Chapt15 cardiovascular
Transcript of Chapt15 cardiovascular
1
BIOL 2074: Anatomy & Physiology II
Chapter 15 Cardiovascular System
Brenda Holmes MSN/ED, RN
Associate Professor
Biology
South Arkansas Community College
Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display
2
15.1: Introduction
• The heart pumps 7,000 liters of blood through the body each day• The heart contracts 2.5 billion times in an average lifetime• The heart and all blood vessels make up the cardiovascular system• The blood vessels make up two circuits:
• Pulmonary circuit• Systemic circuit
3
Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.
Alveolus
Oxygenated blood
Deoxygenated blood
CO2
CO2CO2
CO2
CO2
CO2
O2O2
O2
O2
O2
O2
O2O2
CO2
CO2
Right atrium
Right ventricle
Left atrium
Left ventricle
Systemic circuit delivers oxygen to allbody cells and carries away wastes.
Oxygenatedblood pumped toall body tissuesvia aorta
Deoxygenatedblood pumpedto lungs viapulmonary arteries
Pulmonary circuit eliminates carbondioxide via the lungs and oxygenates theblood.
Oxygenated blood returnsto heart via pulmonary veins
Deoxygenated blood returnsto heart via venae cavae
4
15.2: Structure of the Heart
• The heart is a hollow, cone-shaped, muscular pump• There are four chambers:
• Two atria (for blood storage)• Two ventricles (one low pressure pump and one high pressure pump)
5
Size and Location of the HeartCopyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.
0 1 2 3 4 5 cm© McGraw-Hill Companies, Inc./Photo and dissection by Christine Eckel
• The heart size varies with body size• The heart lies in the thoracic cavity• The average size of the heart is:
• 14 cm long• 9 cm wide
• The heart is:• Posterior to the sternum• Medial to the lungs• Anterior to the vertebral column• The base lies beneath the 2nd rib• The apex at the 5th intercostal space• It lays just above the diaphragm
6
Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.
Diaphragm
Base of heart
Apex of heart
Heart
Sternum
7
Coverings of the Heart
• The coverings of the heart include the pericardium:• Fibrous pericardium• Visceral pericardium• Parietal pericardium
Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.
Auricle of right atrium
Right ventricle
Pericardial cavity
Left ventricle
Pulmonary trunk
Auricle of left atriumFibrous pericardium
Aorta
Right lung Left lung
Diaphragm
Superiorvena cava
Anterior interventricularsulcus
Heart (covered byvisceral pericardium)
Cut edge ofparietal pericardium
8
Wall of the Heart
Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.
Endocardium
Myocardium
Epicardium(visceral pericardium)
PericardialcavityParietalpericardium
Fibrouspericardium
Coronaryblood vessel
• The heart wall has three distinct layers:• Epicardium (outer layer)• Myocardium (middle layer)• Endocardium (inner layer)
9
10
Heart Chambers and Valves
• The heart is divided into four chambers:• Right atrium:
• Receives blood from the: • Inferior vena cava• Superior vena cava• Coronary sinus
• Right ventricle• Receives blood from the right atrium
• Left atrium• Receives blood from the pulmonary veins
• Left ventricle• Receives blood from the left atrium
11
12
Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.
Superior vena cava
Aortic valve
Right atrium
Inferior vena cava
(b)
(c)
Right ventricleTricuspid valve
Left ventriclePapillary muscle
Chordae tendineae
Left atrium
Pulmonary trunk
Aorta
Superior vena cava
Pulmonary valve
Right atrium
Inferior vena cava
(a)
Right ventricleTricuspid valve
Left ventriclePapillary muscle
Chordae tendineaeMitral (bicuspid) valveLeft atrium
Pulmonary trunk
Aorta
Right pulmonaryarteryRight pulmonaryveins
Left pulmonaryartery
Left pulmonaryveins
Interventricularseptum
Right pulmonaryartery
Right pulmonaryveins
Opening of coronarysinus
Left pulmonaryartery
Left pulmonaryveins
Mitral (bicuspid)valve
Interventricularseptum
c: © The McGraw-Hill Companies, Inc.
Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.
Rightatrium
Cusps oftricuspidvalve
Chordaetendineae
Interventricularseptum
Papillarymuscles
Muscularridges
© McGraw-Hill Higher Education, Inc./University of Michigan Biomedical Communications
Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.
© McGraw-Hill Higher Education, Inc./University of Michigan Biomedical Communications
13
Skeleton of the Heart
• The fibrous rings, together with other masses of dense connective tissue in the portion of the septum between the ventricles (interventricular septum), constitute the skeleton of the heart Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.
Fibrous skeleton
Mitral valve
Posterior
Opening ofleft coronaryartery
Aorticvalve
Tricuspidvalve
Pulmonary valve
14
15
Path of Blood Through the Heart
Tissue cells
Tissue cells
Alveolus
Alveolus
Left atriumMitral valve
Aortic valveLeft ventricle
Right atrium
Tricuspid valvePulmonary valve
Inferior vena cavaRight ventricle
Aorta
O2
CO2
O2
O2
CO2
CO2
O2CO2
Systemiccapillaries
Superiorvena cava
Alveolarcapillaries
Systemiccapillaries
Pulmonaryveins
Alveolarcapillaries
Pulmonaryartery
Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.
16
Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.
Tricuspid valve
Right atrium
Right ventricle
Pulmonary trunk
Pulmonary arteries
Alveolar capillaries (lungs)
Pulmonary veins
Left atrium
Left ventricle
Aorta
Blood to systemic circuit
Pulmonary valve
Mitral valve
Aortic valve
Venae cavae andcoronary sinus
Blood from systemic circuit
17
Blood Supply to the Heart
• The left and right coronary arteries supply blood to the tissues of the heart
Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.
Aorta
Cardiac veins
Coronary sinus
Right atrium
Right coronary artery Left coronary artery
Posteriorinterventricularartery
Marginalartery
Circumflexartery
Anteriorinterventricularartery
Myocardialcapillaries inventricularwalls
Myocardialcapillaries inventricularwalls
Myocardialcapillaries inwalls of rightatrium and rightventricle
Myocardialcapillaries inwalls of leftatrium and leftventricle
18
Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.
Aorta
Part ofaortaremoved
Aorticvalvecusps
Right coronaryartery
Opening ofleft coronaryartery
19
Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.
Aorta
Pulmonary trunk
Left pulmonary artery
Left pulmonary veinsLeft auricle
Left coronary artery
Great cardiac vein
Left ventricle
Apex of the heart
Superior vena cava
Right auricle
Inferior vena cava
Small cardiac veinAnterior cardiac vein
Right ventricle(a)
Left pulmonary artery
Aorta
Left auricleCircumflex artery
Cardiac vein
Left ventricle
Apex of the heart
Superior vena cava
Left atrium
Right atrium
Inferior vena cavaCoronary sinusMiddle cardiac vein
Right ventricle(b)
Right pulmonaryartery
Right pulmonaryveins
Right coronaryartery Anterior interventricular artery
(left anterior descending artery)
Left pulmonaryveins
Right pulmonaryartery
Right pulmonaryveins
Posterior interventricularartery
20
15.3: Heart Actions• The heart chambers function in coordinated fashion• Heart actions are regulated so that atria contract (atrial systole) while ventricles relax (ventricular diastole); followed by ventricles contract (ventricular systole) while atria relax (atrial diastole)
Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.
(a) (b)
Atrial systoleLA
LV
RV
RA
Atrial diastole
Aorticvalve open
Ventricularsystole
Tricuspidand mitralvalves closed
Ventriculardiastole
Pulmonaryvalve open
Aorticvalve closed
Pulmonaryvalve closed
Tricuspidand mitralvalves open
21
Cardiac Cycle
• During a cardiac cycle, the pressure in the heart chambers rise and falls• In atrial systole and ventricular diastole:
• Blood flows passively into the ventricles• The remaining 30% of blood is pushed into the ventricles• The A-V valves open and the semilunar valves close• The ventricles relax• This causes an increase in ventricular pressure
• In ventricular systole and atrial diastole:• The A-V valves close• The chordae tendinae prevent the cusps of the valves from bulging too far into the atria• The atria relax• The blood flows into atria• The ventricular pressure increases and opens the semilunar valves• The blood flows into pulmonary trunk and aorta
22
Heart Sounds
• A heart beat through a stethoscope sounds like “lubb-dupp”• The “lubb”
• The first heart sound • It occurs during ventricular systole• The A-V valves are closing
•The “dupp”
• The second heart sound• It occurs during ventricular diastole• The pulmonary and aortic semilunar valves are closing
• A murmur – abnormal heart sound from the cusps not completely closing
23
Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.
Aortic area Pulmonary area
Mitral areaTricuspidarea
24
Cardiac Muscle Fibers
• Cardiac muscle fibers form a functional syncytium• This is a mass of cells that function as a unit• Two such areas exist in the heart:
• In the atrial walls called the atrial syncytium• In the ventricular walls called the ventricular syncytium
25
Cardiac Conduction System
• Clumps or strands of specialized cardiac muscle tissue which initiate and distribute impulses throughout the myocardium• The cardiac conduction system coordinates the events of the cardiac cycle
Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.
Atrial syncytium
Junctional fibers
Bundle branches
Purkinje fibers
SA node
AV node
AV bundle
Ventricular syncytium
Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.
Purkinje fibers
Interatrial septum
Leftbundlebranch
Interventricularseptum
Right bundlebranch
Junctionalfibers
AV node
SA node
AV bundle
Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.
(b)
Myocardialmuscle fibers
(a)
26
27
15.1 From Science to Technology
Replacing the Heart – From Transplants to Stem Cell Implants
28
Electrocardiogram
• An electrocardiogram or ECG is a recording of electrical changes that occur in the myocardium during the cardiac cycle• It is used to assess the hearts ability to conduct impulses• The deflections in the normal ECG, or waves, include:
• P wave – atrial depolarization• QRS complex (three waves) – ventricular depolarization• T wave – ventricular repolarization
29
Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.
(b)
(c)
(d)
(e)
(f)
Mil
livo
lts
0
–.5
.5
1.0
Milliseconds0 200 400 600
Mil
livo
lts
0
–.5
.5
1.0
Milliseconds0 200 400 600
Mil
livo
lts
0
–.5
.5
1.0
Milliseconds0 200 400 600
P
Mil
livo
lts
0
–.5
.5
1.0
Milliseconds0 200 400 600
SQ
R
QRS complex
(h)
(g)
Mil
livo
lts
0
–.5
.5
1.0
Milliseconds0 200 400 600
Mil
livo
lts
0
–.5
.5
1.0
Milliseconds0 200 400 600
T
Mil
livo
lts
0
–.5
.5
1.0
Milliseconds0 200 400 600
(a)
Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.
S
Q
R
30
Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.
0
+1
–1
0
120
100
80
60
40
20
0
160
120
80
P
QS
T
R
P
QS
T
R
0.3 0.6 0.9 seconds
Heart sounds
Electrocardiogram (ECG)
Pressure changes
Aortic pressure
Atrial pressureV
olu
me
(mL
)M
illi
volt
sP
ress
ure
(m
m H
g)
One cardiac cycle
Atrialsystole
Ventriculardiastole
Ventricularsystole
Aorticsemilunarvalveopens
AV valvecloses
AV valve opens
Ventricular pressure
Aortic semilunarvalve closes
Atrialdiastole
Ventriculardiastole
Ventricularsystole
Atrialsystole
Ventriculardiastole
Atrialdiastole
Ventricular volume
Lubb: AV valves close
Dupp: Semilunar valves close
Ventricular volume
31
Regulation of the Cardiac Cycle
• The SA node controls the heart rate• There are also sympathetic and parasympathetic fibers that control the heart rate as well• There are also regulatory reflex centers that influence heart rate• Additional factors that may influence heart rate include:
• Physical exercise• Body temperature• Concentration of various ions including:
• Potassium• Calcium
• Parasympathetic impulses decrease heart action• Sympathetic impulses increase heart action• Cardiac center regulates autonomic impulses to the heart
32
Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.
(b)
Hypothalamus
Sympathetic trunk
Aorta
(a)
ReceptorSensory orafferent neuron
CentralNervousSystem
Motor orefferent neuron
Effector(muscle or gland)
Carotidsinus
Sensoryfibers
Parasympatheticvagus nerve
SA node
Sympatheticnerve
AV node
Aorticbaroreceptors
Commoncarotidartery
Carotidbaroreceptors
Cerebrum(frontalsection)
Medulla(transversesection)
Cardiaccenter
Spinal cord(transverse sections)
33
15.1 Clinical Application
Arrhythmias
34
15.4: Blood Vessels
• The blood vessels are organs of the cardiovascular system• The blood vessels form a closed circuit to and from the heart• The blood vessels include:
• Arteries - carry blood away from the ventricles of the heart• Arterioles - receive blood from the arteries and carry blood to the capillaries• Capillaries - sites of exchange of substances between the blood and the body cells• Venules - receive blood from the capillaries• Veins - carry blood toward the atria of the heart
35
Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.
Artery
Lumen
(a) (b)
(c)
Lumen
Vein
Valve
Endothelium oftunica interna
Connective tissue(elastic and collagenous fibers)
Tunica media
Tunica externa
Endotheliumof tunicainterna
Middle layer(tunicamedia)
Outer layer(tunicaexterna)
c: © The McGraw-Hill Companies, Inc./Al Telser, photographer
36
15.2 From Science to Technology
Altering Angiogenesis
37
Arteries and Arterioles
• Arteries:• Thick strong wall (three layers or tunics) • Endothelial lining• Middle layer of smooth muscle and elastic tissue• Outer layer of connective tissue• Carries blood under relatively high pressure
• Arterioles:• Thinner wall than an artery (three layers or tunics)• Endothelial lining• Middle and outer layers are thinned• Some smooth muscle tissue• Small amount of connective tissue• Helps control blood flow into a capillary
Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.
Arteriole
Capillary
Endothelium
Smoothmuscle cell
Precapillarysphincter
38
39
Capillaries
• Capillaries are the smallest diameter blood vessels• They connect the smallest arteriole and the smallest venule• They are extensions of the inner lining of arterioles• The walls are endothelium only• They are semi-permeable
Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.
Arteriole
Artery
Blood flow Blood flow
Capillaries
Metarteriole (forming arteriovenousshunt)
Venule
Vein
Precapillarysphincter
40
Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.
(c)
Cell junction
(b)
Slit
Capillary
(a)
Endothelial cellNucleus ofendothelialcell
Endothelialcell cytoplasm
Lumen ofcapillary
Tissue fluid
Tissue fluid
b,c, : © Don. W. Fawcett/Visuals Unlimited
41
Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.
Arteriole
Capillary
Venule
© Don. W. Fawcett/Visuals Unlimited
42
Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.
Net force at arteriolar end
Outward force, including hydrostatic pressure = 35 mm Hg
Inward force of osmotic pressure = 24 mm HgNet outward pressure = 11 mm Hg
Net force at venular end
Outward force, including hydrostatic pressure = 16 mm HgInward force of osmotic pressure = 24 mm HgNet inward pressure = 8 mm Hg
Capillary
Bloodflowfromarteriole
Outward force,includinghydrostaticpressure35 mm Hg
Inward forceof osmoticpressure24 mm Hg
Net outwardpressure11 mm Hg
Lymphaticcapillary Tissue
cells
Outward force,includinghydrostaticpressure16 mm Hg Inward force of
osmotic pressure24 mm Hg
Net inwardpressure8 mm Hg
Bloodflow tovenule
43
Venules and Veins
• Venule:• Microscopic vessels that continue from the capillaries and merge to form veins• Thinner walls than arterioles• Less smooth muscle and elastic tissue than arteriole
• Veins:• Thinner walls than arteries (three layers or tunics)• Middle wall poorly developed• Many have flap-like valves• Carry blood under relatively low pressure• Function as blood reservoirs
44
Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.
(a) (b)
Towardheart
Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.
100
90
80
70
60
50
40
30
20
10
0
Pe
rce
nt
dis
trib
uti
on
Largeveins
Smallveinsand
venules
Systemicveins
60–70%
Lungs10–12%
Heart8–11%
Systemicarteries10–12%
Capillaries 4–5%
45
46
15.5: Blood Pressure
• Blood pressure is the force the blood exerts against the inner walls of the blood vessels
47
Arterial Blood Pressure
• Arterial blood pressure:• Rises when the ventricles contract• Falls when the ventricles relax• Systolic pressure is the maximum pressure during ventricular contraction• Diastolic pressure is the minimum pressure when the ventricles relax
48
Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.
Temporal a.
Carotid a.
Brachial a.
Radial a.
Dorsalis pedis a.Posterior tibial a.
Popliteal a.
Femoral a.
Facial a.
49
15.2 Clinical Application
Blood Vessel Disorders
50
Factors That Influence Arterial Blood Pressure
Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.
Blood pressure increases
Blood volumeincreases
Heart rateincreases
Stroke volumeincreases
Blood viscosityincreases
Peripheral resistanceincreases
51
15.3 Clinical Application
Measurement of Arterial Blood Pressure
52
15.4 Clinical Application
Space Medicine
53
Control of Blood Pressure
• Blood pressure (BP) is determined by cardiac output (CO) and peripheral resistance (PR) according to this relationship: BP = CO x PR• Maintenance of blood pressure requires regulation of these two factors
Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.
Decreased cardiac output
Increased cardiac output
Increased blood pressure
Decreased blood pressure
Blood pressure maintained
Decreased heart rate Decreased stroke volume
Increased heart rate Increased stroke volume
Decreased peripheral resistance
Increased peripheral resistance
Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.
Cardiac output increases
Blood pressure rises
Sensory impulses to cardiac center
Parasympathetic impulses to heart
Heart rate decreases
Baroreceptors in aortic arch andcarotid sinuses are stimulated
Blood pressure returnstoward normal
SA node inhibited
Rising blood pressure
Sensory impulses to vasomotor center
Decreased peripheral resistance
Blood pressure returns toward normal
Stimulation of baroreceptors inaortic arch and carotid sinuses
Less frequent sympathetic impulsesto arteriole walls
Vasomotor center inhibited
Vasodilation of arterioles
54
Venous Blood Flow• Blood pressure decreases as the blood moves through the arterial system and into the capillary network, so little pressure remains at the venular ends of the capillaries• Only partly a direct result of heart action• Dependent on:
• Skeletal muscle contraction• Breathing• Venoconstriction
Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.
Valve open
Contractedskeletal muscle
Vein
Valve closed
Relaxed skeletalmuscle
Vein
To heart
To heart
55
56
15.5 Clinical Application
Hypertension
57
Central Venous Pressure
• All veins, except those returning to the heart from the lungs, drain into the right atrium• This is therefore pressure in the right atrium• Factors that influence it alter flow of blood into the right atrium• It effects pressure within the peripheral veins• A weakly beating heart increases central venous pressure• An increase in central venous pressure causes blood to back up into the peripheral veins• This can lead to peripheral edema
58
15.6 Clinical Application
Exercise and the Cardiovascular System
59
15.6: Paths of Circulation
• Blood vessels can be divided into two major pathways:• The pulmonary circuit• The systemic circuit (includes coronary circulation)
Pulmonary Circuit
Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.
Left pulmonary artery
Pulmonary capillaries
Left pulmonary veins
Left lung
AortaRight pulmonary artery
Pulmonary capillaries
Pulmonary trunk
Right pulmonary veins
Right lung
Inferior vena cava
Superiorvena cava
60
61
Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.
1
3
4
2
Interstitial space
Blood flowBlood flow
Alveolar capillary
Alveolar air
Alveolar wall
Capillary wall
Fluid from theinterstitial spaceenters lymphaticcapillary or alveolar(blood) capillary
Any excess water inalveolus is drawn out bythe higher osmotic pressureof the interstitial fluid
Solutes fail to enteralveoli but contribute tothe osmotic pressure ofthe interstitial fluid
Slight net outflowof fluid from capillary
Lymphatic capillary
Lymph flow
62
Systemic Circuit
• Composed of vessels that lead from the heart to all body parts (except the lungs) and back to the heart• Includes the aorta and its branches• Includes the system of veins that return blood to the right atrium
63
15.7: Arterial SystemCopyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.
Superficial temporal a.
External carotid a.
Internal carotid a.
Common carotid a.
Brachiocephalic a.Axillary a.
Intercostal a.Suprarenal a.Brachial a.
Renal a.Radial a.
Common iliac a.Internal iliac a.
External iliac a.Ulnar a.
Deep femoral a.
Popliteal a.
Anterior tibial a.
Fibular a.
Dorsalis pedis a.
Subclavian a.
AortaCoronary a.
Celiac a.Superior mesenteric a.
Lumbar a.
Inferior mesenteric a.Gonadal a.
Femoral a.
Posterior tibial a.
Vertebral a.
64
Principal Branches of the Aorta
65
Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.
Right common carotid a.
Right internal jugular v.
Right subclavian a.
Brachiocephalic a.
Superior vena cava
Right pulmonary a.
Right auricle
Pulmonary trunk
Left common carotid a.
Left subclavian a.
Aortic arch
Ligamentum arteriosum
Left pulmonary a.
Left pulmonary vv.
Left auricle
Brachiocephalic vv.
Right pulmonary vv.
Left internal jugular v.
66
Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.
Hepatic a.
Renal aa.
Splenic a.Celiac a.
(b)
(a)
Right gastric a.Hepatic a.
Celiac a.
Phrenic aa.
Suprarenal a.
Renal a.
Middle sacral a.
Gonadal a.Lumbar aa.
Abdominal aorta
Splenic a.Left gastric a.
Common iliac aa.
Superiormesenteric a.
Inferiormesenteric a.
Intestinal branches fromsuperior mesenteric a.
Branches from inferiormesenteric a.
Commoniliac aa.
Abdominalaorta
b: © Dr. Kent M. Van De Graaff
67
Arteries to the Brain, Head, and Neck
Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.
Basilar a.Basilar a.
Vertebral a.
Spinal cord
Spinal a.
Anteriorcerebral a.
Middlecerebral a.
Posteriorcommunicating a.
Posteriorcerebral a.
Anteriorcommunicating a.
Internalcarotid a.
Pituitarygland
Anteriorcerebral a.
Middlecerebral a.
68
Arteries to the Brain, Head, and Neck
Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.
Basilar a.
Occipital a.
Carotid sinus
Subclavian a.
Lingual a.
Common carotid a.
Brachiocephalic a.
Anterior choroid a.
Maxillary a.
Facial a.
Superior thyroid a.
Superficialtemporal a.
Posteriorauricular a.
Internalcarotid a.
Externalcarotid a.
Thyrocervicalaxis
Vertebral a.
69
Arteries to the Shoulder and Upper Limb
Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.
Right common carotid a.
Right subclavian a.
Anterior circumflex a.
Posterior circumflex a.
Axillary a.
Brachial a.
Radial recurrent a.
Radial a.
Ulnar a.
Deep volar arch a.
Superficial volar arch a.
Digital a.
Ulnar recurrent a.
Deep brachial a.
Principalartery ofthumb
70
Arteries to the Thoracic and Abdominal Walls
Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.
Internal intercostal m.
External intercostal m.
Costal cartilage
Internal thoracic a.
Posterior intercostal a.
Anterior intercostal aa.
Sternum
Thoracic aorta
Vertebral body
Arteries to the Pelvis
Inferior mesenteric a.
Inferior epigastric a.Right common iliac a.
Internal iliac a.
External iliac a.
Femoral a.
Obturator a.
Superior vesical a.
Aorta
Left common iliac a.
Middle sacral a.
Iliolumbar a.
Superior gluteal a.
Lateral sacral a.
Inferior gluteal a.Internal pudendal a.
Inferior vesical a.
Perineal a.
Inferior rectal a.
Deepcircumflex iliac a.
Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.
71
Arteries to the Lower LimbCopyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.
External iliac a.
Deep femoral a.
Lateral femoral a.
Femoral a.
Deep genicular a.
Anterior tibial a.
Posterior tibial a.
Dorsalis pedis a.
Medial plantar a.
Anterior view Posterior view
Lateral plantar a.
Fibular a.
Popliteal a.
Right common iliac a.
Deep circumflex iliac a.
Superficial circumflex iliac a.Superficialpudendal a.
Internal iliac a.
Abdominalaorta
72
73
15.8: Venous System
Superior vena cava
Inferior vena cava
Anterior tibial vv.
Small saphenous v.
Posterior tibial vv.
Popliteal v.
Femoral v.
External iliac v.Common iliac v.
Ulnar vv.Radial vv.
Renal v.Median cubital v.
Great saphenous v.
Internal iliac v.Gonadal v.
Ascending lumbar v.
Hepatic v.
Azygos v.
Subclavian v.
External jugular v.
Superficial temporal v.
Anterior facial v.
Internal jugular v.
Right brachiocephalic v.Axillary v.
Cephalic v.Brachial vv.
Basilic v.
Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.
74
Characteristics of Venous Pathways
• Vessels of the venous system originate with the merging of capillaries into venules, venules into small veins, and small veins into larger ones• Unlike arterial pathways, those of the venous system are difficult to follow due to irregular networks and unnamed tributaries
75
Veins from the Brain, Head, and Neck
Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.
Venoussinuses
Vertebral v.
Right externaljugular v.
RightSubclavian v.
Right axillary v.
Right brachiocephalic v.
Superiorophthalmic v.
Anteriorfacial v.
Right internaljugular v.
76
Veins from the Upper Limb and Shoulder
Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.
Superior vena cava
Left brachiocephalic v.
Right internal jugular v.Right external jugular v.
Right subclavian v.
Right brachiocephalic v.
Axillary v.
Brachial vv.
Cephalic v.
Basilic v.
Median cubital v.
Radial vv.
Ulnar vv.
Dorsal arch v.
77
Veins from the Abdominal and Thoracic Walls
Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.
Brachial v.
Basilic v.
Azygos v.
Cephalic v.
External jugular v.
Subclavian v.
Superior vena cava
Axillary v.
Inferior hemiazygos v.
Posterior intercostal v.
Superior hemiazygos v.
Brachiocephalic vv.
Internal jugular v.
78
Veins from the Abdominal Viscera
Liver
Gallbladder
Pancreas
Ascending colon
Stomach
Spleen
Descending colon
Rectum
Hepaticportal v.
Superiormesenteric v.
Portion ofsmall intestine
Inferiormesenteric v.
Splenic v.
Right gastric v.
Left gastric v.
Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.
79
Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.
Lungs
Aorta
Liver
Renal capillaries
Lower limb capillaries
Hepatic vein
Splenic artery
Hepatic artery
Oxygenated blood
Deoxygenated blood
Head and upperlimb capillaries
Superiorvena cava
Inferiorvena cava
Commoniliac vein
Trunk capillaries
Renal efferentarterioles
Hepaticportal vein
Commoniliac artery
Renal afferentarterioles
Mesenteric artery(to intestine)
80
Veins from the Lower Limb and Pelvis
Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.
Anterior view Posterior view
Right commoniliac v.
External iliac v.
Inferiorvena cava
Internaliliac v
Femoral v.
Great saphenous v.
Popliteal v.
Anterior tibial vv.
Fibular vv.
Posterior tibial vv
Lateral plantar vv.
Small saphenous v.
Dorsalis pedis v.
Medial plantar vv.
81
15.9: Lifespan Changes
• Cholesterol deposition in the blood vessels• Heart enlargement• Death of cardiac muscle cells • Increase in fibrous connective tissue of the heart • Increase in adipose tissue of the heart• Increase in blood pressure• Decrease in resting heart rate
82
15.7 Clinical Application
Molecular Causes of Cardiovascular Disease
83
15.8 Clinical Application
Coronary Artery Disease
84
Important Points in Chapter 15:Outcomes to be Assessed
15.1: Introduction
Discuss the functions of the organs of the cardiovascular system.
15.2: Structure of the Heart
Distinguish between the various coverings of the heart and the layers that compose the wall of the heart.
Identify and locate the major parts of the heart and discuss the function of each part.
Trace the pathway of the blood through the heart and the vessels of coronary circulation.
15.3: Heart Actions
Describe the cardiac cycle and explain how heart sounds are produced.
85
Important Points in Chapter 15:Outcomes to be Assessed
Identify the parts of a normal ECG pattern and discuss the significance of this pattern.
Explain control of the cardiac cycle.
15.4: Blood Vessels
Compare the structures and functions of the major types of blood vessels.
Describe how substances are exchanged between blood in capillaries and the tissue fluid surrounding body cells.
15.5: Blood Pressure
Explain how blood pressure is produced and controlled.
Describe the mechanisms that aid in returning venous blood to the heart.
86
Important Points in Chapter 15:Outcomes to be Assessed
15.6: Paths of Circulation
Compare the pulmonary and systemic circuits of the cardiovascular system.
15.7-15.8: Arterial System – Venous System
Identify and locate the major arteries and veins.
15.9: Lifespan Changes
Describe the lifespan changes in the cardiovascular system.