What are the 4 chambers of the heart?
- Right atrium
- Right ventricle
- Left ventricle
- Left atrium
What are the atria separated by?
Interatrial septum
What are the ventricles separated by?
Interventricular septum
What are the great vessels connected to the heart?
- Superior and inferior vena cavae
- Pulmonary trunk, arteries, and veins
- Aorta
Purpose of the right side of the heart?
Pumps blood through pulmonary circuit: to the lungs and back to the heart
Purpose of the left side of the heart?
Pumps blood through systemic circuit: to all systemic vessels and back
What is the aorta?
Biggest arterial vessel of the body that exits the left ventricle
What are the right atrium and ventricle separated by?
Tricuspid valve
What are the left atrium and ventricle separated by?
Mitral valve
What are the right ventricle and pulmonary trunk separated by?
Pulmonary valve
What are the left ventricle and aorta separated by?
Aortic valve
What are the semilunar valves?
Pulmonary and aortic valves separating the heart’s ventricles from outflow tracts
What are the heart valves important for?
Prevent backflow of blood to ensure unidirectional flow of blood through the heart
Describe the cardiovascular pathway.
Right atrium => tricuspid valve => right ventricle => pulmonary valve => pulmonary trunk => right and left pulmonary arteries => right and left lungs alveolar capillaries => 4 pulmonary veins => left atrium => mitral valve => left ventricle => aortic valve => aorta => capillary beds of all body tissues where gas exchange occurs => superior and inferior vena cavae and coronary sinus => right atrium
Role of superior vena cava?
Vein that drains blood from above the diaphragm to right atrium
Role of inferior vena cava?
Vein that drains blood from below the diaphragm to right atrium
What does a trunk refer to in anatomy?
Short structure that divides right away
What does the pulmonary trunk divide into? Where do these go?
Right and left pulmonary arteries: each one goes to a lung
How many pulmonary veins are there? Where are they located?
4
2 on each side of the left atrium
What do arteries carry? Exception?
Oxygenated blood
Pulmonary and umbilical arteries
What do veins carry? Exception?
Deoxygenated blood
Pulmonary and umbilical veins
What is the coronary circulation?
Circulation (veins and arteries) providing vascularization to the heart
How is the heart angled in the body?
- Anterior
- Inferior
- Left
of thoracic cavity
What forms the most anterior heart surface?
Right ventricle
What forms the right border of the heart?
Right atrium
What forms the left border of the heart?
Left ventricle
What forms the most posterior heart surface?
Left atrium
Which is more variable: arterial or venous distribution of vessels?
Venous
Describe the branching of the aorta.
- Ascending aorta: coronary arteries (right and left)
- Aortic arch: (from right to left)
- Brachiocephalic trunk: right subclavian and right common carotid artery
- Left common carotid artery
- Left subclavian artery - Descending aorta: descending down through posterior thorax and abdomen and splits for legs and pelvis
Pathway through the aorta?
Ascending aorta => aortic arch => descending aorta
Where is the right common carotid artery? What does it supply?
From brachiocephalic trunk to neck
Supplies face and head
Where is the right subclavian artery? What does it supply?
From brachiocephalic trunk to shoulder under clavicle and over rib 1
Supplies axilla and right upper limb
What does it mean when a vessel is called common?
It will divide
What does the right common carotid artery divide into?
- Internal carotid artery
2. External carotid artery
What does the internal carotid artery supply?
Brain
What does the external carotid artery supply?
Face
What does the right subclavian artery divide into?
- Axillary artery
2. Vertebral artery
What does the vertebral artery supply?
Brain
What 2 arteries contribute to the cerebral circulation?
- Internal carotid artery
2. Vertebral artery
Where is the vertebral artery located?
Within a hole in cervical vertebrae from right subclavian artery to head
Describe the venous circulation from the head.
Internal/external jugular veins and the vertebral vein drain into the subclavian vein => right and left brachiocephalic veins => superior vena cava => right atrium
Are brachiocephalic arteries paired?
YUP
Are brachiocephalic veins paired?
YUP
Pathway of axillary artery?
Axillary artery =>
- Brachial artery that travels in the anterior compartment => elbow => ulnar artery => superficial and deep palmar arches
- Brachial artery that travels in the posterior compartment = deep brachial branch => elbow => radial artery => superficial and deep palmar arches
What provides blood to boobs?
Axillary artery
What vessel do we use for blood pressure?
Brachial artery
What is another name for the deep brachial branch?
Profunda brachii branch
What does the deep brachial branch go through the upper limbs with?
Radial nerve
Why do we take wrist pulse on the thumb/radius side?
Because the ulnar artery travels posterior to a tendon
What is an anastomosis? E.g.?
Cross-connection between adjacent vessels
E.g. deep and superficial arches of the palm
What pulse is felt in cubital fossa?
Brachial artery
How to assess ulnar and radial contribution to palmar arches?
Allen test:
- Clenched fist with thumbs occluding radial and ulnar arteries
- Relaxed fist with thumb occluding one of the arteries while the other is released
Pathway of descending aorta?
Descending aorta => thoracic aorta => abdominal aorta => right and left common iliac arteries => right and left internal and external iliac arteries => external ones pass under inguinal ligament to become femoral arteries => femoral triangle (anterior side of thigh) and adductor canal (medial side of thigh) => popliteal arteries (posterior knee) => anterior and posterior (through tarsal tunnel in foot) tibial arteries => anterior tibial arteries become dorsalis pedis arteries in dorsal foot => arches of blood supply from both anterior and posterior tibial arteries
What does the thoracic aorta supply?
- Bronchi
- Pericardium
- Esophagus
- Mediastinium
- Thoracic wall through posterior intercostal arteries between the ribs
When does the thoracic aorta become the abdominal aorta?
When it passes the diaphragm
Where do thoracic wall and structures drain to superior vena cava?
Azygos system of veins on the posterior thoracic wall end with the azygos vein connecting to the SVC
3 unpaired branches of abdominal aorta? What does each supply?
- Celiac trunk: foregut
- Superior mesenteric artery: midgut
- Inferior mesenteric artery: hindgut
What does the abdominal aorta supply?
Digestive organs
What is the developing gut derived from in embryology?
3 embryonic divisions:
- Foregut
- Midgut
- Hindgut
What does the foregut develop into?
- Esophagus to duodenum (until major duodenal papilla)
- Liver
- Pancreas
- Gallbladder
- Spleen
What does the midgut develop into?
- Duodenum (after major duodenal papilla)
- Small intestine
- Large intestine
- 2/3rds of transverse colon
What does the hindgut develop into?
Distal 1/3rd of transverse colon to superior portion of the rectum
Are the branches of the abdominal aorta paired or no?
Both
What do the paired branches of the abdominal aorta supply?
- Diaphragm
- Adrenal glands
- Kidneys
- Ovaries/Testes
- Posterior abdominal wall
- Sacrum and coccyx
- Lower abdominal wall, pelvic organs, and lower limbs
What is special about the gonadal arteries?
The ovaries/testes are far away from the branching point because they originally form in the abdomen and then descend during development
What is the abdominal venous circulation called? Describe it.
Hepatic portal circulation:
Splenic vein (foregut), inferior and superior mesenteric veins (midgut and hindgut) => hepatic portal vein => sinusoids in liver in capillary bed => hepatic veins => inferior vena cava
What is special about portal systems?
A vein drains into a second capillary bed before returning to venous circulation
What abdominal organs do not drain into the portal circulation?
Many of those that are not in foregut, midgut and hindgut
What are the 3 major places where the portal circulation forms anastomoses with the systemic circulation? What is this called?
- Esophagus
- Rectum
- Paraumbilical area
Portal-systemic anastomosis or portal-caval anastomosis
What does systemic circulation refer to?
Veins drain directly into vena cavae or azygos system
Other name for paraumbilical wall?
Anterior abdominal wall
Where does the most severe blood pressure build-up occur when there is a blockage in the hepatic portal circulation?
3 major places with portal-systemic anastomoses
What are the 2 common iliac arteries? What does each supply?
- External iliac artery: lower limbs
2. Internal iliac artery: anterior and posterior trunks
What does the anterior trunk include?
- Pelvic viscera (not gonads)
- Perineum
- Gluteal region
- Inner thigh
What does the posterior trunk include?
- Pelvic wall
2. Gluteal region
What is an aortic dissection?
Split of arterial wall that makes it weaker and makes it distribute blood to false lumen
What does the common iliac artery supply?
- Lower abdominal wall
- Pelvic organs (not gonads)
- Lower limbs
