Quiz 1 upper & lower arterial Flashcards
Circulatory system
transportation and distribution of essential substances to tissues and removal of by-products of metabolism
T or F:
veins and arteries at the foot are located distally?
True.
It is suppose to relate to the trunk (heart).
Pulmonary circulation
Right ventricle propels blood to the
lungs for O2 and CO2 exchange. Carries deoxygenated blood from RV to alveoli in lungs Returns oxygenated blood to LA
Systemic circulation
Left ventricle propels blood to all other tissues of the body. Arteries and arterioles carry oxygenated blood from LV to systemic capillaries Veins and venules return deoxygenated blood to RA. All systemic arteries branch from the aorta. Bronchial arteries are also part of systemic
All veins drain into SVC, IVC or coronary sinus
Flow of Blood through the heart
SVC/IVC -> Right Atrium -> Tricuspid Valve -> Right Ventricle -> Pulmonary Artery (to the lungs) -> Pulmonary Veins (4) –> Left Atrium -> Mitral Valve -> Left Ventricle -> Aorta (rest of body)
Pulmonary Trunk
Pulmonary Circulation
Emerges from RV (anterior heart). Passes superiorly, posteriorly and to left
Divides into 2 branches: Rt. and Lt. pulmonary a.
**After birth, PA only arteries to carry deoxygenated blood
Pulmonary veins (n=4)
Exit lungs
Carry oxygenated blood to LA
**After birth, PV only veins to carry oxygenated blood
Intima (tunica intima)
Innermost layer Thin lining of endothelial and elastic fibers
**Most susceptible layer to damage due to direct contact with blood flow (trauma)
Present in all vessels
Media (tunica media)
Middle layer Smooth muscle cells and elastic fibers
Responsible for round shape of arteries
Assists in passively contracting with diastole to propel blood toward heart (
Adventitia (tunica externa or adventitia)
Outermost layer
Longitudinal collagen fibers (fibrous tissue) ! Also contains nerves and vasa vasorum
Vasa Vasorum
Blood supply to the blood vessel itself is from the
vasa vasorum and intima. These are vessels that feed the vessel.Vasa vasorum can only reach so far into vessel. Rest of blood supply to vessel comes from intma. Therefore, any intimal damage decreases blood flow getting to the vessel itself
Arteries
Medium sized arteries Relatively thick walls
Large amount of smooth muscle
Distribute blood to various parts of body
Ex: brachial artery, radial artery
Arterioles
Delivers blood to capillaries
- *Key role in regulating blood flow from arteries to capillaries
- *Change in diameter significantly affects BP. Known as resistance vessels
Vasoconstriction
Contraction of arteriolar smooth muscle Increases resistance
Decreases blood flow to capillaries
Vasodilation
Relaxation of arteriolar smooth muscle Decreases resistance
Increases blood flow to capillaries
Capillaries
Many capillaries arise from each arteriole Connects arterioles to venules (Called microcirculation) Blood flow velocity becomes quite slow in the capillaries
Consist of short tubes with walls one cell thick Thin walls and slow blood flow (Steady Flow). Ideal conditions for exchange of substances between blood and tissues.
Capillary Function
Even though the smallest, capillaries are the most important vessel functionally
Prime function Transport essential materials to
and from cells. Since this occurs at the capillary,
these structures are functionally important
Blood Volume - Systemic
Systemic - 83% Greatest in veins and venules – 67% Capillaries – 5% Aorta, arteries and arterioles – 11%
Blood Volume - Pulmonary
Pulmonary - 17%
Equally divided among arterial, capillary and venous channels
Venules
Several capillaries unite
Collect blood from capillaries and drain into veins
Veins
Distensible to adapt to variations in blood volume and pressure
Cannot stand high pressure Lumen is larger than corresponding artery Collapse under extrinsic pressure
Venous Sinus
Vein with thin endothelial wall, no smooth muscle
Surrounding dense connective tissue replaces tunica media and externa. Examples:
Dural venous sinuses, Blood from brain to heart , Coronary sinus, Main vein of heart
Receives almost all venous blood from myocardium
Fetal Circulation:
Ductus Venosus
Bypasses fetal liver
Fetal umbilical vein to IVC shunt
Nothing to process
Becomes ligamentum venosum
Fetal Circulation:
Ductus Arteriosus
Bypasses fetal lungs
Connects PA to descending aorta
Becomes ligamentum arteriosum
Indirect Testing
Looking at one part of the body to evaluate a
different part of the body
Ex: Pressure testing: sampling the PTA to evaluate the SFA
Direct Testing
The transducer is evaluating whatever is beneath it
Ex: Duplex imaging
Conventional Angiography
Oldest method
Uses ionizing radiation and x-ray contrast
Involves arterial stick into femoral artery
Most invasive of the tests
Computed Tomography Angiography (CTA)
Uses x-ray contrast and ionizing radiation
Magnetic Resonance Angiography (MRA)
Uses very strong magnetic field and RF signal
Contraindications:
Metallic implants (e.g.: aneurysm clips, pacemaker), h/o welding
What chamber pumps blood to the head & body?
Left Ventricle
What chamber receives blood from the pulmonary veins?
Left Atrium
Blood entering the right atrium is?
deoxygenated
Blood gets to the lungs via the
pulmonary arteries
how many pulmonary veins are there?
4
Abdominal Aorta
Supplies trunk & LE blood Potential source of LE symptoms Emboli thrombosis
Slightly&to&left&of&midline&
Bifurcates at 4th lumbar vertebra At region of umbilicus
Divides into Lt. and Rt.common iliac arteries (CIA) Largest artery in body
Common Iliac Arteries
Originate from aortic BIF. Varies in length. Diameter 13-15 mm. Divides into Internal Iliac Artery (feeds pelvis). External Iliac Artery - supplies LE. becomes CFA.
Internal Iliac Arteries
AKA: hypogastric a. Primary arteries of pelvis. Begin at BIF of iliac arteries. Distributes to Pelvis, Buttocks, external glands.
External Iliac Arteries
Larger than internal iliac arteries. distributes to lower limbs. descend along medial border of psoas major muscles. becomes CFA at inguinal crease.
Common Femoral Artery
Level of inguinal ligament (canal). Divides into Profunda Femoris or DFA & Superficial femoral SFA. other branches hard to see due to lieing behind peritoneum & overlying bowel gas.
Profunda Femoris/ Deep Femoral Artery
runs posterolateral to the SFA. Supplies blood to thigh. Important collateral pathway (if SFA occluded). Gives off branches: Medial & Lateral circumflex artery. (descending branch collateral btw SFA & DFA)
Superficial Femoral Artery
Medial course down thigh. Becomes Popliteal artery at level of adductor canal- “Hunter’s Canal” (above knee) Supreme genicular a./ descending genicular originates (pop beaches) are important collateral pathways in the event of obstruction
Popliteal Artery
runs posterior to knee- popliteal fossa. (alot of branches). Supplies-> knee joint & gastrocnemius & soleus muscles. BIF below knee: (1st) Anterior Tibial & Tibioperoneal Trunk.
Anterior Tibial Artery
Prox ATA runs anterolateral through interossseous membrane to anterolateral aspect of upper calf. Continues running to lower calf. Becomes dorsalis pedis over dorsum of foot.
Tibioperoneal (TP Trunk)
AKA: tibial-peroneal trunk. varies in length. BIF: Posterior tibial artery (PTA) & Peroneal artery.
Posterior Tibial Artery
follows medial course along calf. runs behind medial malleolus distally
Peroneal Artery
Lies deeper than PTA against border of fibula. runs toward later malleolus distally. often spared in presence of tibial artery disease. identification useful if distal bypass surgery considered.
Distal Foot
Supplied by dorsalis pedis artery (Branch of ATA) & the medial & lateral plantar arteries which are the terminal branches of the PTA. Dorsalis pedis & Plantar arteries join to form Plantar Arch (supplies arteries to toes)
Collateral Pathways
alternative pathways carry blood around diseased segment. reverse flow observed in major branches distal to area of disease, resupply blood flow to main vessels. hard to follow on US.
The aorta, once is passes through the diaphragm is called?
Abdominal Aorta
The EIA, once it passes through the inguinal canal, is called
Common Femoral Artery
what vessels form the plantar arch?
The dorsalis pedis & medial & lateral plantar arteries
The vessel that lies between the fibula and tibia is the
Anterior Tibial
The vessel that lies posterior to the medial malleolus is the
Posterior Tibial a.
The vessel that lies deep to the PTA is the
Peroneal a.
The vessel that is a branch of the ATA & lies along the dorsum of the foot is
Dorsalis Pedis (DPA)
Thoracic Aorta
Ascending, Arch, Descending
Brachiocephalic Trunk (innominate)
Left Common Carotid a.
Left subclavian
Subclavian Arteries
Run between anterior & middle scalene muscles & passes between clavicle & first rib. Becomes Axillary artery.
Distribution-> brain & spinal cord, neck, shoulder, thoracic viscera & wall, scapular mescles
Subclavian Arteries Branches:
Vertebral a.- 1st branch
Thyrocervical trunk- superior SA branch, divides almost at once.
Internal Thoracic (mammary a.)- jsut inferior to thyrocervical. freq used for coronary artery bypass surgery.
Thoracic Outlet
where subclavian artery, brachial plexus (nerve bundle) & subclavian vein exit the chest.
Axillary Artery
Subclavian artyer passes between clavicle & first rib to become axillary a. distribution -> shoulder, thoracic & scapular muscles, humerus. Becomes brachial artery as it crosses lower margin of tendon of teres Major muscle (top of arm)
Brachial Artery
Runs distally on medial side of arm between triceps & biceps muscles. runs medial to lateral over inner elbow then divides 1-2 cm below elbow to become radial & ulnar arteries. “Deep” artery, but palpable. Main blood supply of arm.
Deep Brachial Artery (branch)
divides from main trunk in upper arm. important collateral if brachial artery is occluded distally
The Brachial a. crosses the _______ fossa at the elbow.
antecubital fossa
Ulnar Artery
Larger branch of brachial artery. divides deep beneath flexor tendons in upper forearm. Runs along medial(ulnar) side of forearm. runs deep then comes superficial. branches supply Superficial Palmar Arch.(more of rigid curve) Common interosseous artery- collateral.
Radial Artery
Runs along lateral aspect of forearm through wrist & hand. Palp at wrist. Supplies Deep Palmar Arch.(gentle arch) begins opposite neck of radius, travels laterally to thumb.
Palmar Digital Arteries
Fingers are supplied by Palmar digital arteries. usually communicating arteries between the superficial & deep palmar arches. in some people, only one wrist artery will supply the palmar arch sms.
