Chapter 15

Lecture
PowerPoint

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Paris Junior College

2402
Anatomy and Physiology II
Chapter 15
Susan Gossett
sgossett@parisjc.edu
Department of Biology
2

Hole’s Human Anatomy
and Physiology
Twelfth Edition

Shier w Butler w Lewis

Chapter
15
Cardiovascular System

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3

15.1: Introduction
• The heart pumps 7,000 liters of blood through the body each
day
• The heart contracts 2.5 billion times in an average lifetime
• The heart and all blood vessels make up the cardiovascular
system
• The blood vessels make up two circuits:
• Pulmonary circuit
• Systemic circuit

4

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Systemic circuit delivers oxygen to all
body cells and carries away wastes.

O2

Oxygenated blood

Oxygenated
blood pumped to
all body tissues
via aorta

O2

CO2
O2
CO2

Pulmonary circuit eliminates carbon
dioxide via the lungs and oxygenates the
blood.

Deoxygenated blood

Deoxygenated
blood pumped
to lungs via
pulmonary arteries

CO2

CO2
CO2

O2

CO2

CO2
O2

O2

CO2

O2

Alveolus
O2

Oxygenated blood returns
to heart via pulmonary veins
Deoxygenated blood returns
to heart via venae cavae
Right atrium

Left atrium
Left ventricle

Right ventricle

5

15.2: Structure of the Heart
• The heart is a hollow, cone-shaped, muscular pump
• There are four chambers:
• Two atria (for blood storage)
• Two ventricles (one low pressure pump and one high
pressure pump)

6

Size and Location of the Heart
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• The heart size varies with body size
• The heart lies in the thoracic cavity
• The average size of the heart is:
• 14 cm long
• 9 cm wide
• The heart is:
• Posterior to the sternum
• Medial to the lungs
• Anterior to the vertebral column
• The base lies beneath the 2nd rib
• The apex at the 5th intercostal space
• It lays just above the diaphragm
0 1 2 3 4

5 cm

© McGraw-Hill Companies, Inc./Photo and dissection by Christine Eckel

7

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Base of heart
Sternum
Heart
Apex of heart

Diaphragm

8

Coverings of the Heart
• The coverings of the heart include the pericardium:
• Fibrous pericardium
• Visceral pericardium
• Parietal pericardium
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Right lung Left lung

Aorta

Superior
vena cava

Pulmonary trunk
Auricle of left atrium
Fibrous pericardium
Cut edge of
parietal pericardium

Diaphragm
Auricle of right
atrium

Heart (covered by
visceral pericardium)
Left ventricle

Right
ventricle

Anterior interventricular
sulcus

9
Pericardial cavity

Wall of the Heart
• The heart wall has three distinct layers:
• Epicardium (outer layer)
• Myocardium (middle layer)
• Endocardium (inner layer)

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Pericardial
cavity
Parietal
pericardium
Fibrous
pericardium

Endocardium
Myocardium

Coronary
blood vessel

Epicardium
(visceral pericardium)

10

11

Heart Chambers and Valves
• The heart is divided into four chambers:
• Right atrium:
• Receives blood from the:
• Inferior vena cava
• Superior vena cava
• Coronary sinus
• Right ventricle
• Receives blood from the right atrium
• Left atrium
• Receives blood from the pulmonary veins
• Left ventricle
• Receives blood from the left atrium
12

13

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Aorta
Left pulmonary
artery

Superior vena cava
Right pulmonary
artery
Right pulmonary
veins

Pulmonary trunk
Left pulmonary
veins
Left atrium
Mitral (bicuspid) valve
Chordae tendineae
Left ventricle
Papillary muscle

Right atrium
Pulmonary valve
Tricuspid valve
Right ventricle

Interventricular
septum

Inferior vena cava
(a)

Aorta
Superior vena cava
Aortic valve
Right pulmonary
artery
Right pulmonary
veins
Right atrium
Opening of coronary
sinus

Tricuspid valve
Right ventricle

Left pulmonary
artery
Pulmonary trunk
Left pulmonary
veins
Left atrium
Mitral (bicuspid)
valve
Chordae tendineae
Left ventricle
Papillary muscle
Interventricular
septum

Inferior vena cava
(b)

14
(c)

c: © The McGraw-Hill Companies, Inc.

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Right
atrium
Cusps of
tricuspid
valve
Chordae
tendineae
Interventricular
septum
Papillary
muscles
Muscular
ridges
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15
© McGraw-Hill Higher Education, Inc./University of Michigan Biomedical Communications

Skeleton of the Heart
• The fibrous rings, together with other masses of dense
connective tissue in the portion of the septum between the
ventricles (interventricular septum), constitute the skeleton of
the heart
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Pulmonary valve

Aortic
valve

Opening of
left coronary
artery
Tricuspid
valve

Mitral valve

Fibrous skeleton

Posterior

16

Path of Blood Through the Heart
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Systemic
capillaries

Tissue cells

CO2

Superior
vena cava

O2

Pulmonary
artery

Alveolus
CO2

CO2

Alveolar
capillaries

O2

O2

Alveolar
capillaries

Alveolus
Pulmonary
veins
Right atrium

Left atrium
Mitral valve
Left ventricle
Aortic valve
Aorta

Tricuspid valve
Pulmonary valve
Right ventricle
Inferior vena cava

CO2
Systemic
capillaries

O2
Tissue cells

17

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Blood from systemic circuit

Venae cavae and
coronary sinus

Right atrium
Tricuspid valve
Right ventricle
Pulmonary valve
Pulmonary trunk

Pulmonary arteries

Alveolar capillaries (lungs)

Pulmonary veins

Left atrium

Mitral valve
Left ventricle
Aortic valve
Aorta

18
Blood to systemic circuit

Blood Supply to the Heart
• The left and right coronary arteries supply blood to the
tissues of the heart
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Aorta

Right coronary artery

Posterior
interventricular
artery

Myocardial
capillaries in
ventricular
walls

Left coronary artery

Marginal
artery

Circumflex
artery

Myocardial
capillaries in
walls of right
atrium and right
ventricle

Myocardial
capillaries in
walls of left
atrium and left
ventricle

Anterior
interventricular
artery

Myocardial
capillaries in
ventricular
walls

Cardiac veins

Coronary sinus

19
Right atrium

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Aorta
Part of
aorta
removed
Aortic
valve
cusps

Right coronary
artery

Opening of
left coronary
artery
20

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Aorta
Superior vena cava
Left pulmonary artery
Pulmonary trunk

Right pulmonary
artery
Right pulmonary
veins

Left pulmonary veins
Left auricle
Left coronary artery

Right auricle

Great cardiac vein
Anterior interventricular artery
(left anterior descending artery)

Right coronary
artery
Anterior cardiac vein
Small cardiac vein

Left ventricle

Inferior vena cava
Right ventricle

Apex of the heart

(a)

Superior vena cava
Aorta

Right pulmonary
artery

Left pulmonary artery
Left pulmonary
veins
Left auricle
Circumflex artery

Right pulmonary
veins
Left atrium

Cardiac vein

Right atrium
Inferior vena cava
Coronary sinus
Middle cardiac vein
Left ventricle
(b)

Apex of the heart

Posterior interventricular
artery
Right ventricle

21

15.3: Heart Actions
• The heart chambers function in coordinated fashion
• Heart actions are regulated so that atria contract (atrial
systole) while ventricles relax (ventricular diastole); followed
by ventricles contract (ventricular systole) while atria relax
(atrial diastole)
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Pulmonary
valve closed

Aortic
valve closed

Pulmonary
valve open

RA

Aortic
valve open

LA
Atrial systole

Tricuspid
and mitral
valves open
(a)

LV
RV

Ventricular
diastole

Atrial diastole

Tricuspid
and mitral
valves closed

Ventricular
systole

(b)

22

Cardiac Cycle
• During a cardiac cycle, the pressure in the heart chambers rise and falls
• In atrial systole and ventricular diastole:
• Blood flows passively into the ventricles
• The remaining 30% of blood is pushed into the ventricles
• The A-V valves open and the semilunar valves close
• The ventricles relax
• This causes an increase in ventricular pressure
• In ventricular systole and atrial diastole:
• The A-V valves close
• The chordae tendinae prevent the cusps of the valves from bulging
too far into the atria
• The atria relax
• The blood flows into atria
• The ventricular pressure increases and opens the semilunar valves
• The blood flows into pulmonary trunk and aorta
23

Heart Sounds
• A heart beat through a stethoscope sounds like “lubb-dupp”
• The “lubb”
• The first heart sound
• It occurs during ventricular systole
• The A-V valves are closing
•The “dupp”
• The second heart sound
• It occurs during ventricular diastole
• The pulmonary and aortic semilunar valves are closing
• A murmur – abnormal heart sound from the cusps not
completely closing

24

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Aortic area

Pulmonary area

Tricuspid
area

Mitral area

25

Cardiac Muscle Fibers
• Cardiac muscle fibers form a functional syncytium
• This is a mass of cells that function as a unit
• Two such areas exist in the heart:
• In the atrial walls called the atrial syncytium
• In the ventricular walls called the ventricular syncytium

26

Cardiac Conduction System
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• Clumps or strands of specialized
cardiac muscle tissue which initiate and
distribute impulses throughout the
myocardium
• The cardiac conduction system
coordinates the events of the cardiac
cycle

SA node

Atrial syncytium

Junctional fibers

AV node

AV bundle

Bundle branches

Purkinje fibers

27
Ventricular syncytium

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Interatrial septum
Left
bundle
branch

SA node
AV node

Junctional
fibers
AV bundle
Right bundle
branch
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display.

Purkinje fibers
Interventricular
septum

Myocardial
muscle fibers

(a)

(b)

28

15.1 From Science to Technology
Replacing the Heart – From
Transplants to Stem Cell Implants

29

Electrocardiogram
• An electrocardiogram or ECG is a recording of electrical
changes that occur in the myocardium during the cardiac
cycle
• It is used to assess the hearts ability to conduct impulses
• The deflections in the normal ECG, or waves, include:
• P wave – atrial depolarization
• QRS complex (three waves) – ventricular depolarization
• T wave – ventricular repolarization

30

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(a)

.5

.5

Millivolts

1.0

Millivolts

1.0

0

0

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display.

–.5

–.5
0
(b)

200 400 600
Milliseconds

0
(f)

200 400 600
Milliseconds

R
.5

.5

Millivolts

1.0

Millivolts

1.0

0

–.5

0

200 400 600
Milliseconds

0
(g)

Millivolts

Millivolts

.5
P

–.5

Millivolts

.5
T
0

200 400 600
Milliseconds

0
(h)

200 400 600
Milliseconds

R

.5
QRS complex
0

–.5

(e)

S

–.5
0

1.0

200 400 600
Milliseconds

1.0

1.0

(d)

Q

–.5

(c)

0

0

Q
S
0 200 400 600
Milliseconds

31

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Atrial
Atrial
Atrial
systole
diastole
systole
Ventricular Ventricular
Ventricular
diastole
systole
diastole
Pressure changes
0
0.3
0.6
120

Aortic
semilunar
valve
opens

Pressure (mm Hg)

100

Atrial
diastole
Ventricular Ventricular
systole
diastole
0.9 seconds

Aortic semilunar
valve closes

80

Aortic pressure

60
Ventricular pressure
40
AV valve
closes

20

AV valve opens
Atrial pressure

0

Volume (mL)

Ventricular volume
160
120
Ventricular volume
80

Millivolts

Electrocardiogram (ECG)

R

R

+1

P

P

T

0

Q
–1

T
Q

S

S
One cardiac cycle

Heart sounds

Lubb: AV
valves close

Dupp: Semilunar
valves close

32

Regulation of the Cardiac Cycle
• The SA node controls the heart rate
• There are also sympathetic and parasympathetic fibers that control the
heart rate as well
• There are also regulatory reflex centers that influence heart rate
• Additional factors that may influence heart rate include:
• Physical exercise
• Body temperature
• Concentration of various ions including:
• Potassium
• Calcium
• Parasympathetic impulses decrease heart action
• Sympathetic impulses increase heart action
• Cardiac center regulates autonomic impulses to the heart

33

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Receptor
Sensory or
afferent neuron
Central
Nervous
System
Motor or
efferent neuron

Effector
(muscle or gland)

(a)

Carotid
sinus
Cerebrum
(frontal
section)
Sensory
fibers

Carotid
baroreceptors

Common
carotid
artery

Hypothalamus
Aorta
Medulla
(transverse
section)
Cardiac
center

Aortic
baroreceptors
Parasympathetic
vagus nerve
SA node
AV node

Spinal cord
(transverse sections)

(b)

Sympathetic
nerve
Sympathetic trunk

34

15.1 Clinical Application
Arrhythmias

35

15.4: Blood Vessels
• The blood vessels are organs of the cardiovascular system
• The blood vessels form a closed circuit to and from the
heart
• The blood vessels include:
• Arteries - carry blood away from the ventricles of the
heart
• Arterioles - receive blood from the arteries and carry
blood to the capillaries
• Capillaries - sites of exchange of substances between
the blood and the body cells
• Venules - receive blood from the capillaries
• Veins - carry blood toward the atria of the heart
36

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Artery

Vein

Lumen
Valve

Endothelium of
tunica interna
Connective tissue
(elastic and collagenous fibers)

Tunica media

Tunica externa

(a)

(b)

Endothelium
of tunica
interna
Lumen

Middle layer
(tunica
media)
Outer layer
(tunica
externa)

37
(c)

c: © The McGraw-Hill Companies, Inc./Al Telser, photographer

15.2 From Science to Technology
Altering Angiogenesis

38

Arteries and Arterioles
• Arteries:
• Thick strong wall (three layers or tunics)
• Endothelial lining
• Middle layer of smooth muscle and elastic tissue
• Outer layer of connective tissue
• Carries blood under relatively high pressure
• Arterioles:
• Thinner wall than an artery (three layers or tunics)
• Endothelial lining
• Middle and outer layers are thinned
• Some smooth muscle tissue
• Small amount of connective tissue
• Helps control blood flow into a capillary

39

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Arteriole

Smooth
muscle cell

Endothelium

Precapillary
sphincter
Capillary
40

Capillaries
• Capillaries are the smallest diameter blood vessels
• They connect the smallest arteriole and the smallest venule
• They are extensions of the inner lining of arterioles
• The walls are endothelium only
• They are semi-permeable
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Metarteriole (forming arteriovenous
shunt)

Precapillary
sphincter

Arteriole

Capillaries

Venule

Artery

Blood flow

Vein
Blood flow

41

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Tissue fluid
Nucleus of
endothelial
cell

Endothelial cell

Endothelial
cell cytoplasm
Lumen of
capillary

Slit

Cell junction

(b)

Tissue fluid

Capillary
(a)

(c)
b,c, : © Don. W. Fawcett/Visuals Unlimited

42

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Arteriole

Capillary

Venule
© Don. W. Fawcett/Visuals Unlimited

43

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Lymphatic
capillary

Blood
flow
from
arteriole

Outward force,
including
hydrostatic
pressure
35 mm Hg

Net outward
pressure
11 mm Hg
Inward force
of osmotic
pressure
24 mm Hg

Net force at arteriolar end
Outward force, including hydrostatic pressure
Inward force of osmotic pressure
Net outward pressure

Capillary

Tissue
cells

Outward force,
including
Net inward
hydrostatic
pressure
pressure
8 mm Hg
Inward force of
16 mm Hg
osmotic pressure
24 mm Hg

Blood
flow to
venule

Net force at venular end
= 35 mm Hg
= 24 mm Hg
= 11 mm Hg

Outward force, including hydrostatic pressure
Inward force of osmotic pressure
Net inward pressure

= 16 mm Hg
= 24 mm Hg
= 8 mm Hg

44

Venules and Veins
• Venule:
• Microscopic vessels that continue from the capillaries
and merge to form veins
• Thinner walls than arterioles
• Less smooth muscle and elastic tissue than arteriole
• Veins:
• Thinner walls than arteries (three layers or tunics)
• Middle wall poorly developed
• Many have flap-like valves
• Carry blood under relatively low pressure
• Function as blood reservoirs
45

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100
90
Percent distribution

80

Toward
heart

70
60
50

Large
veins

40
30
20
10

Small
veins
and
venules

0

(a)

(b)

Systemic
veins
60–70%

Lungs
10–12%

Heart
8–11%

Systemic Capillaries
arteries
4–5%
10–12%

46

47

15.5: Blood Pressure
• Blood pressure is the force the blood exerts against the inner
walls of the blood vessels

48

Arterial Blood Pressure
• Arterial blood pressure:
• Rises when the ventricles contract
• Falls when the ventricles relax
• Systolic pressure is the maximum pressure during
ventricular contraction
• Diastolic pressure is the minimum pressure when the
ventricles relax

49

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Temporal a.
Carotid a.

Facial a.

Brachial a.

Radial a.

Femoral a.

Popliteal a.

Dorsalis pedis a.

Posterior tibial a.
50

15.2 Clinical Application
Blood Vessel Disorders

51

Factors That Influence
Arterial Blood Pressure
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Blood volume
increases

Heart rate
increases

Stroke volume
increases

Blood pressure increases

Blood viscosity
increases

Peripheral resistance
increases
52

15.3 Clinical Application
Measurement of Arterial
Blood Pressure

53

15.4 Clinical Application
Space Medicine

54

Control of Blood Pressure
• Blood pressure (BP) is determined by cardiac output (CO)
and peripheral resistance (PR) according to this relationship:
BP = CO x PR
• Maintenance of blood pressure requires regulation of these
two factors
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Increased blood pressure

Decreased heart rate

Decreased stroke volume

Decreased cardiac output

Decreased peripheral resistance
Blood pressure maintained

Increased cardiac output
Increased heart rate

Increased peripheral resistance

Increased stroke volume

55
Decreased blood pressure

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Cardiac output increases

Rising blood pressure

Blood pressure rises

Stimulation of baroreceptors in
aortic arch and carotid sinuses

Baroreceptors in aortic arch and
carotid sinuses are stimulated

Sensory impulses to vasomotor center

Sensory impulses to cardiac center

Vasomotor center inhibited

Parasympathetic impulses to heart

Less frequent sympathetic impulses
to arteriole walls

SA node inhibited

Vasodilation of arterioles
Heart rate decreases

Blood pressure returns
toward normal

Decreased peripheral resistance

Blood pressure returns toward normal

56

Venous Blood Flow
• Blood pressure decreases as the blood moves through the
arterial system and into the capillary network, so little
pressure remains at the venular ends of the capillaries
• Only partly a direct result
To heart
of heart action
• Dependent on:
To heart
• Skeletal muscle contraction
Relaxed skeletal
• Breathing
muscle
Vein
• Venoconstriction
Valve open
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Contracted
skeletal muscle
Vein

Valve closed

57

15.5 Clinical Application
Hypertension

58

Central Venous Pressure
• All veins, except those returning to the heart from the lungs,
drain into the right atrium
• This is therefore pressure in the right atrium
• Factors that influence it alter flow of blood into the right
atrium
• It effects pressure within the peripheral veins
• A weakly beating heart increases central venous pressure
• An increase in central venous pressure causes blood to back
up into the peripheral veins
• This can lead to peripheral edema

59

15.6 Clinical Application
Exercise and the
Cardiovascular System

60

15.6: Paths of Circulation
• Blood vessels can be divided into two major pathways:
• The pulmonary circuit
• The systemic circuit (includes coronary circulation)

61

Pulmonary Circuit
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Right pulmonary artery

Superior
vena cava Aorta

Left pulmonary artery

Pulmonary capillaries
Pulmonary capillaries

Right pulmonary veins

Left pulmonary veins

Pulmonary trunk
Right lung

Left lung

Inferior vena cava

62

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Lymph flow
Blood flow
Blood flow

Lymphatic capillary

Alveolar capillary

1

Slight net outflow
of fluid from capillary

2

Solutes fail to enter
alveoli but contribute to
the osmotic pressure of
the interstitial fluid

Alveolar air
4

Capillary wall
Alveolar wall

Fluid from the
interstitial space
enters lymphatic
capillary or
alveolar
(blood) capillary

Interstitial space
3

Any excess water in
alveolus is drawn out by
the higher osmotic pressure
of the interstitial fluid

63

Systemic Circuit
• Composed of vessels that lead from the heart to all body
parts (except the lungs) and back to the heart
• Includes the aorta and its branches
• Includes the system of veins that return blood to the right
atrium

64

15.7: Arterial System
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Superficial temporal a.

External carotid a.
Internal carotid a.

Vertebral a.

Common carotid a.
Brachiocephalic a.
Axillary a.
Intercostal a.
Suprarenal a.
Brachial a.
Renal a.
Radial a.
Common iliac a.
Internal iliac a.
External iliac a.
Ulnar a.
Deep femoral a.

Subclavian a.
Aorta
Coronary a.
Celiac a.
Superior mesenteric a.
Lumbar a.
Inferior mesenteric a.
Gonadal a.

Femoral a.
Popliteal a.

Anterior tibial a.
Fibular a.

Posterior tibial a.

65
Dorsalis pedis a.

Principal Branches of the Aorta

66

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Right common carotid a.
Left common carotid a.

Right internal jugular v.

Left internal jugular v.

Right subclavian a.

Left subclavian a.
Brachiocephalic a.
Brachiocephalic vv.

Aortic arch
Ligamentum arteriosum

Superior vena cava

Left pulmonary a.

Left pulmonary vv.

Right pulmonary a.
Right pulmonary vv.

Left auricle

Right auricle
Pulmonary trunk

67

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Abdominal aorta
Phrenic aa.

Splenic a.
Left gastric a.

Celiac a.
Hepatic a.
Right gastric a.
Suprarenal a.
Renal a.
Gonadal a.
Lumbar aa.

Superior
mesenteric a.
Inferior
mesenteric a.

Common iliac aa.
Middle sacral a.
(a)

Abdominal
aorta

Splenic a.
Celiac a.

Hepatic a.
Renal aa.

Intestinal branches from
superior mesenteric a.

Branches from inferior
mesenteric a.

Common
iliac aa.
(b)

b: © Dr. Kent M. Van De Graaff

68

Arteries to the Brain,
Head, and Neck
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Anterior
cerebral a.

Anterior
cerebral a.
Middle
cerebral a.
Posterior
communicating a.

Anterior
communicating a.
Internal
carotid a.

Pituitary
gland

Middle
cerebral a.
Basilar a.

Posterior
cerebral a.

Basilar a.

Vertebral a.
Spinal a.

Spinal cord

69

Arteries to the Brain,
Head, and Neck
Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.

Superficial
temporal a.
Posterior
auricular a.
Basilar a.
Occipital a.

Internal
carotid a.

Anterior choroid a.

Maxillary a.
Facial a.
Lingual a.

External
carotid a.

Superior thyroid a.
Common carotid a.

Carotid sinus

Brachiocephalic a.

Vertebral a.
Thyrocervical
axis
Subclavian a.

70

Arteries to the Shoulder
and Upper Limb
Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.

Right common carotid a.
Right subclavian a.
Axillary a.
Anterior circumflex a.
Posterior circumflex a.
Deep brachial a.
Brachial a.
Radial recurrent a.
Radial a.

Ulnar recurrent a.
Ulnar a.

Principal
artery of
thumb

Deep volar arch a.
Superficial volar arch a.
Digital a.

71

Arteries to the Thoracic and
Abdominal Walls
Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.

Vertebral body
Posterior intercostal a.
Internal intercostal m.

Thoracic aorta

Internal thoracic a.
External intercostal m.

Sternum
Anterior intercostal aa.

Costal cartilage

72

Arteries to the Pelvis
Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.

Aorta
Inferior mesenteric a.
Inferior epigastric a.
Right common iliac a.
Internal iliac a.

Left common iliac a.
Middle sacral a.

External iliac a.

Iliolumbar a.
Superior gluteal a.

Deep
circumflex iliac a.

Lateral sacral a.

Femoral a.
Obturator a.
Superior vesical a.

Inferior gluteal a.
Internal pudendal a.
Inferior vesical a.
Perineal a.
Inferior rectal a.

73

Arteries to the Lower Limb
Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.

Right common iliac a.

Abdominal
aorta

Deep circumflex iliac a.

Internal iliac a.

External iliac a.
Superficial circumflex iliac a.
Deep femoral a.

Superficial
pudendal a.
Femoral a.

Lateral femoral a.

Deep genicular a.
Popliteal a.

Anterior tibial a.
Posterior tibial a.

Fibular a.

Dorsalis pedis a.
Medial plantar a.

Anterior view

Posterior view

Lateral plantar a.

74

15.8: Venous System
Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.

Superficial temporal v.
Anterior facial v.

External jugular v.

Internal jugular v.
Right brachiocephalic v.
Axillary v.
Cephalic v.
Brachial vv.
Basilic v.
Median cubital v.
Renal v.
Radial vv.
Ulnar vv.
Common iliac v.
External iliac v.

Subclavian v.
Superior vena cava
Azygos v.
Hepatic v.
Inferior vena cava
Ascending lumbar v.
Gonadal v.
Internal iliac v.

Femoral v.
Great saphenous v.
Popliteal v.

Posterior tibial vv.
Small saphenous v.
Anterior tibial vv.

75

Characteristics of
Venous Pathways
• Vessels of the venous system originate with the merging of
capillaries into venules, venules into small veins, and small
veins into larger ones
• Unlike arterial pathways, those of the venous system are
difficult to follow due to irregular networks and unnamed
tributaries

76

Veins from the Brain,
Head, and Neck
Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.

Venous
sinuses

Superior
ophthalmic v.

Vertebral v.
Right external
jugular v.
Right
Subclavian v.

Anterior
facial v.
Right internal
jugular v.

Right axillary v.
Right brachiocephalic v.

77

Veins from the
Upper Limb and Shoulder
Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.

Right internal jugular v.

Right external jugular v.
Right subclavian v.

Left brachiocephalic v.
Right brachiocephalic v.
Axillary v.

Superior vena cava
Brachial vv.
Cephalic v.

Basilic v.
Median cubital v.

Radial vv.
Ulnar vv.

Dorsal arch v.

78

Veins from the
Abdominal and Thoracic Walls
Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.

External jugular v.
Subclavian v.
Superior vena cava
Axillary v.
Brachial v.

Internal jugular v.
Brachiocephalic vv.

Cephalic v.
Superior hemiazygos v.
Posterior intercostal v.

Basilic v.
Azygos v.
Inferior hemiazygos v.

79

Veins from the Abdominal Viscera
Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.

Liver

Stomach
Left gastric v.

Hepatic
portal v.
Gallbladder

Right gastric v.
Spleen

Pancreas

Splenic v.

Superior
mesenteric v.
Portion of
small intestine

Inferior
mesenteric v.

Ascending colon

Descending colon

Rectum

80

Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.

Head and upper
limb capillaries

Lungs
Deoxygenated blood
Oxygenated blood

Superior
vena cava
Aorta
Hepatic artery
Inferior
vena cava
Splenic artery

Hepatic vein
Liver

Common
iliac vein

Hepatic
portal vein
Renal capillaries

Mesenteric artery
(to intestine)

Renal efferent
arterioles

Renal afferent
arterioles

Trunk capillaries

Common
iliac artery

81
Lower limb capillaries

Veins from the
Lower Limb and Pelvis
Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.

Inferior
vena cava

Right common
iliac v.

Internal
iliac v

External iliac v.

Femoral v.

Great saphenous v.

Popliteal v.

Anterior tibial vv.
Small saphenous v.
Fibular vv.
Posterior tibial vv

Medial plantar vv.
Dorsalis pedis v.
Anterior view

Lateral plantar vv.
Posterior view

82

15.9: Lifespan Changes
• Cholesterol deposition in the blood vessels
• Heart enlargement
• Death of cardiac muscle cells
• Increase in fibrous connective tissue of the heart
• Increase in adipose tissue of the heart
• Increase in blood pressure
• Decrease in resting heart rate

83

15.7 Clinical Application
Molecular Causes of
Cardiovascular Disease

84

15.8 Clinical Application
Coronary Artery Disease

85

Important Points in Chapter 15:
Outcomes to be Assessed
15.1: Introduction
 Discuss the functions of the organs of the cardiovascular system.
15.2: Structure of the Heart
 Distinguish between the various coverings of the heart and the layers
that compose the wall of the heart.
 Identify and locate the major parts of the heart and discuss the
function of each part.
 Trace the pathway of the blood through the heart and the vessels of
coronary circulation.
15.3: Heart Actions
 Describe the cardiac cycle and explain how heart sounds are
produced.

86

Important Points in Chapter 15:
Outcomes to be Assessed
 Identify the parts of a normal ECG pattern and discuss the
significance of this pattern.
 Explain control of the cardiac cycle.
15.4: Blood Vessels

 Compare the structures and functions of the major types of blood
vessels.
 Describe how substances are exchanged between blood in capillaries
and the tissue fluid surrounding body cells.

15.5: Blood Pressure
 Explain how blood pressure is produced and controlled.
 Describe the mechanisms that aid in returning venous blood to the
heart.

87

Important Points in Chapter 15:
Outcomes to be Assessed
15.6: Paths of Circulation
 Compare the pulmonary and systemic circuits of the cardiovascular
system.
15.7-15.8: Arterial System – Venous System

 Identify and locate the major arteries and veins.
15.9: Lifespan Changes
 Describe the lifespan changes in the cardiovascular system.

88

Quiz 15
Complete Quiz 15 now!
Read Chapter 16.
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