The structure of the vessels veins arteries capillaries. human blood vessels
The distribution of blood throughout the human body is carried out due to the work of cardio-vascular system. Its main organ is the heart. Each of his blows contributes to the fact that the blood moves and nourishes all organs and tissues.
System Structure
It is secreted in the body different kinds blood vessels. Each of them has its own purpose. Thus, the system includes arteries, veins and lymphatic vessels. The first of them are designed to ensure that blood enriched with nutrients enters the tissues and organs. It is saturated with carbon dioxide and various products released during the life of cells, and returns through the veins back to the heart. But before entering this muscular organ, the blood is filtered in the lymphatic vessels.
The total length of the system, consisting of blood and lymphatic vessels, in the body of an adult is about 100 thousand km. And the heart is responsible for its normal functioning. It is it that pumps about 9.5 thousand liters of blood every day.
Principle of operation
The circulatory system is designed to support the entire body. If there are no problems, then it functions as follows. Oxygenated blood exits the left side of the heart through the largest arteries. It spreads throughout the body to all cells through wide vessels and the smallest capillaries, which can only be seen under a microscope. It is the blood that enters the tissues and organs.
The place where the arterial and venous systems connect is called the capillary bed. The walls of the blood vessels in it are thin, and they themselves are very small. This allows you to fully release oxygen and various nutrients through them. The waste blood enters the veins and returns through them to the right side of the heart. From there, it enters the lungs, where it is enriched again with oxygen. passing through lymphatic system, the blood is cleansed.
Veins are divided into superficial and deep. The first are close to the surface of the skin. Through them, blood enters the deep veins, which return it to the heart.
The regulation of blood vessels, heart function and general blood flow is carried out by the central nervous system and secreted in tissues by local chemicals. This helps control the flow of blood through the arteries and veins, increasing or decreasing its intensity depending on the processes taking place in the body. For example, it increases with physical exertion and decreases with injuries.
How does blood flow
The spent "depleted" blood through the veins enters the right atrium, from where it flows into the right ventricle of the heart. With powerful movements, this muscle pushes the incoming fluid into the pulmonary trunk. It is divided into two parts. The blood vessels of the lungs are designed to enrich the blood with oxygen and return them to the left ventricle of the heart. Each person has this part of him more developed. After all, it is the left ventricle that is responsible for how the entire body will be supplied with blood. It is estimated that the load that falls on it is 6 times greater than that to which the right ventricle is subjected.
The circulatory system includes two circles: small and large. The first of them is designed to saturate the blood with oxygen, and the second - for its transportation throughout the orgasm, delivery to every cell.
Requirements for the circulatory system
In order for the human body to function normally, a number of conditions must be met. First of all, attention is paid to the state of the heart muscle. After all, it is she who is the pump that drives the necessary biological fluid through the arteries. If the work of the heart and blood vessels is impaired, the muscle is weakened, then this can cause peripheral edema.
It is important that the difference between the areas of low and high pressure is observed. It is necessary for normal blood flow. So, for example, in the region of the heart, the pressure is lower than at the level of the capillary bed. This allows you to comply with the laws of physics. Blood moves from an area of higher pressure to an area where it is lower. If a number of diseases occur, due to which the established balance is disturbed, then this is fraught with congestion in the veins, swelling.
The ejection of blood from the lower extremities is carried out thanks to the so-called musculo-venous pumps. So called calf muscles. With each step, they contract and push the blood against the natural force of gravity towards the right atrium. If this function is disturbed, for example, as a result of injury and temporary immobilization of the legs, then edema occurs due to a decrease in venous return.
Another important link responsible for ensuring that the human blood vessels function normally are venous valves. They are designed to support the fluid flowing through them until it enters the right atrium. If this mechanism is disturbed, and this is possible as a result of injuries or due to valve wear, abnormal blood collection will be observed. As a result, this leads to an increase in pressure in the veins and squeezing out the liquid part of the blood into the surrounding tissues. A prime example violation of this function is varicose veins veins in the legs.
Vessel classification
To understand how the circulatory system works, it is necessary to understand how each of its components functions. So, the pulmonary and hollow veins, the pulmonary trunk and the aorta are the main ways of moving the necessary biological fluid. And all the rest are able to regulate the intensity of the inflow and outflow of blood to the tissues due to the ability to change their lumen.
All vessels in the body are divided into arteries, arterioles, capillaries, venules, veins. All of them form a closed connecting system and serve a single purpose. Moreover, each blood vessel has its own purpose.
arteries
The areas through which blood moves are divided depending on the direction in which it moves in them. So, all arteries are designed to carry blood from the heart throughout the body. They are elastic, muscular and muscular-elastic type.
The first type includes those vessels that are directly connected with the heart and exit from its ventricles. This is the pulmonary trunk, pulmonary and carotid arteries, aorta.
All of these vessels of the circulatory system consist of elastic fibers that are stretched. This happens with every heartbeat. As soon as the contraction of the ventricle has passed, the walls return to their original form. Due to this, normal pressure is maintained for a period until the heart fills with blood again.
Blood enters all tissues of the body through the arteries that depart from the aorta and pulmonary trunk. Wherein various bodies need different amounts of blood. This means that the arteries must be able to narrow or expand their lumen so that the fluid passes through them only in the required doses. This is achieved due to the fact that smooth muscle cells work in them. Such human blood vessels are called distributive. Their lumen is regulated by the sympathetic nervous system. The muscular arteries include the artery of the brain, radial, brachial, popliteal, vertebral and others.
Other types of blood vessels are also isolated. These include muscular-elastic or mixed arteries. They can contract very well, but at the same time they have high elasticity. This type includes subclavian, femoral, iliac, mesenteric artery, celiac trunk. They contain both elastic fibers and muscle cells.
Arterioles and capillaries
As blood moves along the arteries, their lumen decreases and the walls become thinner. Gradually they pass into the smallest capillaries. The area where arteries end is called arterioles. Their walls consist of three layers, but they are weakly expressed.
The thinnest vessels are the capillaries. Together, they represent the longest part of the entire circulatory system. It is they who connect the venous and arterial channels.
A true capillary is a blood vessel that is formed as a result of branching of arterioles. They can form loops, networks that are located in the skin or synovial bags, or vascular glomeruli that are located in the kidneys. The size of their lumen, the speed of blood flow in them and the shape of the networks formed depend on the tissues and organs in which they are located. So, for example, the thinnest vessels are located in skeletal muscles, lungs and nerve sheaths - their thickness does not exceed 6 microns. They form only flat networks. In mucous membranes and skin, they can reach 11 microns. In them, the vessels form a three-dimensional network. The widest capillaries are found in the hematopoietic organs, endocrine glands. Their diameter in them reaches 30 microns.
The density of their placement is also not the same. The highest concentration of capillaries is noted in the myocardium and brain, for every 1 mm 3 there are up to 3,000 of them. At the same time, there are only up to 1000 of them in the skeletal muscle, and even less in the bone tissue. It is also important to know that in an active state, under normal conditions, blood does not circulate in all capillaries. About 50% of them are in an inactive state, their lumen is compressed to a minimum, only plasma passes through them.
Venules and veins
Capillaries, which receive blood from arterioles, unite and form larger vessels. They are called postcapillary venules. The diameter of each such vessel does not exceed 30 µm. Folds form at the transition points, which perform the same functions as the valves in the veins. Elements of blood and plasma can pass through their walls. Postcapillary venules unite and flow into collecting venules. Their thickness is up to 50 microns. Smooth muscle cells begin to appear in their walls, but often they do not even surround the lumen of the vessel, but their outer shell is already clearly defined. The collecting venules become muscle venules. The diameter of the latter often reaches 100 microns. They already have up to 2 layers of muscle cells.
The circulatory system is designed in such a way that the number of vessels that drain blood is usually twice the number of those through which it enters the capillary bed. In this case, the liquid is distributed as follows. Up to 15% of the total amount of blood in the body is in the arteries, up to 12% in the capillaries, and 70-80% in the venous system.
By the way, fluid can flow from arterioles to venules without entering the capillary bed through special anastomoses, the walls of which include muscle cells. They are found in almost all organs and are designed to ensure that blood can be discharged into the venous bed. With their help, pressure is controlled, the transition of tissue fluid and blood flow through the organ is regulated.
Veins are formed after the confluence of venules. Their structure directly depends on the location and diameter. The number of muscle cells is affected by the place of their localization and the factors under the influence of which fluid moves in them. Veins are divided into muscular and fibrous. The latter include the vessels of the retina, spleen, bones, placenta, soft and hard shells brain. The blood circulating in the upper part of the body moves mainly under the force of gravity, as well as under the influence of the suction action during inhalation of the chest cavity.
The veins of the lower extremities are different. Each blood vessel in the legs must resist the pressure that is created by the fluid column. And if the deep veins are able to maintain their structure due to the pressure of the surrounding muscles, then the superficial ones have a harder time. They have a well-developed muscle layer, and their walls are much thicker.
Also characteristic difference veins is the presence of valves that prevent the backflow of blood under the influence of gravity. True, they are not in those vessels that are in the head, brain, neck and internal organs. They are also absent in the hollow and small veins.
The functions of blood vessels differ depending on their purpose. So, veins, for example, serve not only to move fluid to the region of the heart. They are also designed to reserve it in separate areas. The veins are activated when the body is working hard and needs to increase the volume of circulating blood.
The structure of the walls of the arteries
Each blood vessel is made up of several layers. Their thickness and density depend solely on what type of veins or arteries they belong to. It also affects their composition.
For example, elastic arteries contain a large number of fibers that provide stretching and elasticity of the walls. The inner shell of each such blood vessel, which is called the intima, is about 20% of the total thickness. It is lined with endothelium, and under it is loose connective tissue, intercellular substance, macrophages, muscle cells. outer layer the intima is bounded by an internal elastic membrane.
The middle layer of such arteries consists of elastic membranes, with age they thicken, their number increases. Between them are smooth muscle cells that produce intercellular substance, collagen, elastin.
The outer shell of the elastic arteries is formed by fibrous and loose connective tissue, elastic and collagen fibers are located longitudinally in it. It also contains small vessels and nerve trunks. They are responsible for the nutrition of the outer and middle shells. It is the outer part that protects the arteries from ruptures and overstretching.
The structure of blood vessels, which are called muscular arteries, is not much different. They also have three layers. The inner shell is lined with endothelium, it contains the inner membrane and loose connective tissue. In small arteries, this layer is poorly developed. The connective tissue contains elastic and collagen fibers, they are located longitudinally in it.
The middle layer is formed by smooth muscle cells. They are responsible for the contraction of the entire vessel and for pushing blood into the capillaries. Smooth muscle cells are connected to the intercellular substance and elastic fibers. The layer is surrounded by a kind of elastic membrane. The fibers located in the muscle layer are connected to the outer and inner shells of the layer. They seem to form an elastic frame that prevents the artery from sticking together. And muscle cells are responsible for regulating the thickness of the lumen of the vessel.
The outer layer consists of loose connective tissue, in which collagen and elastic fibers are located, they are located obliquely and longitudinally in it. Nerves, lymphatic and blood vessels pass through it.
The structure of mixed-type blood vessels is an intermediate link between muscular and elastic arteries.
Arterioles also consist of three layers. But they are rather weakly expressed. The inner shell is the endothelium, a layer of connective tissue and an elastic membrane. The middle layer consists of 1 or 2 layers of muscle cells that are arranged in a spiral.
The structure of the veins
In order for the heart and blood vessels called arteries to function, it is necessary that blood can rise back up, bypassing the force of gravity. For these purposes, venules and veins are intended, having special structure. These vessels consist of three layers, as well as arteries, although they are much thinner.
The inner shell of the veins contains endothelium, it also has a poorly developed elastic membrane and connective tissue. The middle layer is muscular, it is poorly developed, there are practically no elastic fibers in it. By the way, precisely because of this, the cut vein always subsides. The outer shell is the thickest. It consists of connective tissue, it contains a large number of collagen cells. It also contains smooth muscle cells in some veins. They help push blood towards the heart and prevent its reverse flow. The outer layer also contains lymph capillaries.
Subject: Cardio- vascular system. Blood vessels. Overall plan buildings. Varieties. Dependence of the vessel wall structure on hemodynamic conditions. arteries. Vienna. Classification. Structural features. Functions. Age features.
Cardiovascular system includes the heart, blood and lymph vessels. In this case, the heart, blood and lymphatic vessels are called the circulatory system or the circulatory system. Lymphatic vessels together with lymph nodes belong to the lymphatic system.
Circulatory system- This is a closed system of tubes of different calibers, which performs a transport, trophic, metabolic function and the function of regulating blood microcirculation in organs and tissues.
Vascular development
The source of the development of blood vessels is the mesenchyme. In the third week of embryonic development outside the body of the embryo in the wall of the yolk sac and in the chorion (in mammals), clusters of mesenchymal cells - blood islands - are formed. The peripheral cells of the islets form the walls of the vessels, and the centrally located mesenchymocytes differentiate into primary blood cells. Later, in the same way, the vessels appear in the body of the embryo and communication is established between the primary blood vessels of the extra-embryonic organs and the body of the embryo. Further development of the vascular wall and the acquisition of various structural features occurs under the influence of hemodynamic conditions, which include: blood pressure, the magnitude of its jumps, and blood flow velocity.
Vessel classification
Blood vessels are subdivided into arteries, veins, and vessels of the microvasculature, which include arterioles, capillaries, venules, and arteriolovenular anastomoses.
General plan of the structure of the wall of blood vessels
With the exception of capillaries and some veins, blood vessels have a general structural plan, they all consist of three shells:
Inner shell (intima) consists of two obligatory layers
Endothelium - a continuous layer of cells of a single-layer squamous epithelium, lying on the basement membrane and lining the inner surface of the vessel;
Subendothelial layer (subendothelium), formed by loose fibrous connective tissue.
Middle shell which usually contains smooth myocytes and the intercellular substance formed by these cells, represented by proteoglycans, glycoproteins, collagen and elastic fibers.
Outer sheath (adventitia) It is represented by loose fibrous connective tissue, with vascular vessels, lymphatic capillaries and nerves located in it.
arteries- these are vessels that ensure the movement of blood from the heart to the microcirculatory bed in organs and tissues. Arterial blood flows through the arteries, with the exception of the pulmonary and umbilical arteries.
Classification of arteries
According to the quantitative ratio of elastic and muscular elements in the vessel wall, the arteries are divided into:
Elastic arteries.
Arteries of mixed type (muscular-elastic) type.
Muscular arteries.
The structure of the elastic type arteries
To the arteries of this type include the aorta and pulmonary artery. The wall of these vessels is subject to large pressure drops, so they require high elasticity.
1. Inner shell consists of three layers:
endothelial layer
The subendothelial layer, which has a significant thickness, because it absorbs pressure surges. Represented by loose fibrous connective tissue. In old age, cholesterol and fatty acids appear here.
The plexus of elastic fibers is a dense interlacing of longitudinally and circularly arranged elastic fibers.
2. Middle shell It is represented by 50-70 fenestrated elastic membranes, which look like cylinders inserted into each other, between which there are separate smooth myocytes, elastic and collagen fibers.
3. outer shell It is represented by loose fibrous connective tissue with blood vessels that feed the wall of the artery (vascular vessels) and nerves.
The structure of the arteries of the mixed (muscle-elastic) type
This type of artery includes the subclavian, carotid, and iliac arteries.
Three layers:
Endothelium
subendothelial layer
Internal elastic membrane
2. The middle shell consists of an approximately equal number of elastic elements (which include fibers and elastic membranes) and smooth myocytes.
3. The outer shell consists of loose connective tissue, where, along with vessels and nerves, there are longitudinally arranged bundles of smooth myocytes.
The structure of the arteries of the muscular type
These are all other arteries of medium and small caliber.
1. The inner shell consists of
endothelium
subendothelial layer
Internal elastic membrane
2. The middle shell has the greatest thickness, it is mainly represented by spirally arranged bundles of smooth muscle cells, between which collagen and elastic fibers are located.
Between the middle and outer shells of the artery is a weakly expressed outer elastic membrane.
3. The outer shell is represented by a loose fibrous connective tissue with vessels and nerves, there are no smooth myocytes.
Vienna are the vessels that carry blood to the heart. Venous blood flows through them, with the exception of the pulmonary and umbilical veins.
Due to the peculiarities of hemodynamics, which include lower blood pressure than in the arteries, the absence of sudden pressure drops, slow blood movement and lower oxygen content in the blood, veins have a number of structural features in their structure with arteries:
The veins are larger.
Their wall is thinner, easily collapses.
The elastic component and the subendothelial layer are poorly developed.
Weaker development of smooth muscle elements in the middle shell.
The outer shell is well defined.
The presence of valves, which are derivatives of the inner shell, the outside of the valve leaflets are covered with endothelium, their thickness is formed by loose fibrous connective tissue, and at the base there are smooth myocytes.
Vessels of vessels are contained in all shells of the vessel.
Vein classification
Muscleless veins.
2. Veins of the muscular type, which in turn are divided into:
Veins with poor myocyte development
Veins with medium myocyte development
Veins with strong myocyte development
The degree of development of myocytes depends on the localization of the vein: in the upper part of the body, the muscular component is poorly developed, in the lower part it is stronger.
The structure of a muscleless vein
Veins of this type are located in the brain, its membranes, retina, placenta, spleen, and bone tissue.
The vessel wall is formed by the endothelium, surrounded by loose fibrous connective tissue, tightly fuses with the stroma of the organs and therefore does not collapse.
The structure of veins with poor development of myocytes
These are the veins of the face, neck, upper body, and superior vena cava.
1. The inner shell consists of
endothelium
Weakly developed subendothelial layer
2. In the middle shell, poorly developed circularly located bundles of smooth muscle cells, between which there are a significant thickness of a layer of loose connective tissue.
3. The outer shell is represented by loose fibrous connective tissue.
The structure of the veins with the average development of myocytes
These include the brachial vein and the small veins of the body.
1. The inner shell consists of:
endothelium
subendothelial layer
2. The middle shell includes several layers of circularly arranged myocytes.
3. The outer shell is thick, contains longitudinally arranged bundles of smooth myocytes in loose fibrous connective tissue.
The structure of the veins with a strong development of myocytes
Such veins are located in the lower body and lower extremities. In addition to the good development of myocytes in all layers, the walls are characterized by the presence of valves that ensure the movement of blood towards the heart.
Regeneration of blood vessels
When the vessel wall is damaged, rapidly dividing endotheliocytes close the defect. The formation of smooth myocytes occurs slowly due to their division and differentiation of myoblasts and pericytes. With a complete rupture of medium and large vessels, their restoration without surgical intervention is impossible, but distal to the rupture, blood supply is restored due to collaterals and the formation of small vessels from protrusions of endotheliocytes in the walls of arterioles and venules.
Age features of blood vessels
The ratio between the diameter of arteries and veins at the time of the birth of a child is 1:1; in the elderly, these ratios change to 1:5. In a newborn, all blood vessels have thin walls, their muscle tissue and elastic fibers are poorly developed. In the first years of life in large vessels, the volume of the muscular membrane increases and the number of elastic and collagen fibers increases. vascular wall. The intima and its subendothelial layer develop relatively quickly. The lumen of the vessels grows slowly. The complete formation of the wall of all blood vessels is completed by the age of 12. At the onset of the age of 40, the reverse development of the arteries begins, while elastic fibers and smooth myocytes are destroyed in the arterial wall, collagen fibers grow, the subendothelium thickens sharply, the vessel wall thickens, salts are deposited in it, and sclerosis develops. Age-related changes in veins are similar, but appear earlier.
In the human body there are vessels (arteries, veins, capillaries) that supply blood to organs and tissues. These vessels form a large and small circle of blood circulation.
Large vessels (aorta, pulmonary artery, vena cava and pulmonary veins) serve mainly as pathways for the movement of blood. All other arteries and veins can, in addition, regulate the flow of blood to the organs and its outflow by changing their lumen. Capillaries are the only part of the circulatory system where the exchange between blood and other tissues takes place. According to the predominance of a particular function, the walls of vessels of different calibers have an unequal structure.
The structure of the walls of blood vessels
The wall of the artery consists of three layers. The outer shell (adventitia) is formed by loose connective tissue and contains vessels that feed the wall of the arteries, vascular vessels (vasa vasorum). The middle shell (media) is formed mainly by smooth muscle cells of a circular (spiral) direction, as well as elastic and collagen fibers. It is separated from the outer shell by an outer elastic membrane. The inner shell (intima) is formed by the endothelium, basement membrane and subendothelial layer. It is separated from the middle shell by an internal elastic membrane.
In large arteries in the middle shell, elastic fibers predominate over muscle cells, such arteries are called elastic-type arteries (aorta, pulmonary trunk). The elastic fibers of the vessel wall counteract the excessive stretching of the vessel by blood during systole (contraction of the ventricles of the heart), as well as the movement of blood through the vessels. During diastole
bleating of the ventricles of the heart), they also ensure the movement of blood through the vessels. In the arteries of "medium" and small caliber in the middle shell, muscle cells predominate over elastic fibers, such arteries are muscle-type arteries. The middle arteries (muscular-elastic) are classified as mixed-type arteries (carotid, subclavian, femoral, etc.).
Veins are large, medium and small. The walls of veins are thinner than the walls of arteries. They have three shells: outer, middle, inner. In the middle shell of the veins, there are few muscle cells and elastic fibers, so the walls of the veins are pliable and the lumen of the vein does not gape on the cut. Small, medium and some large veins have venous valves - semilunar folds on the inner shell, which are located in pairs. Valves allow blood to flow towards the heart and prevent it from flowing back. Nai large quantity valves have veins of the lower extremities. Both vena cava, veins of the head and neck, renal, portal, pulmonary veins do not have valves.
Veins are divided into superficial and deep. Superficial (saphenous) veins follow independently, deep - in pairs adjacent to the same name arteries of the limbs, so they are called accompanying veins. In general, the number of veins exceeds the number of arteries.
Capillaries - have a very small lumen. Their walls consist of only one layer of flat endothelial cells, to which individual connective tissue cells adjoin only in places. Therefore, capillaries are permeable to substances dissolved in the blood and function as an active barrier that regulates the transition nutrients, water and oxygen from the blood to the tissues and the reverse flow of metabolic products from the tissues into the blood. The total length of human capillaries in the skeletal muscles, according to some estimates, is 100 thousand km, their surface area reaches 6000 m.
Small circle of blood circulation
The pulmonary circulation begins with the pulmonary trunk and originates from the right ventricle, forms a bifurcation of the pulmonary trunk at the level of the IV thoracic vertebra and divides into the right and left pulmonary arteries, which branch out in the lungs. In the tissue of the lung (under the pleura and in the region of the respiratory bronchioles) small branches pulmonary artery and bronchial branches of the thoracic aorta form a system of interarterial anastomoses. They are the only place in the vascular system where
movement of blood along a short path from great circle circulation directly into the pulmonary circulation. From the capillaries of the lung, venules begin, which merge into larger veins and, ultimately, in each lung form two pulmonary veins. The right superior and inferior pulmonary veins and the left superior and inferior pulmonary veins pierce the pericardium and empty into the left atrium.
Systemic circulation
The systemic circulation begins from the left ventricle of the heart by the aorta. Aorta (aorta) - the largest unpaired arterial vessel. Compared to other vessels, the aorta has the largest diameter and a very thick wall, consisting of a large number of elastic fibers, which is elastic and durable. It is divided into three sections: the ascending aorta, the aortic arch and the descending aorta, which, in turn, is divided into the thoracic and abdominal parts.
The ascending aorta (pars ascendens aortae) emerges from the left ventricle and has an extension in the initial section - the aortic bulb. At the location of the aortic valves on its inner side there are three sinuses, each of them is located between the corresponding semilunar valve and the aortic wall. The right and left coronary arteries of the heart depart from the beginning of the ascending aorta.
The aortic arch (arcus aortae) is a continuation of the ascending aorta and passes into its descending part, where it has aortic isthmus - a slight narrowing. From the aortic arch originate: the brachiocephalic trunk, the left common carotid artery and the left subclavian artery. In process of an otkhozhdeniye of these branches diameter of an aorta noticeably decreases. Level IV thoracic vertebra the aortic arch passes into the descending aorta.
The descending part of the aorta (pars descendens aortae), in turn, is divided into the thoracic and abdominal aorta.
Thoracic aorta (a. thoracalis) passes through the chest cavity in front of the spine. Its branches feed the internal organs of this cavity, as well as the walls of the chest and abdominal cavities.
The abdominal aorta (a. abdominalis) lies on the surface of the bodies of the lumbar vertebrae, behind the peritoneum, behind the pancreas, duodenum and root of the mesentery of the small intestine. The aorta gives off large branches to the abdominal viscera. At level IV of the lumbar vertebra, it divides into two common iliac arteries (the place of separation is called the aortic bifurcation). The iliac arteries supply the walls and innards of the pelvis and lower extremities.
Branches of the aortic arch
The brachiocephalic trunk (truncus brachiocephalicus) departs from the arc at level II of the right costal cartilage, has a length of about 2.5 cm, goes up and to the right, and at the level of the right sternoclavicular joint is divided into the right common carotid artery and the right subclavian artery.
The common carotid artery (a. carotis communis) on the right departs from the brachiocephalic trunk, on the left - from the aortic arch (Fig. 86).
Coming out of the chest cavity, the common carotid artery rises as part of the neurovascular bundle of the neck, lateral to the trachea and esophagus; does not give branches; at the level of the upper edge of the thyroid cartilage, it divides into the internal and external carotid arteries. Not far from this point, the aorta passes in front of the transverse process of the sixth cervical vertebra, against which it can be pressed to stop bleeding.
The external carotid artery (a. carotis externa), rising along the neck, gives off branches to the thyroid gland, larynx, tongue, submandibular and sublingual glands, and a large external maxillary artery.
External maxillary artery (a. mandibularis externa) bends over the edge mandible in front of the chewing muscle, where it branches into the skin and muscles. The branches of this artery go to the upper and lower lip, anastomose with similar branches of the opposite side, and form a perioral arterial circle around the mouth.
At the inner corner of the eye, the facial artery anastomoses with the ophthalmic artery, one of the large branches of the internal carotid artery.
Rice. 86. Arteries of the head and neck:
1 - occipital artery; 2 - superficial temporal artery; 3 - posterior ear artery; 4 - internal carotid artery; 5 - external carotid artery; 6 - ascending cervical artery; 7 - thyroid trunk; 8 - common carotid artery; 9 - superior thyroid artery; 10 - lingual artery; 11 - facial artery; 12 - lower alveolar artery; 13 - maxillary artery
Medial to the mandibular joint, the external carotid artery divides into two terminal branches. One of them - the superficial temporal artery - is located directly under the skin of the temple, in front of the ear opening and nourishes the parotid gland, temporalis muscle and scalp. Another, deep branch - the internal maxillary artery - feeds the jaws and teeth, masticatory muscles, walls
nasal cavity and adjacent
Rice. 87. Arteries of the brain:
11 with them bodies; gives away
I - anterior communicating artery; 2 - before- „,
the lower cerebral artery smelling the cerebral artery; 3 - internal carotid ar-Ґ Ґ
teriya; 4 - middle cerebral artery; 5 - posterior lobes penetrating the skull. communicating artery; 6 - posterior cerebral ar- Internal SONNYA artery; 7 - main artery; 8 - vertebral artery (a. carotis interna) sub-terium; 9 - posterior inferior cerebellar artery; taken from the side of the throat
Ш - anterior inferior cerebellar artery; to the base of the skull,
II - superior cerebellar artery
into it through the channel of the same name temporal bone and, penetrating the dura mater, gives off a large branch - the ophthalmic artery, and then at the level of the decussation optic nerves is divided into its terminal branches: the anterior and middle cerebral arteries (Fig. 87).
The ophthalmic artery (a. ophthalmica), enters the orbit through the optic canal and supplies blood to the eyeball, its muscles and the lacrimal gland, the terminal branches supply blood to the skin and muscles of the forehead, anastomosing with the terminal branches of the external maxillary artery.
The subclavian artery (a. subclavia), starting to the right of the brachial trunk, and to the left of the aortic arch, exits the chest cavity through its upper opening. On the neck, the subclavian artery appears along with the brachial nerve plexus and lies superficially, bending over the 1st rib and, passing under the clavicle outward, enters the axillary fossa and is called the axillary (Fig. 88). Having passed the fossa, the artery under a new name - the brachial - goes to the shoulder and in the area of the elbow joint is divided into its terminal branches - the ulnar and radial arteries.
From subclavian artery a number of large branches depart, feeding the organs of the neck, the back of the head, part of the chest wall, spinal cord and brain. One of them vertebral artery- steam room, departs at the level of the transverse process of the VII cervical vertebra, rises vertically upward through the openings of the transverse processes of the VI-I cervical vertebrae
and through the greater occipital
Rice. 88. Arteries of the axillary region:
the hole enters the skull
o-7h t-g 1 - transverse artery of the neck; 2 - breast acromi-
(Fig. 87). Along the way she gives back,
K1 "J al artery; 3 - artery that envelopes the scapula;
branches penetrating through 4 - subscapular artery; 5 - lateral thoracic-intervertebral foramen to the naia artery; 6 - thoracic artery; 7 - intra-spinal cord and its sheathed thoracic artery; 8 - subclavian arte-
kam. Behind the head ria bridge; 9 - common carotid artery; 10 - thyroid
trunk; 11 - vertebral artery
brain, this artery connects with a similar one and forms the basilar artery, which is unpaired, and in turn is divided into two terminal branches - the posterior left and right cerebral arteries. The remaining branches of the subclavian artery feed the body's own muscles (diaphragm, I and II intercostal, upper and lower serratus posterior, rectus abdominis), almost all the muscles of the shoulder girdle, skin of the chest and back, neck organs and mammary glands.
The axillary artery (a. axillaris) is a continuation of the subclavian artery (from the level of the 1st rib), located deep in the axillary fossa and surrounded by trunks of the brachial plexus. It gives branches to the region of the scapula, chest and humerus.
The brachial artery (a. brachialis) is a continuation of the axillary artery and is located on the anterior surface of the brachial muscle, medial to the biceps of the shoulder. In the cubital fossa, at the level of the neck of the radius, the brachial artery divides into the radial and ulnar arteries. A number of branches depart from the brachial artery to the muscles of the shoulder and the elbow joint (Fig. 89).
The radial artery (a. radialis) has arterial branches in the forearm, in the distal forearm it passes to the back of the hand, and then to the palm. Terminal section of the radial artery anastomosis
It is a palmar branch of the ulnar artery, forming a deep palmar arch, from which the palmar metacarpal arteries originate, which flow into the common palmar digital arteries and anastomose with the dorsal metacarpal arteries.
The ulnar artery (a. ul-naris) is one of the branches of the brachial artery, located in the forearm, gives branches to the muscles of the forearm and penetrates into the palm, where it anastomoses ^ with the superficial palmar branch of the radial artery,
forming a superficial laris 89 Arteries of the forearm and hand, right:
bottom arc. IN ADDITION to arcs, A - front view; B - rear view; 1 - shoulder ar-on the BRUSH, lateria is formed; 2 - radial recurrent artery; 3 - radial-bottom and dorsal carpal artery; 4 - front
o 5 - palmar network of the wrist; 6 - own la networks. From last
bottom finger arteries; 7 - common palmar to Interosseous interdigital arteries; 8 - superficial palmar ki the dorsal metacarpal arch departs; 9 - ulnar artery; 10 - ulnar ascending arteries. Each of them is a portal artery; 13 - back network of the wrist; divides into two thin arterial - 14 - dorsal metacarpal arteries; 15 - rear
digital arteries
terii fingers, so the brush
in general, and the fingers in particular, are richly supplied with blood from many sources, which anastomose well with each other due to the presence of arcs and networks.
Branches of the thoracic aorta
The branches of the thoracic aorta are divided into parietal and visceral branches (Fig. 90). Parietal branches:
1. Superior phrenic artery (a. phrenica superior) - steam room, supplies blood to the diaphragm and the pleura covering it.
2. Posterior intercostal arteries (a. a. intercostales posteriores) - paired, supply blood to the intercostal muscles, ribs, chest skin.
Visceral branches:
1. Bronchial branches (r. r. bronchiales) supply blood to the walls of the bronchi and lung tissue.
2. Esophageal branches (r.r. oesophageales) supply blood to the esophagus.
3. Pericardial branches (r.r. pericardiaci) go to the pericardium
4. Mediastinal branches (r.r. mediastinales) supply blood to the connective tissue of the mediastinum and lymph nodes.
Branches of the abdominal aorta
Parietal branches:
1. The lower phrenic arteries (a.a. phenicae inferiores) are paired, supply blood to the diaphragm (Fig. 91).
2. Lumbar arteries (a.a. lumbales) (4 pairs) - supply blood to the muscles in the lumbar region and the spinal cord.
Rice. 90. Aorta:
1 - aortic arch; 2 - ascending aorta; 3 - bronchial and esophageal branches; 4 - descending part of the aorta; 5 - posterior intercostal arteries; 6 - celiac trunk; 7 - abdominal part of the aorta; 8 - inferior mesenteric artery; 9 - lumbar arteries; 10 - renal artery; 11 - superior mesenteric artery; 12 - thoracic aorta
Rice. 91. Abdominal aorta:
1 - lower phrenic arteries; 2 - celiac trunk; 3 - superior mesenteric artery; 4 - renal artery; 5 - inferior mesenteric artery; 6 - lumbar arteries; 7 - median sacral artery; 8 - total iliac artery; 9 - testicular (ovarian) artery; 10 - lower suprapo-chechnic artery; 11 - middle adrenal artery; 12 - superior adrenal artery
Visceral branches (unpaired):
1. The celiac trunk (truncus coeliacus) has branches: the left ventricular artery, the common hepatic artery, the splenic artery - it supplies blood to the corresponding organs.
2. Superior mesenteric and inferior mesenteric arteries (a. mes-enterica superior et a. mesenterica inferior) - supply blood to the small and large intestines.
Visceral branches (paired):
1. Middle adrenal, renal, testicular arteries - supply blood to the corresponding organs.
2. At level IV of the lumbar vertebrae, the abdominal aorta divides into two common iliac arteries, forming an aortic bifurcation, and continues into the median sacral artery.
The common iliac artery (a. iliaca communis) follows the direction of the small pelvis and is divided into the internal and external iliac arteries.
Internal iliac artery (a. iliaca interna).
It has branches - sub-ilio-lumbar lateral sacral arteries, superior gluteal, inferior gluteal, umbilical artery, inferior urinary bladder, uterine middle rectal, internal
pudendal and obturator arte- 92 Arteries of the pelvis:
rii - supply blood to the walls; 1 - the abdominal part of the aorta; 2 - common sub-ki and pelvic organs (Fig. 92). iliac artery; 3 - outer gtodudosh-
TT - - naya artery; 4 - internal iliac
External iliac.
artery; 5 - median sacral artery;
art ^ riYa ((1. iliaca eXtema). 6 - posterior branch of the internal iliac
Serves as a continuation of the ob-artery; 7 - lateral sacral arte-
shchi iliac artery ria; 8 - anterior branch of the internal sub-
in the thigh region it passes into the iliac artery; 9 - middle rectal
renal artery. External artery; 10 - lower rectal
artery; 11 - internal genital artery;
12 - dorsal artery of the penis;
13 - lower vesical artery; 14 - superior vesical artery; 15 - bottom
the iliac artery has branches - the inferior epigastric artery and the deep artery
the circumflex iliac artery is the epigastric artery; 16 - deep artery;
new bone (Fig. 93). 140
iliac circumflex
Arteries of the lower limb
The femoral artery (a. femoralis) is a continuation of the external iliac artery, has branches: superficial epigastric artery, superficial artery, envelope of the ilium, external pudendal, deep artery of the thigh, descending artery - blood supply to the muscles of the abdomen and thigh. The femoral artery passes into the patella, which in turn divides into the anterior and posterior tibial arteries.
The anterior tibial artery (a. tibialis anterior) is a continuation of the popliteal artery, goes along the anterior surface of the lower leg and passes to the rear of the foot, has branches: the anterior and posterior tibial recurrent arteries,
hips; 4 - lateral artery; circumflex femur; 5 - medial artery, enveloping the femur; 6 - perforating arteries; 7 - descending -
Rice. 93. Arteries of the thigh, right: A - front view; B - rear view; 1 - on the lateral and medial ventral iliac artery; 2 - hip arteries, dorsal artrenal artery; 3 - deep artery
teryu foot, supplying blood to the knee joint and the anterior group of muscles of the lower leg.
Posterior tibial artery genicular artery; 8 - superior yagotheria (a. tibialis posterior) - prodative artery; 9 - wide berry
due to the popliteal artery. artery; 10 - popliteal artery Goes along the medial surface of the lower leg and passes to the sole, has branches: muscular; branch around the fibula; peroneal medial and lateral plantar arteries, feeding the muscles of the lateral group of the lower leg.
Veins of the systemic circulation
The veins of the systemic circulation are combined into three systems: the system of the superior vena cava, the system of the inferior vena cava and the system of the veins of the heart. The portal vein with its tributaries is isolated as the portal vein system. Each system has a main trunk, into which veins flow, carrying blood from a certain group of organs. These trunks flow into the right atrium (Fig. 94).
Superior vena cava system
The superior vena cava (v. cava superior) drains blood from the upper half of the body - the head, neck, upper limbs and chest wall. It is formed from the confluence of two brachiocephalic veins (behind the junction of the first rib with the sternum and lies in the upper part of the mediastinum). The inferior end of the superior vena cava empties into the right atrium. The diameter of the superior vena cava is 20-22 mm, the length is 7-8 cm. The unpaired vein flows into it.
Rice. 94. Veins of the head and neck:
I - subcutaneous venous network; 2 - superficial temporal vein; 3 - supraorbital vein; 4 - angular vein; 5 - right labial vein; 6 - mental vein; 7 - facial vein; 8 - anterior jugular vein; 9 - internal jugular vein; 10 - mandibular vein;
II - pterygoid plexus; 12 - posterior ear vein; 13 - occipital vein
Unpaired vein (v. azygos) and its branch (semi-unpaired). These are pathways that drain venous blood away from the walls of the body. The azygous vein lies in the mediastinum and originates from the parietal veins, which penetrate the diaphragm from the abdominal cavity. It takes in the right intercostal veins, veins from the mediastinal organs and the semi-unpaired vein.
Semi-unpaired vein (v. hemiazygos) - lies to the right of the aorta, receives the left intercostal veins and repeats the course of the unpaired vein, into which it flows, which creates the possibility of outflow venous blood from the walls of the chest cavity.
The brachiocephalic veins (v.v. brachiocephalics) originate behind the sterno-pulmonary articulation, in the so-called venous angle, from the junction of three veins: internal, external jugular and subclavian. The brachiocephalic veins collect blood from the veins associated with the branches of the subclavian artery, as well as from the veins of the thyroid, thymus, laryngeal, trachea, esophagus, venous plexuses of the spine, deep veins of the neck, veins of the upper intercostal muscles and the mammary gland. The connection between the systems of the superior and inferior vena cava is carried out through the terminal branches of the vein.
The internal jugular vein (v. jugularis interna) begins at the level of the jugular foramen as a direct continuation of the sigmoid sinus of the dura mater and descends along the neck in the same vascular bundle with the carotid artery and vagus nerve. It collects blood from the head and neck, from the sinuses of the dura mater, into which blood enters from the veins of the brain. The common facial vein consists of the anterior and posterior facial veins and is the largest tributary of the internal jugular vein.
The external jugular vein (v. jugularis externa) is formed at the level of the angle of the lower jaw and descends along the outer surface of the sternocleidomastoid muscle, covered by the subcutaneous muscle of the neck. It drains blood from the skin and muscles of the neck and occipital region.
The subclavian vein (v. subclavia) continues the axillary, serves to drain blood from the upper limb and does not have permanent branches. The walls of the vein are firmly connected to the surrounding fascia, which holds the lumen of the vein and increases it with a raised arm, providing an easier outflow of blood from the upper extremities.
Veins of the upper limb
Venous blood from the fingers of the hand enters the dorsal veins of the hand. The superficial veins are larger than the deep ones and form the venous plexuses of the back of the hand. Of the two venous arches of the palm, corresponding to the arterial ones, the deep arch serves as the main venous collector of the hand.
The deep veins of the forearm and shoulder are accompanied by a double number of arteries and bear their name. They repeatedly anastomose with each other. Both brachial veins merge into the axillary vein, which receives all the blood not only from the deep, but also the superficial veins of the upper extremities. One of the branches of the axillary vein, descending along the side wall of the body, anastomoses with the saphenous branch of the femoral vein, forming an anastomosis between the system of the superior and inferior vena cava. The main saphenous veins of the upper limb are the head and main (Fig. 95).
Rice. 95. Superficial veins hands, right:
A - rear view; B - front view; 1 - lateral saphenous vein of the arm; 2 - intermediate vein of the elbow; 3 - medial saphenous vein of the arm; 4 - dorsal venous network of the hand
Rice. 96. Deep veins of the upper limb, right:
A - veins of the forearm and hand: 1 - ulnar veins; 2 - radial veins; 3 - superficial palmar venous arch; 4 - palmar fingers veins. B - veins of the shoulder and shoulder girdle: 1 - axillary vein; 2 - brachial veins; 3 - lateral saphenous vein of the arm; 4 - medial saphenous vein of the arm
The lateral saphenous vein of the arm (v. cephalica) originates from the deep palmar arch and superficial venous plexus of the rear of the hand and stretches along the lateral edge of the forearm and shoulder, taking superficial veins along the way. It flows into the axillary vein (Fig. 96).
The medial saphenous vein of the hand (v. basilica) starts from the deep palmar arch and the superficial venous plexus of the back of the hand. Having passed to the forearm, the vein is significantly replenished with blood from the head vein through an anastomosis with it in the area of the elbow bend - the middle cubital vein (injected into this vein medications and draw blood). The main vein flows into one of the brachial veins.
Inferior vena cava system
The inferior vena cava (v. cava inferior) begins at the level of the V lumbar vertebra from the confluence of the right and left common iliac veins, lies behind the peritoneum to the right of the aorta (Fig. 97). Passing behind the liver, the inferior vena cava sometimes plunges into its tissue, and then through the hole
stia in the tendon center of the diaphragm penetrates into the mediastinum and the pericardial sac, opening into the right atrium. The cross section at its beginning is 20 mm, and near the mouth - 33 mm.
The inferior vena cava receives paired branches both from the walls of the body and from the viscera. The parietal veins include the lumbar veins and the veins of the diaphragm.
Lumbar veins (v.v. lumbales) in the amount of 4 pairs correspond to the lumbar arteries, as well as segmental, as well as intercostal veins. The lumbar veins communicate with each other by vertical anastomoses, due to which thin venous trunks are formed on both sides of the inferior vena cava, which at the top continue into the unpaired (right) and semi-unpaired (left) veins, being one of the anastomoses between the inferior and superior vena cava. The internal branches of the inferior vena cava include: internal testicular and ovarian veins, renal, adrenal and hepatic. The latter through the venous network of the liver are connected with the portal vein.
The testicular vein (v. tecticularis) begins in the testicle and its epididymis, forms a dense plexus inside the spermatic cord and flows to the right into the inferior vena cava, and to the left into the renal vein.
The ovarian vein (v. ovarica) starts from the hilum of the ovary, passing through the broad ligament of the uterus. It accompanies the artery of the same name and further goes like the testicular vein.
The renal vein (v. renalis) begins at the gate of the kidney with several fairly large branches that lie in front renal artery and empty into the inferior vena cava.
Adrenal vein (v. suprarenalis) - on the right flows into the inferior vena cava, and on the left - into the renal.
Rice. 97. Inferior vena cava and its tributaries:
1 - inferior vena cava; 2 - adrenal vein; 3 - renal vein; 4 - testicular veins; 5 - common iliac vein; 6 - femoral vein; 7 - external iliac vein; 8 - internal iliac vein; 9 - lumbar veins; 10 - lower diaphragmatic veins; 11 - hepatic veins
Hepatic veins (v. le-
raisae) - there are 2-3 large ones and several small ones, through which the blood that enters the liver flows. These veins drain into the inferior vena cava.
portal vein system
Portal vein (liver)
(V. robae (heratis)) - collects blood from the walls of the digestive canal, starting from the stomach and up to upper division rectum, as well as from the gallbladder, pancreas and spleen (Fig. 98). This is a short thick trunk, formed behind the head of the pancreas as a result of the confluence of three large veins - the splenic, superior and inferior mesenteric, which branch in the region of the arteries of the same name. The portal vein enters the liver through its gate.
Rice. 98. Portal vein system and inferior vena cava:
1 - anastomoses between the branches of the portal and superior vena cava in the wall of the esophagus; 2 - splenic vein; 3 - top mesenteric vein; 4 - inferior mesenteric vein; 5 - external iliac vein; 6 - internal iliac vein; 7 - anastomoses between the branches of the portal and inferior vena cava in the wall of the rectum; 8 - common iliac vein; 9 - portal vein; 10 - hepatic vein; 11 - inferior vena cava
Veins of the pelvis
The common iliac vein (v. iliaca communis) begins at the level of the sacral vertebral articulation from the confluence of the internal and external iliac veins.
The internal iliac vein (v. iliaca interna) lies behind the artery of the same name and has a branching area in common with it. The branches of the vein, carrying blood from the viscera, form abundant plexuses around the organs. These are the hemorrhoidal plexuses surrounding the rectum, especially in its lower section, the plexuses behind the symphysis, which receive blood from the genitals, the venous plexus of the bladder, and in women, the plexuses around the uterus and vagina.
The external iliac vein (v. iliaca externa) starts above the inguinal ligament and serves as a direct continuation of the femoral vein. It carries the blood of all superficial and deep veins of the lower limb.
Veins of the lower limb
On the foot, venous arches of the rear and soles, as well as subcutaneous venous networks, are isolated. The small saphenous vein of the lower leg and the great saphenous vein of the leg begin from the veins of the foot (Fig. 99).
Rice. 99. Deep veins of the lower limb, right:
A - leg veins, medial surface; B - veins of the back surface of the leg; B - veins of the thigh, anteromedial surface; 1 - venous network heel area; 2 - venous network in the ankles; 3 - posterior tibial veins; 4 - peroneal veins; 5 - anterior tibial veins; 6 - popliteal vein; 7 - great saphenous vein of the leg; 8 - small saphenous vein of the leg; 9 - femoral vein; 10 - deep vein of the thigh; 11 - perforating veins; 12 - lateral veins enveloping the femur; 13 - external iliac vein
The small saphenous vein of the lower leg (v. saphena parva) passes to the lower leg behind the outer ankle and flows into the popliteal vein.
The great saphenous vein of the leg (v. saphena magna) rises to the lower leg in front of the inner ankle. On the thigh, gradually increasing in diameter, it reaches the inguinal ligament, under which it flows into the femoral vein.
The deep veins of the foot, lower leg and thigh in double quantity accompany the arteries and bear their names. All these veins have many
lazy valves. Deep veins abundantly anastomose with superficial ones, through which a certain amount of blood rises from the deep parts of the limb.
Questions for self-control
1. Describe the importance of the cardiovascular system for the human body.
2. Tell us about the classification of blood vessels, describe their functional significance.
3. Describe the large and small circles of blood circulation.
4. Name the links of the microvasculature, explain the features of their structure.
5. Describe the structure of the walls of blood vessels, differences in the morphology of arteries and veins.
6. List the patterns of the course and branching of blood vessels.
7. What are the boundaries of the heart, their projection on the anterior chest wall?
8. Describe the structure of the chambers of the heart, their features in connection with the function.
9. Give a structural and functional description of the atria.
10. Describe the features of the structure of the ventricles of the heart.
11. Name the valves of the heart, explain their meaning.
12. Describe the structure of the heart wall.
13. Tell us about the blood supply to the heart.
14. Name the parts of the aorta.
15. Describe the thoracic part of the aorta, name its branches and areas of blood supply.
16. Name the branches of the aortic arch.
17. List the branches of the external carotid artery.
18. Name the terminal branches of the external carotid artery, describe the areas of their vascularization.
19. List the branches of the internal carotid artery.
20. Describe the blood supply to the brain.
21. Name the branches of the subclavian artery.
22. What are the features of the branching of the axillary artery?
23. Name the arteries of the shoulder and forearm.
24. What are the characteristics of the blood supply to the hand?
25. List the arteries of the organs of the chest cavity.
26. Tell us about the abdominal part of the aorta, its holotopy, skeletopy and syntopy.
27. Name the parietal branches of the abdominal aorta.
28. List the splanchnic branches of the abdominal aorta, explain the areas of their vascularization.
29. Describe the celiac trunk and its branches.
30. Name the branches of the superior mesenteric artery.
31. Name the branches of the inferior mesenteric artery.
32. List the arteries of the walls and organs of the pelvis.
33. Name the branches of the internal iliac artery.
34. Name the branches of the external iliac artery.
35. Name the arteries of the thigh and leg.
36. What are the features of the blood supply to the foot?
37. Describe the system of the superior vena cava, its roots.
38. Tell us about the inner jugular vein and its channels.
39. What are the features of blood flow from the brain?
40. How is the blood flow from the head?
41. List the internal tributaries of the internal jugular vein.
42. Name the intracranial tributaries of the internal jugular vein.
43. Describe the blood flow from the upper limb.
44. Describe the system of the inferior vena cava, its roots.
45. List the parietal tributaries of the inferior vena cava.
46. Name the splanchnic tributaries of the inferior vena cava.
47. Describe the portal vein system, its tributaries.
48. Tell us about the tributaries of the internal iliac vein.
49. Describe the blood flow from the walls and organs of the small pelvis.
50. What are the features of blood flow from the lower limb?
Endotheliocytes lining the walls of the artery from the inside are elongated flat cells of a polygonal or rounded shape. The thin cytoplasm of these cells is spread out, and the part of the cell containing the nucleus is thickened and protrudes into the lumen of the vessel. The basal surface of endothelial cells forms many branched processes penetrating into the subendothelial layer. The cytoplasm is rich in micropinocytic vesicles and poor in organelles. Endotheliocytes have
Rice. 127. Scheme of the structure of the wall of the artery (A) and vein (B) of the muscular type
medium caliber:
I - inner shell: 1 - endothelium; 2 - basement membrane; 3 - subendothelial layer; 4 - internal elastic membrane; II - middle shell: 5 - myocytes; 6 - elastic fibers; 7 - collagen fibers; III - outer shell: 8 - outer elastic membrane; 9 - fibrous (loose) connective tissue; 10 - blood vessels (according to V.G. Eliseev and others)
special membranous organelles 0.1-0.5 microns in size, containing from 3 to 20 hollow tubes with a diameter of about 20 nm.
Endotheliocytes are interconnected by complexes of intercellular contacts; nexuses predominate near the lumen. A thin basement membrane separates the endothelium from the subendothelial layer, which consists of a network of thin elastic and collagen microfibrils, fibroblast-like cells that produce an intercellular substance. In addition, macrophages are also found in the intima. Outwardly, there is an internal elastic membrane (lamina), consisting of elastic fibers.
Depending on the structural features of its walls, they are distinguished elastic type arteries(aorta, pulmonary and brachiocephalic trunks), muscular type(most small and medium-sized arteries), as well as mixed or muscular-elastic type(brachiocephalic trunk, subclavian, common carotid and common iliac arteries).
Elastic type arteries large, have a wide lumen. In their walls, in the middle shell, elastic fibers predominate over smooth muscle cells. The middle shell is formed by concentric layers of elastic fibers, between which lie relatively short spindle-shaped smooth muscle cells - myocytes. A very thin outer shell consists of loose fibrous unformed connective tissue containing many longitudinally or spirally thin bundles of elastic and collagen fibrils. In the outer shell are blood and lymphatic vessels and nerves.
From the point of view of the functional organization of the vascular system, the arteries of the elastic type are shock-absorbing vessels. Received from the ventricles of the heart under pressure, the blood first slightly stretches these vessels (aorta, pulmonary trunk). After that, due to a large number of elastic elements, the walls of the aorta and pulmonary trunk return to their original position. The elasticity of the walls of vessels of this type contributes to a smooth, rather than jerky, flow of blood under high pressure (up to 130 mm Hg) at high speed (20 cm/s).
Arteries of mixed (muscular-elastic) type have an approximately equal number of both elastic and muscular elements in the walls. On the border between the inner and middle shells, they have a clearly visible inner elastic membrane. In the middle shell, smooth muscle cells and elastic fibers are evenly distributed, their orientation is spiral, elastic membranes are fenestrated. In the middle shell
collagen fibers and fibroblasts are found. The boundary between the middle and outer shells is not clearly expressed. The outer shell consists of intertwining bundles of collagen and elastic fibers, between which connective tissue cells meet.
Mixed type arteries, which occupy a middle position between the elastic and muscular arteries, can change the width of the lumen and at the same time are able to withstand high blood pressure due to the elastic structures in the walls.
Muscular type arteries prevail in the human body, their diameter ranges from 0.3 to 5 mm. The structure of the walls of the muscular arteries differs significantly from the arteries of the elastic and mixed types. In small arteries (up to 1 mm in diameter), the intima is represented by a layer of endothelial cells lying on a thin basement membrane, followed by an internal elastic membrane. In larger arteries of the muscular type (coronary, splenic, renal, etc.), a layer of collagen and reticular fibrils and fibroblasts are located between the internal elastic membrane and the endothelium. They synthesize and secrete elastin and other components of the intercellular substance. All muscular-type arteries except the umbilical artery have a fenestrated internal elastic membrane, which looks like a wavy bright pink stripe under a light microscope.
The thickest middle shell is formed by 10-40 layers of spirally oriented smooth myocytes connected to each other by means of interdigitations. Small arteries have no more than 3-5 layers of smooth myocytes. Myocytes are immersed in the ground substance produced by them, in which elastin predominates. Muscular arteries have a fenestrated outer elastic membrane. Small arteries have no external elastic membrane. Small arteries of the muscular type have a thin layer of intertwining elastic fibers that provide a constant gaping of the arteries. The thin outer shell consists of loose fibrous irregular connective tissue. It contains blood and lymphatic vessels, as well as nerves.
Muscular-type arteries regulate regional blood supply (blood flow into the vessels of the microvasculature), maintain blood pressure.
As the diameter of the artery decreases, all their membranes become thinner, the thickness of the subendothelial layer and the internal elastic membrane decreases. Gradually, the number of smooth myocytes and elastic fibers in the middle shell decreases, the outer layer disappears.
elastic membrane. In the outer shell, the number of elastic fibers decreases.
The thinnest arteries of the muscular type - arterioles have a diameter of less than 300 µm. There is no clear boundary between arteries and arterioles. The walls of arterioles are composed of endothelium lying on a thin basement membrane, followed in large arterioles by a thin internal elastic membrane. In arterioles, the lumen of which is more than 50 microns, the internal elastic membrane separates the endothelium from smooth myocytes. Smaller arterioles do not have such a membrane. Elongated endotheliocytes are oriented in the longitudinal direction and are interconnected by complexes of intercellular contacts (desmosomes and nexuses). The high functional activity of endothelial cells is evidenced by a huge number of micropinocytic vesicles.
The processes extending from the base of endotheliocytes pierce the basal and internal elastic membranes of arterioles and form intercellular connections (nexuses) with smooth myocytes (myoendothelial contacts). One or two layers of smooth myocytes in their middle shell are arranged spirally along the long axis of the arteriole.
The pointed ends of smooth myocytes pass into long branching processes. Each myocyte is covered on all sides by the basal plate, except for the zones of myoendothelial contacts and adjacent cytolemmas of neighboring myocytes. The outer shell of the arterioles is formed by a thin layer of loose connective tissue.
Distal part of the cardiovascular system - microvasculature(Fig. 128) includes arterioles, venules, arteriolo-venular anastomoses and blood capillaries, where the interaction of blood and tissues is ensured. The microvasculature begins with the smallest arterial vessel, the precapillary arteriole, and ends with the postcapillary venule. Arteriole (arteriola) with a diameter of 30-50 microns have one layer of myocytes in the walls. depart from the arterioles precapillaries, the mouths of which are surrounded by smooth muscle precapillary sphincters that regulate blood flow in the true capillaries. Precapillary sphincters are usually formed by several myocytes tightly adjacent to each other, surrounding the mouth of the capillary in the zone of its discharge from the arteriole. Precapillary arterioles that retain single smooth muscle cells in their walls are called arterial blood capillaries, or precapillaries. following them "true" blood capillaries there are no muscle cells in the walls. The diameter of the lumen of the blood capillaries varies
from 3 to 11 microns. Narrower blood capillaries with a diameter of 3-7 microns are found in the muscles, wider (up to 11 microns) in the skin, mucous membrane internal organs.
In some organs (liver, endocrine glands, organs of hematopoiesis and immune system), wide capillaries with a diameter of up to 25-30 microns are called sinusoids.
The true blood capillaries are followed by the so-called postcapillary venules (postcapillaries), which have a diameter of 8 to 30 microns and a length of 50-500 microns. Venules, in turn, flow into larger (30-50 microns in diameter) collective venules (venulae), which are the initial link of the venous system.
Walls blood capillaries (hemocapillaries) formed by one layer of flattened endothelial cells - endotheliocytes, a continuous or discontinuous basement membrane and rare pericapillary cells - pericytes (Rouget cells) (Fig. 129). The endothelial layer of capillaries has a thickness of 0.2 to 2 microns. The edges of adjacent endotheliocytes form interdigitations, the cells are interconnected by nexuses and desmosomes. Between endotheliocytes there are gaps from 3 to 15 nm wide, due to which various substances penetrate through the walls of blood capillaries. Endotheliocytes lie
Rice. 128. Scheme of the structure of the microvasculature: 1 - capillary network (capillaries); 2 - postcapillary (postcapillary venule); 3 - arteriovenular anastomosis; 4 - venule; 5 - arteriole; 6 - precapillary (precapillary arteriole). The red arrows show the intake of nutrients into the tissues, the blue arrows show the excretion of products from the tissues.
Rice. 129. The structure of blood capillaries of three types:
1 - hemocapillary with a continuous endothelial cell and basement membrane; II - hemocapillary with fenestrated endothelium and continuous basement membrane; III - sinusoidal hemocapillary with slit-like holes in the endothelium and a discontinuous basement membrane; 1 - endotheliocyte;
2 - basement membrane; 3 - pericyte; 4 - contact of pericyte with endotheliocyte; 5 - the end of the nerve fiber; 6 - adventitial cell; 7 - fenestra;
8 - gaps (pores) (according to V.G. Eliseev and others)
on a thin basement membrane (basal layer). The basal layer consists of intertwining fibrils and an amorphous substance in which pericytes (Rouget cells) are located.
Pericytes are elongated multi-pronged cells located along the long axis of the capillary. The pericyte has a large nucleus and well-developed organelles: a granular endoplasmic reticulum, the Golgi complex, mitochondria, lysosomes, cytoplasmic filaments, as well as dense bodies attached to the cytoplasmic surface of the cytolemma. The processes of pericytes pierce the basal layer and approach endotheliocytes. As a result, each endotheliocyte is in contact with the processes of pericytes. In turn, the end of the axon of a sympathetic neuron approaches each pericyte, which invaginates into its cytolemma, forming a synapse-like structure for the transmission of nerve impulses. The pericyte transmits an impulse to the endothelial cell, due to which the endothelial cells either swell or lose fluid. This leads to periodic changes in the width of the capillary lumen.
Blood capillaries in organs and tissues, connecting with each other, form networks. In the kidneys, the capillaries form glomeruli, in the synovial villi of the joints, papillae of the skin - capillary loops.
Within the limits of the microcirculatory bed there are vessels of direct passage of blood from arterioles to venules - arteriolo-venular anastomoses (anastomosis arteriolovenularis). In the walls of arteriolo-venular anastomoses there is a well-defined layer of smooth muscle cells that regulates blood flow directly from the arteriole to the venule, bypassing the capillaries.
Blood capillaries are exchange vessels in which diffusion and filtration take place. The total cross-sectional area of the capillaries of the systemic circulation reaches 11,000 cm2. The total number of capillaries in the human body is about 40 billion. The density of capillaries depends on the function and structure of the tissue or organ. For example, in skeletal muscles, the capillary density ranges from 300 to 1000 per 1 mm3 of muscle tissue. In the brain, liver, kidneys, myocardium, the density of capillaries reaches 2500-3000, and in fatty, bone, fibrous connective tissues it is minimal - 150 per 1 mm3. From the lumen of the capillaries, various nutrients and oxygen are transported to the pericapillary space, the thickness of which is different. So, wide pericapillary spaces are observed in the connective tissue. This space is significant
already in the lungs and liver and narrowest in the nervous and muscle tissues. In the pericapillary space there is a loose network of thin collagen and reticular fibrils, among which there are single fibroblasts.
Transport of substances through the walls of hemocapillaries carried out in several ways. The most intensive diffusion. With the help of micropinocytic vesicles, metabolites, large protein molecules, are transported through the capillary walls in both directions. Low molecular weight compounds and water are transported through fenestrae and intercellular gaps 2–5 nm in diameter located between nexuses. The wide slits of sinusoidal capillaries are capable of passing not only liquid, but also various macromolecular compounds and small particles. The basal layer is an obstacle for the transport of macromolecular compounds and shaped elements blood.
In the blood capillaries of the endocrine glands, urinary system, vascular plexuses of the brain, ciliary body of the eye, venous capillaries of the skin and intestines, the endothelium is fenestrated, has holes - pores. Rounded pores (fenestra) with a diameter of about 70 nm, arranged regularly (about 30 per 1 µm2), are closed by a thin single-layer diaphragm. There is no diaphragm in the glomerular capillaries of the kidney.
Structure postcapillary venules for a considerable extent similar to the structure of the walls of capillaries. They only have more pericytes and a wider lumen. Smooth muscle cells and connective tissue fibers of the outer shell appear in the walls of small venules. In the walls of larger venule there are already 1-2 layers of elongated and flattened smooth muscle cells - myocytes, and a fairly well-defined adventitia. There is no elastic membrane in the veins.
Postcapillary venules, like capillaries, are involved in the exchange of fluid, ions and metabolites. During pathological processes (inflammation, allergy), due to the opening of intercellular contacts, they become permeable to plasma and blood cells. Collective venules do not have this ability.
Usually, an arterial vessel, an arteriole, approaches the capillary network, and a venule leaves it. In some organs (kidney, liver) there is a deviation from this rule. So, an arteriole (bringing vessel) approaches the vascular glomerulus of the renal corpuscle, which branches into capillaries. An arteriole (efferent vessel) also emerges from the vascular glomerulus, and not a venule. A capillary network inserted between two vessels of the same type (arteries) is called a "wonderful network".
The total number of veins exceeds the number of arteries, and the total value (volume) of the venous bed is greater than the arterial one. The names of the deep veins are similar to the names of the arteries to which the veins are adjacent (ulnar artery - ulnar vein, tibial artery - tibial vein). Such deep veins are paired.
Most of the veins located in the body cavities are solitary. Unpaired deep veins are the internal jugular, subclavian, iliac (common, external, internal), femoral and some others. The superficial veins are connected to the deep veins by the so-called perforating veins, which act as anastomoses. Neighboring veins are also interconnected by numerous anastomoses, which together form venous plexuses (plexus venosus), which are well expressed on the surface or in the walls of some internal organs (bladder, rectum).
The largest veins of the systemic circulation are the superior and inferior vena cava. The system of the inferior vena cava also includes the portal vein with its tributaries.
Roundabout (bypass) blood flow is carried out along collateral veins (venae collaterales), through which venous blood flows around the main route. Anastomoses between tributaries of one large (main) vein are called intrasystemic venous anastomoses. Between the tributaries of various large veins (superior and inferior vena cava, portal vein) there are intersystemic venous anastomoses, which are collateral pathways for the outflow of venous blood bypassing the main veins. Venous anastomoses are more common and better developed than arterial anastomoses.
Wall structure veins fundamentally similar to the structure of the walls of arteries. The wall of the vein also consists of three shells (see Fig. 61). There are two types of veins: amuscular and muscular. TO non-muscular type veins include veins of the dura mater, pia mater, retina, bones, spleen, and placenta. The walls of these veins do not have a muscular membrane. The muscleless veins are fused with the fibrous structures of the organs and therefore do not collapse. In such veins, the basement membrane is adjacent to the endothelium, behind which there is a thin layer of loose fibrous connective tissue, which fuses with the tissues in which these veins are located.
Muscular type veins subdivided into veins with weak, medium and strong development of muscle elements. Veins with weak development of muscle elements (diameter up to 1-2 mm) are located mainly
upper body, neck and face. Small veins are very similar in structure to the widest muscle venules. As the diameter increases, two circular layers of myocytes appear in the walls of the veins. Veins of medium caliber include superficial (subcutaneous) veins, as well as veins of internal organs. Their inner shell contains a layer of flat rounded or polygonal endothelial cells interconnected by nexuses. The endothelium rests on a thin basement membrane that separates it from the subendothelial connective tissue. These veins lack an internal elastic membrane. The thin middle shell is formed by 2-3 layers of flattened small circularly arranged smooth muscle cells - myocytes, separated by bundles of collagen and elastic fibers. The outer shell is formed by loose connective tissue, in which nerve fibers, small blood vessels ("vascular vessels") and lymphatic vessels pass.
In large veins with weak development of muscle elements, the basement membrane of the endothelium is weakly expressed. In the middle shell, a small number of myocytes are circularly located, which have many myoendothelial contacts. The outer shell of such veins is thick, consists of loose connective tissue, in which there are many unmyelinated nerve fibers that form nerve plexuses, vascular vessels and lymphatic vessels pass through.
In veins with an average development of muscular elements (brachial, etc.), the endothelium, which does not differ from that described above, is separated by a basement membrane from the subendothelial layer. The intima forms valves. There is no internal elastic membrane. The median sheath is much thinner than that of the corresponding artery and consists of circularly arranged bundles of smooth muscle cells separated by fibrous connective tissue. The outer elastic membrane is absent. The outer shell (adventitia) is well developed, vessels and nerves pass through it.
Veins with a strong development of muscle elements are large veins of the lower half of the trunk and legs. They have bundles of smooth muscle cells not only in the middle, but also in the outer shell. In the middle shell of the vein with a strong development of muscle elements, there are several layers of circularly arranged smooth myocytes. The endothelium lies on the basement membrane, under which there is a subendothelial layer formed by loose fibrous connective tissue. The internal elastic membrane is not formed.
The inner lining of most medium and some large veins forms valves (Fig. 130). However, there are veins in which valves
Rice. 130. Venous valves. The vein is cut lengthwise and deployed: 1 - the lumen of the vein; 2 - leaflets of venous valves
absent, for example, hollow, brachiocephalic, common and internal iliac veins, veins of the heart, lungs, adrenal glands, brain and its membranes, parenchymal organs, bone marrow.
valves- these are thin folds of the inner shell, consisting of a thin layer of fibrous connective tissue, covered on both sides with endothelium. Valves allow blood to pass only towards the heart, prevent the reverse flow of blood in the veins and protect the heart from wasting energy to overcome the oscillatory movements of the blood.
veins (sinuses) into which blood flows from the brain, located
are located in the thickness (extensions) of the dura mater. These venous sinuses have non-collapsing walls, providing unimpeded blood flow from the cranial cavity to the extracranial veins (internal jugular).
Veins, primarily the veins of the liver, subpapillary venous plexuses of the skin and celiac region, are capacitive vessels and therefore are able to deposit a large amount of blood.
An important role in the implementation of the function of the cardiovascular system is played by shunting vessels - arteriolo-venular anastomoses (anastomosis arteriovenularis). When they open, the blood flow through the capillaries of a given microcirculatory unit or area is reduced or even stopped, blood is coming around the capillaries. There are true arteriolo-venular anastomoses, or shunts, which discharge arterial blood into the veins, and atypical anastomoses, or half-shunts, through which mixed blood flows (Fig. 131). Typical arteriolo-venular anastomoses are found in the skin of the pads of the fingers and toes, the nail bed, lips, and nose. They also form the bulk of the carotid, aortic, and coccygeal bodies. These are short, often tortuous vessels.
Rice. 131. Arteriolo-venular anastomoses (AVA): I - AVA without a special locking device: 1 - arteriole; 2 - venule; 3 - anastomosis; 4 - smooth myocytes of the anastomosis; II - AVA with a special device: A - anastomosis of the type of the trailing artery; B - simple anastomosis of the epithelioid type; B - complex anastomosis of the epithelioid type (glomerular); 1 - endothelium; 2 - longitudinally arranged bundles of smooth myocytes; 3 - internal elastic membrane; 4 - arteriole; 5 - venule; 6 - anastomosis; 7 - epithelioid cells of the anastomosis; 8 - capillaries in the connective tissue sheath; III - atypical anastomosis: 1 - arteriole; 2 - short hemocapillary; 3 - venule (according to Yu.I. Afanasiev)
Blood supply of blood vessels. The blood vessels are supplied by the system "vessels of vessels" (vasa vasorum), which are branches of arteries located in the adjacent connective tissue. blood capillaries are present only in the outer shell of the arteries. Nutrition and gas exchange of the inner and middle membranes is carried out by diffusion from the blood flowing in the lumen of the artery. The outflow of venous blood from the corresponding sections of the arterial wall occurs through veins, also related to the vascular system. The vessels of the vessels in the walls of the veins supply blood to all their membranes, and the capillaries open into the vein itself.
autonomic nerves, accompanying vessels innervate their walls (arteries and veins). These are predominantly sympathetic adrenergic nerves, causing contraction smooth myocytes.
Blood vessels in the human body carry out the function of transferring blood from the heart to all tissues of the body and vice versa. The scheme of interweaving of vessels in the bloodstream allows you to smoothly ensure the operation of all important organs or systems. The total length of human blood vessels reaches 100,000 km.
Blood vessels are tubular formations of different lengths and diameters, through the cavity of which blood moves. The heart acts as a pump, so the blood powerful pressure circulates throughout the body. The speed of blood circulation is quite high, since the system of blood movement itself is closed.
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Structure and classification
In simple terms, blood vessels are flexible, elastic tubes through which blood flows. The vessels are strong enough to withstand even chemical exposure. High strength due to the structure of the three main layers:
The entire vascular network (dispersion scheme), as well as types of blood vessels, includes millions of tiny nerve endings, which are called effectors, receptor compounds in medicine. They have a close, proportional relationship with nerve endings, reflexively providing nervous regulation blood flow in the vascular cavity.
What is the classification of blood vessels? Medicine divides the vascular pathways according to the type of structure, characteristics, functionality into three types: arteries, veins, capillaries. Each type has great importance in the structure of the vascular network. These main types of blood vessels are described below.
Arteries are blood vessels that originate from the heart and heart muscle and go to the vital important bodies. It is noteworthy that in ancient medicine, these tubes were considered air-carrying, since they were empty when the corpse was opened. The movement of blood through the arterial channels is carried out under high pressure. The walls of the cavity are quite strong, elastic, reaching several millimeters in density in various anatomical regions. Arteries are divided into two groups:
Arteries of the elastic type (aorta, its largest branches) are located as close as possible to the heart. These arteries conduct blood - this is their main function. Under the influence of powerful heart rhythms, blood under great pressure rushes through the arteries. The walls of the artery according to the elastic type are quite strong and perform mechanical functions.
Muscular type arteries are represented by many small and medium-sized arteries. In them, the pressure of the blood mass is no longer so great, so the walls of the vessels are constantly contracting to further move the blood. The walls of the arterial cavity consist of a smooth muscular fibrous structure, the walls are constantly changing towards narrowing or natural expansion to ensure uninterrupted blood flow along their paths.
capillaries
They belong to a variety of the smallest vessels in the entire vascular system. Localized between arterial vessels, vena cava. The diameter parameters of the capillaries vary in the range of 5-10 µm. Capillaries are involved in organizing the exchange of gaseous substances and special nutrients between tissues and the blood itself.
Oxygen-containing molecules, carbon dioxide, and metabolic products penetrate the tissues and organs through the thin structure of the capillary walls in the opposite direction.
Veins, on the contrary, have a different function - they provide blood flow to the heart muscle. The rapid movement of blood through the cavity of the veins is performed in the opposite direction from the flow of blood through the arteries or capillaries. Blood through the venous bed does not pass under strong pressure, so the walls of the vein contain less muscle structure.
The vascular system is a vicious circle in which blood regularly circulates from the heart throughout the body, and then, in the opposite direction through the veins to the heart. It turns out a complete cycle that provides adequate vital activity of the body. 
The functionality of vessels depending on the type
The circulatory vascular system is not only a conductor of blood, but has a powerful functional effect on the body as a whole. In anatomy, six subspecies are distinguished:
- precardiac (hollow, pulmonary veins, pulmonary arterial trunk, elastic type arteries).
- main (arteries and veins, large or medium-sized vessels, arteries of the muscular type, enveloping the organ from the outside);
- organ (veins, capillaries, intraorgan arteries responsible for the full trophism of internal organs and systems).
Pathological conditions of the circulatory system
Vessels, like other organs, can be affected by specific diseases, have pathological conditions, developmental anomalies that are the result of other serious diseases and their cause.
There are several serious vascular diseases having a severe course and consequences for the general health of the patient:
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Blood vessels in the human body are a unique system for transporting blood to important systems and organs, tissues and muscle structure.
The vascular system ensures the excretion of decay products as a result of vital activity. The circulatory system must work correctly, so for any manifestations anxiety symptoms you should immediately consult a doctor and begin preventive measures to further strengthen the vascular branches and their walls.
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