Download Arterial Blood Vessels

The blood vessels
1. The structure of the blood vessels
– arteries, capillaries, veins
2. Vessels of the pulmonary circuit –
the pulmonary trunk
3. Aorta – an overview
4. Arteries of the head and neck
5. Arteries of the trunk and limbs
Structural plan of blood vessels
Three layers:
internal layer – tunica interna
(intima)
endothelium
subendothelial layer
internal elastic lamina (membrane)
middle layer – tunica media
smooth muscle cells
elastic and collagen fibers
external layer – tunica externa
(adventitia)
loose connective tissue
smooth muscle tissue
blood vessels, vasa vasorum
vasomotor nerves, nervi vasorum
2
Structure of arterial wall
Large-sized arteries = elastic (conducting) arteries,
arteriae elastotypicae:
aorta and its large branches
pulmonary trunk
3
Structure of arterial wall
Large elastic arteries:
tunica interna (intima) – thick
endothelium
well-developed subendothelium
internal elastic lamina –
longitudinal elastic fibers
tunica media – main layer
parallel elastic membranes
tunica externa (adventitia)
loose connective tissue;
abundant elastic fibers
vasa et nervi vasorum
4
Structure of arterial wall
Medium-sized arteries =
muscular (distributing) arteries,
arteria myotypica:
arteries of limbs
intercostal arteries
intraorgan arteries
5
Structure of arterial wall
Medium (muscular) arteries:
tunica interna (intima)
endothelium
thin subendothelial layer
internal elastic lamina
tunica media – the widest layer
circular muscle fibers
external elastic lamina
tunica adventitia – thick
connective tissue – collagen fibers
lymphatic capillaries,
vasa vasorum and nerves
6
Structure of arterial wall
Small-sized arteries – ≤ 0.4 mm:
tunica intima
thinner subendothelial layer
reduction of internal elastic lamina
tunica media
decrease of muscle fibers
tunica adventitia
very thin
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Structure of arterial wall
Arterioles – ≤ 0.5 mm:
tunica intima
very thin subendothelial layer
absent internal elastic membrane
tunica media
1-2 circular layers of smooth muscle cells
tunica adventitia
very thin to absent
8
Structure of capillaries
Capillaries, vas (hemo)capillare:
part of terminal blood supply
– capillary loops and networks
the sites for metabolic exchange
endothelial tubes
have a basement membrane
two functional portions
arterial – 2-7 µm
venous – 7-12 µm
Three types of capillaries:
continuous (somatic)
fenestrated (visceral)
discontinuous (sinusoidal)
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Structure of capillaries
Continuous (somatic) capillaries:
in organs with nutritive functions
skeletal muscles
skin and CNS
internal organs
vascular wall (vasa vasorum)
Microscopic anatomy:
simple endothelium, endothelium
numerous pinocytotic vesicles
passable intense transport
basal membrane, membrana basalis
morphologically similar to the epithelium
pericytes, pericytus
enveloped by the basal membrane
contractile cells?
stem cells smooth muscle cells
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Structure of capillaries
Fenestrated (visceral) capillaries:
in organs with nutritive and
metabolic function
endocrine glands
intestinal villi
renal glomeruli
Structure and function:
perforated endothelium
fenestrae with diaphragm
basal membrane
continous
intense transport
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Structure of capillaries
Discontinuous (sinusoidal)
capillaries (sinusoids):
liver, spleen, bone marrow
intestinal villi
renal glomeruli
Structure and function:
endothelium
unusually wide gaps
numerous fenestrae
without diaphragm
macrophages between endothelium
absent basal membrane
partial, discontinuous
intense transport of metabolites
and cellular elements
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Structure of venous wall
Venous wall – three provisional layers:
tunica intima
tunica media – thinner
tunica adventitia – main layer
Structural peculiarities:
irregular lumen
thinner wall with prevailing collagen
fibers and valve presence
Morphological types:
venules and small veins
with prominent circular
musculature in the media
with prominent longitudinal
musculature in the adventitia
with less prominent musculature
nonmuscular veins
13
Pulmonary circuit
Pulmonary trunk
pulmonary arteries – venous blood
right chamber
lungs
Pulmonary veins – 4, arterial blood
lungs
left atrium
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Systemic circuit
Systemic circulation – course
arteries
capillaries
veins
coronary vessels
portal veins
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Systemic circuit
Systemic circulation – course
arteries
capillaries
veins
coronary vessels
portal veins
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Major arteries
Aorta – course
ascending aorta
arch of the aorta
descending aorta
thoracic aorta
abdominal aorta
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The carotid system
Common carotid artery, a. carotis communis:
begin
right – truncus brachiocephalicus
left – arcus aorta
two branches:
a. carotis externa
a. carotis interna
sinus caroticus
glomus caroticum
Michael Guevara: Blood Pressure Control Systems
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The carotid system
Common carotid artery, a. carotis communis:
begin
right – truncus brachiocephalicus
left – arcus aorta
two branches:
a. carotis externa
a. carotis interna
sinus caroticus
glomus caroticum
Michael Guevara: Blood Pressure Control Systems
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Arteries of the head
Overview and external carotid artery:
facial artery
maxillary artery
superficial temporal artery
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The carotid system
External carotid artery, a. carotis externa:
anterior branches
a. thyroidea superior
a. lingualis
a. facialis
posterior branches:
a. pharyngea ascendens
a. sternocleidomastoidea
a. occipitalis
a. auricularis posterior
end branches:
a. temporalis superficialis
a. maxillaris
o pars mandibularis
o pars pterygoidea
o pars pterygopalatina
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The carotid system
Internal carotid artery, a. carotis interna:
canalis caroticus
parts:
pars cervicalis –
through canalis caroticus
pars petrosa
pars cavernosa –
through sinus cavernosus
pars cerebralis –
o a. hypophysealis superior
end branches:
o
o
o
o
o
a.
a.
a.
a.
a.
ophthalmica
communicans post.
choroidea anterior
cerebri anterior
cerebri media
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Carotid ultrasonography
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The thoracic aorta, aorta thoracica
The parietal branches – paired:
aa. intercostales posteriores
Х pairs – longer right arteries
•
III-XI intercostal space
•
a. subcostalis
– below the Xth rib
dorsal branch, ramus dorsalis
•
ramus spinalis
•
back muscles
•
skin on the back – medial
and lateral branch
ramus cutaneus lateralis
•
anterior branch –
rr. mammariae
•
posterior branch
aa. phrenicae superiores
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The thoracic aorta, aorta thoracica
The visceral branches:
bronchial arteries, rr. bronchiales
vary (2-3) in number and size
oesophageal arteries,
rr. oesophageales
3-6 in number
ascending and descending branches
pericardial branches, rr.pericardiaci
mediastinal branches,
rr. mediastinales
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Clinical significance
Dissection and aneurysm
of the thoracic aorta:
more common
may affect its descending part
the most common cause –
atherosclerosis
other factors:
congenital syndromes (S. Marfan),
long-lasting high blood pressure, trauma
some infectious diseases such as syphilis
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The abdominal aorta, aorta abdominalis
The main branches:
parietal branches – paired
supply
the abdominal wall
visceral branches –
distributed to viscera
unpaired
paired branches
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The abdominal aorta, aorta abdominalis
The parietal branches:
a. phrenica inferior sinistra et dextra
a. suprarenalis superior
r. oesophagealis – left; r. venae cavae inferioris – right
aa. lumbales I-IV – four paired arteries
r. dorsalis
r. spinalis
branched to the muscles and skin of the abdominal wall
a. sacralis mediana – unpaired, a remnant from the caudal aorta
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The abdominal aorta, aorta abdominalis
Unpaired visceral branches:
celiac trunk
superior mesenteric artery
inferior mesenteric artery
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The coeliac trunk, truncus celiacus
length 1-2 cm; level Th12
divided into three branches:
the left gastric artery,
a. gastrica sinistra – the smallest
rr. oesophageales
the hepatic artery,
a. hepatica communis:
a. gastrica dextra
a. hepatica propria
o r. dexter et r. sinister
o a. cystica
a. gastroduodenalis
o a. gastroomentalis dextra
o aa. pancreaticoduodenales supp.
splenic artery – the largest branch,
the
a. splenica (lienalis)
rr. pancreatici
aa. gastrici breves
a. gastroomentalis
sinistra
rr. splanchnici
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The superior mesenteric artery,
a. mesenterica superior
level L1; in radix mesenterii
branches:
inferior pancreaticoduodenal artery,
a. pancreaticoduodenalis inferior
ramus anterior et ramus posterior
jejunal and ileal branches,
aa. jejunales et ileales:
10-15 in number
distributed to mesenteric intestine
a series (1st, 2nd and 3rd) of arches
straight vessels, vasa rectae
ileocolic artery, a. ileocolica
ileal branch, r. ilealis
aa. cecales anterior et posterior
a. appendicularis
colic branch, r. colicus
right colic artery, a. colica dextra
descending and ascending branch
middle colic artery, a. colica media
right and left branch
arcus Riolani
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The inferior mesenteric artery,
a. mesenterica inferior
level L2-3; length 5-6 cm
branches:
left colic artery, a. colica sinistra
– supplies the descending colon
ramus superior
arcus Riolani
ramus inferior
sigmoid arteries, aa. sigmoideae:
2-4 in number
arches in mesocolon sigmoideum
anastomoses in-between and
with the adjacent arteries
superior rectal artery,
a. rectalis superior – the end branch
runs into the retroperitoneal space
forms loops around
the lower end of the rectum
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The abdominal aorta, aorta abdominalis
Paired visceral branches:
middle suprarenal artery, a. suprarenalis media
renal artery, a. renalis – L2
a. suprarenalis inferior
testicular artery, a. testicularis
ovarian artery, a. ovarica
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Arteries of the upper limb
The brachial artery, a. brachialis:
from m. pectoralis major
along suclus bicipitalis medialis,
accompanied by n. medianus
branches:
a. profunda brachii
canalis humeromuscularis
a. collateralis radialis
• muscular branches, rr. musculares
• deltoid branch, r. deltoideus
• aa. nutriciae humeri
• a. collateralis media
a. collateralis ulnaris superior
a. collateralis ulnaris superior
end branches:
a. radialis
a. ulnaris
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Arteries of the forearm
The radial artery, a. radialis:
laterally and superficially arterial pulsations
through the anatomical snuff box
branches:
a. recurrens radialis
rr. musculares
r. carpalis palmaris
r. palmaris superficialis
r. calparis dorsalis
a. metacarpea dorsalis
prima
a. princeps pollicis
• aa. digitales propriae I-III
continues into:
the deep palmar arch
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Arteries of the forearm
The ulnar artery, a. ulnaris:
downwards anterior-medially
through the canalis carpi ulnaris
branches:
a. recurrens ulnaris
a. interossea communis
• a. interossea anterior
o a. comitans n. mediani
o aa. nutriciae
o rr. musculares
• a. interossea posterior
o a. interossea recurrens
rr. musculares
r. carparis palmaris
r. carpalis dorsalis
r. palmaris profundus
arcus palmaris profundus
continues across the palm as:
the superficial palmar arch
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The arterial anastomoses around
the elbow joint, articulatio cubiti
rete articulare cubiti:
a.
a.
a.
a.
a.
a.
a.
collateralis ulnaris superior
collateralis ulnaris inferior
collateralis radialis
collateralis media
recurrens radialis
recurrens ulnaris
interossea recurrens
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Arteries of the hand
The superficial palmar arch, arcus palmaris superficialis:
direct continuation of the ulnar artery
r. palmaris superficialis of a. radialis:
a. digitalis palmaris propria V
aa. digitales palmares communes
•
aa. digitales palmares propriae
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Arteries of the hand
The deep palmar (volar) arch, arcus palmaris profundus:
direct continuation of the radial artery
r. palmaris profundus of a. ulnaris:
branches to rete carpale palmare
three aa. metacarpales palmares
rr. perforantes
39
Arteries in the pelvis
The common iliac artery, a. iliaca communis – L4:
the internal iliac artery, a. iliaca interna
the external iliac artery, a. iliaca externa
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Arteries of the lower limb
The femoral artery, a. femoralis:
from lacuna vasorum;
behind the inguinal ligament
through the femoral triangle
superficial branches:
a. epigastrica superficialis
a. circumflexa ilium superficialis
aa. pudendae externae
•
rr. scrotales (labiales) anteriores
deep branches:
a. profunda femoris
•
•
•
a. circumflexa femoris medialis
a. circumflexa femoris lateralis
aa. perforantes –
prima, secunda et tertia
rr. musculares
a. descendens genus
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Arteries of the lower limb
The popliteal artery, a. poplitea:
begin
canalis adductorius
transverses the popliteal fossa
branches to the knee joint,
genicular branches:
a. superior medialis genus
a. superior lateralis genus
a. media genus
a. inferior medialis genus
a. inferior lateralis genus
muscular branches:
sural arteries, aa. surales,
medialis et lateralis
the end branches:
a. tibialis anterior
a. tibialis posterior
a. peronea
42
The genicular anastomosis,
articulatio genus
rete articulare genus:
a. genus descendens
a. genus superior medialis
a. genus superior lateralis
a. genus media
a. genus inferior medialis
a. genus inferior lateralis
a. recurrens tibialis anterior
a. recurrens tibialis posterior
r. circumflexus fibulae
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Arteries of the leg
the anterior tibial artery,
a. tibialis anterior:
a. recurrens tibialis posterior
a. recurrens tibialis posterior
a. malleolaris anterior lateralis
a. malleolaris anterior medialis
rr. musculares
the posterior tibial artery,
a. tibialis posterior:
r. circumflexus fibularis
a. nutricia tibiae
rr. malleolares mediales
rr. calcanei
the peroneal artery,
a. peronea (fibularis):
a. nutricia fibulae
r. perforans
rr. malleolares laterales
rr. calcanei
r. communicans
44
Arteries of the foot
The dorsal artery of the foot, a. dorsalis pedis:
an extension of the anterior tibial artery
in the 1st intermetatarsal space
branches:
aa. tarsales mediales
a. tarsalis lateralis
rete dorsalis pedis
a. arcuata
• rete dorsalis pedis
• aa. metatarsales dorsales I-III
o r. perforans
o aa. digitales dorsales
the end branches:
a. metatarsalis dorsalis prima
• two aa. digitales dorsales
a. plantaris profunda
• arcus plantaris
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The plantar arteries
The lateral plantar artery,
a. plantaris lateralis:
rr. muscularis
arcus plantaris profundus
rr. perforantes II-IV
aa. digitales plantares
communes I-IV
• aa. digitales plantares
propriae
The medial plantar artery,
a. plantaris medialis:
rr. musculares
rr. cutanei
r. superficialis
a. metatarsea plantaris I
r. profundus – anastomosis with
arcus plantaris
a. metatarsea plantaris I
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