Lab 18 Flashcards
1
Q
Blood vessels are a closed system of passages that transport
A
blood around the body.
2
Q
The heart pumps blood away
A
from the heart through a series of arteries.
3
Q
Arteries branch as they pass through organs and tissues to form progressively smaller vessels until they branch into
A
tiny capillary beds,
4
Q
tiny capillary beds,
A
where gas, nutrient, and waste exchange take place.
5
Q
The blood is drained from the capillaries via a
A
series of veins that return the blood to the heart.
6
Q
The three major circuits of blood flow in the body are the following:
A
systemic; coronary; pulmonary
7
Q
- Systemic.
A
The systemic circuit consists of a series of arteries that deliver oxygenated blood to capillary beds within the body’s tissues, and a set of veins that return deoxygenated blood back to the heart.
8
Q
- Coronary.
A
The coronary circuit is similar to the systemic circuit except its arteries, capillary beds, and veins supply and drain only the heart.
9
Q
- Pulmonary.
A
The pulmonary circuit features a set of arteries that deliver deoxygenated blood to the capillary beds of the lungs, and a set of veins that return oxygenated blood to the heart.
10
Q
The systemic arterial circuit begins with the
A
largest artery in the body, the aorta.
11
Q
The aorta originates from the
A
left ventricle as the ascending aorta, which ascends until it curves around to form the aortic arch.
12
Q
There are three major branches off the aortic arch:
A
the brachiocephalic trunk, the left common carotid artery, and the left subclavian artery.
13
Q
The brachiocephalic trunk (bray-kee-oh-seh-FAL-ik)
A
is a small trunk that veers to the right. Shortly after passing deep to the clavicle, it splits into the right common carotid and right subclavian arteries.
14
Q
The arterial supply of the head and neck comes primarily from the
A
right and left common carotid arteries (kuh-RAWT-id;
15
Q
Notice that the right and left common carotid arteries have different origins—the right side branches from the
A
brachiocephalic trunk, and the left side from the aortic arch.
16
Q
In the neck, these arteries branch into the
A
internal and external carotid arteries.
17
Q
The external carotid artery gives off many branches that supply the
A
structures of the head, neck, and face.
18
Q
One of its terminal branches is the
A
large superficial temporal artery, which crosses the temporal bone to supply the scalp.
19
Q
The internal carotid arteries pass through the
A
carotid canals to enter the cranial cavity, where they give off branches called the anterior and middle cerebral arteries that supply the brain.
20
Q
The two anterior cerebral arteries are connected by a
A
small anterior communicating artery.
21
Q
Also supplying the brain are the
A
vertebral arteries, which branch from the subclavian arteries.
22
Q
The vertebral arteries then pass through the
A
vertebral foramina of the cervical vertebrae and enter the cranial cavity through the foramen magnum.
23
Q
At the brainstem, the two vertebral arteries fuse to become the
A
single basilar artery (BAY-zih-lur), splitting again near the pituitary gland into the posterior cerebral arteries. These vessels give off small posterior communicating arteries, connecting the circulation of the basilar artery with that of the internal carotid arteries.
24
Q
These vessels form a continuous structure known as the
A
cerebral arterial circle.
25
The connection provides
alternate routes of circulation to the brain if one of the arteries supplying the brain becomes blocked.
26
The arterial supply to the upper limb begins with the
right and left subclavian arteries (sub-KLAY-vee-in; Fig. 18.6). The
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The subclavian artery becomes the
axillary artery near the axilla.
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In the arm, the axillary artery becomes the
brachial artery
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brachial artery (BRAY-kee-uhl), which splits into the
radial artery and the ulnar artery just distal to the antecubital fossa.
30
As you would expect, these arteries travel alongside the bones for which they are named—
the radial artery is lateral and the ulnar artery is medial.
31
Near the left superior sternal border, the aortic arch curves inferiorly to become
the thoracic aorta.
32
The thoracic aorta descends through the thoracic cavity posterior to the heart, giving off
posterior intercostal arteries, after which it passes through the diaphragm to become the abdominal aorta.
33
The six major branches of the abdominal aorta, include the following:
celiac trunk; middle suprarenal arteries; renal arteries; superior mesenteric artery; gonadal arteries; inferior mesenteric artery
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1. Celiac trunk.
The short, stubby celiac trunk is the first branch of the abdominal aorta.
35
The celiac trunk spilts almost immediately into the
common hepatic artery
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common hepatic artery supplies the
liver, stomach, pancreas, and duodenum (part of the small intestine);
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the splenic artery (SPLEN-ik), which supplies the
spleen, stomach, and pancreas;
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and the left gastric artery,
which supplies the stomach.
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2. Middle suprarenal arteries.
Just inferior to the celiac trunk are the small middle suprarenal arteries, which supply the adrenal glands that are located on top of the kidneys.
40
3. Renal arteries.
Inferior to the celiac trunk we find the two renal arteries (REE-nuhl), which serve the kidneys. Note that the kidneys are posterior to the other abdominal organs in Figure 18.7 and so the renal arteries are slightly obscured by other organs and vessels. They are also seen more clearly in Figure 18.3.
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4. Superior mesenteric artery.
In the same vicinity of the renal arteries is another branch called the superior mesenteric artery (mez-en-TEHR-ik). As its name implies, it travels through the membranes of the intestines (called the mesentery) and supplies the small and much of the large intestine.
42
5. Gonadal arteries.
Inferior to the superior mesenteric arteries we find a small pair of arteries that serve the reproductive organs, or gonads, and so are called the gonadal arteries.
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6. Inferior mesenteric artery.
The last large branch off the abdominal aorta is the inferior mesenteric artery, which supplies the remainder of the large intestine.
44
The abdominal aorta terminates by
bifurcating into two common iliac arteries (ILL-ee-ak), which themselves bifurcate into an internal iliac artery and an external iliac artery (Figs. 18.7 and 18.8).
45
The internal iliac artery supplies structures of the
pelvis, and the external iliac artery passes deep to the inguinal ligament to enter the anterior thigh, where it becomes the femoral artery.
46
In the proximal thigh, the femoral artery gives off
the deep femoral artery, which travels posteriorly to supply the hip joint, femur, and other structures in the thigh.
47
The femoral artery remains anterior until
about midway down the thigh when it also passes posteriorly to become the popliteal artery (pahp-lih-TEE-uhl;
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popliteal artery (pahp-lih-TEE-uhl;
named for the popliteal fossa, or the posterior knee).
49
Just distal to the popliteal fossa, the popliteal artery divides
into its two main branches: the anterior tibial artery, which continues in the anterior foot as the dorsalis pedis artery (dohr-SAL-iss PEE-diss), and the posterior tibial artery,
50
dorsalis pedis artery (dohr-SAL-iss PEE-diss), and the posterior tibial artery,
which curls underneath the medial malleolus and continues to the plantar surface of the foot.
51
Arteries of the Trunk
aorta; brachiocephalic trunk; subclavian artery; celiac trunk middle suprarenal artery; superior mesenteric artery; gonadal arteries; inferior mesenteric artery; common iliac artery
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1. Aortaa.
Ascending aortab. Aortic archc. Thoracic aortad. Abdominal aorta
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4. Celiac trunka.
Common hepatic arteryb. Splenic arteryc. Left gastric artery
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5. Middle suprarenal arteries
6. Renal arteries
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10. Common iliac artery
a. Internal iliac arteryb. External iliac artery
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Arteries of the Head and Neck
1. Common carotid arteries; 2. External carotid artery; 3. Internal carotid artery; 4. Vertebral artery; 5. Basilar artery; 6. Cerebral arterial circle
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1. Common carotid arteriesa.
Right common carotid arteryb. Left common carotid artery
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2. External carotid artery
a. Superficial temporal artery
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3. Internal carotid artery
a. Anterior cerebral arteryb. Middle cerebral artery
60
5. Basilar artery
a. Posterior cerebral artery
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6. Cerebral arterial circle
a. Anterior communicating arteryb. Posterior communicating arteries
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Arteries of the Upper Limbs
1. Axillary artery2. Brachial artery3. Radial artery4. Ulnar artery
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Arteries of the Lower Limbs
1. Femoral artery2. Popliteal arterya. Anterior tibial artery (1) Dorsalis pedis arteryb. Posterior tibial artery
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2. Popliteal artery
a. Anterior tibial artery (1) Dorsalis pedis arteryb. Posterior tibial artery
65
Arteries of the systemic circuit deliver
oxygenated, nutrient-rich blood to capillary beds, and here gases, nutrients, and wastes are exchanged.
66
The deoxygenated, carbon dioxide-rich blood is then drained from the
capillary beds by a series of veins.
67
The two largest veins in the body are the
superior vena cava, which drains most structures superior to the diaphragm, and the inferior vena cava, which drains most structures inferior to the diaphragm.
68
The head and the neck are drained primarily by the
internal and external jugular veins, with a small contribution from the vertebral vein in the posterior neck
69
The much smaller and more lateral external jugular vein (JUG-yoo-lur) drains the
face and the scalp,
70
The larger internal jugular vein, which travels in a sheath with the common carotid artery, drains the
brain.
71
Note, however, that venous blood from the brain does not simply drain into one vein and exit the head. Instead, blood from brain capillaries drains into
cerebral veins, and then into spaces between the two layers of the dura mater called the dural sinuses
72
Two of the sinuses, the superior and inferior sagittal sinuses, are located within the
falx cerebri.
73
Blood from the inferior sagittal sinus drains posteriorly into the
straight sinus, and then joins with the blood from the superior sagittal sinus by draining into the transverse sinuses.
74
Once in the transverse sinuses, blood drains into the
sigmoid sinuses, which also receive blood from the anterior cavernous sinus.
75
From the caverous sinus, blood drains into the
At this point blood drains into the internal jugular vein.
76
Blood from the deep structures of the upper limb is drained by the
radial and ulnar veins, both of which parallel the bones for which they are named.
77
the radial and ulnar veins merge into
These two veins merge in the arm to form the brachial vein near the antecubital fossa.
78
The superficial structures of the upper limb are drained by three veins:
the lateral cephalic vein, the middle median antebrachial vein, and the medial basilic vein.
79
The cephalic vein and the basilic vein are united in the
antecubital fossa by the median cubital vein (KYOO-bit-uhl).
80
This is a frequent site for drawing blood with a syringe.
antecubital fossa by the median cubital vein (KYOO-bit-uhl).
81
Around the axilla, the basilic vein joins the
brachial vein to form the axillary vein.
82
Near the clavicle, the axillary vein becomes the
subclavian vein, which drains into the brachiocephalic vein, and finally into the superior vena cava.
83
subclavian vein, which drains into the
brachiocephalic vein, and finally into the superior vena cava.
84
The venous drainage system of the posterior thoracic and abdominal walls, which drains into a set of veins called
the azygos system (ay-ZY-gus).
85
This system consists of three veins:
the azygos vein, the hemiazygos vein, and the accessory hemiazygos vein.
86
The vessels on the left side of the thorax, such as the
posterior intercostal veins, drain into either the hemiazygos or accessory hemiazygos veins, which then drain into the azygos vein.
87
Vessels on the right side of the thorax drain into the
azygos vein.
88
Blood in the azygos vein then drains directly into the
superior vena cava.
89
Veins draining blood from the organs of the abdomen are named largely in parallel with the
arteries that serve the organs:
90
The renal veins drain the
kidneys
91
, the gonadal veins drain the
gonads,
92
the suprarenal veins drain the
adrenal glands
93
The splenic vein drains the
spleen,
94
the gastric veins drain the
stomach,
95
the superior mesenteric vein drains the
small intestine and much of the large intestine,
96
and the inferior mesenteric vein drains the remainder of the
large intestine.
97
Although the renal veins and gonadal veins empty into the inferior vena cava, the blood from the latter four veins does not drain into the inferior vena cava directly. Instead, each vein drains into a
common vein called the hepatic portal vein.
98
hepatic portal vein, nutrients pass through the
sinusoids of the liver, where it is processed and detoxified. In this way, everything we ingest (except lipids, which we discuss in Unit 24) must travel through the liver before entering the systemic circulation.
99
After the blood has filtered through the hepatic portal system, it exits
via hepatic veins and drains into the inferior vena cava.
100
The deep structures of the leg are drained by the
anterior and posterior tibial veins, which unite in the popliteal fossa to form the popliteal vein (Figs. 18.9 and 18.15).
101
A superficial vein called the
small saphenous vein (SAF-en-us)
102
small saphenous vein (SAF-en-us) also drains into the
popliteal vein.
103
In the distal thigh, the popliteal vein becomes the
femoral vein.
104
The largest superficial vein of the lower limb is the
great saphenous vein,
105
great saphenous vein, which drains the
medial leg and thigh and empties into the femoral vein in the proximal thigh.
106
The femoral vein becomes the
external iliac vein after it passes deep to the inguinal ligament.
107
In the pelvis, the external iliac vein merges with the
internal iliac vein, which drains pelvic structures, forming the common iliac vein.
108
The two common iliac veins unite to form the
inferior vena cava near the superior part of the pelvis.
109
Veins of the Trunk
1. Superior vena cava 2. Inferior vena cava 3. Azygos systema. Azygos veinb. Hemiazygos veinc. Accessory hemiazygos vein 4. Renal vein 5. Gonadal veins 6. Suprarenal vein 7. Splenic vein 8. Gastric veins 9. Superior mesenteric vein10. Inferior mesenteric vein 11. Hepatic portal vein12. Hepatic veins
110
Veins of the Upper Limbs
1. Radial vein 2. Ulnar vein 3. Brachial vein 4. Cephalic vein 5. Median antebrachial vein 6. Basilic vein 7. Median cubital vein 8. Axillary vein 9. Subclavian vein10. Brachiocephalic vein
111
Veins of the Head and Neck
1. Vertebral vein 2. External jugular vein 3. Internal jugular vein 4. Dural sinusesa. Superior sagittal sinusb. Inferior sagittal sinusc. Straight sinusd. Transverse sinus e. Sigmoid sinusf. Cavernous sinus
112
Veins of the Lower Limbs and Pelvis
1. Anterior tibial vein2. Posterior tibial vein3. Popliteal vein4. Small saphenous vein5. Great saphenous vein6. Femoral vein7. External iliac vein8. Internal iliac vein9. Common iliac vein
113
Following is an example in which we have started in the right popliteal vein and ended in the left internal carotid artery:Start:
right popliteal vein right femoral vein right external iliac vein right common iliac vein inferior vena cava right atrium tricuspid valve right ventricle pulmonary valve pulmonary trunk pulmonary artery pulmonary capillaries pulmonary veins left atrium mitral valve left ventricle aortic valve ascending aorta aortic arch left common carotid artery left internal carotid artery
114
Three distinct tissue layers make up the walls of arteries and veins.
:1. Tunica interna.
115
:1. Tunica interna.
The innermost lining of the blood vessel is called the tunica interna.
116
:1. Tunica interna consists of
specialized type of simple squamous epithelium called endothelium. It rests on top of a thin layer of extracellular matrix called the basal lamina.
117
2. Tunica media.
The middle layer of the blood vessel wall is called the tunica media, and it
118
2. Tunica media consists of
consists of smooth muscle tissue and elastic fibers. The smooth muscle, innervated by the sympathetic nervous system, controls the diameter of the vessel and plays an important role in regulating tissue perfusion and blood pressure. The elastic fibers allow the vessel to expand with changing pressure and return to its original diameter.
119
3. Tunica externa.
The outermost layer of the blood vessel wall is the tunica externa (or tunica adventitia),
120
3. Tunica externa consists of
which consists of dense irregular collagenous connective tissue with abundant collagen fibers. The collagen fibers reinforce the blood vessel wall and prevent it from rupturing when the pressure in the vessel increases.
121
Pulse palpation is the process of
using the fingertips to feel pulse points—locations where the artery is superficial enough that the artery’s pulsations with each systole can be felt.
122
Pulse palpataion if performed to assess the
the rate, rhythm, and regularity of the heartbeat, and to assess the arterial circulation to different parts of the body.
123
The pulse points commonly assessed are those found at the
radial, ulnar, brachial, carotid, temporal, femoral, popliteal, posterior tibial, and dorsalis pedis arteries,
124
When pulses are palpated, they are graded according to a standard scale. This allows healthcare professionals to communicate about a patient unambiguously and to assess the progress or deterioration of a patient’s condition. The scale utilizes the following four grades:
■Grade 0/4:.■Grade 1/4: .■Grade 2/4: .■Grade 3/4: .■Grade 4/4:
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■Grade 0/4: The pulse is absent.■Grade 1/4: The pulse is barely or only lightly palpable.■Grade 2/4: The pulse is normal.■Grade 3/4: The pulse is abnormally strong.■Grade 4/4: The pulse is bounding and visible through the skin.
The pulse is absent.
126
■Grade 1/4:
The pulse is barely or only lightly palpable.
127
■Grade 2/4:
The pulse is normal.
128
■Grade 3/4:
The pulse is abnormally strong.
129
■Grade 4/4:
The pulse is bounding and visible through the skin.
130
Most strong, healthy pulses are graded as
2/4.
131
You should never assess both of your lab partner’s carotid pulses at the same time. Doing so might initiate the
baroreceptor reflex (BEHR-oh-reh-sep-ter),
132
baroreceptor reflex (BEHR-oh-reh-sep-ter),
in which the parasympathetic nervous system triggers a reflexive and often dramatic drop in blood pressure and heart rate. 18.3.
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This is the Quiz Question: Following is an example in which we have started in the right popliteal vein and ended in the left internal carotid artery:
Start: right popliteal vein right femoral vein right external iliac vein right common iliac vein inferior vena cava right atrium tricuspid valve right ventricle pulmonary valve pulmonary trunk pulmonary artery pulmonary capillaries pulmonary veins left atrium mitral valve left ventricle aortic valve ascending aorta aortic arch left common carotid artery left internal carotid artery End
134
This is a Quiz Question Start: Right renal vein End: Right radial artery
Right Renal Vein > Inferior Vena Cava > Right Atrium > Tricuspid Valve > Right Ventricle > Pulmonic Valve > Pulmonary Arteries > Pulmonary capillary bed > Pulmonary Veins > Left Atrium > Mitral Valve > Left Ventricle > Aortic Valve > Aorta > Brachiocephalic trunk > Right Subclavian Artery > Axillary Artery > Brachial Artery > Right Radial Artery.
135
The pattern of blood flow from the middle cerebral artery to left brachial artery is as follows
Middle cerebral artery→→ Dural venous sinuses →→ Internal jugular veins →→ Brachiocephalic veins →→ Superior vena cava →→ Right atrium, right ventricle, to lungs by way of the pulmonary arteries and returning by way of the pulmonary veins →→ Left atrium, left ventricle →→ Aorta→→ Left subclavian artery →→ Left axillary artery →→ Left brachial artery.
136
Trace the blood flow of the superior mesenteric vein to the right dorsalis pedis artery
A. From the Superior Mesenteric Vein to the Heart (Systemic Circulation)
137
Trace the blood flow of the superior mesenteric vein to the right dorsalis pedis artery
The superior mesenteric vein drains into the splenic vein which forms the hepatic portal vein. From the hepatic portal vein, deoxygenated blood flows into the hepatic veins which fuse into the inferior vena cava. From the inferior vena cava, blood flows and drains into the right atrium of the heart.
138
Trace the blood flow of the superior mesenteric vein to the right dorsalis pedis artery
B. From the Heart to the Lungs and Back (Pulmonary Circulation)
139
Trace the blood flow of the superior mesenteric vein to the right dorsalis pedis artery
From the right atrium, blood flows into the right ventricle and into the pulmonary arteries upon contraction. Blood in the pulmonary arteries travels to the lungs to excrete carbon dioxide and take in oxygen. This exchange takes place in the alveolar capillaries of the lungs. Once the gas exchange is complete, oxygenated blood collects into pulmonary veins and travels back to the heart draining into the left atrium.
140
Trace the blood flow of the superior mesenteric vein to the right dorsalis pedis artery
C. From the Heart to the Right Dorsalis Pedis Artery (Systemic Circulation)
141
Trace the blood flow of the superior mesenteric vein to the right dorsalis pedis artery
From the left atrium, oxygenated blood flows into the left ventricle. Ventricular contraction forces blood into the aorta and down the descending thoracic aorta into the abdominal aorta and then into the median sacral artery. From the median sacral artery, oxygenated blood drains into the right common iliac artery, into the right external iliac artery, and into the femoral artery. From the femoral artery, arterial blood flows into the popliteal artery which then branches off into the anterior tibial and posterior tibial arteries. Both tibial arteries connect to the right dorsalis pedis artery which supplies the dorsal surface of the foot with oxygenated blood.
