Veins, Arteries, Nerves: Test 3 Flashcards
Posterior intercostal artery
course
Pass between internal and innermost intercostal muscles
Origin of posterior intercostal arteries
Supreme intercostal arteries (intercostal spaces 1 and 2)
Thoracic aorta
Posterior intercostal artery
distribution
Intercostal muscles/overlying skin
Parietal pleura
Origin of anterior intercostal artery
Internal thoracic arteries (intercostal spaces 1-6) Musculophrenic arteries (intercostal spaces 7-9)
Anterior intercostal artery
Course
Pass between internal and innermost intercostal muscles
Anterior intercostal artery
Distribution
Intercostal muscles/overlying skin
Parietal pleura
Internal thoracic artery
Origin
Subclavian artery
Internal thoracic artery
Course
Lateral to sternum –> between costal cartilages/internal thoracic muscles –> divides into superior epigastric a. and musculophrenic a.
Internal thoracic artery
Distribution
Intercostal spaces 1-6 (via anterior intercostal a.)
Intercostal spaces 7-9 (via musculophrenic a.)
Right coronary artery
Origin
Right aortic sinus
Right coronary artery
Course
Follows coronary (AV) sulcus between atria and ventricles
Right coronary artery
Distribution
Right atrium
SA/AV nodes
Posterior IV septum
Right marginal artery
Origin
Right coronary artery
Right marginal artery
Course
Passes to inferior margin of heart and apex
Right marginal artery
Anastomoses
IV branches
Right coronary artery
Anastomoses
Circumflex and anterior IV branches (left coronary artery)
Posterior IV artery
Origin
Right coronary artery
Posterior IV artery
Course
Runs in posterior IV sulcus to apex of heart
Posterior IV artery
Distribution
Right and left ventricles
Posterior 1/3 of septum
Posterior IV artery
Anastomoses
Anterior IV branches of left coronary artery (at apex)
Left coronary artery
Origin
Left aortic sinus
Left coronary artery
Course
Runs in AV sulcus and gives off anterior IV and circumflex branches
Left coronary artery
Distribution
Left atrium/ventricle
IV septum
AV bundles
Left coronary artery
Anastomoses
Right coronary artery
Anterior IV artery
Origin
Left coronary artery
Anterior IV artery
Course
Passes along anterior IV sulcus to apex of heart
Anterior IV artery
Distribution
Right and left ventricles
Anterior 2/3 of IV septum
Anterior IV artery
Anastomoses
Posterior IV branch of left coronary artery
Circumflex artery
Origin
Left coronary artery
Circumflex artery
Course
Passes left of AV sulcus and runs to posterior surface of heart
Circumflex artery
Distribution
Left atrium
Left ventricle
Circumflex artery
Anastomoses
Right coronary artery
Left marginal artery
Origin
Circumflex branch
Left marginal artery course
Follows left border of heart
Left marginal artery
Distribution
Left ventricle
Left marginal
Anastomoses
IV branches
Intercostal nerves (1-11) Origin
Anterior rami of T1-T11
Intercostal nerves (1-11) Course
Runs in intercostal spaces between internal and innermost layers
Intercostal nerves (1-11) Distribution
Muscles in skin over intercostal space
Lower nerves: skin of anterolateral abdominal wall
Vagus (CNX) n.
Origin
8-10 rootless from medulla of brainstem
Vagus (CNX) n.
Course
Superior mediastinum (posterior to SC joint) –> gives rise to recurrent laryngeal nerve –> abdomen
Vagus (CNX) n.
Distribution
Pulmonary plexus
Esophageal plexus
Cardiac plexus
Phrenic n.
Origin
Anterior rami of C3-C5
Phrenic n.
Course
Superior thoracic aperture –> mediastinal pleura –> pericardium
Phrenic n.
Distribution
Central portion of diaphragm
Recurrent laryngeal n.
Origin
Vagus n.
Recurrent laryngeal n.
Course
Right: loops around subclavian n.
Left: loops around arch of aorta –> tracheo-esophageal groove
Recurrent laryngeal n.
Distribution
Intrinsic muscles of larynx (except cricothyroid)
Sensory inferior to level of vocal folds
Cardiac plexus
Origin
Cervical and cardiac branches of vagus n.
Sympathetic trunk
Cardiac plexus course
Arch of aorta/posterior surface of heart –> along coronary a. –> sinu-atrial node
Cardiac plexus
Distribution
Sinu-atrial node
Parasympathetic fibers: slow rate/reduce force of heart, constrict coronary a.
Sympathetic fibers: opposite effects
Pulmonary plexus
Origin
Vagus n.
Sympathetic trunk
Pulmonary plexus
Course
Root of lung –> extends along bronchial divisions
Pulmonary plexus
Distribution
Afferents: convey reflexes
Parasympathetic fibers: constrict bronchioles
Sympathetic fibers: dilate bronchioles
Esophageal plexus
Origin
Vagus n.
Sympathetic ganglia
Greater splanchnic n.
Esophageal plexus
Course
Distal to bifurcation, vagus, and sympathetic n. form the plexus around esophagus
Esophageal plexus
Distribution
Vagal and sympathetic fibers –> smooth muscle/glands of inferior 2/3 of esophagus
Ascending aorta origin
Aortic orifice of left ventricle
Ascending aorta
Course
Ascends 5cm to Sternal angle (becomes arch of aorta)
Ascending aorta branches
Right and left coronary arteries
Arch of aorta
Origin
Continuation of ascending aorta
Arch of aorta
Course
Arches posteriorly on left side of trachea, esophagus, and superior to left main bronchus
Arch of aorta
Branches
Brachiocephalic a.
Left common carotid a.
Left subclavian a.
Superior epigastric n.
Origin
Internal thoracic a.
Superior epigastric n.
Course
Rectus sheath –> deep to rectus abdominis
Superior epigastric n.
Distribution
Superior rectus abdominis
Superior part of anterolateral abdominal wall
Inferior epigastric n.
Origin
External iliac a.
Inferior epigastric n.
Course
Runs superiorly and enters rectus sheath
Runs deep to rectus abdominis
Inferior epigastric n.
Distribution
Inferior rectus abdominis
Medial part of anterolateral abdominal wall
Celiac trunk
Origin
Abdominal aorta (T12) distal to aortic hiatus of diaphragm
Celiac trunk course
Bifurcates into splenic a. and common hepatic a.
Celiac trunk
Distribution
Esophagus, liver, duodenum, liver/biliary apparatus, pancreas
Left gastric a.
Origin
Celiac trunk
Left gastric a.
Course
Esophageal hiatus –> gives rise to esophageal branch –> descends down lesser curvature to anastomose with right gastric a.
Left gastric a.
Distribution
Distal esophagus
Left portion lesser curvature of stomach
Splenic a.
Origin
Celiac trunk
Splenic a.
Course
Superior border of pancreas –> passes between layers of splenorenal lig –> hilum of spleen
Splenic a.
Distribution
Pancreas, spleen, greater curvature of stomach
Posterior gastric branch: posterior wall/fundas of stomach
Hepatic a.
Origin
Celiac trunk
Hepatic a.
Course
Hepatoduodenal lig –> porta hepatis –> divides into right and left hepatic arteries
Hepatic a.
Distribution
Liver, gallbladder, stomach, pancreas, duodenum, lobes of liver
Right gastric a.
Origin
Hepatic a.
Right gastric a.
Course
Runs along lesser curvature of stomach
Right gastric a.
Distribution
Right portion of lesser curvature of stomach
Gastroduodenal a.
Origin
Hepatic a.
Gastroduodenal a.
Course
Descends retroperitoneally posterior to gastroduodenal junction
Gastroduodenal a.
Distribution
Stomach, pancreas, 1st part duodenum, distal bile duct