Lab 2: Exploring the Circulatory System Anatomy and Functions

PTH_AS 2203 – Lab 2 – Circulatory System – In-class Exercise modified 8/17/2023 – p. 1 of 17 PTH_AS 2203 Lab 2: Circulatory System Station 1. Human Donor Along the upper limb, one continuous vessel is given three different names depending on where it is. These names are important, as they help to clearly define the location of branches and damage to this vessel in clinical settings. On the donor, find the following vessels: Subclavian artery Axillary artery Brachial artery The right subclavian artery is a branch of which vessel? Brachiocephalic trunk What about the left subclavian artery? Arch of the aorta What are the branches of the brachial artery? Deep brachial, radial & ulnar arteries The body wall is fed and drained by a series of arteries and veins. On this donor, locate the following structures (hint: start with the great vessels and follow their pathways): Intercostal arteries Intercostal veins Azygos vein Superior vena cava Aorta What is the primary source of the intercostal arteries? Aorta (descending) Into what vessel do the intercostal veins drain? Azygos vein (azygos system) Into what vessel does this vein that collects the intercostal veins ultimately drain? Superior vena cava

PTH_AS 2203 – Lab 2 – Circulatory System – In-class Exercise modified 8/17/2023 – p. 2 of 17 Station 2. Donor Heart Because they have different roles in circulation, the four chambers of the heart differ in their structure. Identify the chambers of the heart. Why is the myocardium of the atria so much thinner than the walls of the ventricles? Atria only have to pump blood down into the ventricles, ventricles have to pump blood out of the heart. Why is the myocardium of the left ventricle so much thicker than that of the right ventricle? Left ventricle has to pump blood to entire body, right ventricle only has to pump blood to lungs Station 3. Donor Heart A heart murmur is the sound blood makes when it flows from a ventricle back into the atrium due to an incompetent atrioventricular valve. A normal, healthy heart valve is constructed so this does not happen. On the real heart from a human donor and on the model, identify the following: Atrioventricular valves (bicuspid/mitral & tricuspid) Papillary muscles Chordae tendineae To which structures do the valves attach? Chordae tendineae To which structures do the chordae tendineae attach? Papillary muscles and AV valve flaps What will happen to the patient if the valves are incompetent (not functioning correctly)? Heart has to work harder because of backflow of blood from ventricle into atrium; inefficient circulation, poor oxygenation In your own words, describe how the papillary muscles and chordae tendineae function to maintain proper valve function. Papillary muscles contract when ventricle walls contract. This maintains tension in the chordae tendineae so that the valves close but cannot flap back into the atria during ventricular contraction.

PTH_AS 2203 – Lab 2 – Circulatory System – In-class Exercise modified 8/17/2023 – p. 3 of 17 Station 4. Histology Image You are consulting with a pathologist about a patient who may have atypical neurovasculature in her axilla. The pathologist shows you the biopsy slide and asks your opinion about the patient’s vessels. In order to understand her explanation, you need to be able to differentiate between arteries and veins in a histologic section. Which of the structures shown is a vein? Which is the artery? A = artery, B = vein List three ways you can differentiate between an artery and a vein in a histological image like this. 1. Artery has thicker walls (vein has thinner walls) 2 . Artery often has a smaller lumen 3. Artery is rounder in cross-sectional shape (vein is flatter in cross section) Note: Many veins (particularly arms and legs) have one-way valves to facilitate venous return, but they cannot be seen in this image. Why do arteries and veins differ in the structure of their walls? Higher blood pressure in arteries; so they need thicker walls How could you identify a capillary? Very small, lumen only 1 blood cell wide; very thin walls (single epithelial layer) Which aspect of capillary structure is directly related to its function? Thin walls, simple squamous epithelium (endothelium), facilitates gas/molecule exchange

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PTH_AS 2203 – Lab 2 – Circulatory System – In-class Exercise modified 8/17/2023 – p. 4 of 17 Station 5. Histology Image Because different diseases or disorders may affect various parts of vessels, or affect the performance of those components, it is important to be able to identify the structure and location of the layers comprising the vessel walls. Identify the following in this image: Tunica media Tunica intima (interna) Tunica externa Which of these layers is composed of simple squamous epithelium? Tunica intima Which of these layers is composed of smooth muscle? Tunica media

PTH_AS 2203 – Lab 2 – Circulatory System – In-class Exercise modified 8/17/2023 – p. 5 of 17 Station 6. Model 2A1(2A2) A femoral hernia, in which the abdominal contents protrude into the space where the femoral artery enters the thigh, can compress the femoral artery. Identify the femoral artery on the lower limb model. What is the source of this artery? External iliac artery What is the femoral artery’s branch in the thigh? And what region of the thigh does the branch supply? Deep femoral artery – posterior thigh When the femoral artery passes behind the knee, what is it called? Popliteal artery List the three branches of this vessel that branch off distal to the knee joint. Anterior tibial, posterior tibial & fibular arteries Veins use several different mechanisms to ensure blood return to the heart from the extremities. In addition to the pumping of the heart itself, name two other mechanisms of venous return Valves, muscle contraction Station 7. 4C2(4C3) and 1A1(1A2) A middle-aged man undergoes a cardiac stress test. Based on his results, the cardiologist determines that he has an occluded (blocked) vessel in his coronary circulation. The cardiologist decides to perform angioplasty, a procedure during which a small balloon is inserted into the affected vessel to open it up. The balloon is threaded up to the heart through a catheter that has been inserted in the femoral vein. This pathway is chosen for the catheter because the femoral vein is large and superficial, and provides a relatively straight pathway to the heart. Trace the pathway of the catheter from femoral vein to the right atrium. List the vessels the catheter will pass through on its way to the heart. Femoral vein → external iliac vein → common iliac vein → inferior vena cava → right atrium Find these vessels on the models to understand this pathway.

PTH_AS 2203 – Lab 2 – Circulatory System – In-class Exercise modified 8/17/2023 – p. 6 of 17 Station 8. Model 4B3(4B4) Inadequate circulation in the hand may result from blockage in the arterial blood supply. This can result in significant pain and muscle weakness, impairing hand function in your patient. Which arteries supply blood to the hand? Superficial & deep palmar arterial arches Identify them on this model. What is the primary source of each of these arteries? Superficial palmar arch from ulnar artery Deep palmar arch from radial artery If one of these arteries is blocked, is circulation to the entire hand necessarily cut off? No, the arches in the hand have anastomotic connections What is the term for arteries joining together ‘downstream’ so that one can take over for the other and ensure adequate blood supply to the region? Anastomosis Station 9. Model 24A1(24B1) The lymphatic system brings extracellular fluids back into the circulatory system from throughout the body, and also brings fat from the digestive tract into circulation. Locate the lymph nodes in the groin and axilla on this model. If a surgeon must remove cancerous lymph nodes from the axilla of a patient, what function of the lymph system would be disrupted? Filtering of lymph and removal of lymph from upper limb What symptoms does this patient present with? Swelling of the upper limb because lymph has no pathway of drainage out of the upper limb (lymphedema ) The lymphatic system eventually drains into the great veins in the mediastinum. It is not symmetrical on the right and left sides of the body. Identify the thoracic duct. Into which vein does it drain? Junction of left internal jugular & left subclavian veins (left venous angle) Station continues on next page…

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PTH_AS 2203 – Lab 2 – Circulatory System – In-class Exercise modified 8/17/2023 – p. 7 of 17 Lymph from what portion of the body drains into the venous system through the thoracic duct? Lower half of the body, left upper limb, left upper quadrant of torso, left side of head/neck If a patient suffers from metastatic prostate cancer (the prostate sits in the pelvic cavity inferior to the bladder), would the cancer cells reach the venous system through the thoracic duct or through the right lymphatic duct? Thoracic duct Station 10. Model 20A3(20A4) A lifetime tobacco chewer has a high risk of developing oral cancer. If this occurs, growing tumors may block one or more important vessels in his head. Identify the following structures on this model: Common carotid artery Internal carotid artery External carotid artery Facial artery Maxillary artery Superficial temporal artery Which area is supplied by the facial artery? Superficial face What is the source of the facial artery (what it is a branch of)? External carotid artery Which artery would supply blood to the pterygoid muscles and deep structures of the face? Maxillary artery Which area is supplied by the superficial temporal artery? Side of the head, temples What part of the body does the internal carotid artery supply? Brain

PTH_AS 2203 – Lab 2 – Circulatory System – In-class Exercise modified 8/17/2023 – p. 8 of 17 Station 11. Histology Images Different types of muscle have different structures that affect their function. Which of these images is cardiac muscle? B Give two distinctive features of cardiac muscle visible in this image. 1. Intercalated disks 2. Branching chains of cells, uni- or bi-nucleate cells Is cardiac muscle voluntary or involuntary? Involuntary

PTH_AS 2203 – Lab 2 – Circulatory System – In-class Exercise modified 8/17/2023 – p. 9 of 17 Station 12. Model 16A2(16A1) A 15-year-old girl was brought to the clinic suffering from chronic fatigue and weakness. Tests revealed that she had an incompetent (malfunctioning) mitral valve due to a congenital malformation on one of the flaps of that valve. Surgeons replaced her defective mitral valve with an artificial one, and after recuperation her symptoms disappeared. The mitral (bicuspid) valve is located between which chambers of the heart? Left atrium & left ventricle Is the blood passing through this valve oxygenated or deoxygenated? Oxygenated The tricuspid valve is located between which two chambers? Between right atrium & right ventricle Is the blood passing through this valve oxygenated or deoxygenated? Deoxygenated Locate the mitral and tricuspid valves on this model. How many cusps (flaps) are in each of these valves? Bicupsid/mitral – 2 Tricuspid – 3

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PTH_AS 2203 – Lab 2 – Circulatory System – In-class Exercise modified 8/17/2023 – p. 10 of 17 Station 13. Model 17B1(17B2) A middle-aged man with a long history of smoking is diagnosed with a malfunctioning pulmonary semilunar valve. In normal function, the semilunar valves are flexible: when the ventricle contracts and ejects blood into the artery, the semilunar valve will collapse under the positive pressure and allow unimpeded outward flow. When the ventricle is relaxed, the valve will close to prevent blood from flowing backwards. Stiffening of the valve tissue can prevent the flaps from sealing off the vessel, allowing reflux of blood back into the ventricle. Identify the pulmonary valve on this model. Is the blood passing through this valve oxygenated or deoxygenated? Deoxygenated Is the blood passing through this valve entering or exiting the heart? Exiting Where is this blood going? To the lungs Identify the aortic valve on this model. Is the blood passing through this valve oxygenated or deoxygenated? Oxygenated Is the blood entering or exiting the heart? Exiting Where is this blood going? Systemic circulation

PTH_AS 2203 – Lab 2 – Circulatory System – In-class Exercise modified 8/17/2023 – p. 11 of 17 Station 14. Model 7B5(7A3) When there is a pulmonary embolism (blood clot in the lungs), blood flow through the lung is blocked or restricted. This results in pulmonary hypertension (high blood pressure in the pulmonary system) which can then lead to chest pain and weakness throughout the body. Identify the pulmonary arteries on this model. The pulmonary arteries branch from what vessel? Which chamber of the heart does that vessel emerge from? Pulmonary trunk and right ventricle The pulmonary arteries are heading toward which structure? Lungs Are these vessels carrying oxygenated or deoxygenated blood? Deoxygenated Identify the pulmonary veins on this model. The pulmonary veins have just left which organ? Lungs The pulmonary veins are heading toward which structure? Heart (left atrium) Are these vessels carrying oxygenated or deoxygenated blood? Oxygenated

PTH_AS 2203 – Lab 2 – Circulatory System – In-class Exercise modified 8/17/2023 – p. 12 of 17 Station 15. Model 16A3(16A4) A 68-year-old man with a long history of smoking collapses while mowing his lawn. When paramedics arrived he was unconscious, not breathing, and without a pulse. CPR was successfully performed and the man was transported to the hospital. Once stable, an angiogram of his coronary circulation revealed that his anterior interventricular (LAD) artery was 95% blocked. He will need heart surgery, but the heart muscle has already been severely damaged. Identify the following vessels on this model: Right coronary artery Posterior interventricular artery (posterior descending artery) Left coronary artery Anterior interventricular artery (left anterior descending, LAD) Great cardiac vein Cardiac sinus The blockage in the anterior interventricular artery (LAD) has led to muscle death in the regions that vessel feeds. Which regions of the heart has this affected? Ventricles & interventricular septum What structure of the heart transmits the signal to contract to the ventricles? Atrioventricular node in the interventricular septum Station 16. Model 24E9 Your middle-aged patient suffers from a tumor in his mediastinum that is compromising the great vessels. To understand what clinical symptoms he will experience, you must understand the location and distribution of these vessels. Identify the following structures: Aortic arch Ascending aorta Descending aorta Brachiocephalic trunk Left common carotid artery Right common carotid artery Left subclavian artery Right subclavian artery Station continues on next page…

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PTH_AS 2203 – Lab 2 – Circulatory System – In-class Exercise modified 8/17/2023 – p. 13 of 17 Which area(s) of the body do the common carotid arteries supply? Head and neck Which area(s) of the body do the subclavian arteries supply? Upper limbs The left subclavian artery is a branch of which vessel? Aorta (arch) The right subclavian artery is a branch of which vessel? Brachiocephalic trunk Station 17. 4A2 Muscular compartments are bounded by a dense connective tissue, called fascia. If an artery ruptures and bleeds into one of these compartments, pressure builds up and leads to severe pain and muscle weakness. This condition is called compartment syndrome. The fascia must be surgically opened to relieve the pressure. A rupture in which artery would lead to compartment syndrome in the anterior compartment of the arm? Brachial artery What about the posterior compartment of the arm? Deep brachial artery Within the forearm, the arteries run within the anterior compartment, but supply both anterior and posterior compartments. Which arteries are in the forearm? Radial & ulnar arteries What are they a branch of? Brachial artery

PTH_AS 2203 – Lab 2 – Circulatory System – In-class Exercise modified 8/17/2023 – p. 14 of 17 Station 18. Model 17A3 Pericarditis is a clinical condition in which the pericardial sac becomes inflamed, usually due to infection. Severe cases of pericarditis can result in cardiac tamponade, in which increased pressure on the heart restricts its ability to contract and expand naturally. On this model, identify the fibrous pericardium at its cut edge. Where would the serous layer of the pericardial sac be? On the surface of the heart, and lining the inside of the fibrous pericardial sac What is the function of the serous pericardium? Lubrication, allows heart to move within sac Station 19. 4B1 The limbs have both superficial and deep veins. The deep veins accompany arteries of the same names. Blood is usually drawn from superficial veins because they are easy to see through the skin and to reach with the needle. Central lines used to deliver drugs to a patient are generally inserted into deep veins because they are stronger. On this model, identify the following structures: Basilic vein Cephalic vein Median cubital vein From which vein is blood usually drawn? Median cubital vein If a drug is injected into the cephalic vein, where does the medicine travel next (into which vessel)? Axillary vein The deep veins of the upper limb accompany the arteries. Identify the following veins: Radial vein Ulnar vein Brachial vein Which veins join to form the brachial vein? Radial & ulnar veins Where does blood in the brachial vein go next? Axillary vein

PTH_AS 2203 – Lab 2 – Circulatory System – In-class Exercise modified 8/17/2023 – p. 15 of 17 Concept Station What structures are found inside veins that are not found in arteries? Valves Why are the valves inside of veins important? Why aren’t they found in arteries? Veins have lower blood pressure than arteries, blood flow must also work against Gravity. High pressure in arteries keeps flow unidirectional, valves not necessary. On a long plane flight, passengers are advised to flex and extend and roll their ankles, and to get up and move about periodically. Why do you think they are advised to do this? To help move blood through veins back to heart. Contracting muscles of the lower limb squeezes the veins, helping push blood up and out of the lower limbs where it tries to settled with gravity. What would be a potential consequence of not doing so? Swelling of the feet & ankles as fluid accumulates in tissues (insufficient movement for good circulation affects both venous and lymph return); blood clots or deep vein thrombus can build up from insufficient venous circulation Concept Station Draw the arterial supply of blood from the descending aorta to the lower limb (all the way to the foot). Stick figure or schematic drawings are fine. Make sure you include all relevant vessels from your list. Aorta Common Iliac External Iliac Internal Iliac Femoral Popliteal Fibular Posterior Tibial Anterior Tibial

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PTH_AS 2203 – Lab 2 – Circulatory System – In-class Exercise modified 8/17/2023 – p. 16 of 17 Concept Station Draw the arterial supply of blood from the aorta to the upper limb (all the way to the hand). Stick figure drawings or subway map style schematics are fine. Make sure you include all relevant vessels from your list. Subclavian Axillary Brachial Deep Brachial Radial Ulnar Superficial Arch Deep Arch

PTH_AS 2203 – Lab 2 – Circulatory System – In-class Exercise modified 8/17/2023 – p. 17 of 17 Review Stations REVIEW! Before you leave today, make sure you have completed all of today’s lab stations. Make sure you understood everything at each of these stations. If you didn’t, ask an instructor to explain it to you. Go over your list of Structures to Know for this week, and make sure you understand where each is and can identify it. Quiz your lab partners over the heart and vessels. Have them quiz you, too. Don’t leave until you’ve covered everything and understand this week’s material. Do you remember the different tissue types from last week? Can you identify all these histology images? What about the different planes of sectioning?

2203 Lab 2 In-Class Exercise F2023 KEY (1)

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