Peripheral Vasculature Lecture Notes (Queen Mary University of London) PDF

Peripheral Vasculature Dr I.T. Ikele MBBS, MSc, PhD Clinical Anatomy and Human Identification 03/12/2024  Lecture Objectives 1. Classify the different types of blood vessel 2. Identify the great vessels 3. Describe peripheral vasculature of the upper and lower limbs 4. T...

Peripheral Vasculature Dr I.T. Ikele MBBS, MSc, PhD Clinical Anatomy and Human Identification 03/12/2024  Lecture Objectives 1. Classify the different types of blood vessel 2. Identify the great vessels 3. Describe peripheral vasculature of the upper and lower limbs 4. To describe the arterial system and how collateral circulation maintains the blood supply of the limbs during movement 5. Describe both the deep and superficial venous return of blood from the periphery CLASSIFICATION OF BLOOD VESSELS Arteries: Carry oxygenated blood away from the heart Veins: Carry blood back to the heart Capillaries: Extremely tiny vessels that link arterioles and venules, facilitating the exchange of oxygen and nutrients between blood and tissues. Found in the skin and skeletal muscles Sinusoids: Narrow vessels present in the liver, spleen, and bone marrow image by Creative Commons  Basic structure Common organisation – 3 layers 1. Tunica Intima Basement membrane Endothelium – simple squamous (Transportation, Osmosis Endothelial function - Vasoactive / Minimizes friction Circular Smooth Muscle 2. Tunica media Collagen( Structural support) & Elastic Fibers(Resilience and flexibility)Vaso-constriction/dilation CT elastin and collagen 3. Tunica adventitia Protects, Strengthens, Anchors Vasa vasorum - Arteries have a narrow, patent, and non- collapsible lumen (NPN) Elastic/Conducting - Thick walls of smooth muscle and elastic fibres help arteries withstand and maintain Artery Large tunica media high blood pressure Intern al Large amount of Elastin Elastic Lamin Own blood supply vasa vasorum a Aorta, common iliac, subclavian Extern al Muscular/Distributing Elastic Lamina Artery Large tunica media with IEL and EEL Large amount of Smooth muscle Renal artery, brachial, femoral Arteriole/Resistance artery Narrow lumen-hence resists amount of blood to an organ Large amount of Smooth muscle image by Creative Commons Splenic arteriole  Vein Venules and veins have a wider lumen and thinner walls than corresponding arteries making them more collapsible under pressure (WBC) Valves Thick tunica adventitia which help vein withstand the lower pressure and prevent collapse image by Creative Commons  Histologic al structure of the artery and vein Image from Chegg.com Capillary Single layer of endothelial cells for gaseous exchange, nutrients, and waste products No adventitia or media layers Lumen: 5 to 10 microns Pericytes are contractile cells that wrap around the capillaries. They regulate blood flow Fenestrations and pores allow for rapid exchange of substances Sluggish blood flow, which allows sufficient time for diffusion across the endothelial layer  Musculo-venous pump “Skeletal muscle pump or peripheral When the calf heart” muscles(skel etal), This action contract, helps to push they the blood compress the upward deep veins, against (anterior and Gravi posterior gravity and ty promotes the tibial veins) flow of blood and a back to the superficial heart. vein(small saphenous The dense Theveins). venous fascia in the valves legs supports prevent the the muscles backflow of and helps blood, ensure ensuring efficient efficient blood return circulation. to the heart. Image leglux.com Pulmonary trunk: It carries deoxygenated blood from the right ventricle to the lungs. The flow of blood from the heart through the lungs and back to the heart It picks up oxygen and releases carbon dioxide in the lungs Systemic circulation Aorta. It carries oxygenated blood from the left ventricle to the rest of the body. The flow of blood from the heart through the body back to the heart Delivers oxygen and picks up carbon dioxide in the body's tissues Blood flow through heart Arteries  (away from the heart). Veins  (towards the heart Blood flow through heart Superio r vena cava Right atrium Inferior vena Blood flow through heart Tricuspi d valve Right ventricl e  Blood flow through heart L. R. Pulmonar Pulmonar y artery y artery Pulmona ry trunk Pulmona ry valve Blood flow through heart x4 Pulmonary veins Left atrium Blood flow through heart Mitral valve Left ventricle Blood flow through heart Arch of the Aorta Ascending Aorta Aortic valve is 1 of 2 semilunar valves  Heart in situ Arch of the aorta Ascending aorta Pulmonary Trunk R A LV R V  Great Vessels/Arteries Right Common Carotid artery Right Subclavian Left Common artery Carotid artery Left Brachiocephal 3 Subclavian ic artery 2 artery 1 a t he Aort of Arch Great Vessels Great Vessels/Veins 4 3 1 2 6 5 7 1. R Subclavian vein 2. L Subclavian vein 3. L Internal jugular vein 4. R Internal jugular vein 5. L Brachiocephalic vein 6. R Brachiocephalic Close laptops/cover notes… Identify A-E C E D A B  Subclavian artery Axillary artery Brachial artery Radial artery Ulnar artery Palmar arches and digital branches  Subclavi an Circumflex Axillary humeral artery (anterior and posterior) Deep artery of the arm Brachi (profunda al brachii) Superior ulnar collateral artery Radial collateral Inferior ulnar artery collateral artery Collateral vessels are found Radial around joints to allow Ulnar continuous blood supply during Radial Ulnar artery artery Deep palmar arch Anterior interosseou Superficial s artery palmar arch Digital Superficial branches palmar arch Axillary pulse Brachial pulse Brachial pulse Radial pulse Ulnar pulse Radial pulse  Veins Superficial Deep Superficial veins are in Deep veins are within the superficial fascia the muscular compartments and have the same name as the arteries  Veins Cephalic Median Basilic cubital Cephalic Basilic Dorsal venous network Deep Superficial Deep veins have the same name as the  Cephalic Subclavian vein artery Axillary and vein artery and vein Brachial artery and vein Basilic vein Median Radial cubital artery vein and vein Ulnar artery and vein Palmar arches and digital  Identify C D A B Lower limb blood supply Right Common iliac artery  Common Iliac Artery 1 1. Aorta 2 2 4 3 2. Common iliac artery 3. Internal iliac artery 4. External Iliac artery  Superior gluteal artery Externa l iliac artery Internal iliac artery Femoral Obturat or Inferior gluteal artery  Femoral artery Lateral circumflex Medial femoral circumflex artery femoral Popliteal artery Deep artery of artery the thigh (profunda Femoral femoris)  Femoral artery Adductor hiatus Femoral artery passes through the adductor hiatus to become the popliteal artery. Popliteal artery Genicular arteries Anterior Posterior tibial tibial artery artery c Posterior tibial The popliteal artery continues posteriorly down the leg as the posterior Posterior tibial artery. tibial artery Fibular It runs in the posterior compartment of branch the leg and gives off a fibular branch laterally. It passes through the tarsal tunnel behind the medial malleolus to reach the sole of the foot. Medial and Tarsal tunnel Lateral plantar arteries  Anterior tibial Anterior tibial artery Branches from the popliteal artery and passes through the interosseous membrane to reach the anterior compartment, into the foot to become the dorsalis pedis artery. Dorsalis pedis pulse can be found lateral to Extensor hallucis longus tendon Dorsalis Extensor pedis Hallucis longus  Behind medial malleolus * * * Great/long Saphenous vein Small/Short Saphenous vein Superfici Deep al  Femoral pulse Popliteal pulse Posterior tibial pulse Dorsalis pedis pulse External Internal iliac iliac artery and and artery vein vein Femoral artery and vein Great Sapheno us vein Poplitea Short l artery Sapheno and us vein vein Anterior Posterio tibial r tibial artery artery and and vein vein Arcuate artery and digital QUESTIONS 45 Thank you