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The aorta is the root systemic artery.
Instead of coming from the pulmonary trunk, supply develops from the aorta and other systemic arteries.
Systemic arteries deliver blood to the arterioles, and then to the capillaries, where nutrients and gases are exchanged.
The lungs are perfused via extensive collaterals from the systemic arteries, and sometimes also via the ductus arteriosus.
Doppler studies are helpful to identify the characteristic aberrant systemic artery that arises from the aorta and to delineate venous drainage.
In this case, the cyanosis is most likely due to blood that moves from the systemic veins to the systemic arteries via a right-to-left shunt without ever going through the lungs.
The arterial system of the human body is divided into systemic arteries, carrying blood from the heart to the whole body, and pulmonary arteries, carrying deoxygenated blood from the heart to the lungs.
In addition, deoxygenated blood that is carried from the tissues back to the heart for reoxygenation in systemic circulation still carries some oxygen, though it is considerably less than that carried by the systemic arteries or pulmonary veins.
Systemic arteries are the arteries (including the peripheral arteries), of the systemic circulation, which is the part of the cardiovascular system that carries oxygenated blood away from the heart, to the body, and returns deoxygenated blood back to the heart.
Systemic arteries can be subdivided into two types - muscular and elastic - according to the relative compositions of elastic and muscle tissue in their tunica media as well as their size and the makeup of the internal and external elastic lamina.
Inhaled nitric oxide vasodilates, decreasing pulmonary arterial pressure (PAP) and pulmonary vascular resistance (PVR) without affecting systemic artery pressure because it is rapidly inactivated by hemoglobin, and improves oxygenation by redistributing pulmonary blood flow to ventilated areas of lung.