Let's start from the placenta. This is partially mom and partially fetus.

So the placenta has mom's blood kind of pooling in this area.

And the baby actually sticks its little capillaries inside of that pool of blood. And you can see that the
purplish blood is kind of going in, and the reddish blood is coming out. And essentially what I was trying
to explain is that oxygen is getting picked up. So it's actually getting oxygenated.

And this blood, as it's kind of reddish, is joining into this blood vessel down here which is the umbilical
vein. So this umbilical vein is actually going to carry oxygen and blood back towards the liver area. So
once the blood goes into the umbilical vein, it has kind of a branch point. You can see that it can either
go to the right or the left. And if it goes to the left, it's going to enter the liver. So if it goes kind of this
way, it's going enter the liver. And it's going to take a while for that blood to come out on the other side,
because it has to go through all the little capillaries in the liver and then emerge on the other side. But
there is a shortcut or a shunt. So the shortcut is actually going to be right here. This is called our ductus
venosus. And the ductus venosus is basically going to allow blood to go from the umbilical vein, through
it. So it's like a little tube, like any other blood vessel. And on the other side, it hits and meets up with
our inferior vena cava. So this is our inferior vena cava is a large vein picking up blood from the right leg
and also from the left leg. So the interior vena cava meets up with the blood coming from the umbilical
vein, which is very oxygenated.

And so this blood I'm going to draw is kind of purplish now, because it's kind of got some oxygen, but it's
not as rich as what was coming out initially

from the umbilical vein because it mixed in with the IVC. And that blood dumps into the right atrium.
And simultaneously, you actually have blood from the superior vena cava. This is our head and arm
region, draining down this way. And this blood also kind of ends up in the right atrium. So you've got this
blood kind of mixing. And now I'm going to draw it as kind of a deeper purple, because it's mixed up
blood. Now, the blood is in the right atrium.

So it has a couple of options. First, it could simply go down into the right ventricle. And some of the
blood does that.

It just goes right down into the right ventricle. And if goes into the right ventricle, it's going to get
squeezed. And once it gets squeezed, it goes into the pulmonary artery. And we know the pulmonary
artery has a branch over to the lungs on both sides. So we've got some blood going to one lung and
some blood going to the other lung. But remember, once that blood kind of approaches the lungs, we
have to think about what's going on inside of the lungs. You've got these sacs, air sacs, that actually are
not full of air. Because when the baby is still inside of the uterus, or when the fetus is in the uterus, it's
full of fluid. So you've got these sacs full of fluid.

And going past them are little blood vessels or arteriole. Now, if it's full of fluid, that means there's not
much oxygen. So what ends up happening is that there's a process called hypoxic pulmonary
vasoconstriction. And what that means is that the alveolus (tiny air sacs) literally tries to help constrict
the arteriole. So the arteriole has some smooth muscle and because there's no oxygen, the alveolus is
going to cause that little arteriole to basically constrict down. And when it constricted, what we've
essentially done is increased the resistance of that arteriole. And if this is happening millions of times in
millions and millions of alveoli, then the entire lung is going to have a lot of resistance. So if that's the
case, if there's a lot of resistance, then a few things we have to kind of deduce from that. The first is that
if there's a lot of resistance, then the pressure in the pulmonary artery is going to go very high. And
that's simply because you've got a lot of resistance that you have to try to fight against. So they have a
lot of pressure. And if there's a lot of pressure in the pulmonary artery, just think back, and think, well,
where did that pulmonary artery come from?

It came from the right ventricle. So for there to be forward flow of blood, you better have a lot of
pressure in the right ventricle. if you have a lot of pressure in the right ventricle, then you must have a
lot of pressure in the right atrium. So you have a lot of pressure, basically, on the right side of the heart,
because of the fact that you've got a lot of resistance in the lungs. So these pressures, especially the
right atrial pressure, starts getting so high that it starts getting higher than the pressure in the left
atrium. And so you get a little bit of blood flow that starts going from the right atrium, across that
foramen ovale, that allows blood to actually go across it. Foramen ovale allows blood to go from one
atrium over to the other.

And since blood can now go across, you're going to see some of the blood

continue down in the right ventricle. But some of the blood will also kind of go across into here. And
that's actually quite useful, because at the same time that you have blood going across, you actually
don't have too much blood coming back through the pulmonary veins. And the reason for that, again, is

because it's hard to get blood flow through the lungs because there's so much resistance there. So you
have a little bit of blood kind of coming in through the pulmonary veins. And you get some blood coming
from the right atrium.

Now, from the left atrium, blood is going to go down into the left ventricle.
And its going to get squeezed around into the aorta. So now you get blood in the aorta. That gets
squeezed there or sent there from the left ventricle. So the left ventricle is squeezing blood down into
the aorta.

And the aorta is distributing blood all the way down.

So you actually have this little guy right here. A little connection, a little vessel between the pulmonary
artery and the aorta. So this thing right here is called the ductus arteriosus. So the ductus arteriosus
allows blood to go from the pulmonary artery to the aorta. And why would blood go in that direction in
particular? Well, remember the pulmonary artery, again, has very high pressures. And the high
pressures are because of the high resistance in the lungs. So because of those high pressures, blood, of
course, goes from high pressure to a place where there's lower pressure usually.

And in this case, it's going to go from the pulmonary artery over to the aorta. So it's actually going to
flow in this direction. And this actually explains, then, why you don't get too much blood coming back
through the pulmonary veins. Because a lot of the blood goes into the ductus arteriosus, ends up going
into the aorta. It actually doesn't even go into the lungs because the resistance is so high. Let's say blood
is now down in the aorta.

As I said, it's going to go into the legs. And it's also going to kind of go

into these internal iliac arteries. And there are, of course, lots of branches off the internal iliac. But the
important branch that I want to point out right now is the umbilical artery. So this is actually bringing
blood back

towards the placenta. Now, why would so much blood go to the placenta? Well, it turns out that the
placenta and umbilical artery actually has a very low resistance, So just as the lungs have a high
resistance and they're kind of making blood divert away from them, the placenta has a low resistance,
and it makes blood divert towards it. So you can see now that this is a really ingenious kind of system.

And this is how blood flows in the fetus.