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Pulmonary arteries and veins: want to learn more about it?

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Pulmonary arteries and veins

The pulmonary arteries and the pulmonary veins are the vessels of the pulmonary circulation; which means they are responsible for carrying the oxygenated blood to the heart from the lungs and carrying the deoxygenated blood from the heart to the lungs.

The pulmonary circulation is different than systemic in context that within the pulmonary circulation veins carry oxygenated blood, whereas the arteries carry deoxygenated blood. The difference originates from the fact that every blood vessel that transports the blood from the periphery to the heart is a vein, whereas the vessel that transports the blood from the heart to the periphery is an artery. 

Key facts
Pulmonary arteries Right ventricle -> pulmonary trunk -> right and left pulmonary arteries
Purpose: deliver deoxygenated blood to the respective lung
Pulmonary veins Lung capillaries -> 4 pulmonary veins (2 from each lung) -> left atrium
Purpose: deliver oxygenated blood to the left ventricle which will distribute it to the body
Clinical relations Pulmonary hypertension, heart failure, pulmonary embolism, hypoxia

In this article, we are going to discuss the gross and microscopic anatomy, structure, and function of the pulmonary vessels along with some high-yield clinical notes.

Anatomy

Embryologically, the pulmonary arteries originate from the truncus arteriosus (as does the aorta).

Pulmonary arteries

In the developed heart, the pulmonary trunk (pulmonary artery or main pulmonary artery) begins at the base of the right ventricle. The pulmonary trunk is a short and stout (wide) structure that is about 5 cm in length and 3 cm in diameter, which branches into 2 pulmonary arteries; the left and right pulmonary arteries, which act to deliver deoxygenated blood to its respective lung.

Sternocostal surface of the heart (overview)

Pulmonary veins

On the other hand, pulmonary veins are large blood vessels that receive oxygenated blood from the lungs to delivery to the rest of the body. There are 4 total pulmonary veins—with 2 pulmonary veins coming from each lung, left and right—that empty into the left atrium of the heart. Two pulmonary veins emerge from the hilus of each lung, and each pulmonary vein receives blood from 3-4 bronchial veins apiece before draining into the left atrium. The pulmonary veins are fixed to the pericardium travel alongside the pulmonary arteries.

Diaphragmatic surface of the heart (overview)

The right superior pulmonary vein passes in front of and a tad below the pulmonary artery at the root of the lung, and the inferior pulmonary vein is situated at the lowest part of the lung hilum. In reference to the heart, the right pulmonary veins pass behind the right atrium and superior vena cava return, and the left pulmonary veins pass in front of the descending thoracic aorta. Finally, the bronchus is located behind the pulmonary artery.

Medial view of the lungs in a cadaver: Both pulmonary blood vessels are located anterior to the bronchus. The pulmonary artery is superior to the pulmonary vein and has firmer, thicker walls compared to the latter.

Function

While veins usually carry deoxygenated blood from tissues back to the heart, in this case, pulmonary veins are among the few veins that carry oxygenated blood instead. Oxygenated blood from the lungs is circulated back to the heart through the pulmonary veins that drain into the left atrium. Once blood is pumped from the left atrium through the mitral valve into the left ventricle, this oxygenated blood will then be pumped from the left ventricle through the aortic valve to the rest of the body’s organs and tissues through the aorta.

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Deoxygenated blood that has circulated through the system will be collected from the superior vena cava and inferior vena cava, which drain into the right atrium of the heart. Once deoxygenated blood is pumped from the right atrium through the tricuspid valve into the right ventricle, contraction of the right ventricle will push blood through the pulmonic valve into the pulmonary artery that will carry deoxygenated blood to the lungs. Within the lungs, the blood passes through capillaries adjacent to alveoli and becomes oxygenated through respiration (breathing). Branches of the pulmonary artery travel closely alongside the bronchial tree on their way to the alveoli. However, the bronchial tree itself is supplied by the bronchial artery, which arises from the aorta and carries systemic blood. Each alveolus is surrounded by a nest of blood capillaries that are supplied by small branches of the pulmonary artery.

Check the following study units to learn more about the pulmonary arteries and veins and their relation to the hilum of the lungs and the heart. 

Overview of alveoli anatomy

In summary, the pulmonary circuit begins with the pulmonary trunk, which is a large vessel that ascends diagonally from the right ventricle and branches into the right and left pulmonary arteries. As the circuit approaches the lung, the right pulmonary artery branches into two arteries and both branches enter the lung at a medial indentation called the hilum of the lung. The upper branch is the superior lobar artery, which feeds into the superior lobe of the lung. The lower branch divides again within the lung to form the middle lobar and inferior lobar arteries that supply the lower 2 lobes of the lung since there are 3 lobes of the right lung. The left pulmonary artery is more variable in number and gives off several superior lobar arteries that feed into the superior lobe before entering the hilum of the lung to branch off into inferior lobar arteries that feed the left lower lung lobe.

Are you curious to find out more about the anatomy of the pulmonary arteries and veins and a condition called pulmonary embolism?

Histology of the arteries and veins

Large veins have diameters greater than 10 mm. They have some smooth muscle in all three tunics. They have a relatively thin tunica media with only a moderate amount of smooth muscle; the tunica externa is the thickest layer and contains longitudinal bundles of smooth muscle.

Large veins include the venae cavae, pulmonary veins, internal jugular veins, and renal veins. Since the pressure of the pulmonary veins cannot be easily measured, the pulmonary capillary wedge pressure is used instead, and the normal range is 2-15 mmHg. The pulmonary arteries have thin distensible walls with less elastic tissue than the systemic arteries. Thus, they have a blood pressure range of 15-30 mmHg systolic, and 4-12 mmHg diastolic.

Pulmonary arteries and veins: want to learn more about it?

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