Structural plan of blood vessels

Transcription

1 The blood vessels 1. The structure of the blood vessels arteries, capillaries, veins 2. Vessels of the pulmonary circuit the pulmonary trunk 3. Aorta an overview 4. Arteries of the head and neck 5. Arteries of the trunk and limbs

2 Structural plan of blood vessels Three layers: internal layer tunica interna (intima) endothelium subendothelial layer internal elastic lamina (membrane) middle layer tunica media smooth muscle cells elastic and collagen fibers external layer tunica externa (adventitia) loose connective tissue smooth muscle tissue blood vessels, vasa vasorum vasomotor nerves, nervi vasorum 2

3 Structure of arterial wall Large-sized arteries = elastic (conducting) arteries, arteriae elastotypicae: aorta and its large branches pulmonary trunk 3

4 Structure of arterial wall Large elastic arteries: tunica interna (intima) thick endothelium well-developed subendothelium internal elastic lamina longitudinal elastic fibers tunica media main layer parallel elastic membranes tunica externa (adventitia) loose connective tissue; abundant elastic fibers vasa et nervi vasorum 4

5 Structure of arterial wall Medium-sized arteries = muscular (distributing) arteries, arteria myotypica: arteries of limbs intercostal arteries intraorgan arteries 5

6 Structure of arterial wall Medium (muscular) arteries: tunica interna (intima) endothelium thin subendothelial layer internal elastic lamina tunica media the widest layer circular muscle fibers external elastic lamina tunica adventitia thick connective tissue collagen fibers lymphatic capillaries, vasa vasorum and nerves 6

7 Structure of arterial wall Small-sized arteries 0.4 mm: tunica intima thinner subendothelial layer reduction of internal elastic lamina tunica media decrease of muscle fibers tunica adventitia very thin 7

8 Structure of arterial wall Arterioles 0.5 mm: tunica intima very thin subendothelial layer absent internal elastic membrane tunica media 1-2 circular layers of smooth muscle cells tunica adventitia very thin to absent 8

9 Structure of capillaries Capillaries, vas (hemo)capillare: part of terminal blood supply capillary loops and networks the sites for metabolic exchange endothelial tubes have a basement membrane two functional portions arterial 2-7 µm venous 7-12 µm Three types of capillaries: continuous (somatic) fenestrated (visceral) discontinuous (sinusoidal) 9

10 Structure of capillaries Continuous (somatic) capillaries: in organs with nutritive functions skeletal muscles skin and CNS internal organs vascular wall (vasa vasorum) Microscopic anatomy: simple endothelium, endothelium numerous pinocytotic vesicles passable intense transport basal membrane, membrana basalis morphologically similar to the epithelium pericytes, pericytus enveloped by the basal membrane contractile cells? stem cells smooth muscle cells 10

11 Structure of capillaries Fenestrated (visceral) capillaries: in organs with nutritive and metabolic function endocrine glands intestinal villi renal glomeruli Structure and function: perforated endothelium fenestrae with diaphragm basal membrane continous intense transport 11

12 Structure of capillaries Discontinuous (sinusoidal) capillaries (sinusoids): liver, spleen, bone marrow intestinal villi renal glomeruli Structure and function: endothelium unusually wide gaps numerous fenestrae without diaphragm macrophages between endothelium absent basal membrane partial, discontinuous intense transport of metabolites and cellular elements 12

13 Structure of venous wall Venous wall three provisional layers: tunica intima tunica media thinner tunica adventitia main layer Structural peculiarities: irregular lumen thinner wall with prevailing collagen fibers and valve presence Morphological types: venules and small veins with prominent circular musculature in the media with prominent longitudinal musculature in the adventitia with less prominent musculature nonmuscular veins 13

14 Pulmonary circuit Pulmonary trunk pulmonary arteries venous blood right chamber lungs Pulmonary veins 4, arterial blood lungs left atrium 14

15 Systemic circuit Systemic circulation course arteries capillaries veins coronary vessels portal veins 15

16 Major arteries Aorta course ascending aorta arch of the aorta descending aorta thoracic aorta abdominal aorta 16

17 The carotid system Common carotid artery, a. carotis communis: begin right truncus brachiocephalicus left arcus aorta two branches: a. carotis externa a. carotis interna sinus caroticus glomus caroticum Michael Guevara: Blood Pressure Control Systems 17

18 Arteries of the head Overview and external carotid artery: facial artery maxillary artery superficial temporal artery 18

19 The carotid system External carotid artery, a. carotis externa: anterior branches a. thyroidea superior a. lingualis a. facialis posterior branches: a. pharyngea ascendens a. sternocleidomastoidea a. occipitalis a. auricularis posterior end branches: a. temporalis superficialis a. maxillaris o pars mandibularis o pars pterygoidea o pars pterygopalatina 19

20 The carotid system Internal carotid artery, a. carotis interna: canalis caroticus parts: pars cervicalis through canalis caroticus pars petrosa pars cavernosa through sinus cavernosus pars cerebralis o a. hypophysealis superior end branches: o a. ophthalmica o a. communicans post. o a. choroidea anterior o a. cerebri anterior o a. cerebri media 20

21 Carotid ultrasonography 21

22 The thoracic aorta, aorta thoracica The parietal branches paired: aa. intercostales posteriores Х pairs longer right arteries III-XI intercostal space a. subcostalis below the X th rib dorsal branch, ramus dorsalis ramus spinalis back muscles skin on the back medial and lateral branch ramus cutaneus lateralis anterior branch rr. mammariae posterior branch aa. phrenicae superiores 22

23 The thoracic aorta, aorta thoracica The visceral branches: bronchial arteries, rr. bronchiales vary (2-3) in number and size oesophageal arteries, rr. oesophageales 3-6 in number ascending and descending branches pericardial branches, rr.pericardiaci mediastinal branches, rr. mediastinales 23

24 Clinical significance Dissection and aneurysm of the thoracic aorta: more common may affect its descending part the most common cause atherosclerosis other factors: congenital syndromes (S. Marfan), long-lasting high blood pressure, trauma some infectious diseases such as syphilis 24

25 The abdominal aorta, aorta abdominalis The main branches: parietal branches paired supply the abdominal wall visceral branches distributed to viscera unpaired paired branches 25

26 The abdominal aorta, aorta abdominalis The parietal branches: a. phrenica inferior sinistra et dextra a. suprarenalis superior r. oesophagealis left; r. venae cavae inferioris right aa. lumbales I-IV four paired arteries r. dorsalis r. spinalis branched to the muscles and skin of the abdominal wall a. sacralis mediana unpaired, a remnant from the caudal aorta 26

27 The abdominal aorta, aorta abdominalis Unpaired visceral branches: celiac trunk superior mesenteric artery inferior mesenteric artery 27

28 The coeliac trunk, truncus celiacus length 1-2 cm; level Th 12 divided into three branches: the left gastric artery, a. gastrica sinistra the smallest rr. oesophageales the hepatic artery, a. hepatica communis: a. gastrica dextra a. hepatica propria o r. dexter et r. sinister o a. cystica a. gastroduodenalis o a. gastroomentalis dextra o aa. pancreaticoduodenales supp. the splenic artery the largest branch, a. splenica (lienalis) rr. pancreatici aa. gastrici breves a. gastroomentalis sinistra rr. splanchnici 28

29 The superior mesenteric artery, a. mesenterica superior level L 1 ; in radix mesenterii branches: inferior pancreaticoduodenal artery, a. pancreaticoduodenalis inferior ramus anterior et ramus posterior jejunal and ileal branches, aa. jejunales et ileales: in number distributed to mesenteric intestine a series (1 st, 2 nd and 3 rd ) of arches straight vessels, vasa rectae ileocolic artery, a. ileocolica ileal branch, r. ilealis aa. cecales anterior et posterior a. appendicularis colic branch, r. colicus right colic artery, a. colica dextra descending and ascending branch middle colic artery, a. colica media right and left branch arcus Riolani 29

30 The inferior mesenteric artery, a. mesenterica inferior level L 2-3 ; length 5-6 cm branches: left colic artery, a. colica sinistra supplies the descending colon ramus superior arcus Riolani ramus inferior sigmoid arteries, aa. sigmoideae: 2-4 in number arches in mesocolon sigmoideum anastomoses in-between and with the adjacent arteries superior rectal artery, a. rectalis superior the end branch runs into the retroperitoneal space forms loops around the lower end of the rectum 30

31 The abdominal aorta, aorta abdominalis Paired visceral branches: middle suprarenal artery, a. suprarenalis media renal artery, a. renalis L 2 a. suprarenalis inferior testicular artery, a. testicularis ovarian artery, a. ovarica 31

32 Arteries of the upper limb The brachial artery, a. brachialis: from m. pectoralis major along suclus bicipitalis medialis, accompanied by n. medianus branches: a. profunda brachii canalis humeromuscularis a. collateralis radialis muscular branches, rr. musculares deltoid branch, r. deltoideus aa. nutriciae humeri a. collateralis media a. collateralis ulnaris superior a. collateralis ulnaris superior end branches: a. radialis a. ulnaris 32

33 Arteries of the forearm The radial artery, a. radialis: laterally and superficially arterial pulsations through the anatomical snuff box branches: a. recurrens radialis rr. musculares r. carpalis palmaris r. palmaris superficialis r. calparis dorsalis a. metacarpea dorsalis prima a. princeps pollicis aa. digitales propriae I-III continues into: the deep palmar arch 33

34 Arteries of the forearm The ulnar artery, a. ulnaris: downwards anterior-medially through the canalis carpi ulnaris branches: a. recurrens ulnaris a. interossea communis a. interossea anterior o a. comitans n. mediani o aa. nutriciae o rr. musculares a. interossea posterior o a. interossea recurrens rr. musculares r. carparis palmaris r. carpalis dorsalis r. palmaris profundus arcus palmaris profundus continues across the palm as: the superficial palmar arch 34

35 The arterial anastomoses around the elbow joint, articulatio cubiti rete articulare cubiti: a. collateralis ulnaris superior a. collateralis ulnaris inferior a. collateralis radialis a. collateralis media a. recurrens radialis a. recurrens ulnaris a. interossea recurrens 35

36 Arteries of the hand The superficial palmar arch, arcus palmaris superficialis: direct continuation of the ulnar artery r. palmaris superficialis of a. radialis: a. digitalis palmaris propria V aa. digitales palmares communes aa. digitales palmares propriae 36

37 Arteries of the hand The deep palmar (volar) arch, arcus palmaris profundus: direct continuation of the radial artery r. palmaris profundus of a. ulnaris: branches to rete carpale palmare three aa. metacarpales palmares rr. perforantes 37

38 Arteries in the pelvis The common iliac artery, a. iliaca communis L 4 : the internal iliac artery, a. iliaca interna the external iliac artery, a. iliaca externa 38

39 Arteries of the lower limb The femoral artery, a. femoralis: from lacuna vasorum; behind the inguinal ligament through the femoral triangle superficial branches: a. epigastrica superficialis a. circumflexa ilium superficialis aa. pudendae externae rr. scrotales (labiales) anteriores deep branches: a. profunda femoris a. circumflexa femoris medialis a. circumflexa femoris lateralis aa. perforantes prima, secunda et tertia rr. musculares a. descendens genus 39

40 Arteries of the lower limb The popliteal artery, a. poplitea: begin canalis adductorius transverses the popliteal fossa branches to the knee joint, genicular branches: a. superior medialis genus a. superior lateralis genus a. media genus a. inferior medialis genus a. inferior lateralis genus muscular branches: sural arteries, aa. surales, medialis et lateralis the end branches: a. tibialis anterior a. tibialis posterior a. peronea 40

41 The genicular anastomosis, articulatio genus rete articulare genus: a. genus descendens a. genus superior medialis a. genus superior lateralis a. genus media a. genus inferior medialis a. genus inferior lateralis a. recurrens tibialis anterior a. recurrens tibialis posterior r. circumflexus fibulae 41

42 Arteries of the leg the anterior tibial artery, a. tibialis anterior: a. recurrens tibialis posterior a. recurrens tibialis posterior a. malleolaris anterior lateralis a. malleolaris anterior medialis rr. musculares the posterior tibial artery, a. tibialis posterior: r. circumflexus fibularis a. nutricia tibiae rr. malleolares mediales rr. calcanei the peroneal artery, a. peronea (fibularis): a. nutricia fibulae r. perforans rr. malleolares laterales rr. calcanei r. communicans 42

43 Arteries of the foot The dorsal artery of the foot, a. dorsalis pedis: an extension of the anterior tibial artery in the 1 st intermetatarsal space branches: aa. tarsales mediales a. tarsalis lateralis rete dorsalis pedis a. arcuata rete dorsalis pedis aa. metatarsales dorsales I-III o r. perforans o aa. digitales dorsales the end branches: a. metatarsalis dorsalis prima two aa. digitales dorsales a. plantaris profunda arcus plantaris 43

44 The plantar arteries The lateral plantar artery, a. plantaris lateralis: rr. muscularis arcus plantaris profundus rr. perforantes II-IV aa. digitales plantares communes I-IV aa. digitales plantares propriae The medial plantar artery, a. plantaris medialis: rr. musculares rr. cutanei r. superficialis a. metatarsea plantaris I r. profundus anastomosis with arcus plantaris a. metatarsea plantaris I 44

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