Chapter 22 The Cardiovascular System Vessels and Circulation

Chapter 22 The Cardiovascular System Vessels and Circulation

Chapter 22 The Cardiovascular System Vessels and Circulation Lecture Presentation by Steven Bassett Southeast Community College 2015 Pearson Education, Inc. 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 2015 Pearson Education, Inc. 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 2015 Pearson Education, Inc. 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 2015 Pearson Education, Inc. Figure 22.1 The Structure of Blood Vessels (4 of 8) Histological Comparison of Arteries and Veins Adventitia AV bundle Adventitia Media Intima Media Lumen of vein Intima Smooth muscle The internal elastic membrane is a network of elastic fibers located between the intima and the media. The media is separated from the adventitia by the external

elastic membrane, a band of elastic tissue. Smooth muscle Lumen of artery Endothelium Endothelium Elastic fiber ARTERY 2015 Pearson Education, Inc. Artery and Vein LM 60 VEIN 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 2015 Pearson Education, Inc.

Figure 22.1 The Structure of Blood Vessels (2 of 8) Structural Differences between Arteries and Veins VEINS ARTERIES Start 7 Large Vein Elastic Artery Large veins include the superior and inferior venae cavae (also termed the great veins) and their tributaries within the abdominopelvic and thoracic cavities. 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 Internal elastic layer Media Intima Endothelium

Endothelium Media Intima Adventitia 6 Medium-Sized Vein Muscular Artery 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. 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 Adventitia Media Media Endothelium Endothelium Intima

Intima 5 Venule Arteriole 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. 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 Adventitia Endothelium Endothelium Basal lamina 4 Fenestrated capillaries are

capillaries that contain windows, or pores in their walls, due to an incomplete or perforated endothelial lining. 2015 Pearson Education, Inc. 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. Histological Organization of Blood Vessels Arteries As blood leaves the heart, it travels through: Elastic arteries Muscular arteries Arterioles 2015 Pearson Education, Inc. 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 2015 Pearson Education, Inc. Figure 22.1 The Structure of Blood Vessels (2 of 8) Structural Differences between Arteries and Veins VEINS ARTERIES Start 7 Large Vein Elastic Artery Large veins include the superior and inferior venae cavae (also termed the great veins) and their tributaries within the abdominopelvic and thoracic cavities.

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 Internal elastic layer Media Intima Endothelium Endothelium Media Intima Adventitia 6 Medium-Sized Vein Muscular Artery 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.

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 Adventitia Media Media Endothelium Endothelium Intima Intima 5 Venule Arteriole 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.

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 Adventitia Endothelium Endothelium Basal lamina 4 Fenestrated capillaries are capillaries that contain windows, or pores in their walls, due to an incomplete or perforated endothelial lining. 2015 Pearson Education, Inc. 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. 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 2015 Pearson Education, Inc. Figure 22.1 The Structure of Blood Vessels (2 of 8) Structural Differences between Arteries and Veins VEINS ARTERIES Start 7 Large Vein

Elastic Artery Large veins include the superior and inferior venae cavae (also termed the great veins) and their tributaries within the abdominopelvic and thoracic cavities. 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 Internal elastic layer Media Intima Endothelium Endothelium Media Intima Adventitia 6 Medium-Sized Vein

Muscular Artery 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. 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 Adventitia Media Media Endothelium Endothelium Intima Intima 5 Venule Arteriole 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. 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 Adventitia Endothelium Endothelium Basal lamina 4 Fenestrated capillaries are capillaries that contain windows, or pores in their walls, due to an incomplete or perforated endothelial lining. 2015 Pearson Education, Inc. 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. Histological Organization of Blood Vessels Arterioles Small arteries around 30 microns in diameter Poorly defined adventitia Control blood flow between arteries and capillaries 2015 Pearson Education, Inc. Figure 22.1 The Structure of Blood Vessels (2 of 8) Structural Differences between Arteries and Veins VEINS ARTERIES Start 7 Large Vein Elastic Artery

Large veins include the superior and inferior venae cavae (also termed the great veins) and their tributaries within the abdominopelvic and thoracic cavities. 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 Internal elastic layer Media Intima Endothelium Endothelium Media Intima Adventitia 6 Medium-Sized Vein Muscular Artery

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. 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 Adventitia Media Media Endothelium Endothelium Intima Intima 5 Venule Arteriole 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. 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 Adventitia Endothelium Endothelium Basal lamina 4 Fenestrated capillaries are capillaries that contain windows, or pores in their walls, due to an incomplete or perforated endothelial lining. 2015 Pearson Education, Inc. 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. 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 2015 Pearson Education, Inc. 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 2015 Pearson Education, Inc.

Figure 22.2ab Structure of Capillaries and Sinusoids Basal lamina Endothelial cell Nucleus Endosomes Fenestrations, or pores Endosomes Basal lamina Boundary between endothelial cells a This diagrammatic view of a continuous capillary shows the structure of its wall. 2015 Pearson Education, Inc. Boundary between endothelial cells Basal lamina b This diagrammatic view of a fenestrated capillary details the structure of the wall. 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 2015 Pearson Education, Inc. 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 2015 Pearson Education, Inc. Figure 22.3a Organization of a Capillary Bed Vein Smooth muscle cells Collateral arteries Venule Arteriole Metarterioles Thoroughfare channel Capillaries

Section of precapillary sphincter Small venule Precapillary sphincters Arteriovenous anastomosis a 2015 Pearson Education, Inc. 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 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 2015 Pearson Education, Inc.

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 2015 Pearson Education, Inc. Figure 22.3a Organization of a Capillary Bed Vein Smooth muscle cells Collateral arteries Venule Arteriole Metarterioles Thoroughfare channel Capillaries Section of precapillary sphincter Small venule Precapillary sphincters Arteriovenous

anastomosis a 2015 Pearson Education, Inc. 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 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 2015 Pearson Education, Inc. Histological Organization of Blood Vessels Venules Smallest of the veins

Collect blood from the capillaries Lack or have thin tunica media 2015 Pearson Education, Inc. Figure 22.1 The Structure of Blood Vessels (2 of 8) Structural Differences between Arteries and Veins VEINS ARTERIES Start 7 Large Vein Elastic Artery Large veins include the superior and inferior venae cavae (also termed the great veins) and their tributaries within the abdominopelvic and thoracic cavities. 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 Internal elastic layer

Media Intima Endothelium Endothelium Media Intima Adventitia 6 Medium-Sized Vein Muscular Artery 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. 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 Adventitia Media Media

Endothelium Endothelium Intima Intima 5 Venule Arteriole 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. 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 Adventitia Endothelium Endothelium

Basal lamina 4 Fenestrated capillaries are capillaries that contain windows, or pores in their walls, due to an incomplete or perforated endothelial lining. 2015 Pearson Education, Inc. 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. Histological Organization of Blood Vessels Medium-Sized Veins The adventitia (tunica externa) is the largest of the layers Contains elastic fibers

2015 Pearson Education, Inc. Figure 22.1 The Structure of Blood Vessels (2 of 8) Structural Differences between Arteries and Veins VEINS ARTERIES Start 7 Large Vein Elastic Artery Large veins include the superior and inferior venae cavae (also termed the great veins) and their tributaries within the abdominopelvic and thoracic cavities. 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 Internal elastic layer Media

Intima Endothelium Endothelium Media Intima Adventitia 6 Medium-Sized Vein Muscular Artery 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. 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 Adventitia Media Media Endothelium

Endothelium Intima Intima 5 Venule Arteriole 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. 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 Adventitia Endothelium Endothelium Basal lamina

4 Fenestrated capillaries are capillaries that contain windows, or pores in their walls, due to an incomplete or perforated endothelial lining. 2015 Pearson Education, Inc. 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. Histological Organization of Blood Vessels Large Veins All three layers are relatively thick Examples of large veins are: Superior vena cava Inferior vena cava

2015 Pearson Education, Inc. Figure 22.1 The Structure of Blood Vessels (2 of 8) Structural Differences between Arteries and Veins VEINS ARTERIES Start 7 Large Vein Elastic Artery Large veins include the superior and inferior venae cavae (also termed the great veins) and their tributaries within the abdominopelvic and thoracic cavities. 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 Internal elastic layer Media Intima

Endothelium Endothelium Media Intima Adventitia 6 Medium-Sized Vein Muscular Artery 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. 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 Adventitia Media Media Endothelium

Endothelium Intima Intima 5 Venule Arteriole 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. 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 Adventitia Endothelium Endothelium Basal lamina

4 Fenestrated capillaries are capillaries that contain windows, or pores in their walls, due to an incomplete or perforated endothelial lining. 2015 Pearson Education, Inc. 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. 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 2015 Pearson Education, Inc. Figure 22.4 Function of Valves in the Venous System Valve closed Valve opens above contracting muscle Valve closed Valve closes below contracting muscle 2015 Pearson Education, Inc. 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 2015 Pearson Education, Inc. The Distribution of Blood The total blood volume is distributed unevenly within the vessels of the body Arteries and capillaries contain 3035 percent of the volume Veins contain 6570 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 2015 Pearson Education, Inc. Figure 22.5 The Distribution of Blood in the Cardiovascular System te rie s 3% Large veins 18% Large venous networks (liver, bone marrow, skin) 21% a lm lmon u u P P Heart 7% mi ste Sy s le rio te Ar

Aorta 2% Elas tic a Mu rter ies sc 4% ul ar ar ter ies 7% 2015 Pearson Education, Inc. 2% ies llar api cc Venules and medium-sized veins 25% Pu lm on ar y

ar 2% s e i r lla pi a % c s4 ry ein v a ry on 5% 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 2015 Pearson Education, Inc. 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 2015 Pearson Education, Inc. 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 2015 Pearson Education, Inc. 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 2015 Pearson Education, Inc. Figure 22.6 An Overview of the General Pattern of Circulation

Brain Upper limbs Pulmonary circuit (arteries) Pulmonary circuit (veins) Lungs LA RA Systemic circuit (veins) Left ventricle Right ventricle Systemic circuit (arteries) Kidneys Spleen Liver Digestive organs Gonads

Lower limbs 2015 Pearson Education, Inc. Figure 22.7a The Pulmonary Circuit Trachea Ascending aorta Aortic arch Pulmonary trunk Superior vena cava Left lung Right lung Left pulmonary arteries Right pulmonary arteries Left pulmonary veins Right pulmonary veins Alveolus Capillary Inferior vena cava Descending aorta 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. 2015 Pearson Education, Inc.

O2 CO2 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 2015 Pearson Education, Inc. Figure 22.6 An Overview of the General Pattern of Circulation Brain Upper limbs Pulmonary circuit (arteries) Pulmonary circuit (veins) Lungs LA RA Systemic circuit (veins)

Left ventricle Right ventricle Systemic circuit (arteries) Kidneys Spleen Liver Digestive organs Gonads Lower limbs 2015 Pearson Education, Inc. 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 2015 Pearson Education, Inc. Figure 22.8 An Overview of the Systemic Arterial System Vertebral

Brachiocephalic trunk Right subclavian Aortic arch Right common carotid Left common carotid Left subclavian Axillary Pulmonary trunk Ascending aorta Descending aorta Diaphragm Celiac trunk Renal Brachial Superior mesenteric Gonadal Inferior mesenteric Radial Common iliac Ulnar Internal iliac Palmar arches External

iliac Popliteal Deep femoral Femoral Descending genicular Posterior tibial Anterior tibial Fibular Dorsalis pedis Plantar arch 2015 Pearson Education, Inc. 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 2015 Pearson Education, Inc. 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 2015 Pearson Education, Inc. Figure 22.9 Aortic Angiogram Right common carotid artery Thyrocervical trunk Right subclavian artery Brachiocephalic trunk Internal thoracic artery Ascending aorta 2015 Pearson Education, Inc. Left common carotid artery Left subclavian artery Aortic arch Descending aorta 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 2015 Pearson Education, Inc. Figure 22.19a Major Veins of the Head and Neck Superior sagittal sinus Inferior sagittal sinus Superficial cerebral veins Temporal Great cerebral Deep cerebral Straight sinus Cavernous sinus Maxillary Petrosal sinuses Right

transverse sinus Facial Occipital sinus Sigmoid sinus Occipital Vertebral External jugular Internal jugular Right subclavian Clavicle Right brachiocephalic Axillary Left brachiocephalic Firs t rib a An oblique lateral view of the head and neck showing the major superficial and deep veins. 2015 Pearson Education, Inc. Superior vena cava Internal thoracic 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 2015 Pearson Education, Inc. 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 22.12 Left subclavian Brachiocephalic trunk Right subclavian Right Right internal thoracic Left common carotid

thyrocervical trunk Right Right common vertebral carotid Left common carotid Aortic arch Thoracoacromial Left subclavian Right axillary Ascending aorta Lateral thoracic Anterior humeral circumflex Posterior humeral circumflex Thoracic aorta Subscapular Left ventricle Deep brachial Intercostals Right brachial Abdominal aorta

Superior ulnar collateral Inferior ulnar collateral Right radial Right ulnar Anterior ulnar recurrent Posterior ulnar recurrent Anterior interosseous Deep palmar arch Superficial palmar arch Digital arteries 2015 Pearson Education, Inc. 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 Clavicle (cut and removed)

Axillary artery Medial trunk of brachial plexus Right subclavian artery Deep brachial artery Subscapular artery Brachial artery Pectoralis major muscle (cut and reflected) Biceps brachii muscle Serratus anterior muscle Median nerve Brachial artery Biceps brachii muscle Brachial artery Inferior ulnar collateral artery Brachioradialis muscle Ulnar artery

Flexor carpi radialis muscle Radial artery Ulnar artery c 2015 Pearson Education, Inc. Anterior view of the right forearm dissected to show the main arteries Superficial palmar arch 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 2015 Pearson Education, Inc. Figure 22.12a Arteries of the Neck and Head Superficial temporal Anterior cerebral Cerebral arterial circle Carotid canal Middle cerebral Ophthalmic

Posterior cerebral Maxillary Basilar Occipital Facial Lingual Internal carotid External carotid Vertebral Carotid sinus Inferior thyroid Thyrocervical trunk Common carotid Transverse cervical Suprascapular Subclavian Axillary Internal thoracic Second rib a Clav ic Firs t

le Brachiocephalic trunk r ib General circulation pattern of arteries supplying the neck and superficial structures of the head; this is an oblique lateral view from the right side. 2015 Pearson Education, Inc. Systemic Arteries The Internal and External Carotid Arteries External carotids Supply the neck and outside of the skull Branches to form: 2015 Pearson Education, Inc. Lingual artery Facial artery Occipital artery Superficial temporal artery Figure 22.12a Arteries of the Neck and Head Superficial temporal Anterior cerebral Cerebral arterial circle Carotid canal Middle cerebral

Ophthalmic Posterior cerebral Maxillary Basilar Occipital Facial Lingual Internal carotid External carotid Vertebral Carotid sinus Inferior thyroid Thyrocervical trunk Common carotid Transverse cervical Suprascapular Subclavian Axillary Internal thoracic Second rib a Clav ic Firs t

le Brachiocephalic trunk r ib General circulation pattern of arteries supplying the neck and superficial structures of the head; this is an oblique lateral view from the right side. 2015 Pearson Education, Inc. 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) 2015 Pearson Education, Inc. 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) 2015 Pearson Education, Inc.

Figure 22.19a Major Veins of the Head and Neck Superior sagittal sinus Inferior sagittal sinus Superficial cerebral veins Temporal Great cerebral Deep cerebral Straight sinus Cavernous sinus Maxillary Petrosal sinuses Right transverse sinus Facial Occipital sinus Sigmoid sinus Occipital Vertebral External jugular Internal jugular

Right subclavian Clavicle Right brachiocephalic Axillary Left brachiocephalic Firs t rib a An oblique lateral view of the head and neck showing the major superficial and deep veins. 2015 Pearson Education, Inc. Superior vena cava Internal thoracic 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. 2015 Pearson Education, Inc. Systemic Arteries The Descending Aorta A continuation of the aortic arch Divided into thoracic aorta and abdominal aorta at the diaphragm area 2015 Pearson Education, Inc. Figure 22.14 Major Arteries of the Trunk Vertebral Thyrocervical trunk Brachiocephalic trunk Aortic arch Common carotid

Left subclavian Axillary Internal thoracic Bronchial Mediastinal Esophageal Pericardial Intercostal THORACIC AORTA Superior phrenic Inferior phrenic Celiac trunk Diaphragm Left gastric Common hepatic Splenic Suprarenal Superior mesenteric Renal ABDOMINAL AORTA Lumbar

Gonadal Right common iliac External iliac Internal iliac 2015 Pearson Education, Inc. Inferior mesenteric Terminal segment of the aorta Median sacral Systemic Arteries The Thoracic Aorta Branches to form the following vessels: Bronchial arteries Pericardial arteries Mediastinal arteries Esophageal arteries Intercostal arteries Superior phrenic arteries 2015 Pearson Education, Inc. Figure 22.14 Major Arteries of the Trunk Vertebral Thyrocervical trunk Brachiocephalic trunk

Aortic arch Common carotid Left subclavian Axillary Internal thoracic Bronchial Mediastinal Esophageal Pericardial Intercostal THORACIC AORTA Superior phrenic Inferior phrenic Celiac trunk Diaphragm Left gastric Common hepatic Splenic Suprarenal Superior mesenteric Renal ABDOMINAL

AORTA Lumbar Gonadal Right common iliac External iliac Internal iliac 2015 Pearson Education, Inc. Inferior mesenteric Terminal segment of the aorta Median sacral 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

2015 Pearson Education, Inc. Figure 22.14 Major Arteries of the Trunk Vertebral Thyrocervical trunk Brachiocephalic trunk Aortic arch Common carotid Left subclavian Axillary Internal thoracic Bronchial Mediastinal Esophageal Pericardial Intercostal THORACIC AORTA Superior phrenic Inferior phrenic Celiac trunk Diaphragm Left gastric Common hepatic Splenic

Suprarenal Superior mesenteric Renal ABDOMINAL AORTA Lumbar Gonadal Right common iliac External iliac Internal iliac 2015 Pearson Education, Inc. Inferior mesenteric Terminal segment of the aorta Median sacral Systemic Arteries The Celiac Trunk Supplies the following organs: Liver Stomach

Esophagus Gallbladder Duodenum Pancreas Spleen 2015 Pearson Education, Inc. 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 2015 Pearson Education, Inc. 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 2015 Pearson Education, Inc.

Figure 22.15a Arteries of the Abdomen Inferior vena cava THORACIC AORTA Celiac trunk ABDOMINAL AORTA Liver Stomach Common hepatic Hepatic artery proper Left gastric Cystic Gastroduodenal Right gastric Splenic Spleen Right gastroepiploic Superior mesenteric Superior pancreaticoduodenal Left gastroepiploic Pancreas Pancreatic Inferior mesenteric Duodenal

Left colic Inferior pancreaticoduodenal Middle colic (cut) Sigmoid Ascending colon Left common iliac Right colic Ileocolic Intestinal Small intestine Sigmoid colon Rectal Right external iliac Right internal iliac Rectum a Major arteries supplying the abdominal viscera 2015 Pearson Education, Inc. 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 2015 Pearson Education, Inc. Figure 22.15a Arteries of the Abdomen Inferior vena cava THORACIC AORTA Celiac trunk ABDOMINAL AORTA Liver Stomach Common hepatic Hepatic artery proper Left gastric Cystic Gastroduodenal Right gastric Splenic Spleen Right gastroepiploic Superior mesenteric Superior pancreaticoduodenal Left gastroepiploic Pancreas

Pancreatic Inferior mesenteric Duodenal Left colic Inferior pancreaticoduodenal Middle colic (cut) Sigmoid Ascending colon Left common iliac Right colic Ileocolic Intestinal Small intestine Sigmoid colon Rectal Right external iliac Right internal iliac Rectum a Major arteries supplying the abdominal viscera 2015 Pearson Education, Inc. Systemic Arteries Inferior Mesenteric Artery Branches to supply Terminal portion of the large intestine Left colic artery

Sigmoid arteries Rectum Rectal arteries 2015 Pearson Education, Inc. Figure 22.15a Arteries of the Abdomen Inferior vena cava THORACIC AORTA Celiac trunk ABDOMINAL AORTA Liver Stomach Common hepatic Hepatic artery proper Left gastric Cystic Gastroduodenal Right gastric Splenic Spleen Right gastroepiploic Superior mesenteric Superior pancreaticoduodenal Left gastroepiploic Pancreas

Pancreatic Inferior mesenteric Duodenal Left colic Inferior pancreaticoduodenal Middle colic (cut) Sigmoid Ascending colon Left common iliac Right colic Ileocolic Intestinal Small intestine Sigmoid colon Rectal Right external iliac Right internal iliac Rectum a Major arteries supplying the abdominal viscera 2015 Pearson Education, Inc. Systemic Arteries Five paired arteries branch off the descending aorta

Inferior phrenic arteries Suprarenal arteries Renal arteries Gonadal arteries Lumbar arteries 2015 Pearson Education, Inc. 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 2015 Pearson Education, Inc. 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 2015 Pearson Education, Inc. Figure 22.14 Major Arteries of the Trunk

Vertebral Thyrocervical trunk Brachiocephalic trunk Aortic arch Common carotid Left subclavian Axillary Internal thoracic Bronchial Mediastinal Esophageal Pericardial Intercostal THORACIC AORTA Superior phrenic Inferior phrenic Celiac trunk Diaphragm Left gastric Common hepatic Splenic Suprarenal Superior

mesenteric Renal ABDOMINAL AORTA Lumbar Gonadal Right common iliac External iliac Internal iliac 2015 Pearson Education, Inc. Inferior mesenteric Terminal segment of the aorta Median sacral 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) 2015 Pearson Education, Inc. Figure 22.8 An Overview of the Systemic Arterial System Vertebral Brachiocephalic trunk Right subclavian

Aortic arch Right common carotid Left common carotid Left subclavian Axillary Pulmonary trunk Ascending aorta Descending aorta Diaphragm Celiac trunk Renal Brachial Superior mesenteric Gonadal Inferior mesenteric Radial Common iliac Ulnar Internal iliac Palmar arches External iliac Popliteal

Deep femoral Femoral Descending genicular Posterior tibial Anterior tibial Fibular Dorsalis pedis Plantar arch 2015 Pearson Education, Inc. 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 2015 Pearson Education, Inc. Figure 22.16a Major Arteries of the Lower Limb, Part I Iliolumbar Superior gluteal Inguinal ligament Deep femoral Common iliac Internal iliac External iliac Lateral sacral

Internal pudendal Obturator Medial femoral circumflex Lateral 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 2015 Pearson Education, Inc. Figure 22.17 Major Arteries of the Lower Limb, Part II Superior gluteal Right external iliac (see Fig. 22.15)

Femoral (see Fig. 22.16) Thigh Deep femoral (see Fig. 22.16) 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

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 2015 Pearson Education, Inc. Anterior tibial Systemic Arteries Arteries of the Foot The anterior tibial artery forms: Dorsalis pedis artery The posterior tibial artery forms: Medial and lateral plantar arteries 2015 Pearson Education, Inc. 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 2015 Pearson Education, Inc. Figure 22.7a The Pulmonary Circuit Trachea Ascending aorta Aortic arch Pulmonary trunk Superior vena cava Left lung Right lung Left pulmonary arteries Right pulmonary arteries Left pulmonary veins Right pulmonary veins Alveolus Capillary Inferior vena cava Descending aorta 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. 2015 Pearson Education, Inc. O2

CO2 Figure 22.18 An Overview of the Systemic Venous System Vertebral External jugular Subclavian Internal jugular Brachiocephalic Axillary Superior vena cava Cephalic Brachial Intercostal Basilic Inferior vena cava Hepatic Renal Gonadal Median cubital Lumbar Radial Median antebrachial Left and right common iliac

Ulnar External iliac Palmar venous arches Internal iliac Digital Deep femoral Great saphenous Femoral Popliteal Small saphenous Fibular Posterior tibial Anterior tibial KEY Dorsal venous arch Plantar venous arch 2015 Pearson Education, Inc. Superficial veins Deep veins 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 2015 Pearson Education, Inc. 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 2015 Pearson Education, Inc.

Figure 22.19a Major Veins of the Head and Neck Superior sagittal sinus Inferior sagittal sinus Superficial cerebral veins Temporal Great cerebral Deep cerebral Straight sinus Cavernous sinus Maxillary Petrosal sinuses Right transverse sinus Facial Occipital sinus Sigmoid sinus Occipital Vertebral External jugular Internal jugular Right

subclavian Clavicle Right brachiocephalic Axillary Left brachiocephalic Firs t rib a An oblique lateral view of the head and neck showing the major superficial and deep veins. 2015 Pearson Education, Inc. Superior vena cava Internal thoracic 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 2015 Pearson Education, Inc. 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. 2015 Pearson Education, Inc. 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 2015 Pearson Education, Inc. Figure 22.19a Major Veins of the Head and Neck Superior sagittal sinus Inferior sagittal sinus Superficial cerebral veins Temporal Great cerebral Deep cerebral Straight sinus Cavernous sinus Maxillary Petrosal sinuses Right transverse sinus Facial Occipital sinus Sigmoid sinus

Occipital Vertebral External jugular Internal jugular Right subclavian Clavicle Right brachiocephalic Axillary Left brachiocephalic Firs t rib a An oblique lateral view of the head and neck showing the major superficial and deep veins. 2015 Pearson Education, Inc. Superior vena cava Internal thoracic 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 2015 Pearson Education, Inc. Figure 22.20 The Venous Drainage of the Trunk and Upper Limb Vertebral Internal jugular SUPERIOR VENA CAVA External jugular Subclavian Mediastinal Highest intercostal Brachiocephalic Esophageal Axillary Cephalic Azygos Accessory hemiazygos Hemiazygos Internal thoracic Brachial Intercostal INFERIOR VENA CAVA Hepatic

Basilic Phrenic Suprarenal KEY Renal Superficial veins Gonadal Deep veins Lumbar Median cubital Common iliac Internal iliac External iliac Cephalic Anterior interosseous Median sacral Radial Basilic Median antebrachial Ulnar Palmar venous

arches Digital 2015 Pearson Education, Inc. 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 2015 Pearson Education, Inc. Figure 22.20 The Venous Drainage of the Trunk and Upper Limb Vertebral Internal jugular SUPERIOR VENA CAVA External jugular Subclavian Mediastinal Highest intercostal Brachiocephalic Esophageal Axillary

Cephalic Azygos Accessory hemiazygos Hemiazygos Internal thoracic Brachial Intercostal INFERIOR VENA CAVA Hepatic Basilic Phrenic Suprarenal KEY Renal Superficial veins Gonadal Deep veins Lumbar Median cubital Common iliac Internal iliac External iliac Cephalic

Anterior interosseous Median sacral Radial Basilic Median antebrachial Ulnar Palmar venous arches Digital 2015 Pearson Education, Inc. 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 2015 Pearson Education, Inc. Figure 22.20 The Venous Drainage of the Trunk and Upper Limb Vertebral Internal jugular SUPERIOR

VENA CAVA External jugular Subclavian Mediastinal Highest intercostal Brachiocephalic Esophageal Axillary Cephalic Azygos Accessory hemiazygos Hemiazygos Internal thoracic Brachial Intercostal INFERIOR VENA CAVA Hepatic Basilic Phrenic Suprarenal KEY Renal Superficial veins Gonadal

Deep veins Lumbar Median cubital Common iliac Internal iliac External iliac Cephalic Anterior interosseous Median sacral Radial Basilic Median antebrachial Ulnar Palmar venous arches Digital 2015 Pearson Education, Inc. Systemic Veins Venous Return from the Upper Limb Blood can also return to the heart from the hands in the following sequence The deep palmar veins drain into the radial and ulnar veins

Those veins will unite to form the brachial vein Axillary vein Subclavian vein Brachiocephalic vein Superior vena cava Right atrium 2015 Pearson Education, Inc. Figure 22.20 The Venous Drainage of the Trunk and Upper Limb Vertebral Internal jugular SUPERIOR VENA CAVA External jugular Subclavian Mediastinal Highest intercostal Brachiocephalic Esophageal Axillary Cephalic Azygos Accessory hemiazygos Hemiazygos Internal thoracic Brachial Intercostal INFERIOR VENA CAVA

Hepatic Basilic Phrenic Suprarenal KEY Renal Superficial veins Gonadal Deep veins Lumbar Median cubital Common iliac Internal iliac External iliac Cephalic Anterior interosseous Median sacral Radial Basilic Median antebrachial Ulnar

Palmar venous arches Digital 2015 Pearson Education, Inc. Systemic Veins The Formation of the Superior Vena Cava The following veins drain into the superior vena cava, which then drains into the right atrium Azygos veins Brachiocephalic veins Subclavian veins drain into the brachiocephalic veins Internal thoracic veins drain into the brachiocephalic veins 2015 Pearson Education, Inc. Figure 22.20 The Venous Drainage of the Trunk and Upper Limb Vertebral Internal jugular SUPERIOR VENA CAVA External jugular Subclavian Mediastinal Highest intercostal Brachiocephalic Esophageal Axillary

Cephalic Azygos Accessory hemiazygos Hemiazygos Internal thoracic Brachial Intercostal INFERIOR VENA CAVA Hepatic Basilic Phrenic Suprarenal KEY Renal Superficial veins Gonadal Deep veins Lumbar Median cubital Common iliac Internal iliac External iliac Cephalic

Anterior interosseous Median sacral Radial Basilic Median antebrachial Ulnar Palmar venous arches Digital 2015 Pearson Education, Inc. Systemic Veins The Inferior Vena Cava The following veins drain into the inferior vena cava, which drains into the right atrium Common iliac veins Lumbar veins Gonadal veins: The right gonadal vein drains into the inferior vena cava, the left gonadal vein drains into the left renal vein and then into the inferior vena cava Hepatic veins 2015 Pearson Education, Inc. Figure 22.18 An Overview of the Systemic Venous System Vertebral External jugular

Subclavian Internal jugular Brachiocephalic Axillary Superior vena cava Cephalic Brachial Intercostal Basilic Inferior vena cava Hepatic Renal Gonadal Median cubital Lumbar Radial Median antebrachial Left and right common iliac Ulnar External iliac Palmar venous arches

Internal iliac Digital Deep femoral Great saphenous Femoral Popliteal Small saphenous Fibular Posterior tibial Anterior tibial KEY Dorsal venous arch Plantar venous arch 2015 Pearson Education, Inc. Superficial veins Deep veins Systemic Veins Veins Draining the Pelvis The following veins drain into the internal iliac and then into the common iliac and then into the IVC Gluteal veins

Internal pudendal veins Obturator veins Lateral sacral veins Median sacral veins drain into the left common iliac 2015 Pearson Education, Inc. Figure 22.21a The Venous Drainage of the Lower Limb Right common iliac Superior gluteal Right external iliac Internal iliac Inferior gluteal External Iliac Internal pudendal Lateral sacral Obturator Femoral Femoral circumflex Deep femoral Femoral Collects blood from the thigh Great saphenous Small saphenous Collects blood from superficial veins of the leg and foot Popliteal

Small saphenous Posterior tibial Fibular Anterior tibial Fibular The dorsal and plantar venous arches collect blood from the foot and toes Dorsal venous arch Plantar venous arch Digital a Anterior view showing the veins of the right lower limb 2015 Pearson Education, Inc. KEY Superficial veins Deep veins Figure 22.21b The Venous Drainage of the Lower Limb External Iliac Superior gluteal Inferior gluteal Internal pudendal Obturator Femoral Femoral circumflex Deep femoral

Femoral Great saphenous Collects blood from the superficial veins of the lower limb Small saphenous Popliteal Anterior tibial Posterior tibial Anterior tibial Fibular The dorsal and plantar venous arches collect blood from the foot and toes KEY Superficial veins Deep veins Dorsal venous arch Plantar venous arch Digital b Posterior view showing the veins of the right lower limb 2015 Pearson Education, Inc.

Systemic Veins Veins Draining the Abdomen The abdominal portion of the inferior vena cava collects blood from: Lumbar veins Gonadal veins Hepatic veins Renal veins Suprarenal veins Phrenic veins 2015 Pearson Education, Inc. Figure 22.18 An Overview of the Systemic Venous System Vertebral External jugular Subclavian Internal jugular Brachiocephalic Axillary Superior vena cava Cephalic Brachial Intercostal

Basilic Inferior vena cava Hepatic Renal Gonadal Median cubital Lumbar Radial Median antebrachial Left and right common iliac Ulnar External iliac Palmar venous arches Internal iliac Digital Deep femoral Great saphenous Femoral Popliteal Small saphenous

Fibular Posterior tibial Anterior tibial KEY Dorsal venous arch Plantar venous arch 2015 Pearson Education, Inc. Superficial veins Deep veins Systemic Veins Veins Draining the Lower Limb Blood returns to the heart from the feet in the following sequence Plantar veins Drain into the anterior tibial, posterior tibial, and fibular veins Popliteal vein Femoral vein External iliac vein Common iliac vein Inferior vena cava Right atrium 2015 Pearson Education, Inc. Figure 22.18 An Overview of the Systemic Venous System Vertebral External jugular Subclavian Internal jugular Brachiocephalic

Axillary Superior vena cava Cephalic Brachial Intercostal Basilic Inferior vena cava Hepatic Renal Gonadal Median cubital Lumbar Radial Median antebrachial Left and right common iliac Ulnar External iliac Palmar venous arches Internal iliac Digital

Deep femoral Great saphenous Femoral Popliteal Small saphenous Fibular Posterior tibial Anterior tibial KEY Dorsal venous arch Plantar venous arch 2015 Pearson Education, Inc. Superficial veins Deep veins Systemic Veins Veins Draining the Lower Limb Blood also leaves the foot and returns to the heart via the following veins Dorsal venous arch Great saphenous vein Femoral vein

External iliac vein Common iliac vein Inferior vena cava Right atrium 2015 Pearson Education, Inc. Figure 22.21a The Venous Drainage of the Lower Limb Right common iliac Superior gluteal Right external iliac Internal iliac Inferior gluteal External Iliac Internal pudendal Lateral sacral Obturator Femoral Femoral circumflex Deep femoral Femoral Collects blood from the thigh Great saphenous Small saphenous Collects blood from superficial veins of the leg and foot Popliteal

Small saphenous Posterior tibial Fibular Anterior tibial Fibular The dorsal and plantar venous arches collect blood from the foot and toes Dorsal venous arch Plantar venous arch Digital a Anterior view showing the veins of the right lower limb 2015 Pearson Education, Inc. KEY Superficial veins Deep veins Figure 22.21b The Venous Drainage of the Lower Limb External Iliac Superior gluteal Inferior gluteal Internal pudendal Obturator Femoral Femoral circumflex Deep femoral

Femoral Great saphenous Collects blood from the superficial veins of the lower limb Small saphenous Popliteal Anterior tibial Posterior tibial Anterior tibial Fibular The dorsal and plantar venous arches collect blood from the foot and toes KEY Superficial veins Deep veins Dorsal venous arch Plantar venous arch Digital b Posterior view showing the veins of the right lower limb 2015 Pearson Education, Inc.

Systemic Veins The Hepatic Portal System Blood from the small intestine, large intestine, stomach, and pancreas flows into the hepatic portal system Inferior mesenteric vein drains a portion of the large intestine Splenic vein drains the spleen, lateral border of the stomach, and the pancreas Superior mesenteric vein drains a portion of the stomach, small intestine, and a portion of the large intestine 2015 Pearson Education, Inc. Systemic Veins The Hepatic Portal System From the hepatic portal veins, venous blood enters into: Liver sinusoids Hepatic veins Inferior vena cava Right atrium 2015 Pearson Education, Inc. Figure 22.22 The Hepatic Portal System Esophagus Inferior vena cava Aorta Hepatic Stomach

Liver Left gastric Right gastric Cystic Left gastroepiploic Hepatic portal Spleen Right gastroepiploic Pancreaticoduodenal Middle colic (from transverse colon) Superior mesenteric Pancreas Splenic Pancreatic Left colic Inferior mesenteric Right colic Ascending colon Ileocolic Descending colon Sigmoid Intestinal Small intestine Superior rectal

2015 Pearson Education, Inc. Cardiovascular Changes at Birth The fetal cardiovascular system differs from the adult cardiovascular system The fetal lungs are nonfunctional The fetal digestive system is nonfunctional All fetal nutritional and respiratory needs are provided by diffusion across the placenta Blood in the fetal internal iliacs enters the umbilical arteries Enters the umbilical cord Enters the placenta 2015 Pearson Education, Inc. Cardiovascular Changes at Birth All fetal nutritional and respiratory needs are provided by diffusion across the placenta Blood leaves the placenta Enters the umbilical vein Enters the ductus venosus Enters the fetal liver Enters the inferior vena cava Enters the fetal right atrium 2015 Pearson Education, Inc. Cardiovascular Changes at Birth Fetal heart circulation uses two short circuits to

the lungs Blood in the right atrium can enter into the left atrium via the foramen ovale Blood in the pulmonary trunk can enter into the aortic arch via the ductus arteriosus 2015 Pearson Education, Inc. Figure 22.23a Changes in Fetal Circulation at Birth Foramen ovale (open) Aorta Ductus arteriosus (open) Pulmonary trunk Liver Umbilical vein Inferior vena cava Ductus venosus Placenta Umbilical cord a Circulation pathways in a full-term fetus. Red indicates oxygen-rich blood, blue indicates oxygen-poor blood, and violet indicates a mixture of oxygen-rich and oxygen-poor blood. 2015 Pearson Education, Inc. Umbilical arteries

Figure 22.23b Changes in Fetal Circulation at Birth Ductus arteriosus (closed) Pulmonary trunk Foramen ovale (closed) Left atrium Right atrium Left ventricle Inferior vena cava Right ventricle b 2015 Pearson Education, Inc. Blood flow through the heart of the newborn. Figure 22.23c Changes in Fetal Circulation at Birth Superior vena cava Right atrium Foramen ovale An opening in the

interatrial septum that permits some blood to flow directly into the left atrium Inferior vena cava Right ventricle Ductus venosus A shunt that permits most blood to bypass the fetal liver so as to directly enter the inferior vena cava and then the right atrium General systemic circulation Minimal blood flow Ductus arteriosus A vessel that shunts blood from the pulmonary trunk, away from the pulmonary circuit, into the aortic arch Transports oxygen-rich, nutrient-rich blood from placenta to fetal liver General systemic circulation Umbilical arteries c 2015 Pearson Education, Inc. Left ventricle

FETAL HEART Lungs Umbilical vein PLACENTA Left atrium Internal iliac arteries Flowchart for circulatory patterns in the fetus and newborn infant. Aorta KEY Oxygen-rich blood Oxygen-poor blood Mixed blood Cardiovascular Changes at Birth Upon birth: Smooth muscles of the ductus arteriosus contract forming the ligamentum arteriosum found in the adult heart Pressure in the left atrium increases, thus closing the valvular flap of the foramen ovale, forming the fossa ovalis found in the adult heart 2015 Pearson Education, Inc. Aging and the Cardiovascular System Age-related changes in the cardiovascular system Blood changes Decreased hematocrit Thrombi and emboli form more easily

Pooling of blood in veins of the leg Heart changes Reduced efficiency and elasticity Atherosclerosis of coronary vessels Scar tissue forms Blood vessel changes Loss of elasticity Calcium deposits damage vessel walls 2015 Pearson Education, Inc.

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