CV Study Guide Flashcards
Thecardiovascularsystemconsistsofthe
heartandallthebloodvessels.Functionally,
theheartislikea
doublepumpwitheachpumpconnectedtotheotherthroughalongseriesofbloodvessels
heart consists of how many chambers
4
tworeceivingchamberscalled
atria
twopumpingchamberscalled
ventricles.
Theleftsideoftheheartalwayspumps
oxygenatedblood,
andtherightsidealwayspumps
deoxygenatedblood.
Thepulmonarycircuitrefersto
allthebloodvesselsthattakedeoxygenatedbloodfromtherightventricleofthehearttothelungs,andthenreturnoxygenatedbloodtotheleftatrium.
systemiccircuit.
bloodvesselsthattransportthisoxygenatedbloodtothebody
gasexchangeoccurswithin
capillaries
capillaries
microscopicbloodvesselsonlyonecelllayerthick
capillaries wall made up of
simplesquamousepithelium.
Theseflatcellseasilypermitthediffusionofgases,suchasoxygen(O2)andcarbondioxide(CO2)
simplesquamousepithelium.
normalby-productofcellularrespirationandgraduallybuildsupwithinbodycells
Carbondioxide
Carbondioxidediffusesfromthebodycellsintothe
capillary.
pathwaythatbeginsandendswiththe
right atrium
whichatrioventricularvalve—bicuspidortricuspid—comesfirst
Yourideyourtricycle(tricuspid)beforeyourbicycle(bicuspid).
Coronarycirculationreferstothe
bloodsupplytotheheart
oronaryarteriessupplyoxygenatedbloodtothe
heart
cardiacveinscarrydeoxygenatedbloodbackto
the heart
flowchartsummarizescoronarycirculationthroughthebloodvessels
Baseofaortaleftandrightcoronaryarteriesbranchesofcoronaryarteries(circumflexa.,anteriorinterventriculara.,marginala.,posteriorinterventriculara.)coronarycapillariescardiacveinscoronarysinusrightatrium
coronaryarteriesbecomeblocked
bloodsupplytotheheartisreduced
coronaryarteriesbecomeblocked deprives cardiac muscles cells of
oxygen
if coronary arteries remain blocked for many years, it can lead to
myocardialinfarction(heartattack)
Todistinguishtheanteriorfromtheposteriorviewoftheheart
usethecoronarysinusasalandmarkfortheposteriorview
Goodlandmarksfortheanteriorviewinclude
pulmonarytrunk,anteriorinterventricularartery,circumflexartery,andascendingaorta.
heartisdividedinto
leftandrighthalvesandhasfourchambers,twoatriaandtwoventricles.
firstchamberstoreceivebloodfromthebody.
atria
what happens in the atria
fillwithblood,contract,andtransferbloodtothepumpingchambers,orventricles
which are the pumping chambers
ventricles.
rightventriclepumps
deoxygenatedbloodtothelungs
leftventriclepumps
oxygenatedbloodtotherestofthebody
hearthastwodifferenttypesofvalves
atrioventricular(AV)valvesandsemilunarvalves
atrioventricular(AV)valvesandsemilunarvalves.
TheAVvalvesarelocatedbetweentheatriaandtheventricles.Theoneontherightsideofthehearthasthreevalveflaps,soitiscalledthetricuspidvalve,andtheoneontheleftsidehastwovalveflaps,soitiscalledthebicuspid(mitral)valve.Thesevalvespermitaone-wayflowofbloodfromatriatoventricles.
semilnar valves
??
chordaetendineae
Long,fibrous,cord-likestructures anchor the valve flaps to the papillary muscles
papillary muscles
long,cone-shaped,muscularextensionsoftheinnerventricles
chordaetendineaeandpapillarymuscleshelp
keeptheAVvalvesclosedduringventricularcontraction.
semilunarvalvesarelocatedat
thebaseofeachmajorarterythatleaveseachventricle
Ontherightsideisthepulmonarysemilunarvalve,andontheleftistheaorticsemilunarvalve
??
Semilunarvalvesprevent
backflowofbloodintotheventricles
Fromoutermosttoinnermost,thewalloftheheartismadeofthreelayers
epicardium,myocardium,andendocardium
Theepicardium(visceralpericardium)ismadeof
fibrousconnectivetissueandistheinnermostlayerofthepericardialsacthatsurroundstheheart
myocardiumiscomposedof
multiplelayersofcardiacmuscleandmanybloodvesselsandnerves
endocardiumismadeof
simplesquamousepitheliumandlinestheinsideofalltheheartchambersandvalves
endocardium is continuous with the
endotheliumofbloodvesselsthatenterandexittheheart,suchastheaortaandthepulmonaryveins.
Thesemilunarvalvesresembleamodified
peacesignwhenclosed
Todistinguishbetweentheleftandrightventricles,notethatthewalloftheleftventricleis
thicker than the wall of the right ventricle
Theatrioventricularvalvesandassociatedstructuresresemblea
parachute; The valve flaps are the parachute, ventricle. the parachute cords are the chordae tendineae, and the paratrooper is the papillary muscle
Thehearthasitsowninternalregulationsystemtoachievetwoimportantfunctions:
(1)triggeringtheheartbeat,and(2)coordinatingthetimingbetweencontractionoftheatriaandcontractionoftheventricles
intrinsicconductionsystem
Thehearthasitsowninternalregulationsystemtoachievetwoimportantfunctions
without the intrinsicconductionsystem to ensure that the heart chambers do what
completelyfillwithbloodbeforecontracting,theheartwouldbeaveryinefficientpump
intrinsicconductionsystemconsistsofthefollowingsixstructures
sinoatrial (SA) node; Internodal pathway; atrioventricular node; atrioventricular (AV) bundle; bundle branches (right and left); purkinje fibers
intinsic conduction system cann be structurally divided into two main parts
thenodes(SAandAVnodes)andthepathway(internodalpathway,AVbundle,bundlebranches,andPurkinjefibers).
the nodes
(SAandAVnodes)
the pathway
(internodalpathway,AVbundle,bundlebranches,andPurkinjefibers)
Thenodesconsistof
clustersofspecializedcardiacmusclecellsthatcontainveryfewcontractileproteins—myosinandactin—foundinnormalcardiacmusclecells
nodes are the only cells in the body that are
autorhythmicmusclecells
Insteadofcontracting,nodesserveasakindof
“sparkplug,”orstimulus,toestablishtheheartbeat
SAnodeislocated
withinthewalloftherightatriumandisreferredtoastheprimarypacemaker.
AVnodeislocatedinthe
septumbetweenthetwoatriaandisreferredtoasthesecondarypacemaker
Likesmoothmusclecells,cardiacmusclecellscan
stimulateadjacentcells.
becausecardiacmusclecellsinterdigitatewitheachotherlikepiecesofajigsawpuzzle,stimulatingthefirstcellwill
quicklystimulatealltheothersinthepathway.
Theinternodalpathwayradiatesfromthe
SAnodeandextendstotheleftandrightatriaandAVnode.
AVbundleisarelativelyshortsegmentofcellsthatextendsfrom
theAVnodeandpenetratesintothetopoftheinterventricularseptum
AV BUNDLE IS THE ONLY
electricalconnectionbetweentheatriaandtheventricles.
AV bundle splits into two pathways at the interventricular septum
therightandleftbundlebranches,whichextendthroughtheinterventricularseptumtowardtheapexoftheheart
Theflowoftheimpulseforcontractionalwaysmovesinthefollowingsequence:
SAnodeinternodalpathwayAVnodeAVbundlebundlebranchesPurkinjefibers
theautorhythmiccellswithintheSAnodetriggerthe
impulsetospreadtotheleftandrightatriathroughtheinternodalpathway.
Theimpulsecausesthe_____tocontract,whichforcesbloodintotheventricles.
atria
Adelayinventricularcontractionisneededtoallow
theventriclestofillwithblood.ThisdelaycomesintheformofthetimeittakestostimulatetheAVnodeandsendtheimpulsedowntheAVbundleandbundlebranches.BythetimetheimpulsehasspreadtothePurkinjefibers,theventricleshavefinishedfillingwithblood,andtheventriclesarestimulatedtocontract.
Theintrinsicconductionsystemisan___________thatleadstothecontractingoftheheartchambers,amechanicaleventImpulsePathwaySpecializedcardiac
ELECTRICALEVENT
Anelectrocardiogram(ECGorEKG)
graphoftheheart’selectricalactivityasexpressedinmillivolts(mV)overtime.
instrumentusedtoobtainanECGiscalledan
electrocardiograph
AnECGisusedtodetectif
electricalconductionpathwaywithintheheartisnormalandifanydamagehasbeendonetotheheart
InatypicalleadIIrecording,threedifferentwavesappear:
P,QRScomplex,andT; Each wave represents an electrical event called a depolarization or a repolarization.
electricaleventsstimulate
cardiacmusclewithintheheartwalltoeithercontractorrelax.Consequently,theseeventsleadtothecontractionandrelaxationoftheheartchambers—atriaandventricles.
P WAVE
atrialdepolarization—attheendofthePwave,bothatriahavedepolarized,whichcausestheatriatocontract.
QRS COMPLEX
ventriculardepolarization—attheendoftheQRScomplex,bothventricleshavedepolarized,whichcausestheventriclestocontract.Note:Atrialrepolarizationalsooccursduringthisperiod,butitismaskedbytheventriculardepolarization.
T WAVES
ventricularrepolarization—attheendoftheTwave,bothventricleshaverepolarized,whichcausestheventriclestorelax.
Twotypesofvariations IN AN ECGmaysignalabnormalities:
Variationinwaveheight(theymaybeelevatedordepressed); 2.Variationinnormaltimeintervals
ifaPwaveiselevated,itmayindicate
atrialenlargement.
IftheQRScomplexiselevated,itmayindicate
ventricularenlargement.
AtallandpointedTwavemayindicate
myocardialischemia.
Theheartisessentially
twopumpsthatworktogetherasonesynchronizedunit.
Theleftsidepumpsonly
oxygenatedblood,andtherightsidepumpsonlydeoxygenatedblood
Thecardiaccyclereferstoallthe
pumpingactionsthatoccurwithintheheartduringoneentireheartbeat.Itconsistsofboththeatriaandtheventriclesfillingwithbloodandthencontracting.Itbeginswithcontractionoftheatriaandendswithrefillingoftheatria.Onaverage,thiscontinuouscycletakesabout800msec.tocompleteinanadult.
Theatriaandtheventricleshaverepeatedpatternsofcontraction_____andrelaxation________.
SYSTOLE AND DIASTOLE
Theatriafunctionasthe
receivingchambersofbloodfromthebody.Aftertheyfillwithblood,theycontractandforceblooddownwardintothetruepumps—themorepowerfulventricles.
TRUE PUMPS OF THE HEART
THE VENTRICLES
Becausethesechambershavethemoredifficulttaskofpumpingthebloodtothebody,theyhaveathickerlayerofcardiacmuscleintheirwallsandalargervolume.
THE VENTRICLES
Recallthatthehearthastwopairsof
valves:atrioventricular(AV)valvesandsemilunarvalves.
TheAVvalvesfunctionas
one-wayvalvestopermitbloodtoflowfromtheatriatotheventricles.Theclosingofthesemilunarvalvespreventsbloodfromflowingbackintotheventriclesafterbeingejected.
Theelectrocardiogram(ECG)isrelatedtothe
cardiaccycle.
AnECGmeasures
atrial contraciton; sovolumetric ventricular contraction ; Ventricular ejection; Isovolumetric ventricular relaxation; Passive ventricular filling
,thecardiaccyclehasbeendividedintofivesteps,asfollows:
atrial contraciton; sovolumetric ventricular contraction ; Ventricular ejection; Isovolumetric ventricular relaxation; Passive ventricular filling
atrial contraciton;
ECGconnection:fromPwavetoQwave; AVvalvesopen; Semilunarvalvesclosed; Description:Theleftandrightatriacontractsimultaneously,causingtheatrialpressuretoincrease.ThisforcesbloodthroughtheAVvalvesandintotheventricles.Theventriclesarerelaxedandfillingwithblood.Thesemilunarvalvesareclosedbecausethepressureintheventriclesistoolowtoforcethemopen.
sovolumetric ventricular contraction ;
ECGconnection:beginswithRwave●AVvalvesclosed; Semilunarvalvesclosed●Description:Theventriclesbegincontractinginthisphase,causingtheventricularpressuretoincrease.HigherventricularpressurerelativetotheatriaclosestheAVvalves.Thevolumeofbloodintheventriclesremainsconstant(isovolumetric).Allheartvalvesareclosed.
Ventricular ejection;
ECGconnection:fromSwavetoTwave●AVvalvesclosed●Semilunarvalvesopen●Description:Theventriclescontinuecontractingduringthisphase.Likewringingoutawetrag,theventricleswringtheblood out, beginning at the apex and moving upward. This allows for the maximum volume of blood to be ejected - about 70ml per ventricle. The high ventricular pressure forces the semilunar valves to open, and blood is ejected into the pulmonary arteries and the aorta
Isovolumetric ventricular relaxation;
ECGconnection:beginsatendofTwave●AVvalvesclosed●Semilunarvalvesclosed●Description:Theventriclesarerelaxing,andtheheartvalvesareallclosed.Thevolumeofbloodintheventriclesremainsconstant(isovolumetric).Becauseventricularpressuresarehigherthanatrialpressures,nobloodflowsintotheventricles.Ventricularpressureisquicklydecreasingduringthisphase.
Passive ventricular filling
ECGconnection:afterTwavetonextPwave; ●AVvalvesopen●Semilunarvalvesclosed; ●Description:Asbloodflowsintotheatria,theatrialpressureincreasesuntilitexceedstheventricularpressure.ThisforcestheAVvalvesopen,andbloodfillstheventricles.Thisisthemainwaytheventriclesarefilled.Attheendofthisphase,theventricleswillbeabout70–80%filled.
TheCARDIACCYCLEisa
MECHANICALEVENTlikesqueezingabottleofwater.Justasthepressureinthebottleriseswhensqueezed,sodoesthepressureinaheartchamberwhenitiscontracted.
Inthecentralnervoussystem(CNS),thecardiovascular(CV)centerinthemedullaoblongatais
thecommand-and-controlcenterforregulatingheartfunction.Itusesreflexpathwaystocontrolheartrate.
ThethreemajorperipheralsensoryreceptorsthatprovideinputtotheCVcenterare:
1.Proprioceptors; 2.Chemoreceptors—; 3.Baroreceptors;
1.Proprioceptors—
measuretensionchangesinmusclesandjoints
2.Chemoreceptors—
detectchangesinbloodaciditybysensingchangesinCO2andHlevels
3.Baroreceptors—
locatedinthecarotidsinus,aorticarch,andotherarteries;detectchangesinbloodpressure
TheCVcentersendsitsmotoroutputtotheheartthroughtwodifferentnerves:
1.Vagusnerve—todecreaseheartrate; 2.Cardiacacceleratornerve—toincreaseheartrate
VAGUS NERVE
TO DECREASE HEART RATE
CARDIAC ACCELERATOR NERVE
TO INCREASE HEART RATE
Theinternalpacemakerswithintheheart—
theSAnodeandAVnode—
Theinternalpacemakerswithintheheart helps set the
itsnormalrateandrhythm
Thevagusnerve(cranialnerveX)ispartofthe
parasympatheticdivisionoftheANSandsendsimpulses to the heart to decrease heart rate
why is the vagus nerve a mixed nerve
meaningthatitcontainsbothsensoryandmotorneurons.Baroreceptors,locatedinthecarotidsinus,aorticarch,andotherarteries,detectchangesinbloodpressure
Asbloodpressureincreasesabovenormallevels,impulsesaresentalongsensoryneuronstothe
CVcenterandthencarriedalongmotorneuronswithinthevagusnervetotheheart.
Thevagusnerveinnervatestheheartatthe
SAnodeandAVnode.
THE VAGUS NERVE FUNCTIONS TO INHIBIT THE HEART, THEREBY ….
reducingtheheartrateandstrengthofcontractions.This,inturn,decreasescardiacoutput,whichlowersbloodpressurebacktonormal.Atthesametime,impulsesalsoaresentoutalongvasomotornerves(notshowninillustration)thatstimulatevasodilation,therebyfurtherloweringthebloodpressure.
Thecardiacacceleratornerveispartofthe
sympatheticdivisionoftheANSandsendsimpulsestothehearttoincreasetheheartrate.
Asbloodpressuredecreasesbelownormallevels,thisisdetectedby
baroreceptorsthatsendimpulsesalonganeuralnetworkovertotheCVcenter,thentothespinalcordandtotheheart.Thefinalnerveinthispathway—thecardiacacceleratornerve—
thecardiacacceleratornerve—innervatestheheartatthe
SAnode,AVnode,andcardiacmuscleintheventricularwall(ventricularmyocardium).Theresponseisthatboththeheartrateandstrengthofcontractionsincrease.This,inturn,increasescardiacoutput,whichincreasesbloodpressure.Atthesametime,impulsesaresentoutalongvasomotornerves(notshowninillustration)thatstimulatevasoconstrictionandtherebyfurtherincreasebloodpressure.
Thebodyhasfivefundamentaltypesofbloodvessels:
arteries,arterioles,capillaries,venules,andveins.Allofthemconnectinthefollowingpredictablepattern:
PATH OF BLOOD
Heart TO artery(larger) TO artery(smaller)TO arterioleTO capillary TOvenuleTO vein(smaller)TO vein(larger)
Arteriesalwayscarryblood
awayfromtheheart.
ARTERIES ARE THICKER WALLED THAN VEINS BECAUSE
becausethebloodwithinthemisatahigherpressure.
Allveinsalwayscarryblood
BACK TO THE HEART
WHY ARE VEINS THINNER WALLED
BECAUSE PRESSURE WITHIN THEM IS LOWER
LARGER VEINS CONTAIN
valves—similartoonewaysemilunarvalvesintheheart—thatassistthelow-pressurevenousbloodreturntotheheart.
Whenapersonisstanding,gravityworksagainst
venousbloodflow.
valvesbreakuplargerveinsinto
smallersegments.
Arteriesandveinsconnectatthemicroscopiclevelby
capillarynetworks.
Capillariesare
thesmallestbloodvesselsinthebodyandareimportantfunctionallybecausegasandfluidexchangeoccurshere.Theirentirewallisoftenasinglecelllayerinthickness.
Arteriolesandvenulesaremicroscopicvesselsthatfeedanddrain
Capillaries
ATERIOLOES ANDcapillariesarestructurallysimilartoacapillaryexcept
theyhavesmallamountsofsmoothmusclearoundthem.Thesmoothmusclearoundanarteriolecanbestimulatedtoeitherconstrict(vasoconstriction)orrelax(vasodilation).This,inturn,causeschangesinbloodflowtoacapillaryandsystemicbloodpressure.
Vasoconstrictionofarterioles
decreasesbloodflowandincreasesbloodpressure,andvasodilationdoesjusttheopposite.
Arteriesandveinshavethreemajorlayersintheirwalls:
tunicaexterna,tunicamedia,andtunicainterna:
tunicaexterna,
connectivetissuelayermademostlyofcollagenfibers
tunicamedia,
layersofsmoothmuscleandsomeelasticfibers
tunicainterna:
endotheliallayer(simplesquamousepithelium)withunderlyinglooseconnectivetissue
somearteries/veinscarryoxygenatedbloodandotherscarrydeoxygenatedblood. TRUE OR FALSE
TRUE
ArteriesAway!
Arteriesalwayscarrybloodawayfromtheheart.
●Torecallonestructuraldifferencebetweenarteriesandveins:
VeinshaveValves(arteriesdonothavevalves).
●Todistinguishanarteryfromaveinunderthemicroscope,
rememberthatarteriesalwayshaveathickertunicamedia.
Bloodalwaysfollowsapredictablecircuitthroughbloodvessels.Therearefivefundamentaltypesofbloodvesselsinthebody:
arteries,arterioles,capillaries,venules,andveins.Allofthemconnectinthefollowingpattern:
PATH OF BLOOD
HEART TO LARGE ARTERY TO SMALLER ARTERY TO ARTERIOLOE TO CAPILLARY TO VENULE TO SMALLER VEIN TO LARGER VEIN TO HEART
AS ARTERIES MOVE FARTHER AWAY FROM THE HEART (DISTANCE INCREASES) WHAT HAPPENS TO BLOOD PRESSURE
Asdistancefromtheheartincreases,bloodpressuredecreases.
Arteriesandveinsconnecttogetheratthemicroscopiclevelby
capillarynetworks.
Capillariesarethesmallest
bloodvesselsinthebodyandare
Capillariesveryimportantfunctionallybecause
gasexchangeandfluidexchangeoccurshere.Oxygenexitsthebloodtobeusedbybodycells,andcarbondioxideentersthebloodfromcells.Theliquidplasmaisfilteredoutofthebloodtobecomeinterstitialfluid(tissuefluid).
VeinscarrY WHAT TO WHERE
low-pressure,deoxygenatedblooddrainintothevenacava,whichdrainsintotheheart’srightatrium(RA)
WHAT IS THE RIGHT ATRIUM
receivingchamberfillswithblood,contracts,andforcesbloodintotherightventricle(RV).
WHAT HAPPENS IN THE RIGHT VENTRICLE
Allthisdeoxygenatedbloodisthenpumpedoutoftherightventricletogotothelungstogetoxygenated.
WHAT HAPPENS IN THE LUNGS
thepulmonarycapillariesfunctiononlyforgasexchange,inwhichoxygendiffusesintothebloodandcarbondioxidediffusesout.Theoxygenatedbloodisthentransportedthroughveinstotheleftatrium(LA)
WHAT HAPPENS IN THE LEFT ATRIUM
LAfillswithblood,contracts,andforcesbloodintotheleftventricle(LV).
WHAT HAPPENS IN THE LEFT VENTRICLE
hisoxygenatedbloodisthenpumpedouttothebodyviatheaorta.
Theheartfeedsitsowncardiacmusclefirstthrough
coronarycapillariessoitcancontinuepumpingbloodeveryminuteofeveryday
Arteriescarry
oxygenatedbloodabovethehearttothecapillariesinthebrain,trunk,andupperlimbs.Otherarteriescarrybloodbelowtheheart
ARTERIES CARRY BLOOD BELOW THE HEART TO THE FOLLOWING MAJOR AREAS
Digestiveorgansandspleen; Kidney; Gonads; Liver, lower limbs
WHAT HAPPENS AT THE Digestiveorgansandspleen—
Aftergasandfluidexchangeoccursatthesplenicandmesentericcapillaries,deoxygenatedbloodiscarriedbyveinstothehepaticportalsystemintheliver.Notethatcapillariesinthissystemarenotforthetypicalpurposeofgasandfluidexchange.Instead,thesehighlypermeablecapillariesarespecializedfordeliveringnutrientsabsorbedbythedigestivetracttolivercellsbeforeenteringthegeneralcirculation.Thelivercellsserveasspecialprocessingcentersthatperformmanyfunctions.Forexample,theystoreglucoseasglycogenanddetoxifyalcohols.
WHAT HAPPENS AT THE KIDNEY
Anotheruniquegroupofpermeablecapillariesistheglomerularcapillaries.Likethecapillariesinthehepaticportalsystem,thesearealsonotforthetypicalpurposeofgasandfluidexchange.Instead,theyarespecializedtofilteronlythebloodplasma,placeitinaseparatetubularsystem,andprocessthisliquidintourine.Thesecapillariesleadintotheperitubularcapillaries,wheregasandfluidexchangedoesoccur.
WHAT HAPPENS AT THE GONAD
Inthemale,gasandfluidexchangeoccursatcapillariesinthetestes,whereasinthefemale,thisoccursatcapillariesintheovaries.
Thetwotypesofflowpatternsare:
(1)laminarflow,and(2)turbulentflow.
1Laminar(lamina4layer)flowisthe
normalflowpatterninhealthybloodvessels; Theconcentriclayersoffluidflowtogether,butnotatthesamerate.Asshownintheillustration,theouterlayerstravelmoreslowlythantheinnerlayers.Why?Asthefluidintheoutermostlayerrubsagainstthevesselwall,itishinderedbytheforceoffrictionandmovestheslowest.Incontrast,thefluidinthecenterofthetubeisinterferedwiththeleast,soitmovesthefastest.Normal,healthybloodvesselsaresmoothontheirinnersurface.Likethesmoothsurfaceontheinsideofagardenhoseoradrainpipe,thisallowsthefluidtoflowthroughmosteasily.
Asanotherclinicalexample,turbulentbloodflow
isheardmovingthroughadefectiveheartvalveasa“murmur.”
2Turbulentflowistheresultofanydisruptioninthenormal,
laminarflow.
Somelowlevelsofturbulentflowarenormal
asbloodflowsthroughallthevesselsinthebody,buthighlevelsmayindicateanabnormality.
WhatcausesTURBULENCE?Twothings:
(1)physicalchangeinavessel(ex.:constriction,sharpturn,ornarrowingofavessel)or(2)Diseasestate(ex.:atherosclerosis).Becauselargebloodvesselsconnecttosmallerones,somenarrowingisnormal,butitisagradualchangethatdoesn’tusuallyresultinturbulentflow.
(1)physicalchangeinavessel(ex.:
constriction,sharpturn,ornarrowingofavessel)or
(2)Diseasestate(ex.:
atherosclerosis).Becauselargebloodvesselsconnecttosmallerones,somenarrowingisnormal,butitisagradualchangethatdoesn’tusuallyresultinturbulentflow.
Theheartgeneratesthebloodpressureby
ejectingbloodintothearterialsystem.
Bloodpressure(BP)isatypeof
hydrostaticpressure—orforceofafluidagainstthewallofatube.
Astheventriclescontractandforcebloodoutintothearteries,thesevessels
expand,andthepressurerisestoamaximumpressure.Astheventriclesrelax,andnomorebloodisejectedintothearteries,thearteriesrecoil,andpressurefallstoaminimumpressure.
thesourceofourpulse.
constantcycleofrisingandfallingbloodpressureis
Whenbloodpressureistaken,itismeasuredin
mmHgandexpressednumericallyasthemaximumpressureovertheminimumpressure.Thisisreferredtoasthesystolicpressureoverthediastolicpressure.Forexample,anormalbloodpressurereadingmightbe120/70,readas“120over70.”
Bloodpressurehastobehomeostaticallymaintainedatanormallevel.Ifbloodpressureexceedsnormallevels,itcancause
smallervesselstorupture,leadingtoanythingfromastrokeeventoblindness.
IfBLOOD PRESSURE levelsfalltoolow,thisalsocanleadtonumerousproblems.Forexample,filtrationistotallydependentonpressure.
Thekidneysconstantlyfilterthebloodtoremovewasteproducts,andthecapillariesinallourorgansfilterthebloodtoformtissuefluid.Nopressure,nofiltration.ThebodyhasnumerousphysiologicalmechanismstoincreaseBPwhenitfallstoolow.
bloodpressureresultsfrom
theforceofbloodagainstthewallofthebloodvessel.
1Whenabloodpressurecuffiswrappedaroundtheupperarm,theintendedpurposeisto
compressthebrachialartery,whichdeliversoxygenatedbloodtothearm.
Bloodpressure(BP)isatypeof
hydrostaticpressure(HP)orfluidforceagainstthewallofatube.
Theheartgeneratesthebloodpressurebyejectingbloodinto
the arterial system
themostmicroscopicbloodvesselsinthebody,joinarteriolestovenules
Capillaries,Theirdiameterissosmallthatredbloodcellsmustpassthroughsinglefile.Thesevesselsformaninterconnectingnetworkormeshofvesselscalledcapillarybeds.
capillarybeds.
interconnectingnetworkormeshofvessels
.Allthevarioustissuesinthebodydependonthesetoremovewastesandtodelivernutrientsandfluid.
capillarybeds.
Thetubelikestructureofeachcapillaryissimple.Thewallofthevesselismadeupof
endothelialcellsorsimplesquamousepithelialcells.Eachofthesecellsisflattoallowforeasydiffusionofsolutesfrombloodtotissuecellsandviceversa.
basementmembrane
Wrappedaroundtheoutsideofthesecellslikeathinblanketareproteinfiberscalledthebasementmembrane.
intercellularclefts
Gapsbetweenadjacentendothelialcellscalledallowforpassageoffluidandsmallsolutes.
Thethreetypesofcapillariesare:
(1)continuouscapillaries,(2)fenestratedcapillaries,and(3)sinusoidalcapillaries.
(1)continuouscapillaries,
most common; least permeable; skin, connective tissues, skeletal muscle, smooth muscle and lungs
(2)fenestratedcapillaries,
most permeable, found in kidneys, small intestines, choroid plexus in brain and some endocrine glands
(3)sinusoidalcapillaries.
most permeable, found in liver, red bone marrow, spleen, and some endocrine glands
fenestrations
endothelial cells contain small holes called fenestrations that increase permeability
Bloodflowthroughacapillarybediscontrolledby
bandsofsmoothmusclecalledprecapillarysphincters.
precapillarysphincters.
Whentheyareclosed,bloodbypassesthecapillarybedbygoingthroughtheshunt.Whentheyareopen,bloodmovesthroughtheentirecapillarybed(asillustrated).Thisallowsthebodytorespondtodifferentsituations.Forexample,duringexercise,thesphinctershavetobeopenedinthecapillariesinskeletalmusclestomeetthemuscle’sincreasedoxygendemandanddealwithincreasedproductionofcarbondioxide.Duringthedigestionofaheavymeal,morebloodhastobeshuntedtothecapillariesinthedigestivetractratherthantotheskeletalmuscles.
Capillarybedsarethesitesof
nutrientandwasteexchangebetweenthebloodandbodycells.Nutrientsmovefromthebloodintotissuecells,andwastesmovefromtissuecellsintotheblood.Forexample,therespiratorygases—oxygenandcarbondioxide—diffuseacrossthewallofthecapillary.
Oxygenisavitalnutrientthatdiffusesoutofthebloodandinto
tissuecells,andcarbondioxideisawasteproductthatdiffusesfromtissuecellsintotheblood.
Recallthatdiffusiondependsona
gradient(seepp.78–79).Theruleforsimplediffusionisthatasolutemovesfromaregionofhighersoluteconcentrationtoaregionoflowersoluteconcentration.Oxygeniscarriedinthebloodprimarilybytheproteinhemoglobin.Ascellsconsumeoxygentometabolizeglucoseinthecellularrespirationprocess,thisensuresthatthegradientforoxygenismaintained.Carbondioxideisaby-productofcellularrespiration,soitmaintainsagradientasitconstantlyaccumulateswithinbodycells.
Gasexchangeoccursacross
capillarybeds.
Thisishowoxygenisdeliveredtoyourcellsandhowcarbondioxideisremovedfromtissues.
capillarybeds.
Twoprocessesareoccurringsimultaneouslywithdiffusion:
filtrationandreabsorption.
filtrationprocessiscompletelydependentona
force.NO FORCE, NO FILTRATION
(CHP)
capillaryhydrostaticpressure
capillaryhydrostaticpressure
thebloodpressureinsidethecapillarieS
THIS drivesthefiltrationprocessandismeasuredinmillimetersofmercury(Hg).
capillaryhydrostaticpressure (CHP)
Acrossacapillarybed,theCHPquicklydropsas
bloodmovesfromthehigherpressurearterioleend(35mmHg)tothelowerpressurevenuleend(18mmHg).
WorkingagainsttheCHPisacounterforcecalledthe
bloodcolloidalosmoticpressure(BCOP).
Osmoticpressurerepresents
theforcefromwater’stendencytomoveacrossasemipermeablemembranetowardthesolutionwiththegreaterconcentrationofnonpenetratingsolutes(primarilyproteins)
osmoticpressureisproportionaltothe
soluteconcentration.Thehigherthesoluteconcentration,thegreateristheosmoticforce.
Becausetheconcentrationofnonpenetratingsolutesinthebloodisgreaterthanthetissuefluidwithintheinterstitialspaces,water’stendencyisto
movebackintotheblood.
UnliketheCHP,theBCOPremains
constantacrossthecapillarybedat25mmHg.Why?Becausetheconcentrationofnonpenetratingsolutesdoesnotchangefromoneendofthecapillarybedtotheother.
Filtrationoccursonlyatthe
arterioleendofthecapillarybed.
Thisprocessoffilteringthebloodplasmaistheonlywaythebodyhasto
createinterstitialfluid.
Theinterstitialfluidisthendrainedintothe
lymphaticsystemtobecomelymph
Reabsorptionofwateroccursonlyatthe
venuleend.
somewaterisalwaysreabsorbedatthevenuleendofthecapillarybecauseof
osmosis.
Thecapillaryhydrostaticpressure(CHP)isthe
bloodpressureinsidethecapillary.
Venousreturnrefersto
thevolumeofbloodreturningtotheheartthroughtheveins.
Veinsareundermuchlowerpressurethanarteries,whichmakesitdifficulttoreturnvenousbloodtotheheart. TRUE OR FALSE
TRUE
Veinscontain________atregularintervals,whichallowforbloodflowinonedirectionandpreventbackflow.
semilunarvalves
Venousreturniseasierwhenapersonislyingdownbecause
theforceofgravityisnotafactor.Butwhensomeoneisstandingup,considerhowlongajourneyitisforthevenousbloodinyourfoottoreturntotheheartwhilemovingagainstgravity.
Althoughtheheart’snormalpumpingactionhelpsmovethevenousbloodbacktotheheart,thebodyhastwoothermechanisms
(1)skeletalmuscle“pump,”and(2)respiratory“pump.”
Whenyouarewalking,thenormalmusclecontractionsinyourlegsgreatlyaid
invenousreturn.Theyactuallysqueezebloodupthroughtheperipheralveinstowardtheheartinanactioncalled“milking.”
milking
Hereishowitworks:Theillustrationshowsashortsegmentofaveinwithtwosemilunarvalves.Theproximalvalveisnearertheheart,andthedistalvalveisfartherfromtheheart.Astheskeletalmusclearoundthisveincontracts,thevesselissqueezed,therebyincreasingthepressureinsidethevein.Thisincreasedpressureforcestheproximalvalvetoopen,butthedistalvalveremainsclosedbecauseofbackpressure.Theendresultofthisactionisthatsomevenousbloodismovedupintothenextsectionofthevein.Byrepeatingthispattern,venousbloodisgivenanextrapushonitsjourneybacktotheheart.
Ifyouhavetostandforalongtime,itisgoodtoflexyourgastrocnemiusmuscles(calfmuscles)toprevent
fainting.
Faintingiscausedbya
decreaseinvenousreturn,whichleadstodecreasedcardiacoutput,whichcausesadecreaseinthebloodsupplytothebrain.Thismeansthatlessoxygenandglucosearebeingdeliveredtoneuronsinthebrain,whichcausesfainting.
Byflexingyourgastrocnemiusmusclesafterstandingstillforalongtime,youwillputyour__________toworkforyou.
skeletalmuscle“pump”
Normalbreathingfacilitates
venousreturn.Thedeeperthebreathing,thegreateristheassistanceinthisregard.
Normalbreathinginvolvesarepeatingcycleof
contractionandrelaxationofthediaphragm.
Whenthisdiaphragm contractsforanormalinspiration,itmovesdownwardand
compressesthecontentsoftheabdominalcavity,whichincreasestheabdominalpressure.Simultaneously,thevolumeinthethoraciccavityincreases,causingadecreaseinpressure.Thispressuregradientforcesbloodoutofthevariousveinsintheabdominalregionandintotheinferiorvenacava(IVC)toallowbloodtomovebackintotherightatriumoftheheart.
Cardiac output (CO) is
the amount of blood pumped out of a ventricle in 1 minute and is expressed as milliliters of blood per minute. It is mathematically defined as the product of the stroke volume (SV) times the heart rate (HR)
A normal stroke volume is the amount of
blood pumped out of each ventricle in one beat—about 70 mL for an adult heart.
A healthy adult male has a resting heart rate of about
70 beats per minute
In general, factors that effect SV also affect
HR. For example, during exercise, both SV and HR increase
FactorsaffectingSV
preload, contractility; afterload
Preload:
definedastheamountoftensionintheventricularcardiacmusclecellspriortocontracting.Theruleisthatthegreaterthetensiononthecells,themoreforcefullytheycontract.
Frank-StarlingLaw.
ThisrelationshipisreferredtoastheForexample,duringexercise,morebloodisreturnedtotheheartthroughthevenousreturn.Asmorebloodenterstheheart,itstretchescardiacmusclescells,resultinginamoreforcefulejectionofblood.Forthisreason,exerciseincreasesSV.
Contractility:definedas
thedegreetowhichcardiacmusclecellscanshortenwhenstimulatedbyaspecificchemicalsubstance.Forexample,calciumionshaveapositiveinfluenceoncardiacmusclecontraction.Abnormallylowlevelsofcalciumresultinanirregularheartbeat,decreasingtheSV.
Afterload:definedas
theamountofforceneededfromventricularcardiacmusclecellstoejectbloodfromtheventriclesandpastthesemilunarvalves.Anythingthatimpedesbloodflowcanincreaseafterload.Forexample,anyblockageintheperipheralbloodvessels(suchasatherosclerosis)wouldrestrictbloodflowandincreasetheafterload.Hypertension(highbloodpressure)alsoincreasestheafterload.Astheafterloadincreases,theSVdecreases.
FactorsaffectingHR
age, sex, state of activity, endurance training, stress, anxiety
Age:
HRgraduallydecreasesfromchildhoodtoadulthood.AnewbornmayhaveanHRof120bpm,whereasanadultmalemayhave70bpm.Intheelderly,theHRincreasesagainrelativetothatofayoungadult.
●Sex:
Onaverage,femaleshaveslightlyhigherrestingHRsthanmales.Thedifferenceisabout5bpm.
●Stateofactivity:
Duringcertainphasesofthesleepcycle,theHRdecreases.ButduringexercisetheHRtemporarilyincreases.
●Endurancetraining:
MarathonrunnersmayhavearestingHRof50bpm.ThistypeoftrainingincreasesheartsizeaswellasSV.ThisallowsforanormalCOwithalowerHR.
●Stress,anxiety:
StressandanxietyincreaseHR.
TheCOdoesnotremainconstant. True or False
Itregularlyrisesandfalls.
MaintainingtheCOinanormalrangeisprimarilythejobofthe
cardiovascular(CV)centerinthemedullaoblongataofthebrain.
Usingreflexpathwaysinthe
autonomicnervoussystem,theCVcenterregulatestherhythmandforceoftheheartrate.
Hormonesalsohelptocontrol
cardiacactivity.
Forexample,epinephrineandnorepinephrinearepowerful
cardiacstimulators.
Inshort,thenervoussystemandhormonalregulatorsworktogethertoregulate
heartactivity,therebyindirectlyensuringthatanormalCOisachieved.
Heartrate(HR)isthenumberof
heartbeatsperunittime,typicallyexpressedasbeatsperminute(bpm).Anormalaverageis 70bpm.
Strokevolume(SV)istheamountof
bloodpumpedoutofeachventricleinonebeat(BPM),expressedinmilliliters(mL)ofblood.Anormalvalueis70mL.
Cardiacoutput(CO)istheamountof
bloodpumpedoutoftheleftventricleinoneminute,expressedinmilliliters(mL)ofbloodperminute.Anormalvalueis4,900mL/min.
Thefollowingfourregulatorymechanismsareusedtocontrolbloodpressure(BP):
cardiovascularcenter,neuralregulation,hormonalregulation,andautoregulation.
1Neuralregulationthroughthecardiovascularcenter
Neuralregulationusesreflexpathwaystoregulatenormalbloodpressure.Asitsnameimplies,thecardiovascularcenter(CV),inthemedullaoblongata,isthenervoussystem’scommand-and-controlcenterforregulatingtheheartrateandvasoconstriction.
thecardiovascularcenter(CV),inthemedullaoblongatareceivesperipheralsensoryinputfromthreemajorsources:
proprioceptors,chemoreceptors,andbaroreceptors.TheCVrespondsbysendingtheappropriatemotoroutputtotheheartandbloodvessels.Dependingonthestimulus,theheartrate(HR)eitherincreasesordecreases,andbloodvesselsarestimulatedtoconstrict.TheendresultisthattheBPeitherincreasesordecreasesbacktonormallevels.Fordetailsofthesereflexpathways
proprioceptors
(detectchangesinmuscletension),
chemoreceptors
(detectchangesinbloodacidity),
andbaroreceptors
(detectchangesinbloodpressure)
Hormonalregulationinvolvestheuseof
chemicalmessengerscalledhormonesthatbindtoreceptorsatatargettissueinordertoinducearesponse.
●Renin-angiotensin-aldosterone(RAA)system
Whenbloodpressuredecreases,itstimulatesthekidneytoreleasetheenzymereninintotheblood.ThisleadstotheproductionofapowerfulvasoconstrictorcalledangiotensinII.This,inturn,stimulatestheadrenalcortextoproducethehormonealdosterone.Thenetresultisanincreaseinbloodpressure.
renin
??
angiotensinII
vasoconstrictor
●Epinephrine(EPI)/norepinephrine(NE)EPIandNEareproducedby
cellsintheadrenalmedullainresponsetoemergencyorstressfulsituations.Twooftheorganstheytargetaretheheartandbloodvessels.Theresultisthatheartrateincreasesandbloodvesselsconstrict,respectively.Together,thesetworesponsesleadtoanincreaseinbloodpressure.
Waterlossfromtheblood,likewhatoccursduringexcessivesweating,stimulatesthe
posteriorlobeofthepituitaryglandtoproduceADH.Thishormonetargetsthenephronsinthekidneysandcausesmorewatertobereabsorbedintotheblood,thusrestoringnormalbloodpressure.
Asbloodvolumeincreases,thisstretchestheatriaintheheart,whichstimulatescellsintheatriatoproduce
●Atrialnatriureticpeptide(ANP); ANP.Byincreasingvasodilation,sodiumionexcretion,andurineproductionandblockingthereleaseofhormoneslikeADHandaldosterone,ANPdecreasesBP.
3Autoregulation—
theautomaticcontrolofbloodflowtoatissue;
Thesemechanismsarenormallynotassignificantastheneuralandhormonalmechanisms
physical changes; chemical changes
●Physicalchanges
ChangesinbodytemperatureaffectBP.Forexample,coldcausessuperficialbloodvesselstoconstrict,whichincreasesBP.Incontrast,heatcausesbloodvesselstodilate,leadingtoadecreaseinbloodpressure.
●Chemicalchanges
Differenttypesofbodycells,suchassmoothmusclescells,endothelialcells,andmacrophages,producevariouschemicalsthatsignalbloodvesselstoeitherdilateorconstrict.Forexample,smoothcellsproducelacticacid,whichcausesbloodvesselstodilate.Othervasodilatingchemicalsincludenitricoxide(NO),H,andK.
Whatisthehepaticportalsystem?
Thetermhepaticreferstotheliverandthetermportalreferstoaportalvesselwhichisdefinedasabloodvesselthatcarriesbloodfromonecapillarynetworktoanother.Allthebloodvesselsassociatedwiththisnetworkconstituteasystem.
Thefirstcapillarynetworkisfoundin
allthedigestiveorgans
Secondcapillarynetworkislocatedin
theliver(thecapillariesherearecalledsinusoids).Thevesselthatlinksthemtogetheristhehepaticportalvein.Thiswidevesselislabeledas#1intheillustrationonthefacingpage.Placeyourfingeronitandnoticethat
sinusoids
capillaries found in the liver
hepaticportalvein
??
??
therearemanyvesselsdrainingdeoxygenatedbloodfromthedigestiveorgansandcarryingitthroughthehepaticportalveinandintotheliver. Thebloodvesselsinthissystemcarrynutrient-richbloodtotheliversothenutrientscanbeprocessedinlivercellsbeforeenteringthegeneralcirculation.Thedeoxygenatedvenousbloodinthissystemisdifferentfromnormalvenousbloodinthatthelevelofnutrientssuchasglucoseandaminoacidsismuchhigher.Forexample,afterameal,bloodglucoselevelsriseandexcessglucoseneedstobedeliveredtolivercellswhereitisstoredasglycogen.Afterallthesenutrientshavebeenprocessedinlivercells,thenthedeoxygenatedbloodisdrainedbythehepticveins(#2intheillustration)whichcarrybloodtotheinferiorvenacava(labeledintheillustration)whereitentersthegeneralcirculation.
Therearethreemajorveinsthatdrainthebloodintothehepaticportalvein:●
Superiormesentericvein(#10); ●Inferiormesentericvein(#9); ●Splenicvein(#8)
Superiormesentericvein(#10)
bloodvesselstotheleftthataredrainingbloodfrompartofthelargeintestine.Alsonoticethebloodvesselsdrainingbloodfromthepancreasandthebottomofthestomach.Doyouseethewordsduodenumandileumintheillustration?Thesearetwoofthethreepartsofthesmallintestineandbloodisbeingdrainedfrombothofthem.Thethirdpart,thejejunum,isnotshownintheillustration.Evenso,youcanseebloodvesselsbranchingofftherightsideofthesuperiormesentericveinthathavebeencut.Thesearedrainingtherestofthesmallintestinethatisnotshown.
●Inferiormesentericvein(#9)
Noticethatitdrainsbloodfromtherectumandthedistalportionofthelargeintestine.Asyoufollowitupwards,noticethatitmergeswiththesplenicvein(#
●Splenicvein(#8)
Thenamesplenicobviouslyinformsusthatitdrainsbloodfromthespleen,butifyoulooknearitsterminus,youwillseethatitalsodrainsbloodfrompartofthestomach.Lastly,ifyoulookatthepancreas,youcanseethatitalsodrainsbloodfromthepancreasviathepancreaticveins(#7).
TheFetalcirculationisdifferentfrom
adultbloodcirculation.Thisistobeexpectedifyougiveitsomethought.Althoughthefetalheartisfunctioningandpumpingthefetalblood,thefetallungsarecollapsedandfilledwithfluid,sotheyarenotfunctioningforgasexchange.Thekidneysarealsonotfunctioningtoremovefetalwasteproductsfromtheblood.Noneofthedigestiveorgansarefunctioningbecausenofoodisbeingingested,sonutrientscannotbeobtained.Whatreplacesthesenonfunctionalorgansinthefetus?Theplacenta,theorganinthemother’suterus,isthesiteforexchangingbloodgases(O2andCO2),removingwasteproducts,andobtainingnutrients.Thisiswhyitissoimportantforapregnantwomantomaintainahealthydiet.Thefetus’slifelineistheumbilicalcord,abendable,cable-likestructurethatconnectsthefetustotheplacenta.
pathwaythatbloodflowsinfetalcirculation.
pairofumbilicalarteriesthatbranchofftheinternaliliacarteriesandcarrythefetalbloodtotheplacentatobecomeoxygenated.Thenewlyoxygenatedbloodfromtheplacentaflowsthroughthesingleumbilicalveintothenonfunctionalliverwhereitconnectstotheductusvenosusthatdrainsintotheinferiorvenacava.Thedeoxygenatedbloodfromtheinferiorvenamixeswiththeoxygenatedbloodfromtheductusvenosustobecomemixedbloodenteringtheheart.Bloodthendrainsfromboththesuperiorvenacavaandtheinferiorvenacavaintotherightatrium(RA).BloodintheRAfollowstwodifferentpaths.SomeofthebloodintheRAgoesthroughanopeningwithaflapcalledtheforamenovaleandenterstheleftatrium(LA).Theremainingbloodenterstherightventricle,andthenflowsintothepulmonarytrunk.Interestinglyenough,bothpathwaysendupbypassingthenonfunctionallungs.Bloodintheleftatriumispumpedintotheleftventricle,flowsthroughtheaorticarch,andmovesintothesystemiccircuit.Whileasmallamountofbloodinthepulmonarytrunkgoestothelungs,almostallofitispumpedthroughtheductusarteriosus—ashortfetalbloodvesselthatconnectsthepulmonarytrunktotheaortaanddivertsthebloodintothesystemiccircuit.Asthemixedbloodmovesthroughthecommoniliacarteryandintotheinternaliliacartery,itenterstheumbilicalarteriesonceagaintorepeatthecycle.
Afterbirth,theumbilicalcordistiedoffandblooddoesn’tflowthroughitanymore.Thefollowingkeychangesoccur:
●Umbilicalarteriescloseandbecomefibrouscordsattheirdistalends.
●Foramenovaleclosesandsealsofftobecomea
shallowdepressionintheinteratrialseptumcalledthefossaovalis.
●Ductusarteriosus—closestobecomethe
fibrousligamentumarteriosum.
Theumbilicalveinclosestobecomethe
fibrousligamentumteres(roundligament).●
Ductusvenosusclosestobecomethe
fibrousligamentumvenosum.
Thearterialsystemintheheadandneckfeedsoxygenatedbloodtothe
brain,face,eyes,neck,larynx,pharynx,esophagus,andotherimportantstructures.
Thearteriesbranchingofftheabdominalaortafeedoxygenatedbloodto
thedigestiveorgans,kidneys,spleen,gonads,urinarybladder,andotherimportantstructuresintheabdominopelviccavityandthelowerlimbs.
Thearterialsystemintheupperlimbsfeedsoxygenatedbloodto
allthetissuesinthearms.
Thearterialsysteminthelowerlimbsfeedsoxygenatedbloodto
allthetissuesinthelegs.
Thevenoussystemintheheadandneckdrainsdeoxygenatedbloodfrom
thebrain,face,eyes,neck,larynx,pharynx,esophagus,andotherimportantstructures.
Thevenoussystemintheabdominopelviccavitydrainsdeoxygenatedbloodintothe
inferiorvenacava,whichemptiesintotherightatriumoftheheart.
Thevenoussystemintheupperlimbsdrainsdeoxygenatedbloodfrom
allthetissuesinthearms.
Thevenoussysteminthelowerlimbsdrainsdeoxygenatedbloodfrom
allthetissuesinthelegs.