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Chapter Twenty-Three
Circulation
| Question | Answer |
|---|---|
| Oxygenated blood is pumped out of the left ventricle of the heart and enters the | ascending aorta. |
| The left and right coronary arteries | emerge immediately from the wall of the ascending aorta and supply the heart. |
| The ascending aorta curves toward the left side of the body and becomes the | aortic arch (arch of the aorta). |
| three main arterial branches emerge from the aortic arch: | (1) the brachiocephalic trunk, which bifurcates into the right common carotid artery, supplying arterial blood to the right side of the head and neck. |
| The right subclavian artery | suppling thr right upper limb and some thoracic structures |
| (2) The left common carotid artery | suppling the left side of the head and neck. |
| (3) The left subclavian artery | suppling the left upper limb and some thoracic structures |
| The aortic arch curves and projects inferiorly as the | descending thoracic aorta that extends several branches to supply the thoracic wall. |
| When this artery extends inferiorly through the aortic opening (hiatus) in the diaphragm, it is renamed the | descending abdominal aorta. |
| At the level of the fourth lumbar vertebra, the descending abdominal aorta bifurcates | into left and right common iliac arteries. |
| Each of these arteries further divides into an | internal and iliac artery (to supply pelvic and perineal structures) and an external iliac artery ( to supply the lower limb). |
| The veins that drain the head, neck, and upper limbs merge to form | the left and right brachiocephalic veins, which in turn merge to form the superior vena cava. |
| The veins inferior to the diaphragm merge to collectively form the | inferior vena cava. |
| At the superior border of the thyroid cartilage, each artery divides into an | external carotid artery that supplies structures ecternal to the skill, and an internal carotid that supplies internal skull structures. |
| the external carotid artery supplies blood to several branches: | (1) the superior thyroid artery supplies the throid gland, larynx, and some anterior neck muscle. |
| (2) the ascending pharyngeal artery | supplies the pharynx |
| (3) the lingual artery | supplies the tongue |
| (4) the facial artery | supplies most of teh facial region |
| (5) the occipital artery | supplies the posterior portion of the scalp. |
| (6) the posterior auricular artery | supplies the ear and the scalp around the ear |
| Thereafter, the external carotid artery divides into | the maxillary artery, which supplies the teeth, gums, nasal cavity, and meninges and the superficial temporal artery which supplies the side of the head and the parotid gland |
| Venous return is through smaller veins that merge to form the | facial, superficial temporal, and mazillary veins. |
| Some of these veins merge and drain into either the | internal jugular vein or the external jugular vein that drains into the subclavian vein and then into the brachiocephalic vein. |
| Once inside the skull, it forms multiple branches, including the | anterior and middle cerebral arteries, which supply the brain, and the ophthalmic arteries, which supply the eyes. |
| The vertebral arteries emerge from the subclavian arteries and travel through the transverse foramina of the cervical vertebrae before entering the skull through the foramen magnum, where they merge to form the | basilar artery |
| The basilar artery travels immediately anterior to the pons and extends many branches prior to subdividing into the | posterior cerebral arteries, which supply the posterior portion of the cerebrum. |
| The cerebral arterial circle | is an important anastomosis of arteries around the sella turcica. |
| the circle is formed from posterior cerebral arteries, | posterior communicating arteries (branches of the posterior cerebral arteries), internal carotid arteries, anterior cerebral arteries, and anterior communicating arteries (which connect to the two anterior cerebral arteries). |
| Some cranial venous blood is drained by the | vertebral veins that extend through the transverse foramina of the cervical vertebrae and drain into the brachiocephalic veins. |
| However, most of the venous blood of the cranium drains through several large veins collectively known as | the dural venous sinuses. |
| The dural venous sinus system | has several components. |
| The superior sagittal sinus | is located superior to the longitudinal fissure of the brain; it drains into one of the transverse sinuses (usually the right one). |
| The inferior sagittal sinus | occupies the inferior free edge of the falx cerebri. |
| The straight sinus | is formed by the merging of the inferior sagittal sinus and the great cerebral vein; this sinus drains into left and right transverse sinuses that run horizontally along the internal margin of the occipital bone. |
| Finally, the S-shaped left and right sigmoid sinuses | are a continuation of the transverse sunuses; they drain into the internal jugular veins. |
| Additional components of the dural venous sinus system include | the occipital and marginal sinuses, the superior and inferior petrosal sinuses, and the cavernous sinues. |
| A left and right | internal thoracic artery emerges from each subclavian artery to supply the mammary gland and anterior thoracic wall. |
| Each internal thoracic artery has the following branches: | the first six anterior intercostal arteries that supply the anterior intercostal spaces, and a musculophrenic artery that divides into anterior intercostal arteries 7-9. |
| The internal thoracic artery then becomes the | superior epigastric artery, which carries blood to the superior abdominal wall. |
| The inferior epigastic artery, | a branch of the external iliac artery, supplies the inferior abdominal wall. |
| The left and right costocervical trunks and thyrocervical trunks | emerge from each subclavian artery. |
| The costocervical trunk has a branch called the | supreme intercostal artery, which branches into the first and second posterior intercostal arteries. |
| Finally, five pairs of | lumbar arteries branch from the descending abdominal aorta to supply the posterolateral abdominal wall. |
| In addition to the paired vessels just described, an unpaired | median sacral artery arises at the bifurcation of the aorta in the pelvic region to supply the sacrum and coccyz. |
| Anterior intercostal veins, a superior epigastric vein, and a musculophrenic vein all merge into the | internal thoracic vein. |
| The inferior epigastric vein | merges with the external iliac vein that eventually drains into the inferior vena cava. |
| The first and second posterior intercostal veins | then merge with the supreme intercostal vein that drains into the brachiocephalic vein. |
| The lumber veins and posterior intercostal veins drain | into the azygos system of beins along the posterior thoracic wall. |
| The hemiazygos and accessory hemiazygos veins | on the left side of the verebrae drain the left-side veins. |
| The azygos vein | drains the right-side veins and also receives blood from the esophageal veins, bronchial veins, and pericardial veins; merges into the superior vena cava. |
| The bronchi, bronchioles, and connective tissue of the lungs are supplied by three or four small | bronchial arteries that emerge as tiny branches from the anterior wall of the descending thoracic aorta. |
| Left and right | bronchial veins drain into the azygos system of veins. |
| Several small | esophageal arteries emerge from the anterior wall of the descending thoracic aorta and supply the esocphagus. |
| Additionally, the left gastric artery forms several | esophageal branches that supply the abdominal portion of the esophagus. |
| Esophageal veins | drain the esophageal wall, and may take either of tow routes: into the azygos vein or into the left gastric vein. |
| Superior phrenic arteries | emerge from the descending thoracic aorta; |
| both musculophrenic arteries | and pericardiacophrenic arteries arise from the internal thoracic artery |
| and inferior phrenic arteries | emerge from the descending abdominal aorta to supply the diaphragm.. |
| The celiac trunk is located | immediately inferior to the aortic opening (hiatus) of the diaphragm. |
| (1) The left gastric artery | supplies the lesser curvature of the stomach, and extends some esophageal branches. |
| The left artery anastomoses | with the right gastric artery. |
| (2) The splenic artery | supplies the spleen part of the stomach (via branches called the left gastroepiploic artery and short gastric arteries), and the pancreas (via branches called pancreatic arteries). |
| (3) The last branch of the celiac trunk is the | common hepatic artery, whcih ectends to the right side fo the body where it divides into a hepatic artery proper and a gastroduodenal artery. |
| The hepatic artery proper | supplies the liver (via left and right hepatic arteries), the gallbladder (via the cystic artery), and part of the stomach (via the right gastric artery). |
| The gastroduodenal artery | supplies the greater curvature of the stomach (via the right gastroepiploic artery), the duodenum, and the pancreas (via the superior pancreaticoduodenal arteries). |
| The superior mesentric artery | is located immediately inferior to the celiac trunk. |
| (2) 18-20 intestinal arteries that supply the jejunum and ileum; | (3) the ileocolic artery that supplies the ileum,cecum, and appendix |
| (4) the right colic artery that typically supplies the ascending colon; | and (5) the middle colic artery that supplies most of the transverse colon |
| The inferior mesenteric srtery is the nmost inferior of the three unpaired arteries that arise from the | descending abdominal aorta |
| The branches of the inferior mesenteric artery include: | (1) the left colic artery that supplies the distal part of the transverse colon and part of the descending colon; |
| (2) the sigmoid arteries that supply the inferior descending colon and the sigmoid colon | and (3) the superior recetal artery that is continuation of the inferior mesenteric artery and supplies the rectum |
| The hepatic portal system is a venous network that drains | the GI tract and shunts the blood to the liver for absorption and processing of transported materials. |
| Following nutrient absorption, the blood exits the liver through | hepatic veins that merge with the inferior vena cava. |
| The hepatic portal vein . | is the large vein that recieves deoxygenated but nutrient-rich blood from the gastrointestinal organs. |
| The inferior mesenteric vein | a vertically positioned vein draining the distal part of the large intestine, recieves blood from the superior rectal vein, sigmoid veins, and left colic vein. |
| The splenic vein | a horizontally positioned vwin draining the spleen, recieves blood from pancreatic veins, short gastric viens, and the right gastroepiploic vein |
| The superior mesenteric vein | another vertically positioned vein on the right side of the body, drains the small intestine and part of the large intestine. |
| (1) The middle suprarenal artery | supplies each adrenal gland; |
| (2) the renal artery | supplies each kidney |
| (3) the gonadal artery supplies each gonad | (testes in males, ovaries in females) |
| Left suprarenal and gonadal veins | typically merge with and drain into the left renal vein. |
| The left renal vein, right renal vein, | right suprarenal vein, and right gonadal vein merge directly into the inferior vena cava. |
| The primary arterial supply to the pelvis and perineum is from the | internal iliac artery, one of the two main branches of the common iliac artery. |
| Some branches of the internal iliac artery incldue: | (the superior and inferior gluteal arteries that supply the gluteal region |
| (2) the obturaror artery that | supplies medial muscles of the thigh |
| (3) the internal pudendal artery | that suppplies the anal canal and perineum |
| (4) the middle rectal artery that | supplies the lower portion of the rectum |
| and (5)the uterine artery and vaginal artery that | supply the uterus and vagina. |
| The veins merge with the | internal iliac vein that merges with the common iliac vein, which subsequently drains into the inferior vena cava. |
| A subclavian artery supplies | blood to each upper limb. |
| After the subclavian artery passes over the lateral border of the first rib, | it is renamed the axillary artery. Extends many branches to the shoulder and thoracic region, including the supreme thoracic artery .....page 705 |
| When the axillary artery passes the inferior border of teh teres muscle, | it is renanmed the brachial artery. |
| The brachial artery travels alongside the humerus; one of its braches is the | deep brachial artery, which supplies blood to most brachial arm muscles. |
| IN the cubital fossa, the brachial artery divides into | an ulnar artery and a radial artery. |
| both arteries supply the forearm and wrist before they anastomose and form two arterial arches in the palm: | the superficial palmer arch and the deep palmer arch. |
| Digital arteries | emerge from the arches to supply the fingers. |
| On the dorsum of the hand, | a dorsal venous network of veins drains into both basilic vein and the cephalic vein. |
| In the cubital region, an obliquely positioned | median cubital vein connects the cephalic and basilic veins. |
| The midian cubital vein is a common site for | venipuncture, in which a vein is punctured to draw blood or inject a solute. |
| The digital veins and superficial and deep palmar venous arches | drain into pairs of radial veins and ulnar veins that run parallel to arteries of the same name. |
| At the level of the cubital fossam the radial and ulnar veins merge to form a pair of | brachial veins that travel with the brachial artery. |
| Brachial veins and the basilic vein merge to form the | axillary vein. |
| Superior to the lateral border of the first rib, the axillary vein is renamed the | subclavian vein. |
| The external ilia artery travels inferior to the inguinal ligament, where it is | renamed the femoral artery. |
| The deep femoral artery | emerges from the femoral artery to supply the hip joint and many of the thigh muscles, before tracersing posteromedially along the thigh. |
| The femoral artery passes through an opening in the adductor magnus muscle and enters the posteriorly placed popliteal fossa, where the vessel is renamed the | popliteal artery. |
| the popliteal artery divides into an | anterior tibial artery that supplies the anterior compartment of the leg, and a posterior tibial artery that supplies the posterior compartment of the leg. |
| The posterior tibial artery extends a branch called the fibular artery, | which supplies the lateral compartment leg muscles. |
| The posterior tibial artery continues to the plantar side of the foot, | where it branches into medial and lateral plantar arteries. |
| The anterior tibial artery crosses over teh anterior surface of teh ankle, | where it is renamed the dorsalis pedis artery. |
| the dorsalis pedis artery and a branch of the lateral plantar artery unite to form the | plantar arch of the foot. |
| Digital arteries extend | from the plantar arch and supply the toes. |
| On the dorsum of the foot, | a dorsal venous arch drains into the great saphenous vein and the small saphenous vein. |
| The digital veins and deep veins of teh foot drain into pairs | of medial and lateral plantar veins. |
| These veins drain into a pair of | posterior tibial veins. |
| A pair of fibular veins | travel alongside the fibular artery and drain into the posterior tibial veins. |
| On the dorsum of the foot and ankle, | deep veins drain into a pair of anterior tibial veins, which traverse alonhside the anterior tibial artery. |
| The anterior and posterior tibial veins merge to form a | popliteal vein that accompanies the popliteal artery in the popliteal fossa. |
| This vein curves to the anterior portion of the thigh and is | renamed the femoral vein. |
| Once this vein passes superior to the inguinal ligament, it is renamed once again as the | external iliac vein. |
| The external and internal iliac veins merge in the pelvis, | forming the common iliac vein. |
Created by:
morgan.klukkert