Download Section one Introduction

Angiology
Include the cardiovascular system and the lymphatic system.
Chapter one The cardiovascular system
Section one
一、
Introduction
Composition of the cardiovascular system
Heart and blood vessels ( arteries , veins and capillaries)
二、
The cardiovascular circuits
1 The systemic or greater circulation
The course of the blood from the left ventricle through the whole body finally to the right
atrium.
2 The pulmonary or lesser circulation
Its passage from the right ventricle via the lung to the left atrium.
3 The difference between the systemic circulation and pulmonary circution
三、
Anastomoses
1 Forms
In addition to artery-capillary-vein , the blood vessels may unite to form the arterial
anastomoses , venous plexus or network , arteriovenous anastomoses.
2 Collateral circulation
The blood circulation is established by the collateral (accessory) vessels.
Section two
一、
The heart
Location
Occupies the middle mediastinum between the lungs and the pleurae, enclosed in the
pericardium. Approximately 1/3 lies to right of the median plane and 2/3 to the left.
二、
The cardiac shape
One apex , one base , two surfaces , three borders and three sulci
1 Cardiac apex : formed by the left ventricle. Situated in the 5th left intercostals space 1-2 cm to
the medial of the left mid-clavicular line.
2 Cardiac base : directed back and right.
3 Two surfaces : the anterior (sternocostal ) surface and inferior ( diaphragmatic) surface
4 Three borders : right , left and inferior borders
5 Three sulci :
the coronary ( atrioventricular) sulcus,
the anterior interventricular groove,
the posterior interventricular groove
三、
The chambers of heart
1 The right atrium
a Anterior part ( atrium proper) and posterior part (sinus venarum)
b Three vessels openings :
orifice of the superior vena cava
orifice of the inferior vena cava
orifice of the coronary sinus
c The fossa ovalis
d The right auricle
2 The right ventricle
a Inflowing part and outflowing part(infundibulum):
separated by supraventricular crest
b The right atrioventricular orifice : attached by the tricuspid valve→chordae tendineae
(tendinouscords) → the papillary muscle
c The pulmonary orifice : encircled by the pulmonary valves
d other structures : trabeculae carneae , septomarginal trabecula
3 The left atrium
a The left auricle
b The orifices of the pulmonary veins
4 The left ventricle
a Inflowing part and outflowing part : separated by the anterior cusp of the mitral valve
b The left atrioventricular orifice : attached by the bicuspid(mitral) valve→chordae tendineae
(tendinouscords) → the papillary muscle
c The aortic orifice : encircled by the aortic valves
四、
Cardiac architecture
1 The wall of the heart
from inner to outer : endocardium → myocardium → epicardium
2 The interatrial septum
3 The interventricular septum :
the membraneous part and the muscular part
4 The skeleton of the heart :
fibrous rings and fibrous trigones
a fibrous rings : surround the atrioventricular and arterial orifices
b fibrous trigones : left fibrous trigone and right fibrous trigone (central fibrous body)
五、
The conducting system
1 The sinoatrial node (SA node)
2 The atrioventricular node (AV node)
3 The atrioventricular bundle (His bundle)
4 Left and right bundle branches (limbs) → Purkinje network
六、
Vessels of the heart
1 Arteries of heart
a The right coronary artery → (main rami) post. interventricular branch and post. branch of the left
ventricle
b The left coronary artery → (main rami) ant. interventricular brach , circumflex A. and diagonal
A.
2 Veins of heart
a The coronary sinus ← the great , middle and small cardiac veins
b The anterior cardiac veins
c The smallest cardiac veins
七、
The pericardium
1 The fibrous pericardium
2 The serous pericardium
a The pericardial cavity
b The transverse sinus of pericardium
c The oblique sinus of pericardium
八、
The cardiac surface projection
1 left superior dot
2 right superior dot
3 left inferior dot
4 right inferior dot
Section three the arteries
一、
The arteries of pulmonary circulation
1 Main trunk → right and left pulmonary arteries
2 Arterial ligament : as the ductus arteriosus in fetus
二、
The arteries of systemic circulation
(一) The aorta
Be divided into three parts: the ascending aorta , the aortic arch , the descending aorta
1 The ascending aorta (ascending part of aorta)
a. The course
b. Branches → coronary a.
2 The aortic arch
a. The course
b. Branches → from right to left : the brachiocephalic trunk(innominated a. → right common
carotid a. and right subclavian a.) , left common carotid a. , the left subclavian a.
3 The descending aorta (descending part of aorta)
a The course
b Two portions : the thoracic a. and the abdominal a.
(二) The arteries of head and neck
main trunk → the common carotid a.
1 The common carotid a.
Carotid sinus : pressure-receptor
Carotid body: chemoreceptor
1) The internal carotid a.
2) The external carotid a.
a. The course
b. Branches :
(1)The superior thyroid a. → the superior laryngeal a.
(2)The lingual a.
(3)The facial a.
(4)Maxillary a.
(5)The superficial temporal a.
2 The subclavian a.
a. The course
b. Branches
(1)The vertebral a.
(2)The internal thoracic a.
(3)The thyrocervical trunk → the inferior thyroid a.
（三）The arteries of thorax
1 The parietal branches : the posterior intercostal a. , the subcostal a.
2 The visceral branches
（四）The arteries of abdomen
1 The parietal branches : inferior phrenic a. and lumbar a.
2 The visceral branches
■ The paired :
a. The middle suprarenal a.
b. The renal a.
c. The testicular a.(the ovarian a.)
■ The three unpaired
a. The celiac trunk:
(1)The left gastric a.
(2)the common hepatic a. → proper hepatic a. → cystic a. and right gastric a.
gastroduodenal a. →right gastroepiploic a.
(3)The splenic a. →left gastroepiploic a. and short gastric a. et al.
b. The superior mesenteric a.
(1) The jejunal and ileal a.
(2) The ileocolic a. → the appendicular a.
(3) The right colic a.
(4) The middle colic a.
c. The inferior mesenteric a.
(1) The left colic a.
(2) The sigmoid a.
(3) The superior rectal a.
（五）The arteries of pelvis
from the common iliac a.
1 The internal iliac a.
a. The parietal branches
(1) The obturator a.
(2) The superior and inferior gluteal a.
(3) Others: ilio-lumbar a. and lateral sacral a.
b. The visceral branches
(1) The umbilical a. → the superior vesical a.
(2) The inferior vesical a.
(3) The rectal a.
(4) The uterine a.
(5) The internal pudendal a.
2 The external iliac a. → inferior epigastric a.
(六) Arteries of axilla and upper limb
1 The axillary artery
a.
The thoracoacromial a.
b.
The lateral thoracic a.
c.
The subscapular a.→the thoracodorsal a.
the circumflex scapular a.
d.
The post. humeral circumflex a.
e.
The ant. humeral circumflex a.
2 The brachial artery→the deep brachial a.
3 The radial a. →the muscular branches
the superficial palmar branch
the principal a. of thumb
4 The ulnar a. →the muscular branches
the common interossous a.
the deep palmar branch
5 The superficial palmar arch
a.
Formation: terminal part of ulnar a. and the superficial palmar branch of radial a.
b.
Branches: common palmar digital a. →proper palmar digital a.
6 The deep palmar arch
a. Formation: terminal part of radial a. and the deep palmar branch of ulnar a.
b.Branches: palmar metacarpal a.
(七) Arteries of lower limb
1 The femoral a.→
the deep femoral a.→lat. femoral circumflex a.
med. femoral circumflex a.
perforating a.
2 The popliteal a.
3 The post. tibial a. →med. and lat. plantar a.
peroneal a.
4 The ant. tibial a.
5 The dorsal artery of foot →deep plantar a.
the doral first metatarsal a.
Section four the veins
一、The pulmonary veins
four in number → right superior and inferior pulmonary v. , left superior and inferior
pulmonary v.
二、The systemic veins
include three groups: the superior vena cava and its tributaries, the inferior vena cava
and its tributaries, the veins of the heart
(一) The superior vena cava and its tributaries
1 The superior vena cava
2 The brachiocephalic (innominate) veins
a.
The internal jugular v.←the facial v.
the retromandibular v.
b.
The subclavian v. ← the external jugular v.
c.
The veins of upper limb
1) The superficial v.
①The cephalic v.
②The basilic v.
③The median cubital v.
2) The deep v. : accompany the arteries and are similarly named
3 The azygos v. ←the hemiazygos v.
the accessory hemizygos v.
(二) The inferior vena cava and its tributaries
1 The inferior vena cava
2 The common iliac v.
a.
The internal iliac v. ← the parietal tributaries
the visceral tributaries
b.
The external iliac v.
c.
The veins of lower limb
1)
The superficial v.
① The great saphenous v.
② The small saphenous v.
2) The deep v. : accompany the arteries and are similarly named
3 The tributaries of the inferior vena cava
a.
The parietal tributaries
b.
The visceral tributaries
1)
The testicular v. ( the ovarian v. in the female) ← the pampiniform plexus
2)
The renal v.
3)
The suprarenal v.
4)
The hepatic v.
4 The hepatic portal venous system
a.
Composition : hepatic portal v. and its tributaries
b.
The hepatic portal v.
c.
The tributaries of the hepatic portal v.
1)
The sup. mesenteric v.
2)
The inf. mesenteric v.
3)
The splenic v.
4)
The left and right gastric v.
5)
The paraumbilical v.
d.
The anastomoses between the hepatic portal venous system
1)
hepatic portal v. →left gastric v. →esophageal venous plexus→esophageal v. →azygos
v. →sup. vena cava
2)
hepatic portal v. →inf. mesenteric v. →sup. rectal v. →rectal venous plexus →inf. rectal
and anal v. →internal iliac v. → common iliac v. →inf. vena cava
3)
hepatic portal v. →paraumbilical v. →periumbilical venous network →
①thoracoepigastric and sup. epigastric v. →sup. vena cava ②superficial and inf.
epigastric v. →inf. vena cava
4) hepatic portal v. →small tributaries of the superior and inferior mesenteric v. → small
tributaries of the posterior intercostals v.,inferior phrenic v., renal v.and testicular v. →sup. and
inf. vena cavae
5) hepatic portal v. →small tributaries of the superior and inferior mesenteric v. → vertebral
venous plexus→small tributaries of the posterior intercostals v., lumbar v. →sup. and inf. vena
cavae
Chapter two The lymphatic system
Section one
Introduction
一、Composition : lymphatic vessels , lymphatic tissue and lymphatic organs
二、The lymphatic vessels
1 The lymphatic capillary
2 The lymphatic vessels
3 The trunks : nine trunks →
the right and left jugular trunks, the right and left subclavian trunks, the right and left
bronchomediastinal trunks, the right and left lumbar trunks, the intestinal trunk
4 The lymphatic ducts:
the right lymphatic duct and the thoracic duct
三、
The lymphatic tissue
四、
The lymphatic organs
Include lymph nodes, thymus,spleen and tonsils.
1 Lymph nodes
a Mophology : bean-shaped matter. The afferent and efferent lymph vessels enter and leave the
nodes.
b Groups: superficial and deep lymph nodes
c Regional lymph node
Section two
The lymphatic ducts
1 The thoracic duct(left lymphatic duct)
a Coures :arise from the cisterna chyli and ends by opening into the left venous angle.
b Collecting lymph vessels:
six trunks. About three-quarters of the body
2 The right lymphatic duct
three trunks. About upper right quadrant of the body.
Section three
The lymphatic drainage
一、The lymphatic drainage of head
1 Location : around the adjoining part of the head and neck.
2 Lymph nodes
二、The lymphatic drainage of neck
1 Anterior cervical lymph node
2 Lateral cervical lymph node
a Superficial lateral cervical lymph nodes
lie along external jugular v.
b Deep lateral cervical lymph nodes
lie along internal jugular v.
1) Superior deep lateral cervical lymph nodes
retropharyngeal nodes, jugulodigastric lymph nodes, juguloomohyoid lymph nodes
2) Inferior deep lateral cervical lymph nodes
supraclavicular lymph nodes ( left →Virchow lymph nodes )
三、The lymphatic drainage of upper limb
1 Supratrochlear lymph nodes
2 Infraclavicular nodes
3 The axillary lymph nodes
a.
The anterior group(pectoral lymph nodes)
b.
The lateral group
c.
The posterior group(subscapular group)
d.
The central group
e.
The apical group
四、The lymphatic drainage of thorax
1 Lymph nodes of thoracic wall
a.
parasternal lymph nodes
b.
intercostal lymph nodes
2 Lymph nodes of thoracic viscera
a.
anterior mediastinal lymph nodes
b.
posterior mediastinal lymph nodes
c.
lymph nodes of trachea, bronchus and lungs
1)
pulmonary lymph nodes
2)
bronchopulmonary lymph nodes
3)
tracheobronchial lymph nodes
4)
paratracheal lymph nodes
五、The lymphatic drainage of abdomen
1 Lymph nodes of the abdominal wall
2 Lymph nodes of the abdominal viscera
paired viscera→lumbar lymph nodes
unpaired viscera→the celiac lymph nodes , the superior mesenteric lymph nodes and inferior
mesenteric lymph nodes
六、The lymphatic drainage of pelvis
1 The common iliac lymph nodes
2 The internal iliac lymph nodes
3 The external iliac lymph nodes
七、The lymphatic drainage of lower limb
1 Popliteal lymph nodes
2 Superficial inguinal lymph nodes
3 Deep inguinal lymph nodes
Section four
The spleen
1 Location : in the left hypochondriac region, between the ninth rib and the eleven rib
2 Formation : splenic notch on the superior border
3 Accessory spleen