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The Circulatory System
How will knowing this help me to be a better
Chiropractor?
1) Understanding cardiac anatomy will help
me perform a better physical exam.
2) It will allow me to explain cardiac and
circulatory dysfunctions to my patients.
3) It will help me in future course work.
• Introduction
– Functions of the circulatory system
• Transportation
– RBC’s carry O2 and CO2
– nutrients
– waste products
– hormones
• Protection
– WBC’s, immune cells, antibodies
Major components of the circulatory
system
• Blood
• Blood vessels
• Heart
The Heart
• Location and General Description
– apex is between 5th and 6th ICS
– Mediastinum - median portion of the thoracic cavity,
contains all thoracic viscera except the lungs.
– Pericardium
• fibrous pericardium
• serous pericardium
– parietal serous pericardium
– visceral serous pericardium - epicardium
• pericardial cavity
• Heart wall
– epicardium
– myocardium
– endocardium
• Heart Chambers and Valves
– 4 chambers, 2 upper atria and 2 lower
ventricles
– interatrial septum
– interventricular septum
– atrial walls and much thinner than
ventricular walls
– atrioventricular valves - right and left
– semilunar valves - aortic and pulmonary
circulation of blood through the heart
Blood from the body returns to the right
atrium via the Vena Cavae, then past the
right AV valve to the
right ventricle. Then past the
semilunar valve into the
pulmonary trunk to the lungs, blood returns in
the pulmonary veins to the
left atrium, past the left AV valve to the
left ventricle, past the semilunar valve
in to the aorta - to be delivered to body
Right Atrium
• Vessels entering the right atrium
– superior Venn cava
– inferior Venn cava
– coronary sinus
• Pectinate muscles
• Fossa ovale
Right Ventricle
– Right atrioventricular valve - tricuspid
valve
– Chordae tendineae
– Papillary muscles
– Trabeculae carneae
– Conus arteriosus
– Pulmonary valve - pulmonary semilunar
valve
– Pulmonary trunk
• Left Atrium
– Pulmonary veins - 4
• Left Ventricle
– Left atrioventricular valve - bicuspid
valve, mitral valve
– Aortic valve - aortic semilunar valve
– Aorta
Conduction System of the Heart
• Sinoatrial node - SA node - internodal
fibers - carry impulses down to the
ventricles
• Atrioventricular node - AV node
• Atrioventricular Bundle - Bundle of His
• Conduction Myofibers - Purkinje Fibers
• Systole - contraction of the heart,
especially the ventricles
• Diastole - postsystolic dilation of the
heart, in which the chambers fill with
blood
Heart sounds
• first heart sound - Lub - closing of the AV
valves, during ventricular systole
• second heart sound - dup - closing of the
semilunar valves, during ventricular diastole
The Coronary Vessels
• Right Coronary Artery
– Right marginal artery
– Posterior Interventricular artery
• Left Coronary Artery
– Anterior Interventricular artery
– Circumflex artery
• Coronary Veins
– Great cardiac vein
– Middle cardiac vein
– Coronary sinus
The Blood Vessels
BP = CO x PR
• Peripheral resistance
– blood vessel length
• obesity
– viscosity of blood
• water consumption and renal output
– vessel diameter
• effects of drugs
• CO = HR x SV
– factors that affect heart rate
– factors that affect stroke volume
Blood Pressure
• 120/80
• 120 = systolic pressure
– pressure generated by the contraction of the left
ventricle
– things that affect systolic pressure
• 80 = diastolic pressure
– pressure present in the arterial system
– due to pressure placed on blood by arterial
walls
The Arteries
• Aortic Arch
– Brachiocephalic Trunk
• Right common carotid artery
• Right subclavian
– Left common carotid artery
– Left subclavian
Blood Supply to the Neck and Head
• Common carotid artery
– Internal carotid artery
•
•
•
•
ophthalmic artery
posterior communicating artery
anterior cerebral artery
middle cerebral artery
Common Carotid artery, cont.
• External carotid artery
–
–
–
–
–
–
–
–
superior thyroid a.
ascending pharyngeal a.
lingual a.
facial a.
maxillary a.
superficial temporal a.
posterior auricular a.
occipital a.
Arteries to the Shoulder and
Upper Extremity
Subclavian artery
• Vertebral artery
– basilar artery
– Circle of Willis
• posterior cerebral artery
• posterior communicating artery
• internal carotid artery
Thyrocervical trunk
• thyroid gland, trachea and larynx
– inferior thyroid a.
– suprascapular a.
– transverse cervical a.
Costocervical trunk
• upper intercostal m., Spinal cord, meninges,
posterior neck muscles.
– superior intercostal a.
– deep cervical a.
• Internal thoracic a.
Axillary artery (inferior to first rib)
• superior thoracic a.
• thoracoacromial a.
–
–
–
–
acromial a.
deltoid a.
pectoral a.
clavicular a.
• lateral thoracic a.
• subscapular a.
– circumflex scapular a.
– thoracodorsal a.
• anterior and posterior circumflex humeral aa.
• Brachial artery (inferior to the teres major m.)
– profunda a.
– superior ulnar collateral a.
– inferior ulnar collateral a.
• Radial artery
– joins ulnar to form the superficial palmar arch
• Ulnar artery
– superficial palmar arch
• Branches of the Thoracic Portion of the
Aorta
– pericardial arteries
– bronchial arteries
– esophageal arteries
– posterior intercostal arteries
– superior phrenic arteries
Branches of the Abdominal Portion of the Aorta
• Inferior phrenic a.
• Celiac Trunk (for foregut derivatives)
– left gastric a.
– common hepatic a.
– splenic a.
• Superior mesenteric a.(for midgut derivatives)
–
–
–
–
–
inferior pancreaticoduodenal a.
jejunal and ileal aa.
Ileocolic a.
right colic a.
middle colic a.
Branches of the Abdominal Aorta, con’t.
• Inferior mesenteric a. (for hind gut derivatives)
– left colic a.
– sigmoid a.
– superior rectal a.
• Renal arteries
– suprarenal a.
• Gonadal arteries
– testicular a. - male
– ovarian a. - female
• Lumbar arteries
• Middle sacral a.
Arteries of the Pelvis and Lower Extremity
• Common iliac arteries
– External iliac a.
• femoral a.
–
–
–
–
–
–
–
–
superficial circumflex iliac a.
superficial epigastric a.
superficial external pudendal a.
deep external pudendal a.
profunda femoris a. - medial and lateral femoral circumflex aa.
Popliteal a.
Anterior Tibial a. - dorsal pedal a and arcuate a.
Posterior Tibial a. - peroneal a. and medial and lateral plantar aa.
– Internal iliac a.
• internal pudendal a. and perineal a.
The Veins
• Veins that Drain the Brain
– Dural Sinuses
• superior sagittal sinus
• inferior sagittal sinus
• straight sinus
• confluence of sinuses
• transverse sinus
• sigmoid sinus
• internal jugular vein
Veins, cont.
• Miscellaneous Veins
– Medial cubital vein
– Great saphenous vein
Portal systems
• Hepatic portal vein
– superior mesenteric vein
– splenic vein
– liver drained by the hepatic vein
• Hypophyseal portal system
– superior hypophyseal a.
– primary plexus
– long and short hypophyseal portal veins - to
adenohypophysis
– secondary plexus
– efferent hypophyseal veins to cavernous sinus
Fetal circulation
The End
of
Systemic Anatomy
Lecture Material