Fistulous communication between internal mammary and pulmonary arteries

The female breast is a hemispheric projection of variable size positioned anterior to the pectoralis major and serratus anterior muscles. A fascia layer composed of dense, irregular connective tissue connects it to these muscles.
Each breast features a pigmented projection known as the nipple, through which milk emerges via closely spaced openings of ducts, referred to as lactiferous ducts. Surrounding the nipple is a circular pigmented area of skin named the areola, which appears rough due to...

The pulmonary circulation is a vital system in our body that acts as a bridge between the respiratory and cardiovascular systems. It serves as a transport network for deoxygenated blood from the heart to the lungs and then returns oxygen-rich blood back to the heart.
The process begins with the right ventricle of the heart pumping deoxygenated blood into the pulmonary trunk. This large vessel extends about 5 centimeters before splitting into the left and right pulmonary arteries. These arteries...

The heart, an organ critical to survival, gets nourishment not from the blood it pumps but from a separate circulation system known as coronary circulation. This is the shortest circulation in the body and is responsible for supplying the heart with the nutrients it needs to function effectively.
Coronary circulation begins at the base of the aorta, where two main arteries arise—the left and right coronary arteries. These arteries encircle the heart in the coronary sulcus and supply the...

Fetal circulation is a unique system that facilitates the exchange of gases, nutrients, and waste products between the developing fetus and the mother. This intricate process takes place through a special organ called the placenta.
Two umbilical arteries transport blood from the fetus to the placenta. At the placenta, the blood absorbs oxygen and nutrients while simultaneously eliminating waste products. This oxygen-enriched and nutrient-rich blood then returns to the fetus through one...

The systemic and pulmonary circuits are crucial components of the circulatory system, working together to transport blood between the heart, lungs, and the rest of the body. The process begins with pulmonary circulation, where deoxygenated blood is pumped from the right ventricle to the lungs via the pulmonary trunk and arteries. Upon reaching the lungs, the blood becomes oxygenated and returns to the heart, specifically to the left atrium, via the pulmonary veins.
The oxygenated blood is sent...

Auscultation, an essential part of a heart examination, is done using a stethoscope. It provides crucial information about heart function and possible heart problems. Due to heart problems, abnormal sounds can be heard during systole or diastole. These sounds include S3 and S4 gallops, opening snaps, systolic clicks, and murmurs.
Abnormal Heart Sounds
Gallops: