Arteries: Aorta and Ascending Aorta

• Summary table of arteries including origin, path and relationships, portions, termination, branches and terminal branches, and irrigation territory.

Aorta

• Begins at the aortic opening of the left ventricle.
• Exits the left ventricle behind the pulmonary trunk.
• Passes above and in front of the right and left pulmonary arteries
• Circles the main bronchus.
• Descends at the level of the 4th thoracic vertebra.
• Portions include the ascending aorta, aortic arch, and descending aorta.
• Terminates at the level of the 4th lumbar vertebra.
• Branches and terminal branches consist of the common iliac arteries.
• Provides blood to all organs through its branches

Ascending Aorta

• Continuous with the arterial cone.
• Originates from the aortic opening of the left ventricle.
• Extends upwards and to the right.
• Passes behind the pulmonary trunk.
• Located to the right of the pulmonary trunk, with the anterior thoracic wall and thymus in front.
• The right pulmonary artery is behind it, and the superior vena cava is to the right and behind it.
• Terminates at the second right intercostal space.
• Branches into the right and left coronary arteries, which supply the heart.

Aortic Arch

• Follows the ascending aorta at the second right costal cartilage.
• Curves back and to the left
• Lies above the left main bronchus.
• Terminates at the 4th thoracic vertebra.
• Its concave side gives rise to thymic and bronchial arteries.
• Its convex side gives rise to the brachiocephalic trunk.
• Other arteries that come from the convex side are the left common carotid artery and the left subclavian artery.
• Branches irrigate the head, neck, upper limb, and parts of the thoracic wall.

Brachiocephalic Trunk

• The first branch of the aortic arch.
• Extends up and to the right to the right sternoclavicular joint.
• At the right sternoclavicular joint it branches to form the right common carotid and right subclavian arteries.
• Behind the trachea, in front of the left brachiocephalic vein and the thymus.
• Has the right brachiocephalic vein, mediastinal pleura, and the same side's lung to the right.

Common Carotid Arteries

• The right common carotid begins in the bifurcation of the brachiocephalic trunk.
• The left originates from the aortic arch, making it longer than the right with both thoracic and cervical portions.
• Ascends the lateral side of the trachea and esophagus with the internal jugular vein and vagus nerve. Both arteries terminate by dividing into two branches: the internal carotid and external carotid.
  • Occurs at the upper border of the thyroid cartilage or level of the hyoid bone.

Internal Carotid Artery

• Arises from the bifurcation of the common carotid artery.
• Ascends vertically, forming part of the neurovascular bundle of the neck (with vagus nerve and internal jugular vein).
• Related to cranial nerves IX, XI, and XII, and the pharynx.
• Enters the cranial cavity through the external opening of the carotid canal at the base of the skull
• Exits to the cranial cavity through the internal opening of the carotid canal.
• Gives no branches in the neck.
• Enters the cranial cavity, where it emits the caroticotympanic and ophthalmic arteries.
• Supplies the ear, eye, and brain.
• The cerebral anterior artery, cerebral media artery, posterior communicating artery, and choroid artery also branch from it.
• Forms part of the arterial circle of the brain, or Circle of Willis, alongside the basilar artery.
  • The Circle of Willis helps blood reach the brain even with blockages.

External Carotid Artery

• Branches off level with superior cartilage or hyoid bone
• Ascends medially to the posterior belly of the digastric muscle and to the stylohyoid
• Passes through the retromandibular fossa to the parotid gland around the mandibular condyle.
• Divides into terminal branches: the superficial temporal artery and the maxillary artery.
• Branches classified into anterior, posterior, and middle groups based exit point.
  • Anterior group: superior thyroid, lingual and facial arteries.
  • Posterior group: sternocleidomastoid, occipital and posterior auricular arteries.
  • Middle group: ascending pharyngeal artery
• Supplies structures such the thyroid gland, tongue, and face muscles.
• Other structures that recieves blood from the ECA are the sternocleidomastoid muscle, occipital region, pharynx,.

Subclavian Artery

• Paired artery, right originates at the right sternoclavicular joint.
• The left is from the aortic arch.
• Subclavian curves upward around the top of the lung.
• It exits the thoracic cavity, extending under the clavicle and above the first rib passing between the scalene muscles.
• Location is divided into three sections:
  • Prescalene: vertebral artery, internal thoracic artery and thyrocervical trunk branches.
  • Interscalene: costocervical trunk.
  • Postscalene: cervical transverse.

Vertebral Artery

• Joins with the basilar artery with each artery contributing one spinal artery.
  • These give off anterior and posterior spinal arteries that supply the spinal cord.
• Supply the prevertebral muscles, spinal cord and meninges.
• Terminal branches of the basilar trunk are the posterior cerebral arteries that supply the brain structures.

Internal Thoracic Artery:

• The internal thoracic artery terminates its branches near the 7th costal cartilage,
• Terminates to the musculophrenic and superior epigastric arteries.
• The artery and its branches supply blood to the intercostal muscles, ribs, abdominal muscles, diaphragm, and mammary gland.

Thyrocervical Trunk

• Branches from the thyrocervical trunk, including the inferior thyroid, ascending cervical, superficial cervical, and suprascapular arteries.
• The costocervical trunk divides into two branches: deep cervical which feeds deep neck muscles, and supreme intercostal artery.

Axillary Artery

• Follows the subclavian which starts at the external border 1st rib
• Extends through the axillary fossa connecting to the axillary vein and medial, lateral, and posterior cords of the brachial plexus.
• Enters the inferior border of the teres major muscle or at the level of the inferior border of the pectoralis major.
• Branches are superior and lateral thoracic, thoracoacromial, subscapular, and anterior and posterior humeral circumflex arteries.
• Supplies blood to the axilla (armpit), shoulder, superolateral part of the thorax, humeral joint, and proximal epiphysis.

Brachial Artery

• Is a continuation of the axillary artery that passes the bicipital groove medially
  • Accompanied by two brachial veins and the median nerve, referred to as the neurovascular bundle
• The artery branches out to the radial and ulnar arteries at the level of the elbow crease, as well as the brachial branch and ulnar collaterals.
• Supplies blood to the arm and elbow with arteries and veins.
• The deep artery travels back with the radial nerve along the back of the upper arm.
• Several branches contribute to the irrigation of all arm muscles, the deltoid muscle, the humerus, and the elbow joint.

Radial Artery

• Terminal branch of brachial artery, located at elbow.
• Travels distally on anterolateral side of the forearm medial to brachiradialis muscle.
• Artery only covered by fascia and skin, on inferior third
• At elbow level the artery can be found on ulnar and radial arteries.
• Connects branches of ulnar arteries in the hand, creating palmar arch
• Branches irrigate structures and muscles of the elbow and forearm.

Ulnar Artery

• Originates at elbow
• Travels below pronator, towards the ulnar side of the forearm
• Joins the superficial palmar branch of radial artery to forma superficial palmar arch.
• Runs through elbow and forearm (anteromedial and posterior aspect)

Palmar Arteries

• Metacarpal palmar artery stems from arch
• They further stem common and proper digital arteries, which supplies blood to all parts of the hand.
• Supplies blood to palmar and back of hand depending on arteries location.

Descending Aorta

• Continuation of the aortic arch from the fourth thoracic vertebra.
• Goes down the vertebrae on the left side of the inferior vena cava
• Ends on fourth lumbar vertebra
• Contains the illac common arteries to the viscera and thorax walls.

Thoratic Aorta

• Begins as a continuation of the aortic arch
• Descends from around thoracic vertebra 4 to thoracic vertebra 12 where it ends at aortic opening of diaphragm.
• The thoracic aorta is in the posterior mediastinum, where it follows the vertebral column.
• Relationally is situated between pleura and esophagus.
• The visceral branches are bronchial, esophageal, mediastinal, and pericardial branches.
• The parietal branches are posterior intercostal, subcostal, and superior phrenic arteries.
• Supply blood to the mediastinum, pericardium, lungs, esophagus, and diaphragm.

Abdominal Aorta

• Reaches level of lumbar vertebra 4
• Situated to the left of the vertebral column in mediastinum and ends in front of column.
• Esophagus is first to right then crosses over, also located to the left of posterior
• The visceral branches are celiac trunk, superior mesenteric artery, and inferior mesenteric artery.
• The paired visceral branches are middle suprarenal, renal with inferior suprarenal branches), testicular, and ovarian arteries.
• Parietal branches consist Inferior phrenic arteries that supply to the superior suprarenal arteries.
• Supplies to lower portion of the body

Celiac Trunk

• Forms the first branch of the abdominal aorta, originating below the aortic hiatus of the diaphragm. - Situated at the level of the 12th thoracic vertebra.
• Divides into 3 different sections to supply the pancreas, duodenum, stomach, and more.
  • Left Gastric Artery
  • Common Hepatic Artery
  • Splenic Artery

Superior mesenteric artery

• Arises from the superior surface of the abdominal aorta, beneath the celiac trunk.
• Travels downward and rightward , existing between the two layers of the mesentery.
• Sends blood to the pancreaticoduodenal arteries, intestinal arteries, iliocolic arteries, right colic arteries, middle colic

Inferior mesenteric artery

• The artery projects down and to the left between the leaves of the sigmoid mescolon.
• It sends blood to the left colic, sigmoid and superior rectal arteries.
  • As it heads towards the large vessels by the intestines.
• Completes blood flow to the duodenum, and pancreas.

Common Iliac Artery

• The common illiac arteries extend down and sideways to reach the level of the sacroiliac joints.
• The common Illiac arteries divide into the Sacral Medial Side.
• The common illiac arteries are in the walls and organs of the pelvis and the lower limb - It is composed of the Aliaca externa and the iliaca internal arteries as well as Aliaco Externa that project to the side.

Internal Iliac Artery

• Originates from the end of the Iliac Comun.
• Descends within the minor pelvis
• Arteries in pelvis also has arteries relating to organs such as:
  • iliolumbar
  • upper gluteal
  • lower gluteal Thes feed the blood to the organs as well as Gluteas.

External Iliac Artery

• Exits at level of sacroiliac joint, close to medial border of muscle
• Follows inguinal ligament, to the muscles in leg.
• Blood goes to the pelvis, cremaster, testicles and iliac muscle.
• Gives rise to the deep circumflex iliac arteries and the inferior epigastric artery.

Femoral Artery

• Continuous with external leg through the anterior part of the thigh where the triangle is located, accompanied by femoral nerve blood supply.
• Artery penetrates towards to the adductor to give a sense of popliteal.
• supplies to the leg mucles, and surrounding areas.
• Blood circulates around the knee and the joint around.

Popliteal Artery

• Runs from the posterior thigh down to the head near the joint to supply blood
• Perforates muscle and extends into interior or tibia region to supply blood
• Is a direct continuation of the femoral artery.
• Blood flows through the bottom of the back to the front
• It is connected to blood vessels and supplies the head and surrounding leg muscles.

Tibial Arteries

• Descend blood thought the posterior,
• The anterior arteries provide blood to the dorsal on top and supply blood to the structure. - Also contains the malleori to transverse structure.
• The posterior provide the leg.

Dorsal artery of the foot

• Provides blood from the tibia top part where there are ligaments connecting structures. - Transports the upper tarsal and connects with the surrounding leg.
• Supplies top skin on the foot and around the leg.