Blood vessel of the body.pptx

Blood vessel of the body

1. Blood vessel By Don.Siyum A. 5/3/2022 Don. Siyum A. 1

2. Introduction The three major types of blood vessels are arteries, capillaries, and veins. When the heart contracts, it forces blood into the large arteries that leave the ventricles. Blood leaving the capillaries is collected by venules small veins that merge to form larger veins that ultimately empty into the heart. This pattern of vessels applies to both the pulmonary and systemic circuits. 5/3/2022 Don. Siyum A. 2 2

3. WALLS OF BLOOD VESSEL 5/3/2022 Don. Siyum A. 3 The walls of all blood vessels, except the very smallest, are composed of three distinct layers, or tunics. The tunica intima Tunica media and Tunica externa  That surround the central blood-filled space, the lumen. common to arteries as well as veins. 3

4. TYPES OF BLOOD VESSELS 5/3/2022 Don. Siyum A. 4 The three major types of blood vessels are: Arteries Capillaries and Veins. Arteries Arteries are vessels that carry blood away from the heart. The passage of blood through the arteries proceeds from elastic arteries , to muscular arteries , to arterioles . 4

5. 5/3/2022 Don. Siyum A. 5 Arterioles Arterioles are the smallest arteries , with diameters ranging from about 0.3 mm to 10 μm . Their tunica media contains only one or two layers of smooth muscle cells. Larger arterioles have all three tunics plus an internal elastic network in the tunica intima. Smaller arterioles, which lead into the capillary beds, are little more than a single layer of smooth muscle cells spiraling around an underlying endothelium. 5

6. C apillaries Capillaries are the smallest blood vessels, with a diameter of 8–10 μm. They are the body’s most important blood vessels because they renew and refresh the surrounding tissue fluid (interstitial fluid; with which all body cells are in contact. Capillaries deliver to this fluid the oxygen and nutrients cells need, and they remove the carbon dioxide and nitrogenous wastes that cells deposit f l ui d . int o 17/ 1 t / h 20 e 6 Don. Siyum A . 6 5/3/2022 Don. Siyum A. 6

7. Along with these universal functions, some capillaries also perform site-specific functions. In the lungs , oxygen enters the blood (and carbon dioxide leaves it) through capillaries. Capillaries in the small intestine receive digested nutrients. Those in the endocrine glands pick up hormones ; and those in the kidneys remove nitrogenous wastes from the body. 5/3/2022 Don. Siyum A. 7

8. Capillary Beds Capillaries supply body tissues through structures called capillary beds. A capillary bed is a network of the body’s smallest vessels . Capillary beds run throughout almost all tissues, especially the loose connective tissues. A terminal arteriole leads to a metarteriole—a vessel that is structurally intermediate between an arteriole and a capillary—from which branch true capillaries. 5/3/2022 Don. Siyum A. 8

9. 5/3/2022 Don. Siyum A. 9 Veins Veins are the blood vessels that conduct blood from the capillaries toward the heart. Veins in the systemic circuit carry blood that is relatively oxygen-poor , but the pulmonary veins carry oxygen-rich blood returning from the lungs. The smallest veins are called venules The smallest venules, called postcapillary venules.

10. 5/3/2022 Don. Siyum A. 10 VASCULAR ANASTOMOSES Where vessels unite or interconnect, they form vascular anastomoses. Most organs receive blood from more than one arterial branch, and neighboring arteries often connect with one another to form arterial anastomoses . Arterial anastomoses provide alternativen pathways, or collateral channels, for blood to reach a given body region. If one arterial branch is blocked or cut, the collateral channels can often provide the region with an adequate blood supply.

11. 5/3/2022 Don. Siyum A. 11 Arterial anastomoses occur around joints , where active body movements may hinder blood flow through one channel, as well as in the abdominal organs, brain, and heart. By contrast, because arterial anastomoses are poorly developed in the kidneys , spleen , parts of bone diaphyses nearest the epiphyses , and central artery of the retina, blockage of such arteries causes severe tissue damage . Veins anastomose much more freely than arteries. You may be able to see venous anastomoses through the skin on the dorsal surface of your hand. Because of the abundant anastomoses, occlusion of a vein rarely blocks blood flow or leads to tissue death.

12. VASA VASORUM 5/3/2022 Don. Siyum A. 12 The walls of blood vessels contain living cells and therefore require a blood supply of their own. For this purpose, the larger arteries and veins have tiny arteries, capillaries, and veins in their tunica externa. These little vessels, the vasa vasorum (“vessels of the vessels”), arise either as tiny branches from the same vessel or as small branches from other, nearby vessels and nourish the outer half of the wall of the larger vessel. The inner half, by contrast, gets its nutrients by diffusion from the blood in the vessel’s own lumen. Small blood vessels need no vasa vasorum because their walls are entirely supplied by luminal blood .

13. BLOOD VESSELS OF THE BODY Blood vessels in the body called the vascular system has two basic circuits: The pulmonary circuit carries blood to and from the lungs for the uptake of oxygen and the removal of carbon dioxide, Whereas the systemic circuit carries oxygenated blood throughout the body and picks up carbon dioxide from body tissues. 5/3/2022 Don. Siyum A. 13

14. Blood vessels in the systemic circuit also pick up nutrients from the digestive tract and deliver them to cells throughout the body, Receive nitrogenous wastes from body cells and transport them to the kidneys for elimination in the urine, and pick up hormones or other signaling molecules and transport them to their target organ . 5/3/2022 Don. Siyum A. 14

15. THE PULMONARY CIRCULATION The pulmonary circulation begins as oxygen-poor blood leaves the right ventricle of the heart via the pulmonary trunk . Each pulmonary artery penetrates the medial surface of a lung and then divides into several lobar arteries serving the lobes of the lung, three in the right lung and two in the left lung. As the branching arteries decrease in size, they become arterioles and finally the pulmonary capillaries that surround the delicate air sacs ( lung alveoli ). Gas exchange occurs across these capillaries, and the newly oxygenated blood enters venules and then progressively larger veins. 5/3/2022 Don. Siyum A. 15

16. 5/3/2022 Don. Siyum A. 16 Systemic Arteries The systemic arteries carry oxygenated blood from the heart to the capillaries of organs throughout the body. Arterial pulses can be palpated in the muscular arteries at numerous body locations and can be used to determine heart rate and to assess blood flow to a body region after trauma, surgery, or disease. Deep pressure at a pulse point is a first aid technique used to limit blood flow through a vessel that is hemorrhaging and thus limit blood loss.

17. Aorta The aorta, the largest artery in the body, leaves the heart, arcs superiorly and then descends along the bodies of the vertebrae to the inferior part of the abdomen. The aorta is divided into the following three parts. Ascending Aorta The ascending aorta one of the great vessels leaving the heart, arises from the left ventricle and ascends for only about 5 cm. The only branches of the ascending aorta are the two coronary arteries that supply the wall of the heart . 5/3/2022 Don. Siyum A. 17

18. Aortic Arch Arching posteriorly and to the left, the aortic arch lies posterior to the manubrium of the sternum. The ligamentum arteriosum, a fibrous remnant of a fetal artery called the ductus arteriosus , interconnects the aortic arch and the pulmonary trunk . Three arteries branch from the aortic arch Brachiocephalic trunk it divides into the right common carotid and right subclavian arteries. Left common carotid Left subclavian arteries 5/3/2022 Don. Siyum A. 18

19. Descending Aorta 5/3/2022 Don. Siyum A. 19 Continuing from the aortic arch, the descending aorta runs posterior to the heart and inferiorly on the bodies of the thoracic and lumbar vertebrae. It has two parts, The thoracic aorta and The abdominal aorta.

20. Arteries of the Head and Neck Four pairs of arteries supply the head and neck: The common carotid arteries Subclavian artery— the vertebral artery, the thyrocervical trunk, and the costocervical trunk . 5/3/2022 Don. Siyum A. 20

21. Common Carotid Arteries Most parts of the head and neck receive their blood from the common carotid arteries, which ascend through the anterior neck just lateral to the trachea. These vessels are more vulnerable than most other arteries in the body because their relatively superficial location. If a common carotid artery is cut, the victim can bleed to death in minutes common carotid by dividing into an external and internal carotid artery. 5/3/2022 Don. Siyum A. 21

22. 5/3/2022 Don. Siyum A. 22 External C a r ot i d Artery The external carotid artery is one of the terminal branches of the common carotid artery. It supplies structures in the neck , face , and scalp ; it also supplies the tongue and the maxilla . The external carotid artery terminaly dividing into the superficial temporal and maxillary arteries .

23. Before these terminal branches, six arteries arise from the external carotid artery: One branch arises medially ( ascending pharyngeal) , Two branches arise posteriorly ( occipital and posterior auricular ), and Three branches arise anteriorly ( superior thyroid, lingual , and facial ). 5/3/2022 Don. Siyum A. 23

24. Thyrocervical and Costocervical Trunks The rest of the neck receives its blood from two smaller branches of the subclavian arteries, the thyrocervical and costocervical trunks . 5/3/2022 Don. Siyum A. 24

25. Blood Supply of The Brain 5/3/2022 Don. Siyum A. 25 Arteries of the Brain The brain is supplied by the two internal carotid and the two vertebral arteries . The four arteries lie within the subarachnoid space, and their branches anastomose on the inferior surface of the brain to form the circle of Willis.

26. 5/3/2022 Don. Siyum A. 26 Internal Carotid Artery Begins – bifurcation of Common Carotid Artery Perforates base of skull – carotid canal it divides into the anterior and middle cerebral arteries. Branches of the Cerebral Portion 1. The ophthalmic artery It enters the orbit through the optic canal below and lateral to the optic nerve. It supplies the eye and other orbital structures. 2. The posterior communicating artery Thus forming part of the circle of Willis.

27. 5/3/2022 Don. Siyum A. 27

28. 5/3/2022 Don. Siyum A. 28 3. The choroidal artery It gives off numerous small branches to surrounding structures, including the crus cerebri , the lateral geniculate body and the internal capsule . 4. The anterior cerebral artery is the smaller terminal branch of the internal carotid artery. The anterior cerebral artery thus supplies the “ leg area ” of the precentral gyrus . 5. The middle cerebral artery , the largest branch of the internal carotid artery. This artery thus supplies all the motor area except the “leg area.”

29. 5/3/2022 Don. Siyum A. 29

30. 5/3/2022 Don. Siyum A. 30

31. Vertebral Artery Branch of first part of subclavian artery It enters the skull through the foramen magnum At the lower border of the pons, it joins the vessel of the opposite side to form the basilar artery . Branches of the Cranial Portion The meningeal branches are small and supply the bone and dura in the posterior cranial fossa. The posterior spinal artery may arise from the vertebral artery or the posterior inferior cerebellar artery. 5/3/2022 Don. Siyum A. 31

32. 5/3/2022 Don. Siyum A. 32

33. 5/3/2022 Don. Siyum A. 33 Circle of Willis The circle of Willis lies in the interpeduncular fossa at the base of the brain. It is formed by the anastomosis between the two internal carotid arteries and the two vertebral arteries. The anterior communicating, Anterior cerebral, internal carotid, Posterior communicating, Posterior cerebral, and basilar arteries all contribute to the circle.

34. 5/3/2022 Don. Siyum A. 34 34

35. Arteries of the Thorax 5/3/2022 Don. Siyum A. 35 35

36. 5/3/2022 Don. Siyum A. 36 Arteries of the thoracic Wall The arterial supply to the thoracic wall derives from the: Thoracic aorta , thru the posterior intercostal & subcostal arteries. Subclavian artery , thru the internal thoracic & supreme intercostal arteries. Axillary artery , thru the superior & lateral thoracic arteries. 36

37. 5/3/2022 Don. Siyum A. 37 Vasculature of thoracic wall Intercostal vessels run in the costal groove Posterior intercostal arteries 1st & 2nd - arise from superior intercostal artery (a branch of costocervical trunk of subclavian artery) 3rd -11th - branches of the thoracic aorta Accompanies intercostal nerve Anterior intercostal arteries 1st – 6th – from internal thoracic 7th- 9th – from musculophrenic 10th & 11th – have no anterior intercostal anastomose with the posterior vessels in the intercostal spaces around the midclavicular line 37

38. Arteries of the Thoracic Visceral Organs Many thoracic viscera receive their functional blood supply from small branches off the thoracic aorta. Branches : – Esophageal arteries – Bronchial arteries – Pericardial branches – Mediastineal branches – Posterior intercostal arteries – Superior phrenic arteries 17/10 / t 2 h 06 e first b ran c hes o M f e ng i t s t u h D . - e BDU ( a 20 o 5/0 6 r E . t C) a. 38  Coronary arteries (visceral layer pericardium only), 5/3/2022 Don. Siyum A. 38

39. 17/10/2006 Don. Siyum A. 39 5/3/2022 Don. Siyum A. 39

40. Arteries of the upper limb The subclavian artery , becomes axilary artery as it courses the axilla. The axilary artery in turn becomes brachial artery as it extends in to the arm. At the elbow brachial artery branches to ulnar and radial arteries which supply the fore arm and hand. Radial artery is used to take impulse on the wrist. Superficial palmar arch and Deep palmar arch formed by ra d 1 i 7 / a 10 / l 20 a 6 n d ul n ar aa . Don. Siyum A. 40 5/3/2022 Don. Siyum A. 40

41. 5/3/2022 Don. Siyum A. 41 Axillary Artery The axillary artery descends through the axilla, giving off the following branches: The thoracoacromial artery, which arises just inferior to the clavicle and branches to supply much of the pectoralis and deltoid muscles; The lateral thoracic artery, which descends along the lateral edge of pectoralis minor and sends important branches to the breast; The subscapular artery, which serves the dorsal and ventral scapular regions and the latissimus dorsi muscle; and The anterior and posterior circumflex humeral arteries, which wrap around the surgical neck of the humerus and help supply the deltoid muscle and shoulder joint

42. 5/3/2022 Don. Siyum A. 42

43. Arteries and veins Brachial artery The major artery of the arm, the brachial artery, is found in the anterior compartment. Beginning as a continuation of the axillary artery at the lower border of the teres major muscle . it terminates just distal to the elbow joint where it divides into the radial and ulnar arteries. The main branches are : The deep artery of the arm/ profunda brachi artery The superior & inferior ulnar col l 1 a 7 / t 1 e /2 r 6 a l arteri e s. Don. Siyum A. 43 5/3/2022 Don. Siyum A. 43

44. Radial artery The radial artery originates from the brachial artery at approximately the neck of the radius and passes along the lateral aspect of the forearm. In the distal forearm, the radial artery can be located using the flexor carpi radialis muscle as a landmark. The radial pulse can be felt by gently palpating the radial artery against the underlying muscle and bone. 5/3/2022 Don. Siyum A. 44

45. Ulnar Artery o Pulsations of the ulnar artery can be palpated on the lateral side of the FCU tendon. o The common interosseous artery , a short branch of the ulnar artery, arises in the distal part of the cubital fossa & divides almost immediately into anterior & posterior interosseous arteries o The ulnar artery is larger than the radial artery and passes down the medial side of the forearm. 5/3/2022 Don. Siyum A. 45

46. Palmar Arches In the palm, branches of the radial and ulnar arteries join to form two horizontal arches: The superficial Deep palmar arches The superficial arch underlies the skin and fascia of the hand, whereas the deep arch lies against the metacarpal bones . The digital arteries, which supply the fingers, branch from these arches. 5/3/2022 Don. Siyum A. 46

47. Arteries of the Abdomen 5/3/2022 Don. Siyum A. 47

48. 5/3/2022 Don. Siyum A. 48 Arteries of the anterolateral abdominal wall The anterolateral abdominal wall is supplied: Superficially : The superior part of the wall is supplied by branches from the musculophrenic artery , a terminal branch of the internal thoracic artery. The inferior part of the wall is supplied by The medially placed superficial epigastric artery and The laterally placed superficial circumflex iliac artery , both branches of the femoral artery.

49. 5/3/2022 Don. Siyum A. 49

50. At a Deep level: The superior epigastric artery , one of the terminal branches of the internal thoracic artery. The inferior epigastric artery is a branch of the external iliac artery just above the inguinal ligament. supplying the lower central part of the anterior abdominal wall, and anastomoses with the superior epigastric artery . The deep circumflex iliac artery is a branch of the external iliac artery just above the inguinal ligament. 5/3/2022 Don. Siyum A. 50

51. The neurovascular bundles of abdominal cavity Blood supply: Descending Abdominal Aorta. Enters the aortic hiatus between the right and left crus of the diaphragm at the level of T12 . Extends retroperitoneally along the anterior surface of the vertebrae (slightly to the left), until the level of L4 . Principle Branches to GIT: It has three unpaired (single visceral) branches from its anterior aspect to the fore gut , mid gut and hind gut which are: 5/3/2022 Don. Siyum A. 51

52. 5/3/2022 Don. Siyum A. 52 The branches of the abdominal aorta may be described as visceral or parietal and paired or unpaired. The paired visceral branches are : Suprarenal arteries (L1) Renal arteries (L1). Gonadal arteries, the ovarian or testicular arteries (L2). The unpaired visceral branches are : Celiac trunk (T12). Superior mesenteric artery (L1). Inferior mesenteric artery (L3).

53. 5/3/2022 Don. Siyum A. 53

54. The paired parietal branches are: Inferior phrenic arteries supply the inferior surface of the diaphragm and the suprarenal glands. Lumbar arteries that pass around the sides of the superior four lumbar vertebrae to supply the posterior abdominal wall. The unpaired parietal branch : Median sacral artery , which arises from the aorta at its bifurcation and descends into the lesser pelvis. 5/3/2022 Don. Siyum A. 54

55. 5/3/2022 Don. Siyum A. 55

56. 5/3/2022 Don. Siyum A. 56

57. The Celiac Trunk 5/3/2022 Don. Siyum A. 57 Is located just inferior to Aortic hiatus. Branches: The Splenic artery. The Common Hepatic artery. Left Gastric artery.

58. 5/3/2022 Don. Siyum A. 58

59. 5/3/2022 Don. Siyum A. 59

60. 17/10/2006 Don. Siyum A. D. - BDU(2005/06 E .C ) 60 The Superior Mesenteric Artery Is located below celiac trunk at L1 . Branches:  Right colic artery.  Jejenial arteries. Midd l e Co l ic art e ry Ileocolic artery Ileal arteries  Inferior Pancreaticoduodenal 5/3/2022 Don. Siyum A. 60

61. 17/10/2006 Don. Siyum A. 61 5/3/2022 Don. Siyum A. 61

62. 17/10/2006 Me ngis tu D. - BDU(2005/06 E .C ) 62 The Inferior Mesenteric Artery ( IMA ) Is located below SMA at L3. Branches: Left Colic artery. Sigmoidal artery. Superior Rectal artery . 5/3/2022 Don. Siyum A. 62

63. 5/3/2022 Don. Siyum A. 63

64. Common Iliac Arteries 5/3/2022 Don. Siyum A. 64 At the level of L4, the aorta splits into the right and left common iliac arteries , which supply the inferior part of the anterior abdominal wall, as well as the pelvic organs and the lower limbs.

65. Arteries of the Pelvis and Lower Limbs At the level of the sacroiliac joint on the pelvic brim, Each common iliac artery forks into two branches: The internal iliac artery , which mainly supplies the pelvic organs, and The external iliac artery , which supplies the lower limb Don. Siyum A. 5/3/2022 65 Don. Siyum A.

66. Arteries of the True Pelvis 5/3/2022 Don. Siyum A. 66 The following arteries enter the pelvic cavity: Internal iliac artery Superior rectal artery Ovarian artery Median sacral artery

67. 5/3/2022 Don. Siyum A. 67 Internal Iliac Artery The internal iliac artery passes down into the pelvis to the upper margin of the greater sciatic foramen, where it divides into anterior and posterior divisions. The branches of these divisions supply the pelvic viscera , the perineum , the pelvic walls , and the buttocks.

68. 5/3/2022 Don. Siyum A. 68

69. Branches of the Anterior Division 5/3/2022 Don. Siyum A. 69 Umbilical artery: The lumen of the umbilical aa becomes obliterated after birth and the remnant of the vessel becomes the medial umbilical ligament. Gives off : Superior vesical artery, Artery of the ductus deferens Supply to : the upper portion of the bladder; ductus deferens

70. 5/3/2022 Don. Siyum A. 70

71. 5/3/2022 Don. Siyum A. 71 Obturator artery: This artery runs along the lateral wall of the pelvis with the obturator nerve and leaves the pelvis through the obturator canal. Inferior vesical artery: This artery supplies the base of the bladder and the prostate and seminal vesicles in the male. Middle rectal artery: It supplies the muscle of the lower rectum and anastomoses with the superior rectal and inferior rectal arteries.

72. 5/3/2022 Don. Siyum A. 72

73. 5/3/2022 Don. Siyum A. 73 Internal pudendal artery Its branches supply the musculature of the anal canal and the skin and muscles of the perineum. Inferior gluteal artery: This artery leaves the pelvis through the greater sciatic foramen below the piriformis muscle. Vaginal artery: Usually a branch of uterine artery but may independently arise from the internal iliac artery. It supplies the vagina and the base of the bladder.

74. 5/3/2022 Don. Siyum A. 74

75. 5/3/2022 Don. Siyum A. 75 Uterine artery: This artery runs medially on the floor of the pelvis and crosses the ureter superiorly. remember the saying " water under the bridge “ where it anastomoses with the ovarian artery. The uterine artery gives off a vaginal branch . Divides into: Large tubal branch supplying uterine tube Small vaginal branch supplying cervix & vagina

76. 5/3/2022 Don. Siyum A. 76

77. 5/3/2022 Don. Siyum A. 77 Branches of the Posterior Division Iliolumbar artery: This artery ascends across the pelvic inlet posterior to the external iliac vessels, psoas, and iliacus muscles. Lateral sacral arteries: These arteries descend in front of the sacral plexus, giving off branches to neighboring structures. Superior gluteal artery: This artery leaves the pelvis through the greater sciatic foramen above the piriformis muscle. It supplies the gluteal region.

78. 5/3/2022 Don. Siyum A. 78 Ovarian Artery It crosses the external iliac artery at the pelvic inlet and enters the suspensory ligament of the ovary . It then passes into the broad ligament and enters the ovary by way of the mesovarium. Superior Rectal Artery The superior rectal artery is a direct continuation of the inferior mesenteric artery. It supplies the mucous membrane of the rectum and the upper half of the anal canal. Median Sacral Artery The median sacral artery is a small artery that arises at the bifurcation of the aorta.

79. 5/3/2022 Don. Siyum A. 79

80. 5/3/2022 Don. Siyum A. 80

81. 5/3/2022 Don. Siyum A. 81 External Iliac Artery The external iliac artery runs along the medial border of the psoas muscle, following the pelvic brim, and gives off the inferior epigastric and deep circumflex iliac branches. It leaves the false pelvis by passing under the inguinal ligament to become the femoral artery.

82. 5/3/2022 Don. Siyum A. 82

83. Blood Supply of the Lower limb 5/3/2022 Don. Siyum A. 83 Femoral Artery The femoral artery enters the thigh from behind the inguinal ligament, as a continuation of the external iliac artery . The femoral artery is the main arterial supply to the lower limb. Ends at the opening in the adductor magnus muscle by entering the popliteal space as the popliteal artery.

84. Branches The superficial circumflex iliac artery The superficial epigastric artery The superficial external pudendal artery The deep external pudendal artery The profunda femoris artery The descending genicular artery . 5/3/2022 Don. Siyum A. 84

85. 5/3/2022 Don. Siyum A. 85

86. 5/3/2022 Don. Siyum A. 86 The Cruciate Anastomosis The cruciate anastomosis is situated at the level of the lesser trochanter of the femur. provides a connection between the internal iliac and the femoral arteries. The following arteries take part in the anastomosis: The inferior gluteal artery , the medial femoral circumflex artery, the lateral femoral circumflex artery, and the first perforating artery, a branch of the profunda artery .

87. The popliteal artery: The continuation of the femoral artery . Ends at the inferior border of the popliteus by dividing into the anterior & posterior tibial arteries. Branches: Cutaneous Muscular Articular ( 5) 5/3/2022 Don. Siyum A. 87

88. 5/3/2022 Don. Siyum A. 88 Muscular branches of the popliteal artery supply the hamstring, gastrocnemius, soleus, & plantaris muscles. Five genicular branches of the popliteal artery supply the capsule & ligaments of the knee joint.  Superior medial genicular aa  superior lateral genicular aa  Middle genicular aa  Inferior medial, genicular aa  Inferior lateral genicular aa

89. 5/3/2022 Don. Siyum A. 89

90. 5/3/2022 Don. Siyum A. 90 Arteries of the Foot The arteries of the foot are terminal branches of the anterior & posterior tibial arteries, respectively  the dorsal & plantar arteries. Dorsal artery of the foot The dorsal artery of the foot ( dorsalis pedis) is often a major source of blood supply to the forefoot. Is the direct continuation of the anterior tibial artery .

91. 5/3/2022 Don. Siyum A. 91

92. 5/3/2022 Don. Siyum A. 92 Anterior Tibial Artery The anterior tibial artery is the smaller of the terminal branches of the popliteal artery. It descends on the anterior surface of the interosseous membrane, accompanied by the deep peroneal nerve. At the ankle, it becomes the dorsalis pedis artery. At the base of the metatarsal bones, the arcuate artery branches from the dorsalis pedis and sends smaller branches distally along the metatarsals.

93. 5/3/2022 Don. Siyum A. 93

94. 5/3/2022 Don. Siyum A. 94 The dorsalis pedis artery is superficial, and the pulse from this artery can be palpated in the proximal space between the first and second metatarsals. The absence of this pulse can indicate that the blood supply to the leg is inadequate . Routine checking of the pedal pulse is indicated for patients known to have impaired circulation to the legs and for those recovering from surgery to the leg.

95. Arteries of the sole of the foot 5/3/2022 Don. Siyum A. 95 Supplies by blood derived from the posterior tibial artery, which divides deep to the flexor retinaculum. The terminal branches the medial & lateral plantar arteries. Medial Plantar Artery Is the smaller terminal branch of the posterior tibial artery. Branches: Muscular,Articular & join 1 st ,2 nd , 3 rd plantar metatarsal Completes plantar arch.

96. 5/3/2022 Don. Siyum A. 96

97. 5/3/2022 Don. Siyum A. 97 Lateral plantar artery Is much larger than the medial plantar artery , & arises with & accompanies the nerve of the same name. Gives calcaneal, cutaneous, muscular & articular branches Forms the plantar arch by joining with the deep plantar branch of the dorsalis pedis artery.

98. Pulse feeling areas in the body 5/3/2022 Don. Siyum A. 98 Radial artery -at the wrist Temporal artery- in front of the ear Common carotid artery- at the neck Facial artery- at the lower margin of lower jaw Brachial artery- at the elbow region Femoral artery- at the groin region Popliteal artery- at the back of knee Dorsalis pedis artery - at the dorsum of the foot

99. 5/3/2022 Don. Siyum A. 99

100. 5/3/2022 Don. Siyum A. 100 Systemic Veins Although most veins run with corresponding arteries, there are some important differences in the distributions of arteries and veins: Whereas just one systemic artery leaves the heart—the aorta exiting the left ventricle, three major veins enter the right atrium of the heart the superior and inferior venae cavae and the coronary sinus. All large and medium-sized arteries have deep locations for protection. In contrast, many veins lie just beneath the skin, unaccompanied by any arteries; these are called superficial veins.

101. 5/3/2022 Don. Siyum A. 101

102. 5/3/2022 Don. Siyum A. 102 Several parallel veins often take the place of a single larger vein. Such multi vein bundles, including networks of veins forming anastomoses, are called venous plexuses. Two important body areas have unusual patterns of venous drainage. First, veins from the brain drain into dural sinuses , which are not typical veins but endothelium-lined channels supported by walls of dura mater. Second, venous blood draining from the digestive organs enters a special subcirculation, the hepatic portal system, and passes through capillaries in the liver before the blood reenters the general systemic circulation.

103. 5/3/2022 Don. Siyum A. 103

104. Venae Cavae and their Major Tributaries The unpaired superior and inferior venae cavae, the body’s two largest veins, empty directly into the right atrium of the heart. MAJOR VRINS The superior vena cava returns blood from the head, neck, thorax & upper limbs to the right atrium; and inferior vena cava returns blood from the abdomen, pelvis and lower limbs to the right atrium. Superior Vena Cava The superior vena cava receives the systemic blood from all body regions superior to the diaphragm excluding the heart wall. 5/3/2022 Don. Siyum A. 104

105. Superior vena cava (SVC) Formed by union of right and left brachiocephalic veins behind the right first costal cartilage near to the sternum Brachiocephalic vein Formed by union of internal jugular vein and subclavian vein behind sternoclavicular joint. Right brachiocephalic vein Short & vertical Left brachiocephalic vein left is longer and nearly horizontal 5/3/2022 Don. Siyum A. 105

106. Inferior Vena Cava Which ascends along the posterior wall of the abdominal cavity and is The widest blood vessel in the body, returns blood to the heart from all body regions inferior to the diaphragm . The IVC, the largest vein in the body. The IVC begins anterior to L5 vertebra by the union of the common iliac veins. The IVC returns poorly oxygenated blood from the lower limbs , most of the back , the abdominal walls, and the abdomino pelvic viscera . Blood from the viscera passes through the portal venous system and the liver before entering the IVC via the hepatic veins. Drains into right atrium 5/3/2022 Don. Siyum A. 106

107. 5/3/2022 Don. Siyum A. 107

108. 5/3/2022 Don. Siyum A. 108

109. Veins of the Head and Neck 5/3/2022 Don. Siyum A. 109 Most blood draining from the head and neck enters three pairs of veins: The internal jugular veins from the dural sinuses, the external jugular veins , and the vertebral veins .

110. 5/3/2022 Don. Siyum A. 110 Dural Venous Sinuses The venous sinuses of the cranial cavity are situated between the layers of the dura mater . Their main function is to receive blood from the brain through the cerebral veins and the cerebrospinal fluid from the subarachnoid space through the arachnoid villi. The superior sagittal sinus The superior sagittal and straight sinuses then drain posteriorly into the transverse sinuses, The inferior sagittal sinus The inferior sagittal sinus drains posteriorly into the straight sinus.

111. 5/3/2022 Don. Siyum A. 111

112. 5/3/2022 Don. Siyum A. 112 The straight sinus It is formed by the union of the inferior sagittal sinus with the great cerebral vein . The transverse sinuses The right sinus is usually continuous with the superior sagittal sinus , and the left is continuous with the straight sinus .

113. 5/3/2022 Don. Siyum A. 113

114. 5/3/2022 Don. Siyum A. 114

115. 5/3/2022 Don. Siyum A. 115 The sigmoid sinuses are a direct continuation of the transverse sinuses. which becomes the internal jugular vein as it leaves the skull through the jugular foramen. The occipital sinus is a small sinus occupying the attached margin of the falx cerebelli. The blood in the dural sinuses ultimately drains into the internal jugular veins in the neck.

116. 5/3/2022 Don. Siyum A. 116

117. 5/3/2022 Don. Siyum A. 117 Internal Jugular Veins The large internal jugular veins drain almost all of the blood from the brain . internal jugular veins- larger and deeper ,drain blood from brain anterior head ,face and neck it joins the sub clavian vein on each side to form the brachiocephalic veins which empty in to the superior vena cava .

118. 5/3/2022 Don. Siyum A. 118 External Jugular Vein The external jugular vein begins just behind the angle of the mandible by the union of the posterior auricular vein with retromandibular vein. Drains into the subclavian vein. Tributaries The external jugular vein has the following tributaries: Posterior auricular vein Posterior division of the retromandibular vein Posterior external jugular vein Transverse cervical vein Suprascapular vein Anterior jugular vein

119. 5/3/2022 Don. Siyum A. 119

120. 5/3/2022 Don. Siyum A. 120

121. 5/3/2022 Don. Siyum A. 121 Veins of the Thorax Blood draining from the first few intercostal spaces enters the brachiocephalic veins . Blood from the other intercostal spaces , as well as from some of the thoracic viscera , drains into a group of veins called the azygos system. This group of veins, which flank the vertebral column and ultimately empty into the superior vena cava, consists of the azygos vein , the hemiazygos vein , and the accessory hemiazygos vein .

122. Azygos vein The azygos vein, ascends along the right or the center of the thoracic vertebral bodies. It receives all of the right posterior intercostal veins (except the first), plus the subcostal vein. Connects superior and inferior venae cavae. Formation Originate in the abdomen by union of lumbar azygos, right ascending lumbar and right subcostal veins 5/3/2022 Don. Siyum A. 122

123. 5/3/2022 Don. Siyum A. 123 Tributaries Right superior intercostal vein Right 5 – 11 intercostal veins Right subcostal vein and right ascending lumbar Right bronchial vein Esophageal, Mediastinal & pericardial veins Hemiazygos vein Accessory hemiazygos vein

124. Hemiazgos vein Origin The hemiazygos vein , which ascends on the left side of the vertebral column, It receives the ninth through eleventh left posterior intercostal veins and the subcostal vein. Tributaries 9th – 11th left intercostal Left subcostal Left ascending lumbar 5/3/2022 Don. Siyum A. 124

125. Accessory hemiazygos vein 5/3/2022 Don. Siyum A. 125 The accessory hemiazygos vein can be thought of as a superior continuation of the hemiazygos, receiving the fourth ( fifth) through the eighth left posterior intercostal veins. Tributaries Left 5 th - 8 th posterior intercostal veins Left bronchial vein

126. 5/3/2022 Don. Siyum A. 126 Veins of the Upper Limbs The veins of the upper limbs are: Deep Superficial

127. The Deep veins The deep veins of the upper limbs follow the paths of their companion arteries and have the same names. The Deep and superficial palmar venous arches of the hand empty into the radial and ulnar veins of the forearm, which unite just inferior to the elbow joint to form the brachial vein of the arm. As the brachial vein enters the axilla, it empties into the axillary vein, which becomes the subclavian vein at the first rib. 5/3/2022 Don. Siyum A. 127

128. Superficial Veins The superficial veins of the upper limb are larger than the deep veins and are visible beneath the skin. They form anastomoses frequently along their course. They begin with the dorsal venous network . The dorsal venous network drains superiorly into the cephalic vein, this vein ascends through the anterolateral side of the entire limb and ends inferior to the clavicle, where it joins the axillary vein. 5/3/2022 Don. Siyum A. 128

129. The basilic vein arises from the medial aspect of the hand’s dorsal venous network, then ascends along the posteromedial forearm and the anteromedial surface of the arm. In the axilla, the basilic vein joins the brachial vein to become the axillary. On the anterior aspect of the elbow joint, in the region called the cubital fossa, the median cubital vein connects the basilic and cephalic veins . 5/3/2022 Don. Siyum A. 129

130. Veins of the Abdomen Blood returning from the abdominopelvic viscera and the abdominal wall reaches the heart via the inferior vena cava. Most venous tributaries of this great vein share the names of the corresponding arteries. The veins from the paired abdominal organs, the pelvis, and the abdominal wall drain directly into the inferior vena cava. Blood from the digestive organs returns via the hepatic portal system . 5/3/2022 Don. Siyum A. 130

131. 5/3/2022 Don. Siyum A. 131 Lumbar Veins Several pairs of lumbar veins drain the posterior abdominal wall, running horizontally with the corresponding lumbar arteries. Gonadal (Testicular or Ovarian) Veins The right and left gonadal veins ascend along the posterior abdominal wall with the gonadal arteries. The right gonadal vein drains into the anterior surface of the inferior vena cava at L2. The left gonadal vein drains into the left renal vein .

132. 5/3/2022 Don. Siyum A. 132 Renal Veins The right and left renal veins drain the kidneys; each lies just anterior to the corresponding renal artery. Suprarenal Veins Although each adrenal gland has several main arteries, it has just one suprarenal vein. The right suprarenal vein empties into the nearby inferior vena cava ; The left suprarenal vein drains into the left renal vein .

133. 5/3/2022 Don. Siyum A. 133 Hepatic Veins The right and left hepatic veins exit the liver superiorly and empty into the most superior part of the inferior vena cava. These veins carry all the blood that originated in the digestive organs in the abdominal and pelvic cavities and arrived via the hepatic portal system . Portal Vein (Hepatic Portal Vein) The hepatic portal system is a specialized part of the vascular circuit that serves a function unique to digestion:

134. 5/3/2022 Don. Siyum A. 134 It picks up digested nutrients from the stomach and intestines and delivers these nutrients to the liver for processing and storage. The hepatic portal system is a series of vessels in which two separate capillary beds lie between the arterial supply and the final venous drainage . In this case, capillaries in the stomach and intestines receive the digested nutrients and then drain into the tributaries of the hepatic portal vein.

135. 5/3/2022 Don. Siyum A. 135

136. 5/3/2022 Don. Siyum A. 136 This vein then delivers the nutrient-rich blood to a second capillary bed —the liver sinusoids —through which nutrients reach liver cells for processing. The liver cells also break down toxins that enter the blood through the digestive tract. After passing through the liver sinusoids , the blood enters the hepatic veins and inferior vena cava . The portal vein is about 5 cm long and is formed behind the neck of the pancreas by the union of the superior mesenteric and splenic veins .

137. 5/3/2022 Don. Siyum A. 137

138. Tributaries of the Portal Vein The tributaries of the portal vein are the splenic vein, superior mesenteric vein, left gastric vein, right gastric vein, and cystic veins. Splenic vein: o It unites with the superior mesenteric vein behind the neck of the pancreas to form the portal vein. o It receives the short gastric, left gastroepiploic , inferior mesenteric , and pancreatic veins. 5/3/2022 Don. Siyum A. 138

139. 5/3/2022 Don. Siyum A. 139

140. 5/3/2022 Don. Siyum A. 140

141. Inferior mesenteric vein: This vein ascends on the posterior abdominal wall and joins the splenic vein behind the body of the pancreas. It receives the superior rectal veins , the sigmoid veins, and the left colic vein. Superior mesenteric vein: This vein ascends in the root of the mesentery of the small intestine. o It passes in front of the third part of the duodenum and joins the splenic vein behind the neck of the pancreas. It receives the jejunal, ileal, ileocolic, right colic, middle colic, inferior pancreaticoduodenal, and right gastroepiploic veins . 5/3/2022 Don. Siyum A. 141

142. Left gastric vein: o This vein drains the left portion of the lesser curvature of the stomach and the distal part of the esophagus. o I t o pens directl y into the por t al vein . Right gastric vein: o This vein drains the right portion of the lesser curvature of the stomach and drains directly into the portal vein . Cystic veins: o These veins either drain the gallbladder directly into the liver or join the portal vein . 5/3/2022 Don. Siyum A. 142

143. Portal-systemic anastomoses Under normal conditions venous blood transverses liver and drains into IVC by way of hepatic veins . When portal circulation through the liver is diminished or obstructed because of liver disease or physical pressure from a tumor, blood from the digestive tract can still reach the right atrium of the heart through the IVC by way of collateral routes. Smaller communications occur between portal and systemic venous systems forming portosystemic anastomosis at some sites. 5/3/2022 Don. Siyum A. 143

144. 5/3/2022 Don. Siyum A. 144

145. Don. Siyum A. 145 1. At the lower end of the esophagus (A). The esophageal branches of the left gastric vein ( portal tributary ) anastomose with the esophageal veins draining the middle third of the esophagus into the azygos veins ( systemic tributary ). 2. At rectal venous plexus (B). Halfway down the anal canal, the superior rectal veins (portal tributary) draining the upper half of the anal canal anastomose with the middle and inferior rectal veins (systemic tributaries) , which are tributaries of the internal iliac and internal pudendal veins, respectively. 5/3/2022

146. Don. Siyum A. 146 5/3/2022

147. Don. Siyum A. 147 3. At paraumbilical venous plexus (C) Connect the left branch of the portal vein with the superficial veins of the anterior abdominal wall ( systemic tributaries ). The paraumbilical veins travel in the falciform ligament and accompany the ligamentum teres. 4. Portal-retroperitoneal anastomosis The veins of the ascending colon, descending colon, duodenum, pancreas, and liver (portal tributary) anastomose with the renal, lumbar , and phrenic veins (systemic tributaries). 5/3/2022

148. Don. Siyum A. 148 5/3/2022

149. 5/3/2022 Don. Siyum A. 149

150. 5/3/2022 Don. Siyum A. 150 Site Portal tributary Systemic tributary 1. Lower third of esophagus Esophageal branches of left gastric vein Esophageal veins which drain middle third of it to azygous. 2. Half way down anal canal. Superior rectal veins. Middle and inferior rectal veins. 3. Bare area of liver. Left branch of portal vein. Superficial veins of anterior abdominal wall via paraumblical veins. 4. Posterior abdominal wall. Small and large intestine and pancreas. Lumbar veins and phrenic veins.

151. 5/3/2022 Don. Siyum A. 151 Venous drainage of the LL The LL has Superficial & deep vein. The superficial veins are in the subcutaneous tissue. The deep veins are beneath the deep fascia & accompany all major arteries. Superficial & deep veins have valves, which are more numerous in deep veins. Superficial Veins of the LL The two major superficial veins in the LL are the great & small saphenous veins. They are of great clinical importance.

152. 5/3/2022 Don. Siyum A. 152 The great saphenous vein The great saphenous vein drains the medial end of the dorsal venous arch of the foot and passes upward directly in front of the medial malleolus. The vein passes behind the knee and curves forward around the medial side of the thigh. It passes through the lower part of the saphenous opening in the deep fascia and joins the femoral vein. The great saphenous vein has 10-12 valves, which are more numerous in the leg than in the thigh.

153. 5/3/2022 Don. Siyum A. 153

154. 5/3/2022 Don. Siyum A. 154 At the saphenous opening in the deep fascia, the great saphenous vein usually receives three tributaries that are variable in size and arrangement: The superficial circumflex iliac vein The superficial epigastric vein, and The superficial external pudendal vein. These veins correspond with the three branches of the femoral artery found in this region.

155. 5/3/2022 Don. Siyum A. 155

156. 17/10/2006 Don. Siyum A. 156 Tributaries include: Accessory saphenous vein ( the main communication b/n the great & the small saphenous veins). Lateral & anterior cutaneous veins. 5/3/2022 Don. Siyum A. 156

157. 5/3/2022 Don. Siyum A. 157

158. 5/3/2022 Don. Siyum A. 158

159. 5/3/2022 Don. Siyum A. 159 Deep Veins Arising on the sole of the foot from the union of the medial and lateral plantar veins, the posterior tibial vein ascends deep within the calf muscles and receives the fibular (peroneal) vein. The anterior tibial vein, which is the superior continuation of the dorsalis pedis vein of the foot, ascends to the superior part of the leg, where it unites with the posterior tibial vein to form the popliteal vein.

160. 5/3/2022 Don. Siyum A. 160 The popliteal vein passes through the popliteal fossa and ascends to become the femoral vein, which drains the thigh. The femoral vein is located with the femoral artery and nerve in the femoral triangle. This vessel continues superiorly deep to the inguinal ligament and becomes the external iliac vein. In the pelvis, the external iliac vein unites with the internal iliac vein to form the common iliac vein.

161. Pelvic Veins Pelvic veins follow the course of all branches of the internal iliac artery except for the umbilical artery and the iliolumbar artery . On each side, the veins drain into internal iliac veins , which leave the pelvic cavity to join common iliac veins . Within the pelvic cavity, extensive interconnected venous plexuses are associated with the surfaces of the viscera. 5/3/2022 Don. Siyum A. 161

162. The various plexuses within the lesser pelvis ( rectal, vesical, prostatic, uterine, and vaginal ) unite and are drained mainly by tributaries of the internal iliac veins . but some of them drain through the lateral sacral veins into the internal vertebral venous plexus. The part of the venous plexus surrounding the rectum and anal canal drains via superior rectal veins (tributaries of inferior mesenteric veins) into the hepatic portal system, and via middle and inferior rectal veins into the caval system. 5/3/2022 Don. Siyum A. 162

163. The single Deep dorsal vein that drains erectile tissues of the clitoris and the penis does not follow branches of the internal pudendal artery into the pelvic cavity. The vein joins the prostatic plexus of veins in men and the vesical (bladder) plexus of veins in women. (Superficial veins that drain the skin of the penis and corresponding regions of the clitoris drain into the external pudendal veins, which are tributaries of the great saphenous vein in the thigh.) 5/3/2022 Don. Siyum A. 163

164. 17/10/2006 Don. Siyum A. 164 5/3/2022 Don. Siyum A. 164

165. THANK YOU! 5/3/2022 Don. Siyum A.