LEC62: Vascular Anatomy: The Aorta

Question 1

major parts of the aorta

Answer 1

aortic valve

ascending aorta

transverse aortic arch

descneidng aorta

thoracho-abdominal aorta

abdominal aorta

aortic bifurcation

pelvic arteries

Question 2

first branches off of aorta?

Answer 2

R and L coronary aa

Question 3

order of branches off of aortic arch?

Answer 3

1) incominate / brachiocephalic trunk > R carotid, R subclavin
2) L carotid
3) L subclavian

Question 4

4 vessels that go to brain? what is unique about them?

Answer 4

R and L carotids and vertebral aa

can serve brain with just 1 of these vessels because of extensive collateral circulation

Question 5

identify vessels

Answer 5

Question 6

most common artery used for bypass? what does it replace?

Answer 6

internal thoracic used to replaced L coronary artery

Question 7

what is double aortic arch? incidence?

Answer 7

0.01% of patients

duplicated aortic arch

circular/redundant secondary arch encircles trachea and esophagus, can cause clinical sequealae and make difficult to swallow, breathe

Question 8

what’s an aberrant right subclavian artery

Answer 8

comes off aortic arch LAST rather than immediately from inominant / brachiocephalic trunk

so must loop around to get from L to R side of body

can compress trachea and esophagus

Question 9

what is this

Answer 9

aberrant right subclavian artery

Question 10

what is happening here

Answer 10

see aberrant R subclavian artery beating on wall of trachea/esophagus

Question 11

what is aberrant L subclavian artery

Answer 11

comes off as 1st vessel in transverse aortic arch

Question 12

what is bovine arch?

Answer 12

11% occurrence

3 branches come off of 1 branch - L common carotid comes off of inominant / brachiocephalic trunk too

Question 13

types of arterial vascular diseases?

Answer 13

1) occlusive disease
2) aneurysm disease

Question 14

what is occlusive disease, where

Answer 14

plaque, hardening, stenosis

in carotid aa

cause of strokes

Question 15

what is aneurism

Answer 15

wall of artery cracks, leakage outside of artery, causes dilitation

Question 16

why do strokes occur

Answer 16

internal carotid develops plaque

plaque > downstraem > brain

loss of circulation in brain

Question 17

Answer 17

plaque build up > stenosis > stroke

Question 18

Answer 18

stroke

Question 19

what is thoracic outlet syndrome

Answer 19

extra cervical rib in thoracic outlet where nn, aa, vv traverse anterior & middle scalene mm, compresses the brachial plexus, subclavian aa

Question 20

cause of aneurysm or stenosis of subclavian artery?

Answer 20

thoracic outlet syndrome

Question 21

what is arrow pointing to

Question 22

what is arrow pointing to

Answer 22

stenosis

Question 23

Answer 23

aneurismal degeneration of entire aortic arch

if in transverse arch, likely syphilis

Question 24

what is artery of adamkiewicz?

Answer 24

aka great radicular artery

makes a hairpin turn by anterior spinal artery

crucial to spinal circulation for most all animals

very important to not damage in younger person, can lead to paralysis

Question 25

what supplies diaphragm?

Answer 25

phrenic artery from abdominal aorta

Question 26

abdominal aorta major branches

Answer 26

celiac artery superior mesenteric artery renal arteries inferior mesenteric artery iliac arteries

Question 27

branches of celiac artery

Answer 27

splenic left gastric common hepatic gastroduodenal

Question 28

where is most common site for occlusion of aorta?

Answer 28

renal arteries

Question 29

SMA branches

Answer 29

interior pancreatico-duodenal jejunal branches middle colic ileocolic *these begin collateralization btwn all otehr mesenteric/intestinal branches*

Question 30

how many renal arteries? where?

Answer 30

come off abdominal aorta after SMA 2 renal arteries usu R then L (60% of time)

Question 31

what comes off abdominal aorta after renal aa? branches?

Answer 31

inferior mesenteric artery left colic, sigmoidal, superior-hemmorhoidal

Question 32

name these branches of aorta

Answer 32

Question 33

where does aorta terminate?

Answer 33

at common iliac aa

Question 34

what are the mesenteric collaterals?

Answer 34

1) superior and inferior pancreaticoduodenal aa, via gastroduodenal a, for celiac-SMA 2) arc of riolan, "meandering mesenteric artery," for SMA-IMA 3) marginal artery of drummond (at periphery of colon) 4) lumbars, epigatric, middle sacral, internal iliac

Question 35

what is arc of riolan?

Answer 35

anastomoses between IMA and SMA runs in the mesentery

Question 36

what is arc of drummond?

Answer 36

IMA-SMA collateralization runs just on the inside of the mesentery

Question 37

Answer 37

horseshoe kidney

Question 38

what is this

Answer 38

horseshoe kidney

Question 39

what is this

Answer 39

hepatic artery aneurysm

Question 40

what is this

Answer 40

splenic artery aneurysm

Question 41

Answer 41

marginal artery of drummond IMA-SMA, more interior

Question 42

Answer 42

arc of riolan SMA-IMA collateralization, more exterior in mesentery