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Blood from the ductus venosus thus mixes with deoxygenated blood from the inferior vena cava and hepatic veins AS. Due to the relatively minimal admixture of deoxygenated blood, it remains well oxygenated and passes via the inferior vena cava to the right atrium A9. From there the blood is directed by the valve of the inferior vena cava toward the foramen ovale Al0 that lies in the septum between the right and left atria and connects them. Most of the blood reaches the left atrium All , passes from there into the left ventricle A12 and flows via the branches of the aortic arch AB to the heart, head, and upper limbs.
Deoxygenated blood from the head and arms of the fetus flows through the superior vena cava A14 into the right atrium and crosses the bloodstream from the inferior vena cava to reach the right ventricle A1S , passing from there into the pulmonary trunk A1G.
A minimal amount of blood passes through the pulmonary arteries A17 into the not yet aerated lungs and from there through the pulmonary veins A1S to the left atrium All.
Most of the blood from the pulmonary trunk flows directly into the aorta through the ductus arteriosus A19 , a shunt connecting the bifurcation of the pulmonary trunk or left pulmonary artery with the aorta.
The branches given off by the portion of the aorta after the connection of the ductus arteriosus thus receive blood with a lower oxygen concentration before the connection which supply the head and upper limbs. A considerable amount of blood from the fetal aorta is returned to the placenta through the paired umbilical arteries A Circulatory Adjustments at Birth B At birth the fetal circulation is converted into postnatal circulation.
With the first cry of the infant, the lungs are inflated and aerated reducing resistance in the pulmonary circulation which in turn increases the volume of blood flowing from the pulmonary trunk into the pulmonary arteries.
The blood is oxygenated in the lungs and transported by the pulmonary veins into the left atrium. The right of J.
Gosling, P. Harris, J.
Humpherson, I. Whitmore and P.
No part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, photocopying, recording or otherwise, without the prior permission of the Publishers. Standard safety precautions must be followed, but as new research and clinical experience broaden our knowledge, changes in treatment and drug therapy may become necessary or appropriate.
Readers are advised to check the most current product information provided by the manufacturer of each drug to be administered to verify the recommended dose, the method and duration of administration, and contraindications.
It is the responsibility of the practitioner, relying on experience and knowledge of the patient, to deter- mine dosages and the best treatment for each individual patient.
The Publisher Printed in Spain Last digit is the print number: 9 8 7 6 5 4 3 2 1 Working together to grow libraries in developing countries www. Typically the illustra- tions and text are grouped together on the left and right sides of self-contained spreads, making for easy cross-reference.
In addition, all the diagrams accompanying the dis- sections have been checked and, where necessary, amended to improve clarity and accuracy.
Several free-standing diagrams, including those illustrating dermatomes, have been redrawn. The introductory pages for the chapters on the abdomen and back have been expanded and improved. In many institutions changing educational approaches have resulted in the phasing out of traditional topographical anatomy courses that included dissection. In their place have appeared integrated courses which incorporate imaging and clinical ana- tomical relevance.