Blood draining from the myocardium

is collected by the cardiac veins and reenters the right atrium vis the coronary sinus

Deep Veins

parallel the course of systemic arteries. Naming of veins is identical to their companion arteries

Superficial Veins

run beneath the skin. Can be seen in limbs, face, & neck

- There are NO superficial arteries; therefore, names of superficial veins don't correspond to any arteries

Dural Sinuses

venous blood draining from the brain enters here rather than veins

Hepatic portal circulation

venous blood draining from digestive organs enters here and perfuses through the liver BEFORE entering systemic circulation again.

• vein-capillary-vein system

Blood pressure changes with age

Newborn: arterial pressure = 90/55

childhood (rises) to adulthood = 120/80

Old age (norm) = 150/90

What effects do atherosclerosis have on a vessel?

increase resistance due to rigidity and protein buildup

Are the vessels of males or females more affected by atherosclerosis and why?

Females: puberty to ~45, women have less atherosclerosis due to protection of estrogen

• estrogen reduces resistance due to the enhanced nitric oxide production, inhibiting endothelial release & block voltage-gated Ca2+
• stimulates the liver to produce enzymes that speed up catabolism of LDLs & increases production of HDLs, thus reducing atherosclerosis

Both sexes: after age of 65, atherosclerosis risk rises

Pulmonary Circulation

function: only brings blood into close contact w/ alveoli sofas can be exchanged.

blood: oxygen-poor, dark red blood

pulmonary circulation route

enters the R Ventricle > large pulmonary trunk > R & L pulmonary arteries > (in lungs) blood subdivides into lobar arteries > arterioles > pulmonary capillaries embedded in the air sacs

- O2 moves from alveolar sacs into blood & CO2 swaps

Pulmonary circulation route post gas exchange

Bright red blood in capillaries drain--> venules --> (form) 2 pulmonary veins exiting from each lung (2 each) > O2 rich blood is dumped into R Atrium

Pulmonary Arteries

carry O2-poor blood, CO-rich blood

Pulmonary veins

Carry O2-Rich blood, CO2-poor blood

Systemic circulation arteries

carry O2-rich blood

Systemic circulation veins

carry CO2-rich, and O2-poor blood

Systemic circulation

Function: provides functional blood supply to all body tissues. Delivers O2, nutrients, and carries away wastes & CO2

Systemic circulation route

oxygenated blood returning from pulmonary circuit is pumped OUT of L ventricle > aorta > aortic branches > arterioles > capillaries (organs)

Systemic circulation route

Venous blood draining from organs inferior to the diaphragm enter the Inferior vena cava. The vena cava dump CO2 laden blood into the R Atrium

Systemic circulation route

Venous blood draining from organs superior to the diaphragm enter the Superior vena cava. The vena cava dump CO2 laden blood into the R Atrium

Blood passes from the systemic veins to systemic arteries ...

ONLY after first moving through the pulmonary circuit

Although the entire cardiac output of the R ventricle passes through the pulmonary circulation...

a small fraction of the output of the L ventricle flow through any single organ

Aorta

• largest artery in the body & issues from L ventricle
• internal diameter is 2.5 cm
• wall is 2 MM thick; decreases slightly in size at terminus
• Aortic sinus = Opposite each aortic valve cusp; contains baroreceptors important in reflex regulation of B/P

Ascending aorta

• runs posteriorly and to Right of pulmonary trunk
• ~5 cm long before curving the left as the Aortic arch

Right and left coronary arteries

• the only branches of the ascending aorta
• supply the myocardium

Aortic arch

• is deep to the sternum
• begins and ends at the sternal angle (T4 level)
• has 3 major branches that supply the head, neck & upper limbs

Aortic arch: Brachiocephalic trunk (1)

• "armhead"
• passes superiorly under the right clavicle and branches under the right clavicle and branches into
  • Right common carotid artery
  • Right subclavian artery

Aortic arch: branches 2 & 3

• Left common Carotid artery (2)
• Left subclavian artery (3)
• these 3 vessels provide blood supply to head, neck, upper limbs & thorax wall.

Descending (thoracic) aorta

• runs along anterior spine of T5 - T12
• various small arteries run off from here into viscera

Abdominal Aorta

• stems from descending aorta
• supplies abdominal walls & viscera
• ends at the T4 level

Right and left common iliac

• splits off from end of abdominal aorta
• supply the pelvic and lower limbs

Common carotid arteries

• each common carotid artery divides into 2 branches
• at the division point, each internal carotid artery has a slight dilation point => carotid sinus
• ascend through the lateral neck, at the superior border of the larynx; branches off

Carotid Sinus

contains baroreceptors that assist in flex blood pressure control

Carotid Bodies

chemoreceptors are located here and are involved in the control of respiratory rate

Right common carotid artery

• arises from the brachiocephalic trunk

Left common carotid artery

• its the second brach of the aortic arch

External Carotid Arteries

• supply cranial tissue EXCEPT for the brain and orbit

Superior thryoid artery

• branches off from external carotid into thyroid gland and larynx

Linguinal artery

• branches off from external carotid artery and supplies the tongue

Facial Artery

• branches off from external carotid artery
• supplies the skin & muscles of the anterior face

Occipital Artery

• branches off from external carotid artery
• supplies the posterior scalp

Superficial temporal Artery

• splits off from the ends of the external carotid artery
• supplies the parotid salivary gland and most of the scalp

Maxillary Artery

• supplies the upper and lower jaws, chewing muscles, teeth and nasal cavity

Middle meningeal Artery

• enters the skull through the foramen spinosum
• supplies the inner surface of the parietal bones, squamous region of temporal bones, and underlying dura mater

Internal Carotid Artery

• supplies the orbits & 80% of the cerebrum
• inside cranium, it divides into
  • ophthalmic artery
  • anterior & middle cerebral artery

Ophthalmic artery

• supplies the eyes, orbits, forehead, and nose

Anterior cerebral artery

• supplies the medial surface of the frontal and parietal lobes of the cerebral hemispheres

Middle Cerebral Arteries

• run in the lateral sulci of respective cerebral hemispheres
• supply the lateral parts of the temporal, parietal and frontal lobes

Vertebral arteries

• spring from the subclavian arteries at the root of the neck and ascend through the foramina in the transverse processes of the cervical vertebrae to enter the skull through the foramen magnum

Basilar artery

• ascends along anterior aspect of the brain stem
• gives off branches to the cerebellum, pons, and inner ear

Posterior cerebral arteries

• Supply the occipital lobes & inferior parts of temporal bones

Posterior communicating arteries

• arterial shunts that connect the posterior cerebral arteries to the middle cerebral arteries anteriorly

Cerebral arterial circle (circle of Willis)

• arterial anastomoses created by the anterior and 2 posterior communicating arteries
• structure encircles the pituitary gland & optic chiasma
• unites the brain's anterior & posterior blood supplies
• equalizes BP & provides alternate blood routes (IF blockage present)

Thryocervical trunk

• short vessel that arises from subclavian artery
• supplies the thyroid gland, portions of cervical vertebrae, & spinal cord, some scapular muscles

Costocervical Trunk

• short vessel that arises from subclavian artery
• serves the deep neck & superior intercostal muscles

Subclavian Arteries

• branch to entirely supply the upper limbs

Axillary Artery

• branching from subclavian artery; runs through axilla
• gives off branches to axilla, chest wall, & shoulder girdle

Thoracoacromial artery

• supplies the deltoid muscle and pectoral region

Lateral Thoracic artery

• serves the lateral chest wall and breast

Subscapular artery

• scapula
• dorsal thorax wall
• part of latissimus dorsi muscle

Anterior & Posterior circumflex humeral arteries

• wrap around the humeral neck
• supply the shoulder joint & deltoid muscle

Brachial artery

• emerges from the axillary artery
• runs down medial aspect of humerus
• supplies the anterior flexor muscles of arm

Deep Artery of the Arm

• major branch of brachial artery
• supplies serves posterior triceps brachii muscle

Radial Artery

• runs from the median line of the cubital fossa to the styloid process of the radius
• supplies lateral muscles of forearm, wrist, thumb & index finger
• find radial pulse here

Ulnar artery

• supplies the medial aspect of the forearm, fingers 3-5, medial aspect of index finger

Common interosseous artery

• short brach at proximal end
• runs between the radius and ulna to serve the deep flexors & extensors of the forearm

Palmar arches

• branches of radial & ulnar arteries anastomose to form the superficial & deep palmar arches

Metacarpal & digital arteries

• supply the fingers
• arise from palmar arches

Internal thoracic arteries

• "mammary arteries"
• arise from subclavian arteries
• supply blood to most of anterior thorax wall

anterior intercostal arteries

• supply the intercostal spaces anteriorly

Posterior intercostal arteries

• superior 2 pair: derive from costocervical trunk
• next 9 pairs: issue from the thoracic aorta, course around the rib cage to anastomose anteriorly with anterior intercostal arteries

Subcostal artery

• 12th rib artery: emerges from thoracic aorta

Posterior intercostal arteries

Supplies:

• posterior intercostal spaces
• deep muscles of the back
• vertebrae
• spinal cord

Superior phrenic arteries

• serve the posterior aspect of the diaphragm surface

Pericardial Arteries

• several tiny branches supply the posterior pericardium

Bronchial arteries

• 2 left and 1 right bronchial arteries supply systemic blood to the lungs, bronchi, and pleurae

Esophageal arteries

• 4-5; supply esophagus

mediastinal arteries

• many & small; serve the posterior mediastinum

Inferior phrenic arteries

• emerge from the aorta at T12, inferior to diaphragm
• serve the inferior diaphragm surface

Celiac trunk

• large and unpaired branch that divides into 3 branches
  • common hepatic
  • splenic
  • left gastric arteries

Common hepatic artery

• gives off branches to the stomach, duodenum & pancreas

Gastroduodenal artery

• branches off of common hepatic artery
• becomes the hepatic artery proper

Hepatic artery proper

• splits into right and left branches
• branches serve the liver

Splenic Artery

• passes deep to the stomach
• sends branches to the pancreas and stomach
• terminates in branches to the spleen

Left gastric artery

• supplies part of the stomach & inferior esophagus

Right and Left gastroepiplotic artery

• branches off the gastroduodenal and splenic arteries
• Serve the greater curvature of the stomach

Right Gastric Artery

• supplies the lesser curvature of the stomach
• may arise from the common hepatic artery OR the hepatic artery proper

Superior Mesenteric artery

• large, unpaired artery arises from the abdominal aorta at the L1 level immediately below the celiac trunk
• runs deep to the pancreas, enters the mesentery

Intestinal Arteries

• anastomoses from the superior mesenteric artery
• serves all of the small intestine
• serves most of the large intestine (appendix, cecum, ascending colon)

Ileocolic artery

• a part of the intestinal artery
• serves appendix, cecum, and ascending colon

Right and middle colic arteries

• is a part of the intestinal artery
• serves part of the transverse colon

Suprarenal arteries

• supply blood to the adrenal glands overlying the kidneys

Renal Arteries

• short, wide; right and left, issue from the lateral surfaces of the atria slightly below the superior mesenteric artery
• serves the kidneys

Gonadal arteries: Testicular

• paired & long; descend through the pelvis and inguinal canal to enter the scrotal sac
• serve the testes

Gonadal arteries: Ovarian

• extend into the pelvis to serve the ovaries and part of the uterine tubes

Inferior mesenteric artery

• final major branch of the abdominal aorta
• unpaired & aries from anterior aortic surface at the L3 level
• serves the distal part of large intestine

Lumbar Arteries

• four pairs of lumbar arteries arise from posterolateral surface of aorta in the lumbar region
• supplies the posterior abdominal wall

Median sacral artery

• unpaired and issues from posterior surface of abdominal aorta at the terminus
• supplies the sacrum and coccyx

Common Iliac arteries

• at L4 level; splits into Right & Left common iliac arteries
• supply lower abdominal wall, pelvic organs and lower limbs
• divides into 2 branches

Internal Iliac arteries

• paired arteries run into the pelvis
• supply blood to pelvic walls & viscera
  • bladder, rectum, uterus, & vagina
  • prostate gland & ductus deferens in males

Superior and Inferior gluteal arteries

• serve the gluteal muscles

Obturator artery

• serve the adductor muscles of the medial thigh

Pudendal artery

• serve the external genitalia and perineum

External Iliac Arteries

• supply the lower limbs
• as they course through the pelvis, they give off branches to the anterior abdominal wall

Deep Femoral artery

• largest of the femoral arteries branch
• main supply to thigh muscles
  • hamstrings
  • quads
  • adductors

Lateral & medial circumflex femoral arteries

• encircle the neck of the femur
• Medial: supplies head & neck of femur
• Lateral: supplies the vests lateralis muscle

Popliteal Artery

• Supplies the knee region
• splits into anterior and posterior tibial arteries in leg

Anterior Tibial artery

• runs through anterior compartment of the leg
• supplies the extensor muscles

Dorsalis pedis artery

• supplies the ankle and dorsum of the foot
• pulse point; strong pulse = goof blood flow to leg

Arcuate artery

• branches off from dorsallis pedis artery
• issues the metatarsal arteries
  • supplies the metatarsals of the foot

Posterior Tibial artery

• large artery; courses through posteromedial part of leg
• supplies flexor muscles

Fibular (peroneal) artery

• proximal to posterior tibial artery
• large branch
• supplies the lateral fibularis muscle of the leg

Lateral and medial plantar arteries

• at the ankle, the posterior tibial artery divides into these
• supplies the plantar surface of the foot
• Lateral: forms the lateral end of plantar arch

Digital arteries

• serve the toes and arise from the plantar arch

Veins of the systemic circulation

• run toward the heart
• distal veins are names first
• closest to the heart named last

Superior vena cava

• great vein receives systemic blood from all areas SUPERIOR to the diaphragm, EXCEPT heart wall
• formed by the union of the Right and Left Brachiocephalic veins
• empties INTO the RIGHT atrium

Brachiocephalic Veins

• two; each vein is formed by the union of the internal jugular & subclavian vein

Inferior vena cava

• widest blood vessel in the body
• returns blood TO the heart from all body regions BELOW the diaphragm
• abdominal aorta lies to the left

Inferior vena cava

• Distal end of inferior vena cava is formed by junction of paired common iliac veins at L5
  • travels superiorly along anterior aspect of spine
  • receives venous blood draining from abdominal walls, gonads & kidneys
  • enters the inferior aspects of the right atrium

Dural Sinuses

• veins of the brain drain here
• an interconnected series of enlarged chambers located between the dura mater layers

Superior and Inferior sagittal sinuses

• located in the falx cerebri, which dips down between the cerebral hemispheres
• these drain into the straight sinus posteriorly

Transverse sinus

• the superior sagittal and straight sinuses empty here
• run in shallow grooves on the internal surface of the occipital bone

Sigmoid Sinuses

• the transverse sinuses drain here
• "S-shaped"
• become the Internal jugular veins
• Leave the skull via the jugular foramen

Cavernous sinuses

• flank the sphenoid body
• receive venous blood from the ophthalmic veins

Ophthalmic veins

• supply the orbits and facial veins
• drain into the nose and upper lip area

External jugular veins

• R & L drain superficial scalp & face structures served by the external carotid arteries
• descend through the lateral neck; pass obliquely over sternocleidomastoid muscles
• empty into subclavaian vein

Vertebral Veins

• DON'T serve much of the brain
• drain the cervical vertebrae, spinal cord, & some neck muscles
• run inferiorly through transverse foramina of cervical vertebrae
• join brachiocephalic veins at root of neck

Internal Jugular Veins

• paired; receive the bulk of the blood draining from the brain
• largest of the paired veins draining from the head & neck
• arise from dural venous sinuses & exit the skull via Jugular foramina
• descend through the neck alongside the internal carotid arteries

Brachiocephalic Veins

• blood from the mammary glands and the first 2 or 3 intercostal spaces drain here

Azygos System

• drain the thoracic tissues & thorax wall
• branching nature provides a collateral circulation for draining the abdominal wall and other parts served by the inferior vena cava

Palmar venous arch

• deep and superficial
• found in the hand
• empty into the Radial & Ulnar veins of the forearm
• all unite to form the Brachial vein

Brachial Vein

• vein found in the arm
• becomes the Axillary vein as it enters the axilla

Axillary Vein

• Found in the armpit, adjacent to axillary artery
• this vein becomes the Subclavian vein at the level of the first rib

Dorsal venous arch

• the superficial venous system begins here
• it's a plexus of superficial veins in the dorm of the hand
• in the distal forearm, the plexus drains into the
  • cephalic, basilic veins, & median antebrachial vein

Cephalic vein

• bends around the radius as it travels upward
• continues up the lateral superficial aspect of the arm to the shoulder
• runs in the the groove between the deltoid and pectoralis muscles to join the axillary vein

Basilic vein

• runs along the posteromedial aspect of the forearm & crosses the elbow
• Joins the brachial vein in the axilla to make the axillary vein

Medial cubital vein

• on the anterior aspect of the elbow
• connects the basilic and cephalic veins

Median antebrachial vein

• on the forearm; lies between the radial & ulnar veins in the forearm
• terminates at the elbow by entering either the basilic or cephalic vein

Azygos vein

• located against the right side of the vertebral column
• originates in the abdomen, from the R ascending lumbar vein that drains most of the right abdominal cavity wall
• and from R posterior intercostal veins that drain the chest muscles
• at T4 level, it arches over great vessels that run to the R lung & empties into Superior vena cava

Hemiazygos vein

• vessel ascends on the left side of the vertebral column
• origin: from L ascending lumbar vein & lower posterior intercostal veins mirror the inferior portion of the azygos vein on the right
• midthorax, this vein passes in front of vertebral column & joins the azygos vein

Accessory Vein

• completes the venous drainage on the L thorax
• continuation of the hemiazygos vein
• receives blood from 4-8th posterior intercostal vein
• crosses Right to empty into azygos vein
• receives venous blood from lungs

Hepatic portal vein

• veins draining digestive viscera empty here
• transports blood into liver BEFORE entering systemic circulation via hepatic veins

Portal system

• a venous system
• veins -> capillaries (or sinusoids) -> veins
• serve specific regional tissue needs

Hepatic portal system

• carries nutrient rich blood from digestive organs to liver
• hepatocytes, in liver sinusoids, remove nutrients (metabolic functions)
• phagocytic cells in the sinusoids rid blood bacteria/debris

Lumbar veins

• drain the posterior abdominal wall
• empty into inferior vena cava and into ascending lumbar veins of azygos system of thorax

Gonadal Veins (testicular or ovarian)

• Right vein drains the ovary or testis on the R side of body and empties into the inferior vena cava
• Left vein drains into the left renal vein superiorly

Renal veins

• the R and L renal veins drain the kidneys

Suprarenal veins

• Right: drink the adrenal gland on the right; empties into inferior vena cava
• Left: drains into the left renal vain

Hepatic portal system

• series of vessels in which 2 separate capillary beds lie between the arterial supply and the venous drainage
• numerous tributaries from stomach & pancreas contribute to this system
• 1st capillary bed: in stomach, intestines, drain into hepatic portal vein

Hepatic portal vein

• second capillary bed in the liver
• short portal; begins at L2 level

Superior Mesenteric vein

• major vessel of hepatic portal vein
• drains entire small intestine, part of large intestine & stomach

Splenic Vein

• major vessel of hepatic portal vein
• collects blood from spleen, parts of stomach & pancreas
• joins superior mesenteric vent form hepatic portal vein

Inferior mesenteric vein

• drains distal portions of large intestine & rectum
• joins the splenic vein before the vessel joins the superior mesenteric vein to form hepatic portal vein

Hepatic Veins

• R & L veins carry venous blood from liver to the inferior vena cava

Cystic veins

• drain the gall bladder
• join hepatic veins

Inferior phrenic veins

• drain the inferior surface of the diaphragm

Deep Veins: Posterior Tibial Vein

• formed by the union of the medial & lateral plantar veins
• ascends deep in the calf muscle
• receives the fibular vein

Anterior Tibial vein

• it's the superior continuation of the doornails pedis vein of the foot
• unites at the knee w/ the posterior tibial vein to form the popliteal vein

Popliteal vein

• crosses the back of the knee
• as it emerges from knee, it becomes the femoral vein

Femoral Vein

• emerges from popliteal vein
• drains the deep structures of the thigh
• its becomes the external iliac vein

External Iliac Vein

• enters the pelvis
• inside the pelvis, this vein unites with the internal iliac vein = common iliac vein

Superficial veins: Great & small saphenous veins

• issue from the dorsal venous arch of foot
• anastomose frequently with each other and deep veins

Great Saphenous Vein

• longest vein in the body
• travels superiorly along the medial aspect of the leg to the thigh
• empties (from thigh) distal to the inguinal ligament

Small Saphenous vein

• runs along the lateral aspect of foot & then through the fascia of the calf muscle
• Drains the calf muscle
• at the knee, it empties into the popliteal vein