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Lab 8: Blood Vessels Identify the great arteries and veins of the upper part of the body: right and left internal jugular and subclavian veins; right and left brachiocephalic veins; superior vena cava (SC ); the azygos vein; arch of the aorta and the descending thoracic aorta; pulmonary trunk, right and left pulmonary arteries and ligamentum arteriosum connecting the aortic arch and left pulmonary artery noting the course of the left recurrent laryngeal nerve hooking below the ligamentum and the aortic arch; brachiocephalic trunk, common carotid (right and left), and subclavian (right and left) arteries; external and internal carotid arteries; axillary, brachial, radial and ulnar arteries and corresponding veins and venae comitantes; internal thoracic arteries and veins, both sides; posterior intercostal arteries and veins, right side; cephalic vein; basilic vein; median cubital vein. Identify the following great arteries and veins of the lower part of the body: abdominal aorta, right and left common iliac arteries and veins, inferior vena cava (IVC), origins of the celiac trunk, superior and inferior mesenteric arteries, right and left renal arteries and veins, right and left testicular/ovarian arteries and veins, inferior phrenic arteries, median sacral artery, origin of right and left internal iliac artery and the corresponding veins, external iliac arteries and veins, femoral arteries and veins, popliteal, anterior and posterior tibal arteries and corresponding veins, great saphenous vein and small saphenous vein. Christopher Ramnanan, Ph.D. [email protected] Circulation to the Upper Body Review: ‘BCS’ pattern, veins superficial to arteries, phrenic and vagus nerves, asymmetrical recurrent laryngeal nerves L Common Carotid A. L Internal Jugular V R Common Carotid A. R Internal Jugular V. L Subclavian A. L Subclavian V. Brachiocephalic Trunk R Subclavian A. R Subclavian V. R Brachiocephalic V. Superior Vena Cava B C S L Brachiocephalic V. Circulation to the Head and Neck Review: -Carotid triangle (carotid bifurcation, carotid sinus, jugular vein, vagus nerve, ansa cervicalis) -Submandibular triangle (submandibular gland, facial artery, CN XII) -IJV vs EJV -Phrenic Nerve and Brachial Plexus roots relative to scalenes Circulation of the Upper Limb Axillary A. (continuation of Subclavian A., recall namechange landmarks) Note: Deep veins in limbs run retrograde with, and named for, partner arteries (venae comitantes); limb veins are valved Cephalic V. (lateral, long) Basilic V. (medial, short) Brachial A. Radial A. Median Cubital V. Ulnar A. Circulation in Anterior Thorax Subclavian A/V Internal Thoracic A/V Anterior Intercostal A/V Circulation in Posterior Thorax Descending (Thoracic) Aorta Supplies: body wall (posterior intercostal a.), bronchial tree (bronchial a.), esophagus (esophageal arteries) SVC and IVC (cut) Drains thoracic structures with assistance of complimentary back body wall venous system (Azygos system; azygos vein drains anteriorly to SVC via Arch of the Azygos on right side of back body wall) Vessels Entering/Exiting Heart Aorta (Arch) SVC leaving left ventricle Pulmonary Trunk (divides into R+L Pulmonary arteries) Leaving right ventricle SVC IVC Pulmonary Veins entering left atrium IVC Abdomen Arterial Supply T12: Celiac Trunk, Inf. Phrenic. A. L1: SMA, Renal A., Middle Suprarenal. A. L2: Gonadal A. L3: IMA L4: Bifurcation of Abd. Aorta L5/S1: Bifurcation of Common Iliac A. Note: Median Sacral A. Median Sacral A. Posterior Abdominal (Caval) Venous Drainage Asymmetrical paired visceral (organ) veins that drain to the IVC include: Suprarenal Veins Renal Veins Gonadal veins Note: IVC, esophagus, and aorta pierce the diaphragm at vertebral levels T8, T10, and T12, respectively IVC formed by union of common iliac veins at ~L5 Common iliac veins formed by union of ext./int. iliac veins The Portal System: Portal Vein (drains foregut; formed by junction of Splenic V. and SMV behind pancreas) Superior Mesenteric Vein (SMV; drains midgut) Inferior Mesenteric Vein (IMV; drains hindgut; usually drains to splenic v.) Splenic Vein The Portal System: GI drainage Portal Vein (drains foregut; formed by junction of Splenic V. and SMV behind pancreas) Superior Mesenteric Vein (SMV; drains midgut) Inferior Mesenteric Vein (IMV; drains hindgut; usually drains to splenic v.) The Caval System in Abdomen: Back Body Wall Drainage Splenic Vein Hepatic Vein (drains liver blood directly to IVC) Renal vein Gonadal Vein Left and Right Common Iliac Veins Join to Form the IVC Proximity of the two systems leads to anatomical communication (4 sites) as well as potential for surgical communications Circulation of the Lower Limb Ext .Iliac A. Femoral A. Deep Femoral A. (hip supply*) Popliteal A. Ant. Tibial A. (becomes Dorsalis Pedis in foot) Post. Tibial A. Fibular A. Great Saphenous V. drains to fem. vein in fem. triangle Small Saphenous V: drains to popliteal v. in popliteal fossa (not shown) Note: Deep veins run retrograde, and named for, partner arteries, in v. comitantes pattern; flow is superficialdeep via perforating veins Superficial Temporal A. Facial A. Common Carotid A Brachial A Radial A Femoral A Popliteal A Post. Tib. A Dorsalis Pedis A LAB 8 CHECKLIST – Review BLOOD VESSELS NB: Items italicized are conceptual, those denoted with a * are FYI ARTERIAL SUPPLY Head/Neck/Thorax - Brachiocephalic Trunk - Right and left subclavian a. - Right and left common carotid a. - Internal carotid a. - External carotid a. -Facial a. -Superficial temp. a. - Intercostal a. - Arch of the aorta - Thoracic (descending) aorta - Pulmonary arteries/trunk - Internal thoracic a. - Posterior intercostal a. Abdomen - Abdominal aorta - Celiac trunk - Inferior phrenic a. - Superior mesenteric a. - Renal a. - Gonadal a. - Inferior mesenteric a. - Bifurcation of abdominal aorta - Common iliac a. - Internal iliac a. - External iliac a. - Median sacral a. Lower Limb - Femoral a. - Deep femoral a. - Popliteal a. - Anterior tibial a. - Posterior tibial a. - Dorsalis pedis Upper Limb - Axillary a. - Brachial a. - Radial a. - Ulnar a. VENOUS DRAINAGE Head/Neck/Thorax -Right and left subclavian v. -Right and left internal jugular v. -Right and left brachiocephalic v. -Right and left external jugular v. -Azygos vein (and arch) -Superior vena cava -Pulmonary Trunk -Internal thoracic v. -Posterior intercostal v. Abdomen -Inferior vena cava -Suprarenal v. -Right and left renal v. -Gonadal v. -Common iliac v. -Internal iliac v. -External iliac v. -Superior mesenteric v. -Inferior mesenteric v. -Splenic v. Upper limb -Axillary v. -Brachial v. -Cephalic v. -Basilic v. -Median cubital v. Lower limb - Great saphenous v. - Femoral vein - Small saphenous v. - Popliteal v. - Ant./Post tibial v. Other objectives from this lab: -ligamentum arteriosum -left recurrent laryngeal nerve Objectives from Lab 2 that are also testable on Final: -Hepatic portal v. -Superior mesenteric v. -Inferior mesenteric v. -Splenic v.