Hepatic circulation

The function of the hepatic portal circulation is to route the venous blood (in this respect,
deoxygenated blood) from the GI (gastro-intestinal) tract through the liver, before mixing it with
venous blood from the rest of the body through the inferior vena cava, a short distance from the
right atrium of the heart. This is a crucial step, since the liver has the important function (among
many) of “filtrating”/cleaning the blood which has received most of the absorbed substances
from the intestines and stomach (limited absorbtive capabilities). Macrophages (kuppfer cells)
of the hepatic sinusoids can destroy pathogens and take up waste particles, dead cells and so
fourth present in the blood. The liver is also essential in regulating the amount of nutrients in
the blood, especially glucose, which makes it an appropriate first stop for arbsorbed nutrients,
where the liver can take up glucose and synthesize glycogen, a glucose polymere, which can then
be degraded in the fasting state to maintain an adequate blood sugar level.
Cerebral circulation is the movement of blood through the network of cerebral
arteries and veins supplying the brain. The rate of the cerebral blood flow in the adult is typically
750 milliliters per minute, representing 15% of the cardiac output. The arteries deliver oxygenated
blood, glucose and other nutrients to the brain, and the veins carry deoxygenated blood back to
the heart, removing carbon dioxide, lactic acid, and other metabolic products. Since the brain is very
vulnerable to compromises in its blood supply, the cerebral circulatory system has many safeguards
including autoregulation of the blood vessels and the failure of these safeguards can result in
a stroke. The amount of blood that the cerebral circulation carries is known as cerebral blood flow.
The presence of gravitational fields or accelerations also determine variations in the movement and
distribution of blood in the brain, such as when suspended upside-down.

Fetal circulation

The blood that flows through the fetus is actually more complicated than after the baby
is born (normal heart). This is because the mother (the placenta) is doing the work that
the baby’s lungs will do after birth.

The placenta accepts the bluest blood (blood without oxygen) from the fetus through
blood vessels that leave the fetus through the umbilical cord (umbilical arteries, there
are two of them). When blood goes through the placenta it picks up oxygen and
becomes red. The red blood then returns to the fetus via the third vessel in the umbilical
cord (umbilical vein). The red blood that enters the fetus passes through the fetal liver
and enters the right side of the heart.

The red blood goes through one of the two extra connections in the fetal heart that will
close after the baby is born.

The hole between the top two heart chambers (right and left atrium) is called a patent
foramen ovale (PFO). This hole allows the reddest blood to go from the right atrium to
left atrium and then to the left ventricle and out the aorta. As a result the blood with the
most oxygen gets to the brain.

Blood coming back from the fetus’s body also enters the right atrium, but the fetus is
able to send this blue blood from the right atrium to the right ventricle (the chamber that
normally pumps blood to the lungs). Most of the blood that leaves the right ventricle in
the fetus bypasses the lungs through the second of the two extra fetal connections
known as the ductus arteriosus.

The ductus arteriosus sends the bluer blood to the organs in the lower half of the fetal
body. This also allows for the bluest blood to leave the fetus through the umbilical
arteries and get back to the placenta to pick up oxygen.

Since the patent foramen ovale and ductus arteriosus are normal findings in the fetus, it
is impossible to predict whether or not these connections will close normally after birth
in a normal fetal heart. These two bypass pathways in the fetal circulation make it
possible for most fetuses to survive pregnancy even when there are complex heart
problems and not be affected until after birth when these pathways begin to close.