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© 2011 Pearson Education, Inc.

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

Copyright © 2011 Pearson Education, Inc.

MAJOR BLOOD VESSELS

Pulmonary and Systemic Circulations


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


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


PULMONARY CIRCULATION

“Lungs”

Arteries low in oxygen

Veins high in oxygen


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


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


SYSTEMIC CIRCULATION

Blood flow to major organs and regions of the body


Naming Major Arteries

1. Body region

2. Organ served

3. Bone followed

• Veins often take name of artery


The Aorta

• Receives blood directly from left ventricle

• Largest artery

Four regions

1. Ascending aorta

2. Aortic arch

3. Thoracic aorta

4. Abdominal aorta


Ascending Aorta

• Supplies myocardium

• R. & L. coronary arteries


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


Circle of Willis

• Blood supply to the brain is important

• Circle of Willis provides possible alternative circulation


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


Thoracic Aorta

• Visceral branch - supplies organs of the thorax (above the diaphragm)

• Esophagus

• Lungs

• Pericardium

• Parietal branch supplies thoracic:

• Muscles

• Bones

• Nerves


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)


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


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


SYSTEMIC VEINS

Inferior and superior vena cavas


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


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


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


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


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


(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


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


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


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


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


(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


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


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


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


VITAL SIGNS

blood pressure


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


Measuring Blood Pressure

• Systemic arterial BP

• Measured indirectly by the auscultatory method using a sphygmomanometer (pressure cuff) and stethoscope


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


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

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