The blanks in your question should be filled in as
follows:
I. Vena
cava
Tricuspid valve
Pulmonic
valve
Lungs
II.
Lungs
Mitral valve
Aortic
Valve
Aorta
The
above cycle traces blood as it passes in the un-oxygenated state from the vena cava
through the heart to the lungs. In the lungs the blood is oxygenated, then passes
through the left heart where it is pumped through the aorta to the rest of the body. As
oxygenated blood leaves the heart into the aorta it also passes into the openings of the
coronary arteries (ostia which are located in the cusps of the aortic valve), providing
oxygen to the heart itself. Thus, there are pulmonary (lung), cardiac and systemic
segments of the circulatory system.
Starting
with deoxygenated blood in the vena cavae, the structures in order of blood flow is as
follows:
1. Superior and Inferior Vena
Cavae
2. Right Atrium
3.
Tricuspid Valve
4. Right
Ventricle
5. Pulmonic
Valve
6. Pulmonary Artery
7.
Right and Left Main Pulmonary Arteries
8. Pulmonary
circulation (pulmonary arteries, arterioles, capillaries, venules and
veins)
9. Right and Left Pulmonary
Veins
10. Left Atrium
11.
Mitral Valve
13. Left
Ventricle
14. Coronary Circulation (left and right
coronary arteries and left circumflex artery)
15.
Ascending Aorta
16. Aortic
Arch
17. Large arteries to upper
body
18. Descending
Aorta
19. Lower Thoracic
Aorta
20. Abdominal
Aorta
21. Large Arteries to lower
body
22. Organ vascular beds (arteries, arterioles,
capillaries, venules, veins)
23. Superior and Inferior
Vena Cavae
And so on, as the cycle
repeats.
Coronary
Circulation:
As opposed to the systemic circulatory system
(which provides blood to all organs other than the heart), the coronary system provides
blood to the heart itself. The right and left coronary arteries arise as openings at
the base of the right and left cusp of the aortic valve in the form of ostia…the right
and left coronary ostia. The left main coronary artery gives off the left anterior
descending (LAD) coronary artery with passes down along the anterior aspect of the left
ventricle. It also gives rise to the left circumflex coronary artery that passes
posteriorly. The right main coronary artery passes around the right upper portion of
the heart and gives rise to the posterior descending branch that passes down the
posterior aspect of the right ventricle.
The
commonest sites of coronary artery occlusion (obstruction) leading to heart attacks are
the proximal right coronary artery (usually s few centimeters from the right coronary
ostium), and the proximal LAD (usually about one or two centimeters below or distal to
the LAD’s origin from the left main coronary artery). Coronary occlusions occur at the
sites where there has been a build-up of arteriosclerotic plaque. They can be from
coronary thrombosis (clotting at the plaque site) or spasm of the
vessel.
Systemic Circulation: As opposed to the
coronary circulation the systemic circulation constitutes the circulation to the entire
body other than the heart. It begins after the aortic valve where blood has left the
heart, and ends in the superior and inferior vena cavae that bring deoxygenated blood
from the organs back to the
heart.
Summary:
The
heart pumps blood through the lungs to become oxygenated, then through the coronary
circulation to supply oxygen to the heart itself, then through the systemic circulation
to supply the entire remainder of the body.
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