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ANGIOLOGY/

circulatory system
DR IRAM IQBAL
AIM
To describe common
features of,
cardiovascular system
along with types and
their different
component .
SEQUENCE
 Defination
 Different types and subtypes of
circulatory system
 Components of Cardiovascular System
 Anatomy of the Heart and blood
vessels
 Classifications of blood vessels
 Vascular patterns
 End arteries
 anastomosis
 Association between arteries and
veins
 Anatomy of the Lymphatic System
 Points of clinical significance
 Main arteries and veins of the body
 conclusion
Circulatory systems are
composed of great
numbers of cell lined
tubes and spaces which
surround and permeate
the tissues, providing a
continuous perfusion of
body fluids.
The most extensive of
Circulatory system of the
human body are
 Vascular system
 CSF
 Perilymph
 Various endocochlear fluids
 Ocular aqueous humour
 Synovial fluid
 The fluids of the coelomic spaces –
Pericardial, Pleural and Peritoneal
Vascular System
 Cardiovascular
system

 Lymphatic
system
ANGIOLOGY
Is the study of
cardiovascular system
which is one of the
major circulatory system
of the body.
Cardiovascular system is of
three type

 Systemic circulation
 Pulmonary circulation
 Portal circulation
SYSTEMIC CIRCULATION

1. Provides the functional blood


supply to all tissues of the body.

2. Supplies Oxygen and other


nutrients to body tissues and
organs.

3. Removes Carbon Dioxide and


other wastes.
SYSTEMIC CIRCULATION

 Systemic circulation
pathways arise from the
aorta and end in the right
atrium.
4. Blood always goes through
the pulmonary circulation
SYSTAMIC CIRCULATION
PULMONARY
CIRCULATION
1..Transports blood (low in
oxygen) from the right
ventricle to the lungs.
2. Exchange of oxygen and
carbon dioxide occurs
between alveoli & blood in
pulmonary capillaries.
Pulmonary Circulatory
Route
Right Atrium
Tricuspid
Valve
Right
Ventricle
Pulmonary Semilunar
Valve
Pulmonary
Arteries
Lungs
Pulmonary Veins

Left Atrium
HEPATIC PORTAL
CIRCULATION
1. The term “PORTAL” is used to refer
to veins which carry blood to organs
other than the heart.
2. In this case the arterial blood
passes through two sets of capillaries
finally to be drained into the heart.
This takes place at three sites
Hepatic Portal Circulation Route
Inferior Vena Cava
Aorta

Celiac Artery

Digestive
Organs
Hepatic Portal Vein

Liver

Hepatic Veins

Inferior Vena
Cava
Right Atrium
Hypothalamo-hypophyseal
Circulation
One set in
hypothalamus.

Hypothalamo
hypophyseal V

ramify into hypophyseal


capillaries in
pitutiary gland

hypophyseal V drain
Hypothalamo - hypophysial
portal circulation
Renal postal Circulation
 arterial in type .
 one set of capillaries
is situated
between two
arteries
(a glomeruli
between afferent
and efferent
arterioles )
 efferent arterioles
divide into
2nd set of
capillaries
(Peritubular
Blood
 Volume in body is 5 litres, equals about
7% of total body weight.
 Composed of plasma and cells.
 Plasma / fluid portion :

is 91% water and 9% solids {e.g.


Proteins, Salts, Products of digestion and
waste products. It also contains
respiratory gases (O2 and CO2), internal
secretions ,enzymes etc}

Components of
Cardiovascular System

 Heart .

 Blood
vessels.
Anatomy of the Heart
The heart is a funnel-
shaped, hollow,
muscular organ that is
responsible for
pumping blood to all
parts of the body.
 The heart is located near the center
of the thoracic cavity between the
lungs and is contained in the
pericardial sac.
 The pericardial sac supports the
heart and contains some fluid for
lubrication.
 The broad end,
or base, of the
heart is also
supported by
large arteries
and veins.
 The pointed
end, or apex,
of the heart is
directed
The heart wall is made up of three
layers.
Epicardium
outer layer
of heart
wall, which
is also the
inner layer
of epicardial
sac;
Endocardiu
m inner
layer that
consists of
endothelial
cells, which
line the
heart,
covers the
• Myocardium – middle
layer composed of cardiac
muscle.
The cardiac muscle is an
involuntary, striated
muscle with fibers that
intertwine.
Therefore, the heart is said to
have four chambers (right
atrium, right ventricle, left
The AV valves have flaps of
tissues, called leaflets or
cusps, which open and close
to ensure that the blood flows
only in one direction and
does not backflow into the
atriums.
The AV valve on the right side
of the heart is called the
tricuspid valve because it has
three leaflets (cusps).
The AV valve on the left side of
the heart is called the bicuspid
valve (or mitral valve) because
it has two leaflets.
The pulmonary valve and the
aortic valve prevent blood
from back-flowing into their
respective ventricles.
The pulmonary valve is
located between the right
ventricle and the
pulmonary artery.
The aortic valve is located
between the left ventricle
A group of cells called the
sinoatrial node (SA node)
control the beat of the heart by
sending out electrical signals to
make
Blood the heart
supply pump.
of heart
The heart wall is supplied
.
by
the coronary arteries and
the cardiac veins
Coronary
Circulation
Pattern
Aorta

Coronary Arteries

Myocardium
Coronary Circulation
Pattern

Aorta

Coronary
Arteries
Myocardium

Cardiac
Veins
Coronary
Sinus
Right
Atrium
Vessel Wall
 (intima)
 Endothelial cell resting on
basement membrane
 Sub endothelial ells
 internal elastic lamina
 Tunica media
 middle layer
 usually thickest; smooth
muscle, collagen, some
elastic
 (tunica adventitia)
 outermost layer
 External elastic lamina
 loose connective tissue with
vasa vasorum and nerve
BLOOD VESSELS

Arterioles Veinules
Histological Structure of Blood
Vessels
 Notes
Muscular arteries
Classification of Blood
Vessels
A. Anatomical Classification:
Based upon structure of tunica
media and diameter of blood
vessels.
B. Functional Classification
4. Conduction vessels.
5. Distribution vessels
6. Resistance vessels
7. Exchange vessels
1. Large sized/Elastic/Conduction vessels.
(73000micro m or 30mm)
2. Medium sized/Muscular/Distribution
vessels.
(1000- 3000micro m)
3. Small sized/Muscular/Distribution vessels.
(50-1000micro m)
4. Muscular arterioles/Resistance vessels.
(50-100 micro m)
5. Terminal arterioles/Resistance vessels (50
micro m)
7. Capillarie/Exchange vessels. (5 micro
m)
8. Venules/Exchange vessels.(20-
30micro m)
9. Post capillary venules/Exchange
vessels.
(20-30 micro m)
10. Small sized muscular
vein/Capacitance vessels.
11. Medium sized muscular
BLOOD VESSELS
COMPARISON OF
ARTERIES,
CAPILLARIES, & VEINS
Arteries & Capillarie Veinules &
Arterioles s Veins
Tunica
Tunica
Media
Intima

(Blood)

Tunica
Adventitia
Avascular Structures :
 cartilage.
 stratified epithelium.
 cornea.
 hair .
 nails.
CAPILLARIES
 Diameter (5 micro
m)
 Endothelium
Continuous

(muscles, lungs, CNS)


Fenestrated(80-
100nm), gallbladder

,intestine)
Discontinuous
Discontinuo
us
 -liver, bone
marrow, spleen
irregular
blood-filled
spaces; some
have extra
large
fenestrations,
allow proteins
and blood cells
VASA VESORUM
(vessels of vessels)
 Arteries and veins
with a diameter
greater than 1 mm
are
supplied by small
vessels called Vasa
vesorum.
Vascularity
 Cellular tissues are vascular.
 Glands are very vascular (Kidney, Suprarenal,
Thyroid and Renal)
 C.T. are only slightly vascular
Loose and dense fibrous tissues have a very
less blood supply.
Fat and bone have a fair supply.
Hyaline cartilage, cornea & epidermis ,nail & hair
are non
vascular.
 Nervous tissue
Gray matter of brain and spinal medulla, being
cellular, is more vascular than the white matter
and the peripheral nerve.
VEINS

Tunica intima
Little more than endothelium
Tunica media
Thin layer of smooth muscle
Tunica adventitia
Thickest layer
Veins
 lower blood pressure: 10mmHg
with little fluctuation
 thinner walls, less muscular and
elastic tissue
 expand easily, have high
capacitance
 venules more porous than
capillaries
VENOUS PUMP
 Valves - formed from
folds of tunica intima
prevent backflow of blood
in veinules & veins.
 Function like semilunar
valves forcing blood to
flow against gravity
VENOUS PUMP
 Skeletal
muscles
pressing
against walls
of veins
provide force
to move blood
from one
valve through
the next
toward the
heart.
Valves are absent in
veins of < 2 mm in
diameter, Vena
Cava,
hepatic, renal,
uterine
ovarian, cerebral,
spinal, pulmonary
and
 There are no functioning
valves in the Portal
System and only rarely
do those (2 or 3) in the
cardiac veins function.
 Valves are most
numerous in the veins of
the limbs and they are
commonly placed just
distal to the mouth of a
tributary
End arteries
End arteries are arteries that do not
anastomose with neighboring arteries
except through terminal
capillaries.
 Obstruction of such an artery is likely to
lead to local death, resulting in the case
of the:
 cerebral artery, in paralysis
 central artery to the retina, in blindness
 branch of the renal or splenic artery, in
death of a
segment of the kidney or spleen
 several adjacent end arteries of the gut, in
gangrene
Anastomoses
Arteries
do not
always
end in
arterioles
and
capillaries
. They
may unite
Arterial anastomosis
Communication between two vessels through
collateral channels.
May occur between arteries, between veins,
between arterioles and venules
Arterial anastomosis

Heterocladic & homocladic


 End to end
 Collateral anastomosis
 Convergence anastomosis
 Transverse anastomosis
 Potential (at capillary
1. Arterial Anastomosis
 Arterial anastomosis provide alternate
(collateral) ways for tissues to receive
Oxygen and nutrients if one artery is shut
off.
 The circle of Willis is an example of
Anastomoses which reduce the
chance of an interruption to the
supply of O2 to the brain.
 Aerobic exercises promote collateral
circulation .This could prevent or reduce
End to end
anastomosis
Collateral anastomosis
Convergence
anastomosis
Transverse anastomosis
Potential anastomosis
2.Arterio-venous
anastomosis
(vascular shunts)
 The blood is not allowed to
pass through the capillaries,
rather the blood of arterial
tree bypasses the capillary
beds and sinusoids and enter
directly into the venous
i..Preferential thorough fare
channels:
Terminal
arteriovenular
anastomosis.
 Side branches
 Functional micro
circulatory unit
 found in almost all
the sites of body
 Control of blood
flow
 Direct communication
ii..the
b/e Simple arteriovenous
branches of
smallanastomosis
muscular arteries
and vein.
 Innervated by
sympathetic
nerve fibres
 When patent the
blood is
bypassed to exclude
the
capillary bed from the
circulation for the
iii.Glomera
In the skin of hands and feet
(especially digital pads and nail
beds) anastomosis form a large
number of small units termed
“glomera”. They are deep in the
corium; each “glomus” has one
or more afferents arteries,
stemming from branches of
cutaneous arteries approaching
Veno-venous anastomosis

External Iliac

Great Saphenous
Femoral

Popliteal

Posterior Tibial
Anterior Tibial Great Saphenous

Dorsal Venous Arch


Anatomy of the
Lymphatic System
LYMPHOID SYSTEM The
lymphoid system drains
surplus fluid from the
extracellular spaces to the
bloodstream. ♦ The lymphoid
system also constitutes a
Functions of the lymphatic
system:
•Drainage of surplus tissue
fluids, and leak plasma
proteins to the blood stream.
•Removal of debris from
cellular decomposition and
infection.
• absorb fatty acid and
transport fat to circulatory
system, and
•produce immune cells
(lymphocytes, monocytes,
Lymphatic System:
Lympha = pure, clear water
 Important components of the
lymphoid system are
 networks of lymphatic capillaries,

 lymphatic plexuses;
 lymphatic vessels;
 lymph;
 lymph nodes;
 lymphocytes
Starling hypothesis
Starling hypothesis
Starling hypothesis
 e fluid and electrolytes entering the extracellular
spaces from the blood capillaries is also reabsorbed by
them. However, as much as 3 L each day fails to be
reabsorbed by the blood capillaries. Furthermore, some
plasma protein leaks into the extracellular spaces, and
material originating from the tissue cells that cannot
pass through the walls of blood capillaries, such as
cytoplasm from disintegrating cells, continually enters
the space in which the cells live. If this material were to
accumulate in the extracellular spaces, a reverse
osmosis would occur, bringing even more fluid and
resulting in edema (an excess of interstitial fluid,
manifest as swelling). However, the amount of
interstitial fluid remains fairly constant under normal
Blood fluid escapes
through the thin-walled
capillaries into spaces
between body tissue
cells.
Lymph vessels, which
have very thin walls,
pick up these fluids
The lymph
vessels join
to form
larger ducts
that pass
through
lymph
nodes (or
glands).
Each lymph
node has a
fibrous
outer
covering
(capsule), a
Lymph nodes filter foreign
substances, such as bacteria
and cancer cells, from the
lymph before it is re-entered
into the blood system through
the larger veins.
Lymph nodes, which are
scattered among the lymph
vessels, act as the body’s first
defense against infection.
Each lymph node has its
own blood supply and
venous drainage.
The lymph nodes usually
have names that are
related to their location in
the body.
When a specific location gets
infected, the lymph nodes in
that area will enlarge to fight
the infection.
If the lymph node closest to
an infected area is unable to
eliminate the infection, other
lymph nodes in the system
will attempt to fight the
infection.
This is particularly
critical in the case of
cancer, which can be
spread from its point
of origin to all parts of
the body through the
lymphatic system.
Clinical notes
 Atherosclerosis
 Varicoseveins
 Lymphangitis
 Lymphadenitis
 Lymphography
 Spread of cancer
VARICOSE VEINS
1. Veins that are stretched, dilated &
overfilled with blood due to
incompetent valves
2. Contributing causes:
Weak valves or veins - (heredity)
Excessive weight
Excessive standing, straining
Inadequate exercise
Increased intra-pelvic pressure -
pregnancy, constipation
VARICOSE VEINS
MAJOR ARTERIES OF THE
BODY
Brachiocephalic
Aortic Arch
Ascending Aorta Thoracic Aorta

Abdominal Aorta
Celiac
ARTERIES OF THE LEG

External Internal
Iliac Iliac
Femor
al

Popliteal (behind
knee)
Anterior Tibial
Posterior Tibial (behind
Tibia)
ARTERIES OF THE HEAD &
NECK
ARTERIES OF THE ARM &
SHOULDER
Subclavia
n Axillary

Brachia
l

Radil
Ulnar
ARTERIES OF THE HEART

Aort
Pulmonary Artery
a

Coronary Arterie
MAJOR VEINS OF THE
BODY
MAJOR VEINS OF THE HEAD &
NECK
MAJOR VEINS OF ARM &
SHOULDER
Subclavi
an
Axilla
Cephal y
icBrachi
al Basil
ic
Median
Cubital
Radial Ulna
r
MAJOR VEINS OF THE
LEG
External Iliac

Great Saphenous
Femoral

Popliteal

Posterior Tibial
Anterior Tibial Great Saphenous

Dorsal Venous Arch


MAJOR VEINS OF THE
ABDOMEN

Inferior Vena Cava


Hepatic Veins
Renal Renal
Inferior Vena Cava
Common Iliac Common Iliac
Internal Iliac Internal Iliac
External Iliac
External Iliac
MAJOR VEINS OF THE
HEART
Superior Vena Cava

Pulmonary Veins
Inferior Vena Cava

Coronary Sinus
Cardiac Veins
CONCLUSION
REFERENCES
 Gray’s Anatomy (37 th
edition).
 Grant’s method of Anatomy.

(10 th edition).
 Clinical Anatomy by Richard S.
Snell, (7 th edition).
 Clinical oriented
Anatomy(klm)6th edt