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CARDIOVASCULAR
DANIL HAMMOUDI.MD
18
Systemic Circulation
Figure 19.19
Pulmonary Circulation
Figure 19.18b
1. Thyroid gland
2. Trachea
3. Brachiocephalic
artery
4. Common carotid
artery
5. Internal jugular vein
6. Superior vena cava
Figure 19.21a
Superficial
temporal artery
Basilar artery
Occipital artery
Vertebral artery
Internal
carotid artery
External
carotid artery
Common
carotid artery
Thyrocervical
trunk
Costocervical
trunk
Subclavian
artery
Axillary
artery
(b)
Ophthalmic artery
Maxillary artery
Facial artery
Lingual artery
Superior thyroid
artery
Larynx
Thyroid gland
(overlying trachea)
Clavicle (cut)
Brachiocephalic
trunk
Internal thoracic
artery
Figure 19.21b
Figure 19.20 Schematic flowchart
showing an overview of the systemic
circulation.
Common
carotid arteries
to head and
subclavian
arteries to
upper limbs
Capillary beds of
head and
upper limbs
Superior
vena cava
Aortic
arch
Aorta
RA
LA
RV
Inferior
vena
cava
LV
Azygos
system
Thoracic
aorta
Venous
drainage
Arterial
blood
Capillary beds of
mediastinal structures
and thorax walls
Diaphragm
Abdominal
aorta
Inferior
vena
cava
Capillary beds of
digestive viscera,
spleen, pancreas,
kidneys
Capillary beds of gonads,
pelvis, and lower limbs
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Figure 19.21a Major arteries of the
systemic circulation.
R. external
carotid artery
R. vertebral
R. axillary
R. subclavian
– neck and
R. upper limb
R. internal
carotid artery
R. common carotid
– right side of head and neck
Brachiocephalic
– head, neck, and
R. upper limb
Arteries of
R. upper
limb
L. external
carotid artery
L. internal
carotid artery
L. common carotid
– left side of head and neck
Aortic arch
L. vertebral
L. subclavian
– neck and L.
upper limb
L. axillary
Arteries of
L. upper
limb
Ascending aorta
– L. ventricle to sternal angle
L. and R. coronary
arteries
Thoracic aorta T5 – T12 (diaphragm)
L. ventricle of heart
Parietal branches
Visceral branches
Mediastinal
– posterior
mediastinum
Esophageal
– esophagus
Bronchial
– lungs and
bronchi
Pericardial
– pericardium
Posterior intercostals
– intercostal muscles, spinal
cord, vertebrae, pleurae, skin
Superior phrenics
– posterior and superior
diaphragm
Diaphragm
Abdominal aorta T12 (diaphragm) – L4
Parietal branches
Visceral branches
Gonadal
– testes or
ovaries
Suprarenal
– adrenal
glands
and
Renal
– kidneys
Superior
and inferior
mesenterics
– small
intestine
– colon
Celiac trunk
– liver
– gallbladder
– spleen
– stomach
– esophagus
– duodenum
R. common iliac
– pelvis and R. lower limb
Arteries of R. lower limb
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Inferior phrenics
– inferior diaphragm
Lumbars
– posterior
abdominal
wall
Median sacral
– sacrum
– coccyx
L. common iliac
– pelvis and L. lower limb
(a) Schematic flowchart
Arteries of L. lower limb
Figure 19.21b Major arteries of the
Arteries that supply
systemic circulation.
the upper limb
Arteries of the head and trunk
Internal carotid artery
External carotid artery
Common carotid arteries
Vertebral artery
Subclavian artery
Brachiocephalic trunk
Aortic arch
Ascending aorta
Coronary artery
Thoracic aorta (above
diaphragm)
Celiac trunk
Abdominal aorta
Superior mesenteric artery
Renal artery
Gonadal artery
Common iliac artery
Inferior mesenteric artery
Internal iliac artery
(b) Illustration, anterior
view
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Subclavian artery
Axillary artery
Brachial artery
Radial artery
Ulnar artery
Deep palmar arch
Superficial palmar arch
Digital arteries
Arteries that supply
the lower limb
External iliac artery
Femoral artery
Popliteal artery
Anterior tibial artery
Posterior tibial artery
Arcuate artery
Arteries of
the head,
neck, and
brain.
R. and L. anterior cerebral arteries
R. middle
cerebral
artery
Anterior
communicating
artery
Cerebral arterial circle
Ophthalmic
artery
Superficial
temporal
artery
Maxillary
artery
R. and L.
posterior
communicating
arteries
R. posterior
cerebral
artery
Basilar
artery
R. and L.
vertebral
arteries
Occipital
artery
Facial
artery
R. and L.
internal
internal
arteries
Lingual
artery
Superior
thyroid
artery
R. and L.
external
carotid
arteries
R. and L.
common
carotid
arteries
R. and L.
subclavian
arteries
Brachiocephalic trunk
Aortic arch
(a) Schematic flowchart
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Arteries of the head, neck, and brain.
Ophthalmic artery
Branches of
the external
carotid artery
Basilar artery
Vertebral artery
• Superficial
temporal artery
• Maxillary artery
• Occipital artery
• Facial artery
• Lingual artery
• Superior thyroid
artery
Internal
carotid artery
External
carotid artery
Common
carotid artery
Thyrocervical
trunk
Costocervical
trunk
Subclavian
artery
Axillary
artery
Larynx
Thyroid gland
(overlying trachea)
Clavicle (cut)
Brachiocephalic
trunk
Internal thoracic
artery
(b) Arteries of the head and neck, right aspect
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Arteries of the head, neck, and brain.
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Figure 19.22d Arteries
of the head, neck,
Anterior
Cerebral arterial
Frontal lobe
circle
and
brain.
(circle of Willis)
Optic chiasma
• Anterior
communicating
artery
• Anterior
cerebral artery
• Posterior
communicating
artery
• Posterior
cerebral artery
Basilar artery
Middle
cerebral
artery
Internal
carotid
artery
Mammillary
body
Temporal
lobe
Pons
Occipital lobe
Vertebral artery
Cerebellum
Posterior
(d) Major arteries serving the brain (inferior view, right side
of cerebellum and part of right temporal lobe removed)
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ICA Internal Carotid A &
branches (the ICA bifurcates
into the ACA & MCA)
•ACA - Anterior cerebral artery
•A-Com - Anterior
communicating Artery
•MCA - Middle cerebral artery
•P-Com - Posterior
communicating artery
VA Vertebral artery (the left
and right vertebral arteries join
to form the basilar artery)
Basilar artery & its branches
•PCA - Posterior cerebral artery
•SCA - Superior cerebellar
artery
•PICA - Posterior inferior
cerebellar artery
Figure 19.21d
Veins of the Brain
Superior sagittal
sinus
Falx cerebri
Inferior sagittal
sinus
Straight sinus
Cavernous sinus
Junction of sinuses
Transverse sinuses
Sigmoid sinus
Jugular foramen
(c)
Right internal
jugular vein
Figure 19.26c
FigureSuperior
19.27c
sagittal Venous drainage of the
sinus
neck, and brain.
Falx head,
cerebri
Inferior sagittal
sinus
Cavernous
sinus
Straight sinus
Confluence
of sinuses
Transverse
sinuses
Sigmoid sinus
Jugular foramen
Right internal
jugular vein
(c) Dural venous sinuses of the brain
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Veins of the Upper Limbs and Thorax
Internal jugular vein
External jugular vein
Brachiocephalic veins
Left subclavian vein
Right subclavian vein
Superior vena cava
Axillary vein
Azygos vein
Accessory hemiazygos vein
Brachial vein
Cephalic vein
Basilic vein
Hemiazygos vein
Posterior
intercostals
Inferior
vena cava
Ascending
lumbar vein
Median
cubital vein
Median
antebrachial
vein
Cephalic
vein
Radial
vein
Basilic vein
Ulnar vein
Deep palmar
venous arch
Superficial palmar
venous arch
Digital veins
(b)
Figure 19.27b
Common carotid
arteries
Right subclavian
artery
Left subclavian
artery
Left axillary
artery
Brachiocephalic
trunk
Vertebral artery
Thyrocervical trunk
Costocervical trunk
Suprascapular artery
Thoracoacromial artery
Axillary artery
Subscapular artery
Posterior circumflex
humeral artery
Anterior circumflex
humeral artery
Brachial artery
Posterior
intercostal
arteries
Anterior
intercostal
artery
Internal
thoracic
artery
Descending
aorta
Lateral
thoracic
artery
Deep artery
of arm
Common
interosseous
artery
Radial
artery
Ulnar
artery
Deep palmar arch
Superficial palmar arch
Digitals
(b)
Figure 19.22b
Arteries of the Abdomen
Liver (cut)
Inferior vena cava
Celiac trunk
Hepatic artery
proper
Common hepatic
artery
Right gastric artery
Gallbladder
Gastroduodenal
artery
Right gastroepiploic
artery
Duodenum
Abdominal aorta
(b)
Diaphragm
Esophagus
Left gastric
artery
Left gastroepiploic
artery
Splenic artery
Spleen
Stomach
Pancreas
(major portion
lies posterior
to stomach)
Superior
mesenteric
artery
Figure 19.23b
Opening
for inferior
vena cava
Arteries of the Abdomen
Hiatus (opening)
for esophagus
Celiac trunk
Diaphragm
Inferior phrenic
artery
Middle suprarenal
artery
Renal artery
Kidney
Superior
mesenteric artery
Lumbar arteries
Abdominal aorta
Median sacral
artery
Gonadal (testicular
or ovarian) artery
Inferior
mesenteric artery
Common iliac artery
Ureter
(c)
Figure 19.23c
Arteries of the
Lower Limbs
Common iliac artery
Internal iliac artery
Superior gluteal artery
External iliac artery
Deep artery of thigh
Lateral circumflex
femoral artery
Medial circumflex
femoral artery
Obturator artery
Femoral artery
Adductor hiatus
Popliteal artery
Anterior tibial artery
Posterior tibial artery
Fibular artery
Popliteal
artery
Posterior
tibial
artery
Lateral
plantar
artery
Medial
plantar
artery
Anterior
tibial
artery
Fibular
artery
Dorsalis
pedis artery
(from top
of foot)
Plantar
arch
(c)
Dorsalis pedis artery
Arcuate artery
Metatarsal arteries
(b)
Figure 19.24b, c
Figure 19.23a Arteries of the right upper
limb and thorax.
R. vertebral artery
Thyrocervical trunk
Suprascapular artery
R. common carotid artery
L. common carotid artery
L. vertebral artery
L. subclavian artery
R. subclavian artery
Axillary artery
Thoracoacromial artery
Thoracoacromial artery
(pectoral branch)
Anterior and posterior
circumflex humeral
arteries
Brachial artery
Deep artery of arm
Aortic arch
Brachiocephalic
trunk
Internal
thoracic
artery
Anterior
Posterior intercostal
intercostal
arteries
arteries
Lateral
thoracic
Descending thoracic aorta
artery
Subscapular
artery
Anastomosis
Common
interosseus
artery
Radial artery
Ulnar artery
Deep palmar arch
Metacarpal arteries
Superficial palmar arch
(a) Schematic flowchart
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Costocervical trunk
Digital arteries
Figure
19.23b Arteries of the
right
upper
Vertebral artery
Common carotid
arteries
Thyrocervical trunk
limb
and
thorax.
Left subclavian artery
Suprascapular artery
Costocervical trunk
Thoracoacromial artery
Axillary artery
Posterior circumflex
humeral artery
Anterior circumflex
humeral artery
Subscapular artery
Brachial artery
Deep artery of arm
Common
interosseous
artery
Right subclavian artery
Brachiocephalic trunk
Posterior intercostal
arteries
Anterior intercostal
artery
Internal thoracic artery
Descending aorta
Lateral thoracic artery
Radial artery
Ulnar artery
Deep palmar arch
Superficial palmar arch
Digital arteries
(b) Illustration, anterior view
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Figure 19.24a Arteries of the abdomen.
Diaphragm
Abdominal
aorta
Inferior
phrenic
arteries
L. gastric artery
Common
hepatic
artery
Celiac
trunk
Splenic
artery
Middle
suprarenal
arteries
R. gastric
artery
Hepatic
L
artery
proper
Gastroduodenal R
artery
R. gastroepiploic
artery
L. gastroepiploic artery
Middle Intestinal arteries
colic
artery
Superior
mesenteric
artery
R.
colic
artery
Renal
arteries
Gonadal
arteries
Ileocolic artery
Sigmoidal
arteries
Inferior
mesenteric
artery
L. colic
artery
Lumbar
arteries
(a) Schematic flowchart.
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Median sacral artery
Common iliac arteries
Superior rectal
artery
Figure 19.24b Arteries of the abdomen.
Liver (cut)
Inferior vena cava
Diaphragm
Esophagus
Celiac trunk
Common hepatic
artery
Hepatic artery
proper
Gastroduodenal
artery
Right gastric artery
Gallbladder
Pancreas
(major portion lies
posterior to stomach)
Duodenum
Abdominal aorta
Left gastric
artery
Stomach
Splenic artery
Left
gastroepiploic
artery
Spleen
Right
gastroepiploic
artery
Superior
mesenteric
mesenteric
(b) The celiac trunk and its major branches. The left half of the liver has been removed.
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Figure 19.24c Arteries of the abdomen.
Hiatus (opening)
for inferior
vena cava
Hiatus (opening)
for esophagus
Adrenal
(suprarenal)
gland
Kidney
Celiac trunk
Abdominal aorta
Lumbar arteries
Ureter
Median sacral
artery
(c) Major branches of the abdominal aorta.
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Diaphragm
Inferior
phrenic artery
Middle
suprarenal
artery
Renal artery
Superior
mesenteric
artery
Gonadal
(testicular or
ovarian) artery
Inferior
mesenteric
artery
Common
iliac artery
Figure 19.24d Arteries of the abdomen.
Celiac trunk
Transverse colon
Superior
mesenteric artery
Aorta
Branches of
the superior
mesenteric artery
• Middle colic artery
• Intestinal arteries
• Right colic artery
• Ileocolic artery
Ascending colon
Right common iliac
artery
Inferior mesenteric
artery
Branches of
the inferior
mesenteric
artery
• Left colic artery
• Sigmoidal arteries
• Superior rectal
artery
Descending colon
Ileum
Cecum
Sigmoid colon
Appendix
Rectum
(d) Distribution of the superior and inferior mesenteric arteries.
The transverse colon has been pulled superiorly.
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Figure 19.25a Arteries of the right pelvis
and lower limb.
Abdominal
aorta
Superior gluteal
artery
Internal
iliac
artery
Inferior
gluteal
artery
Internal
pudendal
Medial
circumflex
femoral
artery
Lateral
circumflex
femoral
artery
Deep artery
of thigh
Common
iliac artery
Obturator
artery
External
iliac
artery
Femoral
artery
Adductor
hiatus
Arterial
anastomosis
Popliteal
artery
Anterior
tibial
artery
Posterior tibial
artery
Fibular
(peroneal)
artery
Dorsalis
pedis
artery
Lateral
plantar
artery
Arcuate
artery
Dorsal metatarsal
arteries
(a) Schematic flowchart
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Lateral
plantar
artery
Medial
plantar
artery
Plantar arch
Plantar
metatarsal arteries
Figure 19.25b
Arteries
of the right pelvis
Common iliac
artery
Internal iliac artery
and
lower
limb.
Superior
gluteal
artery
External iliac artery
Deep artery of thigh
Lateral circumflex
femoral artery
Medial circumflex
femoral artery
Obturator artery
Femoral artery
Adductor hiatus
Popliteal artery
Anterior tibial artery
Posterior tibial artery
Fibular artery
Dorsalis pedis artery
Arcuate artery
Dorsal metatarsal
arteries
(b) Anterior view
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Figure 19.25c Arteries of the right pelvis
and lowerPopliteal
limb.artery
Anterior tibial artery
Posterior tibial
artery
Lateral plantar
artery
Medial plantar
artery
(c) Posterior view
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Fibular artery
Dorsalis pedis artery
(from top of foot)
Plantar arch
Figure 19.26a Major veins of the systemic
circulation.
Veins of
R. upper
limb
R. axillary
R. external
jugular
– superficial
head and neck
R. vertebral
– cervical spinal
cord and
vertebrae
Intracranial
dural venous sinuses
R. internal jugular
– dural venous
sinuses of the brain
R. subclavian
– R. head, neck,
and upper
limb
Same as R. brachiocephalic
R. brachiocephalic
– R. side of head and R. upper limb
L. brachiocephalic
– L. side of head and L. upper limb
Superior vena cava
– runs from union of brachiocephalic
veins behind manubrium to R. atrium
Azygos system
– drains much of
thorax
R. atrium of heart
Diaphragm
Inferior vena cava
– runs from junction of common iliac
veins at L5 to R. atrium of heart
R. suprarenal
(L. suprarenal drains
into L. renal vein)
– adrenal glands
R. gonadal
(L. gonadal drains
into L. renal vein)
– testis or ovary
R. common iliac
– pelvis and R. lower
limb
(a) Schematic flowchart
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Veins of
R. lower limb
L., R., and middle
hepatic veins
– liver
L. and R. renal veins
– kidneys
Lumbar veins
(several pairs)
– posterior abdominal
wall
L. common iliac
– pelvis and L. lower
limb
Veins of
L. lower limb
Figure 19.26b Major veins of the
systemic circulation.
Veins of the head and trunk
Dural venous sinuses
External jugular vein
Veins that drain
the upper limb
Subclavian vein
Vertebral vein
Axillary vein
Internal jugular vein
Right and left
brachiocephalic veins
Superior vena cava
Great cardiac vein
Hepatic veins
Cephalic vein
Brachial vein
Basilic vein
Splenic vein
Hepatic portal vein
Renal vein
Superior mesenteric
vein
Inferior vena cava
Median cubital vein
Ulnar vein
Radial vein
Digital veins
Veins that drain
the lower limb
External iliac vein
Femoral vein
Inferior mesenteric vein
Great saphenous vein
Common iliac vein
Popliteal vein
Internal iliac vein
Posterior tibial vein
Anterior tibial vein
(b) Illustration, anterior
view. The vessels of the
pulmonary circulation
are not shown.
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Small saphenous vein
Dorsal venous arch
Dorsal metatarsal veins
Figure 19.27a Venous drainage of the
head, neck, and brain.
Superior sagittal sinus
Inferior
sagittal
sinus
Occipital
vein
Superficial
temporal
vein
Straight
sinus
Transverse
sinus
Ophthalmic vein
Cavernous
sinus
Facial vein
Posterior auricular
vein
Sigmoid sinus
Internal jugular vein
External jugular
vein
Vertebral vein
Superior thyroid vein
Middle thyroid vein
Brachiocephalic veins
Subclavian vein
(a) Schematic flowchart
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Superior vena cava
Figure
19.27b Venous drainage of the
Superficial temporal
vein
Ophthalmic vein
head, neck, and brain.
Occipital vein
Posterior
auricular vein
External
jugular vein
Facial vein
Vertebral vein
Internal jugular
vein
Superior and middle
thyroid veins
Brachiocephalic
vein
Subclavian vein
Superior
vena cava
(b) Veins of the head and neck, right superficial aspect
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Figure 19.28a Veins of the thorax and
right upper limb.
Subclavian
Internal
vein
jugular vein
External
Brachiocephalic
Axillary
jugular vein
veins
vein
Superior
vena cava
Accessory
hemiazygos
vein
Median
cubital
vein
Azygos
vein
Brachial
vein
Hemiazygos
vein
Right and left
posterior intercostal
veins
Cephalic
vein
Radial
vein
Median
antebrachial
vein
Basilic
vein
Ulnar
vein
Deep palmar
venous arch
Metacarpal veins
(a) Schematic flowchart
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Superficial
palmar venous arch
Digital veins
Figure 19.28b Veins of theInternal
thorax
and
jugular vein
Brachiocephalic veins
jugular vein
Right subclavian vein
right upper limb.External
Left subclavian vein
Axillary vein
Brachial vein
Cephalic vein
Basilic vein
Superior vena cava
Azygos vein
Accessory hemiazygos
vein
Hemiazygos vein
Posterior intercostals
Inferior vena cava
Ascending lumbar vein
Median cubital vein
Median antebrachial
vein
Cephalic vein
Radial vein
Basilic vein
Ulnar vein
Deep palmar venous arch
Superficial palmar venous arch
Digital veins
(b) Anterior view
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Figure 19.29a Veins of the abdomen.
Cystic vein
Hepatic
portal
system
Inferior
vena cava
Inferior phrenic veins
Hepatic veins
Hepatic portal vein
Superior mesenteric vein
Splenic vein
Suprarenal
veins
Renal veins
Inferior
mesenteric
vein
Gonadal veins
Lumbar veins
R. ascending
lumbar vein
L. ascending
lumbar vein
Common iliac veins
External iliac vein
(a) Schematic flowchart.
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Internal iliac veins
Figure 19.29b Veins of the abdomen.
Hepatic veins
Inferior vena cava
Right suprarenal
vein
Right gonadal
vein
External iliac
vein
(b) Tributaries of the inferior vena cava. Venous drainage
of abdominal organs not drained by the hepatic portal vein.
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Inferior phrenic
vein
Left suprarenal
vein
Renal veins
Left ascending
lumbar vein
Lumbar veins
Left gonadal vein
Common iliac
vein
Internal iliac vein
Figure 19.29c Veins of the abdomen.
Inferior vena cava
(not part of hepatic
portal system)
Hepatic veins
Liver
Hepatic portal
vein
Small intestine
Gastric veins
Spleen
Inferior vena cava
Splenic vein
Right gastroepiploic
vein
Inferior
mesenteric vein
Superior
mesenteric vein
Large intestine
Rectum
(c) The hepatic portal circulation.
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Figure 19.30a Veins of the right lower
limb.
Internal
iliac vein
Inferior
vena cava
Common iliac vein
External iliac vein
Femoral vein
Small
saphenous
vein
Fibular
(peroneal)
vein
Dorsal
venous arch
Dorsal
metatarsal
veins
Great
saphenous
vein
Popliteal
vein
Anterior
tibial vein
Femoral vein
Small saphenous
vein
Fibular (peroneal)
vein
Posterior
tibial vein
Dorsalis
pedis
vein
Plantar veins
Deep plantar arch
Digital veins
Anterior
Posterior
(a) Schematic flowchart of the anterior and posterior veins
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Figure 19.30b Veins of the right lower
iliac vein
limb. Common
Internal iliac vein
External iliac vein
Inguinal ligament
Femoral vein
Great saphenous
vein (superficial)
Popliteal vein
Small saphenous
vein
Fibular vein
Anterior tibial vein
Dorsalis pedis vein
Dorsal venous arch
Dorsal metatarsal
veins
(b) Anterior view
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Figure 19.30c Veins of the right lower
Great saphenous
limb. vein
Popliteal vein
Anterior tibial vein
Fibular vein
Small saphenous
vein (superficial)
Posterior tibial vein
Plantar veins
Deep plantar arch
(c) Posterior view
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Digital veins
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Table 19.2 Influence of Selected
Hormones on Variables Affecting
Blood Pressure
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