VASCULAR Flashcards
Where does the abdominal aorta start and end?
T12-L4
- Begins by passing behind the median arcuate ligament and between the crura of the diaphragm in front of the body of T12.
- It passes downwards on the bodies of the lumbar vertebrae, inclining slightly to the left with the left sympathetic trunk at its left margin.
- It terminates by dividing into the two common iliac arteries on the body of L4.
What are the branches of the abdominal aorta?
Rule of 3 x 3
3 single branches to GUT
- Coeliac
- SMA
- IMA
3 paired branches to viscera
- Suprarenal
- Renal
- Gonadal
3 paired branches to anterior abdominal wall
- Subcostal
- Inferior phrenic
- Lumbar
What are the branches of the internal iliac artery?
9 in total. Remembered as “Pils Aprove”
POSTERIOR
Iliolumbar
Lateral sacral
Superior Gluteal
ANTERIOR
Pudendal (internal)
Rectal middle
Obturator
Vesical (inferior and superior)
Else - Uterine
where does the internal iliac artery begin and what are its divisions?
- Commences at the bifurcation of the common iliac arteries at the pelvic brim opposite the sacroiliac joint.
- Bifurcates into a short posterior and a longer anterior division.
What are the branches of the femoral artery?
Femoral
- Superficial epigastric
- Superficial circumflex iliac
- Superficial external pudendal
- Deep external pudendal
Profunda femoris
- Medial circumflex femoral
- Lateral circumflex femoral
What are the tributaries of the long saphenous vein?
- external pudendal (sup and deep)
- sup circumflex iliac
- sup inferior epigastric
- posterolateral thigh vein
- anterolateral thigh vein
What is the course of the long saphenous vein?
- Continuation of marginal vein of foot
- Anterior to medial malleolus
- Behind medial border of patella
- Through cribriform fascia
- 3 cm below & lateral to pubic tubercle
What factors aid in identification of the LSV and SFJ?
- placement of incision — groin crease medial to femoral artery pulse
- the LSV enters the CFV on its anteromedial border at an acute angle
- the LSV typically receives multiple tributaries
- the LSV typically looks thin walled compared to the CFV
- pre-operative marking with Duplex US can aid localisation of SFJ and significant tributaries
- dissection of the CFV 2 cm proximal and distal to the SFJ ensures that the CFV continues down into the thigh.
What are some of the perforator veins in the lower limb?
- These are veins that connect the superficial and deep venous systems.
- There are three large ones on the medial aspect of the calf (Cockett’s perforators), occurring at approximately 3, 6 and 9 cm above the medial malleolus.
- These perforators usually terminate in the posterior tibial veins and may connect directly to LSV.
- There are various other perforators described (e.g. Hunterian perforator above the knee).
What are the anterior and posterior relations of the IVC?
From bottom to top
Posterior (Lies on)
- right renal artery
- right adrenal gland
- right crus
- right sympathetic chain
Anterior (Lies behind)
- root of mesentry
- D1
- head of pancreas
- portal triad
- epiploic formaen
- bare area of liver
What are the tributaries of the IVC?
From bottom up
- Lumbar.
- Renal.
- Right gonadal
- Right Suprarenal.
- Hepatic.
- Inferior Phrenic.
What are the sites of portosystemic anastomosis?
- Splenic and superior mesenteric (formative branches)
- superior pancreaticoduodenal
- Left/right gastric
- cystic
What are the branches of the external carotid artery?
Some Anatomists Like Freaking Out Poor Medical Students
- S: superior thyroid artery
- A: ascending pharyngeal artery
- L: lingual artery
- F: facial artery
- O: occipital artery
- P: posterior auricular artery
- M: maxillary artery
- S: superficial temporal artery
