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- 1. PowerPoint® Lecture Slides prepared by Janice Meeking, Mount Royal College CHAPTER 18 The Cardiovascular System: Blood Vessels: Part B © 2011 Pearson Education, Inc.
- 2. MAJOR BLOOD VESSELS Pulmonary and Systemic Circulations Copyright © 2011 Pearson Education, Inc.
- 3. Circulatory Pathways 1. Pulmonary circulation • Loop from heart to lungs 1. Systemic circulation • Long loop from heart to body • Arteries: away from heart • Veins: towards heart Copyright © 2011 Pearson Education, Inc.
- 4. Arteries vs Veins Arteries • Arteries run deep Veins • Veins can be superficial • Distinct pathways • Interconnected pathways • Brain & digestive systems • Unique venous drainage • O2 rich blood shown in red • O2 poor blood shown in blue Copyright © 2011 Pearson Education, Inc.
- 5. PULMONARY CIRCULATION “Lungs” Arteries low in oxygen Veins high in oxygen Copyright © 2011 Pearson Education, Inc.
- 6. 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 Copyright © 2011 Pearson Education, Inc.
- 7. 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.
- 8. Pulmonary capillaries of the R. lung R. pulmonary L. pulmonary Pulmonary capillaries of the L. lung artery artery To systemic circulation Pulmonary trunk R. pulmonary veins (2x) From systemic circulation RA LA RV LV L. pulmonary Veins (2x) (a) Schematic flowchart. Copyright © 2011 Pearson Education, Inc. Figure 18.19a
- 9. SYSTEMIC CIRCULATION Blood flow to major organs and regions of the body Copyright © 2011 Pearson Education, Inc.
- 10. Naming Major Arteries 1. Body region 2. Organ served 3. Bone followed • Veins often take name of artery Copyright © 2011 Pearson Education, Inc.
- 11. The Aorta • Receives blood directly from left ventricle • Largest artery Four regions 1. Ascending aorta 2. Aortic arch 3. Thoracic aorta 4. Abdominal aorta Copyright © 2011 Pearson Education, Inc.
- 12. Ascending Aorta • Supplies myocardium • R. & L. coronary arteries Copyright © 2011 Pearson Education, Inc.
- 13. Aortic Arch Three branches 1. Brachiocephalic trunk • R. common carotid (same branching as L.) • R. subclavian artery (same branching as L.) 1. L. common carotid • Internal carotid - brain • External carotid – head & neck 1. L. subclavian artery • Vertebral – posterior brain • Axillary - arm Copyright © 2011 Pearson Education, Inc.
- 14. Circle of Willis • Blood supply to the brain is important • Circle of Willis provides possible alternative circulation Copyright © 2011 Pearson Education, Inc.
- 15. 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 Copyright © 2011 Pearson Education, Inc.
- 16. Thoracic Aorta • Visceral branch - supplies organs of the thorax (above the diaphragm) • Esophagus • Lungs • Pericardium • Parietal branch supplies thoracic: • Muscles • Bones • Nerves Copyright © 2011 Pearson Education, Inc.
- 17. Abdominal Aorta Serves 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) Copyright © 2011 Pearson Education, Inc.
- 18. 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.
- 19. R. external carotid artery R. internal carotid artery R. vertebral R. axillary R. common carotid – right side of head and neck R. subclavian – neck and R. upper limb Brachiocephalic – head, neck, and R. upper limb Arteries of R. upper limb L. external carotid artery L. internal carotid artery L. common carotid – left side of head and neck L. vertebral L. subclavian – neck and L. upper limb Aortic arch L. axillary Arteries of L. upper limb Ascending aorta – L. ventricle to sternal angle L. and R. coronary arteries Thoracic aorta T5 – T12 (diaphragm) L. ventricle of heart Parietal branches Visceral branches Mediastinal – posterior mediastinum Esophageal – esophagus Bronchial – lungs and bronchi Pericardial – pericardium Posterior intercostals – intercostal muscles, spinal cord, vertebrae, pleurae, skin Superior phrenics – posterior and superior diaphragm Diaphragm Visceral branches Gonadal – testes or ovaries Suprarenal – adrenal glands and Renal – kidneys Superior and inferior mesenterics – small intestine – colon Abdominal aorta T12 (diaphragm) – L4 Celiac trunk – liver – gallbladder – spleen – stomach – esophagus – duodenum R. common iliac – pelvis and R. lower limb Arteries of R. lower limb Copyright © 2011 Pearson Education, Inc. Parietal branches Inferior phrenics – inferior diaphragm Lumbars – posterior abdominal wall Median sacral – sacrum – coccyx L. common iliac – pelvis and L. lower limb (a) Schematic flowchart Arteries of L. lower limb Figure 18.21a
- 20. Arteries of the head and trunk Internal carotid artery External carotid artery Common carotid arteries Vertebral artery Subclavian artery Brachiocephalic trunk Aortic arch Ascending aorta Coronary artery Thoracic aorta (above diaphragm) Celiac trunk Abdominal aorta Superior mesenteric artery Renal artery Gonadal artery Common iliac artery Inferior mesenteric artery Internal iliac artery (b) Illustration, anterior view Copyright © 2011 Pearson Education, Inc. Arteries that supply the upper limb Subclavian artery Axillary artery Brachial artery Radial artery Ulnar artery Deep palmar arch Superficial palmar arch Digital arteries Arteries that supply the lower limb External iliac artery Femoral artery Popliteal artery Anterior tibial artery Posterior tibial artery Arcuate artery Figure 18.21b
- 21. SYSTEMIC VEINS Inferior and superior vena cavas Copyright © 2011 Pearson Education, Inc.
- 22. 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 Copyright © 2011 Pearson Education, Inc.
- 23. 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 Copyright © 2011 Pearson Education, Inc.
- 24. 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.
- 25. Veins Draining into the Inferior Vena Cava Common iliac vein Internal iliac vein External iliac vein Inguinal ligament Femoral vein Great saphenous vein (superficial) Popliteal vein Small saphenous vein Fibular vein Anterior tibial vein Dorsalis pedis vein Dorsal venous arch Dorsal metatarsal veins Copyright © 2011 Pearson Education, Inc. (b) Anterior view Figure 18.30b
- 26. 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.
- 27. Inferior Vena Cava Hepatic veins Inferior vena cava Right suprarenal vein Right gonadal vein Hepatic portal vein Inferior phrenic vein Left suprarenal vein Renal veins Left ascending lumbar vein Lumbar veins Left gonadal vein Common iliac vein Internal iliac vein External iliac vein (b) Tributaries of the inferior vena cava. Venous drainage of abdominal organs not drained by the hepatic portal vein. Copyright © 2011 Pearson Education, Inc. Figure 18.29b
- 28. 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 Copyright © 2011 Pearson Education, Inc.
- 29. 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.
- 30. Veins of R. upper limb R. axillary R. external jugular – superficial head and neck R. vertebral – cervical spinal cord and vertebrae R. subclavian – R. head, neck, and upper limb Intracranial dural venous sinuses R. internal jugular – dural venous sinuses of the brain Same as R. brachiocephalic R. brachiocephalic – R. side of head and R. upper limb L. brachiocephalic – L. side of head and L. upper limb Superior vena cava – runs from union of brachiocephalic veins behind manubrium to R. atrium Azygos system – drains much of thorax R. atrium of heart Diaphragm Inferior vena cava – runs from junction of common iliac veins at L5 to R. atrium of heart R. suprarenal (L. suprarenal drains into L. renal vein) – adrenal glands R. gonadal (L. gonadal drains into L. renal vein) – testis or ovary R. common iliac – pelvis and R. lower limb (a) Schematic flowchart Copyright © 2011 Pearson Education, Inc. Veins of R. lower limb L., R., and middle hepatic veins – liver L. and R. renal veins – kidneys Lumbar veins (several pairs) – posterior abdominal wall L. common iliac – pelvis and L. lower limb Veins of L. lower limb Figure 18.26a
- 31. Veins of the head and trunk Dural venous sinuses External jugular vein Veins that drain the upper limb Subclavian vein Vertebral vein Axillary vein Internal jugular vein Cephalic vein Brachial vein Basilic vein Right and left brachiocephalic veins Superior vena cava Great cardiac vein Hepatic veins Splenic vein Hepatic portal vein Renal vein Superior mesenteric vein Inferior vena cava Inferior mesenteric vein Median cubital vein Ulnar vein Radial vein Digital veins Veins that drain the lower limb External iliac vein Femoral vein Great saphenous vein Common iliac vein Popliteal vein Internal iliac vein Posterior tibial vein Anterior tibial vein (b) Illustration, anterior view. The vessels of the pulmonary circulation are not shown. Copyright © 2011 Pearson Education, Inc. Small saphenous vein Dorsal venous arch Dorsal metatarsal veins Figure 18.26b
- 32. Superficial temporal vein Occipital vein Posterior auricular vein External jugular vein Ophthalmic vein Facial vein Vertebral vein Internal jugular vein Superior and middle thyroid veins Brachiocephalic vein Subclavian vein Superior vena cava (b) Veins of the head and neck, right superficial aspect Copyright © 2011 Pearson Education, Inc. Figure 18.27b
- 33. Subclavian Internal vein jugular vein External Brachiocephalic Axillary jugular vein veins vein Superior vena cava Accessory hemiazygos vein Median cubital vein Azygos Hemiazygos vein vein Brachial vein Right and left posterior intercostal veins Cephalic vein Radial vein Median antebrachial vein Basilic vein Ulnar vein Deep palmar venous arch Metacarpal veins (a) Schematic flowchart Copyright © 2011 Pearson Education, Inc. Superficial palmar venous arch Digital veins Figure 18.28a
- 34. Brachiocephalic veins Right subclavian vein Axillary vein Brachial vein Cephalic vein Basilic vein Median cubital vein Median antebrachial vein Internal jugular vein External jugular vein Left subclavian vein Superior vena cava Azygos vein Accessory hemiazygos vein Hemiazygos vein Posterior intercostals Inferior vena cava Ascending lumbar vein Cephalic vein Basilic vein Radial vein Ulnar vein Deep palmar venous arch Superficial palmar venous arch Digital veins (b) Anterior view Copyright © 2011 Pearson Education, Inc. Figure 18.28b
- 35. Internal iliac vein Inferior vena cava Common iliac vein External iliac vein Femoral vein Small saphenous vein Fibular (peroneal) vein Dorsal venous arch Great saphenous vein Popliteal vein Anterior tibial vein Femoral vein Small saphenous vein Fibular (peroneal) vein Posterior tibial vein Dorsalis pedis vein Plantar veins Deep plantar arch Dorsal Digital veins metatarsal veins Anterior Posterior (a) Schematic flowchart of the anterior and posterior veins Copyright © 2011 Pearson Education, Inc. Figure 18.30a
- 36. VITAL SIGNS blood pressure Copyright © 2011 Pearson Education, Inc.
- 37. 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.
- 38. Pulse points Superficial temporal artery Facial artery Common carotid artery Brachial artery Radial artery Femoral artery Popliteal artery Posterior tibial artery Dorsalis pedis artery Copyright © 2011 Pearson Education, Inc. Figure 18.12
- 39. Measuring Blood Pressure • Systemic arterial BP • Measured indirectly by the auscultatory method using a sphygmomanometer (pressure cuff) and stethoscope Copyright © 2011 Pearson Education, Inc.
- 40. Measuring Blood Pressure 1. 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 Copyright © 2011 Pearson Education, Inc.
- 41. 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 Copyright © 2011 Pearson Education, Inc.