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Semelhante a Circulation online (20)
Circulation online
- 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
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- 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
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- 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
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- 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
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- 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.
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Figure 18.19a
- 10. Naming Major Arteries
1. Body region
2. Organ served
3. Bone followed
•
Veins often take name of artery
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- 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
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- 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
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- 14. Circle of Willis
• Blood supply to the brain is important
• Circle of Willis provides possible alternative
circulation
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- 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
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- 16. Thoracic Aorta
• Visceral branch - supplies organs of the thorax
(above the diaphragm)
• Esophagus
• Lungs
• Pericardium
• Parietal branch supplies thoracic:
• Muscles
• Bones
• Nerves
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- 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)
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- 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
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- 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
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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
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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
- 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
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- 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
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- 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
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- 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
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(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
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- 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.
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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
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- 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
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- 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
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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.
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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
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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
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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
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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
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Figure 18.30a
- 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)
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- 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
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Figure 18.12
- 39. Measuring Blood Pressure
• Systemic arterial BP
• Measured indirectly by the auscultatory method
using a sphygmomanometer (pressure cuff) and
stethoscope
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- 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
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- 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
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