chapt15 cardiovascular

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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

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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

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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

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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


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


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)

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

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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


c: © The McGraw-Hill Companies, Inc.


Rightatrium

Cusps oftricuspidvalve

Chordaetendineae


Papillarymuscles

Muscularridges

© McGraw-Hill Higher Education, Inc./University of Michigan Biomedical Communications


© McGraw-Hill Higher Education, Inc./University of Michigan Biomedical Communications

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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

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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


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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

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Blood Supply to the Heart

• The left and right coronary arteries supply blood to the tissues of the heart


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

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Aorta

Part ofaortaremoved

Aorticvalvecusps

Right coronaryartery

Opening ofleft coronaryartery

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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)


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 coronaryartery Anterior interventricular artery

(left anterior descending artery)

Left pulmonaryveins



Posterior interventricularartery

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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)


(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

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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

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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

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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

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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


Atrial syncytium

Junctional fibers

Bundle branches

Purkinje fibers

SA node

AV node

AV bundle

Ventricular syncytium


Purkinje fibers

Interatrial septum

Leftbundlebranch


Right bundlebranch

Junctionalfibers

AV node

SA node

AV bundle


(b)

Myocardialmuscle fibers

(a)

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15.1 From Science to Technology

Replacing the Heart – From Transplants to Stem Cell Implants

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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

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(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


Mil

livo

lts

0

–.5

.5

1.0


P

Mil

livo

lts

0

–.5

.5

1.0


SQ

R

QRS complex

(h)

(g)

Mil

livo

lts

0

–.5

.5

1.0


Mil

livo

lts

0

–.5

.5

1.0


T

Mil

livo

lts

0

–.5

.5

1.0


(a)


S

Q

R

30


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

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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

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(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)

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15.1 Clinical Application

Arrhythmias

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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


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

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15.2 From Science to Technology

Altering Angiogenesis

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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


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


Arteriole

Artery

Blood flow Blood flow

Capillaries

Metarteriole (forming arteriovenousshunt)

Venule

Vein

Precapillarysphincter

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(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

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Arteriole

Capillary

Venule

© Don. W. Fawcett/Visuals Unlimited

42


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

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(a) (b)

Towardheart


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%

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


Temporal a.

Carotid a.

Brachial a.

Radial a.

Dorsalis pedis a.Posterior tibial a.

Popliteal a.

Femoral a.

Facial a.

49


Blood Vessel Disorders

50

Factors That Influence Arterial Blood Pressure


Blood pressure increases

Blood volumeincreases

Heart rateincreases

Stroke volumeincreases

Blood viscosityincreases

Peripheral resistanceincreases

51


Measurement of Arterial Blood Pressure

52


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


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


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


Valve open

Contractedskeletal muscle

Vein

Valve closed

Relaxed skeletalmuscle

Vein

To heart

To heart

55

56


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


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



Pulmonary capillaries

Left pulmonary veins

Left lung

AortaRight pulmonary artery

Pulmonary capillaries

Pulmonary trunk

Right pulmonary veins

Right lung

Inferior vena cava

Superiorvena cava

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61


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

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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


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


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


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


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


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


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.


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

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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.


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


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


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


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.


79


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


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


Molecular Causes of Cardiovascular Disease

83


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.

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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.

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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.

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