Download - chapter 15
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Anatomy ∙ Physiology IIChapter 15,
Section 1The Cardiovascular
System
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FUNCTIONS OF THE HEART
It pumps 7000L (1800 gallons) of blood through our body every day.
The heart contracts 2.5 billion times in a lifetime.
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The heart is composed of two pumps
The pulmonary circuit carries blood to the lungs
The systemic circuit carries blood to the body
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The heart is located within the mediastinum
1/3 2/3
It is about the size of a fist (14cm x 9cm)
2/3 of the heart is left of the midline
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The heart is posterior to the sternum
Baseattachment of major vessels2nd intercostal space
ApexPointed inferior margin5th intercostal space
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The heart is surrounded by a pericardial membrane.
The fibrous pericardium forms a thick outer layer of connective tissue.
The parietal pericardium is a serous membrane attached directly to the fibrous layer.
A visceral pericardium is a serous membrane that forms the outer layer of the heart wall .
The pericardial cavity contains serous fluid.
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The wall of the heart contains 3 layers
The epicardium is also called the visceral pericardium
The myocardium contains a thick layer of cardiac muscle, with blood vessels and nerves
The endocardium is a smooth layer of squamous epithelium that lines the heart chambers and valves
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The heart contains 4 chambers
The left atrium receives blood from the lungs
The right atrium receives blood from the body
The left ventricle pumps blood towards the body
The right ventricle pumps blood towards the lungs
Interventricular septum
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A pocket, called the auricleincreases the capacity of the atria .
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blood enters the heart through the great veins
The superior vena cava returns blood from the upper body to the heart
The inferior vena cava returns blood from the lower body to the heart
The coronary sinus returns blood from the myocardium to the heart
Four pulmonary veins return blood from the lungs to the heart
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Great arteries carry blood away from the heart
The aorta delivers oxygenated blood to the systemic circulation
The pulmonary trunk* delivers deoxygenated blood to the lungs
*The pulmonary trunk immediately divides into a left and right pulmonary artery.
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AV valves prevent backflow into the atria .
The tricuspid valve guards the right AV orifice
The bicuspid (mitral) valve guards the left AV orifice
*AV = atrioventricular
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Chordae tendineae anchored to the
cusps papillary muscles
Papillary muscles contract to pull the
valves tightly shut
AV valves are anchored to the ventricles by chordae tendineae
Mitral Valve Prolapse – cusp of the mitral valve protrudes into atrium .Symptoms include: chest pain, heart palpitations, and fatigue.
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An aortic valve (not shown) is
located at the base of the aorta
Semilunar valves prevent backflow of blood into the ventricles
A pulmonary valve is located at the base of the pulmonary trunk
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The semilunar valves close as the ventricles relax to prevent blood from entering the ventricles.
Each cusp of a semilunar valve is shaped like a crescent moon
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path of blood through the right heart
1 .Blood enters right atrium through the SVC, IVC, and coronary sinus
2 .It passes through the tricuspid valve into the right ventricle
3 .Blood is pumped from the right ventricle, through the pulmonary valve, and into the pulmonary trunk.
4 .Blood passes into the pulmonary arteries towards the lungs
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path of blood through the left heart
5 .Oxygenated blood is returned to the heart through 4 pulmonary veins .
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9 .Blood enters systemic circulation to the tissues throughout the body .
6 .Blood enters the left atrium .
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7 .Blood passes through the bicuspid valve into the left ventricle .
8 .The left ventricle pumps blood through the aortic valve into the aorta.
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Section 2, Chapter 15
Cardiac Cycle & Cardiac Conduction
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Systole – contraction
Diastole – relaxation
Ventricular Diastole• Ventricles are relaxed, filling with blood• Ventricles are 70% full before atria contract• Atrial systole pushes the remaining 30% of blood into ventricles• AV valves are opened while semilunar valves are closed
Ventricular Systole • Ventricles contract to expel blood• Atria are in diastole during ventricular systole, filling with blood• Semilunar valves are opened, while AV valves are closed
The left and right sides of the heart contract together in a coordinated fashion
The cardiac cycle
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Heart SoundsThe heart valves produce a distinct sound as they close, which can be heard through a stethoscope.
Lubb-DuppLubb (S1) = sound of AV valves closing
occurs during ventricular systole
Dupp (S2) = sound of semilunar valve closing occurs during ventricular diastole
murmur = abnormal sound from the cusps not closing completely
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Heart Sounds - Ausculation
Image from Grant’s Atlas of Anatomy. Each heart valve is indicated by a colored oval and the area of auscultation of the valve is indicated as a circle of the same color containing the first letter of the valve name.
aortic valve (A)heard at 2nd intercostal space, right of the sternum
pulmonary valve (P)heard at 2nd intercostal space, left of the sternum
tricuspid valve (T)heard at 5th intercostal space, either right or left of the sternum
mitral valve (M)heard at 5th intercostal space, below left nipple
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Cardiac Conduction of the Heart
The heart is autorhythmic:Specialized cardiac tissue initiate and distribute electrical impulses that generate heart contractions.
Syncytium – intercalated discs contain gap junctions that transmit action potentials from cell-to-cell. Cardiac muscles contract as a functional unit (syncytium)
Atrial Syncytium – left and right atria contract together
Ventricular Syncytium – left and right ventricles contract together
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Cardiac Conduction of the Heart
Pacemaker of heart
Initiates atrial syncytium
Fires 80 impulses per minute
Parasympathetic inhibition keeps heart rate at about 72 beats per minute
conduct impulses towards towards AV node
Figure 15.18 Illustrates the cardiac conduction system.
sinoatrial (SA) node
junctional fibers
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Cardiac Conduction of the Heart
Located within inferior wall of interatrial septum
Provides a junction between atrial and ventricular syncytia
Only known conduction pathway between atria and ventricles
divides into left and right bundle branches
Figure 15.18 Illustrates the cardiac conduction system.
atrioventricular (AV) node
AV Bundle (Bundle of His)
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Cardiac Conduction of the Heart
Conduction pathways along the interventricular septum
Gives rise to Purkinje Fibers
Transmits action potentials to ventricular myocardium and papillary muscles
Initiates ventricular syncytium at apex of heart
bundle branches (left and right)
purkinje fibers
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Figure 15.19 Summarizes the cardiac conduction system
Figure 15.20 Muscle fibers of the ventricles are whorled shape, which increases the blood output during ventricular systole.
End of Section 2, Chapter 15
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An electrocardiogram, or ECG (or EKG) is a recording of the electrical changes in the myocardium during the cardiac cycle.
Electrocardiogram
section 3, chapter 15
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atrial depolarization that initiates atrial contraction
conduction of electrical impulse across atria from right to left and downward
Ventricular depolarization that initiates contraction of the ventricles
This massive wave hides the atria repolarization
Electrocardiogram
P Wave
QRS Complex
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T Wave represents repolarization of ventricles
Electrocardiogram
Normal ECG pattern
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ECG of a regular heart rhythm at 75 beats per minute
Atrial Flutter. Atria fire 250-350 times per minute. For every QRS complex there may be 4 or more P waves.
Heart Arrhythmias:
normal
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Bradycardia – cardiac rhythm less than 60 beats per minute .
Tachycardia– cardiac rhythm greater than 100 beats per minute .
Examples of Heart Arrhythmias. Arrows indicate p Wave.
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Atrial fibrillation. Instead of contracting, the atria become quivering chambers. The ventricles respond only to impulses that make it to the AV node .
Ventricular fibrillation = Life threatening arrhythmia. Ventricles quiver, and are unable to pump blood properly. Requires immediate defibrillation.
Examples of Heart Arrhythmias, fibrillation
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The heart rate is controlled intrinsically by the SA node, but sympathetic and parasympathetic fibers alter the rate at which the pacemaker fires.
regulation of cardiac cycle
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Cardiac Control Center
Located within Medulla Oblongata
Receives sensory impulses from throughout the cardiovascular system and relays motor impulses to heart in response.
The cardiac control centers include a Cardioinhibitor & cardioaccelerator reflex center
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Cardioinhibitor reflex center
Parasympathetic fibers from vagus nerves innervate SA & AV nodes.
Vagus nerves release Acetylcholine (ACh) that decreases the firing rates of SA & AV nodes.
Heart rate decreases
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Cardioaccelerator reflex center
Sympathetic fibers from accelerator nerves innervate SA & AV nodes.
Norepinephrine released from fibers increases the firing rates of SA & AV nodes.
Heart rate and force of contraction increases
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Cardioinhibitor & cardioaccelerator reflex centers alter the heart rate in response to sensory impulses from receptors
Baroreceptors – monitor blood pressure•Located within aortic arch and carotid sinuses
•Rising blood pressure stimulates cardioinhibitor center
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`
Figure 15.24b Illustration of the baroreflex arc
End of Section 3, Chapter 15
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Section 4, Chapter 15
Blood Vessels
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Arteries•Convey blood away from the
heart
Arterioles•Thinner vessels that convey
blood towards capillaries
Capillaries•Site of exchange between blood and
body tissues
Venules•Receives blood from capillaries
Veins•Returns blood towards the
heart
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Endothelium •A layer of smooth simple squamous
epithelium
•Secretes biochemicals with a wide variety of functions.
Basement membrane•Bed of connective tissue with elastic &
collagenous fibers
Tunica Interna (inner)
Walls of the blood vessels consists of 3 Layers
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Tunica Media (middle)
Smooth Muscles •Vasoconstriction – muscles contract, decreasing
diameter of vessel
•Vasodilation – muscles relax, allowing vessel diameter to increase
Elastic Connective tissue• Recoil of elastic fibers helps propel
blood through vessels
3 Layers of the blood vessel wall
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Tunica Externa (outer)
Fibrous Connective TissueElastic and collagenous fibers
Attaches blood vessel to organs
Vasa Vasorum “vessels of the vessels”Provide blood supply to walls of thicker arteries
3 Layers of the blood vessel wall
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Figure 15.27An arteriovenous shunt
provided by a metarteriole.
Arterioles are smaller divisions of arteries .
metarterioles – small arterioles that join capillaries
Arteriovenous shunt – connects an arteriole directly to a venuleShunt allows blood to bypass a capillary bed.
Arterioles
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Figure 15.28 Substances are exchanged through openings (slits) separating endothelial cells.
Capillaries smallest diameter blood vessels that
consists of a single layer of endothelial cells
Site of gas, nutrient, and waste exchange
Capillaries
Slits Spaces between endothelia that
facilitate diffusion across vessel wall
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Figure 15.26 A precapillary sphincter at the base of a capillary.
Capillaries
Precapillary sphincters Smooth muscles that regulate the flow of blood
through a capillary
Closes a capillary bed when oxygen demand to an organ is low
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Artificially colored electron micrograph depicts sinusoids throughout the liver.
Capillaries
large cavities within discontinuous capillaries
Sinusoids allow a rapid exchange of nutrients, debris, proteins, and even cells.
located throughout the liver and spleen.
Sinusoids
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VenulesContinue from capillaries and merge to form veins
VeinsConvey blood from body back to the atria of heart
Veins follow a pathway roughly parallel to arteries
Vessel wall of veins has 3 layers (tunics) similar to arteries
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Figure 15.31. Venous valves (a) open as blood moves towards the heart, but (b) close to prevent blood from moving backward away from the
heart.
Veins have poorly developed tunica mediaThinner walls, and a larger lumen than arteries
Tunica Interna of veins contain valvesValves prevent blood from flowing backwards towards capillaries.
Veins act as blood reservoirsMost blood (60-70%) is in the veins and venules.
Differences between veins and arteries
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Figure 15.25 Blood vessels (a) the wall of an artery. (b) The wall of a vein. (c) cross section
of an arteriole (bottom) and a venule (top).
Differences between veins and arteries
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End of Section 4, Chapter 15
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Blood Pressure
Section 5, Chapter 15
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Blood PressureBlood pressure is the force the blood exerts against the inner walls of the blood vessels
Usually refers to pressure in systemic arteries
Arterial blood pressure:Rises with ventricular contractions and falls as ventricles relax
Systolic pressure is the maximum pressure during ventricular contraction
Diastolic pressure is the minimum pressure when the ventricles relax
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.1Cardiac Output- volume of blood ejected from one ventricle per minute
Volume of blood expelled from ventricle with each contractionAverage = 70 milliliters per beat (mL/beat) for adult male
Average = 72 beats per minute
Stroke Volume
70 mL/beat X
Heart Rate
70 beats/minute =
Cardiac Output
5040mL/minuteexample:
Factors that influence blood pressure
cardiac output = stroke volume (mL) X heart rate (beats/minute)
Stroke Volume
Heart Rate
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Cardiac output (and blood pressure) increases with an increase in stroke volume or heart rate.
Factors that influence blood pressure
blood pressure increases
heart rate increases stroke volume increasesor
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Blood VolumeAverage blood volume in adults = 5 Liters (1.3 gallons)As blood volume increases, blood pressure initially increases
Peripheral ResistancePeripheral resistance = friction between blood and blood vesselsVasoconstriction increases resistance and increases blood pressureVasodilation decreases blood pressure
Viscosity of bloodViscosity = resistance of a fluid to flow (thickness of a fluid).Blood cells and some plasma proteins increase the viscosity of blood.
Anemia (deficiency of red blood cells) reduces viscosity & lowers blood pressure
Factors that influence blood pressure
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Some of the factors that influence arterial blood pressure
Factors that influence blood pressure
blood volume increases heart rate increases stroke volume increases
blood viscosity increases peripheral resistance increases
blood pressure increases
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blood pressure is maintained
Increased blood pressure
heart rate decreases stroke volume decreases
cardiac output decreases peripheral resistance decreases
cardiac output increases peripheral resistance increases
heart rate increases stroke volume increases
decreased blood pressure
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Control of Blood Pressure
Factors that affect stroke volume
End-diastolic volume (EDV)Volume of blood in ventricles at the end of ventricular diastoleVentricles are filled with blood
End-systolic volume (ESV)Volume of blood in ventricles at the end of ventricular systoleOnly 60% of blood is expelled from heart during a normal contractionIncreasing the force of ventricular contractions decreases ESV
Stroke volume = EDV– ESVIncrease stroke volume by increasing EDV or decreasing ESV
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stroke volume
Stroke Volume is directly related to the force of ventricular contraction.
Two events that occur in the ventricles coincide with stroke volume:
1 .End-diastolic volume (EDV)Volume of blood in ventricles at the end of ventricular diastole
As ventricles fill with blood, muscle fibers are mechanically stretched - preload
2 .End-systolic volume (ESV)Volume of blood in ventricles at the end of ventricular systole
A normal health heart expels 60% of blood present in ventricle .
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stroke volume
Stroke Volume is the difference between end diastolic volume (EDV) and end systolic volume (ESV) : Stroke Volume = EDV - ESV
Frank-Starling Principle:
The ability of a heart muscle to generate force depends on the original stretch of a muscle prior to contraction (similar to stretching a rubber band)
The degree of stretch (preload) of the myocardial fibers before contraction determines the stroke volume
A greater end diastolic volume results in a greater force of contraction, leading to a greater stroke volume.
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Figure 15HBlood pressure decreases as blood moves away from the heart.
Blood pressure rapidly decreases as the blood moves through the arterial system and into the capillary network.
Little pressure remains in the veins, therefore heart actions contribute very little to venous return.
Venous Return
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Venous return depends on:
Skeletal muscle contractions – massaging actions push blood towards heart
Respiratory movements – generates pressure in abdominal and thoracic cavitiesChanges in pressure pushes blood along veins
Vasoconstriction – contraction of smooth muscles in tunica mediaSympathetic reflexes vasoconstrict the smooth muscles in veins, which can propel additional blood from venous reservoir towards the heart.
Venous Return
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AortaMain trunk of the systemic circulation
Divisions of the aortaAortic root = attachment to heartAscending AortaAortic arch
Thoracic aorta Abdominal aorta
Arterial System
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Aortic Valve
Aortic Sinus Swelling at aortic root
Right and left coronary arteries Supply blood to myocardium of the heart
Myocardial infarction = blocked coronary artery
Aortic BodiesChemoreceptors - monitor CO2 & O2 levels in blood
Components of the aortic root
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Brachiocephalic Artery Brachiocephalic artery divides into:Right common carotid artery Supplies blood to right side of face and head
Right subclavian artery - Supplies blood to right arm
Left common carotid arterysupplies blood to left side of face and head
Left subclavian artery supplies blood to left arm
Branches of the aortic arch
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Figure 15.42 The major branches of the aortic arch are highlighted in yellow.
End of Section 5, Chapter 15
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Section 6, Chapter 15
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•Aorta - Main trunk of the systemic circulation.
•Divisions of the aorta•Aortic root = attachment to heart
•Ascending Aorta
•Aortic arch
•Thoracic aorta
•Abdominal aorta
Arterial Divisions
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Section 6, Chapter 15
Systemic arteries and veins
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Aorta - Main trunk of the systemic circulation.
Divisions of the aortaAortic root = attachment to heart
Ascending Aorta
Aortic arch
Thoracic aorta
Abdominal aorta
Arterial Divisions
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Aortic Valve
Aortic Sinus - Swelling at aortic root
Aortic BodiesChemoreceptors - monitor CO2 & O2 levels in blood
4 .Right and left coronary arteries
Structures at the aortic root
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Right Coronary Artery branchesPosterior interventricular artery :
supplies walls of both ventricles
Marginal artery:supplies right atrium and right ventricle
Coronary Arteries
Left Coronary Artery branchesAnterior interventricular artery:
supplies walls of both ventricles
Circumflex Artery: supplies left atrium and left ventricle
Blocked coronary artery = myocardial infarction
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Brachiocephalic artery Right common carotid artery: supplies right
neck and head
Right subclavian artery: supplies right arm
2 .Left common carotid artery supplies left neck and head
3 .Left subclavian artery Supplies left arm
Branches of Aortic Arch
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Branches of Thoracic Aorta
Grant’s Anatomy. Branches of the thoracic aorta
Bronchial Arteries – supplies bronchi
Pericardial artery – supplies pericardium
Esophageal arteries – supplies esophagus
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Branches of Abdominal Aorta
Phrenic arteries supply diaphragm
Celiac Trunk Gastric a. - supply stomachSplenic a. – supply spleen & pancreasHepatic a. – supplies liver with O2 blood
Superior Mesenteric a .Supplies small intestine
Suprarenal a.Supplies adrenal glands
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Branches of Abdominal Aorta
Gonadal arteries .Male = testicular arteriesFemale = Ovarian arteries
Renal arteriesSupplies kidneys
Lumbar arteriesSupplies skin and muscles of lower back
Inferior mesenteric arterySupplies most of large intestine
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Divisions of Common Carotid Arteries
External Carotid ArteriesSupplies blood to face, neck, and scalp
Internal Carotid ArteriesSupplies blood to brain
Provides 75% of blood to brain
Carotid Sinus - point of bifurcationCarotid bodies – chemoreceptorsCarotid baroreceptorsCommon site of stenosis (narrowing)
Arteries to the Brain, Head, and Neck
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Branches of Internal Carotid Artery
1 .Ophthalmic arterysupplies eyes
2 .Anterior cerebral artery supplies medial surface of brain
3 .Middle cerebral artery Supplies lateral surface of brain
Internal carotid arteries
Arteries to the Brain, Head, and Neck
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Vertebral Arteries Provides 25% of blood supply to
brain
Branch from subclavian arteries
Pass through transverse foramen of cervical vertebrae
Enter skull through foramen magnum
Arteries to the Brain, Head, and Neck
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Basilar Artery Both vertebral arteries merge to form a basilar
artery at the base of the brain .
Supplies blood to brainstem
Branch: Posterior cerebral arterySupplies occipital and temporal lobes
Arteries to the Brain, Head, and Neck
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Cerebral Arterial Circle (Circle of Willis) Joins the internal carotid arteries with basilar artery at base of brain
Provides anastomoses (alternate routes) for blood flow
Arteries to the Brain, Head, and Neck
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Arteries to the Shoulder and Upper Limb
Axillary Artery Arises from subclavian artery
Brachial Artery Continuation of axillary arteryUsed for measuring blood pressure
Ulnar ArteryContinues along medial arm to wrist
Radial Artery Continues along lateral arm to wrist
Convenient vessel for taking your pulse
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Veins that drain the head and neck
Dural Venous SinusesLocated between 2 layers of dura materMajor CSF draining pathway from brain
Internal Jugular VeinsDrains blood from brain and
deep faceArise from dural sinuses
External Jugular VeinsDrains blood from face, scalp, and neck
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Veins that drain the arm
Ulnar & Radial Veins drain forearm and handsMerge for form brachial veins
Basilic VeinLocated on medial aspect of armJoins the brachial vein near the axilla
Cephalic VeinCourses upward on the lateral armJoins axillary vein to form subclavian vein
Axillary VeinFormed from the merging of basilic and brachial veins
Median Cubital VeinJoins basilic and cephalic veins at elbowOften the site of venipuncture
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Hepatic Portal System
Portal System – drains blood from one capillary bed into a second capillary bed.
Hepatic Portal Vein (HPV)•Carries nutrient rich blood
from abdominal viscera to the liver for processing
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Hepatic Portal SystemTributaries of Hepatic Portal Vein
•Gastric vein – blood from stomach
•Splenic vein – blood from spleen & pancreas
•Superior mesenteric vein – blood from small intestine
•Inferior mesenteric vein – blood from large intestine
Pathway of Hepatic Portal System
End of Chapter 15
heart aorta abdominal viscera HPV liver hepatic vein IVC heart