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FETAL CIRCULATION 1. Oxygenated blood enters the umbilical vein from the placenta 2. Enters ductus venosus 3.

Passes through inferior venacava 4. Enters the right atrium 5. Enters the foramen ovale 6. Goes to the left atrium 7. Passes through left ventricle 8. Flows to ascending aorta to supply nourishment to the brain and upper extremeties 9. Enters superior vena cava 10. Goes to right atrium 11. Enters the right ventricle 12. Enters pulmonary artery with some blood going to the lungs to supply oxygen and nourishment 13. Flows to ductus arteriosus 14. Enters descending aorta ( some blood going to the lower extremeties) 15. Enters hypogastric arteries 16. Goes back to the placenta

Special Structures in Fetal Circulation Placenta Where gas exchange takes place during fetal life Umbilical Arteries Carry unoxygenated blood from the fetus to placenta Umbilical Vein Brings oxygenated blood coming from the placenta to the fetus

Foramen Ovale Connects the left and right atrium. It pushes blood from the right atrium to the left atrium so that blood can be supplied to brain, heart and kidney Ductus Venosus - Carry oxygenated blood from umbilical vein to inferior venacava, bypassing fetal liver Ductus Arteriosus - Carry oxygenated blood from pulmonary artery to aorta, bypassing fetal lungs.

PULMONARY CIRCULATION
is the portion of the cardiovascular system which carries oxygen-depleted blood away from the heart, to the lungs, and returns oxygenated blood back to the heart. The term is contrasted with systemic circulation. A separate system known as the bronchial circulation supplies blood to the tissue of the larger airways of the lung. Course Pulmonary circulation is the movement of blood from the heart, to the lungs, and back to the heart again. De-oxygenated blood leaves the heart, goes to the lungs, and then re-enters the heart; oxygen poor blood leaves through the right ventricle through the pulmonary artery, the only artery in the body that carries oxygen-poor blood, to the capillaries where carbon dioxide diffuses out of the blood cell into the alveoli, and oxygen diffuses out of the alveoli into the blood. Blood leaves the capillaries to the pulmonary vein, the only vein in the body that carries oxygen-rich blood in the body, to the heart, where it re-enters at the left atrium. Right heart Oxygen-depleted blood from the body leaves the systemic circulation when it enters the right heart, more specifically the right atrium through the superior (upper) vena cava and inferior (lower) vena cava. The blood is then pumped through the tricuspid valve (or right atrioventricular valve), into the right ventricle. Blood is then pumped through the semilunar valve and into the pulmonary artery. Arteries From the right ventricle, blood is pumped through the pulmonary semilunar valve into the left and right pulmonary arteries (one for each lung) and travels through the lungs.

Lungs The pulmonary arteries carry deoxygenated blood to the lungs, where it releases carbon dioxide and pick up oxygen during respiration. Arteries are further divided in to very fine branches called the capillaries. In structure the capillaries are very thin walled. Their function is to carry blood to all cells of the body. Veins The oxygenated blood then leaves the lungs through pulmonary veins, which return it to the left heart, completing the pulmonary cycle. This blood then enters the left atrium, which pumps it through the bicuspid valve, also called the mitral or left atrioventricular valve, into the left ventricle. The blood is then distributed to the body through the systemic circulation before returning again to the pulmonary circulation. Embryonic The pulmonary circulation loop is virtually bypassed in fetal circulation. The fetal lungs are collapsed, and blood passes from the right atrium directly into the left atrium through the foramen ovale, an open passage between the two atria. When the lungs expand at birth, the pulmonary pressure drops and blood is drawn from the right atrium into the right ventricle and through the pulmonary circuit. Over the course of several months, the foramen ovale closes, leaving a shallow depression known as the fossa ovalis in the adult heart.

Pulmonary circulation is the system through which blood is oxygenated. Deoxygenated blood is sent from the heart to the lungs where it gathers oxygen, leaves carbon dioxide behind, and is sent back to the heart to be distributed to the rest of the body. Pulmonary circulation is a part of the larger circulatory system. Basically, the circulatory system is the transport system of the body. Blood travels through a vast system of blood vessels, carrying everything from nutrients to hormones to water before cycling back through the heart. In a simpler sense, the circulatory system is composed of two loops: the pulmonary circulation loop and the systemic circulation loop. Systemic circulation refers to the system through which oxygenated blood is sent out into the body and then returns to the heart after delivering its oxygen to distant cells. In the pulmonary circulation loop, the blood is oxygenated in preparation for entering the systemic loop again. A blood cell circulation when trip around the the right atrium the atrium, the blood into the then through a pulmonary pulmonary and carries the lungs. enters pulmonary it returns from its body and enters of the heart. From heart pushes the right ventricle and valve to the artery. The artery splits in two blood to both

in the lungs, the arteries branch into ever smaller tubes, eventually pushing the blood through tiny vessels called capillaries. The average diameter of a capillary is about eight microns, or roughly the size of one blood cell. Capillaries are spread over the walls of the minute air sacs in the lungs, called alveoli, where oxygen diffuses through the walls of capillaries and is picked up by the blood cells. The blood cells, in turn, drop the waste carbon dioxide they have been carrying into the lungs, allowing it to be exhaled. Now laden with oxygen, the blood cells are sent back toward the heart. The tiny capillaries segue into pulmonary veins, which merge into ever larger ones until there are two from each lung. These are referred to as the right superior and inferior pulmonary veins and the left superior and inferior pulmonary veins. All of them, however, empty into the left atrium of the heart. With a contraction of the heart muscle, the blood will be forced into the left ventricle and out the left pulmonary artery and back into the systemic loop.

SYSTEMIC CIRCULATION
is the system of blood vessels and associated tissues that supplies blood, and hence oxygen, to all parts of the body. Oxygenated Blood Oxygenated blood leaves the lungs and enters the Left Atrium (LA) of the heart via the pulmonary veins.

This oxygenated blood is then pumped from the Left Atrium (LA) of the heart to the Left Ventricle (LV) of the heart, and then out of the heart to the body tissues via the aorta, which is the major artery leaving the heart. The aorta divides into other arteries that serve different parts of the body (as mentioned on the page about the structure of the heart). These can be separated

into two categories: blood supply to the upperbody, and blood supply to the lower-body.

Blood Supply to the Upper-Body: The aorta leads to the subclavian arteries that take blood to the arms (some of which eventually reaches the hands), and also to the carotid artery that carries blood to the head. Blood Supply to the Lower-Body: The aorta also leads to the hepatic artery that carries blood to the liver, the mesenteric artery that carries blood to the small intestines, the renal arteries that carry blood to the kidneys, and the iliac arteries that carry blood to the legs (some of which eventually reaches the feet.).

Return of Blood from the Upper-Body: Blood returns from the head via the jugular veins, and from the arms via the subclavian veins. All of the blood in the major veins of the upper body flows into the superior vena cava, which returns the blood to the right ventricle of the heart. Return of Blood from the Lower-Body: Blood returns from the small intestines by passing through the hepatic portal vein to the liver. Blood returns from the liver via the hepatic vein, from the kidneys via the renal veins, and from the legs via the iliac veins. All of the blood in the major veins of the lower body flows into the inferior vena cava, which returns the blood to the right ventricle of the heart. After re-entering the (right atrium of the) heart via the superior vena cava and the inferior vena cava, deoxygenated blood is pumped into the right ventricle of the heart and then out of the heart to the lungs via the pulmonary artery. Deoxygenated blood enters the lungs and is oxygenated before leaving the lungs (as oxygenated blood), and so the cycle begins again. Systemic circulation refers to the part of the circulatory system in which the blood leaves the heart, services the body's cells, and then reenters the heart. Blood leaves through the left ventricle to the aorta, the body's largest artery. The aorta leads to smaller arteries, arterioles, and finally capillaries. Waste and carbon dioxide diffuse out of the cell into the blood and oxygen in the blood diffuses out of the blood and into the cell, blood then moves to venious capillaries, and then the vena cave: the lower inferior vena cave and the upper superior vena cave , through which the blood re-enters the heart at the right atrium.

Deoxygenated Blood Blood is deoxygenated when it leaves the tissues and organs it has supplied with oxygen and other nutrients, to return back to the pulmonary circulatory system. This can also be summarized for the upperbody and lower-body separately:

Arteries Oxygenated blood enters the systemic circulation when leaving the left ventricle, through the aortic semilunar valve. The first part of the systemic circulation is the aorta, a massive and thick-walled artery. The aorta arches an branches into major arteries to the upper body before passing through the diaphragm, where it branches further into arteries which supply the lower parts of the body. Capillaries Veins After their passage through body tissues, capillaries merge once again into venules, which continue to merge into veins. The venous system finally coalesces into two major veins: the superior vena cava (roughly speaking draining the areas above the heart) and the inferior vena cava (roughly speaking from Right-Hand Side of the Heart The right-hand side of the heart receives deoxygenated blood from the body tissues (from the upper- and lower-body via the Superior Vena Cava and the Inferior Vena Cava, respectively) into the right atrium. This deoxygenated blood passes through the tricuspid valve into the right ventricle. This blood is then pumped under higher pressure from the right ventricle to the lungs via the pulmonary artery. Left-Hand Side of the Heart The left-hand side of the heart receives oxygenated blood from the lungs (via the pulmonary veins) into the left atrium. This oxygenated blood then passes through the bicuspid valve into the left ventricle. It is then pumped to the aorta under greater pressure (as explained below). This higher pressure ensures that the oxygenated blood leaving the heart via the aorta is effectively delivered to other parts of the body via the vascular system

areas below the heart). These two great vessels empty into the right atrium of the heart. Coronary vessels The heart itself is supplied with oxygen and nutrients through a small "loop" of the systemic circulation Portal veins The general rule is that arteries from the heart branch out into capillaries, which collect into veins leading back to the heart. Portal veins are a slight exception to this. In humans the only significant example is the hepatic portal vein which combines from capillaries around the gut where the blood absorbs the various products of digestion; rather than leading directly back to the heart, the hepatic portal vein branches into a second capillary system in the liver. What are the Functions of the Heart ? of blood vessels (incl. arteries, arterioles, and capillaries). How does the heart perform these functions ? The pump action performed by the heart is achieved by a sequence of alternating contraction and relaxation of the heart muscle (illustrated above). In this context the term "systole" refers to the contraction part of the sequence and the term "diastole" to the relaxation part of the sequence. Hence, the "systolic" and "diastolic" pressures may be measured and recorded separately when monitoring blood pressure. This process is directed by the nervous system, nerve impulses initiating each sequence. The whole series of actions that cause alternating contractions and relaxations may be summarized in five stages:

1. The vagus nerve stimulates the sinoatrial node (SAN), the pacemaker of the heart. The sinoatrial node (SAN) is a tiny area of specialized cardiac (meaning "heart") muscle in the upper wall of the right atrium, near the vena cava - as shown above. The fibres of the SAN contract rhythmically approx. 70 times each minute. After each of these contractions, the impulse is dispersed across the atrial cardiac muscle, leading to ... 2. .. simultaneous contraction of both the right and left atria. This movement of the cardiac muscle pushes blood from the atria into the ventricles (via the tricuspid and bicuspid valves). 3. The contractions of the atria send impulses down the Purkinje fibers, which in turn stimulate the

atrioventricular node (AVN). The atrioventricular node is a mass of modified cardiac muscle located in the lower/central part of the right atrium of the heart. The Purkinje fibres are referred to by various names in different textbooks, so are also known as "Purkyne Fibres", "Purkynje Fibres", and as the "Bundle of His". This/these are a bundle of modified cardiac muscle fibers that transmit impulses from the atra, via the AVN, to the ventricles. 4. The action potential from the impulse transmitted down the Purkinje fibers 5. ... ventricles to contract, which pushes blood upwards into the arteries that take the blood away from the heart (the pulmonary artery taking blood to the lungs, and the aorta taking blood to the body).

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