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Vessels and Circulation

Some embryology first


There are at first six pairs of aortic arches In fish these are connected to the gills They undergo a transformation in mammals
Birds use the right arch of the fourth pair Mammals use the left arch of the fourth pair
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Ventral (anterior) view

Full set of arches develops, but not all present at the same time; (before transformation)

Transformation : 4th through 7th weeks: some persist, some atrophy


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4th arches become: Left side: aortic arch Right side: brachiocephalic trunk

Right common carotid a ------------------------------. Right subclavian a. -------------------------Brachiocephalic trunk-----------------------------------

What the aortic arches become

Right common carotid a ---------------------------. Right subclavian a. --------------------------Brachiocephalic trunk-------------------------------

3 Major types of blood vessels


Body RA RV Lungs LA LV Boby

1.Arteries 2.Capillaries 3.Veins


Arteries carry blood away from the heart -branch, diverge or fork Veins carry blood toward the heart -join, merge, converge

General characteristics of vessels


Three layers (except for the smallest)
1. Tunica intima - AKA intima 2. Tunica media smooth muscle 3. Tunica externa - AKA adventitia

Lumen is the central blood filled space


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Intima is endothelium (simple squamous epithelium)


May have subendothelial layer if 1mm or larger

Tunica media: layers of circular smooth muscles


Lamina (layers) of elastin and collagen internal and external Thicker in arteries than veins (maintain blood pressure)
Smooth muscle contraction: vasoconstriction

Smooth muscle relaxation: vasodilation


Sympathetic vasomotor nerves of autonomic nervous system regulate
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Adventitia (t. externa) longitudinally running collagen and elastin for strength and recoil

muscular middle sized artery

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Arteries
Carry blood away from the heart From big to small, these are the categories:
1. Elastic 2. Muscular 3. Arterioles (then these to capillaries)

Pressure diminishes along the route

1. Elastic arteries: act as conduits


2.5-1 cm diameter Expand with surge of blood from heart Recoil and continue the propagation of blood Elastin is thick in media: dampens the surge of blood pressure Aorta and its branches

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Arteries continued
2. Muscular arteries: act as distributing arteries
Middle sized .3mm-1cm Changes diameter to differentially regulate flow to organs as needed Internal as well as external elastic lamina Most of what we see as arteries
Tunica media larger in proportion to the lumen, thus muscular 12

Arteries continued
3. Arterioles
Smallest: .3mm-10um Only larger ones have all 3 layers Regulated 2 ways:
Locally in the tissues Sympathetic control

Systemic blood pressure (the BP we measure) can be regulated through them Send blood into capillaries
Tunica media has only a few layers of smooth muscle cells
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Capillaries
Heart to arteries to capillaries to veins to heart Capillaries are smallest
8-10um Just big enough for single file erythrocytes Composed of: single layer of endothelial cells surrounded by basement membrane

Universal function
Oxygen and nutrient delivery to tissues CO2 and nitrogenous waste (protein break-down product) removal

Some also have tissue specific functions

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Capillaries

Theres a capillary bed in almost all tissues

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Capillary permeability
Direct diffusion through endothelial cell membranes
Only O2 and CO2

Other molecules by various other methods Blood brain barrier: complete tight junctions
Selective transport of necessary molecules Lipid soluble agents (like anesthetics) get through, as do O2 and CO2
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Veins
Pressure has been lowered so capillaries can tolerate With lower pressure, walls (of veins) can be thinner From smallest to large:
Capillaries to postcapillary venules to venules to veins

Veins are larger than arteries, plus


Tunica externa is thicker There is less elastin
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Special features of veins


Valves
Prevent backflow Most abundant in legs (where blood has to travel against gravity)

Muscular contraction
Aids the return of blood to heart in conjunction with valves Mechanical issues (really good to know)
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Exercise helps circulation (because muscles contract and squeeze blood back to the heart)

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Vascular anastomoses
Vessels communicating with each other Veins have more than arteries Form alternative pathways or collateral channels Protect organs from being supplied by just one route
Poor anastomoses & therefore vulnerable: central artery of retina, kidneys, spleen, bone diaphyses

Vasa vasorum
Means vessels of the vessels Blood supply to vessel itself Smallest vessels dont need

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Vascular System
(Blood vessels of the body)
Two circulations
Systemic Pulmonary

Arteries and veins usually run together Often nerves run with them Sometimes the systems do not have bilateral symmetry
In head and limbs, most are bilaterally symmetrical
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Pulmonary Circulation

Pulmonary trunk branches


Right and left pulmonary arteries Division into lobar arteries
3 on right 2 on left

Smaller and smaller arterioles, into capillaries surrounding alveoli


Gas exchange

Pulmonary system pressure is only 1/6 of systemic blood pressure

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Pulmonary Circulation

After gas exchange blood enters venules Larger and larger into Superior and Inferior Pulmonary veins Four Pulmonary Veins empty into left atrium

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In lungs

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Systemic Circulation

Oxygenated blood to body Leaves LV through Ascending Aorta


Only branches are the 2 coronary arteries to the heart

Aortic Arch has three arteries branching from it:


1. Brachiocephalic trunk, has 2 branches:
Right common carotid a. Right subclavian a.

2. Left common carotid a. 3. Left subclavian a.


Ligamentum arteriosum connecting to pulmonary a.
remember aortic arches
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Descending aorta
Thoracic aorta
at T12 becomes abdominal aorta

Abdominal aorta
ends at L4 branching into: R & L common iliac arteries

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Common carotids branch:


Internal carotids External carotids

Subclavian: 3 branches
Vertebral arteries Thyrocerical trunk Costocervical trunk

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Head and neck


Common carotids just lateral to trachea: feel
At larynx divides into internal & external

External carotid: supplies head external to brain and orbit


Feel superficial temporal a. Middle meningeal: vulnerable (branch of maxillary)

Internal carotid
Supply orbits and most of cerebrum
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Internal carotid a.
Enters skull through carotid canal Gives off:
Ophthalmic artery

Then divides into anterior and middle cerebral arteries (see next slides):
together they supply 80% of cerebrum
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Angiogram

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arteriogram

Middle cerebral arteries run through lateral fissures Anterior cerebral arteries of each side, through anterior communicating artery, anastomose

(an anastomosis is a union)


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R and L vertebral arteries* (from subclavians)


Ascend through vertebral foramina of C6-C1 transverse processes Through foramen magnum into skull Join to form one Basilar artery*

* *

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* *

Basilar artery: branches


Divides into posterior cerebral arteries

Posterior communicating arteries connect to middle cerebral arteries Note how it loops CIRCLE OF WILLIS around pituitary
(now called cerebral arterial circle)
gland & optic chiasm

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Upper limb
Subclavian runs laterally onto 1st rib, under clavicle Enters axilla as axillary artery
Sends branches

Continues as brachial artery in upper arm


Splits into radial & ulnar arteries See hand supply
Feel brachial & radial pulses
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overview

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Thorax
Anterior intercostals branch off Internal thoracic* (branch of subclavian) Posterior intercostals branch off Thoracic aorta
Small bronchial arteries supply the lung structures

Intercostal arteries, veins and nerves run just UNDER the ribs

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Arteries to the abdomen


Arise from the abdominal aorta At rest, arterial blood is here! Three single midline branches supply the digestive tube
1. Celiac trunk 2. Superior mesenteric artery 3. Inferior mesenteric artery

1. 2.

3.
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1. Celiac trunk: divides into 3 right away: left gastric, splenic & common hepatic (see pic; the latter is the only which goes off to the right) 2. Superior mesenteric supplies most of intestines
Definition of mesenteries: double layered sheets of peritoneum that support most organs in the abdominopelvic cavity

1.

2.

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3. Inferior mesenteric supplies distal half of large intestine


(The 1, 2 and 3 are branches of the abdominal aorta) 1. 2.

3.

Know what these terms mean: phrenic, gastric, hepatic, renal, colic

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Arteries to the abdomen Paired branches off the abdominal aorta supply adrenal glands, kidneys, gonads and abdominal body wall
supply diaphragm supply adrenals to kidney

3.
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Abdominal aorta branches into Common iliacs at L4; these branch into
Internal iliacs to pelvic organs, perineum, buttocks, medial thighs External iliacs: to 48 rest of lower limbs

External iliac passes under inguinal ligament becoming Femoral artery At back of knee femoral becomes popliteal artery, and branches
Feel dorslis pedis & posterior tibial
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review

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review

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Systemic Veins
3 major vessels enter Right Atrium:
SVC (superior vena cava) IVC (inferior vena cava) Coronary sinus

Many veins are very superficial (unlike arteries) Venous plexuses (networks of anastomoses and parallel veins) are very common Head and hepatic portal systems are unusual
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Dural sinuses
Drain the veins of the brain Cavernous sinuses
Carotid arteries and some cranial nerves run within them Dangerous if trauma

Come together as sigmoid sinus becomes Internal Jugular vein


Exits skull through jugular foramen
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Internal jugular veins


Drain most of blood from brain Run lateral to internal then common carotid At base of neck joins subclavian v. to form brachiocephalic v.

External jugulars drain some of scalp & face

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Vein overview
Note that unlike the arteries, the veins have a brachiocephalic on the right and left sides

Azygos system drains the thorax:

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Deep veins of upper limbs follow arteries, most of them double to one artery Superficial veins: see pic Blood drawn from median cubital vein in antecubital fossa

(look at)

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Tributaries of IVC: note asymmetry


Left gonadal and suprarenal veins drain into left renal vein On right they drain directly into IVC Right and left hepatic veins enter superior part of IVC

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Hepatic portal system


Picks up digested nutrients from stomach & intestines and delivers them to liver for processing and storage
Storage of nutrients Detoxification of toxins, drugs, etc.

Two capillary beds Route: artery to capillaries of gut to hepatic portal vein to livers capillaries to hepatic vein to IVC

Dont confuse hepatic vein with hepatic portal vein

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Kind of confusing

Superior mesenteric and splenic veins join to form hepatic portal vein, which goes up into liver Inferior mesenteric empties into the splenic vein

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(same info with different pic)

Tributaries of hepatic portal vein: -superior mesenteric vein


-splenic vein -inferior mesenteric vein

Hepatic portal system


Picks up digested nutrients from stomach & intestines and delivers them to liver for processing and storage
Storage of nutrients Detoxification of toxins, drugs, etc.

Two capillary beds Route: artery to capillaries of gut to hepatic portal vein to livers capillaries to hepatic vein to IVC
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Leg veins
Names similar to arteries Femoral becomes external iliac after crossing under inguinal ligament
_________used for grafting in coronary artery bypass grafts: is the longest vein in the body

External iliac joins with internal iliac to form common iliac vein

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Fetal Circulation
The one umbilical vein brings blood which has been to the placenta for oxygenation (by gas diffusion from moms blood) The pair of umbilical arteries (branches from babys internal iliac arteries) carry blood to placenta to pick up oxygen and nutrients Fetal heart starts beating at 21 days post conception
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Some Diseases
Atherosclerotic cardiovascular disease
Cerebrovascular disease affects brain, strokes Coronary artery disease (CAD) arteries of heart Peripheral vascular disease (PVD) arterial

Affecting veins
Chronic venous insufficiency venous = veins Deep venous thrombosis (DVT)

Aneurysms Portal hypertension Hypertension


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