2014 1 02 introduction to myology and angiology
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7/24/2019 2014 1 02 Introduction to Myology and Angiology
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Introduction to myologyIntroduction to myology
Introduction to angiologyIntroduction to angiology
Prof. Dr. MihProf. Dr. Miháály, Andr ly, Andr ááss
09 Sep 2014 1
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MUSCLEMUSCLE – – FASCICLEFASCICLE – – FIBERFIBER
(EPIMYSIUM, PERIMYSIUM, ENDOMYSIUM)(EPIMYSIUM, PERIMYSIUM, ENDOMYSIUM)
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MORPHOLOGICAL VARIETIES OF SKELETAL MUSCLEMORPHOLOGICAL VARIETIES OF SKELETAL MUSCLE
(MUSCLES AS ORGANS)(MUSCLES AS ORGANS)
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Skeletal muscle:Skeletal muscle:electron microscopyelectron microscopy
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Muscles work in lever Muscles work in lever
systems: as the insertion andsystems: as the insertion and
the action of the load arethe action of the load are
separated by the fulcrumseparated by the fulcrum
they work in a firstthey work in a first--classclass
lever. In cases of lever. In cases of
secondsecond--classclass-- and thirdand third--classclass
levers, the action of thelevers, the action of the
muscle may be different,muscle may be different,
according to the relationaccording to the relation
and distance of the muscleand distance of the muscle
force, the load and theforce, the load and the
fulcrum.fulcrum.
(A: m. triceps brachii;(A: m. triceps brachii;
B: m. triceps surae;B: m. triceps surae;
C: m. biceps brachii)C: m. biceps brachii)
GREATER FORCEGREATER FORCE
GREATER SPEEDGREATER SPEED
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Brachialis muscle: anatomicalBrachialis muscle: anatomical
structure and function (thirdstructure and function (third--class lever)class lever)
TENDON INSERTIONTENDON INSERTION
VENTER (BELLY)VENTER (BELLY)
ATTACHMENTATTACHMENT
OF THE BELLYOF THE BELLY
Upon contractionUpon contraction
of the muscle,of the muscle,
the humerus andthe humerus and
the ulna move closer the ulna move closer
(flexion)(flexion)
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THE FINE STRUCTURE OF THE MYOTENDINOUS JUNCTIONTHE FINE STRUCTURE OF THE MYOTENDINOUS JUNCTION
End-piece of myofiber/myofibrils
Tendon collagenReticular fibers connecting
collagen bundles and BL Basal lamina (BL)8
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Effector nerve ending (motor endplate =Effector nerve ending (motor endplate =
nervenerve--muscle synapse or junction)muscle synapse or junction)
in skeletal muscle (mnj: motor endplate;in skeletal muscle (mnj: motor endplate;arrows: motor nerve fibers).arrows: motor nerve fibers).
Every muscle fiber has motor endplate.Every muscle fiber has motor endplate.
The chemical transmitter of theThe chemical transmitter of the
motor endplate is acetylcholine.motor endplate is acetylcholine.
Muscle cell membrane has nicotinicMuscle cell membrane has nicotinic
acetylcholine receptors. The surplusacetylcholine receptors. The surplus
acetylcholine will be degradedacetylcholine will be degraded
by the enzyme acetylcholinesterase.by the enzyme acetylcholinesterase.
Acetylcholinesterase wasAcetylcholinesterase was
stained in this motor endplatestained in this motor endplate
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Sensory nerve endingsSensory nerve endings
in muscle: muscle spindle (A)in muscle: muscle spindle (A)
tendon organ (B)tendon organ (B)
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THE MUSCLE FIBER IS A SYNCYTIUMTHE MUSCLE FIBER IS A SYNCYTIUM
The syncytium is made by the fusion of smallThe syncytium is made by the fusion of small
cells: the myoblasts. The myoblast is thecells: the myoblasts. The myoblast is the
undifferentiated cell in the embryo.undifferentiated cell in the embryo.
Fusion of the myoblasts results inFusion of the myoblasts results in „„myotubemyotube””
formation. Differentiation of the myotube willformation. Differentiation of the myotube will
result in the appearance of myofibrils.result in the appearance of myofibrils.
Finally, nerves grow to the myotube andFinally, nerves grow to the myotube and
provide innervation, and the formationprovide innervation, and the formation
of motor endplates (neuromuscular junctions),of motor endplates (neuromuscular junctions),
which release acetylcholine, which further which release acetylcholine, which further
stimulates the maturation of the muscle.stimulates the maturation of the muscle.
In adult, muscles have satellite cells (small,In adult, muscles have satellite cells (small,
undifferentiated cells between the muscle fibers).undifferentiated cells between the muscle fibers).
Satellite cells stand for regeneration andSatellite cells stand for regeneration and
healing of the injured muscle.healing of the injured muscle.
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Tendon sheaths of the long flexor muscles of the fingers The shTendon sheaths of the long flexor muscles of the fingers The sheathseaths
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Tendon sheaths of the long flexor muscles of the fingers. The shTendon sheaths of the long flexor muscles of the fingers. The sheathseaths
protect the tendons running in the wrist region. Some sheaths ar protect the tendons running in the wrist region. Some sheaths ar ee
continuous from the wrist to the tip of the finger (I. and V.).continuous from the wrist to the tip of the finger (I. and V.). OthersOthers
will be interrupted in the hand and commence again on the finger will be interrupted in the hand and commence again on the finger ss
(II., III., IV.).(II., III., IV.).Vagina communis tendinumVagina communis tendinum
musculorum flexorum (commonmusculorum flexorum (common
sheath of the finger flexors)sheath of the finger flexors)
Vagina tendinis musculiVagina tendinis musculi
flexoris pollicis longi (sheathflexoris pollicis longi (sheath
containing a single tendon)containing a single tendon) 12
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Fascicles in the bipennate muscle (dorsal interosseus muscles)Fascicles in the bipennate muscle (dorsal interosseus muscles)
Thin tendon in the middleThin tendon in the middle
The fascicles insert to a thinThe fascicles insert to a thintendon in the middletendon in the middle
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Tendinous intersectionsTendinous intersections
Typical aponeurosisTypical aponeurosis
Tendons, which are flat, not ropeTendons, which are flat, not rope--like: tendinous intersectionslike: tendinous intersections
(musculus rectus abdominis). Flat, broad tendon = aponeurosis of (musculus rectus abdominis). Flat, broad tendon = aponeurosis of
the external oblique muscle of the abdominal wall.the external oblique muscle of the abdominal wall.
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Muscles are separated by fasciaeMuscles are separated by fasciae
• Superficial fascia: under the skin
everywhere (except the face). Their name
is „fascia superficialis”.
• Deep fascia: covering and separating
muscle groups (e.g.: fascia brachii, fascia
lata).
• Subserous fascia: related to bodycavities inside (e.g.: endothoracic fascia).
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Muscles of the trunk moving
the arm and the shoulder
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Movements in the pectoral girdle
and the shoulder
• The clavicle articulates to the sternum(sternoclavicular joint) and to the shoulderblade (acromioclavicular joint).
• The scapula is fixed to the thorax by muscleswhich also mediate movements.
• The arm joins to the girdle at the
glenohumeral joint.• Stability and movements of the pectoralgirdle is achieved by the muscles whichconnect to the vertebral column, thorax,
head and neck. 17
M l ti th li b ith
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Muscles connecting the upper limb with
the trunk
• Trapezius: from midline ligaments and bonystructures (from the occipital bone, down to thoracicvertebra #12) to clavicle, acromion and scapularspine. Motor innervation: accessory nerve.
• Rhomboid minor & major: from vertebral spines (C7-T5) to medial border of scapula. Innervation: dorsalscapular nerve.
• Levator scapulae: from the transverse processes ofC1-4 to superior angle of scapula. Innervation:
dorsal scapular nerve.• Latissimus dorsi: from vertebral column (T7-
sacrum), iliac crest, lower ribs to the floor of theintertubercular sulcus. Innervation: thoracodorsal n.
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Muscles connecting the UL to the trunk
• Pectoralis major: from the clavicle, sternum, rib
cartilages to crista tuberculi majoris. Innervation:
medial and lateral pectoral nerves.
• Pectoralis minor: from ribs #3-5 to coracoid process.
Innervation: medial and lateral pectoral nerves.
• Subclavius: between the clavicle and the first rib.
Innervation: nerve to the subclavius.
• Serratus anterior: from the outer surfaces and upper
borders of the upper 8 ribs to the medial border of
the scapula (runs beneath the scapula). Innervation:
long thoracic nerve.
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• Retraction: medial border of the scapulaapproaches the vertebral column (bracingthe shoulder).
• Protraction: movement of the scapula on thechest wall forwards (rounding the shoulder).
• Elevation: shrugging the shoulder.
• Depression: pectoral girdle pulleddownwards.
• Lateral rotation: the inferior angle of thescapula moves laterally, the glenoid fossaturned increasingly upwards.
• Medial rotation: return from the previousmovement.
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MOVEMENTS IN THE SHOULDER GIRDLEMOVEMENTS IN THE SHOULDER GIRDLE
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Scapula and clavicle move together, helping
upper limb movements
• Retraction: rhomboidei, trapezius.
• Protraction: serratus anterior, pectoralis minor.
• Elevation: trapezius upper part, levator scapulae.
• Depression: trapezius lower part.• Lat. rotation: trapezius upper, serratus anterior.
• Medial rotation: rhomboids, levator scapulae,pectoralis minor.
• Participation of the m. subclavius: stabilization ofthe clavicle.
• Rotation of the clavicle: during the extreme flexionor extension of the arm (pectoralis major, latissimusdorsi).
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Abduction and elevation of the arm with the
concomitant movements (rotation) of the
scapula on antero-posterior X-ray pictures.
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Trapezius muscle
Deltoid muscle
Pectoralismajor
Deltopectoral
triangle
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Pectoralis major
cut, pectoralis minor revealed.
Pectoralis minor
Serratus anterior
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M. deltoideus
M.pectoralis major
M. serratus anterior
Deltopectoral triangle
Anterior and lateral trunk muscles
participating in
shoulder and upper arm movements(from the Collection of the Anatomy
Department, Szeged).
M. trapezius
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Shoulder:
strong elevation
and depression,with some
protraction at the
end of movement
(trapezius, levator scapulae,
rhomboids).
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Shoulder:
strong elevation
and depression(trapezius).
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Shoulder: strong
retraction.Arm: slight
adduction and
lateral
rotation, extension.Trapezius, rhomboids,
deltoid, infraspinatus,
teres minor
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Arm:
Extension, flexion,medial rotation
(pectoralis major),
adduction
(latissimus dorsi).Shoulder:
protraction
(serratus anterior).
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Arm:
abduction.Shoulder:
elevation.
Muscles:
trapezius,
deltoideus
supraspinatus.
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Arm:
adduction
(latissimus dorsi,
teres major).
Shoulder:
depression
(rhomboidei,
trapezius lower segment).
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ANGIOLOGYANGIOLOGY
Anatomy and histology of theAnatomy and histology of the
cardiovascular systemcardiovascular system
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Th t f th itiTh t f th iti
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TRUNCUS PULMONALIS: beginningTRUNCUS PULMONALIS: beginning
of pulmonary circulationof pulmonary circulation
ARCUS AORTAE: beginning of systemic ARCUS AORTAE: beginning of systemic
circulationcirculation
Blood circulation isBlood circulation ismaintained by themaintained by the
pumping work of pumping work of
the heart (Harvey, 1628).the heart (Harvey, 1628).
The cast of the cavitiesThe cast of the cavities
of the human heart.of the human heart.
Left ventricleLeft ventricle
Right ventricleRight ventricle
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The blood vascular system consists of arteries,The blood vascular system consists of arteries,
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VEIN VEIN A R T E R Y
A R T E R Y
y ,y ,
arterioles, capillaries, venules and veins.arterioles, capillaries, venules and veins.
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Blood vessels I.
•• Conducting vessels: aorta, pulmonaryConducting vessels: aorta, pulmonarytrunk.trunk.
•• Distributing vessels (subclavian a.,Distributing vessels (subclavian a.,
axillary a., brachial a.)axillary a., brachial a.)•• Resistance vessels: small muscularResistance vessels: small muscular
arteries and arterioles.arteries and arterioles.
•• Exchange vessels: capillaries, venules.Exchange vessels: capillaries, venules.•• Reservoir vessels: veins.Reservoir vessels: veins.
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Blood vessel anastomoses
•• Arterial anastomoses: arch (arcade) anastomosisArterial anastomoses: arch (arcade) anastomosis(or end(or end--toto--end anastomosis: palmar arch);end anastomosis: palmar arch);convergence anastomosis (vertebral arteriesconvergence anastomosis (vertebral arteries – –basilar artery).basilar artery).
•• Collateral anastomoses: around large jointsCollateral anastomoses: around large joints(shoulder, elbow).(shoulder, elbow).
•• Venous anastomoses: perforating veins on theVenous anastomoses: perforating veins on the
limbs (connecting superficial and deep veins).limbs (connecting superficial and deep veins).•• Arteriovenous anastomoses: in microcirculationArteriovenous anastomoses: in microcirculation
metarterioles connect arteriole and venule,metarterioles connect arteriole and venule,circumventing capillaries.circumventing capillaries.
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Arcade Arcade--like endlike end--toto--endend
anastomosis between theanastomosis between the
branches of the inferior andbranches of the inferior and
superior mesenteric arteriessuperior mesenteric arteries(arcus Riolani).(arcus Riolani).
Arteria mesenterica superior Arteria mesenterica superior
anastomosisanastomosis
Arteria mesenterica inferior Arteria mesenterica inferior
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Arteries of the forearm and hand: deep palmar arch is visible.Arteries of the forearm and hand: deep palmar arch is visible.
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Arteries of the forearm and hand: deep palmar arch is visible. Arteries of the forearm and hand: deep palmar arch is visible.
The deep palmar arch is and archThe deep palmar arch is and arch--like anastomosislike anastomosis
between the radial and ulnar arteries.between the radial and ulnar arteries.
a. radialis
a. ulnaris
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Blood vessels IIBlood vessels II
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Blood vessels II.Blood vessels II.
Arteria vertebralis Arteria vertebralis
Arteria basilaris Arteria basilaris
Circulus arteriosus WillisiiCirculus arteriosus Willisii
mmmm
1.1. Elastic arteries (aorta).Elastic arteries (aorta).2.2. Muscular arteries (princepsMuscular arteries (princeps
pollicis artery).pollicis artery).
3. Arterioles: small vessels,3. Arterioles: small vessels,
containing endothelium andcontaining endothelium and11--3 smooth muscle layers3 smooth muscle layers
only (diameter: less thanonly (diameter: less than
0.3 mm).0.3 mm).
Convergence anastoConvergence anasto--mosis between twomosis between two
vertebral arteries.vertebral arteries.
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Elastic artery (aorta)Elastic artery (aorta)
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The media contains dozens of elastic laminaeThe media contains dozens of elastic laminae
Elastic artery (aorta)Elastic artery (aorta)
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Bl d l III V iBl d l III V i
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Blood vessels III. VeinsBlood vessels III. Veins
•• Reservoir vessels: their thin distensible wallReservoir vessels: their thin distensible wallallows them to contain large amount ofallows them to contain large amount of
blood.blood.
•• We have superficial and deep veins.We have superficial and deep veins.•• Veins often possess valves inside, whichVeins often possess valves inside, which
direct blood flow in one direction (toward thedirect blood flow in one direction (toward the
heart).heart).
•• Anastomoses between veins: venousAnastomoses between veins: venous
plexuses, perforating veins.plexuses, perforating veins.
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Bl d l IV P t l iBl d l IV P t l i
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Blood vessels IV. Portal veinsBlood vessels IV. Portal veins
•• The abdominal digestive organs possessThe abdominal digestive organs possessportal circulation: the veins collected fromportal circulation: the veins collected fromcapillaries form a second capillary network incapillaries form a second capillary network inthe liver. Two capillary beds are present, onethe liver. Two capillary beds are present, onein the organs (e.g.: stomach), the other in thein the organs (e.g.: stomach), the other in theliver.liver.
•• Portal circulation aims at the transport ofPortal circulation aims at the transport of
substances which were absorbed in the gutsubstances which were absorbed in the gutfrom the food, into the liver, targeting thefrom the food, into the liver, targeting thehepatocytes.hepatocytes.
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Innervation of blood vesselsInnervation of blood vessels
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•• We find sensory and effector nerve endings in vesselWe find sensory and effector nerve endings in vessel
wall.wall.•• Sensory nerve endings:Sensory nerve endings: receptors for pressure andreceptors for pressure and
the composition of blood (baroreceptors,the composition of blood (baroreceptors,chemoreceptors). Sensory nerve endings belong tochemoreceptors). Sensory nerve endings belong toglossopharyngeal (IX) and vagus (X) nerves.glossopharyngeal (IX) and vagus (X) nerves.
•• Effector nerve endingsEffector nerve endings areare postganglionicpostganglionicsympathetic nerve endingssympathetic nerve endings which releasewhich releasenorepinephrine as transmitter: cause smooth musclenorepinephrine as transmitter: cause smooth musclecontraction in vessel wallcontraction in vessel wall – – vasoconstriction.vasoconstriction.Inhibition of norepinephrine actionInhibition of norepinephrine action – – vasodilatation.vasodilatation.
•• Some organs (salivary glands) possessSome organs (salivary glands) possessparasympathetic vasodilator nerve endingsparasympathetic vasodilator nerve endings whichwhichrelease vasoactive intestinal polypeptide (VIP).release vasoactive intestinal polypeptide (VIP).
•• Blood vessel smooth muscle can be relaxed byBlood vessel smooth muscle can be relaxed bytissue mediatorstissue mediators which are relased from other cells:which are relased from other cells:endothelial cell, mast cell.endothelial cell, mast cell. 45
MICROCIRCULATIONMICROCIRCULATION
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The local circulation of the organs contains a complex pattern oThe local circulation of the organs contains a complex pattern off
arterioles, metarterioles, capillaries and venulesarterioles, metarterioles, capillaries and venules. These micro. These micro--vessels are regulated by nerves, hormones and local tissuevessels are regulated by nerves, hormones and local tissue
mediators.mediators.
MetarteriolesMetarterioles branch from arterioles and contain less smoothbranch from arterioles and contain less smooth
muscle. Capillaries branch from metarterioles and, at the originmuscle. Capillaries branch from metarterioles and, at the origin
of the capillary, a smooth muscle sphincter is present, whichof the capillary, a smooth muscle sphincter is present, which
regulates the amount of blood flowing through the capillary.regulates the amount of blood flowing through the capillary.
CapillariesCapillaries are true exchange vessels. The endothelial cells andare true exchange vessels. The endothelial cells and
some tissue cells together with the endothelium may exert strictsome tissue cells together with the endothelium may exert strict
regulation on the exchange of material (barriers). No muscleregulation on the exchange of material (barriers). No muscle
cells are present around capillaries.cells are present around capillaries.
From capillaries we enter theFrom capillaries we enter the postcapillary venulespostcapillary venules (some(someamount of smooth muscle is present in their wall).amount of smooth muscle is present in their wall).
TheThe arteriovenous metarteriolearteriovenous metarteriole--anastomosesanastomoses may play amay play a
substantial role in the regulation of local blood flowsubstantial role in the regulation of local blood flow
(e.g.: in the skin).(e.g.: in the skin).46
Arteriole: scanning EM
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Arteriole: scanning EM
Smooth muscle cells
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Arteriole: electron microscopic structure. Arteriole: electron microscopic structure.
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Contracted arteriole under the electron microscope.
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Arterioles (1 Arterioles (1--4) and capillaries4) and capillaries
(asterisk shows metarteriole)(asterisk shows metarteriole)
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( )( )
1122
33
44
**
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Types of capillaries:Types of capillaries:
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1.1. Continuous capillaryContinuous capillary
(picture): in lungs,(picture): in lungs,
muscle, brain.muscle, brain.
2.2. Fenestrated capillary:Fenestrated capillary:
kidney, endocrinekidney, endocrine
glands, gut.glands, gut.
3.3. Sinusoid capillary:Sinusoid capillary:
liver, red boneliver, red bone
marrow.marrow.
Capillary diameter:Capillary diameter:
55--8 micrometers8 micrometers
(sinusoid capillaries(sinusoid capillaries
are larger).are larger).
Endothelial cell + basalEndothelial cell + basal
lamina. Pericyteslamina. Pericytes
may attach to capillaries.may attach to capillaries.
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rbcrbc
Capillaries in connective tissue and muscle (rbc: red blood cellCapillaries in connective tissue and muscle (rbc: red blood cell))
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Capillaries (A,B) and arteriole (C) with pericytes (P).Capillaries (A,B) and arteriole (C) with pericytes (P).
Pericytes regulate the regeneration of microvessels (angiogenesiPericytes regulate the regeneration of microvessels (angiogenesis).s).
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PP
PP
PP
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Continuous capillary (A) and fenestrated capillary (B).Continuous capillary (A) and fenestrated capillary (B).
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Originates from the left ventricle: ascending aorta, aortic archOriginates from the left ventricle: ascending aorta, aortic arch, descending, descending
AORTA AORTA
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Originates from the left ventricle: ascending aorta, aortic archOriginates from the left ventricle: ascending aorta, aortic arch , descending , descending
aorta. Thoracic aorta, abdominal aorta. Abdominal aorta dividesaorta. Thoracic aorta, abdominal aorta. Abdominal aorta divides at the levelat the level
of L4 into common iliac arteries. The common iliac arteries furtof L4 into common iliac arteries. The common iliac arteries further divideher divide
into external iliac and internal iliac (hypogastric) arteries.into external iliac and internal iliac (hypogastric) arteries.
SUPERIOR VENA CAVA (SVC)SUPERIOR VENA CAVA (SVC)
The SVC transports venous blood from head, neck, upper limb andThe SVC transports venous blood from head, neck, upper limb and upperupper
trunk. Internal jugular veins and subclavian veins form the bractrunk. Internal jugular veins and subclavian veins form the brachiocephalichiocephalicvein. Their junction is called the venous angle of Pirogov. Thevein. Their junction is called the venous angle of Pirogov. The SVC is formedSVC is formed
by the right and left brachiocephalic veins.by the right and left brachiocephalic veins.
INFERIOR VENA CAVA (IVC)INFERIOR VENA CAVA (IVC)
The IVC commences at L4 in the abdominal cavity from the two comThe IVC commences at L4 in the abdominal cavity from the two commonmoniliac veins. The common iliac veins are formed by the internal iiliac veins. The common iliac veins are formed by the internal iliac veins andliac veins and
the external iliac veins.the external iliac veins.
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Aorta ascendens (3), arcus Aorta ascendens (3), arcus
aortae, aorta descendens (thoracica).aortae, aorta descendens (thoracica).
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Arcus aortae: Arcus aortae:
--Truncus brachiocephalicus (5)Truncus brachiocephalicus (5)
-- Arteria carotis communis sinistra (12) Arteria carotis communis sinistra (12)-- Arteria subclavia sinistra (14) Arteria subclavia sinistra (14)
Truncus brachiocephalicus (5):Truncus brachiocephalicus (5):
-- Arteria carotis communis dextra (16) Arteria carotis communis dextra (16)
-- Arteria subclavia dextra (18) Arteria subclavia dextra (18)
Arteria subclavia (14,18): Arteria subclavia (14,18):
-- Arteria vertebralis (22) Arteria vertebralis (22)
-- Arteria thoracica interna (11) Arteria thoracica interna (11)
--Truncus costocervicalis (6)Truncus costocervicalis (6)
-- Arteria thyroidea inferior (9) Arteria thyroidea inferior (9)
Ribs are also visible.Ribs are also visible.
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Subclavian arterySubclavian artery
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Subclavian arterySubclavian artery
•• Origin: brachiocephalic trunk (right), aorticOrigin: brachiocephalic trunk (right), aorticarch (left). Between clavicle and first rib itarch (left). Between clavicle and first rib it
becomes the axillary artery.becomes the axillary artery.
••
Three sections from its origin: (1) from originThree sections from its origin: (1) from origin
to the scalenus anterior muscle; (2) behindto the scalenus anterior muscle; (2) behind
the scalenus anterior muscle; (3) from thethe scalenus anterior muscle; (3) from the
muscle to the edge of the first rib.muscle to the edge of the first rib.
•• Branches supply neck tissues, upper chestBranches supply neck tissues, upper chestwall and UL.wall and UL.
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Branches of the subclavian arteryBranches of the subclavian artery
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•• Vertebral arteryVertebral artery: supplies the brain and: supplies the brain andspinal cordspinal cord
•• Internal thoracic arteryInternal thoracic artery: supply the chest wall: supply the chest wall
•• Thyrocervical trunkThyrocervical trunk: (1) inferior thyroid: (1) inferior thyroidartery; (2) superfical cervical artery; (3)artery; (2) superfical cervical artery; (3)
suprascapular artery; (4) transverse cervicalsuprascapular artery; (4) transverse cervical
arteryartery
•• Costocervical trunkCostocervical trunk: (1) deep cervical artery;: (1) deep cervical artery;(2) superior intercostal artery(2) superior intercostal artery
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Subclavian branches supplying theSubclavian branches supplying the
h ld ih ld i
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shoulder regionshoulder region
•• Suprascapular arterySuprascapular artery: supplies the supraspinatus: supplies the supraspinatusand infraspinatus muscles, the clavicle, scapula,and infraspinatus muscles, the clavicle, scapula,acromioclavicular and glenohumeral joints.acromioclavicular and glenohumeral joints.Anastomosing with the branches of the circumflexAnastomosing with the branches of the circumflex
scapular artery.scapular artery.•• Dorsal scapular arteryDorsal scapular artery: runs from the superior angle: runs from the superior angle
(scapula) down along the medial scapular border.(scapula) down along the medial scapular border.Supplies scapula and muscles on it. AnastomosingSupplies scapula and muscles on it. Anastomosingwith branches of the subscapular artery. The dorsalwith branches of the subscapular artery. The dorsalscapular artery can be a separate branch from thescapular artery can be a separate branch from thesubclavian artery, or it may be the strong branch ofsubclavian artery, or it may be the strong branch ofthe transverse cervical artery.the transverse cervical artery.
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Subclavian vein, axillary veinSubclavian vein, axillary vein
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Subclavian vein, axillary veinSubclavian vein, axillary vein
•• Subclavian vein runs together with artery.Subclavian vein runs together with artery.•• Axillary vein is continuation of the basilicAxillary vein is continuation of the basilic--
brachial veins (which forms uniting basilicbrachial veins (which forms uniting basilicand brachial veins).and brachial veins).
•• Axillary vein receives the cephalic vein in theAxillary vein receives the cephalic vein in thedeltopectoral trigone.deltopectoral trigone.
•• Subclavian and internal jugular veins formSubclavian and internal jugular veins formthe brachiocephalic vein. The angle of thethe brachiocephalic vein. The angle of thetwo veins is called venous angle. Venoustwo veins is called venous angle. Venousangle is the site of junction of largeangle is the site of junction of largelymphatic trunks (thoracic duct and rightlymphatic trunks (thoracic duct and rightlymphatic duct).lymphatic duct).
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Recommended handout
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Recommended handout
• Mihály, A.: Myology Notes. Free access
for students from the webpage of the Anatomy Department.
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Picture sources
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c u e sou ces
• Anatomy Collection, Department of Anatomy, Szeged.• Histology collection, Department of Anatomy, Szeged.
• Standring, S (Chief Editor): Gray’s Anatomy. 40thEdition. Churchill-Livingstone, 2008.
• Fawcett, DW: A textbook of histology. Saunders,Philadelphia, 1986.
• Delavier, F: Strength Training Anatomy. Human Kinetics,2006.
• Weir, J, Abrahams, PH: Imaging atlas of human
anatomy. Mosby-Wolfe, 1997.• Thiel, W: Photographic atlas of practical anatomy.
Springer, 1997.
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