Vessels and Circulation

Some embryology
first
 There are at first six
pairs of aortic
arches
 In fish these are
connected to the
gills
 They undergo a
transformation in
mammals
 Birds use the right
arch of the fourth pair
 Mammals use the
left arch of the
fourth pair

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Ventral (anterior)
view

Transformation :
Full set of arches develops, 4th through 7th
but not all present at weeks: some persist,
the same time; (before some atrophy
transformation)
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4th arches become:
Left side: aortic arch
Right side: brachiocephalic trunk

Right common carotid a ------------------------------.

Right subclavian a. --------------------------
Brachiocephalic trunk-----------------------------------

4
 What the aortic
arches become…

Right common carotid a ---------------------------.

Right subclavian a. ---------------------------
Brachiocephalic trunk-------------------------------

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 3 Major types of
blood vessels
 Body
 RA 1.Arteries
 RV 2.Capillaries
 Lungs 3.Veins
 LA
 LV Arteries carry blood away from the heart
 Boby -”branch,” “diverge” or “fork”
Veins carry blood toward the heart
-”join”, “merge,” “converge”

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 General characteristics of vessels

 Three layers (except for the smallest)

1. Tunica intima - AKA intima
2. Tunica media – smooth muscle
3. Tunica externa - AKA adventitia

 Lumen is the central blood filled space

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  Intima is endothelium (simple squamous epithelium)
 May have subendothelial layer if 1mm or larger
 Tunica media: layers of circular smooth muscles
 Lamina (layers) of elastin and collagen internal and external
 Thicker in arteries than veins (maintain blood pressure)

Smooth muscle
contraction:
vasoconstriction

Smooth muscle
relaxation:
vasodilation

Sympathetic
vasomotor
nerves of
autonomic
nervous system
regulate
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 Adventitia (t. externa) – longitudinally running
collagen and elastin for strength and recoil

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“muscular” middle sized artery 10
 Arteries
 Carry blood away from the heart
 From big to small, these are the categories:
1. Elastic
2. Muscular
3. Arterioles (then these to capillaries)
 Pressure diminishes along the route

1. Elastic arteries: act as conduits

 2.5-1 cm diameter
 Expand with surge
of blood from heart
 Recoil and continue
the propagation of blood
 Elastin is thick in media:
dampens the surge of blood
pressure
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 Aorta and its branches
 Arteries continued

2. Muscular arteries: act as

distributing arteries
 Middle sized .3mm-1cm
 Changes diameter to
differentially regulate flow
to organs as needed
 Internal as well as
external elastic lamina
 Most of what we see as
“arteries”
Tunica media larger in proportion
to the lumen, thus “muscular” 12
 Arteries continued
3. Arterioles
 Smallest: .3mm-10um
 Only larger ones have all 3
layers
 Regulated 2 ways:
 Locally in the tissues
 Sympathetic control
 Systemic blood pressure (the
“BP” we measure) can be
regulated through them
 Send blood into capillaries
Tunica media has only a few
layers of smooth muscle cells
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 Capillaries
Heart to arteries to capillaries to veins to heart

 Capillaries are smallest

 8-10um
 Just big enough for single file erythrocytes
 Composed of: single layer of endothelial cells surrounded
by basement membrane

 Universal function
 Oxygen and nutrient delivery to tissues
 CO2 and nitrogenous waste (protein break-down product)
removal
 Some also have tissue specific functions 14
 Capillaries

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There’s a capillary “bed” in almost all tissues
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 Capillary permeability

 Direct diffusion through endothelial cell

membranes
 Only O2 and CO2
 Other molecules by various other methods
 Blood brain barrier: complete tight junctions
 Selective transport of necessary molecules
 Lipid soluble agents (like anesthetics) get
through, as do O2 and CO2

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 Veins
 Pressure has been lowered so capillaries
can tolerate
 With lower pressure, walls (of veins) can
be thinner
 From smallest to large:
Capillaries to postcapillary venules to venules to
veins
 Veins are larger than arteries, plus
 Tunica externa is thicker
 There is less elastin
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Special features of veins

 Valves
 Prevent backflow
 Most abundant in legs (where
blood has to travel against gravity)
 Muscular contraction
 Aids the return of blood to heart in
conjunction with valves

Mechanical issues…
(really good to know)
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Exercise helps
circulation
(because
muscles
contract and
squeeze blood
back to the
heart)

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 Vascular anastomoses
 Vessels communicating with each other
 Veins have more than arteries
 Form alternative pathways or collateral channels
 Protect organs from being supplied by just one
route
 Poor anastomoses & therefore vulnerable: central
artery of retina, kidneys, spleen, bone diaphyses

 Vasa vasorum
 Means vessels of the vessels
 Blood supply to vessel itself
 Smallest vessels don’t need 21
 Vascular System
(Blood vessels of the body)
 Two circulations
 Systemic
 Pulmonary

 Arteries and veins usually run together

 Often nerves run with them
 Sometimes the systems do not have bilateral
symmetry
 In head and limbs, most are bilaterally symmetrical
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 Pulmonary Circulation

 Pulmonary trunk branches

 Right and left pulmonary arteries
 Division into lobar arteries
 3 on right
 2 on left
 Smaller and smaller arterioles, into capillaries surrounding alveoli
 Gas exchange
 Pulmonary system pressure is only 1/6 of systemic blood pressure 23
 Pulmonary Circulation

 After gas exchange blood enters venules

 Larger and larger into Superior and Inferior
Pulmonary veins
 Four Pulmonary Veins empty into left atrium 24
25
In lungs

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 Systemic Circulation
 Oxygenated blood to body
 Leaves LV through Ascending Aorta
 Only branches are the 2 coronary arteries to the heart
 Aortic Arch has three arteries branching from it:
1. Brachiocephalic trunk, has 2 branches:
 Right common carotid a.
 Right subclavian a.
2. Left common carotid a.
3. Left subclavian a.

Ligamentum arteriosum
connecting to pulmonary a.

remember aortic arches…

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 Descending aorta

 Thoracic aorta
 at T12 becomes
abdominal aorta

 Abdominal aorta
 ends at L4
branching into:
 R & L common
iliac arteries

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 Common
carotids branch:
 Internal carotids
 External carotids

 Subclavian: 3
branches
 Vertebral
arteries
 Thyrocerical
trunk
 Costocervical
trunk

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Head and neck
 Common carotids just
lateral to trachea: feel
 At larynx divides into
internal & external
 External carotid:
supplies head
external to brain and
orbit
 Feel superficial
temporal a.
 Middle meningeal:
vulnerable (branch of
maxillary)
 Internal carotid
 Supply orbits and
most of cerebrum
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Internal carotid a.
 Enters skull
through carotid
canal
 Gives off:
 Ophthalmic artery
 Then divides into
anterior and middle
cerebral arteries
(see next slides):
together they supply
80% of cerebrum
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32
33
Angiogram

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 arteriogram

 Middle cerebral
arteries run through
lateral fissures
 Anterior cerebral
arteries of each
side, through
anterior
communicating
artery, anastomose

(an anastomosis is a union)

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  R and L vertebral arteries* (from subclavians)
 Ascend through vertebral foramina of C6-C1
transverse processes
 Through foramen magnum into skull
 Join to form one Basilar artery*

*
*

*
36 *
 Basilar artery: branches
 Divides into posterior cerebral arteries
 Posterior communicating arteries connect to
middle cerebral arteries
CIRCLE OF WILLIS Note how it loops
around pituitary
(now called “cerebral arterial circle”) gland & optic chiasm

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38
 Upper limb
 Subclavian runs
laterally onto 1st rib,
under clavicle
 Enters axilla as
axillary artery
 Sends branches
 Continues as
brachial artery in
upper arm
 Splits into radial &
ulnar arteries
 See hand supply

Feel brachial & radial pulses

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40
overview

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 Thorax
 Anterior intercostals
branch off Internal
thoracic* (branch of
subclavian)
 Posterior
*
intercostals branch
off Thoracic aorta
Small bronchial
arteries supply the
lung structures

Intercostal arteries,
veins and nerves
run just UNDER the
ribs 42
 Arteries to the abdomen
 Arise from the abdominal aorta
 At rest, ½ arterial blood is here!
 Three single midline branches supply the digestive tube
1. Celiac trunk
2. Superior mesenteric artery
3. Inferior mesenteric artery

1.

2.

3.

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1. Celiac trunk: divides into 3 right away: left gastric,
splenic & common hepatic (see pic; the latter is
the only which goes off to the right)
2. Superior mesenteric supplies most of intestines
Definition of mesenteries: double layered sheets of peritoneum
that support most organs in the abdominopelvic cavity

1.

2. 44
3. Inferior mesenteric supplies distal half of
large intestine
(The 1, 2 and 3 are branches of the abdominal aorta)

1.

2.

3.

Know what these terms mean: phrenic, gastric, hepatic, renal, colic
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 Arteries to the abdomen
 Paired branches off the abdominal aorta
supply adrenal glands, kidneys, gonads
and abdominal body wall

supply
diaphragm

supply
adrenals

to kidney

3.

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47
 Abdominal aorta
branches into
Common iliacs at
L4; these branch
into
 Internal iliacs to
pelvic organs,
perineum,
buttocks, medial
thighs
 External iliacs: to
rest of lower limbs
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 External iliac
passes under
inguinal ligament
becoming Femoral
artery
 At back of knee
femoral becomes
popliteal artery,
and branches

Feel dorslis pedis &

posterior tibial

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50
review

51
review

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 Systemic Veins
 3 major vessels enter Right Atrium:
 SVC (superior vena cava)
 IVC (inferior vena cava)
 Coronary sinus
 Many veins are very superficial (unlike
arteries)
 Venous plexuses (networks of anastomoses
and parallel veins) are very common
 Head and hepatic portal systems are unusual
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 Dural sinuses
 Drain the veins of
the brain
 Cavernous sinuses
 Carotid arteries and
some cranial nerves
run within them
 Dangerous if trauma
 Come together as
sigmoid sinus –
becomes Internal
Jugular vein
 Exits skull through
jugular foramen
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 Internal jugular veins
 Drain most of blood from brain
 Run lateral to internal then common carotid
 At base of neck joins subclavian v. to form brachiocephalic v.
 External jugulars – drain some of scalp & face

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 Vein
overview
Note that unlike the arteries, the veins
have a brachiocephalic on the right
and left sides

Azygos system
drains the thorax:

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 Deep veins of
upper limbs follow
arteries, most of
them double to
one artery
 Superficial veins:
see pic
 Blood drawn from
median cubital
vein in antecubital
fossa

(look at)

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 Tributaries of IVC: note asymmetry
 Left gonadal and suprarenal veins drain into left renal
vein
 On right they drain directly into IVC
 Right and left hepatic veins enter superior part of IVC

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 Hepatic portal system
 Picks up digested nutrients from stomach & intestines and delivers them
to liver for processing and storage
 Storage of nutrients
 Detoxification of toxins, drugs, etc.
 Two capillary beds
 Route: artery to capillaries of gut to hepatic portal vein to liver’s
capillaries to hepatic vein to IVC

Don’t confuse hepatic vein with hepatic portal vein

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 Kind of confusing…

Superior mesenteric
and splenic veins join
to form hepatic *
portal vein, which
goes up into liver

Inferior mesenteric
empties into the
*
splenic vein

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(same info with different pic)

Tributaries of hepatic
portal vein:
-superior mesenteric vein
-splenic vein
-inferior mesenteric vein

 Hepatic portal system

 Picks up digested nutrients from stomach & intestines
and delivers them to liver for processing and storage
 Storage of nutrients
 Detoxification of toxins, drugs, etc.
 Two capillary beds
 Route: artery to capillaries of gut to hepatic portal
vein to liver’s capillaries to hepatic vein to IVC
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62
 Leg veins
 Names similar to
arteries
 Femoral becomes
external iliac after
crossing under
inguinal ligament

_________used for grafting in coronary

artery bypass grafts: is the
longest vein in the body

 External iliac joins

with internal iliac to
form common iliac
vein

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 Fetal
Circulation
 The one umbilical
vein brings blood
which has been to
the placenta for
oxygenation (by gas
diffusion from mom’s
blood)
 The pair of umbilical
arteries (branches
from baby’s internal
iliac arteries) carry
blood to placenta to
pick up oxygen and
nutrients
 Fetal heart starts
beating at 21 days
post conception
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 Some Diseases

 Atherosclerotic cardiovascular disease

 Cerebrovascular disease – affects brain, strokes
 Coronary artery disease (CAD) – arteries of heart
 Peripheral vascular disease (PVD) – arterial
 Affecting veins
 Chronic venous insufficiency – venous = veins
 Deep venous thrombosis (DVT)
 Aneurysms
 Portal hypertension
 Hypertension
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