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



MUSCLEMUSCLE – – FASCICLEFASCICLE – – FIBERFIBER

(EPIMYSIUM, PERIMYSIUM, ENDOMYSIUM)(EPIMYSIUM, PERIMYSIUM, ENDOMYSIUM)

2



MORPHOLOGICAL VARIETIES OF SKELETAL MUSCLEMORPHOLOGICAL VARIETIES OF SKELETAL MUSCLE

(MUSCLES AS ORGANS)(MUSCLES AS ORGANS)

3



4



Skeletal muscle:Skeletal muscle:electron microscopyelectron microscopy

5



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

6



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)

7



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



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

9



Sensory nerve endingsSensory nerve endings

in muscle: muscle spindle (A)in muscle: muscle spindle (A)

tendon organ (B)tendon organ (B)

10



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



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



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

13



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.

14



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

16



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



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.

20

MOVEMENTS IN THE SHOULDER GIRDLEMOVEMENTS IN THE SHOULDER GIRDLE



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).

21



Abduction and elevation of the arm with the

concomitant movements (rotation) of the

scapula on antero-posterior X-ray pictures.

22



Trapezius muscle

Deltoid muscle

Pectoralismajor

Deltopectoral

triangle

23



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

26



Shoulder:

strong elevation

and depression,with some

protraction at the

end of movement

(trapezius, levator scapulae,

rhomboids).

27



Shoulder:

strong elevation

and depression(trapezius).

28



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



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,



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.



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



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)



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



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



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



•• 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



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



Arteriole: scanning EM

Smooth muscle cells

47

Arteriole: electron microscopic structure. Arteriole: electron microscopic structure.



48

Contracted arteriole under the electron microscope.



49

Arterioles (1 Arterioles (1--4) and capillaries4) and capillaries

(asterisk shows metarteriole)(asterisk shows metarteriole)



( )( )

1122

33

44

**

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Types of capillaries:Types of capillaries:



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).



PP

PP

PP

53



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



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).



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



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



•• 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



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



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



Recommended handout

• Mihály, A.: Myology Notes. Free access

for students from the webpage of the Anatomy Department.

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Picture sources



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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2014 1 02 Introduction to Myology and Angiology

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