Major veins and arteries are found in similar locations deep beneath the skin and muscle tissue, making blood color and rate of bleeding important identifying factors. Some notable arteries and veins are located above the heart and in the neck, with the carotid arteries pumping blood to the brain and the jugular veins draining blood to the heart. Several large arteries and veins also run through the extremities, particularly in the upper arm with the brachial arteries and veins and in the upper leg with the femoral artery and vein. These are all connected to the major major vessels within the trunk, made up of the upper chest and the upper and lower abdomen. These large vessels connect to those in the extremities and head, as well as circulate through the internal organs, and for this reason these structures are not only susceptible to external bleeding but also internal bleeding (786, 811). Internal bleeding is another type of hemorrhage that can occur with hypovolemic shock and is caused by damage from a blunt force that damages internal organs or causes blood vessels inside the body to rupture, causing blood to leak into the body cavity. Traumatic force injuries can occur when a victim is in an automobile accident, where the force from impact on the steering wheel can cause a blunt blow to the chest or abdomen or break bones in the body that can damage internal structures. Internal bleeding can also result from an open wound, commonly with penetrating wounds such as those caused by a gunshot or knife (Red Cross 161). Other important causes of internal bleeding can be caused by vascular disorders, as in the case of aneurysms (Kolecki's "Cause"), which occur when high blood pressure causes the arterial wall to weaken and bulge, and possibly... .... possible further blood loss and to restore the body to the adequate volume of fluids (Kolecki "Emergency Department Care"). They first stabilize the airway, often placing the victim on "high-flow supplemental oxygen" and "ventilator support" when needed. An intravenous line will then be added, focusing on the central veins located on the inside of the arm, however when the fluids in these lines are not effective an arterial line may also be placed, especially in cases of severe blood loss. The fluid lines will contain a “lactated Ringer solution” or normal saline solution, which will help maximize circulation in the body and increase not only capillary exchange but can help stabilize blood volume. If fluid intake is not effective, the emergency room will intervene with a blood transfusion or by elevating the patient's legs to help blood flow to the heart and brain (Kolecki, “EDC.”).