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Anatomy of the peripheral

vascular system

Dr. Khin Ma Ma
mama_khin@imu.edu.my
2015
Learning out comes

1.Describe the arterial system, capillaries and


venous system.

2.Describe the two main circulations of the body.

3.Describe the peripheral vessels of the upper and


lower limbs.

4.Describe some clinical importance of the


peripheral vascular system.
CVS - closed
system of
tubes.
- consists
of heart and
blood vessels
( arteries, veins
& capillaries).
Heart- a muscular pump
- propels the blood through the
blood vessels up to capillaries where
gaseous exchange occurs.
The blood vessels carry:
1. blood to the lungs for oxygenation
2. blood to the intestines for absorption of nutritive
materials
3. blood to the endocrine glands for hormones to
4. enter
bloodthe circulation.
vessels also transports waste products of
tissue fluid to the kidneys, lungs and skin
where they are excreted.

Thus, the stability of the internal environment


depends on a proper functioning of the CVS and the
composition of blood .
CIRCULATION
1. Pulmonary circulation
blood passes from the
heart through the
pulmonary arteries (CO 2) to
the lungs and returns
through the pulmonary veins
(O2) to the heart.

Systemic circulation
blood passes from the
heart to all parts of the
body via the arteries and
returns to the heart through
the superior and inferior
vena cava and cardiac
veins.
TYPES OF BLOOD VESSELS

1. Arteries

2. Veins

3. Capillaries

4. Sinusoids

5. Cavernous tissue
ARTERIES
Arteries emerge from the heart
carry oxygenated blood, except pulmonary and umbilical arteries

yellowish or bluish grey in colour.


pulsation present
smaller diameter and a smaller lumen compared to
corresponding vein.
when cut, blood spurts out.
walls are thicker to withstand the pressure from within
do not
Types of collapse
arteriesafter death.
1.Large arteries/ Conducting arteries/ Elastic arteries arteries
arising directly from the heart and their main branches, eg
Aorta, pulmonary
trunk.

2.Medium-size arteries/Distributing arteries / Muscular arteries


most of the arteries of the body, eg Axillary artery, Femoral
artery.

3. Smallest arteries/ Resistant arteries/Arterioles the


smallest division of arteries, whose diameter is < 100 um.
ARTERIOLES
the smallest division of the arteries
their diameter is <100um (0.1 mm) and is the size of a thin
thread.
characteristic feature is compared to the small lumen size the
walls are relatively thick
contain mostly of smooth muscle.
arterioles provide the greatest resistance to the flow of blood,
and their constriction serves to reduce the pressure of the blood
before it enters the capillaries.
CAPILLARIES
- form the communicating link between arterioles and venules.
- semi-permeable - permit the exchange of small molecules and
is impermeable to large molecules.
- Size : 7u or more
- Length : to 1 mm long
- present in greatest number in active tissues (muscles, glands,
kidneys and lungs)
- fewer in number in inactive tissues (tendons and ligaments).
- absent in cornea, epidermis & hyaline cartilage.

Types: 3 different types


Continuous capillaries found in muscles

Fenestrated capillaries in kidney, endocrine glands and intestines

Discontinuous capillaries or sinusoids in liver, spleen, bone marro


SINUSOIDS
- are wider and more tortuous than
capillaries
- The endothelial wall is incomplete
- Lined by 2 types of cells ..
Endothelial cells and
macrophage cells
- Found in spleen, bone marrow, liver,
carotid and coccygeal bodies,
pituitary gland, adrenal cortex and
parathyroid glands

CAVERNOUS TISSUE
They are numerous blood -filled
spaces lined with endothelium and is
separated by septa containing smooth
muscle.
They are found in erectile tissue
of the external genitalia (penis) and lining
of nasal cavity.
Arteries of the upper limb

Subclavian A - passes between 1st rib and clavicle and enters into axilla.
- at outer border of 1st rib, becomes Axillary A.

Axillary A accompanied by cords of Brachial plexus


- supplies axilla, chest wall and shoulder girdle.
- divides into 3 parts by Pectoralis minor m/s.
1st part = medial to P. minor m/s
2nd part = posterior to P. minor m/s- 6 branches
3rd part = lateral to P. minor m/s
- becomes Brachial A at lower border of Teres major m/s.
Brachial A descends in medial aspect of humerus
- major branch profunda brachii A
- crosses the anterior mid-line aspect of the elbow, where
can feel for brachial pulse.
- divides into Radial A and Ulnar A in cubital fossa .

Radial A supplies lateral muscles of forearm, wrist and thumb& index finger.
- Radial pulse can be felt at root of thumb, lateral to tendon of Flexor carpi
radialis.

Ulnar A supplies the medial aspect of forearm,fingers 3-5.

Palmar arches branches of Radial A & Ulnar A anastomose to form superficial


and deep palmar
arches.
Arteries of lower limb
Femoral artery continuation of External iliac artery .
- descends down in the antero-medial aspect of thigh .
- at lower 1/3 of thigh ,it becomes popliteal rtery.
- branches
Profunda femoral A ( deep femoral A) .. Supplies thigh muscles
.. Its branches called medial & lateral circumflex
femoral arteries encircle the neck of femur.
.. Medial circumflex A is the main vessel to the head of
femur.
Popliteal artery
- continuation of femoral artery, at adductor hiatus ( in
adductor magnus m/s)
- descends down through popliteal fossa, together with
popliteal vein and tibial nerve.
- gives branches for anastomosis around the knee joint.
Anterior- tibial
splitsAinto Anterior
runs & Posterior
through tibialcompartment
the anterior arteries . of the leg
and supplies the muscles.
- at ankle ,it becomes dorsalis pedis artery.
Dorsalis pedis artery
which is for dorsum of foot and ankle region.
It is a clinically important pulsation point.
its branch arcuate artery gives off dorsal metatarsal
arteries.
it ends by penetrating the sole and forms medial part of
Posterior tibial artery - courses through posteromedial part of leg
- supplies the flexor muscles.
- a branch ,peroneal / fibular artery- to supplu
lateral muscles of leg.
- on medial side of foot, divides into lateral &
medial plantar arteries.
- lateral plantar A forms lateral part of plantat
arch.
- plantar metatarsal arteries and digital arteries
arise from plantar arch.
VEINS

dark blue in the living,


do not pulsate
blood oozes out when cut.
carry deoxygenated blood to the heart, except pulmonary
and umbilical veins.
more numerous than arteries.
walls are thinner because they have to withstand little
pressure from
within .
diameter are larger than those of corresponding arteries.
they collapse after death.
Veins contain valves.

Venules are small sized veins that collect, blood from


the capillaries and join similar vessels to form veins.
2 types:
1.Superficial veins

2. Deep veins

Medium sized arteries below the elbow and knees are


accompanied by paired veins called venae
commitantes.

Superficial vein

Deep vein
Superficial veins
- in the
subcutaneous tissue.
not accompany
arteries.
eg. median cubital
vein
Deep veins
- accompany the
arteries
- have the same
names.
eg. femoral vein &
artery
Venous return to the heart
Mostly by way of vena cava.
Alternate pathways which do not
accompany the arteries are:-
1. The azygos system
2. The portal system SV
C
3. The vertebral system
Azyg
os
vein

Port
al
vein
Valves
valves are present in many veins.

when closed, they prevent the reverse flow of blood.

the free edges of the cusps are directed towards the heart.

valves are numerous in veins of the limbs

absent in most veins of the trunk (SVC, IVC) including the


portal and vertebral systems.
ANASTOMOSIS ( Coming together / Interconnection )
I. Arterial anastomosis
Sites .. palm of hand & sole of foot ( palmar & plantar arches )
.. at base of brain ( arterial circle of Willis)
.. around the joints
Function
1. Provide collateral circulation when one artery is blocked or
ligated.
2. Equalization of pressure between two arteries.

II. Arterio-venous anastomosis or shunt


- where arterioles communicate directly with venules
bypassing the capillary bed.
- they do not permit exchange of materials as walls are thicker.
Function:
Prevents heat loss
Increases the venous return
Sites:
Palm, terminal phalanges and nail bed
Skin of nose, lips and eyelids
Tip of tongue
Intestines

III. Venous anastomosis


END ARTERY - artery which does
not anastomosis with their
neighboring arteries.
- there is no collateral
circulation.
1. Anatomical end artery
Artery that does not
anastomose with neighbouring
arteries.
Death of tissue occurs if this
type of artery is occluded.
e.g central retina artery of the eye

2. Functional end artery


An artery anastomosing so
poorly with neighbouring arteries, that
adequate blood supply is not
maintained after its occlusion.
e.g. Coronary arteries of heart,
kidney, brain, spleen and intestines.
ARTERY. VEINS
3 TUNICS or LAYERS in 3 TUNICS or LAYERS in the wall.
the wall 1.Innermost Tunica intema
1.Innermost Tunica intema 2.Middle - Tunica media
2.Middle - Tunica media 3.Outermost Tunica adventitia
( thickest , composed mainly of ( thickest )
muscle )
3.Outermost Tunica CAPILLARY
adventitia . Only one layer of cells(simple
squamous) called endothelium on basement
membrane.
Applied anatomy / Clinical
importance

1. To take
pulsation .
2. To take blood pressure.
3. Aneurysm.
4.
THANK
YOU.