorta
4. Abdominal aorta
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Ascending Aorta
• Supplies myocardium
• R. & L. coronary arteries
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Aortic Arch
Three branches
1. Brachiocephalic trunk
• R. common carotid (same branching as L.)
• R. subclavian artery (same branching as L.)
2. L. common carotid
• Internal carotid - brain
• External carotid – head & neck
3. L. subclavian artery
• Vertebral – posterior brain
• Axillary - arm
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Circle of Willis
• Blood supply to the brain is important
• Circle of Willis provides possible alternative circulation
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Arteries of the Upper Limbs and Thorax
Subclavian arteries form:
•Axillary Artery
• Thoracic branches
• Brachial artery (branches at elbow)
• Radial artery – follows radius
• Ulnar artery – follow ulna
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Thoracic Aorta
• Visceral branch - supplies organs of the thorax (above the diaphragm)
• Esophagus
• Lungs
• Pericardium
• Parietal branch supplies thoracic:
• Muscles
• Bones
• Nerves
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Abdominal AortaServes abdominal organs and lower limbs
•Celiac trunk
• Hepatic - liver
• Gastric - stomach
• Splenic - spleen
•Superior mesenteric artery (largest branch of a.a.)
• Small intestine & ½ of large intestine
•Renal arteries – kidneys
•Gonadal arteries – gonads (ovaries or testies)
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Abdominal Aorta
In the pelvis the aorta splits
•Common iliac arteries
• Internal iliac artery – glutes and adductors
• External iliac artery – anterior abdomen and legs
•External iliac becomes the femoral artery
• At the knee the femoral artery becomes the popliteal artery
• Popliteal splits into
• Anterior tibial artery – leg & foot
• Posterior tibial artery – leg & foot
Copyright © 2011 Pearson Education, Inc. Figure 18.21a
R. externalcarotid artery
R. internalcarotid artery
R. common carotid– right side of head and neck
L. externalcarotid artery
L. internalcarotid artery
L. common carotid– left side of head and neck
R. vertebral L. vertebral
R. axillary
Arteries ofR. upperlimb
Mediastinal– posterior media- stinum
Esophageal– esophagus
Pericardial– pericardium
Bronchial– lungs and bronchi
Gonadal– testes or ovaries
Suprarenal– adrenal glands and Renal– kidneys
Celiac trunk– liver– gallbladder– spleen– stomach– esophagus– duodenum
Superiorand inferiormesenterics– small intestine– colon
Brachiocephalic– head, neck, and R. upper limb
Posterior intercostals– intercostal muscles, spinal cord, vertebrae, pleurae, skin
Inferior phrenics– inferior diaphragm
Lumbars– posterior abdominal wall
Median sacral– sacrum– coccyx
Superior phrenics– posterior and superior diaphragm
R. subclavian– neck and R. upper limb
L. and R. coronaryarteries
L. subclavian– neck and L. upper limb
L. ventricle of heart
Thoracic aorta T5 – T12 (diaphragm)
Abdominal aorta T12 (diaphragm) – L4
Ascending aorta– L. ventricle to sternal angle
L. axillary
R. common iliac– pelvis and R. lower limb
Arteries of R. lower limb (a) Schematic flowchart
L. common iliac– pelvis and L. lower limb
Arteries of L. lower limb
Arteries ofL. upperlimb
Diaphragm
Visceral branches Parietal branches
Visceral branches Parietal branches
Aortic arch
Copyright © 2011 Pearson Education, Inc. Figure 18.21b
Internal carotid artery
Common carotid arteries
Subclavian artery
Subclavian artery
Aortic archAscending aortaCoronary arteryThoracic aorta (abovediaphragm)
Renal artery
Superficial palmar arch
Radial arteryUlnar artery
Internal iliac artery
Deep palmar arch
Vertebral artery
Brachiocephalic trunk
Axillary artery
Brachial artery
Abdominal aortaSuperior mesenteric artery
Gonadal arteryCommon iliac artery
External iliac artery
Digital arteries
Femoral arteryPopliteal arteryAnterior tibial arteryPosterior tibial artery
Arcuate artery(b) Illustration, anterior view
Inferior mesenteric artery
Celiac trunk
External carotid artery
Arteries of the head and trunk
Arteries that supply the upper limb
Arteries that supply the lower limb
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SYSTEMIC VEINS
Inferior and superior vena cavas
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Systemic Veins
All veins drain into the vena cava’s
•Superior vena cava
• Drains head and upper limbs
•Inferior vena cava
• Drains lower body
•Both empty into right atrium
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Veins of Lower Limb
Drain into inferior vena cava
•Anterior / posterior tibial veins
• Drain plantar regions
•Tibial veins join to form the poplietal vein
•Poplietal vein becomes the femoral vein
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Veins Draining into the Inferior Vena Cava
Veins of lower limb
•Great saphenous vein
• Longest vein / superficial medial thigh
• Dorsal venous arch femoral vein
•Femoral vein forms the external iliac vein
•External combines with internal iliac (drains
pelvis) to form the common iliac veins
Copyright © 2011 Pearson Education, Inc. Figure 18.30b
Popliteal vein
Common iliac vein
Fibular veinAnterior tibial vein
Dorsalis pedis veinDorsal venous arch
Dorsal metatarsalveins
(b) Anterior view
Internal iliac veinExternal iliac veinInguinal ligament
Femoral veinGreat saphenousvein (superficial)
Small saphenousvein
Veins Draining into the Inferior Vena Cava
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Inferior Vena Cava
• The R & L common iliac veins combine to form the inferior vena cava
• Inferior vena cava also drains abdominal organs
• Hepatic veins – liver
• Hepatic portal vein – drains digestive organs into hepatic circulation
• Renal veins – kidneys
• Gonadal veins – reproductive glands
Copyright © 2011 Pearson Education, Inc. Figure 18.29b
(b) Tributaries of the inferior vena cava. Venous drainage of abdominal organs not drained by the hepatic portal vein.
Hepatic veins
Left suprarenalvein
Left ascendinglumbar vein
Lumbar veins
Left gonadal vein
Common iliacveinInternal iliac vein
Renal veins
Inferior vena cava
Right suprarenalvein
Right gonadalvein
External iliacvein
Inferior phrenicvein
Hepatic portal veinInferior Vena Cava
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Superior Vena Cava - Head
• Drains the head, neck, thorax and upper limb
Head
• Jugular veins
• Internal jugular vein - brain
• External jugular vein – face and neck
• Empty into brachiocephalic veins
• Right & left (two)…unlike arteries
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Superior Vena Cava – Upper limb
• Subclavian vein empties into brachiocephalic
• Formed by two veins
1. Cephalic – drains lateral arm
2. Axillary
• Basilic
• Brachial
• Radial
• Ulnar
• Median cubital connects cephalic and basilic
• Anterior elbow
Copyright © 2011 Pearson Education, Inc. Figure 18.26a
R. externaljugular– superficial head and neck
R. vertebral– cervical spinal cord and vertebrae
R. brachiocephalic– R. side of head and R. upper limb
Superior vena cava– runs from union of brachiocephalic veins behind manubrium to R. atrium
Inferior vena cava– runs from junction of common iliac veins at L5 to R. atrium of heart
R. atrium of heart
L. brachiocephalic– L. side of head and L. upper limb
Intracranialdural venous sinuses
R. internal jugular– dural venous sinuses of the brainR. subclavian
– R. head, neck, and upper limb
Same as R. brachiocephalicR. axillary
Azygos system– drains much of thorax
L., R., and middlehepatic veins– liver
Veins ofL. lower limb
(a) Schematic flowchart
L. and R. renal veins– kidneys
Lumbar veins(several pairs)– posterior abdominal wall
R. suprarenal(L. suprarenal drainsinto L. renal vein)– adrenal glands
R. gonadal(L. gonadal drainsinto L. renal vein)– testis or ovary
Veins ofR. lower limb
Veins ofR. upperlimb
R. common iliac– pelvis and R. lower limb
L. common iliac– pelvis and L. lower limb
Diaphragm
Copyright © 2011 Pearson Education, Inc. Figure 18.26b
Renal vein
Splenic vein
Basilic vein
Brachial vein
Cephalic vein
Dural venous sinuses
External jugular vein
Vertebral vein
Internal jugular vein
Superior vena cava
Right and leftbrachiocephalic veins
Axillary vein
Great cardiac vein
Hepatic veins
Hepatic portal vein
Superior mesentericveinInferior vena cava
Ulnar vein
Radial vein
Common iliac vein
External iliac vein
Internal iliac vein
Digital veins
Femoral vein
Great saphenous vein
Popliteal vein
Posterior tibial vein
Anterior tibial vein
Small saphenous vein
Dorsal venous arch
(b) Illustration, anterior view. The vessels of the pulmonary circulation are not shown. Dorsal metatarsal veins
Inferior mesenteric vein
Median cubital vein
Subclavian vein
Veins of the head and trunk Veins that drainthe upper limb
Veins that drainthe lower limb
Copyright © 2011 Pearson Education, Inc. Figure 18.27b
(b) Veins of the head and neck, right superficial aspect
Vertebral vein
Ophthalmic vein
Externaljugular vein
Superficial temporalvein
Facial veinOccipital vein
Posteriorauricular vein
Internal jugularvein
Superior and middlethyroid veins
Brachiocephalicvein
Subclavian vein
Superiorvena cava
Copyright © 2011 Pearson Education, Inc. Figure 18.28a
Axillaryvein
Subclavianvein
Externaljugular vein
Internaljugular vein
Brachiocephalicveins
Superiorvena cava
Accessoryhemiazygosvein
Brachialvein
Mediancubitalvein
Hemiazygosvein
Right and leftposterior intercostalveins
Azygosvein
Ulnarvein
Radialvein
Deep palmarvenous arch
Metacarpal veins
Superficialpalmar venous archDigital veins
Basilicvein
Cephalicvein
Medianantebrachialvein
(a) Schematic flowchart
Copyright © 2011 Pearson Education, Inc. Figure 18.28b
Right subclavian veinBrachiocephalic veins
Axillary veinBrachial veinCephalic veinBasilic vein
Median cubital vein
Median antebrachialvein
Basilic vein
Internal jugular veinExternal jugular veinLeft subclavian veinSuperior vena cavaAzygos vein
Inferior vena cavaAscending lumbar vein
Accessory hemiazygosveinHemiazygos veinPosterior intercostals
Ulnar veinDeep palmar venous arch
Superficial palmar venous arch
Digital veins
Cephalic vein
Radial vein
(b) Anterior view
Copyright © 2011 Pearson Education, Inc. Figure 18.30a
Smallsaphenousvein
Fibular(peroneal)vein
Dorsalvenous arch
Dorsalmetatarsalveins
(a) Schematic flowchart of the anterior and posterior veinsAnterior Posterior
Inferiorvena cava
Femoral vein
External iliac vein
Femoral vein
Small saphenousvein
Fibular (peroneal)vein
Plantar veins
Deep plantar arch
Digital veins
Greatsaphenous
veinPopliteal
vein
Anteriortibial vein
Posteriortibial vein
Dorsalispedisvein
Common iliac vein
Internaliliac vein
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VITAL SIGNS
blood pressure
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Monitoring Circulatory Efficiency
• Vital signs:
• Pulse
• Blood pressure
• Respiratory rate
• Body temperature
• Pulse: pressure wave caused blood flow through arteries
• Beats / minute
• Radial pulse (taken at the wrist)
Copyright © 2011 Pearson Education, Inc. Figure 18.12
Common carotidartery
Brachial artery
Radial artery
Femoral artery
Popliteal artery
Posterior tibialartery
Dorsalis pedisartery
Superficial temporalartery
Facial artery
Pulse points
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Measuring Blood Pressure
• Systemic arterial BP
• Measured indirectly by the auscultatory method using a sphygmomanometer (pressure cuff) and stethoscope
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Measuring Blood Pressure1. Pressure is increased until no sounds are heard
• Sounds of Korotkoff
1. Pressure released slowly until first sounds heard = systolic pressure
2. When sounds disappear, blood is free flowing = diastolic pressure
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Alterations in Blood Pressure
• Hypotension: low blood pressure
• Systolic pressure <100 mm Hg
• Often associated with long life and lack of cardiovascular illness
• Hypertension: high blood pressure
• Pressure > 140/90
• May lead to heart failure, vascular disease, renal failure, and stroke
• Risk factors include: heredity, diet, obesity, age, stress, diabetes mellitus, and smoking