Arteries of the Body PDF

ARTERIES OF THE BODY  Learning objectives After the class; Students will define the arteries of the body which exit from the heart and their branches according to region. The very first branches off of the aorta are the coronary arteries, which supply blood to the heart muscle it...

ARTERIES OF THE BODY  Learning objectives After the class; Students will define the arteries of the body which exit from the heart and their branches according to region. The very first branches off of the aorta are the coronary arteries, which supply blood to the heart muscle itself. These are followed by the branches off the aortic arch, namely the brachiocephalic artery, the left common carotid, and the left subclavian arteries. it 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 artery and right subclavian arteries The left and right common carotid arteries (carotids) are arteries that supply the head and neck with oxygenated blood; they divide in the neck to form the external and internal carotid arteries. The right common carotid originates in the neck from the brachiocephalic trunk; the left from the aortic arch in the thorax. These split into the external and internal carotid arteries at the upper border of the thyroid cartilage, at around the level of the C4-C5 vertebra. At the lower neck the two common carotid arteries are separated from each other by a very narrow interval which contains the trachea; but at the upper part, the thyroid gland, the larynx and pharynx separate the two arteries. The common carotid artery is contained in a sheath known as the carotid sheath, which is derived from the deep cervical fascia and encloses also the internal jugular vein and vagus nerve, the vein lying lateral to the artery, and the nerve between the artery and vein, on a plane posterior to both. The internal carotid artery is a major paired artery, one on each side of the head and neck. They arise from the common carotid arteries where these bifurcate into the internal and external carotid arteries at cervical vertebral level 3 or 4; the internal carotid artery supplies the brain. Terminologia Anatomica in 1998 subdivided the artery into four parts: "cervical", "petrous", "cavernous", and "cerebral". However, in clinical settings, the classification system of the internal carotid artery usually follows the 1996 recommendations by Bouthillier, describing seven anatomical segments of the internal carotid artery, each with a corresponding alphanumeric identifier— C1 cervical, C2 petrous, C3 lacerum, C4 cavernous, C5 clinoid, C6 ophthalmic, and C7 communicating. The cervical segment, or C1, or cervical part of the internal carotid, extends from the carotid bifurcation until it enters the carotid canal in the skull anterior to the jugular foramen. The named branches of the petrous segment of the internal carotid artery are: the vidian artery or artery of the pterygoid canal, the caroticotympanic artery The named branches of the cavernous segment are: -the meningohypophyseal artery -the inferolateral trunk The named branches of the ophthalmic segment are: -the ophthalmic artery -the superior hypophyseal artery The ophthalmic artery (OA) is the first branch of the internal carotid artery distal to the cavernous sinus. Branches of the OA supply all the structures in the orbit as well as some structures in the nose, face and meninges. Occlusion of the OA or its branches can produce sight-threatening conditions. Central retinal artery Lacrimal artery Posterior ciliary arteries Muscular branches Supraorbital artery Ethmoidal arteries Medial palpebral arteries Terminal branches The central retinal artery runs in the dura mater inferior to the optic nerve. About 12.5mm (0.5 inch) posterior to the globe, the central retinal artery turns superiorly and penetrates the optic nerve continuing along the center of the optic nerve entering the eye to supply the inner retinal layers. Lacrimal artery: The next branch of the OA is the lacrimal artery, one of the largest, arises just as the OA enters the orbit and runs along the superior edge of the lateral rectus muscle to supply the lacrimal gland, eyelids and conjunctiva. Lacrimal artery at the eyelids and conjunctiva. Terminal branches: The OA terminates in two branches, the supratrochlear (or frontal) artery and the dorsal nasal artery. Both exit the orbit medially to supply the forehead and scalp. 3- A. supraorbitalis: N. supraorbitalis ile orbita tavanından geçip, margo supraorbitale’ye ulaşır. The dorsal nasal artery (nasal artery) is an artery of the head. It is one of the two terminal branches of the ophthalmic artery. It emerges from the orbit above the medial palpebral ligament, and, after giving a twig to the upper part of the lacrimal sac, divides into two branches. One of these crosses the root of the nose, and anastomoses with the angular artery. The other runs along the dorsum of the nose, supplying its outer surface, and anastomoses with its fellow artery of the opposite side, and with the lateral nasal branch of the facial artery. The named branches of the communicating segment are: -the posterior communicating artery -the anterior choroidal artery The internal carotid then divides to form -the anterior cerebral artery and -middle cerebral artery. The internal carotid artery can receive blood flow via an important collateral pathway supplying the brain, the cerebral arterial circle, which is more commonly known as the Circle of Willis. The anterior cerebral artery (ACA) is one of a pair of arteries on the brain that supplies oxygenated blood to most midline portions of the frontal lobes and superior medial parietal lobes The (middle cerebral artery) MCA arises from the internal carotid It continues into the lateral sulcus where it then branches and projects to many parts of the lateral cerebral cortex. It also supplies blood to the anterior temporal lobes and the insular cortices. External carotid artery The external carotid artery is a major artery of the head and neck. It arises from the common carotid artery when it splits into the external and internal carotid artery. It supplies blood to the face and neck. The external carotid artery begins at the upper border of thyroid cartilage, and curves, passing forward and upward, and then inclining backward to the space behind the neck of the mandible, where it divides into the superficial temporal and maxillary artery within the parotid gland. At its origin, this artery is closer to the skin and more medial than the internal carotid, and is situated within the carotid triangle.  As the artery travels upwards, it supplies: In the carotid triangle: -Superior thyroid artery, arising from its anterior aspect -Ascending pharyngeal artery - arising from medial, or deep, aspect -Lingual artery - arising from its anterior aspect -Facial artery - arise from its anterior aspect -Occipital artery - arising from its posterior aspect -Posterior auricular artery - arising from posterior aspect The lingual artery arises from the external carotid between the superior thyroid artery and facial artery. It can be located easily in the tongue. It first runs obliquely upward and medialward to the greater horns of the hyoid bone. The deep lingual artery (or ranine artery) is the terminal portion of the lingual artery after the sublingual artery is given off. The facial artery (external maxillary artery in older texts) is a branch of the external carotid artery that supplies structures of the superficial face. The facial artery arises in the carotid triangle from the external carotid artery a little above the lingual artery and, sheltered by the ramus of the mandible It then curves upward over the body of the mandible at the antero- inferior angle of the masseter; passes forward and upward across the cheek to the angle of the mouth, then ascends along the side of the nose, and ends at the medial commissure of the eye, under the name of the angular artery. The ascending palatine artery arises to the side of the pharynx along which it is continued between the superior pharyngeal constrictor and the medial pterygoid muscle to near the base of the skull. Supplies the soft palate and the palatine glands, the palatine tonsil and auditory tube, anastomosing with the tonsillar branch of the facial artery and the ascending pharyngeal artery. The inferior labial artery (inferior labial branch of facial artery) arises near the angle of the mouth as a branch of the facial artery The superior labial artery follows a course along the edge of the upper lip, lying between the mucous membrane and the orbicularis oris, and anastomoses with the artery of the opposite side. The lateral nasal branch of facial artery (lateral nasal artery) is derived from the facial artery as that vessel ascends along the side of the nose. It supplies the ala and dorsum of the nose, anastomosing with its fellow, with the septal and alar branches, The angular artery is the terminal part of the facial artery; it ascends to the medial angle of the eye's orbit, The ascending pharyngeal artery is an artery in the neck that supplies the pharynx. It arises from the back part of the external carotid, and ascends vertically between the internal carotid and the side of the pharynx. The occipital artery arises from the external carotid artery opposite the facial artery. Its path is below the posterior belly of digastric to the occipital region. This artery supplies blood to the back of the scalp and sterno-mastoid muscles, and deep muscles in the back and neck. The posterior auricular artery ascends posteriorly beneath the parotid gland, along the styloid process of the temporal bone. The posterior auricular artery gives off the stylomastoid artery, small branches to the auricle, and supplies blood to the scalp posterior to the auricle. The external carotid artery terminates as two branches: Maxillary artery and Superficial temporal artery The maxillary artery supplies deep structures of the face. It branches from the external carotid artery just deep to the neck of the mandible. It runs, either superficial or deep to the lateral pterygoid muscle, to the pterygopalatine fossa. It supplies the deep structures of the face, and may be divided into mandibular, pterygoid, and pterygopalatine portions. MMA ascends between the sphenomandibular ligament and the lateral pterygoid muscle, and between the two roots of the auriculotemporal nerve to the foramen spinosum of the sphenoid bone, through which it enters the cranium; The inferior alveolar artery (inferior dental artery) is an artery of the face. It is a branch of the first portion of the maxillary artery. It runs along the mandibular canal in the substance of the bone, accompanied by the nerve, and opposite the first premolar tooth divides into two branches, incisor and mental. Mental branch: The mental branch escapes with the nerve at the mental foramen, supplies the chin, and anastomoses with the submental and inferior labial arteries. The accessory meningeal artery is a branch of the maxillary artery, sometimes derived from the middle meningeal artery. It enters the skull through the foramen ovale, and supplies the semilunar ganglion and dura mater. Second portion: The second or pterygoid portion Branches include: -Masseteric artery -Pterygoid branches -Deep temporal arteries -Buccal artery The pterygoid branches of the maxillary artery, irregular in their number and origin, supply the lateral pterygoid muscle and medial pterygoid muscle. The superficial temporal artery arises from the external carotid artery when it splits into the superficial temporal artery and maxillary artery. **** Its pulse can be felt above the zygomatic arch, above and in front of the tragus of the ear. The superficial temporal artery gives off the following side branches that supply the external ear, parotid gland, temporal muscle: transverse facial artery, anterior auricular branches, middle temporal artery. The transverse facial artery is given off from the superficial temporal artery before that vessel leaves the parotid gland; It anastomose with the facial artery, the masseteric artery, the buccinator artery, and the infraorbital artery. The anterior auricular branches of the superficial temporal artery are distributed to the anterior portion of the auricula, the lobule, and part of the external meatus, anastomosing with the posterior auricular. They supply the external acoustic meatus and the visible part of the ear. Subclavian artery The subclavian arteries are paired major arteries of the upper thorax, below the clavicle. They receive blood from the aortic arch. The left subclavian artery supplies blood to the left arm and the right subclavian artery supplies blood to the right arm, with some branches supplying the head and thorax. On the left side of the body, the subclavian comes directly off the aortic arch, while on the right side it arises from the relatively short brachiocephalic artery when it bifurcates into the subclavian and the right common carotid artery. The usual branches of the subclavian on both sides of the body are the vertebral artery, the internal thoracic artery, the thyrocervical trunk, the costocervical trunk and the dorsal scapular artery, which may branch off the transverse cervical artery which is a branch of the thyrocervical trunk. The subclavian becomes the axillary artery at the lateral border of the first rib. From its origin, the subclavian artery travels laterally, passing between anterior and middle scalene muscles, with the anterior scalene (scalenus anterior) on its anterior side and the middle scalene (scalenus medius) on its posterior. As the subclavian artery crosses the lateral border of the first rib, it becomes the axillary artery. 1-The vertebral arteries: Typically, the vertebral arteries originate from the subclavian arteries. Each vessel courses superiorly along each side of the neck, merging within the skull to form the single, midline basilar artery. As the supplying component of the vertebrobasilar vascular system, the vertebral arteries provide supply blood to the upper spinal cord, brainstem, cerebellum, and posterior part of brain. 2- The internal thoracic artery: arises from the subclavian artery near its origin. It travels downward on the inside of the ribcage, approximately a centimeter from the sides of the sternum, and thus medial to the nipple. It is accompanied by the internal thoracic vein. Internal thoracic artery is an artery that supplies the anterior chest wall and the breasts. It is a paired artery, with one running along each side of the sternum, to continue after its bifurcation as the superior epigastric and musculophrenic arteries. After passing the sixth intercostal space, the internal thoracic artery splits into the following two terminal branches: Musculophrenic artery - roughly follows the costal margin Superior epigastric artery - continues the course of the internal thoracic artery, travelling downward into the abdominal wall 3- Thyrocervical trunk: The thyrocervical trunk is located distally to the vertebral artery and proximally to the costocervical trunk. It is a short and thick vessel and it divides soon after its origin into four branches: A-Inferior thyroid artery B-Suprascapular artery C-Ascending cervical artery D- Transversa colli or transverse cervical artery The axillary artery is a continuation of the subclavian artery that begins at the outer border of the first rib. It then courses through the axilla while being bordered by the lateral (superiorly), posterior (posteriorly), medial (inferiorly) cords of the brachial plexus and the ansa pectoralis (anteriorly). The axillary artery is often referred to as having three parts, with these divisions based on its location relative to the pectoralis minor muscle, which is superficial to the artery. First part - the part of the artery superior to the pectoralis minor Second part - the part of the artery posterior to the pectoralis minor Third part - the part of the artery inferior to the pectoralis minor. First part (has 1 branch) Superior thoracic artery (Supreme thoracic artery): It supplies branches to the first and second intercostal spaces as well as to the superior portion of serratus anterior. It anastomoses with the internal thoracic artery and superior two anterior intercostal arteries. Second part (has 2 branches) Thoraco-acromial artery and Lateral thoracic artery. Projecting forward to the upper border of the Pectoralis minor, it pierces the coracoclavicular fascia and divides into four branches—pectoral, acromial, clavicular, and deltoid. Third part (has 3 branches) Subscapular artery Anterior humeral circumflex artery Posterior humeral circumflex artery Continues as the brachial artery past the inferior border of the teres major. The brachial artery is is the continuation of the axillary artery beyond the lower margin of teres major muscle. It continues down the ventral surface of the arm until it reaches the cubital fossa at the elbow. It then divides into the radial and ulnar arteries which run down the forearm. The brachial artery gives rise to the following branches: -Profunda brachii artery (deep brachial artery) -Superior ulnar collateral artery -Inferior ulnar collateral artery -Radial artery (a terminal branch) -Ulnar artery (a terminal branch) -Nutrient branches to the humerus (nutricial arteries) The palmar carpal arch is the combination (anastomosis) of two arteries: the palmar carpal branch of radial artery and the palmar carpal branch of ulnar artery. Descending aorta Has 2 parts thoracal and abdominal The descending thoracic aorta begins at the lower border of the T4 vertebra where it is continuous with the aortic arch, and ends in front of the lower border of the T12 vertebra, at the aortic hiatus in the diaphragm where it becomes the abdominal aorta. Behind the descending thoracic aorta, there is the vertebral column and the hemiazygos vein. To the right is the azygos veins and thoracic duct, and to the left is the left pleura and lung. The esophagus, which is covered by a nerve plexus lies to the right of the descending thoracic aorta. Lower, the esophagus passes in front of the aorta, and ultimately is situated on the left. The aorta gives off several paired branches as it descends. In descending order, these include the Bronchial arteries Mediastinal arteries Esophageal arteries Pericardial arteries Superior phrenic arteries The bronchial arteries supply the lungs with nutrition and oxygenated blood. Although there is much variation, there are usually two bronchial arteries that run to the left lung, and one to the right lung. The mediastinal branches are numerous small vessels which supply the lymph glands and loose areolar tissue in the posterior mediastinum. The esophageal arteries four or five in number, arise from the front of the aorta, They anastomose with the esophageal branches of the inferior thyroid arteries above, and with ascending branches from the left inferior phrenic and left gastric arteries below. Pericardial arteries The superior phrenic arteries are small and arise from the lower part of the thoracic aorta; they are distributed to the posterior part of the upper surface of the diaphragm, and anastomose with the musculophrenic and pericardiacophrenic arteries. Abdominal aorta The abdominal aorta is the largest artery in the abdominal cavity. As part of the aorta, it is a direct continuation of the descending aorta (of the thorax). The abdominal aorta supplies blood to much of the abdominal cavity. It begins at T12 and ends at L4 with its bifurcation into the common iliac arteries The abdominal aorta begins at the level of the diaphragm, crossing it via the aortic hiatus, at the vertebral level of T12. It travels down the posterior wall of the abdomen, anterior to the vertebral column. It runs parallel to the inferior vena cava, which is located just to the right of the abdominal aorta, and becomes smaller in diameter as it gives off branches. The abdominal aorta is clinically divided into 2 segments: The suprarenal abdominal or paravisceral segment, inferior to the diaphragm but superior to the renal arteries. The Infrarenal segment, inferior to the renal arteries and superior to the iliac bifurcation.  Direct branches of the abdominal aorta: 1.inferior phrenic a. 2.celiac a. 3.superior mesenteric a. 4.middle suprarenal a. 5.renal a. 6.testicular or ovarian a. 7.four lumbar arteries 8.inferior mesenteric a. 9.median sacral a. 10.common iliac a. The abdominal aorta is covered anteriorly, by the lesser omentum and stomach, behind which are the branches of the celiac artery and the celiac plexus; below these, by the lienal vein (splenic vein), the pancreas, the left renal vein, the inferior part of the duodenum, the mesentery, and aortic plexus. On the right side it is in relation above with the azygos vein, cisterna chyli, thoracic duct, and the right crus of the diaphragm the inferior vena cava is in contact with the aorta below. On the left side are the left crus of the diaphragm, the left celiac ganglion, the ascending part of the duodenum, and some coils of the small intestine. 1- Inferior phrenic: Originates above the celiac trunk, below the diaphragm. Passes upward and medially to the suprarenal gland, and crosses crus of diaphragm of corresponding side. Supplies diaphragm and gives superior suprarenal arteries. 2- The celiac artery or truncus coeliacus, is the first major branch of the abdominal aorta. It is 1.25 cm in length. Branching from the aorta at thoracic vertebra 12 (T12) in humans, it is one of three anterior/ midline branches of the abdominal aorta (the others are the superior and inferior mesenteric arteries). 2. Celiac a. A-Left gastric a. B-Splenic a. 1. short gastric arteries 2. splenic arteries 3. left gastroepiploic a. 4. pancreatic arteries C-Common hepatic a. 1. right gastric a. 2. gastroduodenal a. 1.right gastroepiploic a. 2.superior pancreaticoduodenal a. 3. right hepatic a. 1.cystic a. 4. left hepatic a. 3- The superior mesenteric artery (SMA) arises from the anterior surface of the abdominal aorta, just inferior to the origin of the celiac trunk, and supplies the intestine from the lower part of the duodenum through two- thirds of the transverse colon, as well as the pancreas. Testicular or ovarian a. The term gonadal artery is a generic term for a paired artery, with one arising from the abdominal aorta for each gonad. Specifically, it can refer to: the testicular artery in males the ovarian artery in females The lumbar arteries are arteries located in the lower back or lumbar region. The lumbar arteries are in parallel with the intercostals. They are usually four in number on either side, and arise from the back of the aorta, opposite the bodies of the upper four lumbar vertebrae. The inferior mesenteric artery, often abbreviated as IMA, is the third main branch of the abdominal aorta and arises at the level of L3, Supplies the large intestine from the left colic (or splenic) flexure to the upper part of the rectum, which includes the descending colon, the sigmoid colon, and part of the rectum. The median sacral artery (or middle sacral artery) is a small vessel that arises posterior to the abdominal aorta and superior to its bifurcation. The common iliac arteries are two large arteries that originate from the aortic bifurcation at the level of the fourth lumbar vertebra. They end in front of the sacroiliac joint, one on either side, and each bifurcates into the external and internal iliac arteries. The distribution of the common iliac artery is basically the pelvis and lower limb (as the femoral artery) on the corresponding side. The internal iliac artery (formerly known as the hypogastric artery) is the main artery of the pelvis. Branches: Iliolumbar artery, lateral sacral artery, superior gluteal artery, inferior gluteal artery, middle rectal artery, uterine artery, obturator artery, inferior vesical artery, superior vesical artery, obliterated umbilical artery, internal pudendal artery The external iliac arteries are two major arteries which bifurcate off the common iliac arteries anterior to the sacroiliac joint of the pelvis. They proceed anterior and inferior along the medial border of the psoas major muscles. They exit the pelvic girdle posterior and inferior to the inguinal ligament about one third laterally from the insertion point of the inguinal ligament on the pubic tubercle at which point they are referred to as the femoral arteries. Inferior epigastric( branch of external iliac) and superior epigastric (branch of internal thoracic a.) anastomose, above the umbilicus The femoral artery is a large artery in the thigh and the main arterial supply to the thigh and leg. It enters the thigh from behind the inguinal ligament as the continuation of the external iliac artery. Branches The femoral artery gives off several branches in the thigh which include; 1-The superficial circumflex iliac artery 2-The superficial epigastric artery 3-The superficial external pudendal artery 4-The deep external pudendal artery 5-The profunda femoris artery 6-The descending genicular artery The popliteal artery is a deeply placed continuation of the femoral artery after it passes through the adductor hiatus, or opening in the distal portion of the adductor magnus muscle. It courses through the popliteal fossa and ends at the lower border of the popliteus muscle, where it branches into the anterior and posterior tibial arteries. Ant.tibial artery crosses the anterior aspect of the ankle joint, at which point it becomes the dorsalis pedis artery. The posterior tibial artery of the lower limb carries blood to the posterior compartment of the leg and plantar surface of the foot, from the popliteal artery via the tibial- fibular trunk. It is accompanied by a deep vein, the posterior tibial vein, along its course. The fibular artery: This vessel is a branch of the posterior tibial artery. And is the artery of the lateral or fibular compartment of the leg. Although it supplies the lateral compartment, it actually runs in the posterior compartment, and from there, sends perforating branches into the lateral compartment to supply the fibularis muscles (longus and brevis). Descending with the tibila nerve the posterior tibial artery gives rise to the medial plantar artery, lateral plantar artery, The lateral plantar artery (external plantar artery), much larger than the medial, passes obliquely lateralward and forward to the base of the fifth metatarsal bone. It then unites with the deep plantar branch of the dorsalis pedis artery, thus completing the plantar arch. The medial plantar artery (internal plantar artery), much smaller than the lateral plantar artery, passes forward along the medial side of the foot. It is at first situated above the abductor hallucis, and then between it and the flexor digitorum brevis, both of which it supplies.