Download Artery Vein - Stephen Tavoni

Chapter Opener 18
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Figure 18.1 Generalized structure of arteries, veins, and capillaries.
Artery
Vein
Tunica intima
• Endothelium
• Subendothelial layer
• Internal elastic membrane
Tunica media
(smooth muscle and
elastic fibers)
• External elastic membrane
Tunica externa
(collagen fibers)
• Vasa vasorum
Artery
Vein
Valve
Capillary
network
Lumen
Capillary
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Lumen
Basement membrane
Endothelial cells
Figure 18.1a Generalized structure of arteries, veins, and capillaries.
Artery
Vein
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Figure 18.1b Generalized structure of arteries, veins, and capillaries.
Tunica intima
• Endothelium
• Subendothelial layer
• Internal elastic membrane
Tunica media
(smooth muscle and
elastic fibers)
• External elastic membrane
Tunica externa
(collagen fibers)
• Vasa vasorum
Artery
Vein
Valve
Capillary
network
Lumen
Capillary
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Lumen
Basement membrane
Endothelial cells
Figure 18.2 The relationship of blood vessels to each other and to lymphatic vessels.
Venous system
Large veins
(capacitance
vessels)
Arterial system
Heart
Elastic
arteries
(conducting
arteries)
Large
lymphatic
vessels
Lymph
node
Lymphatic
system
Small veins
(capacitance
vessels)
Muscular
arteries
(distributing
arteries)
Arteriovenous
anastomosis
Lymphatic
capillaries
Sinusoid
Arterioles
(resistance
vessels)
Terminal
arteriole
Postcapillary
venule
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Thoroughfare
channel
Capillaries
(exchange
vessels)
Precapillary
sphincter
Metarteriole
Table 18.1 Summary of Blood Vessel Anatomy (1 of 2)
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Table 18.1 Summary of Blood Vessel Anatomy (2 of 2)
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Figure 18.3 Capillary structure.
Pericyte
Red blood
cell in lumen
Intercellular
cleft
Endothelial
cell
Basement
membrane
Tight junction
Pinocytotic
Endothelial
vesicles
nucleus
Continuous capillary. Least permeable, and most
common (e.g., skin, muscle).
Pinocytotic
vesicles
Red blood
cell in lumen
Fenestrations
(pores)
Endothelial
nucleus
Basement membrane
Tight junction
Intercellular
cleft
Endothelial
cell
Fenestrated capillary. Large fenestrations (pores)
increase permeability. Occurs in areas of active
absorption or filtration (e.g., kidney, small intestine).
Endothelial
cell
Red blood
cell in lumen
Large
intercellular
cleft
Tight junction
Nucleus of
Incomplete
endothelial
basement
cell
membrane
Sinusoid capillary. Most permeable. Occurs in special
locations (e.g., liver, bone marrow, spleen).
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Figure 18.3a Capillary structure.
Pericyte
Red blood
cell in lumen
Intercellular
cleft
Endothelial
cell
Basement
membrane
Tight junction
Endothelial
nucleus
Pinocytotic
vesicles
Continuous capillary. Least permeable, and most
common (e.g., skin, muscle).
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Figure 18.3b Capillary structure.
Pinocytotic
vesicles
Red blood
cell in lumen
Fenestrations
(pores)
Endothelial
nucleus
Basement membrane
Tight junction
Intercellular
cleft
Endothelial
cell
Fenestrated capillary. Large fenestrations (pores)
increase permeability. Occurs in areas of active
absorption or filtration (e.g., kidney, small intestine).
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Figure 18.3c Capillary structure.
Endothelial
cell
Red blood
cell in lumen
Large
intercellular
cleft
Tight junction
Incomplete
basement
membrane
Nucleus of
endothelial
cell
Sinusoid capillary. Most permeable. Occurs in special
locations (e.g., liver, bone marrow, spleen).
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Figure 18.4 Anatomy of a capillary bed.
Precapillary sphincters
Vascular shunt
Metarteriole Thoroughfare
channel
True
capillaries
Terminal arteriole
Postcapillary venule
Sphincters open—blood flows through true capillaries.
Terminal arteriole
Postcapillary venule
Sphincters closed—blood flows through metarteriole – thoroughfare
channel and bypasses true capillaries.
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Figure 18.4a Anatomy of a capillary bed.
Vascular shunt
Precapillary sphincters
Metarteriole Thoroughfare
channel
True
capillaries
Terminal arteriole
Postcapillary venule
Sphincters open—blood flows through true capillaries.
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Figure 18.4b Anatomy of a capillary bed.
Terminal arteriole
Postcapillary venule
Sphincters closed—blood flows through metarteriole – thoroughfare
channel and bypasses true capillaries.
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Figure 18.5 Relative proportion of blood volume throughout the cardiovascular system.
Pulmonary blood
vessels 12%
Systemic arteries
and arterioles 15%
Heart 8%
Capillaries 5%
Systemic veins
and venules 60%
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Figure 18.6 Blood pressure in various blood vessels of the systemic circulation.
120
Systolic pressure
100
Mean pressure
80
60
40
Diastolic
pressure
20
0
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Figure 18.7 The muscular pump.
Venous valve (open)
Contracted skeletal
muscle
Venous valve
(closed)
Vein
Direction of blood flow
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Figure 18.8 Major factors enhancing cardiac output.
Exercise
BP activates cardiac centers in medulla
Activity of respiratory pump
(ventral body cavity pressure)
Sympathetic activity
Parasympathetic activity
Activity of muscular pump
(skeletal muscles)
Epinephrine in blood
Sympathetic venoconstriction
Venous return
Contractility of cardiac muscle
ESV
EDV
Stroke volume (SV)
Heart rate (HR)
Initial stimulus
Physiological response
Result
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Cardiac output (CO = SV
 HR)
Figure 18.9 Baroreceptor reflexes that help maintain blood pressure homeostasis.
3 Impulses from baroreceptors
stimulate cardioinhibitory center
(and inhibit cardioacceleratory
center) and inhibit vasomotor
center.
4a
Sympathetic
impulses to heart
cause HR,
contractility, and
CO.
2 Baroreceptors
in carotid sinuses
and aortic arch
are stimulated.
4b
Rate of
vasomotor impulses
allows vasodilation,
causing R.
1 Stimulus:
Blood pressure
(arterial blood
pressure rises
above normal
range).
5 CO and R
return blood
pressure to
homeostatic range.
1 Stimulus:
5 CO and R return
blood pressure to
homeostatic range.
Blood pressure
(arterial blood
pressure falls below
normal range).
4b Vasomotor
fibers stimulate
vasoconstriction,
causing R.
2 Baroreceptors
in carotid sinuses
and aortic arch
are inhibited.
4a
Sympathetic
impulses to heart
cause HR,
contractility, and
CO.
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3 Impulses from baroreceptors
activate cardioacceleratory center
(and inhibit cardioinhibitory center)
and stimulate vasomotor center.
Figure 18.9 Baroreceptor reflexes that help maintain blood pressure homeostasis. (1 of 2)
3
Impulses from baroreceptors
stimulate cardioinhibitory center
(and inhibit cardioacceleratory
center) and inhibit vasomotor
center.
4a
Sympathetic
impulses to heart
cause HR,
contractility, and
CO.
2 Baroreceptors
in carotid sinuses
and aortic arch
are stimulated.
4b
Rate of
vasomotor impulses
allows vasodilation,
causing R.
1 Stimulus:
Blood pressure
(arterial blood pressure rises above
normal range).
© 2014 Pearson Education, Inc.
5
CO and R
return blood
pressure to
homeostatic range.
Figure 18.9 Baroreceptor reflexes that help maintain blood pressure homeostasis. (2 of 2)
1 Stimulus:
Blood pressure
(arterial blood
pressure falls below
normal range).
5
CO and R return
blood pressure to
homeostatic range.
4b
Vasomotor
fibers stimulate
vasoconstriction,
causing R.
2
Baroreceptors in
carotid sinuses
and aortic arch
are inhibited.
4a
Sympathetic
impulses to heart
cause HR,
contractility, and
CO.
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3 Impulses from baroreceptors
activate cardioacceleratory center
(and inhibit cardioinhibitory center)
and stimulate vasomotor center.
Table 18.2 Effects of Selected Hormones on Blood Pressure
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Figure 18.10 Direct and indirect (hormonal) mechanisms for renal control of blood pressure.
Direct renal mechanism
Arterial pressure
Indirect renal mechanism (renin-angiotensin-aldosterone)
Initial stimulus
Arterial pressure
Physiological response
Result
Inhibits baroreceptors
Sympathetic nervous
system activity
Filtration by kidneys
Angiotensinogen
Renin release
from kidneys
Angiotensin I
Angiotensin converting
enzyme (ACE)
Angiotensin II
Urine formation
Adrenal cortex
ADH release by
posterior pituitary
Thirst via
hypothalamus
Secretes
Aldosterone
Blood volume
Sodium reabsorption
by kidneys
Water reabsorption
by kidneys
Water intake
Blood volume
Mean arterial pressure
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Mean arterial pressure
Vasoconstriction;
peripheral resistance
Figure 18.11 Factors that increase MAP.
Activity of
muscular
pump and
respiratory
pump
Release
of ANP
Fluid loss from
hemorrhage,
excessive
sweating
Crisis stressors:
exercise, trauma,
body
temperature
Conservation
of Na+ and
water by kidneys
Blood volume
Blood pressure
Blood pH
O2
CO2
Blood
volume
Baroreceptors
Chemoreceptors
Venous
return
Activation of vasomotor and cardioacceleratory centers in brain stem
Stroke
volume
Heart
rate
Vasomotor tone;
bloodborne
chemicals
(epinephrine,
NE, ADH,
angiotensin II)
Diameter of
blood vessels
Cardiac output
Physiological response
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Blood
viscosity
Body size
Blood vessel
length
Peripheral resistance
Initial stimulus
Result
Dehydration,
high hematocrit
Mean arterial pressure (MAP)
Figure 18.12 Body sites where the pulse is most easily palpated.
Superficial temporal artery
Facial artery
Common carotid artery
Brachial artery
Radial artery
Femoral artery
Popliteal artery
Posterior tibial
artery
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Dorsalis pedis
artery
Figure 18.13 Distribution of blood flow at rest and during strenuous exercise.
750
750
Brain
750
Heart
250
12,500
1200
Skeletal
muscles
500
Skin
Kidneys
1100
Abdomen
1400
1900
Other
600
Total blood
flow at rest
5800 ml/min
600
600
400
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Total blood flow during
strenuous exercise
17,500 ml/min
Figure 18.14 Blood flow velocity and total cross-sectional area of vessels.
Relative crosssectional area of
different vessels
of the vascular bed
5000
4000
Total area
(cm2) of the 3000
vascular
2000
bed
1000
0
Velocity of
blood flow
(cm/s)
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50
40
30
20
10
0
Figure 18.15 Intrinsic and extrinsic control of arteriolar smooth muscle in the systemic circulation.
Vasodilators
Metabolic
O2
CO2
H+
K+
• Prostaglandins
• Adenosine
• Nitric oxide
Neuronal
Sympathetic tone
Hormonal
• Atrial natriuretic
peptide
Extrinsic mechanisms
Intrinsic mechanisms
(autoregulation)
Vasoconstrictors
• Metabolic or myogenic controls
• Distribute blood flow to individual
organs and tissues as needed
Myogenic
• Stretch
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Neuronal
Sympathetic tone
Metabolic
Hormonal
• Endothelins
• Angiotensin II
• Antidiuretic hormone
• Epinephrine
• Norepinephrine
• Neuronal or hormonal controls
• Maintain mean arterial pressure
(MAP)
• Redistribute blood during exercise
and thermoregulation
Figure 18.16 Capillary transport mechanisms.
Pinocytotic
vesicles
Red blood
cell in lumen
Endothelial
cell
Fenestration
(pore)
Endothelial
cell nucleus
Basement
membrane
Tight
junction
Lumen
Intercellular
cleft
Caveolae
Pinocytotic
vesicles
Intercellular
cleft
Endothelial
fenestration
(pore)
Basement
membrane
1 Diffusion
through
membrane
(lipid-soluble
substances)
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2 Movement
through
intercellular
clefts (watersoluble
substances)
4 Transport
via vesicles
or caveolae
(large
substances)
3 Movement
through
fenestrations
(water-soluble
substances)
Figure 18.16 Capillary transport mechanisms. (1 of 2)
Pinocytotic
vesicles
Red blood
cell in lumen
Endothelial
cell
Fenestration
(pore)
Endothelial
cell nucleus
Basement
membrane
© 2014 Pearson Education, Inc.
Tight
junction
Intercellular
cleft
Figure 18.16 Capillary transport mechanisms. (2 of 2)
Lumen
Caveolae
Pinocytotic
vesicles
Intercellular
cleft
Endothelial
fenestration
(pore)
Basement
membrane
1 Diffusion
through
membrane
(lipid-soluble
substances)
© 2014 Pearson Education, Inc.
2 Movement
through
intercellular
clefts (watersoluble
substances)
4 Transport
via vesicles
or caveolae
(large
substances)
3 Movement
through
fenestrations
(water-soluble
substances)
Figure 18.17 Bulk fluid flow across capillary walls causes continuous mixing of fluid between the plasma and the
interstitial fluid compartments, and maintains the interstitial environment.
How do the pressures drive fluid flow across a capillary?
Net filtration occurs at the arteriolar end of a capillary.
The big picture
Fluid filters from capillaries at their arteriolar
end and flows through the interstitial space.
Most is reabsorbed at the venous end.
Boundary
(capillary wall)
Capillary
Hydrostatic pressure in capillary
“pushes” fluid out of capillary.
HPc= 35 mm Hg
Osmotic pressure in capillary
“pulls” fluid into capillary.
OPc= 26 mm Hg
Interstitial fluid
Arteriole
Fluid moves through
the interstitial space.
For all capillary beds,
20 L of fluid is filtered
out per day—almost 7
times the total plasma
volume!
To determine the pressure driving
the fluid out of the capillary at any
given point, we calculate the net
Hydrostatic pressure filtration pressure (NFP)––the
HPif = 0 mm Hg in interstitial fluid
outward pressures (HPc and OPif)
“pushes” fluid into
minus the inward pressures
capillary.
(Hpif and OPc). So,
OPif = 1 mm Hg Osmotic pressure in NFP = (HP + OP ) – (HP + OP )
interstitial fluid
“pulls” fluid out of
capillary.
Net filtration pressure (NFP) determines the
direction of fluid movement. Two kinds of
pressure drive fluid flow:
Hydrostatic pressure (HP)
Osmotic pressure (OP)
• Due to fluid pressing against • Due to nondiffusible solutes
that
cannot cross the
a boundary
• HP “pushes” fluid across the boundary
•
OP
“pulls”
fluid across the
boundary
boundary
• In blood vessels, is due to
•
In
blood
vessels,
is due to
blood pressure
plasma proteins
Piston
Boundary
Solute
molecules
(proteins)
“Pushes”
NFP= 10 mm Hg
if
if
c
Net reabsorption occurs at the venous end of a capillary.
17 L of fluid
per day is
reabsorbed
into the
capillaries at the
venous end.
Boundary
“Pulls”
Venule
Capillary
Boundary
(capillary wall)
Hydrostatic pressure in capillary
“pushes” fluid out of capillary.
HPc = 17 mm Hg
The pressure has dropped
because of resistance encountered
along the capillaries.
Osmotic pressure in capillary
“pulls” fluid into capillary.
About 3 L per
day of fluid (and
any leaked
proteins) are
removed by the
lymphatic system
(see Chapter 20).
Interstitial fluid
OPc = 26 mm Hg
Again, we calculate the NFP:
Lymphatic
capillary
HPif = 0 mm Hg
OPif = 1 mm Hg
NFP= –8 mm Hg
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c
= (35 + 1) – (0 + 26)
= 10 mm Hg (net outward
pressure)
As a result, fluid moves from the
capillary into the interstitial space.
Hydrostatic pressure in NFP = (HPc + OPif) – (HPif + OPc)
= (17 + 1) – (0 + 26)
interstitial fluid “pushes”
= –8 mm Hg (net inward
fluid into capillary.
pressure)
Osmotic pressure in
Notice that the NFP at the venous
interstitial fluid “pulls”
end is a negative number. This
fluid out of capillary.
means that reabsorption, not
filtration, is occurring and so fluid
moves from the interstitial space
into the capillary.
Figure 18.17 Bulk fluid flow across capillary walls causes continuous mixing of fluid between the plasma and the
interstitial fluid compartments, and maintains the interstitial environment. (1 of 5)
The big picture
Fluid filters from capillaries at their arteriolar
end and flows through the interstitial space.
Most is reabsorbed at the venous end.
Arteriole
Fluid moves through
the interstitial space.
For all capillary beds,
20 L of fluid is filtered
out per day—almost 7
times the total plasma
volume!
Net filtration pressure (NFP) determines the
direction of fluid movement. Two kinds of
pressure drive fluid flow:
Hydrostatic pressure (HP)
• Due to fluid pressing against a
boundary
• HP “pushes” fluid across the
boundary
• In blood vessels, is due to blood
pressure
Osmotic pressure (OP)
• Due to nondiffusible solutes that
cannot cross the boundary
• OP “pulls” fluid across the
boundary
• In blood vessels, is due to
plasma proteins
Piston
Boundary
“Pushes”
Solute
molecules
(proteins)
17 L of fluid per
day is reabsorbed
into the capillaries
at the venous end.
Boundary
“Pulls”
Venule
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About 3 L per day
of fluid (and any
leaked proteins) are
removed by the
lymphatic system
(see Chapter 20).
Lymphatic
capillary
Figure 18.17 Bulk fluid flow across capillary walls causes continuous mixing of fluid between the plasma and the
interstitial fluid compartments, and maintains the interstitial environment. (2 of 5)
The big picture
Fluid filters from capillaries at their arteriolar
end and flows through the interstitial space.
Most is reabsorbed at the venous end.
Arteriole
Fluid moves through
the interstitial space.
For all capillary beds,
20 L of fluid is filtered
out per day—almost
7times the total plasma
volume!
17 L of fluid per
day is reabsorbed
into the capillaries
at the venous end.
Venule
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About 3 L per day
of fluid (and any
leaked proteins) are
removed by the
lymphatic system
(see Chapter 20).
Lymphatic
capillary
Figure 18.17 Bulk fluid flow across capillary walls causes continuous mixing of fluid between the plasma and the
interstitial fluid compartments, and maintains the interstitial environment. (3 of 5)
Net filtration pressure (NFP) determines the
direction of fluid movement. Two kinds of
pressure drive fluid flow:
Hydrostatic pressure (HP)
Osmotic pressure (OP)
• Due to fluid pressing against a
boundary
• HP “pushes” fluid across the
boundary
• In blood vessels, is due to blood
pressure
• Due to nondiffusible solutes that
cannot cross the boundary
• OP “pulls” fluid across the
boundary
• In blood vessels, is due to
plasma proteins
Piston
Solute
molecules
(proteins)
Boundary
“Pushes”
© 2014 Pearson Education, Inc.
“Pulls”
Boundary
Figure 18.17 Bulk fluid flow across capillary walls causes continuous mixing of fluid between the plasma and the
interstitial fluid compartments, and maintains the interstitial environment. (4 of 5)
How do the pressures drive fluid flow across a capillary?
Net filtration occurs at the arteriolar end of a capillary.
Capillary
Hydrostatic pressure
in capillary “pushes”
fluid out of capillary.
Osmotic pressure in
capillary “pulls” fluid
into capillary.
Boundary
(capillary wall)
HPc = 35 mm Hg
OPc = 26 mm Hg
HPif = 0 mm Hg
OPif = 1 mm Hg
NFP = 10 mm Hg
© 2014 Pearson Education, Inc.
Interstitial fluid
Hydrostatic
pressure in
interstitial fluid
“pushes” fluid
into capillary.
Osmotic pressure
in interstitial fluid
“pulls” fluid out
of capillary.
To determine the pressure driving
the fluid out of the capillary at any
given point, we calculate the net
filtration pressure (NFP)––the
outward pressures (HPc and OPif)
minus the inward pressures
(HPif and OPc). So,
NFP = (HPc + OPif) – (HPif + OPc)
= (35 + 1) – (0 + 26)
= 10 mm Hg (net outward
pressure)
As a result, fluid moves from the
capillary into the interstitial space.
Figure 18.17 Bulk fluid flow across capillary walls causes continuous mixing of fluid between the plasma and the
interstitial fluid compartments, and maintains the interstitial environment. (5 of 5)
Net reabsorption occurs at the venous end of a capillary.
Boundary
(capillary wall)
Capillary
Interstitial fluid
Hydrostatic pressure in capillary
HPc = 17 mm Hg
“pushes” fluid out of capillary.
The pressure has dropped
because of resistance encountered
along the capillaries.
Osmotic pressure in capillary
“pulls” fluid into capillary.
OPc = 26 mm Hg
HPif = 0 mm Hg
Hydrostatic pressure in
interstitial fluid “pushes”
fluid into capillary.
OPif = 1 mm Hg
Osmotic pressure in
interstitial fluid “pulls”
fluid out of capillary.
NFP= –8 mm Hg
© 2014 Pearson Education, Inc.
Again, we calculate the NFP:
NFP = (HPc + OPif) – (HPif + OPc)
= (17 + 1) – (0 + 26)
= –8 mm Hg (net inward
pressure)
Notice that the NFP at the venous
end is a negative number. This
means that reabsorption, not
filtration, is occurring and so fluid
moves from the interstitial space
into the capillary.
Figure 18.18 Events and signs of hypovolemic shock.
Acute bleeding (or other events that reduce
blood volume) leads to:
1. Inadequate tissue perfusion
resulting in O2 and nutrients to cells
Initial stimulus
Physiological response
Signs and symptoms
Result
2. Anaerobic metabolism by cells, so lactic
acid accumulates
3. Movement of interstitial fluid into blood,
so tissues dehydrate
Chemoreceptors activated
(by in blood pH)
Baroreceptor firing reduced
(by blood volume and pressure)
Hypothalamus activated
(by blood pressure)
Brain
Minor effect
Major effect
Respiratory centers
activated
Cardioacceleratory and
vasomotor centers activated
Heart rate
Sympathetic nervous
system activated
ADH
released
Neurons
depressed
by pH
Intense vasoconstriction
(only heart and brain spared)
Central
nervous system
depressed
Kidneys
Renal blood flow
Adrenal
cortex
Renin released
Angiotensin II
produced in blood
Aldosterone
released
Rate and
depth of
breathing
CO2 blown
off; blood
pH rises
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Tachycardia;
weak, thready
pulse
Kidneys retain
salt and water
Skin becomes
cold, clammy,
and cyanotic
Blood pressure maintained;
if fluid volume continues to
decrease, BP ultimately
drops. BP is a late sign.
Water
retention
Urine output
Thirst
Restlessness
(early sign)
Coma
(late sign)
Figure 18.19 Pulmonary circulation.
Pulmonary
capillaries
of the
R. lung
Pulmonary
capillaries
of the
L. lung
R. pulmonary L. pulmonary
artery
artery
To
systemic
circulation
Pulmonary
trunk
R. pulmonary veins
From
systemic
circulation
RA
LA
RV
LV
L. pulmonary
veins
Schematic flowchart.
Left pulmonary
artery
Air-filled
alveolus
of lung
Aortic arch
Pulmonary trunk
Right pulmonary
artery
Three lobar arteries
to right lung
Pulmonary
capillary
Gas exchange
Two lobar arteries
to left lung
Pulmonary
veins
Pulmonary
veins
Right
atrium
Left atrium
Right
ventricle
Left
ventricle
Illustration. The pulmonary arterial system is shown in blue to indicate that the blood it carries is oxygen-poor.
The pulmonary venous drainage is shown in red to indicate that the blood it transports is oxygen-rich.
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Figure 18.19a Pulmonary circulation.
Pulmonary
capillaries
of the
R. lung
R. pulmonary
artery
Pulmonary
capillaries
of the
L. lung
L. pulmonary
artery
To
systemic
circulation
Pulmonary
trunk
R. pulmonary veins
From
systemic
circulation
LA
RA
L. pulmonary
veins
RV
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Schematic flowchart.
LV
Figure 18.19b Pulmonary circulation.
Left pulmonary
artery
Aortic arch
Air-filled
alveolus
of lung
Pulmonary trunk
Right pulmonary
artery
Three lobar
arteries to
right lung
Pulmonary
capillary
Gas exchange
Two lobar arteries
to left lung
Pulmonary
veins
Right
atrium
Pulmonary
veins
Left atrium
Right
ventricle
Left
ventricle
Illustration. The pulmonary arterial system is shown in blue to indicate that the
blood it carries is oxygen-poor. The pulmonary venous drainage is shown in red
to indicate that the blood it transports is oxygen-rich.
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Figure 18.20 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 LV
Azygos
system
Venous
drainage
Inferior
vena
cava
Thoracic
aorta
Arterial
blood
Capillary beds of
mediastinal structures
and thorax walls
Diaphragm
Abdominal
aorta
Inferior
vena
cava
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Capillary beds of
digestive viscera,
spleen, pancreas,
kidneys
Capillary beds of
gonads, pelvis, and
lower limbs
Figure 18.21a Major arteries of the systemic circulation.
R. internal
carotid artery
R. external
carotid artery
R. common carotid
– right side of head and neck
R. vertebral
R. axillary
R. subclavian
– neck and
R. upper limb
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
L. vertebral
L. subclavian
– neck and L.
upper limb
Aortic arch
L. axillary
Arteries of
L. upper
limb
Ascending aorta
– L. ventricle to sternal angle
Thoracic aorta T5–T12 (diaphragm)
L. and R. coronary
arteries
L. ventricle of heart
Visceral branches
Mediastinal
– posterior
mediastinum
Esophageal
– esophagus
Bronchial
– lungs and
bronchi
Parietal branches
Pericardial
– pericardium
Posterior intercostals
– intercostal muscles, spinal
cord, vertebrae, pleurae, skin
Superior phrenics
– posterior and superior
diaphragm
Diaphragm
Abdominal aorta T12 (diaphragm)–L4
Visceral branches
Gonadal
– testes or
ovaries
Suprarenal
– adrenal
glands
and
Renal
– kidneys
Superior
and inferior
mesenterics
– small
intestine
– colon
Parietal branches
Celiac trunk
– liver
– gallbladder
– spleen
– stomach
– esophagus
– duodenum
R. common iliac
– pelvis and R. lower limb
Arteries of R. lower limb
Schematic flowchart
© 2014 Pearson Education, Inc.
Inferior phrenics
– inferior diaphragm
Lumbars
– posterior
abdominal
wall
Median sacral
– sacrum
– coccyx
L. common iliac
– pelvis and L. lower limb
Arteries of L. lower limb
Figure 18.21b Major arteries of the systemic circulation.
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
Celiac trunk
Abdominal aorta
Superior mesenteric
artery
Renal artery
Gonadal artery
Inferior mesenteric artery
Arteries that supply the upper limb
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
Common iliac artery
Popliteal artery
Internal iliac artery
Anterior tibial artery
Posterior tibial artery
Illustration, anterior view
© 2014 Pearson Education, Inc.
Arcuate artery
Figure 18.22a Arteries of the head, neck, and brain.
R. Middle
cerebral
artery
R. and L. anterior
cerebral arteries
Anterior
communicating artery
Cerebral arterial circle
R. and L.
Posterior
communicating arteries
Ophthalmic artery
Superficial
temporal
artery
R. posterior
cerebral
artery
Basilar
artery
R. and L.
vertebral
arteries
Maxillary
artery
Occipital
artery
R. and L.
internal
carotid
arteries
Facial
artery
Lingual
artery
R. and L.
external
carotid
arteries
Superior
thyroid
artery
R. and L.
common
carotid
arteries
R. and L.
subclavian
arteries
Brachiocephalic trunk
Aortic arch
Schematic flowchart
© 2014 Pearson Education, Inc.
Figure 18.22b–d Arteries of the head, neck, and brain.
Ophthalmic artery
Basilar artery
Branches of
the external
carotid artery
Vertebral
artery
• Superficial
temporal artery
Internal
carotid artery
External
carotid artery
Common
carotid artery
Thyrocervical
trunk
Costocervical
trunk
Subclavian
artery
Axillary
artery
• Maxillary artery
• Occipital artery
• Facial artery
• Lingual artery
• Superior thyroid
artery
Larynx
Thyroid gland
(overlying trachea)
Clavicle (cut)
Brachiocephalic
trunk
Internal thoracic
artery
Anterior
Arteries of th e head and neck, right aspect
Cerebral arterial
circle
(circle of Willis)
Frontal lobe
Optic chiasma
• Anterior
communicating
artery
Middle
cerebral
artery
• Anterior
cerebral artery
Internal
carotid
artery
• Posterior
communicating
artery
Mammillary
body
• Posterior
cerebral artery
Basilar artery
Temporal
lobe
Vertebral artery
Pons
Occipital lobe
Cerebellum
Posterior
Colorized arteriograph of the arterial supply
of the brain
© 2014 Pearson Education, Inc.
Major arteries serving the brain (inferior view, right side
of cerebellum and part of right temporal lobe removed)
Figure 18.22b Arteries of the head, neck, and brain.
Ophthalmic artery
Basilar artery
Vertebral
artery
Internal
carotid artery
External
carotid artery
Common
carotid artery
Thyrocervical
trunk
Costocervical
trunk
Subclavian
artery
Axillary
artery
Arteries of the head and neck, right aspect
© 2014 Pearson Education, Inc.
Branches of
the external
carotid artery
• Superficial
temporal artery
• Maxillary artery
• Occipital artery
• Facial artery
• Lingual artery
• Superior thyroid
artery
Larynx
Thyroid gland
(overlying trachea)
Clavicle (cut)
Brachiocephalic
trunk
Internal thoracic
artery
Figure 18.22c Arteries of the head, neck, and brain.
© 2014 Pearson Education, Inc.
Colorized arteriograph of the arterial supply
of the brain
Figure 18.22d Arteries of the head, neck, and brain.
Anterior
Cerebral arterial
circle
(circle of Willis)
Frontal lobe
Optic chiasma
• Anterior
communicating
artery
Middle
cerebral
artery
• Anterior
cerebral artery
Internal
carotid
artery
• Posterior
communicating
artery
Mammillary
body
• Posterior
cerebral artery
Basilar artery
Temporal
lobe
Vertebral artery
Pons
Occipital lobe
Cerebellum
Posterior
Major arteries serving the brain (inferior view, right side
of cerebellum and part of right temporal lobe removed)
© 2014 Pearson Education, Inc.
Figure 18.23a Arteries of the right upper limb and thorax.
R. vertebral artery
R. common
carotid
artery
L. common carotid
artery
Thyrocervical trunk
L. vertebral artery
L. subclavian
artery
Suprascapular artery
R. subclavian artery.
Axillary artery
Thoracoacromial
artery
Thoracoacromial
artery
(pectoral
branch)
Aortic arch
Anterior
and posterior
circumflex
humeral
arteries
Brachial
artery
Deep
artery
of arm
Brachiocephalic
trunk
Internal
thoracic
artery
Anterior
intercostal
arteries
Lateral
thoracic
artery
Subscapular
artery
Anastomosis
Common
interosseus
artery
Radial
artery
Deep
palmar
arch
Ulnar artery
Metacarpal arteries
Superficial palmar arch
Digital arteries
Schematic flowchart
© 2014 Pearson Education, Inc.
Costocervical
trunk
Thoracic
aorta
Posterior
intercostal
arteries
Figure 18.23b Arteries of the right upper limb and thorax.
Vertebral artery
Thyrocervical trunk
Costocervical trunk
Suprascapular artery
Thoracoacromial artery
Axillary artery
Subscapular artery
Posterior circumflex
humeral artery
Anterior circumflex
humeral artery
Common carotid arteries
Right subclavian artery
Left subclavian artery
Brachiocephalic trunk
Posterior
intercostal arteries
Anterior intercostal artery
Internal thoracic artery
Brachial artery
Deep artery of arm
Lateral thoracic artery
Thoracic aorta
Common
interosseous artery
Radial artery
Ulnar artery
Deep palmar arch
Superficial palmar arch
Digital arteries
Illustration, anterior view
© 2014 Pearson Education, Inc.
Figure 18.24a Arteries of the abdomen.
Diaphragm
Abdominal
aorta
Inferior
phrenic
arteries
L. gastric artery
R. gastric
artery
Common
hepatic
artery
Hepatic
artery
proper
L
Splenic
artery
Gastroduodenal
artery
R
Celiac
trunk
R. gastroepiploic
artery
Middle
suprarenal
arteries
L. gastroepiploic artery
Intestinal arteries
Middle colic
artery
Superior
mesenteric
artery
R. colic
artery
Renal
arteries
Gonadal
arteries
Ileocolic artery
Sigmoidal
arteries
Inferior
mesenteric
artery
Lumbar
arteries
L. colic
artery
Superior rectal
artery
Median sacral artery
Common iliac arteries
Schematic flowchart.
© 2014 Pearson Education, Inc.
Figure 18.24b Arteries of the abdomen.
Liver (cut)
Inferior vena cava
Celiac trunk
Common
hepatic artery
Hepatic
artery proper
Gastroduodenal
artery
Right
gastric artery
Diaphragm
Esophagus
Left gastric artery
Stomach
Splenic artery
Left gastroepiploic
artery
Spleen
Gallbladder
Pancreas
(major portion lies
posterior to stomach)
Right gastroepiploic
artery
Duodenum
Abdominal aorta
Superior mesenteric
artery
The celiac trunk and its major branches. The left half of the liver has been removed.
© 2014 Pearson Education, Inc.
Figure 18.24c Arteries of the abdomen.
Hiatus (opening)
for inferior vena cava
Hiatus (opening)
for esophagus
Diaphragm
Inferior
phrenic artery
Adrenal
(suprarenal) gland
Middle
suprarenal artery
Celiac trunk
Renal artery
Kidney
Superior
mesenteric artery
Abdominal aorta
Lumbar arteries
Ureter
Median
sacral artery
Major branches of the abdominal aorta.
© 2014 Pearson Education, Inc.
Gonadal
(testicular
or ovarian) artery
Inferior
mesenteric artery
Common
iliac artery
Figure 18.24d Arteries of the abdomen.
Celiac trunk
Superior mesenteric
artery
Branches of
the superior
mesenteric artery
• Middle colic artery
• Intestinal arteries
• Right colic artery
• Ileocolic artery
Ascending colon
Right common iliac
artery
Ileum
Transverse colon
Aorta
Inferior mesenteric
artery
Branches of
the inferior
mesenteric artery
• Left colic artery
• Sigmoidal arteries
• Superior rectal
artery
Descending colon
Cecum
Appendix
Distribution of the superior and inferior mesenteric arteries.
The transverse colon has been pulled superiorly.
© 2014 Pearson Education, Inc.
Sigmoid colon
Rectum
Figure 18.25a Arteries of the right pelvis and lower limb.
Abdominal
aorta
Superior
gluteal
artery
Internal
iliac
artery
Inferior
gluteal
artery
Internal
pudendal
Common
iliac
artery
Obturator
artery
Deep artery
of thigh
Medial
circumflex
femoral
artery
Lateral
circumflex
femoral
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
Lateral
plantar
artery
Medial
plantar
artery
Arcuate
artery
Plantar arch
Dorsal
metatarsal
arteries
Schematic flowchart
© 2014 Pearson Education, Inc.
Plantar
metatarsal
arteries
Figure 18.25b–c Arteries of the right pelvis and lower limb.
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
Popliteal artery
Anterior tibial
artery
Anterior tibial artery
Posterior tibial artery
Fibular artery
Dorsalis pedis artery
Arcuate artery
Dorsal metatarsal
arteries
Anterior view
© 2014 Pearson Education, Inc.
Posterior tibial
artery
Lateral plantar
artery
Medial plantar artery
Posterior view
Fibular
artery
Dorsalis pedis
artery (from top of
foot)
Plantar
arch
Figure 18.25b Arteries of the right pelvis and lower limb.
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
Dorsalis pedis artery
Arcuate artery
Dorsal metatarsal
arteries
© 2014 Pearson Education, Inc.
Anterior view
Figure 18.25c Arteries of the right pelvis and lower limb.
Popliteal artery
Anterior tibial
artery
Posterior tibial
artery
Lateral plantar
artery
Medial plantar
artery
© 2014 Pearson Education, Inc.
Posterior view
Fibular artery
Dorsalis pedis
artery (from top
of foot)
Plantar arch
Figure 18.26a 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
Veins of
R. lower limb
© 2014 Pearson Education, Inc.
Schematic flowchart.
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 18.26b Major veins of the systemic circulation.
Veins of the head and trunk
Dural venous sinuses
External jugular vein
Vertebral vein
Internal jugular vein
Right and left
brachiocephalic veins
Superior vena cava
Great cardiac vein
Hepatic veins
Splenic vein
Hepatic portal vein
Renal vein
Superior mesenteric vein
Inferior mesenteric vein
Inferior vena cava
Common iliac vein
Internal iliac vein
Veins that drain
the upper limb
Subclavian vein
Axillary vein
Cephalic vein
Brachial vein
Basilic vein
Median cubital vein
Ulnar vein
Radial vein
Digital veins
Veins that drain
the lower limb
External iliac vein
Femoral vein
Great saphenous vein
Popliteal vein
Posterior tibial vein
Anterior tibial vein
Small saphenous vein
Dorsal venous arch
Dorsal metatarsal veins
Illustration, anterior view. The vessels of the pulmonary circulation are not shown.
© 2014 Pearson Education, Inc.
Figure 18.27a 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
Superior thyroid vein
Vertebral vein
Middle thyroid vein
Brachiocephalic veins
Subclavian vein
Superior vena cava
Schematic flowchart
© 2014 Pearson Education, Inc.
Figure 18.27b–c Venous drainage of the head, neck, and brain.
Ophthalmic vein
Superficial temporal vein
Facial vein
Occipital vein
Posterior auricular vein
External jugular vein
Vertebral vein
Internal jugular vein
Superior and middle
thyroid veins
Brachiocephalic vein
Subclavian vein
Superior vena cava
Veins of the head and neck, right superficial aspect
Superior sagittal sinus
Falx cerebri
Inferior sagittal sinus
Straight sinus
Cavernous sinus
Transverse sinuses
Sigmoid sinus
Jugular foramen
Right internal jugular vein
Dural venous sinuses of the brain
© 2014 Pearson Education, Inc.
Figure 18.27b Venous drainage of the head, neck, and brain.
Ophthalmic vein
Superficial
temporal vein
Facial vein
Occipital vein
Posterior
auricular vein
External
jugular vein
Vertebral vein
Internal
jugular vein
Superior and
middle thyroid veins
Brachiocephalic
vein
Subclavian vein
Superior
vena cava
Veins of the head and neck, right superficial aspect
© 2014 Pearson Education, Inc.
Figure 18.27c Venous drainage of the head, neck, and brain.
Superior sagittal sinus
Falx cerebri
Inferior sagittal sinus
Straight sinus
Cavernous sinus
Transverse sinuses
Sigmoid sinus
Jugular foramen
Right internal jugular vein
Dural venous sinuses of the brain
© 2014 Pearson Education, Inc.
Figure 18.28a Veins of the thorax and right upper limb.
Internal
Subclavian
jugular vein
vein
External
Brachiocephalic
jugular vein veins
Axillary
vein
Superior
vena cava
Accessory
hemiazygos
vein
Median
cubital
vein
Azygos
vein
Brachial
vein
Hemiazygos
vein
Right and left posterior
intercostal veins
Cephalic
vein
Median
antebrachial
vein
Radial
vein
Basilic
vein
Ulnar
vein
Deep venous
palmar arch
Metacarpal veins
Superficial venous
palmar arch
Digital veins
Schematic flowchart
© 2014 Pearson Education, Inc.
Figure 18.28b Veins of the thorax and right upper limb.
Brachiocephalic veins
Right subclavian vein
Axillary vein
Brachial vein
Cephalic vein
Basilic vein
Internal jugular vein
External jugular vein
Left subclavian 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
Anterior view
© 2014 Pearson Education, Inc.
Basilic vein
Ulnar vein
Deep venous
palmar arch
Superficial venous
palmar arch
Digital veins
Figure 18.29a Veins of the abdomen.
Inferior vena cava
Cystic vein
Hepatic
portal
system
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
Internal iliac veins
Schematic flowchart.
© 2014 Pearson Education, Inc.
Figure 18.29b–c Veins of the abdomen.
Hepatic veins
Inferior vena cava
Right suprarenal vein
Right gonadal vein
Inferior phrenic vein
Left suprarenal vein
Renal veins
Left ascending lumbar vein
Lumbar veins
Left gonadal vein
Common iliac vein
External iliac vein
Internal iliac vein
Tributaries of the inferior vena cava. Venous drainage of abdominal
organs not drained by the hepatic portal vein.
Hepatic veins
Liver
Hepatic portal
vein
Small intestine
Rectum
The hepatic portal circulation.
© 2014 Pearson Education, Inc.
Gastric veins
Spleen
Inferior vena cava
Splenic vein
Right gastroepiploic vein
Inferior
mesenteric vein
Superior
mesenteric vein
Large intestine
Figure 18.29b Veins of the abdomen.
Hepatic veins
Inferior phrenic
vein
Inferior vena cava
Right suprarenal
vein
Left suprarenal
vein
Renal veins
Right gonadal
vein
External iliac
vein
Left ascending
lumbar vein
Lumbar veins
Left gonadal
vein
Common iliac
vein
Internal iliac
vein
Tributaries of the inferior vena cava.
Venous drainage of abdominal organs not drained by the hepatic portal vein.
© 2014 Pearson Education, Inc.
Figure 18.29c Veins of the abdomen.
Hepatic veins
Liver
Hepatic portal
vein
Gastric veins
Spleen
Inferior vena cava
Splenic vein
Right
gastroepiploic vein
Inferior
mesenteric vein
Superior
mesenteric vein
Small intestine
Large intestine
Rectum
The hepatic portal circulation.
© 2014 Pearson Education, Inc.
Figure 18.30 Veins of the right lower limb.
Common iliac vein
Internal iliac vein
External iliac vein
Inguinal ligament
Femoral vein
Internal
iliac
vein
Inferior
vena cava
Great saphenous
vein (superficial)
Common iliac vein
External iliac vein
Femoral
vein
Great
saphenous
vein
Femoral
vein
Small
saphenous
vein
Anterior
tibial
vein
Fibular
(peroneal)
vein
Fibular
(peroneal)
vein
Posterior
tibial
vein
Plantar
veins
Dorsalis
pedis
vein
Dorsal
venous
arch
Deep
plantar arch
Dorsal
metatarsal
veins
Digital
veins
Anterior
Popliteal
vein
Anterior
tibial vein
Fibular
vein
Fibular
vein
Small
saphenous
vein
(superficial)
Anterior
tibial vein
Dorsalis
pedis vein
Dorsal
Venous
arch
Posterior
tibial
vein
Plantar
veins
Dorsal
metatarsal
veins
Deep
plantar arch
Digital veins
Posterior
Schematic flowchart of the anterior and posterior veins
© 2014 Pearson Education, Inc.
Popliteal
vein
Small
saphenous
vein
Popliteal
vein
Small
saphenous
vein
Great
saphenous
vein
Anterior view
Posterior view
Figure 18.30a Veins of the right lower limb.
Internal
iliac
vein
Inferior
vena cava
Common iliac vein
External iliac vein
Femoral
vein
Great
saphenous
vein
Femoral
vein
Popliteal
vein
Small
saphenous
vein
Small
saphenous
vein
Anterior
tibial
vein
Fibular
(peroneal)
vein
Fibular
(peroneal)
vein
Posterior
tibial
vein
Plantar
veins
Dorsalis
pedis
vein
Dorsal
venous
arch
Deep
plantar arch
Dorsal
metatarsal
veins
Digital
veins
Anterior
Posterior
Schematic flowchart of the anterior and posterior veins
© 2014 Pearson Education, Inc.
Figure 18.30b Veins of the right lower limb.
Common iliac vein
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
© 2014 Pearson Education, Inc.
Anterior view
Figure 18.30c Veins of the right lower limb.
Great
saphenous
vein
Popliteal
vein
Anterior
tibial vein
Fibular
vein
Small
saphenous
vein
(superficial)
Posterior
tibial
vein
Plantar
veins
Deep
plantar arch
Digital veins
© 2014 Pearson Education, Inc.
Posterior view