21-7 The Systemic Circuit Systemic Arteries Blood moves from left ventricle Into ascending aorta Coronary arteries Branch from aortic sinus

Figure 21-21 An Overview of the Major Systemic Arteries Vertebral Right common carotid Right subclavian Left common carotid Brachiocephalic trunk Left subclavian Axillary Aortic arch Ascending aorta Pulmonary trunk Descending aorta Diaphragm Celiac trunk Brachial Renal Superior mesenteric Gonadal Inferior mesenteric Radial Common iliac Internal iliac Ulnar External iliac Palmar arches Deep femoral Femoral 3

Figure 21-21 An Overview of the Major Systemic Arteries Femoral Descending genicular Popliteal Posterior tibial Anterior tibial Fibular Dorsalis pedis Plantar arch 4

21-7 The Systemic Circuit The Aorta The ascending aorta Rises from the left ventricle Curves to form aortic arch Turns downward to become descending aorta

Figure 21-22a Arteries of the Chest and Upper Limb Suprascapular Thyrocervical trunk Right common carotid Right subclavian Left common carotid Thoracoacromial Vertebral Axillary Brachiocephalic trunk Left subclavian Lateral thoracic Anterior humeral circumflex Aortic arch Ascending aorta Posterior humeral circumflex Thoracic aorta Subscapular Heart Deep brachial Intercostal arteries Internal thoracic Brachial Ulnar collateral arteries Abdominal aorta Ulnar recurrent arteries Arteries of the chest and upper limb, a diagrammatic view 6

Figure 21-22b Arteries of the Chest and Upper Limb Right vertebral Right common carotid Left common carotid Spinal cord, cervical vertebrae (right side); fuses with left vertebral, forming basilar artery after entering cranium via foramen magnum Left vertebral Right thyrocervical trunk Muscles, skin, tissues of neck, thyroid gland, shoulders, and upper back (right side) Left thyrocervical trunk Right subclavian Brachiocephalic trunk Left subclavian Right internal thoracic Left internal thoracic Right axillary AORTIC ARCH Skin and muscles of chest and abdomen, mammary gland (right side), pericardium Muscles of the right pectoral region and axilla Left axillary ASCENDING AORTA Right brachial Left brachial To structures of the arm THORACIC AORTA (see Fig. 2125) Right radial Right ulnar Left ulnar Left radial Forearm, radial side Forearm, ulnar side Connected by anastomoses of palmar arches that supply digital arteries LEFT VENTRICLE ABDOMINAL AORTA (see Fig. 2126) A flowchart of the arteries of the chest and upper limb 7

21-7 The Systemic Circuit Branches of the Aortic Arch Deliver blood to head, neck, shoulders, and upper limbs Brachiocephalic trunk Left common carotid artery Left subclavian artery

21-7 The Systemic Circuit The Subclavian Arteries Leaving the thoracic cavity: Become axillary artery in arm And brachial artery distally

Figure 21-22a Arteries of the Chest and Upper Limb Suprascapular Thyrocervical trunk Right common carotid Right subclavian Left common carotid Thoracoacromial Vertebral Axillary Brachiocephalic trunk Left subclavian Lateral thoracic Anterior humeral circumflex Aortic arch Ascending aorta Posterior humeral circumflex Thoracic aorta Subscapular Heart Deep brachial Intercostal arteries Internal thoracic Brachial Ulnar collateral arteries Abdominal aorta Ulnar recurrent arteries Arteries of the chest and upper limb, a diagrammatic view 10

21-7 The Systemic Circuit The Brachial Artery Divides at coronoid fossa of humerus Into radial artery and ulnar artery Fuse at wrist to form: Superficial and deep palmar arches Which supply digital arteries

Figure 21-22a Arteries of the Chest and Upper Limb Radial Anterior crural interosseous Ulnar Deep palmar arch Superficial palmar arch Digital arteries Arteries of the chest and upper limb, a diagrammatic view 12

21-7 The Systemic Circuit The Common Carotid Arteries Each common carotid divides into: External carotid artery - supplies blood to structures of the neck, lower jaw, and face Internal carotid artery - enters skull and delivers blood to brain Divides into three branches Ophthalmic artery Anterior cerebral artery Middle cerebral artery

Figure 21-23 Arteries of the Neck and Head Anterior cerebral Middle cerebral Ophthalmic Cerebral arterial circle Carotid canal Posterior cerebral Basilar Internal carotid Carotid sinus Vertebral Inferior thyroid Thyrocervical trunk Transverse cervical Suprascapular Subclavian Axillary Internal thoracic Clavicle Second rib First rib 14

Figure 21-23 Arteries of the Neck and Head Branches of the External Carotid Superficial temporal Maxillary Occipital Facial Lingual External carotid Common carotid Brachiocephalic trunk Clavicle First rib 15

21-7 The Systemic Circuit The Vertebral Arteries Also supply brain with blood Left and right vertebral arteries Arise from subclavian arteries Enter cranium through foramen magnum Fuse to form basilar artery Branches to form posterior cerebral arteries Posterior cerebral arteries Become posterior communicating arteries

21-7 The Systemic Circuit Anastomoses The cerebral arterial circle (or circle of Willis) interconnects: The internal carotid arteries And the basilar artery

Figure 21-24a Arteries of the Brain Cerebral Arterial Circle Anterior cerebral Anterior communicating Ophthalmic Anterior cerebral Internal carotid (cut) Posterior communicating Middle cerebral Posterior cerebral Pituitary gland Posterior cerebral Basilar Vertebral Cerebellar Inferior surface 18

Figure 21-24b Arteries of the Brain Middle cerebral Anterior cerebral Posterior cerebral Ophthalmic Basilar Cerebral arterial circle Vertebral Internal carotid Lateral view 19

21-7 The Systemic Circuit Thoracic aorta The Descending Aorta Supplies organs of the chest Bronchial arteries Pericardial arteries Esophageal arteries Mediastinal arteries Supplies chest wall Intercostal arteries Superior phrenic arteries

Figure 21-25a Major Arteries of the Trunk Aortic arch Internal thoracic Thoracic aorta Somatic Branches of the Thoracic Aorta Intercostal arteries Superior phrenic Inferior phrenic A diagrammatic view, with most of the thoracic and abdominal organs removed 21

Figure 21-25a Major Arteries of the Trunk Visceral Branches of the Thoracic Aorta Bronchial arteries Esophageal arteries Mediastinal arteries Pericardial arteries A diagrammatic view, with most of the thoracic and abdominal organs removed 22

21-7 The Systemic Circuit Abdominal Aorta The Descending Aorta Divides at terminal segment of the aorta into: Left common iliac artery Right common iliac artery Unpaired branches Major branches to visceral organs Paired branches To body wall Kidneys Urinary bladder Structures outside abdominopelvic cavity

Figure 21-25a Major Arteries of the Trunk Diaphragm Adrenal Renal Gonadal Lumbar Terminal segment of the aorta Common iliac Median sacral A diagrammatic view, with most of the thoracic and abdominal organs removed 24

Figure 21-25a Major Arteries of the Trunk Celiac Trunk Left gastric Splenic Common hepatic Superior mesenteric Abdominal aorta Inferior mesenteric A diagrammatic view, with most of the thoracic and abdominal organs removed 25

Figure 21-26 Arteries Supplying the Abdominopelvic Organs Branches of the Common Hepatic Artery Hepatic artery proper (liver) Liver Gastroduodenal (stomach and duodenum) Cystic (gallbladder) Right gastric (stomach) Right gastroepiploid (stomach and duodenum) Superior pancreatico- duodenal (duodenum) Ascending colon Pancreas Superior Mesenteric Artery Inferior pancreatico- duodenal (pancreas and duodenum) Middle colic (cut) (large intestine) Right colic (large intestine) Ileocolic (large intestine) Small intestine Intestinal arteries (small intestine) Rectum 26

Figure 21-26 Arteries Supplying the Abdominopelvic Organs The Celiac Trunk Common hepatic Left gastric Splenic Spleen Stomach Branches of the Splenic Artery Left gastroepiploic (stomach) Pancreatic (pancreas) Pancreas Inferior Mesenteric Artery Left colic (colon) Sigmoid (colon) Rectal (rectum) Small intestine Sigmoid colon Rectum 27

21-7 The Systemic Circuit Arteries of the Pelvis and Lower Limbs Femoral artery Deep femoral artery Becomes popliteal artery Posterior to knee Branches to form: Posterior and anterior tibial arteries Posterior gives rise to fibular artery

Figure 21-25b Major Arteries of the Trunk Pelvis and right lower limb Left common iliac Right common iliac Pelvis and left lower limb Pelvic muscles, skin, viscera of pelvis (urinary and reproductive organs), perineum, gluteal region, and medial thigh Right internal iliac Left internal iliac Right external iliac Left external iliac Superior gluteal Hip muscles, hip joint Lateral rotators of hip; rectum, anus, perineal muscles, external genitalia Internal pudendal Ilium, hip and thigh muscles, hip joint and femoral head Obturator Lateral sacral Skin and muscles of sacrum A flowchart showing major arteries of the trunk 29

Figure 21-27a Arteries of the Lower Limb Common iliac External iliac Internal iliac Superior gluteal Inguinal ligament Lateral sacral Internal pudendal Obturator Deep femoral Medial femoral circumflex Lateral femoral circumflex Femoral Descending genicular Anterior view 30

Figure 21-27a Arteries of the Lower Limb Popliteal Anterior tibial Posterior tibial Fibular Dorsalis pedis Medial plantar Lateral plantar Dorsal arch Plantar arch Anterior view 31

Figure 21-27b Arteries of the Lower Limb Superior gluteal Right external iliac Internal pudendal Obturator Deep femoral Lateral femoral circumflex Medial femoral circumflex Femoral Descending genicular Posterior view 32

Figure 21-27b Arteries of the Lower Limb Popliteal Anterior tibial Posterior tibial Fibular Posterior view 33

Figure 21-27c Arteries of the Lower Limb EXTERNAL ILIAC Femoral Thigh Deep femoral Descending genicular Hip joint, femoral head, deep muscles of the thigh Skin of leg, knee joint Medial femoral circumflex Lateral femoral circumflex Popliteal Leg and foot Adductor muscles, obturator muscles, hip joint Quadriceps muscles Posterior tibial Anterior tibial Fibular Connected by anastomoses of dorsalis pedis, dorsal arch, and plantar arch, which supply distal portions of the foot and the toes A flowchart of blood flow to a lower limb 34

21-7 The Systemic Circuit Systemic Veins Complementary Arteries and Veins Run side by side Branching patterns of peripheral veins are more variable In neck and limbs One set of arteries (deep) Two sets of veins (one deep, one superficial) Venous system controls body temperature

Figure 21-28 An Overview of the Major Systemic Veins KEY Superficial veins Deep veins Vertebral External jugular Internal jugular Subclavian Brachiocephalic Axillary Superior vena cava Brachial Intercostal veins Basilic Hepatic veins Inferior vena cava Renal Median cubital Gonadal Radial Lumbar veins Median antebrachial Left and right common iliac Ulnar External iliac Palmar venous arches Internal iliac Digital veins Deep femoral Femoral 36

Figure 21-28 An Overview of the Major Systemic Veins Femoral Great saphenous Popliteal Small saphenous Posterior tibial Anterior tibial Fibular KEY Superficial veins Deep veins Plantar venous arch Dorsal venous arch 37

21-7 The Systemic Circuit The Superior Vena Cava (SVC) Receives blood from the tissues and organs of: Head Neck Chest Shoulders Upper limbs

Figure 21-29c Major Veins of the Head, Neck, and Brain Superior sagittal sinus Superficial cerebral veins Temporal Inferior sagittal sinus Deep cerebral Great cerebral Cavernous sinus Straight sinus Maxillary Petrosal sinuses Right transverse sinus Occipital sinus Facial Sigmoid sinus Occipital Vertebral External jugular Internal jugular Right subclavian Clavicle Right brachiocephalic Axillary Left brachiocephalic Superior vena cava First rib Internal thoracic Veins draining the brain and the superficial and deep portions of the head and neck. 39

21-7 The Systemic Circuit The Dural Sinuses Superficial cerebral veins and small veins of the brain stem Empty into network of dural sinuses Superior and inferior sagittal sinuses Petrosal sinuses Occipital sinus Left and right transverse sinuses Straight sinus

Figure 21-29b Major Veins of the Head, Neck, and Brain Inferior sagittal sinus Superior sagittal sinus Great cerebral vein Straight sinus Occipital sinus Cavernous sinus Petrosal sinuses Internal jugular Right transverse sinus Vertebral vein Right sigmoid sinus A lateral view of the brain showing the venous distribution. 41

21-7 The Systemic Circuit Cerebral Veins Vertebral Veins Great cerebral vein Drains to straight sinus Other cerebral veins Drain to cavernous sinus Which drains to petrosal sinus Vertebral Veins Empty into brachiocephalic veins of chest

Figure 21-29a Major Veins of the Head, Neck, and Brain Superior sagittal, sinus (cut) Cavernous sinus Cerebral veins Petrosal sinus Internal jugular Sigmoid sinus Cerebellar veins Transverse sinus Straight sinus Occipital sinus An inferior view of the brain, showing the venous distribution. 43

21-7 The Systemic Circuit Superficial Veins of the Head and Neck Converge to form: Temporal, facial, and maxillary veins Temporal and maxillary veins Drain to external jugular vein Facial vein Drains to internal jugular vein

Figure 21-29c Major Veins of the Head, Neck, and Brain Superior sagittal sinus Superficial cerebral veins Temporal Inferior sagittal sinus Deep cerebral Great cerebral Cavernous sinus Straight sinus Maxillary Petrosal sinuses Right transverse sinus Occipital sinus Facial Sigmoid sinus Occipital Vertebral External jugular Internal jugular Right subclavian Clavicle Right brachiocephalic Axillary Left brachiocephalic Superior vena cava First rib Internal thoracic Veins draining the brain and the superficial and deep portions of the head and neck. 45