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Часть 1 Кровеносные сосуды Часть 1 Кровеносные сосуды

Структура сосудистой стенки § Стенка сосуда состоит из трех оболочек § Tunica intima – Структура сосудистой стенки § Стенка сосуда состоит из трех оболочек § Tunica intima – выстлана со стороны просвета сосуда эндотелием § Tunica media – построена из волокон неисчерченной мышечной ткани, миоцитов, чередующихся с эластическими волокнами. Обладает двумя функциями § Сужение– вазоконстрикция § Расширение– вазодилятация § Tunica externa – содержит соединительно тканные волокна

Структура артерий, вен и капилляров Структура артерий, вен и капилляров

Типы кровеносных сосудов § § Артерии– несут кровь от сердца Капилляры– маленькие кровеносные сосуды Типы кровеносных сосудов § § Артерии– несут кровь от сердца Капилляры– маленькие кровеносные сосуды § The site of exchange of molecules between blood and tissue fluid § Вены– несут кровь к сердцу

Типы артерий Эластические артерии– самые большие в организме § Их диаметр варьируется от 1 Типы артерий Эластические артерии– самые большие в организме § Их диаметр варьируется от 1 до 2. 5 см § Включают в себя аорту и легочный ствол § Стенки сосудов отличаются высокой прочностью и эластичностью, что соответствует высокому давлению крови, циркулирующей в этих артериях

Types of Arteries Артерии мышечно-эластического типа § Lie distal to elastic arteries § Diameters Types of Arteries Артерии мышечно-эластического типа § Lie distal to elastic arteries § Diameters range from 1 cm to 0. 3 mm § Includes most named arteries § Tunica media is thick § Unique features § Internal and external elastic laminae

Types of Arteries Артериолы § Характеризуются тонкими стенками § Их диаметр составляет 0. 3 Types of Arteries Артериолы § Характеризуются тонкими стенками § Их диаметр составляет 0. 3 mm -10 µm § Во внутреннем слое слабо выражен подэндотелиальный слой § Диаметр артерриол зависит от § Локальных факторов § Симпатической нервной системы Copyright © 2008 Pearson Education, Inc. , publishing as Benjamin Cummings Figure 19. 2 c

Капилляры § Наименьшие по размеру кровеносные сосуды § Диаметр их насчитывает 8– 10 µm Капилляры § Наименьшие по размеру кровеносные сосуды § Диаметр их насчитывает 8– 10 µm § Красные кровяные тельца свободно циркулируют в одном направлении § Специальные функции § Легкие– oxygen enters blood, carbon dioxide leaves § Тонкий кишечник– receive digested nutrients § Железы внутренней секреции– pick up hormones § Почки– removal of nitrogenous wastes Copyright © 2008 Pearson Education, Inc. , publishing as Benjamin Cummings

RBCs in a Capillary Copyright © 2008 Pearson Education, Inc. , publishing as Benjamin RBCs in a Capillary Copyright © 2008 Pearson Education, Inc. , publishing as Benjamin Cummings Figure 19. 3

Capillary Beds § § Network of capillaries running through tissues Precapillary sphincters § Regulate Capillary Beds § § Network of capillaries running through tissues Precapillary sphincters § Regulate the flow of blood to tissues § § Tendons and ligaments – poorly vascularized Epithelia and cartilage – avascular § Receive nutrients from nearby CT PLAY Anatomy Review: Blood Vessel Structure and Function Copyright © 2008 Pearson Education, Inc. , publishing as Benjamin Cummings

Capillary Beds Copyright © 2008 Pearson Education, Inc. , publishing as Benjamin Cummings Figure Capillary Beds Copyright © 2008 Pearson Education, Inc. , publishing as Benjamin Cummings Figure 19. 4 a

Capillary Beds Copyright © 2008 Pearson Education, Inc. , publishing as Benjamin Cummings Figure Capillary Beds Copyright © 2008 Pearson Education, Inc. , publishing as Benjamin Cummings Figure 19. 4 b

Capillary Permeabillity § § Endothelial cells – held together by tight junctions and desmosomes Capillary Permeabillity § § Endothelial cells – held together by tight junctions and desmosomes Intercellular clefts – gaps of unjoined membrane § Small molecules can enter and exit § Two types of capillary § Continuous – most common § Fenestrated – have pores Copyright © 2008 Pearson Education, Inc. , publishing as Benjamin Cummings

Structure of Capillaries – Cross Section Copyright © 2008 Pearson Education, Inc. , publishing Structure of Capillaries – Cross Section Copyright © 2008 Pearson Education, Inc. , publishing as Benjamin Cummings Figure 19. 5 a

Structure of Capillaries – Cross Section Copyright © 2008 Pearson Education, Inc. , publishing Structure of Capillaries – Cross Section Copyright © 2008 Pearson Education, Inc. , publishing as Benjamin Cummings Figure 19. 5 b

Routes of Capillary Permeability § Four routes into and out of capillaries § Direct Routes of Capillary Permeability § Four routes into and out of capillaries § Direct diffusion § Through intercellular clefts § Through cytoplasmic vesicles § Through fenestrations Copyright © 2008 Pearson Education, Inc. , publishing as Benjamin Cummings

Low Permeability Capillaries § Blood-brain barrier § Capillaries have complete tight junctions § No Low Permeability Capillaries § Blood-brain barrier § Capillaries have complete tight junctions § No intercellular clefts are present § Vital molecules pass through § Highly selective transport mechanisms § Not a barrier against § Oxygen, carbon dioxide, and some anesthetics Copyright © 2008 Pearson Education, Inc. , publishing as Benjamin Cummings

Sinusoids § Wide, leaky capillaries found in some organs § Usually fenestrated § Intercellular Sinusoids § Wide, leaky capillaries found in some organs § Usually fenestrated § Intercellular clefts are wide open § Occur in bone marrow and spleen § Sinusoids have a large diameter and twisted course Copyright © 2008 Pearson Education, Inc. , publishing as Benjamin Cummings

Sinusoids Copyright © 2008 Pearson Education, Inc. , publishing as Benjamin Cummings Figure 19. Sinusoids Copyright © 2008 Pearson Education, Inc. , publishing as Benjamin Cummings Figure 19. 5 c

Veins § § § Conduct blood from capillaries toward the heart Blood pressure is Veins § § § Conduct blood from capillaries toward the heart Blood pressure is much lower than in arteries Smallest veins – called venules § Diameters from 8 – 100 µm § Smallest venules – called postcapillary venules § § Venules join to form veins Tunica externa is the thickest tunic in veins Copyright © 2008 Pearson Education, Inc. , publishing as Benjamin Cummings

Mechanisms to Counteract Low Venous Pressure § Valves in some veins § Particularly in Mechanisms to Counteract Low Venous Pressure § Valves in some veins § Particularly in limbs § Skeletal muscle pump § Muscles press against thin-walled veins Copyright © 2008 Pearson Education, Inc. , publishing as Benjamin Cummings Figure 19. 6

Vascular Anastomoses § Vessels interconnect to form vascular anastomoses § Organs receive blood from Vascular Anastomoses § Vessels interconnect to form vascular anastomoses § Organs receive blood from more than one arterial source § Neighboring arteries form arterial anastomoses § Provide collateral channels § Veins anastomose more frequently than arteries Copyright © 2008 Pearson Education, Inc. , publishing as Benjamin Cummings

Vasa Vasorum § Tunica externa of large vessels have § Tiny arteries, capillaries, and Vasa Vasorum § Tunica externa of large vessels have § Tiny arteries, capillaries, and veins § Vasa vasorum vessels of vessels § Nourish outer region of large vessels § Inner half of large vessels receive nutrients from luminal blood Copyright © 2008 Pearson Education, Inc. , publishing as Benjamin Cummings

Легочный круг кровообращения § Pulmonary trunk leaves the right ventricle § Divides into right Легочный круг кровообращения § Pulmonary trunk leaves the right ventricle § Divides into right and left pulmonary arteries § Superior and inferior pulmonary veins § Carry oxygenated blood into the left atrium Copyright © 2008 Pearson Education, Inc. , publishing as Benjamin Cummings

Легочный ствол Легочный ствол

Systemic Circulation § Systemic Arteries § Carry oxygenated blood away from the heart § Systemic Circulation § Systemic Arteries § Carry oxygenated blood away from the heart § Aorta – largest artery in the body Copyright © 2008 Pearson Education, Inc. , publishing as Benjamin Cummings

Магистральные сосуды Магистральные сосуды

Аорта 2 3 § 1 § Восходящая часть– начинается от левого желудочка Дуга аорты– Аорта 2 3 § 1 § Восходящая часть– начинается от левого желудочка Дуга аорты– лежит кзади от рукоятки грудины § ветви § (1)Плечеголовной ствол § (2)Левая общая сонная артерия § (3)Левая подключичная артерия

Аорта Copyright © 2008 Pearson Education, Inc. , publishing as Benjamin Cummings Figure 19. Аорта Copyright © 2008 Pearson Education, Inc. , publishing as Benjamin Cummings Figure 19. 9

Аорта § § Descending aorta – continues from the aortic arch § Thoracic aorta Аорта § § Descending aorta – continues from the aortic arch § Thoracic aorta – in the region of T 5–T 12 § Abdominal aorta – ends at L 4 Divides into right and left common iliac arteries Copyright © 2008 Pearson Education, Inc. , publishing as Benjamin Cummings

19 HUMAN ANATOMY Power. Point® Lecture Slides prepared by Leslie Hendon, University of Alabama, 19 HUMAN ANATOMY Power. Point® Lecture Slides prepared by Leslie Hendon, University of Alabama, Birmingham PART 2 Blood Vessels fifth edition MARIEB | MALLATT | WILHELM Copyright © 2008 Pearson Education, Inc. , publishing as Benjamin Cummings

Arteries of the Head and Neck Copyright © 2008 Pearson Education, Inc. , publishing Arteries of the Head and Neck Copyright © 2008 Pearson Education, Inc. , publishing as Benjamin Cummings Figure 19. 10 a

Major Arteries Serving the Brain § Cerebral arterial circle Copyright © 2008 Pearson Education, Major Arteries Serving the Brain § Cerebral arterial circle Copyright © 2008 Pearson Education, Inc. , publishing as Benjamin Cummings Figure 19. 10 c

Arteries of the Upper Limb and Thorax Arteries of the Upper Limb and Thorax

Arteries of the Abdominal Aorta § § § § Inferior phrenic arteries Celiac trunk Arteries of the Abdominal Aorta § § § § Inferior phrenic arteries Celiac trunk Superior mesenteric artery Suprarenal arteries Renal arteries Gonadal (testicular or ovarian) arteries Inferior mesenteric artery Common iliac arteries Copyright © 2008 Pearson Education, Inc. , publishing as Benjamin Cummings

Arteries of the Abdominal Aorta Copyright © 2008 Pearson Education, Inc. , publishing as Arteries of the Abdominal Aorta Copyright © 2008 Pearson Education, Inc. , publishing as Benjamin Cummings Figure 19. 12

The Celiac Trunk and Main Branches Copyright © 2008 Pearson Education, Inc. , publishing The Celiac Trunk and Main Branches Copyright © 2008 Pearson Education, Inc. , publishing as Benjamin Cummings Figure 19. 13

19 HUMAN ANATOMY Power. Point® Lecture Slides prepared by Leslie Hendon, University of Alabama, 19 HUMAN ANATOMY Power. Point® Lecture Slides prepared by Leslie Hendon, University of Alabama, Birmingham PART 3 Blood Vessels fifth edition MARIEB | MALLATT | WILHELM Copyright © 2008 Pearson Education, Inc. , publishing as Benjamin Cummings

Distribution of the Superior and Inferior Mesenteric Arteries Copyright © 2008 Pearson Education, Inc. Distribution of the Superior and Inferior Mesenteric Arteries Copyright © 2008 Pearson Education, Inc. , publishing as Benjamin Cummings Figure 19. 14

Arteries of the Pelvis and Lower Limbs § § § Internal iliac arteries External Arteries of the Pelvis and Lower Limbs § § § Internal iliac arteries External iliac artery Femoral artery Popliteal artery Anterior tibial artery Posterior tibial artery Copyright © 2008 Pearson Education, Inc. , publishing as Benjamin Cummings

Internal Iliac Artery Copyright © 2008 Pearson Education, Inc. , publishing as Benjamin Cummings Internal Iliac Artery Copyright © 2008 Pearson Education, Inc. , publishing as Benjamin Cummings Figure 19. 15 b

Arteries of the Pelvis and Lower Limbs Copyright © 2008 Pearson Education, Inc. , Arteries of the Pelvis and Lower Limbs Copyright © 2008 Pearson Education, Inc. , publishing as Benjamin Cummings Figure 19. 16 a

Arteries of the Pelvis and Lower Limbs Copyright © 2008 Pearson Education, Inc. , Arteries of the Pelvis and Lower Limbs Copyright © 2008 Pearson Education, Inc. , publishing as Benjamin Cummings Figure 19. 16 b

Flow Chart Summarizing Main Systemic Arteries Copyright © 2008 Pearson Education, Inc. , publishing Flow Chart Summarizing Main Systemic Arteries Copyright © 2008 Pearson Education, Inc. , publishing as Benjamin Cummings Figure 19. 17

Fenestrated Capillary § Describe relevance of pulse points to clinical anatomy Copyright © 2008 Fenestrated Capillary § Describe relevance of pulse points to clinical anatomy Copyright © 2008 Pearson Education, Inc. , publishing as Benjamin Cummings Figure 19. 5 b

Systemic Veins § § Three major veins enter the right atrium Superficial veins lie Systemic Veins § § Three major veins enter the right atrium Superficial veins lie just beneath the skin Multivein bundles – venous plexuses Unusual patterns of venous drainage § Dural sinuses § Hepatic portal system Copyright © 2008 Pearson Education, Inc. , publishing as Benjamin Cummings

Venae Cavae and Tributaries § Superior vena cava § Returns blood from body regions Venae Cavae and Tributaries § Superior vena cava § Returns blood from body regions superior to the diaphragm § Inferior vena cava § Returns blood from body regions inferior to the diaphragm § Superior and inferior vena cava § Join the right atrium Copyright © 2008 Pearson Education, Inc. , publishing as Benjamin Cummings

Abdominal Cavity Showing Vasculature Copyright © 2008 Pearson Education, Inc. , publishing as Benjamin Abdominal Cavity Showing Vasculature Copyright © 2008 Pearson Education, Inc. , publishing as Benjamin Cummings Figure 19. 19

Major Veins of the Systemic Circulation Copyright © 2008 Pearson Education, Inc. , publishing Major Veins of the Systemic Circulation Copyright © 2008 Pearson Education, Inc. , publishing as Benjamin Cummings Figure 19. 18

19 HUMAN ANATOMY Power. Point® Lecture Slides prepared by Leslie Hendon, University of Alabama, 19 HUMAN ANATOMY Power. Point® Lecture Slides prepared by Leslie Hendon, University of Alabama, Birmingham PART 4 Blood Vessels fifth edition MARIEB | MALLATT | WILHELM Copyright © 2008 Pearson Education, Inc. , publishing as Benjamin Cummings

Veins of the Head and Neck § Dural Sinuses § Superior and inferior sagittal Veins of the Head and Neck § Dural Sinuses § Superior and inferior sagittal sinuses § Straight sinus § Transverse sinuses § Sigmoid sinus Copyright © 2008 Pearson Education, Inc. , publishing as Benjamin Cummings Figure 19. 20 b

Veins of the Head and Neck § Venous drainage § Internal jugular veins § Veins of the Head and Neck § Venous drainage § Internal jugular veins § External jugular veins § Vertebral veins Copyright © 2008 Pearson Education, Inc. , publishing as Benjamin Cummings Figure 19. 20 a

Veins of the Upper Limbs § Deep Veins § Superficial veins § Follow the Veins of the Upper Limbs § Deep Veins § Superficial veins § Follow the paths of companion arteries § Have the same names as the companion arteries § Visible beneath the skin § Cephalic vein § Basilic vein § Median cubital vein § Median vein of the forearm Copyright © 2008 Pearson Education, Inc. , publishing as Benjamin Cummings

Veins of the Right Limb Copyright © 2008 Pearson Education, Inc. , publishing as Veins of the Right Limb Copyright © 2008 Pearson Education, Inc. , publishing as Benjamin Cummings Figure 19. 21 a

Antecubital Fossa § § Form anastomese frequently Median cubital vein is used to obtain Antecubital Fossa § § Form anastomese frequently Median cubital vein is used to obtain blood or administer IV fluids Copyright © 2008 Pearson Education, Inc. , publishing as Benjamin Cummings Figure 19. 22

Veins of the Thorax § § § Azygos vein Hemiazygos vein Accessory hemiazygos vein Veins of the Thorax § § § Azygos vein Hemiazygos vein Accessory hemiazygos vein Copyright © 2008 Pearson Education, Inc. , publishing as Benjamin Cummings Figure 19. 21 b

Veins of the Abdomen § § § Lumbar veins Gonadal (testicular or ovarian) veins Veins of the Abdomen § § § Lumbar veins Gonadal (testicular or ovarian) veins Renal veins Suprarenal veins Hepatic veins Copyright © 2008 Pearson Education, Inc. , publishing as Benjamin Cummings

Tributaries of the Inferior Vena Cava Copyright © 2008 Pearson Education, Inc. , publishing Tributaries of the Inferior Vena Cava Copyright © 2008 Pearson Education, Inc. , publishing as Benjamin Cummings Figure 19. 23

The Hepatic Portal System § § § A specialized part of the vascular circuit The Hepatic Portal System § § § A specialized part of the vascular circuit Picks up digested nutrients Delivers nutrients to the liver for processing Copyright © 2008 Pearson Education, Inc. , publishing as Benjamin Cummings

The Basic Scheme of the Hepatic Portal System Copyright © 2008 Pearson Education, Inc. The Basic Scheme of the Hepatic Portal System Copyright © 2008 Pearson Education, Inc. , publishing as Benjamin Cummings Figure 19. 24

19 HUMAN ANATOMY Power. Point® Lecture Slides prepared by Leslie Hendon, University of Alabama, 19 HUMAN ANATOMY Power. Point® Lecture Slides prepared by Leslie Hendon, University of Alabama, Birmingham PART 5 Blood Vessels fifth edition MARIEB | MALLATT | WILHELM Copyright © 2008 Pearson Education, Inc. , publishing as Benjamin Cummings

Veins of the Hepatic Portal System Copyright © 2008 Pearson Education, Inc. , publishing Veins of the Hepatic Portal System Copyright © 2008 Pearson Education, Inc. , publishing as Benjamin Cummings Figure 19. 25

Veins of the Pelvis and Lower Limbs § Deep veins § Share the name Veins of the Pelvis and Lower Limbs § Deep veins § Share the name of the accompanying artery § Superficial veins § Great saphenous vein empties into the femoral vein § Small saphenous vein empties into the popliteal vein Copyright © 2008 Pearson Education, Inc. , publishing as Benjamin Cummings

Veins of the Right Lower Limb and Pelvis Copyright © 2008 Pearson Education, Inc. Veins of the Right Lower Limb and Pelvis Copyright © 2008 Pearson Education, Inc. , publishing as Benjamin Cummings Figure 19. 26 a

Veins of the Right Lower Limb and Pelvis Copyright © 2008 Pearson Education, Inc. Veins of the Right Lower Limb and Pelvis Copyright © 2008 Pearson Education, Inc. , publishing as Benjamin Cummings Figure 19. 26 b

Flow Chart Summarizing Main Veins of Systemic Circulation Copyright © 2008 Pearson Education, Inc. Flow Chart Summarizing Main Veins of Systemic Circulation Copyright © 2008 Pearson Education, Inc. , publishing as Benjamin Cummings Figure 19. 27

Disorders of the Blood Vessels § § § Aneurysm Deep vein thrombosis of the Disorders of the Blood Vessels § § § Aneurysm Deep vein thrombosis of the lower limb Venous disease Microangiopathy of diabetes Arteriovenous malformation Copyright © 2008 Pearson Education, Inc. , publishing as Benjamin Cummings

Blood Vessels Throughout Life § Fetal Circulation § All major vessels in place by Blood Vessels Throughout Life § Fetal Circulation § All major vessels in place by month three of development § Differences between fetal and postnatal circulation § Fetus must supply blood to the placenta § Very little blood is sent through the pulmonary circuit Copyright © 2008 Pearson Education, Inc. , publishing as Benjamin Cummings

Vessels to and from the Placenta § Umbilical vessels run in the umbilical cord Vessels to and from the Placenta § Umbilical vessels run in the umbilical cord § Paired umbilical arteries § Unpaired umbilical vein § Fetal vessels and structures § Ductus venosus § Ligamentum teres § Ligamentum venosum § Medial umbilical ligaments Copyright © 2008 Pearson Education, Inc. , publishing as Benjamin Cummings

Shunts Away from the Pulmonary Circuit § § Foramen ovale Ductus arteriosus Copyright © Shunts Away from the Pulmonary Circuit § § Foramen ovale Ductus arteriosus Copyright © 2008 Pearson Education, Inc. , publishing as Benjamin Cummings

Fetal and Newborn Circulation Compared Copyright © 2008 Pearson Education, Inc. , publishing as Fetal and Newborn Circulation Compared Copyright © 2008 Pearson Education, Inc. , publishing as Benjamin Cummings Figure 19. 28 a

Fetal and Newborn Circulation Compared Copyright © 2008 Pearson Education, Inc. , publishing as Fetal and Newborn Circulation Compared Copyright © 2008 Pearson Education, Inc. , publishing as Benjamin Cummings Figure 19. 28 b

Blood Vessels in Adulthood § Atherosclerosis begins in youth § Consequences evident in middle Blood Vessels in Adulthood § Atherosclerosis begins in youth § Consequences evident in middle to old age § Males § More atherosclerosis than females between ages 45 – 65 § Females § Experience heart disease and atherosclerosis later in life Copyright © 2008 Pearson Education, Inc. , publishing as Benjamin Cummings