CIRCULATORY

SYSTEM
Components:
• Cardiovascular
system
Heart
Blood vessels
Blood

• Lymphatic system
Lymphatic organs
& vessels
Lymph
 CIRCULATORY LOOPS
• Pulmonary
circulation
fr R ventricle →
pulmonary art→
lungs→ pulmonary
vein→L atrium
• Systemic
circulation
from L ventricle →
aorta→ body →vena
cava→R atrium
 Venous drainage:
• Coronary sinus w/c
drains into RA
- tributaries:
1. Great cardiac
2. Middle cardiac
3. Small cardiac

Anterior cardiac
Venae cordis
minimae
opens directly to RA
 Arterial Supply:
• R / L coronaries
from
ascending aorta
3. Right coronary
a. Marginal
b. Post.
Interventricular
6. Left coronary
a. Ant.
Interventricular
b. Circumflex
 Pulmonary Vessels
• L&R PA ~
bifurcation of Pulm
trunk
• RPA crossed
superiorly by Arch
of Ao
• LPA inferior to Arch
of Ao @ T5
vertebral level
 PULMONARY VEINS
• Pulm Venous
system
anatomically
separate fr
bronchial & PA
sytem
• Superior PV
drainage
• Inferior PV
drainage
 PULMONARY VESSELS
• R & L PA lie anteior
to respective
Primary bronchi
• PA fr 20 lobar
branches in hilus
div into 30
segments
 Bronchial Vessels
• BA arise fr Desc Ao
or the 3rd
intercostal
branches
• Carry oxygenated
blood to hilar
structures,
bronchial tree &
supportive tissues
Heart & Great Vessels
Heart & Great Vessels
 AORTA
THORACIC
• Aortic Root

R / L coronaries
• Ascending Aorta

• Arch of Aorta

Brachiocephalic
Left common carotid
Left subclavian
 AORTA
• Descending Aorta
Bronchial
Mediastinal
Esophageal
Posterior intercostal
Pericardial
Subcostal
• Abdominal Aorta
 COMMON CAROTID
• External Carotid
- Superior thyroid
- Asc. Pharyngeal
- Lingual
- Facial
- Occipital
- Post. Auricular
- Superficial Temporal
- Maxillary
• Internal Carotid
 Carotid system
• ↑ neck in carotid sheath
• Vagus n posteriorly
• Int jugular v laterally
• Bifurcate ~hyoid (C3)
• Int Carotid ~↑sheath to
base of skull
• Common Carotid
• (-) neck branches
• Carotid body
~chemoreceptors at
bifurcation
 External Carotid
Supply
Face
Scalp
Deep structures of
upper neck
Floor of mouth
Nasal cavities
 Internal Carotid
• No branches outside of
cranial cavity
• Carotid sinus –
prominent dilatation at
origin ~ baroreceptors
 CIRCLE OF WILLIS
• Internal carotid
Opthalmic
Posterior
Communicating
Ant Cerebral
Middle Cerebral

• Vertebral
 SUBCLAVIAN
Divisible into 3 parts by
Scalenous anterior

• First Part
Vertebral
Thyrocervical
Internal Thoracic

• Second part
Costocervical

• Third part
SUBCLAVIAN

transverse cervical
suprascapular

vertebral

Deep cerv
Inf thyroid

Thyrocervical trunk
Highest IC
Int thoracic

costocervicial

3rd portion
 AXILLARY
Divisible into 3 parts by
Pectoralis Minor

• First
Highest thoracic
• Second
Thoracoacromial
Lateral thoracic
• Third
Subscapular
Anterior Circumflex
humeral
Posterior circumflex
humeral
 UPPER EXTREMITY
• Brachial

• Radial / Ulnar

• Palmar arch
UPPER EXTREMITY

• Radial artery
• Ulnar artery

• Palmar arch
 ABDOMINAL AORTA
• Anterior Visceral
Celiac
Superior Mesenteric
Inferior Mesenteric
• Lateral Visceral
Suprarenal
Renal
Gonadal
• Lateral Abdominal
Inferior Phrenic
Lumbar
• Terminal branches
Common iliac
Median Sacral
 Celiac artery – T 12
1. Left Gastric
2. Splenic
Left Gastroepiploic
Short Gastric
4. Hepatic
Right Gastric
R/L Hepatic
Gastroduodenal –
Right Gastroepiploic
Sup. Pancreaticoduodenal
 Superior Mesenteric Artery – L 1
• Inferior Pancreaticoduodenal

• Middle Colic

• Right Colic

• Ileo-colic

• Jejunal-Ileal
 Inferior Mesenteric Artery – L 3
• Left Colic

• Sigmoid

• Superior Rectal
IMA root
 ABDOMINAL AORTA

L5

L4
 ILIAC VESSELS
• Common iliac
• bifurcation L4
2. Internal iliac/
hypogastric a

4. External iliac
• Inf epigastric
• Deep circumflex
iliac
before becoming
femoral after
inguinal ligament
 Lower extremity
• Common Femoral
• Deep
• Superficial

• Popliteal~trifurcation
• Ant Tibial
• Posterior Tibial
• Peroneal

• Plantar arch
 Internal Iliac

2. Branches to the limb

& perineum
• Superior gluteal
• Inferior gluteal
• Obturator
• Internal pudendal

4. Somatic segmental
branches
• Iliolumbar
• Lateral sacral
 Internal Iliac
1. Visceral
• Umbilical
• Inferior vesical
• Superior vesical
• Middle rectal
• Uterine & vaginal
• (†)
 Anal & Rectal blood supply
Fr IMA
• Superior

rectal/hemorrhoidal
(unpaired)

Fr internal pudendal
• Middle

rectal/hemorrhoidal

• Inferior
rectal/hemorrhoidal
 INFERIOR VENA CAVA
• Largest v in body
• Pierces diaphragm T8
• Crosses 8 vertebrae
• ~2x length of abdominal Ao
• Veins of origin
R / L common iliac
Median sacral
 INFERIOR VENA CAVA
• Anterior Visceral
R / L hepatic
• Lateral Visceral
R suprarenal
R / L renal
R gonadal
• Lateral Abdominal
Inferior phrenic
Lumbar
 PORTAL VENOUS SYSTEM
Tributaries:

• Superior mesenteric

• Splenic

• Inferior mesenteric

• Left gastric

• Paraumbilical
 PORTAL VENOUS SYSTEM
Normal route:
portal vein – liver –
hepatic vein – IVC
 PORTA-CAVAL
ANASTOMOSES
Occur between:
• Left gastric & esophageal
of the azygos system

• Superior rectal &

middle/inferior rectal

• Paraumbilical & superficial

epigastric of abdominal
wall

• Colic & retroperitoneal

 PORTAL HYPERTENSION
 Results from thrombosis of
the portal vein or liver
cirrhosis

 If dilated, results to:

1. esophageal varices
2. hemorrhoids
3. caput medusae
 Azygos system
of veins
• Veins on each side
of vertebral column
• Drain back & walls
of thorax &
abdomen
• Azygos
• asc↑R side of inferio 8 T
vertebrae
• lateral to thoracic d
• Lateral to Desc Thor
Aorta
 AZYGOS system
• Connects SVC from IVC

• Tributaries:
Intercostal vein
Mediastinal
Esophageal
Bronchial
Accessory hemiazygos

Hemiazygos
 Upper extremity
• Cephalic vein 
Axillary vein
• Basilic vein +
Brachial vein =
Axillary vein
• Axillary vein 
Subclavian 
Brachiocephalic
 Internal Jugular
• Continuation of
Sigmoid sinus
• Tributaries:
Inferior petrosal
sinus
Facial
Pharyngeal
Lingual
Sup thyroid
Middle thyroid
 Internal Jugular
• Superior & Inferior bulb
• Bicuspid valve ~ resist backflow of blood fr RA
& SVC
• Intracranial sinuses ~ sigmoid & inf petrosal
drain post cranial fossa & cavernous sinuses
• Lymphatic drainage of H&N

• Removal in Radical Neck dissection

• Access for hemodialysis

 BRACHIOCEPHALIC VEIN
• L & R Int jugular &
subclavian veins

• Unite @ level of inf

border of 1st R costal
cartilage to form SVC

• Tributaries:
Internal thoracic
Vertebral
Inferior thyroid
Superior intercostal
 SUPERIOR VENA CAVA
• Union of R / L
brachiocephalic
veins
• Ends at the level of
the 3rd costal
cartilage to enter
the R atrium
• SVC syndrome
 Venae Commitantes
• Ant / Post Tibial

• Popliteal

• Femoral

• External iliac

• Internal iliac

• Common iliac
 SAPHENOUS Veins
• Great Saphenous
drains into Femoral

• Small Saphenous
drains into Popliteal

• Accessory
Saphenous
Thank you.