LABACT8-AnaPhysio-PPT Cardiovascular System PDF

11 THE CARDIOVASCULAR SYSTEM  The Cardiovascular System A closed system of the heart and blood vessels  The heart pumps blood  Blood vessels allow blood to circulate to all parts of the body  The functions of the cardiovascular system  To deliver oxygen and nutrients...

11 THE CARDIOVASCULAR SYSTEM  The Cardiovascular System A closed system of the heart and blood vessels  The heart pumps blood  Blood vessels allow blood to circulate to all parts of the body  The functions of the cardiovascular system  To deliver oxygen and nutrients to cells and tissues  To remove carbon dioxide and other waste products from cells and tissues The Heart  Location  Thorax between the lungs in the inferior mediastinum  Orientation  Pointed apex directed toward left hip  Base points toward right shoulder  About the size of your fist Midsternal line 2nd rib Sternum Diaphragm Point of maximal intensity (PMI) (a) Figure 11.1a  Mediastinum Heart Left lung Posterior (b) Figure 11.1b Superior Aorta vena cava Parietal pleura (cut) Pulmonary Left lung trunk Pericardium (cut) Apex of heart Diaphragm (c) Figure 11.1c Brachiocephalic trunk Left common carotid artery Superior vena cava Left subclavian artery Right pulmonary artery Aortic arch Ligamentum arteriosum Ascending aorta Left pulmonary artery Pulmonary trunk Left pulmonary veins Right pulmonary Left atrium veins Auricle of left atrium Right atrium Circumflex artery Right coronary artery in coronary sulcus (right Left coronary artery in atrioventricular groove) coronary sulcus (left atrioventricular groove) Anterior cardiac vein Left ventricle Right ventricle Great cardiac vein Marginal artery Anterior interventricular Small cardiac vein artery (in anterior interventricular sulcus) Inferior vena cava Apex (a) Figure 11.3a  Pericardium—a double-walled sac The  Heart: Fibrous pericardiumCoverings is loose and superficial  Serous membrane is deep to the fibrous pericardium and composed of two layers  Visceral pericardium  Next to heart; also known as the epicardium  Parietal pericardium  Outside layer that lines the inner surface of the fibrous pericardium  Serous fluid fills the space between the layers of pericardium  Pulmonary trunk Fibrous pericardium Parietal layer of serous Pericardium pericardium Pericardial cavity Myocardium Epicardium (visceral layer of serous pericardium) Heart wall Myocardium Endocardium Heart chamber Figure 11.2  Three layers The  Heart: Heart Wall Epicardium  Outside layer  This layer is the visceral pericardium  Connective tissue layer  Myocardium  Middle layer  Mostly cardiac muscle  Endocardium  Inner layer  Endothelium  Pulmonary trunk Fibrous pericardium Parietal layer of serous Pericardium pericardium Pericardial cavity Myocardium Epicardium (visceral layer of serous pericardium) Heart wall Myocardium Endocardium Heart chamber Figure 11.2 Superior vena cava Aorta Left pulmonary artery Right pulmonary artery Left atrium Right atrium Left pulmonary veins Right pulmonary veins Pulmonary semilunar valve Left atrioventricular valve Fossa ovalis (bicuspid valve) Aortic semilunar valve Right atrioventricular valve (tricuspid valve) Left ventricle Right ventricle Chordae tendineae Interventricular septum Inferior vena cava Myocardium Visceral pericardium (b) Frontal section showing interior chambers and valves. Figure 11.3b  Right and left side act as separate pumps  The Heart: Chambers Four chambers  Atria  Receiving chambers  Right atrium  Left atrium  Ventricles  Discharging chambers  Right ventricle  Left ventricle Superior vena cava Aorta Left pulmonary artery Right pulmonary artery Left atrium Right atrium Left pulmonary veins Right pulmonary veins Pulmonary semilunar valve Left atrioventricular valve Fossa ovalis (bicuspid valve) Aortic semilunar valve Right atrioventricular valve (tricuspid valve) Left ventricle Right ventricle Chordae tendineae Interventricular septum Inferior vena cava Myocardium Visceral pericardium (b) Frontal section showing interior chambers and valves. Figure 11.3b  Left ventricle Right ventricle Muscular interventricular septum Figure 11.5 The Heart: Septa  Interventricular septum  Separates the two ventricles  Interatrial septum  Separates the two atria Superior vena cava Aorta Left pulmonary artery Right pulmonary artery Left atrium Right atrium Left pulmonary veins Right pulmonary veins Pulmonary semilunar valve Left atrioventricular valve Fossa ovalis (bicuspid valve) Aortic semilunar valve Right atrioventricular valve (tricuspid valve) Left ventricle Right ventricle Chordae tendineae Interventricular septum Inferior vena cava Myocardium Visceral pericardium (b) Frontal section showing interior chambers and valves. Figure 11.3b The Heart’s Role in Blood Circulation  Systemic circulation  Blood flows from the left side of the heart through the body tissues and back to the right side of the heart  Pulmonary circulation  Blood flows from the right side of the heart to the lungs and back to the left side of the heart  Capillary beds of lungs where gas exchange occurs Pulmonary Circuit Pulmonary arteries Pulmonary veins Venae Aorta and cavae branches Left atrium Left Right ventricle atrium Heart Right ventricle Systemic Circuit Capillary beds of all body tissues KEY: where gas Oxygen-rich, exchange CO2-poor blood occurs Oxygen-poor, CO2-rich blood Figure 11.4  Allow blood to flow in only one direction to prevent backflow  The Heart: Valves Four valves  Atrioventricular (AV) valves—between atria and ventricles  Bicuspid (mitral) valve (left side of heart)  Tricuspid valve (right side of heart)  Semilunar valves—between ventricle and artery  Pulmonary semilunar valve  Aortic semilunar valve Superior vena cava Aorta Left pulmonary artery Right pulmonary artery Left atrium Right atrium Left pulmonary veins Right pulmonary veins Pulmonary semilunar valve Left atrioventricular valve Fossa ovalis (bicuspid valve) Aortic semilunar valve Right atrioventricular valve (tricuspid valve) Left ventricle Right ventricle Chordae tendineae Interventricular septum Inferior vena cava Myocardium Visceral pericardium (b) Frontal section showing interior chambers and valves. Figure 11.3b  AV valves The  Heart: Valves Anchored in place by chordae tendineae (“heart strings”)  Open during heart relaxation and closed during ventricular contraction  Semilunar valves  Closed during heart relaxation but open during ventricular contraction  Notice these valves operate opposite of one another to force a one- way path of blood through the heart  (a) Operation of the AV valves 1 Blood returning to the atria puts pressure against AV valves; the AV valves are forced open. Ventricles Figure 11.6a, step 1  (a) Operation of the AV valves 1 Blood returning to the atria puts pressure against AV valves; the AV valves are forced open. 2 As the ventricles fill, AV valve flaps hang limply into ventricles. Ventricles Figure 11.6a, step 2  (a) Operation of the AV valves 1 Blood returning to the atria puts pressure against AV valves; the AV valves are forced open. 2 As the ventricles fill, AV valve flaps hang limply into ventricles. 3 Atria contract, Ventricles forcing additional blood into ventricles. AV valves open; atrial pressure greater than ventricular pressure Figure 11.6a, step 3  (a) Operation of the AV valves 1 Blood returning 4 Ventricles contract, to the atria puts forcing blood against pressure against AV valve flaps. AV valves; the AV valves are forced open. 2 As the ventricles fill, AV valve flaps hang limply into ventricles. 3 Atria contract, Ventricles forcing additional blood into ventricles. AV valves open; atrial pressure greater than ventricular pressure Figure 11.6a, step 4  (a) Operation of the AV valves 1 Blood returning 4 Ventricles contract, to the atria puts forcing blood against pressure against AV valve flaps. AV valves; the AV valves are forced open. 5 AV valves close. 2 As the ventricles fill, AV valve flaps hang limply into ventricles. 3 Atria contract, Ventricles forcing additional blood into ventricles. AV valves open; atrial pressure greater than ventricular pressure Figure 11.6a, step 5  (a) Operation of the AV valves 1 Blood returning 4 Ventricles contract, to the atria puts forcing blood against pressure against AV valve flaps. AV valves; the AV valves are forced open. 5 AV valves close. 2 As the ventricles 6 Chordae fill, AV valve flaps tendineae tighten, hang limply into preventing valve ventricles. flaps from everting into atria. 3 Atria contract, Ventricles forcing additional blood into ventricles. AV valves open; AV valves closed; atrial pressure atrial pressure greater than less than ventricular pressure ventricular pressure Figure 11.6a, step 6  (b) Operation of the semilunar valves Pulmonary trunk Aorta 1 As ventricles contract and intraventricular pressure rises, blood is pushed up against semilunar valves, forcing them open. Semilunar valves open Figure 11.6b, step 1  (b) Operation of the semilunar valves Pulmonary trunk Aorta 1 As ventricles 2 As ventricles contract and relax and intraventricular intraventricular pressure rises, pressure falls, blood is pushed up blood flows against semilunar back from arteries, valves, forcing filling the leaflets them open. of semilunar valves and forcing them to close. Semilunar valves open Semilunar valves closed Figure 11.6b, step 2  Blood in the heart chambers does not nourish the myocardium Cardiac Circulation  The heart has its own nourishing circulatory system consisting of  Coronary arteries—branch from the aorta to supply the heart muscle with oxygenated blood  Cardiac veins—drain the myocardium of blood  Coronary sinus—a large vein on the posterior of the heart, receives blood from cardiac veins  Blood empties into the right atrium via the coronary sinus Brachiocephalic trunk Left common carotid artery Superior vena cava Left subclavian artery Right pulmonary artery Aortic arch Ligamentum arteriosum Ascending aorta Left pulmonary artery Pulmonary trunk Left pulmonary veins Right pulmonary Left atrium veins Auricle of left atrium Right atrium Circumflex artery Right coronary artery in coronary sulcus (right Left coronary artery in atrioventricular groove) coronary sulcus (left atrioventricular groove) Anterior cardiac vein Left ventricle Right ventricle Great cardiac vein Marginal artery Anterior interventricular Small cardiac vein artery (in anterior interventricular sulcus) Inferior vena cava Apex (a) Figure 11.3a The Heart: Associated Great Vessels  Arteries  Aorta  Leaves left ventricle  Pulmonary arteries  Leave right ventricle The Heart: Associated Great Vessels  Veins  Superior and inferior venae cavae  Enter right atrium  Pulmonary veins (four)  Enter left atrium Brachiocephalic trunk Left common carotid artery Superior vena cava Left subclavian artery Right pulmonary artery Aortic arch Ligamentum arteriosum Ascending aorta Left pulmonary artery Pulmonary trunk Left pulmonary veins Right pulmonary Left atrium veins Auricle of left atrium Right atrium Circumflex artery Right coronary artery in coronary sulcus (right Left coronary artery in atrioventricular groove) coronary sulcus (left atrioventricular groove) Anterior cardiac vein Left ventricle Right ventricle Great cardiac vein Marginal artery Anterior interventricular Small cardiac vein artery (in anterior interventricular sulcus) Inferior vena cava Apex (a) Figure 11.3a Blood Flow Through the Heart  Superior and inferior venae cavae dump blood into the right atrium  From right atrium, through the tricuspid valve, blood travels to the right ventricle  From the right ventricle, blood leaves the heart as it passes through the pulmonary semilunar valve into the pulmonary trunk  Pulmonary trunk splits into right and left pulmonary arteries that carry blood to the lungs Blood Flow Through the Heart  Oxygen is picked up and carbon dioxide is dropped off by blood in the lungs  Oxygen-rich blood returns to the heart through the four pulmonary veins  Blood enters the left atrium and travels through the bicuspid valve into the left ventricle  From the left ventricle, blood leaves the heart via the aortic semilunar valve and aorta  Capillary beds of lungs where gas exchange occurs Pulmonary Circuit Pulmonary arteries Pulmonary veins Venae Aorta and cavae branches Left atrium Left Right ventricle atrium Heart Right ventricle Systemic Circuit Capillary beds of all body tissues KEY: where gas Oxygen-rich, exchange CO2-poor blood occurs Oxygen-poor, CO2-rich blood Figure 11.4 The Heart: Conduction System  Intrinsic conduction system (nodal system)  Heart muscle cells contract, without nerve impulses, in a regular, continuous way  The Heart: Conduction Special tissue sets the pace System  Sinoatrial node = SA node (“pacemaker”), is in the right atrium  Atrioventricular node = AV node, is at the junction of the atria and ventricles  Atrioventricular bundle = AV bundle (bundle of His), is in the interventricular septum  Bundle branches are in the interventricular septum  Purkinje fibers spread within the ventricle wall muscles Superior vena cava Sinoatrial (SA) node (pacemaker) Left atrium Atrioventricular (AV) node Right atrium Atrioventricular (AV) bundle (bundle of His) Bundle branches Purkinje fibers Purkinje fibers Interventricular septum Figure 11.7 Heart Contractions  Contraction is initiated by the sinoatrial node (SA node)  Sequential stimulation occurs at other autorhythmic cells  Force cardiac muscle depolarization in one direction—from atria to ventricles Heart Contractions  Once SA node starts the heartbeat  Impulse spreads to the AV node  Then the atria contract  At the AV node, the impulse passes through the AV bundle, bundle branches, and Purkinje fibers  Blood is ejected from the ventricles to the aorta and pulmonary trunk as the ventricles contract Superior vena cava Sinoatrial (SA) node (pacemaker) Left atrium Atrioventricular (AV) node Right atrium Atrioventricular (AV) bundle (bundle of His) Bundle branches Purkinje fibers Purkinje fibers Interventricular septum Figure 11.7 Heart Contractions  Homeostatic imbalance  Heart block—damaged AV node releases them from control of the SA node; result is in a slower heart rate as ventricles contract at their own rate  Ischemia—lack of adequate oxygen supply to heart muscle  Fibrillation—a rapid, uncoordinated shuddering of the heart muscle Heart Contractions  Homeostatic imbalance (continued)  Tachycardia—rapid heart rate over 100 beats per minute  Bradycardia—slow heart rate less than 60 beats per minutes The Heart: Cardiac Cycle & Heart Sounds  Atria contract simultaneously  Atria relax, then ventricles contract  Systole = contraction  Diastole = relaxation The Heart: Cardiac Cycle & Heart Sounds  Cardiac cycle—events of one complete heart beat  Mid-to-late diastole  Pressure in heart is low  Blood flows from passively into the atria and into ventricles  Semilunar valves are closed  Atrioventricular valves are open  Atria contract and force blood into ventricles  The Heart: Cardiac Cycle & Cardiac cycle—events of one complete heart beat Heart  Sounds Ventricular systole  Blood pressure builds before ventricle contracts  Atrioventricular valves close causes first heart sound, “lub”  Semilunar valves open as blood pushes against them  Blood travels out of the ventricles through pulmonary trunk and aorta  Atria are relaxed  The Heart: Cardiac Cycle & Cardiac cycle—events of one complete heart beat Heart  Sounds Early diastole  At the end of systole, all four valves are briefly closed at the same time  Second heart sound is heard as semilunar valves close, causing “dup” sound  Atria finish refilling as pressure in the heart drops  Ventricular pressure is low  Atrioventricular valves open Left atrium Right atrium Left ventricle Right ventricle Ventricular Atrial Isovolumetric Ventricular Isovolumetric filling contraction contraction phase ejection phase relaxation 1 2 3 Mid-to-late diastole Ventricular systole Early diastole (ventricular filling) (atria in diastole) Figure 11.8 Left atrium Right atrium Left ventricle Right ventricle Ventricular filling 1 Mid-to-late diastole (ventricular filling) Figure 11.8, step 1a Left atrium Right atrium Left ventricle Right ventricle Ventricular Atrial filling contraction 1 Mid-to-late diastole (ventricular filling) Figure 11.8, step 1b Left atrium Right atrium Left ventricle Right ventricle Ventricular Atrial Isovolumetric filling contraction contraction phase 1 2 Mid-to-late diastole Ventricular systole (ventricular filling) (atria in diastole) Figure 11.8, step 2a Left atrium Right atrium Left ventricle Right ventricle Ventricular Atrial Isovolumetric Ventricular filling contraction contraction phase ejection phase 1 2 Mid-to-late diastole Ventricular systole (ventricular filling) (atria in diastole) Figure 11.8, step 2b Left atrium Right atrium Left ventricle Right ventricle Ventricular Atrial Isovolumetric Ventricular Isovolumetric filling contraction contraction phase ejection phase relaxation 1 2 3 Mid-to-late diastole Ventricular systole Early diastole (ventricular filling) (atria in diastole) Figure 11.8, step 3  Cardiac output (CO) The  Heart: Cardiac Output Amount of blood pumped by each side (ventricle) of the heart in one minute  Stroke volume (SV)  Volume of blood pumped by each ventricle in one contraction (each heartbeat)  Usually remains relatively constant  About 70 mL of blood is pumped out of the left ventricle with each heartbeat  Heart rate (HR)  Typically 75 beats per minute The Heart: Cardiac Output  CO = HR  SV  CO = HR (75 beats/min)  SV (70 mL/beat)  CO = 5250 mL/min  Starling’s law of the heart—the more the cardiac muscle is stretched, the stronger the contraction  Changing heart rate is the most common way to change cardiac output The Heart: Regulation of Heart Rate  Increased heart rate  Sympathetic nervous system  Crisis  Low blood pressure  Hormones  Epinephrine  Thyroxine  Exercise  Decreased blood volume The Heart: Regulation of Heart Rate  Decreased heart rate  Parasympathetic nervous system  High blood pressure or blood volume  Decreased venous return Figure 11.9 Blood Vessels: The Vascular System  Transport blood to the tissues and back  Carry blood away from the heart  Arteries  Arterioles  Exchanges between tissues and blood  Capillary beds  Return blood toward the heart  Venules  Veins (a) Artery Vein Figure 11.10a Blood Vessels: Microscopic Anatomy  Three layers (tunics)  Tunic intima  Endothelium  Tunic media  Smooth muscle  Controlled by sympathetic nervous system  Tunic externa  Mostly fibrous connective tissue  Valve Tunica intima Endothelium Loose connective tissue Internal elastic lamina Tunica media Smooth muscle Elastic fibers External elastic lamina Tunica externa Collagen fibers Lumen Venule Lumen Artery Arteriole Vein Capillary network Basement membrane Endothelial cells (b) Capillary Figure 11.10b Structural Differences Among Blood Vessels  Arteries have a thicker tunica media than veins  Capillaries are only one cell layer (tunica intima) to allow for exchanges between blood and tissue  Veins have a thinner tunica media than arteries  Veins also have valves to prevent backflow of blood  Lumen of veins are larger than arteries  Valve Tunica intima Endothelium Loose connective tissue Internal elastic lamina Tunica media Smooth muscle Elastic fibers External elastic lamina Tunica externa Collagen fibers Lumen Venule Lumen Artery Arteriole Vein Capillary network Basement membrane Endothelial cells (b) Capillary Figure 11.10b Venous Aids for the Return of Blood to the Heart  Veins:  Have a thinner tunica media  Operate under low pressure  Have a larger lumen than arteries  To assist in the movement of blood back to the heart:  Larger veins have valves to prevent backflow  Skeletal muscle “milks” blood in veins toward the heart  Valve (open) Contracted skeletal muscle Valve (closed) Vein Direction of blood flow Figure 11.11 Movement of Blood Through Vessels  Most arterial blood is pumped by the heart  Veins use the milking action of muscles to help move blood Capillary Beds  Capillary beds consist of two types of vessels  Vascular shunt—vessel directly connecting an arteriole to a venule  True capillaries—exchange vessels  Oxygen and nutrients cross to cells  Carbon dioxide and metabolic waste products cross into blood  Vascular shunt Precapillary sphincters True capillaries Terminal arteriole Postcapillary venule (a) Sphincters open; blood flows through true capillaries. Figure 11.12a Figure 11.12b Major Arteries of System Circulation  Aorta  Largest artery in the body  Leaves from the left ventricle of the heart  Regions  Ascending aorta—leaves the left ventricle  Aortic arch—arches to the left  Thoracic aorta—travels downward through the thorax  Abdominal aorta—passes through the diaphragm into the abdominopelvic cavity Major Arteries of System Circulation  Arterial branches of the ascending aorta  Right and left coronary arteries serve the heart Brachiocephalic trunk Left common carotid artery Superior vena cava Left subclavian artery Right pulmonary artery Aortic arch Ligamentum arteriosum Ascending aorta Left pulmonary artery Pulmonary trunk Left pulmonary veins Right pulmonary Left atrium veins Auricle of left atrium Right atrium Circumflex artery Right coronary artery in coronary sulcus (right Left coronary artery in atrioventricular groove) coronary sulcus (left atrioventricular groove) Anterior cardiac vein Left ventricle Right ventricle Great cardiac vein Marginal artery Anterior interventricular Small cardiac vein artery (in anterior interventricular sulcus) Inferior vena cava Apex (a) Figure 11.3a  Major Arteries of Systemic Arterial branches of the aortia arch (BCS) Circulation  Brachiocephalic trunk splits into the  Right common carotid artery  Right subclavian artery  Left common carotid artery splits into the  Left internal and external carotid arteries  Left subclavian artery branches into the  Vertebral artery  In the axilla, the subclavian artery becomes the axillary artery  brachial artery  radial and ulnar arteries Major Arteries of Systemic Circulation  Arterial branches of the thoracic aorta  Intercostal arteries supply the muscles of the thorax wall  Other branches of the thoracic aorta supply the  Lungs (bronchial arteries)  Esophagus (esophageal arteries)  Diaphragm (phrenic arteries) Major Arteries of Systemic Circulation  Arterial branches of the abdominal aorta  Celiac trunk is the first branch of the abdominal aorta. Three branches are  Left gastric artery (stomach)  Splenic artery (spleen)  Common hepatic artery (liver)  Superior mesenteric artery supplies most of the small intestine and first half of the large intestine Major Arteries of Systemic Circulation  Arterial branches of the abdominal aorta  Left and right renal arteries (kidney)  Left and right gonadal arteries  Ovarian arteries in females serve the ovaries  Testicular arteries in males serve the testes  Lumbar arteries serve muscles of the abdomen and trunk Major Arteries of Systemic Circulation  Arterial branches of the abdominal aorta  Inferior mesenteric artery serves the second half of the large intestine  Left and right common iliac arteries are the final branches of the aorta  Internal iliac arteries serve the pelvic organs  External iliac arteries enter the thigh  femoral artery  popliteal artery  anterior and posterior tibial arteries Arteries of the head and trunk Internal carotid artery External carotid artery Common carotid arteries Vertebral artery Arteries that supply the upper limb Subclavian artery Subclavian artery Brachiocephalic trunk Aortic arch Axillary artery Ascending aorta Coronary artery Thoracic aorta (above diaphragm) Brachial artery Celiac trunk Abdominal aorta Superior mesenteric Radial artery artery Ulnar artery Renal artery Gonadal artery Deep palmar arch Superficial palmar arch Digital arteries Inferior mesenteric artery Arteries that supply the lower limb Common iliac artery External iliac artery Femoral artery Popliteal artery Internal iliac artery Anterior tibial artery Posterior tibial artery Dorsalis pedis artery Arcuate artery Figure 11.13 Major Veins of Systemic Circulation  Superior and inferior vena cava enter the right atrium of the heart  Superior vena cava drains the head and arms  Inferior vena cava drains the lower body Superior vena cava Aorta Left pulmonary artery Right pulmonary artery Left atrium Right atrium Left pulmonary veins Right pulmonary veins Pulmonary semilunar valve Left atrioventricular valve Fossa ovalis (bicuspid valve) Aortic semilunar valve Right atrioventricular valve (tricuspid valve) Left ventricle Right ventricle Chordae tendineae Interventricular septum Inferior vena cava Myocardium Visceral pericardium (b) Frontal section showing interior chambers and valves. Figure 11.3b Major Veins of Systemic Circulation  Veins draining into the superior vena cava  Radial and ulnar veins  brachial vein  axillary vein  These veins drain the arms  Cephalic vein drains the lateral aspect of the arm and empties into the axillary vein  Basilic vein drains the medial aspect of the arm and empties into the brachial vein  Basilic and cephalic veins are jointed at the median cubital vein (elbow area) Major Veins of Systemic Circulation  Veins draining into the superior vena cava  Subclavian vein receives  Venous blood from the arm via the axillary vein  Venous blood from skin and muscles via external jugular vein  Vertebral vein drains the posterior part of the head  Internal jugular vein drains the dural sinuses of the brain Major Veins of Systemic Circulation  Veins draining into the superior vena cava  Left and right brachiocephalic veins receive venous blood from the  Subclavian veins  Vertebral veins  Internal jugular veins  Brachiocephalic veins join to form the superior vena cava  right atrium of heart  Azygous vein drains the thorax  Major Veins of Systemic  Veins draining into the inferior vena cava Circulation  Anterior and posterior tibial veins and fibial veins drain the legs  Posterior tibial vein  popliteal vein  femoral vein  external iliac vein  Great saphenous veins (longest veins of the body) receive superficial drainage of the legs  Each common iliac vein (left and right) is formed by the union of the internal and external iliac vein on its own side Major Veins of Systemic Circulation  Veins draining into the inferior vena cava  Right gonadal vein drains the right ovary in females and right testicle in males  Left gonadal vein empties into the left renal vein  Left and right renal veins drain the kidneys  Hepatic portal vein drains the digestive organs and travels through the liver before it enters systemic circulation Major Veins of Systemic Circulation  Veins draining into the inferior vena cava  Left and right hepatic veins drain the liver Veins of the head and trunk Dural venous sinuses External jugular vein Vertebral vein Internal jugular vein Veins that drain the upper limb Right and left Subclavian vein brachiocephalic veins Axillary vein Superior vena cava Cephalic vein Brachial vein Great cardiac vein Basilic vein Hepatic veins Splenic vein Hepatic portal vein Renal vein Median cubital vein Superior Ulnar vein mesenteric vein Radial vein Inferior mesenteric vein Digital veins Veins that drain the lower limb External iliac vein Inferior vena cava Femoral vein Common iliac vein Great saphenous vein Popliteal vein Internal iliac vein Posterior tibial vein Anterior tibial vein Small saphenous vein Dorsal venous arch Dorsal metatarsal veins Figure 11.14 Arterial Supply of the Brain  Internal carotid arteries divide into  Anterior and middle cerebral arteries  These arteries supply most of the cerebrum  Vertebral arteries join once within the skull to form the basilar artery  Basilar artery serves the brain stem and cerebellum Arterial Supply of the Brain  Posterior cerebral arteries form from the division of the basilar artery  These arteries supply the posterior cerebrum Circle of Willis  Anterior and posterior blood supplies are united by small communicating arterial branches  Result—complete circle of connecting blood vessels called cerebral arterial circle or circle of Willis  Anterior Cerebral arterial circle Frontal lobe (circle of Willis) Optic chiasma Anterior communicating Middle artery cerebral artery Anterior cerebral artery Internal Posterior carotid communicating artery artery Mammillary Posterior body cerebral artery Temporal Basilar artery lobe Vertebral artery Pons Occipital lobe Cerebellum (a) Posterior Figure 11.15a Figure 11.15b Fetal Circulation  Fetus receives exchanges of gases, nutrients, and wastes through the placenta  Umbilical cord contains three vessels  Umbilical vein—carries blood rich in nutrients and oxygen to the fetus  Umbilical arteries (2)—carry carbon dioxide and debris-laden blood from fetus to placenta  Superior vena cava Ductus arteriosus Pulmonary artery Pulmonary veins Foramen ovale Inferior vena cava Hepatic vein Ductus venosus Inferior vena cava Hepatic portal vein Umbilical vein Fetal umbilicus Aorta Common iliac artery Umbilical cord External iliac artery Internal iliac artery Umbilical arteries Urinary bladder KEY: High oxygenation Moderate oxygenation Low oxygenation Very low oxygenation Placenta Figure 11.16 Fetal Circulation  Blood flow bypasses the liver through the ductus venosus and enters the inferior vena cava  right atrium of heart  Blood flow bypasses the lungs  Blood entering right atrium is shunted directly into the left atrium through the foramen ovale  Ductus arteriosus connects the aorta and pulmonary trunk (becomes ligamentum arteriosum at birth) Brachiocephalic trunk Left common carotid artery Superior vena cava Left subclavian artery Right pulmonary artery Aortic arch Ligamentum arteriosum Ascending aorta Left pulmonary artery Pulmonary trunk Left pulmonary veins Right pulmonary Left atrium veins Auricle of left atrium Right atrium Circumflex artery Right coronary artery in coronary sulcus (right Left coronary artery in atrioventricular groove) coronary sulcus (left atrioventricular groove) Anterior cardiac vein Left ventricle Right ventricle Great cardiac vein Marginal artery Anterior interventricular Small cardiac vein artery (in anterior interventricular sulcus) Inferior vena cava Apex (a) Figure 11.3a Superior vena cava Aorta Left pulmonary artery Right pulmonary artery Left atrium Right atrium Left pulmonary veins Right pulmonary veins Pulmonary semilunar valve Left atrioventricular valve Fossa ovalis (bicuspid valve) Aortic semilunar valve Right atrioventricular valve (tricuspid valve) Left ventricle Right ventricle Chordae tendineae Interventricular septum Inferior vena cava Myocardium Visceral pericardium (b) Frontal section showing interior chambers and valves. Figure 11.3b Hepatic Portal Circulation  Veins of hepatic portal circulation drain  Digestive organs  Spleen  Pancreas  Hepatic portal vein carries this blood to the liver  Liver helps maintain proper glucose, fat, and protein concentrations in blood Hepatic Portal Circulation  Major vessels of hepatic portal circulation  Inferior and superior mesenteric veins  Splenic vein  Left gastric vein Arterial Venous blood blood Inferior vena cava Stomach and intestine Liver Nutrients and Liver cells (hepatocytes) toxins absorbed Nutrients and toxins leave Hepatic portal vein First capillary bed Second capillary bed (liver sinusoids) Hepatic vein Hepatic portal system Figure 11.17  Inferior vena cava (not part of hepatic portal system) Gastric veins Liver Spleen Stomach Hepatic portal vein Splenic vein Inferior mesenteric vein Superior mesenteric vein Small intestine Large intestine Figure 11.18 Pulse  Pulse  Pressure wave of blood  Monitored at “pressure points” in arteries where pulse is easily palpated  Pulse averages 70 to 76 beats per minute at rest Superficial temporal artery Facial artery Common carotid artery Brachial artery Radial artery Femoral artery Popliteal artery Posterior tibial artery Dorsalis pedis artery Figure 11.19 Blood Pressure  Measurements by health professionals are made on the pressure in large arteries  Systolic—pressure at the peak of ventricular contraction  Diastolic—pressure when ventricles relax  Write systolic pressure first and diastolic last (120/80 mm Hg)  Pressure in blood vessels decreases as distance from the heart increases  Pressure (mm Hg) −10 80 120 100 20 40 60 0 Aorta Arteries Diastolic pressure Arterioles Capillaries Venules Systolic pressure Veins Venae cavae Figure 11.20  Blood pressure 120 systolic 70 diastolic (to be measured) Brachial artery (a) The course of the brachial artery of the arm. Assume a blood pressure of 120/70 in a young, healthy person. Figure 11.21a  Pressure in cuff above 120; no sounds audible 120 mm Hg Rubber cuff inflated with air Brachial artery closed (b) The blood pressure cuff is wrapped snugly around the arm just above the elbow and inflated until the cuff pressure exceeds the systolic blood pressure. At this point, blood flow into the arm is stopped, and a brachial pulse cannot be felt or heard. Figure 11.21b  Pressure in cuff below 120, but above 70 120 mm Hg 70 mm Hg Sounds audible in stethoscope (c) The pressure in the cuff is gradually reduced while the examiner listens (auscultates) for sounds in the brachial artery with a stethoscope. The pressure read as the first soft tapping sounds are heard (the first point at which a small amount of blood is spurting through the constricted artery) is recorded as the systolic pressure. Figure 11.21c  Pressure in cuff below 70; no sounds audible 70 mm Hg (d) As the pressure is reduced still further, the sounds become louder and more distinct; when the artery is no longer constricted and blood flows freely, the sounds can no longer be heard. The pressure at which the sounds disappear is recorded as the diastolic pressure. Figure 11.20d  Blood Pressure: Effects of BP is blood pressure Factors  BP is affected by age, weight, time of day, exercise, body position, emotional state  CO is the amount of blood pumped out of the left ventricle per minute  PR is peripheral resistance, or the amount of friction blood encounters as it flows through vessels  Narrowing of blood vessels and increased blood volume increases PR  BP = CO  PR Blood Pressure: Effects of Factors  Neural factors  Autonomic nervous system adjustments (sympathetic division)  Renal factors  Regulation by altering blood volume  Renin—hormonal control Blood Pressure: Effects of Factors  Temperature  Heat has a vasodilating effect  Cold has a vasoconstricting effect  Chemicals  Various substances can cause increases or decreases  Diet Figure 11.22  Normal human range is variable Variations Normal in Blood Pressure  140 to 110 mm Hg systolic  80 to 75 mm Hg diastolic  Hypotension  Low systolic (below 110 mm Hg)  Often associated with illness  Hypertension  High systolic (above 140 mm Hg)  Can be dangerous if it is chronic Capillary Exchange  Substances exchanged due to concentration gradients  Oxygen and nutrients leave the blood  Carbon dioxide and other wastes leave the cells Capillary Exchange: Mechanisms  Direct diffusion across plasma membranes  Endocytosis or exocytosis  Some capillaries have gaps (intercellular clefts)  Plasma membrane not joined by tight junctions  Fenestrations (pores) of some capillaries Lumen of capillary Vesicles Endothelial Intercellular fenestration cleft (pore) 4 Transport via vesicles 3 Diffusion through pore 2 Diffusion through 1 Direct intracellular cleft diffusion through membrane Interstitial fluid Figure 11.23 Fluid Movements at Capillary Beds  Blood pressure forces fluid and solutes out of capillaries  Osmotic pressure draws fluid into capillaries  Blood pressure is higher than osmotic pressure at the arterial end of the capillary bed  Blood pressure is lower than osmotic pressure at the venous end of the capillary bed  Tissue cell Interstitial fluid Net fluid Net fluid movement movement Bl out in oo w d fl flo ow d oo Bl Arterial Venule end of end of capillary capillary At the arterial end of At the venule end of a capillary, blood the capillary, blood pressure is more than pressure is less than osmotic pressure, osmotic pressure, and fluid flows out of and fluid flows from the capillary and into the interstitial fluid the interstitial fluid. into the capillary. Blood pressure is higher than osmotic pressure Osmotic pressure (remains steady in capillary bed) Blood pressure is lower than osmotic pressure Figure 11.24 Developmental Aspects of the Cardiovascular System  A simple “tube heart” develops in the embryo and pumps by the fourth week  The heart becomes a four-chambered organ by the end of seven weeks  Few structural changes occur after the seventh week Developmental Aspects of the Cardiovascular System  Aging problems associated with the cardiovascular system include  Venous valves weaken  Varicose veins  Progressive atherosclerosis  Loss of elasticity of vessels leads to hypertension  Coronary artery disease results from vessels filled with fatty, calcified deposits