Vasculature - Aorta

Question 1

What sections can the aorta be divided up into?

Where does it end?

What type of artery is it?

Answer 1

1) Ascending
2) Aortic arch
3) Thoracic
4) Abdominal

Terminates at the level of L4, before bifurcating into the left and right common carotid arteries.

Elastic artery

Question 2

Ascending aorta

Branches of the ascending aorta?

Answer 2

Origin - aortic orifice from the left ventricle. Ascends to become the aortic arch. Travels with the pulmonary trunk the pericardial sheath.

Branches - left and right coronary arteries that supplies the myocardium.

Question 3

Aortic arch

Answer 3

Origin - level of the 2nd sternocostal joint

Arches superiorly, posteriorly and then inferiorly.

It ends at the level of T4.

Arch is connected to the pulmonary trunk by the ligamentum arteriosum (a remnant of the foetal ductus arteriosus).

Branches - proximal to distal:

1) Brachiocephalic artery - ascends to provide right common carotid, and right subclavian arteries, which go on to supply the right side of the head, neck and right upper limb.
2) Left common carotid artery - supplies left side of head and neck.
3) Left subclavian artery - supplies the left upper limb.

Question 4

Clinical relevance - coarctation of the aorta

Answer 4

Narrowing of the vessel.

Usually at the insertion of the ligamentum arteriosum. It is a congenital condition.

Results in increased resistance to the blood flow - increases the after-load of the ventricle - which means the heart has to work hard to clear the blood - this leads to left ventricular hypertrophy.

Blood supply of above the arch of aorta is not compromised.

Blood supply to the rest of the body is reduced - results in a weak, delayed femoral pulse, which presents clinically as radio-femoral delay.

Question 5

Thoracic aorta

Answer 5

Origin - T4

Insertion - T12

Descends left of the vertebral column. Approaches midline as it descends. Leaves the thorax via the aortic hiatus in the diaphragm.

Question 6

What are the branches of the thoracic aorta?

Answer 6

1) Bronchial - paired visceral branches laterally - supplies bronchial and peribronchial tissues.
2) Mediastinal - supplies lymph glands and loose areolar tissue tissue in the posterior mediastinum.
3) Oesophageal - unpaired visceral branch - supplies oesophagus
4) Pericardial - small unpaired arteries - arise anteriorly to supply pericardium.
5) Superior phrenic - paired parietal branches - supplies superior portion of diaphragm.
6) Intercostal and subcostal - small paired arteries - intercostal branch of the length of the aorta to supply the intercostal spaces. Subcostal arteries supply the flat abdominal wall muscles.

Boys May Only Pass Singing Shamelessly like Idiots

Question 7

Abdomial aorta

Answer 7

Origin - T12

End - L4

Bifurcates into the left and right common iliac arteries.

Question 8

What are the branches of the aorta?

Answer 8

1) Inferior phrenic arteries -
2) Coeliac artery -
3) Superior mesenteric artery-
4) Middle suprarenal arteries -
5) Renal arteries -
6) Gonadal arteries -
7) Inferior mesenteric artery -
8) Medial sacral artery -
9) Lumbar arteries -

Question 9

Clinical relevance - aortic aneurysm

Answer 9

Dilation of the artery more that 50% bigger than its normal size.

Abdominal area is the most common site for aneursymal changes.

May suffer abdominal pulsations, pain, and back pain.

A patient may have a hoarse voice due to compression of the left recurrent laryngeal nerve.

Patients may not have any symptoms at all.

Diagnosis - USS

Treatment - surgery

Complications - rupture - medical emergency - death.