ARTERIES AND VIENS Flashcards
Ascending aorta, aortic arch, thoracic aorta (course, syntopy, branches)
→
Key facts about the aorta
- Origin
- Left ventricle
- Branches
- Ascending aorta:
- Left and right coronary artery
- Arch of the aorta:
- Brachiocephalic trunk
- Left common carotid artery
- Left subclavian artery
- Descending thoracic aorta:
- Visceral branches: pericardial, bronchial, esophageal, mediastinal arteries
- Parietal branches: intercostal, subcostal arteries and superior phrenic arteries
- Descending abdominal aorta:
- Anterior group: celiac trunk, superior mesenteric, inferior mesenteric arteries
- Lateral group: suprarenal, renal, gonadal (testicular in males, ovarian in females) arteries
- Dorsal group: inferior phrenic arteries, lumbar arteries, median sacral artery
- Terminal branches: left and right common iliac artery
- Ascending aorta:
- Supply
- Entire body except for the lungs
Desending aorta:
- Largest part of the aorta.
- It arises as a continuation of the aortic arch after the branching of the left subclavian vein.
- Divided into the thoracic aorta and the abdominal aorta, which are anatomically separated by the diaphragm.
Thoracic aorta
- Begins at the level of the T4 vertebra and courses downwards through the posterior mediastinum→
- Initially→ found left to the vertebral column,
- As it descends→ it inclines towards the midline
- Ends up→ being anterior to the lower border of the body of T12 vertebra.
- At this level, it transitions into the abdominal aorta and passes through the aortic orifice of the diaphragm into the abdominal cavity.
Branches
Visceral branches
- intended largely for the organs of the mediastinum
- pericardial, bronchial, esophageal and mediastinal branches,
-
Pericardial branches:
- consist of a few vessels that supply the posterior aspect of the pericardium.
-
Bronchial arteries:
- they are usually one right and two left bronchial arteries.
- The artery on the right side supplies the right bronchus, bronchopulmonary lymph nodes, pericardium and esophagus.
- The two bronchial arteries on the left side supply blood to the components of the bronchial tree below the level of primary bronchi.
- Esophageal branches: consist of four or five vessels that supply blood to the esophagus.
- Mediastinal branches: consist of a few branches that supply blood to lymph nodes, nerves, vessels and areolar tissue located in the posterior mediastinum.
- Parietal branches
- intended for the structures of the thoracic wall.
- intercostal, subcostal and superior phrenic arteries.
-
Posterior intercostal arteries:
- consist of 9 pairs of arteries that run between the ribs and supply the intercostal spaces.
-
Subcostal arteries:
- consists of a pair of arteries that run inferior to the costal margin on each side (inferior to the twelfth ribs) and supply the subcostal space.
-
Superior phrenic arteries:
- consist of a pair of arteries that supply the posterior aspect of the superior surface of the diaphragm, anastomosing with the musculophrenic and pericardiacophrenic arteries.
Relations
- The thoracic aorta is confined to the posterior mediastinum.
- Anteriorly
- Related to the left pulmonary hilum, pericardium that encloses the left atrium, the lower part of the esophagus and the diaphragm.
- Posteriorly
- In proximity with the vertebral column and hemiazygos and accessory hemiazygos veins.
- Laterally
- to the right is the upper part of the esophagus, the azygos vein, thoracic duct and the right lung and pleura.
- to the left is the left lung and pleura.
- To clear out any confusion, the reason why the thoracic aorta has several different relations with the esophagus is due to the course of the esophagus through the mediastinum.
- The esophagus is initially laterally to the right of the thoracic aorta, then as it descends it crosses the thoracic aorta anteriorly. Finally, as it approaches the diaphragm ends up being anterolaterally to the thoracic aorta.
Common carotid artery, internal carotid artery
Internal Carotid Artery
- Parts:
-
Cervical part (neck): has no branches
- Begins at the bifurcation of the common carotid artery
- Situated at a level between the third and fourth cervical vertebrae (C3-C4).
- Possesses a localized dilatation: the carotid sinus.
- The carotid sinus or bulb is a dilation acting as a baroreceptor for detecting blood pressure changes, while the carotid body acts as a chemoreceptor for acid-base disturbances.
- The signal is conducted in a neural pathway through the carotid sinus of the glossopharyngeal nerve . By squeezing the internal carotid artery at the site of the sinus, the blood pressure drops reflectively.
- Travel through the carotid sheath in a superior direction along the neck
- superiorly through the carotid triangle
- common carotid artery (CC), internal jugular vein (IV), vagus nerve (CN 10), deep cervical lymph nodes, and sympathetic nerve fibers.
- Begins at the bifurcation of the common carotid artery
-
Petrous part (temporal bone)
- Enters the skull via the carotid canal of the temporal bone
- travels over the foramen lacerum and ends at the petrolingual ligament.
- This anatomical structure is located on the wall of the cavernous sinus.
-
Cavernous part (cavernous sinus)
- it courses superiorly along the posterior clinoid process of the sphenoid bone,
- making its way towards the anterior clinoid process
- finally emerging through the roof of the cavernous sinus.
- Intercranial part (after piercing the dura mater
-
Cervical part (neck): has no branches
Branches
-
Caroticotympanic artery (C):
- Petrous part (C2)
- Travels through the tympanic cavity via the foramen within the carotid canal.
- It subsequently anastomoses with the anterior tympanic branch of the stylomastoid artery and the maxillary artery.
-
Artery of the pterygoid canal: Vidian artery
- originates from the petrous part
- Courses through the pterygoid canal together with nerve of the pterygoid canal.
- It finally anastomoses with a branch of the greater palatine artery.
-
Meningeal artery
- Cavernous segment
- supplies the dura mater of the anterior cranial fossa.
- Anastomoses with the meningeal branch of the posterior ethmoidal artery.
-
Inferior hypophyseal artery
- Cavernous segment
- Supplies the neurohypophysis, the posterior part of the pituitary gland.
- This artery terminates in the pituitary portal system.
-
Superior hypophyseal artery
- Stems from the ophthalmic segment
- Supplying the infundibulum and median eminence of the hypothalamus, as well as the pars tuberalis of the anterior pituitary gland.
-
Ophthalmic artery
- Stemming from the ophthalmic segment
- Passes through the optic canal, ultimately entering the orbit and supplying its contents.
- its terminal branches supply the frontal area of the scalp, the ethmoid and frontal sinuses, and the dorsum of the nose.
-
Posterior communicating artery
- Anastomoses with posterior cerebral artery coming off the basilar artery,
- contributing to the formation of the circle of Willis.
- runs posteriorly above the oculomotor nerve
-
Anterior choroidal artery
- Follows a complex course by crossing the optic tract to supply the crus cerebri,
- then recrossing it to project onto and supply the lateral geniculate body of the thalamus.
- It then passes through the choroidal fissure to enter the lateral ventricle and supply its choroid plexus.
- In addition, the anterior choroidal artery supplies the mesencephalic, diencephalic, and telencephalic anatomical derivatives.
Terminal branches:
-
Anterior cerebral artery
- Travels towards the longitudinal cerebral fissure,
- Anastomoses with its contralateral counterpart via the short anterior communicating artery.
- As a result, they contribute to the formation of the circle of Willis.
- Cortical branches
- supply medial surface of the cerebral cortex as far back as the parieto-occipital sulcus
- strip of cortex about 1 inch (2.5 cm) wide on the adjoining lateral surface. T
- Central branches
- pierces the anterior perforated substance and helps to supply parts of the lentiform and caudate nuclei and the internal capsule.
-
Middle cerebral artery
- travels through the lateral fissure before coursing over the insula.
- It subsequently divides to supply the lateral cortical surfaces along with the insula.
- Cortical branches
- supply the entire lateral surface of the hemisphere, except for the narrow strip supplied by the anterior cerebral artery,
- the occipital pole, and the inferolateral surface of the hemisphere, which are supplied by the posterior cerebral artery
- This artery thus supplies all the motor area except the “leg area.”
- Central branches enter the anterior perforated substance and supply the lentiform and caudate nuclei and the internal capsule
- supply the entire lateral surface of the hemisphere, except for the narrow strip supplied by the anterior cerebral artery,
Vertebral artery:
- Branch of subclavian artery
- Passing between the longus colli and the anterior scalene muscles.
- Ascends the neck by passing through the foramina in the transverse processes of the upper six cervical vertebrae
- Passes through the transverse foramen of the axis (C2)
- Vertical part courses superiorly, crossing the root of the C2 spinal nerve and entering the transverse foramen of the atlas (C1).
- Artery curves medially and posteriorly, passing behind the superior articular process of the atlas and reaches the groove on the upper surface of the posterior arch of the atlas.
- Passes under the posterior atlantooccipital membrane and enters the vertebral canal.
- The horizontal part is contained in the occipital triangle.
- It enters the skull through the foramen magnum and pierces the dura mater and arachnoid to enter the subarachnoid space.
- At the lower border of the pons, it merges with the opposite vertebral artery and forms the basilar artery.
- The basilar artery ascends along the ventral surface of the pons in its basilar groove within the pontine cistern.
- The vessel terminates as it bifurcates into two posterior cerebral arteries.
- Branchs:
- Anterior spinal artery
- Originates from two smaller vessels from each vertebral artery which unite around the intradural segment.
- Passes through the foramen magnum and descends along the anterior aspect of the spinal cord, supplying its anterior portion.
- Posterior inferior cerebellar artery
- supplies the cerebellum.
- Meningeal branches,
- for supplying the meninges.
- Medullary arteries
- Supply the medulla oblongata.
- Basilar artery
- Terminating branch of the vertebral artery
- Contributes to the circle of Willis.
- It terminates by bifurcating into two posterior cerebral arteries.
- Gives off the posterior communicating artery,
- which anastomoses with the middle cerebral artery, a branch of the internal carotid artery.
- This is how the communication between vertebral and internal carotid arteries is established.
- Anterior spinal artery
LAYERS OF BRAIN????
Layers of the brain
1-Dura Mater
Two layers:
These are closely united except along certain lines, where they separate to form venous sinuses.Endosteal layer
Periosteum covering the inner surface of the skull bones.
At the foramen magnum, it does not become continuous with the dura mater of the spinal cord.
At the sutures, it is continuous with the sutural ligaments
Meningeal layer
Dura mater proper
Dense, strong fibrous membrane covering the brain
Continuous through the foramen magnum with the dura mater of the spinal cord.
It provides tubular sheaths for the cranial nerves as the latter pass through the foramina in the skull.
Sends inward four septa, which divide the cranial cavity into freely communicating spaces
Function: to restrict the displacement of the brain associated head movment
Falx cerebri
sickle-shaped fold of dura mater that lies in the midline between the two cerebral hemispheres
Its narrow anterior end is attached to the internal frontal crest and the crista galli.
Its broad posterior part blends in the midline with the upper surface of the tentorium cerebelli.
Superior sagittal sinus runs in its upper fixed margin,
Inferior sagittal sinus runs in its lower concave free margin
Straight sinus runs along its attachment to the tentorium cerebelli.
Tentorium cerebelli is a crescent-shaped fold of dura mater that roofs over the posterior cranial fossa
It covers the upper surface of the cerebellum and supports the occipital lobes of the cerebral hemispheres.
In the anterior edge there is a gap, the tentorial notch, for the passage of the midbrain which produces an inner free border and an outer attached or fixed border.
The fixed border is attached to the posterior clinoid processes, the superior borders of the petrous bones, and the margins of the grooves for the transverse sinuses on the occipital bone.
The free border runs forward at its two ends, crosses the attached border, and is affixed to the anterior clinoid process on each side. At the point where the two borders cross, the third and fourth cranial nerves pass forward to enter the lateral wall of the cavernous sinus (Fig. 15-4).
Close to the apex of the petrous part of the temporal bone, the lower layer of the tentorium is pouched forward beneath the superior
petrosal sinus to form a recess for the trigeminal nerve and the trigeminal ganglion.
The falx cerebri and the falx cerebelli are attached to the upper and lower surfaces of the tentorium, respectively. The straight sinus
runs along its attachment to the falx cerebri, the superior petrosal sinus runs along its attachment to the petrous bone, and the
transverse sinus runs along its attachment to the occipital bone (Figs. 15-1 and 15-4).
The falx cerebelli, a small, sickle-shaped fold of dura mater attached to the internal occipital crest, projects forward between the two
cerebellar hemispheres. Its posterior fixed margin contains the occipital sinus.
The diaphragma sellae is a small, circular fold of dura mater that forms the roof
Vascular development, structure of arteries, veins, lymphatic vessel, collateral circulation
External carotid artery - course, syntopy, branches
→
1341
1329
1359 ex carotid a branchs
At the bifurcation, the common carotid artery and the beginning of the internal carotid artery are
dilated. This dilation is the carotid sinus and contains receptors that monitor changes in blood
pressure and are innervated by a branch of the glossopharyngeal nerve [IX].
Another accumulation of receptors in the area of the bifurcation is responsible for detecting changes
in blood chemistry, primarily oxygen content. This is the carotid body and is innervated by branches
from both the glossopharyngeal [IX] and vagus [X] nerves.
Carotid system
- Common carotid arteries
-
Right:
- originates from the brachiocephalic trunk immediately posterior to the right sternoclavicular joint and is entirely in the neck throughout its course;
-
Left:
- begins in the thorax as a direct branch of the arch of the aorta and passes superiorly to enter the neck near the left sternoclavicular joint.
-
Right:
-
Carotid bifurcation occurs at the level of the thyroid cartilage in the larynx→
- Terminal branches
- External and internal carotid arteries
- Terminal branches
The external carotid arteries begin giving off branches immediately after the bifurcation of the common carotid arteries as follows:
1- Superior thyroid artery
- Is the first branch, arises from the anterior surface near or at the bifurcation,
- Passes in a downward and forward direction to reach the superior pole of the thyroid gland;
2- Ascending pharyngeal artery
- is the second and smallest branch
- it arises from the posterior aspect of the external carotid artery
- ascends between the internal carotid artery and the pharynx;
-
Lingual artery
- Arises from the anterior surface of the external carotid artery just above the superior thyroid artery at the level of the hyoid bone,
- passes deep to the hypoglossal nerve [XII],
- passes between the middle constrictor and hyoglossus muscles;
3- Facial artery
- the third anterior branch of the external carotid artery
- arises just above the lingual artery,
- passes deep to the stylohyoid and posterior belly of the digastric muscles→
- continues deep between the submandibular gland and mandible→
- emerges over the edge of the mandible just anterior to the masseter muscle→ to enter the face;
-
Key facts about the cervical branches of facial artery
- Acending palatine artery→ Supplies: auditory tube, palatine tonsil, superior pharyngeal constrictor, soft palate
- Tonsilar branch→ Supplies palatine tonsil
- Sumbental artery→ Supplies: submental muscle, submental region skin
- Glandular branches→ Supply: submandibular salivary glands and lymph nodes
- Key facts about the facial branches of facial artery
- Inferior labial artery→Supplies: lower lip, labial glands
- Supreior labial artery→Supplies: upper lip, nasal septum, ala of the nose
- Lateral nasal branch→Supplies: dorsum of the nose, ala of the nose
- Angular artery→Supplies: lacrimal sac, orbicularis oculi muscle
4- Occipital artery
- arises from the posterior surface of the external carotid artery: near the level of origin of the facial artery,
- passes upward and posteriorly deep to the posterior belly of the digastric muscle→
- and emerges on the posterior aspect of the scalp;
- the posterior auricular artery is a small branch arising from the posterior surface of the external carotid artery → passes upward and posteriorly
5- Superficial temporal artery
- is one of the terminal branches
- appears as an upward continuation of the external carotid artery
- beginning posterior to the neck of mandible,
- it passes anterior to the ear→ crosses the zygomatic process of the temporal bone→
- above this point divides into anterior and posterior branches
- Parotid branch
- Transverse facial artery
- Anterior auricular branch
- Zygomatico-orbital artery
- Middle temporal artery
- Frontal branch
- Parietal branch
6- Maxillary artery
- is the larger of the two terminal branches of the external carotid arteryarising posterior to the neck of mandible,
- it passes through the parotid gland →continues medial to the neck of mandible → into the infratemporal fossa → pterygopalatine fossa.
****Maxillary artery: Branches of the maxillary artery are as follows:
1- First part of the maxillary artery (the part between the neck of mandible and the sphenomandibular ligament)
- Two major branches
-
Middle meningeal
- ascends vertically → in the infratemporal fossa→ passes superiorly between the sphenomandibular ligament on the medial side and the lateral pterygoid muscle on the lateral side → between the two roots of the auriculotemporal nerve at their origin from the mandibular nerve [V3] → foramen spinosum→ enter the cranial cavity
- The middle meningeal artery is the largest of the meningeal vessels and supplies much of the dura mater, bone, and related bone marrow of the cranial cavity walls.
-
Inferior alveolar arteries
- descends→enter the mandibular foramen and
- canal with the inferior alveolar nerve→distributed with the inferior alveolar nerve
- Supplies all lower teeth, and contributes to the supply of the buccal gingivae, chin, and lower lip.
- Before entering the mandible, the inferior alveolar artery gives origin to a small mylohyoid branch, which accompanies the nerve to mylohyoid.
- Smaller branches
-
Deep auricular, anterior tympanic, and accessory meningeal
- blood supply of the external acoustic meatus, deep surface of the tympanic membrane, and cranial dura mater, respectively.
-
Deep auricular, anterior tympanic, and accessory meningeal
2- second part of the maxillary artery (the part related to the lateral pterygoid muscle):
-
Deep temporal
- with the deep temporal nerves to supply the temporalis muscle in the temporal fossa
-
Masseteric
- accompanies the masseteric nerve laterally through the mandibular notch to supply the masseter muscle.
-
Buccal
- with the buccal nerve and supplies skin, muscle, and oral mucosa of the cheek.
-
Pterygoid branches,
- which course with branches of the mandibular nerve [V3];
the third part of the maxillary artery is in the pterygopalatine fossa
- anterior to the pterygopalatine ganglion and gives origin to branches that accompany branches of the maxillary nerve [V2]
-
Posterior superior alveolar
- originates from the maxillary artery as it passes through the
- pterygomaxillary fissure→ accompanies posterior superior alveolar nerve into: alveolar foramen on the infratemporal surface of the maxilla→ supplies the molar and premolar teeth, adjacent gingiva, and the maxillary sinus.
-
Infra-orbital
- Passes forward with the infra-orbital nerve → leaves the pterygopalatine fossa: inferior orbital fissure→ lies in the infra-orbital groove and infra-orbital canal → emerges through the infra-orbital foramen → supply parts of the face.
- Within the infra-orbital canal→ branches that contribute to the blood supply of structures near the floor of the orbit
- the inferior rectus and inferior oblique muscles, and the lacrimal sac; and anterior superior alveolar arteries, which supply the incisor and canine teeth and the maxillary sinus.
-
Greater palatine
- passes inferiorly with the palatine nerves → palatine canal.
- It gives origin to a lesser palatine branch→ which passes through the lesser palatine foramen → supply the soft palate, → then continues through the greater palatine foramen → supply the hard palate.
- The latter vessel passes forward on the inferior surface of the palate to enter the incisive fossa and pass superiorly through the incisive canal to supply the anterior aspect of the septal wall of the nasal cavity.
- passes inferiorly with the palatine nerves → palatine canal.
- pharyngeal,
- sphenopalatine/nasopalatine arteries,
- Terminal branch of the maxillary artery.
- It leaves the pterygopalatine fossa medially: sphenopalatine foramen → accompanies the nasal nerves, giving off:
-
Posterior lateral nasal arteries,
- which supply the lateral wall of the nasal cavity and contribute to the supply of the paranasal sinuses;
-
Posterior septal branches,
- which travel medially across the roof to supply the nasal septum-the largest of these branches passes anteriorly down the septum to anastomose with the end of the greater palatine artery.
-
Posterior lateral nasal arteries,
-
Artery of the pterygoid canal:
- passes posteriorly into the pterygoid canal.
- It supplies surrounding tissues and terminates, after passing inferiorly through cartilage filling the foramen lacerum, in the mucosa of the nasopharynx.
Subclavian artery - course, syntopy, branches
Vertebral artery:
- Branch of subclavian artery
- Passing between the longus colli and the anterior scalene muscles.
- Ascends the neck by passing through the foramina in the transverse processes of the upper six cervical vertebrae
- Passes through the transverse foramen of the axis (C2)
- Vertical part courses superiorly, crossing the root of the C2 spinal nerve and entering the transverse foramen of the atlas (C1).
- Artery curves medially and posteriorly, passing behind the superior articular process of the atlas and reaches the groove on the upper surface of the posterior arch of the atlas.
- Passes under the posterior atlantooccipital membrane and enters the vertebral canal.
- The horizontal part is contained in the occipital triangle.
- It enters the skull through the foramen magnum and pierces the dura mater and arachnoid to enter the subarachnoid space.
- At the lower border of the pons, it merges with the opposite vertebral artery and forms the basilar artery.
- The basilar artery ascends along the ventral surface of the pons in its basilar groove within the pontine cistern.
- The vessel terminates as it bifurcates into two posterior cerebral arteries.
- Branchs:
- Anterior spinal artery
- Originates from two smaller vessels from each vertebral artery which unite around the intradural segment.
- Passes through the foramen magnum and descends along the anterior aspect of the spinal cord, supplying its anterior portion.
- Posterior inferior cerebellar artery
- supplies the cerebellum.
- Meningeal branches,
- for supplying the meninges.
- Medullary arteries
- Supply the medulla oblongata.
- Basilar artery
- Terminating branch of the vertebral artery
- Contributes to the circle of Willis.
- It terminates by bifurcating into two posterior cerebral arteries.
- Gives off the posterior communicating artery,
- which anastomoses with the middle cerebral artery, a branch of the internal carotid artery.
- This is how the communication between vertebral and internal carotid arteries is established.
- Anterior spinal artery
Abdominal aorta, position, topographic relations, parietal and visceral branches
→
Key facts about the aorta
- Origin
- Left ventricle
- Branches
- Ascending aorta:
- Left and right coronary artery
- Arch of the aorta:
- Brachiocephalic trunk
- Left common carotid artery
- Left subclavian artery
- Descending thoracic aorta:
- Visceral branches: pericardial, bronchial, esophageal, mediastinal arteries
- Parietal branches: intercostal, subcostal arteries and superior phrenic arteries
- Descending abdominal aorta:
- Anterior group: celiac trunk, superior mesenteric, inferior mesenteric arteries
- Lateral group: suprarenal, renal, gonadal (testicular in males, ovarian in females) arteries
- Dorsal group: inferior phrenic arteries, lumbar arteries, median sacral artery
- Terminal branches: left and right common iliac artery
- Ascending aorta:
- Supply
- Entire body except for the lungs
Abdominal aorta:
Course
- Emerges from the aortic orifice of the diaphragm at the level of T12 vertebra→ It begins its course anterior and to the left of the vertebral column → continues downwards for about 10 cm→ Upon reaching the lower part of the body of L4 vertebra→ it bifurcates into its terminal branches to the left of the median plane:
- Left and right common iliac arteries
- On the skin, this bifurcation is projected 1.5 cm below and to the left of the umbilicus.
Relations
- Courses through the retroperitoneal space of the abdominal cavity.
- Posteriorly
- it is related to the vertebral bodies of the upper four lumbar vertebrae and the overlying anterior longitudinal ligament.
- Anteriorly,
- the abdominal aorta is related to the organ of the abdominal cavity.
- From above downward it relates to the:
- pancreas,
- the descending part of the duodenum,
- the root of the mesentery,
- and the small intestine.
- Several neurovascular structures are also related to the abdominal aorta;
- anteriorly,
- it is related to the splenic and renal veins;
- laterally and to the right,
- it relates to the inferior vena cava,
- laterally to the left
- with the sympathetic trunk.
- anteriorly,
Branches of the abdominal aorta
- Anterior group
- Celiac trunk
- Superior mesenteric artery
- Inferior mesenteric artery
- Lateral group
- Suprarenal artery
- Renal artery
- Gonadal artery
- Dorsal group
- Inferior phrenic artery
- Lumbar arteries
- Median sacral arteries
- Terminal branches
- Left common iliac artery
- Right common iliac artery
Anterior group
1-Celiac trunk:
- Unpaired short vessel
- Arises just inferior to the aortic orifice of the diaphragm at the level of the lower border of T12 vertebra.
- Shortly after its origin, the trunk gives off its three branches:
- Left gastric artery
- Common hepatic artery
- Splenic artery
- The organs supplied include
- abdominal part of the esophagus,
- stomach,
- proximal duodenum,
- liver,
- gallbladder,
- pancreas,
- spleen.
2- Superior mesenteric artery:
- Unpaired artery that arises about 1 cm below the celiac trunk, at the level of L1 vertebra.
-
It supplies blood to the midgut: which refers to the parts of the intestinal tract lying between the proximal segment of the duodenum and the distal 1/3 of the transverse colon of the large intestine.
- Supplies most of the small intestine,
- cecum and appendix,
- ascending colon
- and the first 2/3 of the transverse colon.
3- Inferior mesenteric artery:
- An unpaired artery that arises about 4 cm superior to the bifurcation of the abdominal aorta, at the level of L3 vertebra.
- It supplies blood to the hindgut, which refers to the remaining segments of the intestinal tract that include
- the distal 1/3 of the transverse colon,
- descending colon,
- sigmoid colon,
- rectum,
- and the superior portion of the anal canal.
The lateral group
1- Middle suprarenal artery:
- Paired artery, arises on each lateral side of the abdominal aorta near the origin of the superior mesenteric artery.
- Along with the superior and inferior suprarenal arteries, these arteries supply blood to the suprarenal glands.
2- Renal artery:
a large paired artery that branches off the lateral sides of the aorta at a right angle immediately below the superior mesenteric artery.
It supplies blood to the left and right kidney and gives off the inferior suprarenal artery to supply the suprarenal glands.
3- Gonadal artery:
a paired artery that arises from the anterior aspect of the aorta just inferior to the renal arteries.
In males, this artery is called the testicular artery and supplies the testes, while the female counterpart is called the ovarian artery, which supplies the ovaries.
The dorsal group
1- Inferior phrenic artery:
a paired artery that arises from the posterolateral aspect of the aorta immediately below the aortic hiatus of the diaphragm. This artery supplies the inferior surface of the diaphragm and gives off the superior suprarenal artery to supply the suprarenal glands.
2- Lumbar arteries:
typically four pairs of arteries that arise from the posterior surface of the aorta. They supply the posterior abdominal wall and the spinal cord.
3- Median sacral artery: arises from the posterior aspect of the abdominal aorta just superior to the bifurcation. This artery supplies blood to the lower lumbar vertebrae and the sacrum.
Arteries of the stomach, liver and spleen: the forgut region→
Blood supply to the forgut→ Celiac trunk
- abdominal eosophagus
- stonach
- superior duodenum to the. major papilla
- liver
- pancreas
- gallbladder
- spleed (even though not apart of the gut tube)
Celiac trunk: Unpaired short vessel
- Arises just inferior to the aortic orifice of the diaphragm at the level of the lower border of T12 vertebra.
- Shortly after its origin, the trunk gives off its three branches:
1- Left gastric artery
- Smallest branch
- This is the smallest and the first branch that arises from the coeliac trunk
- Assends a bit→ passes into the lesser omentum (which connects the lesser curvature of the stomach to the liver) → along the lesser curvature of the stomach→ to supply its superior portion.
- Here it anastomoses with right gastric artery.
- Some branches of the left gastric artery also supply the inferior part of the oesophagus.
- eosophageal branchs of the left gastic artery
2- Common hepatic artery
- Arises → runs towards the right towards the liver
- and in order to enter the lesser sac.
- Branchs:
- → Right gastric artery (above the first part of the duodenum)
- from right to left
- which runs between the peritoneal layers of lesser omentum
- to supply the lesser curvature of the stomach
- Anastomoses with the left gastric artery.
- → Hepatic artery proper divides into→
- Right and left hepatic arteries and enter the liver: further into lobar arteries.
- right branch gives branch: cystic artery for gall bladder
- Right and left hepatic arteries and enter the liver: further into lobar arteries.
- → Gastroduodenal artery →
- Arises posterosuperior to the first part of duodenum→ giving off → the right gastromental artery
- sends branchs to greater omentum
- which supplies the greater curvature of the stomach, anastamoses with: Left gastrosplenic artery (from splenic a.)
- Passes to the left
- Terminates as → anterior superior pancreaticoduodenal artery:
- Arieses behind duodenum
- which supplies the head of the pancreas and the anterior and posterior surfaces of the duodenum.
- It anastomose with the inferior pancreaticoduodenal artery (first branch of the superior mesenteric artery).
- Arises posterosuperior to the first part of duodenum→ giving off → the right gastromental artery
- → Right gastric artery (above the first part of the duodenum)
3- Splenic artery
- Longest branch → runs towards the hilum of the spleen on the superior border of the pancreas
- Branchs
- To supply the neck, body and tail of the pancreas.
-
Short gastric arteries:
- It runs within the gastrosplenic ligament in order to supply the fundus of the stomach as well as the superior part of the greater curvature of the stomach
- Before it enters the spleen: Left gastrosplenic artery:
- that supplies the greater curvature of the stomach,
- and anastomoses with the right gastroepiploic artery.
- Branchs
- Mnemonic
- There is an easy way to remember the branches of the splenic artery! The mnemonic ‘ Peter’s Spleen Looks Small’ stands for:
- Pancreatic a.
- Splenic a.
- Left gastroepiploic a.
- Short gastric a.
- There is an easy way to remember the branches of the splenic artery! The mnemonic ‘ Peter’s Spleen Looks Small’ stands for:
External and internal iliac artery
Key facts about the aorta
- Origin
- Left ventricle
- Branches
- Ascending aorta:
- Left and right coronary artery
- Arch of the aorta:
- Brachiocephalic trunk
- Left common carotid artery
- Left subclavian artery
- Descending thoracic aorta:
- Visceral branches: pericardial, bronchial, esophageal, mediastinal arteries
- Parietal branches: intercostal, subcostal arteries and superior phrenic arteries
- Descending abdominal aorta:
- Anterior group: celiac trunk, superior mesenteric, inferior mesenteric arteries
- Lateral group: suprarenal, renal, gonadal (testicular in males, ovarian in females) arteries
- Dorsal group: inferior phrenic arteries, lumbar arteries, median sacral artery
- Terminal branches: left and right common iliac artery
- Ascending aorta:
- Supply
- Entire body except for the lungs
Left and right common iliac arteries,
- arise from the bifurcation in front of the body of L4 vertebra about 1.25 cm to the left of the median plane.
The common iliac arteries supply the lower limb, the gluteal region, and the pelvic viscera.
Arteries of upper extremity - course, syntopy, branches
Arteries of lower extremity - course, syntopy, branches
Anatomical background for vessel punctures, pressure points, palpation
Superior vena cava, brachiocephalic veins, jugular veinsI
Internal jugular vein - course and tributaries
1361
Pterygoid plexus
The pterygoid plexus is a network of veins between the medial and lateral pterygoid muscles, and
between the lateral pterygoid and temporalis muscles (Fig. 8.143).
Veins that drain regions supplied by arteries branching from the maxillary artery in the infratemporal
fossa and pterygopalatine fossa connect with the pterygoid plexus. These tributary veins include
those that drain the nasal cavity, roof and lateral wall of the oral cavity, all teeth, muscles of the
infratemporal fossa, paranasal sinuses, and nasopharynx. In addition, the inferior ophthalmic vein
from the orbit can drain through the inferior orbital fissure into the pterygoid plexus.
Significantly, small emissary veins often connect the pterygoid plexus in the infratemporal fossa to
the cavernous sinus in the cranial cavity. These emissary veins, which pass through the foramen
ovale, through the cartilage that fills the foramen lacerum, and through a small sphenoidal foramen
on the medial side of the lateral plate of the pterygoid process at the base of the skull, are a route by
which infections can spread into the cranial cavity from structures, such as the teeth, that are
drained by the pterygoid plexus. Also, because there are no valves in veins of the head and neck,
anesthetic inadvertently injected under pressure into veins of the pterygoid plexus can backflow into
tissues or into the cranial cavity.
Cranial veins, sinus durae matris, cerebral veins
453
Azygos and hemiazygos veins, vertebral venous plexuses
