Aorta and peripheral arteries anatomy visualization
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AORTA AND PERIPHERAL ARTERIES ANATOMY & VISUALIZATION. Presented By; Dr Rakesh Jain. The Aorta. After originating from LV (about 3 cm in diameter ) , it ascending for a short distance, arches backward and to the left side, descends within the thorax on the left side of the vertebral column

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AORTA AND PERIPHERAL ARTERIES ANATOMY & VISUALIZATION

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Aorta and peripheral arteries anatomy visualization

AORTA AND PERIPHERAL ARTERIES ANATOMY & VISUALIZATION

Presented By; Dr Rakesh Jain


The aorta

The Aorta

After originating from LV (about 3 cm in diameter ), it ascending for a short distance, arches backward and to the left side, descends within the thorax on the left side of the vertebral column

Portions of aorta

Ascending aorta

Arch of the aorta and

Descending aorta (thoracic and abdominal aorta)


Ascending aorta aorta ascendens

Ascending Aorta (Aorta Ascendens)

  • About 5 cm. in length

  • Passes obliquely upward, forward, and to the right, as high as the upper border of the second right costal cartilage

  • At its origin, three small dilatations called the aortic sinuses

  • At the union of the ascending aorta with the aortic arch, the caliber of the vessel is increased, owing to a bulging of its right wall. This dilatation is termed the bulb of the aorta

  • Only branches of the ascending aorta are the two coronary arteries


Arch of the aorta

Arch of the Aorta

  • Begins at the level of the upper border of the Rt 2nd sternocostal joint

  • First runs upward, backward, and to the left, infront of the trachea, then directed backward on the left side of the trachea and finally passes downward on the left side of the body of T4, at lower border of which it becomes continuous with the descending aorta

  • Forms two curvatures: one with its convexity upward, the other with its convexity forward and to the left


Branches of arch of aorta

Branches of arch of aorta

Three in number-

  • Innominate artery

  • Left common carotid artery

  • Left subclavian artery


Aorta and peripheral arteries anatomy visualization

LEFT ANTERIOR OBLIQUE VIEW

CCA= common carotid artery

VA= vertebral artery

SCA= subclavian artery


Variations of the supraaortic vessel origins

Variations of the supraaortic vessel origins

Vertibral

Lt CC

Rt CC

Lt CC

Lt Subclavian

Rt Subclavian

Vertibral

Inominate A

Lt

Subclavian

Rt CC

Rt Subclavian


Descending aorta thoracic aorta

Descending Aorta Thoracic Aorta

  • Contained in the posterior mediastinal cavity

  • Begins at the lower border of the T4

  • Ends in front of the lower border of the T12 vertebra, at the aortic hiatus in the diaphragm


Branches of the thoracic aorta

Branches of the Thoracic Aorta

  • Visceral

  • Pericardial

  • Bronchial

  • Esophageal

  • Mediastinal

  • Parietal

  • Intercostal.- usually 9 pairs

  • Subcostal.

  • Superior Phrenic.


Aorta and peripheral arteries anatomy visualization

LEFT ANTERIOR OBLIQUE VIEW

LCC

RCC

Lt Subclavian

Rt Subclavian

Brachiocephalic A


Abdominal aorta

Abdominal aorta

Begins at aortic

hiatus of diaphragm

In front of lower

border of T12

Descending in front

of the vertebral column

Ends on L4-body,

a little to Left of midline

Summit of the convexity

corresponding to the L3


Branches of the abdominal aorta

Branches of the abdominal aorta

Visceral Branches

Celiac.

Superior Mesenteric.

Inferior Mesenteric.

Middle Suprarenals.

Renals.

Internal Spermatics.

Ovarian (in the female)

Parietal Branches

Inferior Phrenics.

Lumbars.

Middle Sacral.

Terminal Branches

Common Iliacs.


Aorta and peripheral arteries anatomy visualization

  • 1.Abdo Aorta

  • 2.Coeliac trunk

  • Lt gastric A

  • Splenic A

  • Hepatic A

  • 3. S M A

  • 4. I M A

  • 5. Lt Renal A

  • 6. Rt Renal A

a

b

AP VIEW

c

2

5

6

1

3

4


Aorta and peripheral arteries anatomy visualization

LATERAL VIEW

Catheter

Celiac trunk

Superior mesenteric artery

Abdominal aorta


Coeliac artery

Coeliac Artery

  • Short thick trunk

  • ≈1.25 cm length

  • Arises from the front of the aorta, just below the aortic hiatus of the diaphragm

  • Between T12& L1

  • Passing nearly horizontally forward

  • 3 large branches

    • Left gastric A - smallest

    • Hepatic A

    • Splenic A - largest


Aorta and peripheral arteries anatomy visualization

1.Coeliac A

2.Lt gastric A

3.Hepatic A

4.Splenic A

5.Gastroduodenal A

ANTERIO-POSTERIOR VIEW

2

3

1

4

4


Superior mesenteric artery

Superior Mesenteric Artery

Large vessel

Arises from front of aorta, at L1, ~1.25 cm below Coeliac A

Passes downward and forward, to the right iliac fossa

Supply small intestine (expt superior Duo),

Cecum, Asc Colon & Rt ½ Transverse Colon


Sma branches

SMA-Branches

Inferior Pancreatico-duodenal

Middle Colic

Right Colic

Ileocolic

Intestinal


Aorta and peripheral arteries anatomy visualization

1.Abd Aorta

2.S M A

3.Middle colic A

4.Rt colic A

5.Ileocolic A

6. Intestinal A

7.Appendicular

1

2

3

4

5

6

7


Inferior mesenteric artery

Inferior Mesenteric Artery

Smaller than SMA

Arises from aorta at L3, about 3 or 4 cm above its division

Passes downward, posterior to the peritoneum

Continued into pelvis as Superior hemorrhoidal artery &ends on the upper rectum

Supply Lt ½ transverse colon, descending & sigmoid colon, and most of the rectum


Inferior mesenteric artery branches

Inferior Mesenteric Artery branches

Left Colic A

Sigmoid branches

Superior Hemorrhoidal A


Aorta and peripheral arteries anatomy visualization

1.Inf mesentric A

2.Lt colic A

3.Marginal A

4.Sigmoid A

5.Superior hemorrhoidal A

3

1

2

4

5


Superior hemorrhoidal artery

Superior Hemorrhoidal Artery

  • Form a series of loops around lower rectum

  • Communicate with

    • Middle hemorrhoidal branches of Internal Iliac A

      and

    • Inferior hemorrhoidal branches of Internal pudendal A (branch of Internal Iliac A)


Renal arteries

Renal arteries

  • Two large arteries

  • Arises from side of aorta, immediately below SMA

  • Nearly a right angle with the aorta

  • Right is longer than left

  • Before reaching hilus of the kidney, each artery divides into four or five branches

  • Left is somewhat higher than the right


Aorta and peripheral arteries anatomy visualization

AP VIEW

Lt Renal arteries

Rt Renal arteries


Common iliac arteries

Common Iliac Arteries

  • Abdominal Aorta divides, on Lt side of L4

  • Each about 5 cm length

  • Rt Common Iliac A -somewhat longer than the Lt

  • Each divide, opposite the intervertebral fibrocartilage between L5 & S1

  • 2 branches→

    • External Iliac A

      &

    • Internal Iliac A (Hypogastric A )


Aorta and peripheral arteries anatomy visualization

1.Abd Aorta

2.Common iliac A

3.External iliac A

4.Internal iliac A

AP VIEW

1

2

3

4


The external iliac artery

The External Iliac Artery

Larger than Internal Iliac A

Passes obliquely downward and lateralward along the medial border of the Psoas major

Beneath the inguinal ligament, midway between anterior superior iliac spine and symphysis pubis entering the thigh & becomes Femoral A


Eia branches

EIA-Branches

  • 2 branches

  • Inferior epigastric

  • Deep iliac circumflex

  • Continues as femoral A


The internal iliac a hypogastric a

The Internal Iliac A(Hypogastric A)

Short, thick vessel, smaller than EIA

Arises at the bifurcation of the common iliac, opposite the lumbosacral articulation

Abt 4 cm length, on medial side of the thigh

The lengths of the CIA & IIA bear an inverse proportion to each other→ IIA being long when CIA is short, and vice versa.

Divides into 2 large trunks at upper margin of the greater sciatic foramen → anterior & posterior


Branches of internal iliac a

Branches of Internal Iliac A

Anterior Trunk

Superior Vesical

Middle Vesical

Inferior Vesical

Vaginal (in females)

Middle Hemorrhoidal

Obturator

Inferior Gluteal

Internal Pudendal

Inf Hemorrhoidal A

Uterine

Posterior Trunk

Iliolumbar

Lateral Sacral

Superior Gluteal


Femoral artery

Femoral Artery

Begins behind inguinal ligament, midway between ASIS & symphysis pubis,

Ends at junction of upper ⅔ & lower ⅓ of thigh, to become Popliteal A

First 4 cm -enclosed, together with Femoral V, in a fibrous sheath—the Femoral Sheath

In the upper ⅓ of thigh Femoral A is contained in the Femoral Triangle (Scarpa’s triangle)

In the middle ⅓ of thigh, in the Adductor Canal (Hunter’s canal)


Profunda femoris a

Profunda Femoris A

  • Large vessel arising from lateral & back part of Femoral A, 2-5 cm below inguinal ligament

  • Ends at the lower ⅓ of thigh

  • PFA provides an important source of collateral flow to the leg and foot in patients with significant SFA stenoses or occlusion

  • Branches.—

    • Lateral Femoral Circumflex,

    • Medial Femoral Circumflex,

    • Perforating branches (4 no.s)


Aorta and peripheral arteries anatomy visualization

AP VIEW

Catheter

Common femoral

artery

Superficial femoral

artery


Aorta and peripheral arteries anatomy visualization

1.Profnda F A

2.Femoral artery

AP VIEW

1

2


Popliteal artery

Popliteal Artery

Continuation of Femoral A

Extends from the opening in the Adductor magnus, at the junction of middle ⅔ & lower ⅓ of thigh

Courses downward and lateralward to the intercondyloid Popliteal fossa of the femur, then vertically downward to the lower border of the Popliteus

Divides into Anterior tibial A and tibioperoneal trunk.

Tibioperoneal trunk is the direct continuation of the popliteal artey, arises distal to the anterior tibial artery, bifurcates just beyond its origin into the posterior tibial and peroneal arteries


Aorta and peripheral arteries anatomy visualization

Superficial femoral

artery

Popliteal artery

Popliteal artery

Anterior tibial artery

Anterior tibial artery

Posterior tibial artery

Posterior tibial artery

Peroneal artery

Peroneal artery

Tibioperoneal trunk


Posterior tibial a

Posterior Tibial A

Begins at lower border of Popliteus, opposite the interval betw tibia & fibula

Descends, approaching tibial side of leg

In the lower part, situated midway betw med malleolus & med process of calcaneal tuberosity

Divides into Medial & Lateral plantar A


Anterior tibial a

Anterior Tibial A

Begins at bifurcation of Popliteal A, at the lower border of Popliteus

Passes forward through aperture above upper border of interosseous memb

Descends on anterior surface of interosseous memb, gradually approaching the tibia

On the front of ankle-joint (more superficial), becomes Dorsalis Pedis Artery.


Aorta and peripheral arteries anatomy visualization

AP VIEW

Tibioperoneal Trunk

Anterior Tibial

Peroneal

Posterior Tibial


Ankle and foot vascular anatomy

Ankle and Foot Vascular Anatomy

Lateral view

To resolve ischemic rest pain or heal an ulcer, one continuously patent infrapopliteal vessel to the foot is necessary

Peroneal

Anterior Tibial

Posterior Tibial

Medial & lateral

Plantar A

Dorsalis Pedis


Foot arteries front view

Foot arteries front view

A. tibialis anterior

A. dorsalis pedis


Foot arteries down view

Foot arteriesdown view

Arcus plantaris profundus

A. plantaris medialis

A. plantaris lateralis

A. tibialis posterior


Innominate artery

Innominate Artery

  • Largest branch of arch of the aorta

  • 4 to 5 cm. in length

  • Arises, on a level with the upper border of the second right costal cartilage

  • Ascends obliquely upward, backward, and to the right to the level of the upper border of the right sternoclavicular articulation, where it divides into the right common carotid and right subclavian arteries.


Common carotid artery

Common Carotid Artery

  • 2 in number (Rt & Lt)

  • Differ in length and mode of origin

  • The right begins at bifurcation of innominate A, behind sternoclavicular joint and is confined to the neck.

  • The left springs from the highest part of arch of the aorta to the left of, on a plane posterior to the innominate artery

  • Each vessel passes obliquely upward

  • Divides into the ECA & ICA, at the level of upper border of the thyroid cartilage


The subclavian artery

The Subclavian Artery

  • Right side: arises from the innominate artery behind right sternoclavicular articulation

  • Left side: arises directly from the arch of the aorta

  • Extends to the outer border of the first rib, where it becomes the axillary artery


Branches of the subclavian artery

branches of the subclavian artery

  • Vertebral.

  • Internal mammary

  • Thyrocervical

  • Costocervical


Aorta and peripheral arteries anatomy visualization

LEFT ANTERIOR OBLIQUE VIEW

LCC

RCC

Lt Subclavian

Rt Subclavian

Brachiocephalic A

Rt Axillary A


Axillary artery

Axillary Artery

  • Commences at the outer border of the first rib

  • Ends at lower border of the tendon of the Teres major, where it takes the name of brachial

  • At its origin the artery is very deeply situated, but near its termination is superficial


Aorta and peripheral arteries anatomy visualization

ANTERIO-POSTERIOR VIEW


Brachial artery

Brachial Artery

  • Commences at the lower margin of the tendon of the Teres major

  • Passing down the arm

  • Ends about 1 cm. below the bend of the elbow, where it divides into the radial and ulnar arteries

  • Course; At first the brachial artery lies medial to the humerus; as it runs down the arm it gradually gets in front of the bone, and at the bend of the elbow it lies midway between its two epicondyles


Radial artery

Radial Artery

  • Continuation of the brachial

  • Smaller in caliber than ulnar.

  • Commences at bifurcation of the brachial, just below the bend of the elbow

  • Passes along the radial side of the forearm to the wrist

  • Then winds backward, around the lateral side of the carpus, forward toward thumb and index finger into the palm of the hand and unite with the deep volar branch of the ulnar artery to form the deep volar arch


Ulnar artery

Ulnar Artery

  • Larger than radial A.

  • Begins a little below the bend of the elbow

  • Passing obliquely downward, reaches ulnar side of the forearm, midway between the elbow and the wrist. It then runs along the ulnar border to the wrist

  • Immediately beyond pisiform bone, it divides into two branches, which enter into the formation of the superficial and deep volar arches


Aorta and peripheral arteries anatomy visualization

ANTERIO-POSTERIOR VIEW


Aorta and peripheral arteries anatomy visualization

POSTERIO-ANTERIOR VIEW


Aorta and peripheral arteries anatomy visualization

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