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Circulatory System
Comprised of two major divisions
 Cardiovascular: includes the heart, blood and vessels
 Transportation of oxygen, nutrients, hormones and
chemicals necessary for normal body activity.
 Removal of waste products through the kidneys and
lungs
 Maintenance of body temperature and water and
electrolyte balance.
 To prevent hemorrhage by forming blood clots
 Lymphatic system: includes lymph vessels, lymph nodes
and lymph glands
 Protect against disease
 Returns proteins to the blood
 Transfers fat
Cardiovascular Circulation
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Cardiovascular Circulation
Simplified version of the cardiovascular
circulation
 Begins with the heart
 Oxygenated blood is pumped from
the left atria and ventricle into the
aorta and arteries of the body
 Arteries supply blood to body parts
and organ systems through arteriole
and then capillaries.
 Deoxygenated blood is then returned
through venules and eventually veins
 Veins converge into the superior and
inferior venae cavae, which will bring
the deoxygenated blood to the right
atria and ventricle.
Blood components
 Red Blood Cells are Erythrocytes and are produced in the
cancellous or spongy bone (red marrow) of certain bones
(sternum, ribs, vertebrae, and pelvis)
 It’s function is to transport oxygen by protein hemoglobin to
body tissues
 White Blood Cells are Leukocytes and are produced in the
medullary cavity of some bones (yellow bone marrow) and lymph
system.
 It’s job is to protect against infection and disease
 Platelets originate from bone marrow
 They repair tears in blood vessel wall and promote blood
clotting.
 Platelets are irregularly shaped colorless bodies that are present
in blood. Their sticky surface lets them, along with other
substances, form clots to stop bleeding.
Pulmonary Circulation
 Pulmonary circulation is the blood vessels circuit,
which supplies blood to the lungs and then is
returned to the heart.
 The pulmonary arteries carry the deoxygenated
blood from the right ventricle of the heart to the
lungs
 The four pulmonary veins carry the oxygenated
blood from the lungs to the left atrium of the
heart.
Pulmonary Circulation
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Heart
 is a muscular organ that pumps blood to all areas
of the body.
 Lies within the mediastinum; resting on the
diaphragm
 Myocardium – refers to the cardiac tissue and the
heart’s muscular wall. It contracts to pump blood
out of the heart, then relaxes as the heart refills
with returning blood. The outer surface is called
the epicardium and it’s inner lining is the
endocardium.
Heart Circulation
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Interesting facts about the heart
 It is about the size of your fist
 It generally only pumps about 50% of the blood
which is in the chamber at the beginning of its
pumping phase (this is called the ejection fraction)
 It generally pumps about 5 quarts of blood a
minute.
 It can pump up to about 5 gallons a minute with
exercise
 It pumps about 4000 gallons of blood each day.
General Systemic Circulation – Heart
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Superior & Inferior Venae Cavae
Right Atrium
Tricuspid valve- valves are made to prevent substances from re-entering the previous area
Right ventricle: a thin walled chamber that function is to pump blood into the pulmonary
system.
Semilunar or pulmonary value – marks the beginning of the artery system - Pulmonary
system
Pulmonary artery or pulmonary trunk is the main artery taking deoxygenated blood to the
lungs
Blood goes to the right and left lungs where capillaries are in close contact the thin-walled
alveoli so that blood can release CO2 and pick up O2.
From the lungs, the pulmonary vein carries oxygenated blood back into the heart via the left
atrium.
Left atrium receives oxygenated blood from the lungs
Mitral valve or Bicuspid
Blood enters the left ventricle, which is made of thickened walls; the left ventricle must
pump blood throughout the whole body.
Finally blood exits the left semilunar or aortic valve and enters the arch of the aorta to the
aorta.
The first arteries to branch off the aorta are the coronary arteries, which supplies oxygenated
blood to the heart muscle.
Coronary Arteries
The coronary artery goes around the heart like a crown. It’s main function is to
deliver oxygenated blood to the heart muscle.
 Coronary arteries originate at the aortic bulb
 Right coronary artery (RCA) provides blood for the majority of the right
atrium, right ventricle and sinoatrial node (cluster of cells in the right atrial
wall that regulates the heart’s rhythmic rate. (Divides into the right posterior
descending artery and a large marginal branch)
 Left coronary artery (LCA) supplies blood to both ventricles and the left
atrium of the heart. (Divides into the left anterior descending and circumflex
branch)
 Additional arteries branch off the two main coronary arteries to supply the
heart muscle with blood.
 Circumflex artery (Cx) – branches off the left coronary artery and encircles
the heart muscle. This artery supplies blood to the back of the heart.
 Left anterior descending artery (LAD) – branches off the left coronary
artery and supplies blood to the front of the heart.
 Smaller branches of the coronary arteries include: acute marginal,
posterior descending (PDA), obtuse marginal (OM), and diagonals
Coronary Veins
The coronary sinus system returns venous blood to the right atrium of the
heart at the lateral border through the triangle of Koch. Triangle of Koch is
the area around the atrioventricular node which regulates heart rate.
 The coronary sinus is a large vein on the posterior side of the heart between
the atria and ventricles. It drains most of the blood from the heart tissue.
 Branches of the coronary sinus
 Great cardiac vein – receives blood from both ventricles and left
atrium
 Oblique vein (of Marshall) of the left atrium (posterior aspect)
 Obtuse marginal vein
 Middle cardiac vein – drains blood from the right ventricle and
atrium and part of the left ventricle.
 Small cardiac vein – returns blood from the right ventricle. (theses
are also termed thebesian veins. Thebesian veins are small venous
tributaries that drain directly into the cardiac chambers. They exist
primarily in the right atrium and right ventricle.
Coronary Veins
Posterior view
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Cerebral Arteries - Blood Supply to Brain
 The brain is supplied by four major arteries:
 Right and left common carotid arteries which provide
blood to the anterior circulation of the brain
 Right and left vertebral arteries which supply blood for the
posterior circulation of the brain
 A “four-vessel angiogram” would be a radiographic
examination of all four vessels supplying the brain and the
brain circulation
 A “three-vessel angiogram” would be a selective injection of
the two carotids and only one vertebral artery.
Blood Supply to Brain
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Aortic Arch
 Three major branches arise from the arch of the aorta
 The brachiocephalic artery (previously called
Innominate artery) is a short vessel that will bifurcate
into the right common carotid (which further divides
into the right internal and external carotids) and the
right subclavian artery from which the right vertebral
artery will arise.
 The left common carotid arises directly from the aortic
arch and is slightly longer than the right common
carotid.
 The left subclavian artery also arises from the aortic
arch. The left vertebral will originate from the left
subclavian artery.
Three Branches of Aortic Arch
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Carotis Communis- common
carotid
The common carotid arteries differ in length and in their mode
of origin.
 The right common carotid begins at the bifurcation of the
brachiocephalic behind the right sternoclavicular joint. It
extends until it divides into the external and internal
carotids. (around the level of C4.)
 Internal carotid (supply blood to the cerebral
hemispheres, pituitary gland, orbital structure, external
nose and anterior portion of the brain.
 External carotid (supply blood to the anterior neck, face,
greater part of the scalp and meninges)
Common carotid
The left common carotid springs from the highest part of the arch of
the aorta to the left of and on a plane posterior to the innominate
artery and consists of both a thoracic and a cervical portion.
 Thoracic portion ascends from the arch of the aorta and through
the superior mediastinum to the level of the left sternoclavicular
joint.
 Cervical portion begins at the left sternoclavicular joint and
ascends to divide into the left internal and left external carotids.
 The vertebral arteries pass through the transverse foramina from
C6 - C1. From here they pass through the foramen magnum before
uniting to form the basilar artery. (the basilar artery rests on the
clivus portion of the occipital bone)
Neck and Head Arteries
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Right side
Identify vessels A, B, and C
on this right common
carotid arteriogram.
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Internal Carotid Angiogram
(visualizes both anterior and middle cerebral arteries)
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Vertebrobasilar Arteries
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Circle of Willis
The internal carotid branches and the basilar arteries join through this circle
configuration termed the circle of Willis (arterial circle).
It is an elaborate anastomosis (A natural joining of parts or branches of tubular
structures so as to make or become continuous) interconnecting the entire
arterial supply of the brain.
It has five branches:
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Anterior communicating arteries
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Anterior cerebral arteries
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Internal carotid arteries
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Posterior communicating arteries
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Posterior cerebral arteries
The hypophysis or pituitary gland is located within the circle of Willis.
The middle cerebral artery continues as an extension of the internal carotid .
Note the basilar artery and the vertebral arteries relationship to the circle of
Willis.
Arterial Circle (Circle of Willis)
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Cerebral Veins – Great Veins of the Neck
Three major veins that drain blood from the head, face and neck
 Internal Jugular veins – drain blood from the cranial and orbital cavities.
They travel all the way down the neck until they join the subclavian vein.
 Vertebral veins – form outside of the cranium and drain the upper neck
and occipital regions. Each vertebral vein enters the transverse foramen of
C1, descends to C6 and enters the subclavian vein.
 The smaller external jugular veins are more superficial vessels that drain
the scalp and much of the face and neck. They also travel down the neck
and unite with the subclavian vein.
Note: the internal and external jugular, vertebral and subclavian veins join to
form the brachiocephalic veins.
Great Veins of the Neck
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Thoracic Aorta
The thoracic aorta is subdivided into four segments
 Aortic bulb – proximal end of the aorta where it exits the
heart and is the area from which the coronary arteries
originate.
 Ascending aorta – second portion of the aorta and terminates
at the second sternocostal joint
 Aortic arch – has three arterial branches arising from it
(brachiocephalic, left common carotid and left subclavian)
 Descending aorta – continuation of the aorta running to the
left of the thoracic spine down into the abdomen as the
abdominal aorta.
Aortic Arch Variations
Most common variations
 Left circumflex – arch is normal but the descending
aorta is projected downward and to the left.
 Inverse aorta – arch is projected to the right instead of
to the left.
 Pseudocoarctation – descending aorta is arched
Variations of Arch
Left circumflex
Inverse aorta
Pseudocoarctation
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Thoracic Veins
 Superior Vena Cava
 Azygos
 Superior and Inferior Pulmonary Veins
 Pulmonary Arteries
Thoracic Veins cont.
 Four larger pulmonary veins from the lung –
pulmonary veins are the only veins that carry
oxygenated blood
 Superior vena cava – formed from the uniting of the
Left and right brachiocephalic veins
 Azygos vein (terminate at the superior vena cava
posteriorly) and intercostal veins ( spinal column)
Abdominal Aorta Branches
Five major branches from the abdominal aorta
 Celiac axis – supplies blood to the liver, spleen, and
stomach
 Superior mesenteric artery – supplies blood to the
pancreas, most of the small intestine, and portions of the
large intestine (cecum, ascending, ½ of the transverse)
 Left and right renal arteries – supply the kidneys for
filtering.
 Inferior mesenteric artery – supplies blood to ½ of the
transverse colon, descending colon, sigmoid and most of
the rectum.
Branches of Abdominal Aorta
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Abdominal aorta
anatomy
1. Abdominal Aorta
2. Splenic Artery
3. Celiac Artery
4. Hepatic Artery
5. Renal Artery
6. Intestinal Branches
from the Superior
Mesenteric Artery
7. Branches from the
Inferior Mesenteric
Artery
8. Iliac Artery
Common iliac Arteries and branches
 The abdominal aorta bifurcates at the level of L4 to
form the right and left common iliac arteries.
 The common iliac’s split to form:
 The internal iliac – supply blood to the pelvic
organs (urinary bladder, part of the rectum,
reproductive organs, and pelvic muscles)
 The external iliac – supply blood to the lower
limbs
Abdominal Veins
Below the diaphragm all blood is returned to the right
atrium through the inferior vena cava.
 Important parts of the inferior vena cava include:
 Internal/ external and common iliac veins - return blood
from the lower limbs and pelvic area
 Superior/ inferior mesenteric veins - return blood from
small intestine, portal and hepatic area, and large
intestine. One of the large veins of this area is the portal
venous system.
 Renal veins - return filtered blood from the kidneys to the
heart.
Abdominal Veins
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Iliac/ femoral angiography
Portal System
Function is to bring venous blood from the digestive
tract, spleen, pancreas and gallbladder to the liver.
 The liver filters this blood before returning it to the inferior
vena cava.
 The large portal vein is the major vessel that carries the
unfiltered blood to the liver.
 The union of the superior mesenteric and splenic veins
forms the portal vein. In most cases the inferior mesenteric
vein will terminate in the splenic vein and is not considered
a major branch of the portal vein
 Once the liver filters blood, it drains into the hepatic veins
and passes into the inferior vena cava
Hepatic Portal System
 Returns venous blood to
liver
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Upper Limb Arteries
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Upper Limb Veins
Superficial veins
 Cephalic
 Basilic
 Median cubital
Deep veins
 Two brachials
 Radial
 Ulnar
 Palmar arch
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Lower Limb Arteries
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Lower Limb Veins
Superficial veins
 Great (long)
saphenous
 Small (short)
saphenous
 Dorsalis pedis
Deep veins
Posterior tibial
 Anterior tibial
 Popliteal
 Deep femoral
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Lymph Drainage
 Drains interstitial fluid to venous system
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Lymphatic System
Functions:
 Fights disease
 Returns proteins to
the blood
 Filters lymph
 Transfers fats to the
blood
Lymphography vs. lymphangiography
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