11 Blood and Blood Vessels.

11 Blood and Blood Vessels

Chapter 11 Learning Outcomes
Section 1: Blood 11.1 Describe the important components and major properties of blood. 11.2 List the characteristics and functions of red blood cells, and describe the structure and functions of hemoglobin. 11.3 Explain the basis of the ABO blood types and Rh factor, the significance of blood typing, and the important of testing for blood compatibility. © 2013 Pearson Education, Inc.

11.4 CLINICAL MODULE Describe hemolytic disease of the newborn, explain the clinical significance of the cross-reaction between fetal and maternal blood types, and cite preventive measures. 11.5 Identify the various types of white blood cells, categorize the types as granular or agranular, and describe the structures and functions of each type. 11.6 Explain the origins and differentiation of the formed elements, describe platelets and the role of erythropoietin. 11.7 Explain the three phases of the clotting response, describe clot retraction, and compare an embolus with a thrombus. © 2013 Pearson Education, Inc.

11.8 CLINICAL MODULE Explain why venipuncture is useful, and describe various types of blood disorders within clinical categories. Section 2: The Functional Anatomy of Blood Vessels 11.9 Distinguish among the types of blood vessels on the basis of their structure and function. 11.10 CLINICAL MODULE Define arteriosclerosis and atherosclerosis, identify risk factors for each, and cite treatment options. © 2013 Pearson Education, Inc.

11.11 Describe the structure of a capillary bed and the functions of capillaries in the exchange of dissolved materials between blood and interstitial fluid. 11.12 Describe the venous system, and indicate the distribution of blood within the cardiovascular system. 11.13 Describe the pulmonary circuit, citing major arteries and veins and areas each serves. 11.14 Identify the major arteries and veins of the systemic circuit, and name the areas each serves. © 2013 Pearson Education, Inc.

11.15 Identify the branches of the aortic arch and the branches of the superior vena cava, and name the areas each serves. 11.16 Identify the branches of the carotid arteries, and the tributaries of the external jugular veins, and name the areas each serves. 11.17 Identify the branches of the internal carotid and vertebral arteries, and the tributaries of the internal jugular veins, and name the areas each serves. 11.18 Identify the branches of the descending aorta and the tributaries of the venae cavae, and name the areas each serves. © 2013 Pearson Education, Inc.

11.19 Identify the branches of the visceral arterial vessels and the venous tributaries of the hepatic portal system, and name the areas each serves. 11.20 Identify the branches of the common iliac artery and the tributaries of the common iliac vein, and name the areas each serves. © 2013 Pearson Education, Inc.

Components of the Cardiovascular System (Section 1)
Cardiovascular system consists of: Fluid – blood Conducting tubes – blood vessels Capillaries Arteries Veins Pump – heart © 2013 Pearson Education, Inc.

Functions of Cardiovascular Components (Section 1)
Blood Distributes oxygen, carbon dioxide, and blood cells Delivers nutrients and hormones Transports wastes Assists in temperature regulation and defense against disease Blood vessels Distribute blood around the body Heart Propels blood and maintains blood pressure © 2013 Pearson Education, Inc.

The Components of the Cardiovascular System
Heart BLOOD Capillaries Artery BLOOD VESSELS Vein Capillaries Arteries Veins THE HEART Module 11 Section 1 Blood Figure 11 Section 1 1 1 © 2013 Pearson Education, Inc.

Functions of Blood (Section 1)
Transports Oxygen, carbon dioxide, nutrients, hormones, wastes Regulates pH and ion composition by absorbing and neutralizing acids Restricts Fluid loss at injury sites with clotting process Defends Against toxins and pathogens with white blood cells and antibodies Stabilizes Temperature by absorbing heat and distributing blood flow to different areas © 2013 Pearson Education, Inc.

Blood Facts (11.1) Fluid connective tissue Consists of: Amount in body
Plasma Formed elements Amount in body 5–6 liters in average male 4–5 liters in average female Whole blood is term for blood removed from body Blood may be fractionated or separated to analyze a specific component © 2013 Pearson Education, Inc.

Whole Blood (11.1) Temperature roughly 38ºC
Five times as viscous (thick) as water Slightly alkaline, pH ~7.40 (7.35–7.45) © 2013 Pearson Education, Inc.

The composition of whole blood
Plasma Proteins Albumins Globulins PLASMA COMPOSITION Fibrinogen Plasma proteins 7% Other solutes 1% Enzymes and hormones Water 92% Other Solutes Transports organic and inorganic molecules, formed elements, and heat Plasma Electrolytes Organic nutrients 55% (Range: 46–63%) Organic wastes Whole blood Formed elements Platelets 45% (Range: 37–54%) Module 11.1 Blood is a fluid connective tissue containing plasma and formed elements White Blood Cells FORMED ELEMENTS Platelets < .1% Basophils White blood cells < .1% Neutrophils Lymphocytes Red blood cells 99.9% Eosinophils Monocytes Red Blood Cells Figure 11.1 © 2013 Pearson Education, Inc.

Plasma (11.1) Forms 55 percent (46–63 percent) of whole blood volume
Transports organic and inorganic molecules, formed elements, heat Composed of: 92 percent water 7 percent plasma proteins 1 percent other solutes © 2013 Pearson Education, Inc.

Plasma Proteins (11.1) Albumins – about 60 percent of plasma proteins
Contribute to osmotic pressure of plasma Globulins – about 35 percent of plasma proteins Include antibodies (immunoglobulins) and transport globulins Fibrinogen – about 4 percent of plasma proteins Function in clotting Interact to form large strands of fibrin © 2013 Pearson Education, Inc.

Other Plasma Solutes (11.1)
Electrolytes Na+, K+, Ca2+, Mg2+, Cl–, HCO3–, HPO4–, SO42– Organic nutrients Lipids, carbohydrates, amino acids Organic wastes Urea, uric acid, creatinine, bilirubin, ammonium ions © 2013 Pearson Education, Inc.

Transports organic and inorganic molecules, formed elements, and heat
Plasma components Plasma Proteins Albumins Globulins PLASMA COMPOSITION Fibrinogen Plasma proteins 7% Other solutes 1% Enzymes and hormones Water 92% Other Solutes Transports organic and inorganic molecules, formed elements, and heat Electrolytes Plasma Organic nutrients 55% (Range: 46–63%) Module 11.1 Blood is a fluid connective tissue containing plasma and formed elements Organic wastes Figure 1 © 2013 Pearson Education, Inc.

Formed Elements (11.1) Account for about 45 percent (37–54 percent) of whole blood Hematocrit or packed cell volume (PCV) Percentage of whole blood volume that is formed elements Averages 42 percent (females) to 47 percent (males) Androgens (male hormones) stimulate RBC production Estrogens (female hormones) do not Composed of: 99.9 percent red blood cells <.1 percent white blood cells <.1 percent platelets © 2013 Pearson Education, Inc.

Formed Element Details (11.1)
Red blood cells (RBCs) or erythrocytes Most abundant blood cells Essential for oxygen transport White blood cells (WBCs) or leukocytes Part of body's defense mechanism Platelets Membrane-bound cell fragments Important to clotting process © 2013 Pearson Education, Inc.

Formed elements Formed elements Platelets 45% White Blood Cells
(Range: 37–54%) White Blood Cells FORMED ELEMENTS Platelets < .1% Basophils White blood cells < .1% Neutrophils Lymphocytes Red blood cells 99.9% Eosinophils Monocytes Red Blood Cells Module 11.1 Blood is a fluid connective tissue containing plasma and formed elements Figure 2 © 2013 Pearson Education, Inc.

Module 11.1 Review Define hematocrit.
Identify the two components making up whole blood, and list the composition of each. During an infection, which components of blood would be elevated? © 2013 Pearson Education, Inc.

Red Blood Cells (11.2) Red blood cell count is number of RBCs per microliter (cubic millimeter) Males 4.5–6.3 million per µL Females 4.2–5.5 million per µL RBCs make up about one-third of all cells in the human body Biconcave disc with thin center and thicker margin © 2013 Pearson Education, Inc.

7.2–8.4 μm 0.45–1.16 μm 2.31–2.85 μm The anatomy of red blood cells
Stained blood smear LM x 450 RBCs Colorized SEM x 2100 Module 11.2 Red blood cells, the most common formed elements, contain hemoglobin Figure 1 – 2 © 2013 Pearson Education, Inc.

Functional Aspects of Red Blood Cells (11.2)
Large surface area-to-volume ratio Oxygen bound to hemoglobin in RBCs Greater surface area allows for faster exchange of oxygen RBCs can form stacks Allows easier flow through narrow blood vessels without jamming Flexibility Can bend and flex to squeeze through capillaries as small as 4 µm (nearly half the normal RBC diameter) © 2013 Pearson Education, Inc.

in longitudinal section)
Functional aspects of red blood cells Stack of RBCs Blood vessels (viewed in longitudinal section) Module 11.2 Red blood cells, the most common formed elements, contain hemoglobin Nucleus of endothelial cell Red blood cell (RBC) Sectional view of capillaries LM x 1430 Figure 3 © 2013 Pearson Education, Inc.

Features of Red Blood Cells (11.2)
RBCs designed to carry oxygen Contain very few organelles, no nuclei Cannot divide or repair themselves Life span less than 120 days Filled with hemoglobin (Hb) Hemoglobin content of whole blood 14–18 g/dL in males 12–16 g/dL in females © 2013 Pearson Education, Inc.

Subunits Heme Structure of hemoglobin
Module 11.2 Red blood cells, the most common formed elements, contain hemoglobin Subunits Heme Figure 4 – 5 © 2013 Pearson Education, Inc.

Hemoglobin (11.2) Composed of four globin subunits
Each subunit has single heme molecule Each heme holds an iron ion Blood with oxygen bound to hemoglobin Oxyhemoglobin – bright red Blood with lots of hemoglobin not bound to oxygen Deoxyhemoglobin – dark red © 2013 Pearson Education, Inc.

+ Oxygen O2 HbO2 Hb Oxyhemoglobin formation
Module 11.2 Red blood cells, the most common formed elements, contain hemoglobin Figure 6 © 2013 Pearson Education, Inc.

Red Blood Cell Production and Recycling (11.2)
RBCs continually produced and recycled 1 percent replaced each day 3 million new RBCs enter bloodstream each second Short lifespan of 120 days, then: Plasma membrane ruptures or cell is engulfed by macrophages Broken down in liver, spleen, or red bone marrow © 2013 Pearson Education, Inc.

Blood Type (11.3) Antigens trigger an immune response
Plasma membrane of body's cells contains surface antigens Immune system recognizes these as "self" Blood type determined by surface antigens on RBCs Most important A, B, and Rh (D) Plasma contains antibodies that attack antigens on "foreign" RBCs © 2013 Pearson Education, Inc.

Both A and B surface antigens Neither A nor B surface antigens
Blood types and antigens Type A Type B Type AB Type O Both A and B surface antigens Neither A nor B surface antigens Surface antigen A Surface antigen B Neither anti-A nor anti-B antibodies in plasma Anti-B antibodies in plasma Module 11.3 Blood type is determined by the presence or absence of specific surface antigens on RBCs Anti-A antibodies in plasma Both anti-A and anti-B antibodies in plasma Figure © 2013 Pearson Education, Inc.

Cross-reaction (11.3) Surface antigens on RBCs of one blood type exposed to antibodies from another blood type Response is agglutination or clumping together Cells may also rupture (hemolysis) Called a cross-reaction Clumps can block small blood vessels causing damage to tissues One cause would be transfusion of incorrect blood type © 2013 Pearson Education, Inc.

RBC Surface antigens Slide 1
Cross-reaction causing agglutination and hemolysis Slide 1 RBC Surface antigens Module 11.3 Blood type is determined by the presence or absence of specific surface antigens on RBCs Figure © 2013 Pearson Education, Inc.

+ RBC Surface antigens Opposing antibodies
Cross-reaction causing agglutination and hemolysis Slide 2 RBC + Surface antigens Opposing antibodies Module 11.3 Blood type is determined by the presence or absence of specific surface antigens on RBCs Figure © 2013 Pearson Education, Inc.

Agglutination (clumping)
Cross-reaction causing agglutination and hemolysis Slide 3 RBC + Surface antigens Opposing antibodies Agglutination (clumping) Module 11.3 Blood type is determined by the presence or absence of specific surface antigens on RBCs Figure © 2013 Pearson Education, Inc.

Agglutination (clumping)
Cross-reaction causing agglutination and hemolysis Slide 4 RBC + Surface antigens Opposing antibodies Agglutination (clumping) Hemolysis Module 11.3 Blood type is determined by the presence or absence of specific surface antigens on RBCs Figure © 2013 Pearson Education, Inc.

Complete Blood Type (11.3) Different distribution of blood types in human population Rh positive (Rh+) Presence of Rh surface antigen Rh negative (Rh–) Absence of Rh surface antigen Full blood type reported as letter (A, B, AB, O) and positive or negative sign (A+, O–, etc.) © 2013 Pearson Education, Inc.

Module 11.3 Blood type is determined by the presence or absence of specific surface antigens on RBCs
Figure © 2013 Pearson Education, Inc.

Transfusion Reaction (11.3)
Blood typing tests Drops of blood mixed with antibody solution Clumping (agglutination) occurs when solution contains same antibody as surface antigen Cross-reaction is also called transfusion reaction No transfusion reaction if blood types are compatible Donor's blood cells and recipient's plasma will not react © 2013 Pearson Education, Inc.

Blood type Anti-A Anti-B Anti-Rh A+ B+ AB+ O–
Module 11.3 Blood type is determined by the presence or absence of specific surface antigens on RBCs O– Figure © 2013 Pearson Education, Inc.

Antibodies in Plasma (11.3)
Anti-A and anti-B antibodies present at birth Anti-Rh antibodies formed only if an Rh-negative person is exposed to Rh-positive blood © 2013 Pearson Education, Inc.

Module 11.3 Review What is the function of surface antigens on RBCs?
Which blood type(s) can be safely transfused into a person with Type O blood? Why can't a person with Type A blood safely receive blood from a person with Type B blood? © 2013 Pearson Education, Inc.

Hemolytic Disease of the Newborn (11.4)
Surface antigens on RBCs genetically determined Child inherits genes from both parents and may have different blood type than either parent During pregnancy, mother's antibodies may cross placenta If fetus is Rh positive and mother Rh negative, mother's anti-Rh antibodies can attack fetus Hemolytic disease of the newborn (HDN) © 2013 Pearson Education, Inc.

Rh– Mother with First Rh+ Fetus (11.4)
Rh– mother not exposed to fetal red blood cells until delivery Exposure stimulates mother's immune system to produce anti-Rh antibodies Process called sensitization If future pregnancy involves Rh+ fetus: Maternal anti-Rh antibodies can cross placenta © 2013 Pearson Education, Inc.

Rh– Mother with Subsequent Rh+ Fetus (11.4)
Maternal anti-Rh antibodies can cross placenta into fetal bloodstream and destroy fetal RBCs Dropping RBC count in fetus makes immature RBCs (erythroblasts) leave red bone marrow early Condition (HDN), also called erythroblastosis fetalis, has very high fatality rate without treatment Condition prevented by giving mother anti-Rh antibodies (RhoGAM) These antibodies destroy fetal RBCs that have crossed placenta before they stimulate maternal immune response © 2013 Pearson Education, Inc.

Hemolytic disease of the newborn
Rh– mother Rh– mother First Pregnancy of an Rh– Mother with an Rh+ Infant Rh+ fetus Second Pregnancy of an Rh– Mother with an Rh+ Infant Rh+ fetus In future pregnancy with Rh+ fetus, maternal anti-Rh antibodies can cross the placenta and destroy fetal RBCs causing erythroblastosis fetalis (hemolytic disease of the newborn). During first pregnancy Maternal blood supply and tissue Rh– Very few fetal cells enter the maternal bloodstream during first pregnancy. Rh– Rh– Rh– Placenta Rh+ Rh+ During Second Pregnancy Maternal blood supply and tissue Fetal blood supply and tissue Rh– Rh– Rh+ Rh+ Maternal anti-Rh antibodies Rh– Rh– Hemorrhaging at delivery Rh+ Rh+ Bleeding during delivery allows mixing of fetal and maternal blood, stimulating mother's immune system to produce anti-Rh antibodies Rh+ Maternal blood supply and tissue Rh– Maternal RBC Rh+ Fetal blood supply and tissue Rh+ Module 11.4 Hemolytic disease of the newborn is an RBC-related disorder caused by a cross-reaction between fetal and maternal blood types Rh– Rh+ Rh– Hemolysis of fetal RBCs Rh+ Rh+ Rh antigen on fetal red blood cells Fetal blood supply and tissue Rh+ Maternal antibody production Maternal antibodies to Rh antigen Anti-Rh antibodies are produced after delivery, so first infant not affected. Rh– Maternal blood supply and tissue Rh– Rh– Rh– Figure 11.4 © 2013 Pearson Education, Inc.

Module 11.4 Review Define hemolytic disease of the newborn (HDN).
Why is RhoGAM administered to Rh– mothers? Does an Rh+ mother carrying an Rh– fetus require a RhoGAM injection? Explain your answer. © 2013 Pearson Education, Inc.

Shared Properties of White Blood Cells (11.5)
Circulate in bloodstream for short period then migrate into loose and dense connective tissue Activated in bloodstream Squeeze through adjacent endothelial cells in process called diapedesis Attracted to specific chemical stimuli This positive chemotaxis guides WBCs to pathogens and damaged tissue where needed Some (neutrophils, eosinophils, monocytes) are phagocytes © 2013 Pearson Education, Inc.

White blood cells White Blood Cells Cell Type Neutrophils GRANULAR LEUKOCYTES Neutrophils Eosinophils Eosinophils Basophils Basophils Module 11.5 White blood cells defend the body against pathogens, toxins, cellular debris, and abnormal or damaged cells Monocytes AGRANULAR LEUKOCYTES Monocytes Lymphocytes Lymphocytes Figure 11.5 © 2013 Pearson Education, Inc.

Granular Leukocytes (11.5)
Leukocytes with abundant cytoplasmic granules that absorb stains when making slides Neutrophils 50–70 percent of leukocytes Eosinophils 2–4 percent of leukocytes Basophils <1 percent of leukocytes © 2013 Pearson Education, Inc.

White Blood Cells Neutrophils Eosinophils Neutrophils Eosinophils
Granular leukocytes White Blood Cells Cell Type Average Amount per µL Appearance in a Stained Blood Smear Functions Neutrophils 4150 (range 1800–7300) Differential count: 50–70% Round cell; nucleus lobed and may resemble a string of beads; cytoplasm contains large, pale inclusions Phagocytic: engulf pathogens or debris in injured or infected tissues; release cytotoxic enzymes and chemicals GRANULAR LEUKOCYTES 165 (range 0–700) Differential count: 2–4% Round cell; nucleus generally has two lobes; cytoplasm contains large granules that generally stain bright red Phagocytic: engulf antibody-labeled materials; release cytotoxic enzymes; reduce inflammation; increase in number in allergic reactions and parasitic infections Eosinophils Neutrophils Eosinophils Basophils Module 11.5 White blood cells defend the body against pathogens, toxins, cellular debris, and abnormal or damaged cells Basophils 44 (range: 0–150) Differential count: <1% Round cell; nucleus generally cannot be seen through dense, blue-stained granules in cytoplasm Enter damaged tissues and release histamine and other chemicals that pro- mote inflammation Figure 11.5 1 © 2013 Pearson Education, Inc.

Agranular Leukocytes (11.5)
Few, if any, cytoplasmic granules that absorb histological stain Monocytes 2–8 percent of leukocytes Lymphocytes 20–40 percent of leukocytes © 2013 Pearson Education, Inc.

White Blood Cells Monocytes Lymphocytes Cell Type Average Amount
Agranular leukocytes White Blood Cells Cell Type Average Amount per µL Appearance in a Stained Blood Smear Functions 456 (range: 200–950) Differential count: 2–8% Very large cell; nucleus kidney bean- to horseshoe-shaped; abundant cytoplasm Phagocytic: enter tissues and become macrophages; engulf pathogens or debris Monocytes AGRANULAR LEUKOCYTES Monocytes Lymphocytes Lymphocytes 2185 (range: 1500–4000) Differential count: 20–40% Generally round cell, slightly larger than RBC; round nucleus; very little cytoplasm Cells of lymphatic system; provide defense against specific pathogens or toxins Module 11.5 White blood cells defend the body against pathogens, toxins, cellular debris, and abnormal or damaged cells Figure 11.5 2 © 2013 Pearson Education, Inc.

White Blood Cell Count (11.5)
Average 7000 WBCs per microliter (5000–10,000) Pathogenic infections cause changes in circulating WBCs Differential count of WBCs indicates number of each type of WBC in sample of 100 WBCs © 2013 Pearson Education, Inc.

Module 11.5 Review Identify the five types of white blood cells.
Which types of white blood cells would you find in the greatest numbers in an infected cut? How do basophils respond during inflammation? © 2013 Pearson Education, Inc.

Stem Cells (11.6) Formed elements develop in red bone marrow
Process is called hematopoiesis Multipotent stem cell is a hemocytoblast Division of a hemocytoblast produces two types of stem cells Lymphoid stem cell Myeloid stem cell © 2013 Pearson Education, Inc.

Stem Cell Paths (11.6) Lymphoid stem cells develop into lymphocytes
Some stem cells remain in red bone marrow; others migrate to lymphoid tissues Myeloid stem cells develop into all other formed elements Colony-stimulating factors (CSFs) Hormones released by activated lymphocytes and other cells in immune response Stimulate blood cell formation © 2013 Pearson Education, Inc.

Development of formed elements
Blast Cells FORMED ELEMENTS OF BLOOD Lymphoid Stem Cells Lymphoblast Prolymphocyte Lymphocyte Monoblast Promonocyte Monocyte Band Cells Hemocytoblasts Progenitor Cells Neutrophil Eosinophil Myeloblast Basophil Myeloid Stem Cells Module 11.4 Hemolytic disease of the newborn is an RBC-related disorder caused by a cross-reaction between fetal and maternal blood types Megakaryocytes Platelets Proerythroblast Erythroblast stages Reticulocyte Erythrocyte Figure 11.6 1 © 2013 Pearson Education, Inc.

Stimulation of RBC Production (11.6)
Erythropoietin (EPO) is released into plasma when oxygen levels are low (hypoxia) such as with: Anemia Declining blood flow to kidneys Decreased oxygen content of air in lungs (e.g., at high altitudes) Damage to respiratory surface of lungs EPO stimulates stem cells in red bone marrow to produce RBCs © 2013 Pearson Education, Inc.

Platelets (11.6) Cell fragments formed from megakaryocytes
Flattened discs 350,000 (150,000–500,000) per µL Function in blood clotting Continually replaced Circulate 9–12 days before removed by phagocytes primarily in spleen © 2013 Pearson Education, Inc.

Module 11.6 Review Define hemocytoblast.
Explain the role of erythropoietin. Compare the types of cells that lymphoid stem cells and myeloid stem cells produce. © 2013 Pearson Education, Inc.

Clotting Response (11.7) Process of stopping loss of blood through damaged vessels is hemostasis Complex cascade of events requiring completion of one phase to trigger next Three phases Vascular phase Platelet phase Coagulation phase © 2013 Pearson Education, Inc.

Vascular Phase of Hemostasis (11.7)
Lasts about 30 minutes after injury Two major events Endothelial cells contract, exposing basement membrane to bloodstream Local contraction of smooth muscle in vessel wall (vascular spasm) © 2013 Pearson Education, Inc.

Platelet Phase of Hemostasis (11.7)
Begins with attachment of platelets to: Sticky endothelial surfaces Basement membrane Exposed collagen fibers Other platelets Clotting factors released by platelets Attract more platelets to site that stick together (aggregate) Stimulate local vessel contraction © 2013 Pearson Education, Inc.

Coagulation Phase of Hemostasis (11.7)
Starts 30 seconds or more after vessel damage Coagulation (blood clotting) complex sequence of steps Requires procoagulants (clotting factors) circulating in plasma 11 different proteins and calcium Many clotting factors are proenzymes Conversion of one proenzyme to active form commonly creates a chain reaction Final step: fibrinogen is converted to fibrin (insoluble) Fibrin network traps blood cells and platelets, forming clot and sealing damaged area © 2013 Pearson Education, Inc.

Extrinsic and Intrinsic Pathways (11.7)
Extrinsic pathway begins with release of tissue factor by damaged cells More damage = more tissue factor and faster clotting Tissue factor combines with clotting factor VII to activate Factor X (first step in common pathway) Intrinsic pathway begins with activation of proenzymes exposed to collagen fibers at injury Activated proenzyme combines with platelet factor to activate Factor X © 2013 Pearson Education, Inc.

Common Pathway (11.7) Extrinsic and intrinsic pathways both activate Factor X Activated Factor X forms prothrombinase Prothrombinase converts prothrombin to thrombin Thrombin converts fibrinogen to fibrin Clot retraction After fibrin meshwork formed, platelets contract, pulling tissues together Continues for 30–60 minutes © 2013 Pearson Education, Inc.

Process of hemostasis Coagulation Phase Vascular Phase Platelet Phase Common Pathway Extrinsic Pathway Intrinsic Pathway Release of clotting factors Knife blade Plasma in vessel lumen Platelet aggregation Factor X Platelet adhesion to damaged vessel Endothelium Tissue factor complex Prothrombinase Factor X activator complex Blood vessel injury Prothrombin Thrombin Basement membrane Vascular spasm Vessel wall Clotting factor (VII) Fibrin Fibrinogen Clotting factors Platelet plug may form Contracted smooth muscle cells Platelet factor Module 11.7 The clotting response is a complex cascade of events that reduces blood loss Cut edge of vessel wall Tissue factor Activated proenzymes Tissue damage Contracted smooth muscle cells Clot Retraction Figure © 2013 Pearson Education, Inc.

Inappropriate Blood Clotting (11.7)
Blood clots may form in bloodstream where no injury has occurred Drifting blood clot is embolus May lodge in smaller blood vessel, blocking blood flow and causing tissue death Sudden blockage called embolism Tissue damage called infarction or infarct In brain, stroke In heart, myocardial infarction (heart attack) © 2013 Pearson Education, Inc.

Embolism blocks blood vessel Embolus Embolus
Module 11.7 The clotting response is a complex cascade of events that reduces blood loss Embolus Figure © 2013 Pearson Education, Inc.

Thrombus (11.7) A blood clot attached to a vessel wall where no damage has occurred is a thrombus Often forms where platelets attracted to plaques Large quantities of lipids that constrict vessel diameter © 2013 Pearson Education, Inc.

Thrombus Plaque Thrombus
Module 11.7 The clotting response is a complex cascade of events that reduces blood loss Figure © 2013 Pearson Education, Inc.

Clot Dissolution (11.7) Process of clot dissolving is fibrinolysis
Begins with activation of plasminogen to plasmin Thrombin and tissue plasminogen activator (t-PA) part of the process Plasmin erodes clot © 2013 Pearson Education, Inc.

Module 11.7 Review Define hemostasis and name its three phases.
Briefly describe the vascular, platelet, and coagulation phases of hemostasis. Compare an embolus with a thrombus. © 2013 Pearson Education, Inc.

Blood Disorder Diagnosis (11.8)
Have to obtain blood for diagnosis One method is venipuncture Blood collected from superficial vein Advantages Superficial veins easy to locate Walls of veins thinner than arteries Blood pressure in venous system is low, so the puncture heals quickly © 2013 Pearson Education, Inc.

Nutritional Blood Disorders (11.8)
Iron deficiency anemia Caused by insufficient iron intake (needed to form normal hemoglobin) Resulting RBCs are small and transport less oxygen More common in women as iron reserves about ½ that in typical man Pernicious anemia Deficiency of vitamin B12 prevents normal stem cell divisions in red bone marrow Resulting RBCs abnormally large and oddly shaped Clotting disorders Insufficient calcium (needed for clotting process) Insufficient vitamin K (required by liver to synthesize clotting factors) © 2013 Pearson Education, Inc.

Congenital Blood Disorders (11.8)
Hemophilia Inherited bleeding disorder affecting 1 person in 10,000 80–90 percent male Caused by missing or reduced production of clotting factor In severe cases, bleeding with minor contact and around joints and muscles Thalassemia Group of inherited blood disorders Inability to produce enough protein subunits of hemoglobin Sickle cell anemia © 2013 Pearson Education, Inc.

Sickle Cell Anemia (11.8) Mutation affects amino acid sequence of globin subunits in hemoglobin RBCs sickle when they release oxygen RBCs more fragile and sickled shape catches on capillary walls more easily, blocking blood flow Must have two copies of sickling gene to have sickle cell anemia If only one copy of sickling gene, result is sickling trait Sickling trait gives some resistance to malaria Infection of RBCs causes sickling; sickled cells destroyed by macrophages, along with malarial pathogen © 2013 Pearson Education, Inc.

Infections of the Blood (11.8)
Bacteremia Bacteria circulating in blood, but not multiplying there Viremia Viruses circulating in blood, but not multiplying there Sepsis Widespread pathogenic infection of body tissue Septicemia Sepsis of blood ("blood poisoning") Pathogens multiply in blood and spread throughout body © 2013 Pearson Education, Inc.

Malaria (11.8) Parasitic disease caused by protozoan Plasmodium
Kills 1.5–3 million people per year Transmitted by mosquito More common in tropical countries Parasite invades liver cells, enlarges and fragments Fragments infect red blood cells 2–3 day intervals, all infected RBCs rupture and release more parasites Cycles of fever and chills correspond to reinfection Dead RBCs can block blood vessels, resulting in damage to kidney, brain, and any other tissue © 2013 Pearson Education, Inc.

Cancers of the Blood (11.8) Leukemias Myeloid leukemia
Cancers of blood-forming tissues Spread throughout the body instead of compact tumor Myeloid leukemia Presence of abnormal granulocytes in red bone marrow Lymphoid leukemia Involves lymphocytes and their stem cells Symptoms appear when immature and abnormal WBCs in circulation Fatal if untreated © 2013 Pearson Education, Inc.

Degenerative Blood Disorders (11.8)
Disseminated intravascular coagulation (DIC) Bacterial toxins activate steps in coagulation process Fibrinogen is converted to fibrin in circulating blood Resulting small clots can block small vessels Liver has to increase production of fibrinogen or ability to clot where needed declines Result is uncontrolled bleeding © 2013 Pearson Education, Inc.

Module 11.8 Review Define venipuncture.
Identify the two types of leukemia. Compare iron deficiency anemia with pernicious anemia. © 2013 Pearson Education, Inc.

Blood Vessel Circuits (Section 2)
Both circuits begin and end at the heart and flow in sequence Pulmonary circuit Carries blood to and from gas exchange surfaces of lungs Systemic circuit Transports blood to and from rest of body Blood carried away from heart in arteries or efferent vessels Blood returns to heart in veins or afferent vessels Microscopic capillaries interconnect smallest arteries and veins Thin walls allow exchange of nutrients, gases, and waste products © 2013 Pearson Education, Inc.

2 4 Pulmonary Circuit Systemic Circuit Pulmonary arteries
Overview of the cardiovascular system 2 4 Pulmonary Circuit Systemic Circuit Pulmonary arteries Capillaries in head, neck, upper limbs Capillaries in lungs Systemic arteries Pulmonary veins 3 Start 1 Left atrium Right atrium Left ventricle Module 11 Section 2 The Functional Anatomy of Blood Vessels Right ventricle Systemic veins Capillaries in trunk and lower limbs Figure 11 Section 2 © 2013 Pearson Education, Inc.

Three Wall Layers of Arteries and Veins (11.9)
Tunica intima (or tunica interna) Innermost layer Tunica media Middle layer Tunica externa (or tunica adventitia) Outermost layer © 2013 Pearson Education, Inc.

Tunica Intima (11.9) Innermost layer
Includes endothelial lining and underlying connective tissue with elastic fibers Arteries also include internal elastic membrane © 2013 Pearson Education, Inc.

Tunica Media (11.9) Middle layer Concentric sheets of smooth muscle
Contraction decreases vessel diameter (vasoconstriction) Relaxation increases vessel diameter (vasodilation) Arteries also include external elastic membrane © 2013 Pearson Education, Inc.

Tunica Externa (11.9) Outermost layer Connective tissue sheath
Arterial tunica externa contain collagen fibers with scattered elastic fibers Venous tunica externa Thicker than tunica media Contains networks of elastic fibers and bundles of smooth muscles Connective tissue fibers blend into adjacent tissues Stabilizing and anchoring blood vessel © 2013 Pearson Education, Inc.

Artery Artery Vein Tunica intima (tunica interna) Smooth muscle
Comparison of typical artery and typical vein Artery Artery Vein Tunica intima (tunica interna) Smooth muscle Internal elastic membrane External elastic membrane LM x 60 Tunica media Endothelium Vein Elastic fiber Module 11.9 Arteries and veins differ in the structure and thickness of their walls Endothelium Tunica externa (tunicia adventitia) Smooth muscle Tunica intima Tunica media Tunica externa Figure © 2013 Pearson Education, Inc.

Module 11.9 Arteries and veins differ in the structure and thickness of their walls
Figure © 2013 Pearson Education, Inc.

Veins (11.9) Large veins Medium-sized veins Venules
Contain all three vessel wall layers Include superior and inferior venae cavae and tributaries Medium-sized veins Thin tunica media with smooth muscle cells and collagen fibers Thickest layer is tunica externa with elastic and collagen fibers Venules Smallest venous vessels © 2013 Pearson Education, Inc.

Large Vein Tunica externa Tunica media Tunica intima Medium-sized Vein
Cross-sectional views of vein walls Large Vein Tunica externa Tunica media Tunica intima Medium-sized Vein Tunica externa Module 11.9 Arteries and veins differ in the structure and thickness of their walls Tunica media Tunica intima Venule Tunica externa Endothelium Figure © 2013 Pearson Education, Inc.

Arteries (11.9) Elastic arteries Muscular arteries Arterioles
Large vessels transporting blood away from heart Include pulmonary trunk, aorta, and branches Capable of stretching and recoiling Muscular arteries Medium-sized arteries Distribute blood to skeletal muscles and internal organs Arterioles Tunica media has only one or two layers of smooth muscle cells © 2013 Pearson Education, Inc.

Elastic Artery Internal elastic membrane Tunica intima Tunica media
Cross-sectional views of artery walls Tunica intima Tunica media Tunica externa Smooth muscle cells Endothelium Elastic Artery Muscular Artery Arteriole Internal elastic membrane Module 11.9 Arteries and veins differ in the structure and thickness of their walls Figure © 2013 Pearson Education, Inc.

Blood Flow Pattern and Capillaries (11.9)
Arteries carry blood away from the heart Branch into smaller arteries, then into arterioles, and then into capillaries From capillaries, blood flows into venules, then into veins, and back to the heart Capillaries are only blood vessels to allow exchange between blood and interstitial fluid Thin walls allow easy diffusion Pores allow exchange of water and solutes © 2013 Pearson Education, Inc.

Capillaries Pores Endothelial cells Endothelial cells
Capillary structure Capillaries Pores Endothelial cells Endothelial cells Basement membrane Basement membrane Module 11.9 Arteries and veins differ in the structure and thickness of their walls Figure © 2013 Pearson Education, Inc.

Module 11.9 Review List the five general classes of blood vessels.
Describe a capillary. A cross section of tissues shows several small, thin-walled vessels with very little smooth muscle tissue in the tunica media. Which type of vessels are these? © 2013 Pearson Education, Inc.

Arteriosclerosis (11.10) Thickening and toughening of arterial walls
Complications account for half of all deaths in the United States Varied effects include coronary artery disease (CAD), potential heart attacks and stroke © 2013 Pearson Education, Inc.

Atherosclerosis (11.10) Formation of fatty deposits in tunica media of arteries Associated with damage to endothelial lining Most common form of arteriosclerosis Tends to develop in people with elevated lipid (cholesterol) levels Result is atherosclerotic plaque Fatty mass of tissue restricting blood flow Elderly (especially men) more likely to develop plaques Risk factors include high blood pressure and smoking © 2013 Pearson Education, Inc.

Plaque deposit in vessel wall
Coronary artery narrowed by plaque formation Plaque deposit in vessel wall Module Arteriosclerosis can restrict blood flow and damage vital organs Figure © 2013 Pearson Education, Inc.

Treatment for Plaques (11.10)
Remove and replace damaged segment of vessel Balloon angioplasty Catheter with inflatable balloon inserted into artery Balloon inflated, pressing plaque against wall Most effective treating small, soft plaques Advantages over vessel replacement procedure Mortality rate only about 1 percent Success rate over 90 percent Procedure can be done as outpatient © 2013 Pearson Education, Inc.

Catheter Balloon Arterial wall Balloon angioplasty
Module Arteriosclerosis can restrict blood flow and damage vital organs Catheter Balloon Arterial wall Figure © 2013 Pearson Education, Inc.

Module 11.10 Review Compare arteriosclerosis with atherosclerosis.
Identify risk factors for the development of atherosclerosis. Describe balloon angioplasty. © 2013 Pearson Education, Inc.

Capillary Arrangement (11.11)
Capillary beds Contain several connections between arterioles and venules Initial part of connection passageway, metarteriole, has smooth muscle that can contract to change vessel diameter Flow within each capillary variable, adjusted by precapillary sphincters Rhythmic changes to vessel diameter, vasomotion, causes pulsing movement of blood © 2013 Pearson Education, Inc.

Capillary Bed (11.11) May receive blood from more than one artery
Collateral arteries fuse and give rise to arterioles Fusion is example of arterial anastomosis Arterioles branch into dozens of capillaries Precapillary sphincter (band of smooth muscle) found at entry of each capillary controls flow of blood into capillary Arteriovenous anastomosis is direct connection between arteriole and venule Blood flow through anastomoses regulated by sympathetic innervation controlled by cardiovascular centers of medulla oblongata © 2013 Pearson Education, Inc.

Collateral arteries Vein Venule Arteriole Metarteriole Thoroughfare
Typical capillary bed Collateral arteries Vein Venule Arteriole Metarteriole Thoroughfare channel Smooth muscle cells Capillaries Precapillary sphincter Small venules Module Capillaries function as part of an interconnected network called a capillary bed Arteriovenous anastomosis KEY Precapillary sphincters Continuous blood flow Variable blood flow Figure 11.11 © 2013 Pearson Education, Inc.

Module 11.11 Review What is the role of precapillary sphincters?
Define vasomotion. Describe blood flow through an arteriovenous anastomosis. © 2013 Pearson Education, Inc.

Venous System (11.12) Arterial system under high pressure
Peripheral venule blood pressure about 10 percent of that in ascending aorta Mechanisms to maintain flow in veins against gravity Valves Folds of tunica intima projecting from vessel wall and pointing in direction of blood flow Contraction of skeletal muscles © 2013 Pearson Education, Inc.

Valves and Blood Flow (11.12)
Contraction of skeletal muscle squeezes blood toward heart Valves permit blood flow in one direction and prevent backflow of blood toward capillaries If valves do not work properly, blood can pool in veins and distend them causing: Mild discomfort and cosmetic problem as with varicose veins Painful distortion of adjacent tissues as in hemorrhoids © 2013 Pearson Education, Inc.

Valves above the contracting muscle open, allowing blood
Function of valves in the venous system Valve closed Valves above the contracting muscle open, allowing blood to move toward the heart. Valve closed Module The venous system has low pressures and contains almost two-thirds of the body's blood volume Valves below the contracting muscle are forced closed, preventing backflow of blood to the capillaries. Figure © 2013 Pearson Education, Inc.

Blood Distribution in the Body (11.12)
Uneven distribution among arteries, veins, and capillaries Systemic veins contain 64 percent of total blood volume Nearly 1/3 of venous blood in liver, bone marrow, and skin Systemic arteries contain 13 percent total blood volume Remaining blood in systemic capillaries, heart, and pulmonary circuit © 2013 Pearson Education, Inc.

64% 9% 7% 13% 7% Distribution of blood in the cardiovascular system
Systemic venous system Pulmonary circuit 7% Heart Module The venous system has low pressures and contains almost two-thirds of the body's blood volume Systemic arterial system 13% Systemic capillaries 7% Figure © 2013 Pearson Education, Inc.

Venoconstriction (11.12) Body maintains blood volume in arterial system even in case of hemorrhage by reducing volume of blood in venous system Controlled by vasomotor center in medulla oblongata Sympathetic nerves stimulate smooth muscles in medium-sized veins Result is venoconstriction (reduced diameter of veins) © 2013 Pearson Education, Inc.

Sympathetic nerves stimulated Smooth muscle contracts Vein constricts
Venoconstriction in response to sympathetic nerve stimulation Sympathetic nerves stimulated Smooth muscle contracts Vein constricts Module The venous system has low pressures and contains almost two-thirds of the body's blood volume Figure © 2013 Pearson Education, Inc.

Module 11.12 Review Define varicose veins.
Why are valves located in veins, but not in arteries? How is blood flow maintained in veins to counter the pull of gravity? © 2013 Pearson Education, Inc.

Circulatory Circuits (11.13)
Pulmonary circuit Carries deoxygenated blood from right ventricle to lungs Returns oxygenated blood from lungs to left atrium Blood from left ventricle enters systemic circuit Transports oxygenated blood to all organs and tissues Returns deoxygenated blood to right atrium © 2013 Pearson Education, Inc.

Systemic circuit (veins) Pulmonary (arteries) Digestive organs
Schematic overview of the pattern of circulation Systemic circuit (veins) Pulmonary (arteries) Brain Upper limbs Lungs RA LA Left ventricle Right Kidneys Liver Spleen Digestive organs Gonads Lower limbs Module The pulmonary circuit, which is relatively short, carries deoxygenated blood from the right ventricle to the lungs and returns oxygenated blood to the left atrium Figure © 2013 Pearson Education, Inc.

Patterns of Blood Vessel Organization (11.13)
Right and left symmetry Peripheral distribution of arteries and veins on body’s right and left sides generally identical Exception in largest vessels near the heart One vessel but many names Single vessel changes names as crosses anatomical boundaries, allowing for accurate anatomical descriptions Example: external iliac artery becomes femoral artery Redundant supply and drainage to tissues and organs Anastomoses between adjacent arteries or veins reduce impact of occlusion (blockage) of single blood vessel Module The pulmonary circuit, which is relatively short, carries deoxygenated blood from the right ventricle to the lungs and returns oxygenated blood to the left atrium © 2013 Pearson Education, Inc.

Pulmonary Vessels (11.13) Pulmonary trunk, large artery coming out of right ventricle that branches into: Right and left pulmonary arteries that branch into: Smaller arteries and pulmonary arterioles supplying: Alveolar capillaries around alveoli (air pockets) where gas exchange occurs Oxygenated blood returns along small venules that join to form: Pulmonary veins (two right and two left) that drain into the left atrium © 2013 Pearson Education, Inc.

Aortic arch Ascending aorta Pulmonary trunk Superior vena cava
Pulmonary circuit Aortic arch Ascending aorta Pulmonary trunk Superior vena cava Left lung Right lung Left pulmonary arteries Right pulmonary arteries Left pulmonary veins Right pulmonary veins Alveolus Capillary Module The pulmonary circuit, which is relatively short, carries deoxygenated blood from the right ventricle to the lungs and returns oxygenated blood to the left atrium Inferior vena cava Descending aorta Figure © 2013 Pearson Education, Inc.

Module Review Identify the two circulatory circuits of the cardiovascular system. Briefly describe the three major patterns of blood vessel organization. Trace the path of a drop of blood through the lungs, beginning at the right ventricle and ending at the left atrium. © 2013 Pearson Education, Inc.

Systemic Circulation Systems (11.14)
Systemic arterial system All vessels originate from aorta Most arteries paired (left and right) Systemic venous system – all vessels drain into: Superior vena cava (from head, chest, and upper limbs) Inferior vena cava (from all structures inferior to diaphragm) © 2013 Pearson Education, Inc.

Brachiocephalic trunk Descending aorta Axillary Diaphragm
Overview of the systemic arterial system Vertebral Common carotid Subclavian Aortic arch Brachiocephalic trunk Descending aorta Axillary Diaphragm Ascending aorta Celiac trunk Brachial Renal Gonadal Lumbar Radial Ulnar Common iliac Internal iliac Digital arteries External iliac Palmar arches Deep femoral Femoral Module The systemic arterial and venous systems operate in parallel, and the major vessels often have similar names Popliteal Posterior tibial Fibular Anterior tibial Dorsalis pedis Plantar arch Figure © 2013 Pearson Education, Inc.

Arrangement of Arteries and Veins (11.14)
Major veins in neck and limbs Arteries located deep beneath skin for protection Usually two sets of peripheral veins One deep One superficial Important for controlling body temperature Hot weather, venous blood in superficial veins to allow heat loss Cold weather, venous blood in deep veins to minimize heat loss © 2013 Pearson Education, Inc.

Vertebral External jugular Internal jugular Superior vena cava
Overview of the systemic venous system Vertebral External jugular Internal jugular Superior vena cava Subclavian Inferior vena cava Brachiocephalic Axillary Diaphragm Cephalic Renal Brachial Gonadal Basilic Lumbar Median cubital Radial Common iliac Median antebrachial Internal iliac Ulnar External iliac Palmar venous arches Digital veins Deep femoral Module The systemic arterial and venous systems operate in parallel, and the major vessels often have similar names Great saphenous Femoral Popliteal Small saphenous Posterior tibial Fibular Anterior tibial Plantar venous arch KEY Superficial veins Dorsal venous arch Deep veins Figure © 2013 Pearson Education, Inc.

Module Review Name the two large veins that collect blood from the systemic circuit. Identify the largest artery in the body. Besides containing valves, cite another major difference between the arterial and venous systems. © 2013 Pearson Education, Inc.

Branches of the Aortic Arch (11.15)
Aorta arises from base of left ventricle Divided into ascending aorta, aortic arch, descending aorta Aortic arch branches into three elastic arteries Brachiocephalic trunk Branches into right subclavian artery and right common carotid artery Left common carotid artery Left subclavian artery © 2013 Pearson Education, Inc.

Subclavian Artery and Branches (11.15)
In thoracic cavity, branches of subclavian artery are: Internal thoracic artery supplying pericardium and anterior chest wall Vertebral artery supplying brain and spinal cord After passing superior border of first rib, subclavian becomes: Axillary artery © 2013 Pearson Education, Inc.

Subclavian Artery and Branches (11.15)
When the axillary artery enters the arm it's called the brachial artery Branches include deep brachial artery (to deep posterior structures) and ulnar collateral arteries (to elbow areas) In the forearm, the brachial artery branches into: Radial artery Ulnar artery Radial and ulnar arteries fuse to form superficial and deep palmar arches that branch into digital arteries © 2013 Pearson Education, Inc.

Branches of the Aortic Arch Start Brachiocephalic trunk Left common
Arteries of the chest and upper limb Branches of the Aortic Arch Start Brachiocephalic trunk Left common carotid artery Left subclavian artery The Right Subclavian Artery Vertebral Vertebral and internal thoracic arteries branch off subclavian artery Internal thoracic Aortic arch Axillary Ascending aorta Arteries of the Arm Deep brachial Heart Brachial Ulnar collateral arteries Descending aorta Radial Arteries of the Forearm Module The branches of the aortic arch supply structures that are drained by the superior vena cava Ulnar Deep palmar arch Arteries of the Hand Superficial palmar arch Palmar arches and digital arteries. Figure © 2013 Pearson Education, Inc.

Superior Vena Cava Drainage (11.15)
Veins of the neck draining into the superior vena cava include: External jugular vein From superficial structures of head and neck Vertebral vein From cervical spinal cord, posterior surface of skull Internal jugular vein From deep structures of head and neck © 2013 Pearson Education, Inc.

Veins of the Hand and Forearm (11.15)
From the digital veins in the fingers, blood drains into: Deep palmar arch, which drains into: Ulnar vein Radial vein Superficial palmar arch, which drains into: Cephalic vein Median antebrachial vein Basilic vein © 2013 Pearson Education, Inc.

Veins of the Arm and Thoracic Region (11.15)
The median cubital vein interconnects cephalic and basilic veins Ulnar and radial veins merge to form brachial vein Brachial and basilic merge to form axillary vein Axillary vein merges with cephalic to form subclavian vein Subclavian veins merge with jugular veins to form brachiocephalic vein Also receives blood from vertebral and internal thoracic vein Right and left brachiocephalic veins merge to form superior vena cava © 2013 Pearson Education, Inc.

The Right Subclavian Vein
Veins of the chest and upper limb Veins of the Neck External jugular vein Vertebral vein Internal jugular vein The Right Subclavian Vein Junction of axillary vein and cephalic vein Brachiocephalic vein Veins of the Arm Axillary vein Cephalic vein Superior vena cava (SVC) Brachial Veins of the Forearm Basilic Median cubital vein Internal thoracic vein Junction of ulnar and radial veins Cephalic KEY Median antebrachial vein Module The branches of the aortic arch supply structures that are drained by the superior vena cava Radial Superficial veins Basilic Deep veins Ulnar Deep palmar arch Veins of the Hand Start Superficial palmar arch Digital veins and palmar venous arches Figure © 2013 Pearson Education, Inc.

Module Review Name the two arteries formed by the division of the brachiocephalic trunk. A blockage of which branch from the aortic arch would interfere with blood flow to the left arm? Whenever Thor gets angry, a large vein bulges in the lateral region of his neck. Which vein is this? © 2013 Pearson Education, Inc.

Arterial Supply to the Head (11.16)
Common carotid arteries supply blood to face, neck, and brain External carotid artery supplies neck, esophagus, pharynx, larynx, lower jaw, cranium, and face Internal carotid artery delivers blood to brain and eyes Carotid sinus at base of internal carotid artery contains baroreceptors detecting blood pressure Vertebral arteries fuse to form basilar artery at ventral surface of medulla oblongata © 2013 Pearson Education, Inc.

Brachiocephalic trunk
Arteries of the neck and head Basilar Superficial temporal Maxillary Branches of the External Carotid Occipital Facial Internal carotid artery Lingual External carotid Vertebral artery Carotid sinus Module The external carotid arteries supply the neck, lower jaw, and face, and the internal carotid and vertebral arteries supply the brain while the external jugular veins drain the regions supplied by the external carotids, and the internal jugular veins drain the brain Common carotid artery Clavicle First rib Axillary Subclavian Brachiocephalic trunk Figure © 2013 Pearson Education, Inc.

Drainage of Blood from Head (11.16)
External jugular vein drains maxillary and temporal veins from cranium, face, lower jaw, neck Internal jugular vein drains venous sinuses in cranium Exits skull through jugular foramen Vertebral vein drains cervical spinal cord and posterior skull surface Passes through transverse foramina of cervical vertebrae These three veins merge with subclavian vein to form brachiocephalic vein © 2013 Pearson Education, Inc.

Right subclavian Superior vena cava
Veins of the neck and head Dural sinuses draining the brain Temporal Maxillary Tributaries of the External Jugular Jugular foramen Facial Occipital External jugular Vertebral vein Module The external carotid arteries supply the neck, lower jaw, and face, and the internal carotid and vertebral arteries supply the brain while the external jugular veins drain the regions supplied by the external carotids, and the internal jugular veins drain the brain Internal jugular vein Clavicle Right brachiocephalic Left brachiocephalic Axillary Right subclavian Superior vena cava Figure © 2013 Pearson Education, Inc.

Module Review Name the arterial structure in the neck region that contains baroreceptors. Identify branches of the external carotid artery. Identify the veins that combine to form the brachiocephalic vein. © 2013 Pearson Education, Inc.

Blood Supply to the Brain (11.17)
Internal carotid arteries supply anterior half of cerebrum Each internal carotid artery divides into: Ophthalmic artery to the eyes Anterior cerebral artery to frontal and parietal lobes Middle cerebral artery to midbrain and lateral brain surfaces Vertebral and basilar arteries supply rest of brain © 2013 Pearson Education, Inc.

Cerebral arterial circle
Lateral view of arteries of the brain Middle cerebral Anterior cerebral Posterior cerebral Module The internal carotid arteries and the vertebral arteries supply the brain which is drained by the dural sinuses and the internal jugular veins Ophthalmic Basilar Vertebral Cerebral arterial circle Internal carotid Figure © 2013 Pearson Education, Inc.

Cerebral Arterial Circle (11.17)
Internal carotid arteries and basilar artery interconnected in ring-shaped anastomosis Cerebral arterial circle or circle of Willis Allows redundant blood supply from both major blood sources Basilar artery divides into posterior cerebral arteries, which branch into posterior communicating arteries © 2013 Pearson Education, Inc.

Anterior cerebral Anterior communicating Ophthalmic Anterior Cerebral
Inferior view of arteries of the brain Anterior cerebral Anterior communicating Ophthalmic Anterior cerebral Cerebral Arterial Circle Internal carotid (cut) Posterior communicating Middle cerebral Posterior cerebral Pituitary gland Basilar Posterior cerebral Vertebral Cerebellar Module The internal carotid arteries and the vertebral arteries supply the brain which is drained by the dural sinuses and the internal jugular veins Figure © 2013 Pearson Education, Inc.

Blood Drainage from the Brain (11.17)
Superficial cerebral veins and small veins of brain stem drain into dural sinuses Superior sagittal sinus (largest dural sinus) Great cerebral vein drains deep cerebral veins Drains into straight sinus Other small veins drain into cavernous sinus Some blood from dural sinuses drains into vertebral vein Internal jugular vein starts as convergence of: Transverse sinuses, straight sinus, superior sagittal sinus © 2013 Pearson Education, Inc.

Superior sagittal sinus
Lateral view of brain showing venous distribution Superior sagittal sinus Superior sagittal sinus Inferior sagittal sinus Straight sinus Cavernous sinus Occipital sinus Module The internal carotid arteries and the vertebral arteries supply the brain which is drained by the dural sinuses and the internal jugular veins Great cerebral vein Right transverse sinus Internal jugular vein Vertebral vein Figure © 2013 Pearson Education, Inc.

Superior sagittal sinus (cut) Cavernous sinus Cerebral veins Internal
Inferior view of brain showing venous distribution Superior sagittal sinus (cut) Cavernous sinus Internal jugular Cerebral veins Petrosal sinus Module The internal carotid arteries and the vertebral arteries supply the brain which is drained by the dural sinuses and the internal jugular veins Sigmoid sinus Cerebellar veins Transverse sinus Straight sinus Occipital sinus Figure © 2013 Pearson Education, Inc.

Module Review Name the veins that drain the dural sinuses of the brain. Name the three branches of the internal carotid artery and the structures they supply. Describe the structure and function of the cerebral arterial circle. © 2013 Pearson Education, Inc.

Descending Aorta (11.18) Divided by diaphragm into:
Thoracic aorta with branches Bronchial arteries to lung tissue Esophageal arteries to esophagus Mediastinal arteries to mediastinum Pericardial arteries to pericardium Intercostal arteries to chest muscles Phrenic arteries to diaphragm Abdominal aorta with several branches © 2013 Pearson Education, Inc.

Aortic arch Visceral Internal thoracic Branches of the Thoracic Aorta
Major arteries of the trunk Aortic arch Visceral Branches of the Thoracic Aorta Internal thoracic Thoracic aorta Somatic Branches of the Thoracic Aorta Bronchial arteries Esophageal arteries Mediastinal arteries Intercostal arteries Phrenic arteries Pericardial arteries Diaphragm Celiac trunk Adrenal Branches of the celiac trunk Renal Module The regions supplied by the descending aorta are drained by the superior and inferior venae cavae Gonadal Lumbar Superior mesenteric Common iliac Abdominal aorta Inferior mesenteric Figure © 2013 Pearson Education, Inc.

Major Paired Branches of Abdominal Aorta (11.18)
Adrenal arteries Supply adrenal glands Renal arteries Supply the kidneys Gonadal arteries Called testicular arteries in males Called ovarian arteries in females Lumbar arteries Supply vertebrae, spinal cord, and abdominal wall Module The regions supplied by the descending aorta are drained by the superior and inferior venae cavae © 2013 Pearson Education, Inc.

Blood Drainage into Superior and Inferior Venae Cavae (11.18)
Blood drains from thorax into superior vena cava through Azygos vein Hemiazygos vein Drainage into azygos and hemiazygos from: Intercostal veins draining muscles of chest wall Esophageal veins draining esophagus Bronchial veins draining passageways of lungs Mediastinal veins draining mediastinal area Blood from areas inferior to diaphragm drains into inferior vena cava © 2013 Pearson Education, Inc.

Brachiocephalic Superior vena cava The Azygos and Hemiazygos Veins
Veins of the abdomen and chest Brachiocephalic Superior vena cava The Azygos and Hemiazygos Veins Internal thoracic Azygos vein Inferior vena cava Hemiazygos vein Hepatics Branches of azygos and hemiazygous veins Phrenic Adrenal Renal Gonadal Module The regions supplied by the descending aorta are drained by the superior and inferior venae cavae Lumbar Common iliac Figure 11.18 2 © 2013 Pearson Education, Inc.

Major Tributaries of the Inferior Vena Cava (11.18)
Lumbar veins drain spinal cord and muscles of body wall Gonadal veins Ovarian veins drain ovaries Testicular veins drain testes Hepatic veins drain sinusoids (channels) of liver Renal veins collect blood from kidneys Adrenal veins drain adrenal glands Phrenic veins drain diaphragm Module The regions supplied by the descending aorta are drained by the superior and inferior venae cavae © 2013 Pearson Education, Inc.

Module Review Which vessel collects most of the venous blood inferior to the diaphragm? Identify the major tributaries of the inferior vena cava. Grace is in an automobile accident, and her celiac trunk is ruptured. Which organs will be affected most directly by this injury? © 2013 Pearson Education, Inc.

Blood Supply to Abdominal Viscera (11.19)
Unpaired branches off abdominal aorta Celiac trunk Which divides into: Common hepatic artery Supplying liver, stomach, gallbladder, duodenum Left gastric artery Supplying stomach Splenic artery Supplying spleen, stomach, and pancreas Superior mesenteric artery Supplying pancreas, duodenum, small and large intestines Inferior mesenteric artery Supplying terminal portions of colon and rectum © 2013 Pearson Education, Inc.

Arteries supplying the abdominopelvic organs
The Celiac Trunk Common hepatic artery Left gastric artery Splenic artery Celiac trunk Liver Liver Stomach Stomach Right gastric artery Spleen Ascending colon Pancreas Superior Mesenteric Artery Inferior Mesenteric Artery Module The viscera supplied by the celiac trunk and mesenteric arteries are drained by the tributaries of the hepatic portal vein Smaii Small Descending colon intestine intestine Sigmoid Sigmoid colon colon Rectum Rectum Figure © 2013 Pearson Education, Inc.

Drainage of Abdominal Viscera (11.19)
Hepatic portal vein formed by fusion of: Superior mesenteric vein Carries largest volume of blood Collects blood from stomach, small intestine, anterior 2/3 of large intestine Inferior mesenteric vein Collects blood from posterior 1/3 of large intestine and rectum Splenic vein Collects blood from stomach, spleen, pancreas © 2013 Pearson Education, Inc.

Inferior Left gastric vena cava Hepatic Right gastric Cystic
The hepatic portal system Inferior vena cava Left gastric Hepatic Right gastric Liver Cystic Stomach Splenic Vein Hepatic portal Spleen Superior Mesenteric Vein Descending colon Pancreas Inferior Mesenteric Vein Ascending colon Module The viscera supplied by the celiac trunk and mesenteric arteries are drained by the tributaries of the hepatic portal vein Rectum Figure © 2013 Pearson Education, Inc.

Module Review List the unpaired branches of the abdominal aorta that supply blood to the visceral organs. Identify the three veins that merge to form the hepatic portal vein. Identify the branches of the celiac trunk. © 2013 Pearson Education, Inc.

Blood Supply to Lower Limbs (11.20)
Abdominal aorta splits into right and left common iliac arteries, each divides into: Internal iliac artery supplying pelvic organs, medial thigh External iliac artery As it enters lower limb, external iliac artery becomes femoral artery supplying anterior and lateral skin and deep muscles of thigh © 2013 Pearson Education, Inc.

Blood Supply to Lower Limbs (11.20)
Femoral artery becomes popliteal artery posterior to knee joint, branching into: Posterior and anterior tibial arteries Fibular artery branches off posterior tibial artery Vessels in foot include dorsalis pedis, dorsal arch, plantar arch and digital arteries in toes © 2013 Pearson Education, Inc.

Descending genicular artery
Arteries of the lower limb Anterior View Posterior View Common iliac Internal Iliac and Its Branches External iliac Femoral artery Right external iliac Femoral artery branches Femoral Descending genicular artery Popliteal Popliteal artery Anterior tibial Module The pelvis and lower limb are supplied by branches of the common iliac arteries and drained by tributaries of the common iliac veins Posterior tibial Anterior tibial Posterior tibial Fibular Fibular artery Arteries of the Foot Dorsalis pedis Dorsal arch Plantar arch Figure © 2013 Pearson Education, Inc.

Lower Limb Blood Drainage (11.20)
Plantar venous arch delivers blood to deep veins: anterior tibial, posterior tibial, and fibular veins Dorsal venous arch collects from superior foot surface and digital veins Drains into superficial veins: great saphenous vein and small saphenous vein Small saphenous vein merges with popliteal vein at knee to form femoral vein Great saphenous vein joins femoral vein Femoral vein becomes external iliac vein in pelvic cavity Internal iliac vein drains pelvic organs Joins with external iliac vein forming common iliac vein © 2013 Pearson Education, Inc.

Anterior View Posterior View Common iliac External iliac
Veins of the lower limb Anterior View Posterior View Common iliac External iliac Internal iliac Femoral External iliac vein Femoral Great saphenous Femoral vein Popliteal Small saphenous Module The pelvis and lower limb are supplied by branches of the common iliac arteries and drained by tributaries of the common iliac veins Anterior tibial Posterior tibial Fibular Plantar venous arch Dorsal venous arch Digital Figure © 2013 Pearson Education, Inc.

Module Review Name the first two divisions of the common iliac artery. The plantar venous arch carries blood to which three veins? A blood clot that blocks the popliteal vein would interfere with blood flow in which other veins? © 2013 Pearson Education, Inc.

11 Blood and Blood Vessels.

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