CARDIOVASCULARsinoemedicalassociation.org/AP4/VASCULATURE2.pdfR. upper limb L. and R. coronary arteries L. subclavian – neck and L. upper limb L. ventricle of heart Thoracic aorta

18

CARDIOVASCULAR

DANIL HAMMOUDI.MD

Systemic Circulation

Figure 19.19

Pulmonary Circulation

Figure 19.18b

1. Thyroid gland 2. Trachea 3. Brachiocephalic

artery 4. Common carotid

artery 5. Internal jugular vein 6. Superior vena cava

Figure 19.21a

Figure 19.21b(b)

Superficialtemporal artery

Ophthalmic artery

Maxillary arteryOccipital artery

Facial artery

Lingual arterySuperior thyroidarteryLarynxThyroid gland(overlying trachea)

Clavicle (cut)

BrachiocephalictrunkInternal thoracicartery

Basilar artery

Vertebral arteryInternalcarotid artery

SubclavianarteryAxillaryartery

Externalcarotid arteryCommoncarotid arteryThyrocervicaltrunkCostocervicaltrunk

Copyright © 2010 Pearson Education, Inc.

Figure 19.20 Schematic flowchart showing an overview of the systemic

circulation.

Azygossystem

Venousdrainage

Arterialblood

Thoracicaorta

Inferiorvenacava

Abdominalaorta

Inferiorvenacava

Superiorvena cava

Commoncarotid arteriesto head andsubclavianarteries toupper limbs

Aortic arch

Aorta

RA

RV LV

LA

Capillary beds ofhead andupper limbs

Capillary beds ofmediastinal structuresand thorax walls

Diaphragm

Capillary beds ofdigestive viscera,spleen, pancreas,kidneys

Capillary beds of gonads,pelvis, and lower limbs


Figure 19.21a Major arteries of the systemic circulation.

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

glandsandRenal

– 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

abdominalwall

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


Figure 19.21b Major arteries of the systemic circulation.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 trunkArteries that supply the upper limb

Arteries that supply the lower limb


Brachiocephalic trunk

Aortic arch

(a) Schematic flowchart

R. and L. anterior cerebral arteries

Anteriorcommunicating

artery

R. and L.posterior

communicating arteries

Basilarartery

R. and L.commoncarotid arteries

R. and L.subclavian arteries

Superiorthyroidartery

Lingualartery

Facialartery

Occipitalartery

Maxillaryartery

Superficialtemporalartery

Ophthalmicartery

R. middlecerebralartery

R. posterior cerebralartery

R. and L.vertebralarteries

R. and L.internal internal arteries

R. and L.external carotid arteries

Cerebral arterial circle

Arteries of the head, neck, and

brain.


• Superficialtemporal artery

• Maxillary artery• Occipital artery• Facial artery• Lingual artery• Superior thyroid artery

Ophthalmic artery

Larynx

Thyroid gland(overlying trachea)Clavicle (cut)

BrachiocephalictrunkInternal thoracicartery

Basilar artery

Vertebral artery

Internalcarotid artery

SubclavianarteryAxillaryartery

(b) Arteries of the head and neck, right aspect

Externalcarotid arteryCommoncarotid artery

ThyrocervicaltrunkCostocervicaltrunk

Branches ofthe external carotid artery

Arteries of the head, neck, and brain.


Arteries of the head, neck, and brain.


Figure 19.22d Arteries of the head, neck, and brain.Frontal lobe

Optic chiasma

Middlecerebral artery

Internalcarotid arteryMammillarybody

Temporallobe

Occipital lobe

Cerebral arterialcircle (circle of Willis)

• Posteriorcerebral artery

Basilar artery

Vertebral artery

Cerebellum

• Posteriorcommunicating artery

(d) Major arteries serving the brain (inferior view, right side of cerebellum and part of right temporal lobe removed)

Pons

• Anteriorcerebral artery

• Anteriorcommunicating artery

Posterior

Anterior

ICA Internal Carotid A & branches (the ICA bifurcates into the ACA & MCA) •ACA - Anterior cerebral artery •A-Com - Anterior communicating Artery •MCA - Middle cerebral artery •P-Com - Posterior communicating artery

VA Vertebral artery (the left and right vertebral arteries join to form the basilar artery)

Basilar artery & its branches•PCA - Posterior cerebral artery •SCA - Superior cerebellarartery •PICA - Posterior inferior cerebellar artery

Figure 19.21d

Veins of the Brain

Figure 19.26c

(c)

Superior sagittalsinusFalx cerebri

Inferior sagittalsinusStraight sinusCavernous sinus

Junction of sinuses

Transverse sinuses

Jugular foramen

Right internaljugular vein

Sigmoid sinus


Figure 19.27c Venous drainage of the head, neck, and brain.

(c) Dural venous sinuses of the brain

Confluenceof sinuses

Superior sagittalsinus

Falx cerebri

Inferior sagittalsinus

Straight sinus

Cavernoussinus

Transversesinuses

Sigmoid sinus

Jugular foramen

Right internaljugular vein

Veins of the Upper Limbs and Thorax

Figure 19.27b

Right subclavian veinBrachiocephalic veins

Axillary vein

Brachial veinCephalic veinBasilic vein

Median cubital veinMedianantebrachialvein

Basilic vein

Internal jugular veinExternal jugular vein

Left subclavian vein

Superior vena cava

Azygos vein

Inferior vena cavaAscending lumbar vein

Accessory hemiazygos veinHemiazygos veinPosterior intercostals

Ulnar vein

Deep palmarvenous archSuperficial palmarvenous archDigital veins

Cephalic veinRadial vein

(b)

Figure 19.22b

(b)

Vertebral arteryCommon carotidarteries

Left axillaryartery

Right subclavianarteryLeft subclavianartery

Anterior intercostalarteryInternal thoracicartery

Lateral thoracicartery

Descending aorta

BrachiocephalictrunkPosteriorintercostal arteries

Costocervical trunk

Thoracoacromial arteryAxillary arterySubscapular arteryPosterior circumflex humeral arteryAnterior circumflex humeral artery

Common interosseousarteryRadial arteryUlnar artery

Deep palmar archSuperficial palmar archDigitals

Brachial arteryDeep arteryof arm

Suprascapular artery

Thyrocervical trunk

Arteries of the Abdomen

Figure 19.23b

(b)

Liver (cut) DiaphragmEsophagusLeft gastric artery

Superior mesentericartery

Left gastroepiploicartery

Spleen

Pancreas(major portion lies posterior to stomach)

Splenic artery

Stomach

Inferior vena cavaCeliac trunkHepatic artery properCommon hepatic arteryRight gastric arteryGallbladder

Abdominal aorta

Gastroduodenal arteryRight gastroepiploicarteryDuodenum

Arteries of the Abdomen

Figure 19.23c

(c)

Openingfor inferiorvena cava

Diaphragm

Inferior phrenicartery

Middle suprarenalarteryRenal artery

Superiormesenteric artery

Inferiormesenteric artery

Median sacralartery

Common iliac artery

Ureter

Gonadal (testicularor ovarian) artery

Hiatus (opening)for esophagus

Celiac trunk

Kidney

Abdominal aorta

Lumbar arteries

Arteries of theLow

er Limbs

Figure 19.24b, c

(b)

(c)

Common iliac artery

Deep artery of thighLateral circumflexfemoral arteryMedial circumflexfemoral arteryObturator arteryFemoral arteryAdductor hiatusPopliteal artery

Anterior tibial arteryPosterior tibial arteryFibular artery

Dorsalis pedis arteryArcuate arteryMetatarsal arteries

Internal iliac arterySuperior gluteal arteryExternal iliac artery

Popliteal artery

Anterior tibial arteryFibular artery

Plantar arch

Dorsalis pedis artery(from top of foot)

Posterior tibial arteryLateral plantararteryMedial plantar artery


Figure 19.23a Arteries of the right upper limb and thorax.

Internalthoracicartery

Lateralthoracicartery

Anteriorintercostalarteries

Superficial palmar archMetacarpal arteries

Digital arteries

Ulnar artery

Commoninterosseusartery

Radial artery

Deep palmar arch

Anastomosis

Subscapularartery

Descending thoracic aorta

Posterior intercostalarteries

Costocervical trunkAortic arch

Brachio-cephalic trunk

L. subclavian artery

L. vertebral arteryL. common carotid artery


R. common carotid arteryR. vertebral arteryThyrocervical trunk

Suprascapular artery

R. subclavian artery

Axillary arteryThoracoacromial artery

Thoracoacromial artery(pectoral branch)

Anterior and posteriorcircumflex humeralarteries

Brachial artery

Deep artery of arm


Figure 19.23b Arteries of the right upper limb and thorax.

Vertebral artery

Costocervical trunkThoracoacromial arteryAxillary artery

Subscapular artery

Radial arteryUlnar artery

Brachial artery

Suprascapular arteryThyrocervical trunk

Posterior circumflexhumeral arteryAnterior circumflexhumeral artery

Deep artery of armCommoninterosseousartery

Deep palmar archSuperficial palmar archDigital arteries

Common carotidarteries

Right subclavian arteryLeft subclavian artery

Brachiocephalic trunkPosterior intercostalarteriesAnterior intercostalarteryInternal thoracic artery

Lateral thoracic arteryDescending aorta

(b) Illustration, anterior view


Figure 19.24a Arteries of the abdomen.

(a) Schematic flowchart.

AbdominalaortaInferiorphrenicarteries

Celiactrunk

Superiormesentericartery

Middlesuprarenalarteries

Renalarteries

Inferiormesentericartery

Lumbararteries

Median sacral artery

Superior rectalartery

L. colicartery

Sigmoidalarteries

R.colicartery

L. gastroepiploic artery

R. gastroepiploicartery

Ileocolic artery

Intestinal arteries

Common iliac arteries

Gonadalarteries

Gastro-duodenalartery

Hepaticarteryproper

Commonhepaticartery

Splenicartery

R. gastricartery

L. gastric artery

L

Middlecolicartery

R

Diaphragm


Figure 19.24b Arteries of the abdomen.Liver (cut) Diaphragm

Esophagus

Left gastricartery

Superiormesentericmesenteric

LeftgastroepiploicarterySpleen

Stomach

Pancreas(major portion liesposterior to stomach)

Splenic artery

Inferior vena cava

Celiac trunk

Hepatic arteryproper

Common hepaticartery

GastroduodenalarteryRight gastric arteryGallbladder

Abdominal aorta

Rightgastroepiploicartery

Duodenum

(b) The celiac trunk and its major branches. The left half of the liver has been removed.


Figure 19.24c Arteries of the abdomen.

(c) Major branches of the abdominal aorta.

Hiatus (opening)for inferior vena cava

Diaphragm

Inferiorphrenic artery

Middlesuprarenal artery

Renal artery


Median sacralartery

Commoniliac artery

Ureter

Gonadal(testicular or ovarian) artery

Hiatus (opening)for esophagus

Celiac trunk

Adrenal(suprarenal)gland

Kidney

Abdominal aorta

Lumbar arteriesInferiormesenteric artery


Figure 19.24d Arteries of the abdomen.

(d) Distribution of the superior and inferior mesenteric arteries.The transverse colon has been pulled superiorly.

Celiac trunk Transverse colon

Inferior mesentericartery

Aorta

Descending colon

Sigmoid colon

Rectum


Ascending colon

Ileum

Right common iliacartery

Appendix

Cecum

Branches ofthe inferior mesenteric artery

• Left colic artery• Sigmoidal arteries• Superior rectal

artery

Branches ofthe superiormesenteric artery

• Middle colic artery• Intestinal arteries• Right colic artery• Ileocolic artery


Figure 19.25a Arteries of the right pelvis and lower limb.Inferior

glutealartery

InternalpudendalMedialcircumflexfemoralarteryLateralcircumflexfemoralartery

Internaliliacartery

ObturatorarteryExternaliliacartery

Deep arteryof thigh

Femoralartery

Adductorhiatus

Arterialanastomosis

Anteriortibialartery

Poplitealartery

Fibular(peroneal)artery

Lateralplantarartery

Posterior tibialartery

Dorsalispedisartery

Arcuateartery

Lateralplantarartery

Dorsal metatarsalarteries

Plantar arch

Medialplantarartery


Abdominalaorta

Commoniliac artery

Plantarmetatarsal arteries

Superior glutealartery


Figure 19.25b Arteries of the right pelvis and lower limb.

Common iliac artery

Deep artery of thigh

Obturator arteryFemoral arteryAdductor hiatusPopliteal arteryAnterior tibial arteryPosterior tibial arteryFibular arteryDorsalis pedis arteryArcuate arteryDorsal metatarsalarteries

(b) Anterior view

Internal iliac arterySuperior gluteal arteryExternal iliac artery

Lateral circumflexfemoral arteryMedial circumflexfemoral artery


Figure 19.25c Arteries of the right pelvis and lower limb.

(c) Posterior view

Popliteal artery

Anterior tibial artery

Fibular artery

Dorsalis pedis artery(from top of foot)

Plantar archMedial plantarartery

Lateral plantarartery

Posterior tibialartery


Figure 19.26a Major veins of the systemic circulation.

R. externaljugular– superficial

head and neck

R. vertebral– cervical spinal

cord andvertebrae

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 upperlimb

Same as R. brachiocephalicR. axillary

Azygos system– drains much of

thorax

L., R., and middlehepatic veins– liver

Veins ofL. lower limb


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


Figure 19.26b Major veins of the systemic circulation.

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, anteriorview. 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


Figure 19.27a Venous drainage of the head, neck, and brain.


Superior sagittal sinus

Inferiorsagittal sinus Superficial

temporal vein

Ophthalmic vein

Facial veinCavernoussinus

Straightsinus

Transversesinus

Occipitalvein

Posterior auricularvein

Sigmoid sinus

External jugularveinVertebral vein

Subclavian vein

Superior vena cava

Brachiocephalic veins

Middle thyroid vein

Superior thyroid vein

Internal jugular vein


(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

Figure 19.27b Venous drainage of the head, neck, and brain.


Figure 19.28a Veins of the thorax and right upper limb.

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 arch

Digital veins

Basilicvein

Cephalicvein

Medianantebrachialvein



Figure 19.28b Veins of the thorax and right upper limb.Right subclavian vein

Brachiocephalic 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


Figure 19.29a Veins of the abdomen.Inferiorvena cavaInferior phrenic veinsHepatic veins

Hepatic portal vein

Superior mesenteric veinSplenic vein

Inferiormesentericvein

L. ascendinglumbar vein

R. ascendinglumbar vein

Gonadal veins

Renal veins

Suprarenalveins

Lumbar veins

Hepaticportalsystem

Cystic vein

External iliac vein

Internal iliac veins

Common iliac veins

(a) Schematic flowchart.


Figure 19.29b Veins of the abdomen.

(b) Tributaries of the inferior vena cava. Venous drainage of abdominal organs not drained by the hepatic portal vein.

Hepatic veinsInferior phrenicvein

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


Figure 19.29c Veins of the abdomen.

(c) The hepatic portal circulation.

Hepatic veins

Liver

Spleen

Gastric veins

Inferior vena cava

Inferior vena cava(not part of hepaticportal system)

Splenic vein

Right gastroepiploicvein

Inferiormesenteric vein

Superiormesenteric vein

Large intestine

Hepatic portal vein

Small intestine

Rectum


Figure 19.30a Veins of the right lower limb.

Smallsaphenousvein

Fibular(peroneal)vein

Dorsalvenous archDorsalmetatarsalveins

(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

vein

Poplitealvein

Anteriortibial vein

Posteriortibial vein

Dorsalispedisvein

Common iliac vein

Internaliliac vein


Figure 19.30b Veins of the right lower limb.

Popliteal vein

Common iliac vein

Fibular veinAnterior tibial veinDorsalis pedis veinDorsal venous arch

Dorsal metatarsalveins

(b) Anterior view

Internal iliac veinExternal iliac veinInguinal ligament

Femoral veinGreat saphenousvein (superficial)

Small saphenousvein


Figure 19.30c Veins of the right lower limb.

(c) Posterior view

Great saphenousvein Popliteal vein

Anterior tibial vein

Fibular vein

Small saphenousvein (superficial)

Posterior tibial vein

Plantar veins

Deep plantar arch

Digital veins




Table 19.2 Influence of Selected Hormones on Variables Affecting

Blood Pressure

Documents

CARDIOVASCULARsinoemedicalassociation.org/AP4/VASCULATURE2.pdfR. upper limb L. and R. coronary arteries L. subclavian – neck and L. upper limb L. ventricle of heart Thoracic aorta