Clinical anatomy of the abdominal aorta and its branches

Question 1

describe the venous system back to the hearts form the upper veins

Answer 1

right ad left internal jugular go down to thoracic inlet then become the intrathroaic internal jugular veins.

The axillary veins become the subclavian at the first rib and then the subalcains join with the IIJV to become the brachiocephalic veins. These then become the sup vena cava

azygos vein

Question 2

describe aortic arch

Answer 2

ascending aorta - coronary arteries go off first then brachiocephalic trunk with right subclavian and right common carotid then left common carotid and the left subclavian before descending aorta

Question 3

the azygos vein is a large vein on the right side at the back of the thorax, draining into the superior vena cava

what does it drain

Answer 3

It is responsible for draining the thoracic wall and upper lumbar region via the lumbar veins and posterior intercostal veins

Question 4

the arch of the aorta goes up and back. It develops at the 4week of gestation and develops from the distal portion of thee trunks arteriosus - how many arches does it have

Answer 4

6

Question 5

arch 3 becomes what

Answer 5

carotid artery

Question 6

arch 4 becomes

Answer 6

arch of the aorta on the left and on the right becomes the brachiocephalic artery/trunk

Question 7

arch 5 does what

Answer 7

pretty much nothing

Question 8

arch 6 develops into what

Answer 8

right proximal pulmonary artery and on the left the distal part ductus arteriosus

Question 9

how can and apical tumour of the lung affect the left recurrent laryngeal nerve

Answer 9

initially both nerves hook round the sixth aortic arches . on the right after 5th and 6th go the right recurrent laryngeal nerve moves up to hook around the right subclavian artery. on the left the nerve remains hooked around the permitting distal part of the 6th arch sa ductus arteriosus which later becomes the liagementum arteriosum

Question 10

what drugs can close the DA

Answer 10

NSAIDs

Question 11

only branches of the ascending aorta

Answer 11

coronary arteries

Question 12

where does the arch of the aorta begin

Answer 12

2nd right sternocostal joint at level of sternal angle and curve sup-post to left and then inf ant to the right pulmonary artery and the bifurcation to the trachea - and ends by becoming the thoracic aorta ( descending ) post to 2nd left sternocostal joint at level of sternal Angle past eh left lung

Question 13

branches of the arch of the aorta

Answer 13

brachiocephalic trunk( right subclavian dn right common carotid) , left common carotid and left subclavian

Question 14

throaci aorta

Answer 14

T5-12 - post to root of left lung , pericardium and oesophagus

Question 15

abdo aorta

Answer 15

T12-L4

Question 16

anterior relations to abdo aorta

Answer 16

celiac plexus , body of pancreas and splenic veins
left renal vein
horizontal 3rd part of the duodenum
coils of the small intestine

Question 17

key branches of the abdominal aorta

Answer 17

coeliac artery 
SMA 
IMA 
renal artery 
gonadal arteries

Question 18

what are the vasorum of the aorta

Answer 18

walls of large blood like the aorta supplied by small blood cells called VV - from eh main artery lumen, branches of the main artery and drain into the Ain lumen or branches of the concomitant vein

Question 19

vasa vasorum of the aorta is derived from what branches of what vessels

Answer 19

coronary and brachiocephalic arteries

supply tunica media
aortic wall perfused by adventitial - vasa vasorum externae

Question 20

nerve supply of the aorta

Answer 20

aortic plexus contain both sympathetic ( adrenergic NA) and parasympathetic ( cholinergic or acetylcholine ) fibres

Question 21

what is a repo-oesophageal right subclavian artery

Answer 21

arises at the last branch of the arch of the aorta leading to dysphagia lusoria

Question 22

how does a double aortic arch form

Answer 22

persitiant portion of right dorsal aorta from vascular ring around the oesophagus and trachea compression these structures causing difficulty with breathing and swallowing

Question 23

what condition could you see a right sided arch of the aorta

Answer 23

situs inversus

Question 24

what is an interrupted aortic arch

Answer 24

obliteration fo teh 4th arch on left side - occurring with abnormal right subclavian - the aorta therefore supplies the head and the pulmonary artery supplies the rest of the body via the ductus arteriosus

Question 25

what is an aortic aneurysm

Answer 25

localised dilation or enlargement of the aorta to more than 1.5 times its original size

hypo perfusion of adventitial vasa vasorum

Question 26

signs of AAA

Answer 26

chest pain radiating to the back

exert pressure on trachea, oesophagus, recurrent laryngeal nerve

abdominal pain in fornt Nad back

Question 27

coarctation of the aorta

most common site for this

Answer 27

aortic narrowing or stenosis

near the ligamentum arteriosum remanaemtn of ductus arteriosus

Question 28

in post ductal coarctation a good collateral circulation usually develops between the

Answer 28

intercostal and internal thoracic arteries

Question 29

radiofemroal delay

Answer 29

blood supply from the thoracic region down is reduced leading to weak delayed femoral pluse presenting as bravo

Question 30

aortic valve stenosis presents as what

Answer 30

crescendo - decrescendo

Question 31

aortic valve stenosis

Answer 31

narrowing of the aortic valve opening. it restricts the normal blood Flow from the left ventricle to the aorta

Question 32

aortic regurgitation

Answer 32

this is a failure of the aortic valve to close tightly causing a back flow of blood into the left ventricle due to valvular weakness ( incompetence)