The pulmonary vein carries arterial blood. Pulmonary veins. Bronchial veins. Pulmonary diseases. Cold

Veins of the right lung. The veins of the lung from the side of the mediastinum lie more superficial than the arteries. While the arteries go along with the bronchi in the thickness of the lobe and segment, the veins are located along the periphery of the segment and, collecting blood from the segments and lobes, merge into 2 large pulmonary veins.

Veins of the upper and middle lobes. The veins of the upper and middle lobes on the right are collected into one upper pulmonary vein. The location and number of branches varies. The first and more superficial branch of the superior pulmonary vein is called, according to A. V. Melnikov, the superior vein. It is formed from the confluence of 2 veins - apical and anterior.
Second vein, which occurs in the anterior approach, is the inferior vein of the superior lobe. It runs along the lower edge of the upper lobe at the level of the horizontal fissure.

The third, larger and deeper vein of the upper lobe - the posterior vein, is formed from the confluence of 3 small branches. Two veins of the middle lobe flow into the upper pulmonary vein in 1 or 2 trunks.

Veins of the lower lobe. All veins of the right lower lobe flow into the inferior pulmonary vein, which enters the left atrium not only below, but also behind the superior pulmonary vein. It is, as it were, hidden by the lower lobe and the anterior layer of the pulmonary ligament stretched upward. This vein is best seen from the posterior surface.
Inferior pulmonary vein it is formed from the superior lobar or apical vein, which itself is often formed from 2 branches and 4 inferior segmental veins.

Veins of the left lung. As on the right, the veins of the left lung are most often collected in 2 large veins - the upper and lower, which flow into the left atrium. In this case, the veins of the upper lobe flow into the superior pulmonary vein, and the lower lobe into the lower one.

Veins of the upper lobe. 3 large veins of the upper lobe, merging, form the upper. The superior lobar vein, according to A. V. Melnikov, has an unequal relation to the arteries. In the first variant, its main branch lies more superficial than its corresponding artery. In the second case, the vein supplying the apex goes deeper than the artery and fits under the ascending artery, located in the gap between its branches. Both options are equally common.
Second vein(middle) is formed from the confluence of 2 veins. Its length is insignificant and ranges from 0.5 to 2 cm.

third vein- lower lobar - is formed from the confluence of 2, upper and lower, lingular veins. Thus, 3 instead of 4 or 5 flow into the left upper pulmonary vein on the right.

Veins of the lower lobe located below and deeper than the arteries. Hence, they are more hidden and better protected than the arteries. The veins of the lower lobe repeat the course of the same arteries, with the exception of the terminal sections. All veins of the left lower lobe empty into the inferior pulmonary vein. The superior vein, larger and independent, abruptly separates from the underlying ones and is formed from 3 branches.

Next, edge, vein sometimes merges with the previous one just before it flows into the lower pulmonary vein. And finally, 2 or 3 veins come from the lower anterior and lower posterior segments of the lobe.
Bronchial veins multiple and are located around the main bronchus in the form of thin venous trunks. Their number is very variable.

Of great interest is the fact that bronchial veins have distinct anastomoses with branches of the pulmonary veins. When ligating the pulmonary veins in the experiment, an extensive network of fairly large venous trunks develops in the region of the lung root, through which the outflow of venous blood from the lung into the system of vena cava (in v. azygos, etc.) occurs.

The works of recent years show that in a fairly large number there are interlobar and intersegmental vascular anastomoses(E.V. Serova and others) as well as arteriovenous anastomoses of the lungs (A.V. Ryvkind, N.S. Berlyand). At the same time, undoubted anastomoses were established between the system of bronchial and pulmonary arteries. Taken together, it explains the ineffectiveness of ligation of the lobar artery and the inconsistent effect of ligation of the main branch of the pulmonary artery.

The heart is formed from the mesoderm in the form of a paired anlage at the stage of 1-3 somites (the 17th day of embryo development). From this bookmark is formed simple tubular heart, located in the neck. It passes anteriorly into the primitive bulb of the heart, and posteriorly into the dilated venous sinus. The anterior (head) end of a simple tubular heart is arterial, and the posterior end is venous. The middle section of the tubular heart grows intensively in length, bends in the ventral direction in the form of an arc in the sagittal plane. The top of this arc is the future apex of the heart. The lower (caudal) section of the arc is the venous section of the heart, the upper (cranial) section is the arterial section. A simple tubular heart, having the form of an arc, is bent counterclockwise in an S-shape, converted into sigmoid heart. An atrioventricular sulcus (future coronal) is formed on its outer surface. The common atrium grows rapidly, from behind it covers the arterial trunk, on the sides of which two protrusions are visible in front - the tabs of the right and left ears. The atrium and ventricle are connected by a narrow atrioventricular canal, in the walls of which ventral and dorsal thickenings are formed - atrioventricular endocardial ridges (atrioventricular valves develop further from them). Four endocardial ridges (future valves of the aorta and pulmonary trunk) are formed at the mouth of the arterial trunk.

The atrial septum begins to develop at the 4th week of embryogenesis; it grows towards the atrioventricular canal and divides the common atrium into right and left. From the side of the upper posterior wall of the atrium, a secondary (interatrial) septum grows, fusing with the primary and completely separating the right and left atria. At the beginning of the 8th week, a fold forms in the posterior ventricle, growing forward and upward, towards the endocardial ridges and forming the interventricular septum. At the same time, two longitudinal folds are formed in the arterial trunk, growing in the sagittal plane towards each other and downward (towards the interventricular septum). These folds join together and form a septum that separates the ascending aorta from the pulmonary trunk. After the formation of the interventricular and aortopulmonary septum in the embryo, the heart becomes four-chambered. The foramen ovale (in the interatrial septum) closes only after birth, when the small (pulmonary) circulation begins to function.

The development and growth of the heart is not equally active in different age periods. The processes of growth and differentiation are rapidly carried out at the age of up to 2 years. Between the ages of 2 and 10, differentiation proceeds more slowly, its pace accelerating during puberty. Fully the formation of the heart is completed by 27-30 years.

With the complexity of the structure of the heart, its numerous developmental variants and anomalies are associated. Individually vary the size and weight of the heart, the thickness of its walls, the number of valves at the valves of the heart (from 3 to 7 for each of them). The shape and topography of the fossa ovale are very variable, which can be round, pear-shaped, triangular, shift to the upper-lower (high) or antero-lower (low) position in the interatrial septum. With a high position of the oval fossa, its posterior edge is close to the mouths of the inferior vena cava and the coronary sinus, with a low position - to the right atrioventricular opening. The papillary muscles vary in number and shape, they are cylindrical (mostly), often multi-headed, less often cone-shaped. The number of papillary muscles in the right ventricle varies from 2 to 9, in the left - from 2 to 6 and does not always correspond to the number of valves.

The topography and the number of blood vessels of the heart vary individually, the number of coronary arteries varies from 1 to 4. Arteries are more often divided according to loose, less often - according to the main type. The division of the coronary arteries into branches occurs at an acute angle (50-80 °), less often at right and obtuse angles. More often there is a uniform type of blood supply to the heart (68%), less often - "right coronary" (blood supply mainly by the right coronary artery, 24%) or "left coronary" (8%). The location of the orifices of the coronary arteries can be at the level of the free edge of the aortic valve, the middle of the semilunar valves, or at the level of their bases. The coronary sinus can be cylindrical, arcuate, bean-shaped, retort-shaped or spherical. There may be a hole in the valve of the coronary sinus, fibrous sutures are sometimes attached to it.

Individually vary the structure and topography of the conducting system of the heart, especially the atrioventricular bundle, often passing through the thickness of the membranous part of the interventricular septum. Sometimes there are one or two additional atrioventricular bundles that "cross" the right fibrous ring separately from the main bundle and pass into the myocardium of the posterior interventricular septum or the anterior wall of the right ventricle. The course and direction of the right and left legs of the bundle of His vary individually. With a loose form of the structure of the His bundle, the left leg branches off not only from it, but also from the atrioventricular node. This leg has a wide base (beginning area), it breaks up into separate fibers that go to the myocardium of the interventricular septum. With the main character of the structure, the left leg is divided into 2-4 branches, going to the anterior and posterior papillary muscles and reaching the apex of the heart. The right leg of the bundle of His can be located both in the myocardium (more often) and directly under the endocardium.

Table of contents of the subject "Vessels of a small (pulmonary) circle of blood circulation.":

Veins of the small (pulmonary) circulation. Pulmonary veins.

Venae pulmonales, pulmonary veins, carry arterial blood from the lungs to the left atrium. Starting from the capillaries of the lungs, they merge into larger veins that go respectively to the bronchi, segments and lobes, and in the gates of the lungs they fold into large trunks, two trunks from each lung (one is upper, the other is lower), which go in a horizontal direction to the left atrium and flow into its upper wall, and each trunk flows into a separate hole: the right ones - at the right, the left ones - at the left edge of the left atrium. The right pulmonary veins cross the posterior wall of the right atrium on their way to the left atrium. Symmetry of the pulmonary veins(two on each side) is obtained because the trunks emerging from the upper and middle lobes of the right lung merge into one trunk. The pulmonary veins are not completely separated from the veins of the systemic circulation, since they anastomose with the bronchial veins that flow into v. azygos. Pulmonary veins do not have valves.

From the capillaries of the lung, venules begin, which merge into larger veins and form two pulmonary veins in each lung.

Of the two right pulmonary veins, the upper one has a larger diameter, since blood flows from the two lobes of the right lung (upper and middle) through it. Of the two left pulmonary veins, the inferior vein has the larger diameter. In the gates of the right and left lungs, the pulmonary veins occupy their lower part. In the posterior upper part of the root of the right lung is the main right bronchus, anterior and downward from it is the right pulmonary artery. At the top of the left lung is the pulmonary artery, behind and below it is the left main bronchus. In the right lung, the pulmonary veins lie below the artery, run almost horizontally, and, on their way to the heart, lie behind the superior vena cava, the right atrium, and the ascending aorta. Both left pulmonary veins, which are somewhat shorter than the right ones, are located under the left main bronchus and also go to the heart in a transverse direction, anterior to the descending part of the aorta. The right and left pulmonary veins, piercing the pericardium, flow into the left atrium (their terminal sections are covered with the epicardium).

Right superior pulmonary vein(v.pulmonalis dextra superior) collects blood not only from the upper, but also from the middle lobe of the right lung. From the upper lobe of the right lung, blood flows through three veins (tributaries): apical, anterior and posterior. Each of them, in turn, is formed from the confluence of smaller veins: intrasegmental, intersegmental and others. From the middle lobe of the right lung, the outflow of blood occurs in the e-not the middle lobe (v.lobi medii), which is formed from the lateral and medial parts (veins).

Right inferior pulmonary vein(v.pulmonalis dextra inferior) collects blood from five segments of the lower lobe of the right lung: upper and basal - medial, lateral, anterior and posterior. From the first of them, blood flows through the upper vein, which is formed as a result of the merger of two parts (veins) - intrasegmental and intersegmental. From all basal segments, blood flows through common basal vein formed from two tributaries - the upper and lower basal veins. The common basal vein merges with the superior vein of the lower lobe to form the right inferior pulmonary vein.

Left superior pulmonary vein(v.pulmonalis sinistra superior) collects blood from the upper lobe of the left lung (its apical-posterior, anterior, as well as the upper and lower reed segments). This vein has three tributaries: the posterior apex, anterior, and lingual veins. Each of them is formed from the fusion of two parts (veins): posterior apex vein- from intrasegmental and intersegmental; anterior vein- from intrasegmental and intersegmental and reed vein- from the upper and lower parts (veins).

Left inferior pulmonary vein(v.pulmonalis sinistra inferior) larger than the right vein of the same name, carries blood from the lower lobe of the left lung. From the upper segment of the lower lobe of the left lung departs superior vein, which is formed from the fusion of two parts (veins) - intrasegmental and intersegmental. From all the basal segments of the lower lobe of the left lung, as in the right lung, blood flows down common basal vein. It is formed from the merger superior and inferior basal veins. The anterior basal vein flows into the upper one, which, in turn, merges from two parts (veins) - intrasegmental and intersegmental. As a result of the confluence of the superior vein and the common basal vein, the left inferior pulmonary vein is formed.