Circulatory system

• Arch of aorta

  • Continuation of ascending aorta
  • located in superior mediastinum, beginning at level of second sternocostal joint (T4-T5) and curving posteriorly and to left over the left main bronchus.

  
• Relations of arch of aprta

  • Anteriorly and to the left: left phrenic n, cervical cardiac branch of left vagus, left superior intercostal vein, left pleura and lung
  • posterior and to right: trachea, esophagus, left recurrent laryngeal nerve, thoracic duct
  • superior: branches of arch of aorta: brachiocephalic, left common carotid, left subclavian
  • inferior: bifurcation of pulmonary trunk, left bronchus

  
• Branches of arch of aorta

  • Brachiocephalic a. : divides into right common carotid and right subclavian,
  • left common carotid a
  • left subclavian artery

  
• Thoracic aorta

  • part of the aorta, located within the thoracic cavity, and extends from T4 , where the arch of the aorta ends, continues downward to T12, where it passes through aortic hiatus of diaphragm to become the abdominal aorta.
  • branches:
  • 9 posterior intercostal arteries on each side
  • left bronchial a.
  • third right posterior intercostal a
  • esophageal a.
  • pericardial a: post suf of pericardium
  • mediastinal branch: areolar tissue of pericardium
  • sup phrenic a.: sup suf of diaphragm

  
• Descending thoracic aorta

  
• Abdominal aorta

  • continuation of thoracic aorta that runs through abdominal cavity.
  • begins at aortic hiatus of diaphragm at level of T12 vertebra and extends to the level of L4 vertebra, where it bifurcates into the right and left common iliac arteries
  • abdominal aorta descends along anterior surface of the vertebral bodies, slightly to left of the midline

  
• Relations of abdominal aorta

  • Anteriorly: celiac and aortic plexus, body of pancreas, third part of duodenum
  • posterior: body of lumbar vertebrae
  • right: inferior vena cava runs Parralel, right crus of diaphragm, cisterna chyli
  • left: left crus of diaphragm , pancreas, left sympathetic trunk

  
• Branches of abominal aorta

  Ventral branches:

  1. celiac trunk (left gastric, common hepatic, splenic a)
  2. superior mesenteric( inferior pancreaticoduodenal, middle colic, right colic, ileocolic, 12-15jejunal, ileal branches)
  3. inferior mesenteric: (left colic, sigmoid artery, sup rectal)

  lateral branches: inferior phrenic, middle suprarenal, renal arteries, gonadal artery

  posterior branches: lumbar and median sacral arteries

  
• Coeliac trunk supplies

  • Abdominal part of esophagus
  • stomach
  • duodenum (up to half of 2part)
  • liver
  • spleen
  • pancreas

  
• Relations of celiac trunk

  • Anterior: lesser sac + lesser omentum
  • right: right crus of diaphragm + caudate process of liver
  • left: left crus of diaphragm and cardiac part of stomach
  • Inferior: body of pancreas

  
• Branches of celiac trunk

  
• • Superior mesenteric artery supplies midgut (lower part of duodenum, 2/3 of transverse abdomen on right side and pancreas.
  • it has 4 branches on right side and 2 branches of left side
  • branches on right side: inferior pancreaticoduodenal, middle colic, right colic and ileocolic arteries
  • branches on left side: jejunal and ileal arteries

  
• Intestinal Arteries (Jejunal and Ileal Arteries):

  • Typically 12-15 branches.
  • Supply the jejunum and ileum of the small intestine. These branches form anastomotic arcades and vasa recta (straight arteries) in the mesentery.

  
• Jejunal and ileal arteries

  
• Ileocolic artery (terminal ileum, cecum, appendix, beginning of ascending colon) branches into

  • Ascending branch
  • descending branch: anterior and posterior cecal branch, ileal branch and apendicular branch arteries

  
• Inferior mesenteric artery

  • one of three major arteries that supply blood to large intestine.
  • arises from abdominal aorta at the level of the L3 vertebra, just below renal arteries and above aortic bifurcation, supplies distal colon.
  • Branches: left colic artery (ascending + descending branches), sigmoid artery, and superior rectal artery

  
• Inferior mesenteric artery

  
• • Common iliac artery: arise from the bifurcation of the abdominal aorta at the level of the L4 vertebra, near the umbilicus
  • The common iliac arteries bifurcate into two main branches on each side: external and internal iliac arteries.

  
• • internal iliac artery originates from bifurcation of common iliac artery at level of sacroiliac joint, around the L5-S1 vertebral level.
  • major artery that supplies blood to pelvic region, (pelvic organs, gluteal region, medial part of thigh, and perineum.)
• Internal iliac artery
• Anterior and posterior divisions of internal iliac

  
• Posterior division of internal iliac artery

  • ISL: indian super league
  • I: ileolumbar
  • s: superior gluteal artery
  • L: lateral sacral arteries

  
• • external iliac artery arises from bifurcation of the common iliac artery at level of L5-S1, near the sacroiliac join
  • Supplies oxygenated blood to lower limbs

  
• • external iliac artery gives off 2 primary branches before continuing as the femoral artery: the inferior epigastric artery and deep circumflex iliac artery.

  
• External femoral artery

  • Superficial Branches: superficial epigastric artery, superficial circumflex iliac artery, and superficial external pudendal artery.
  • Deep Branches: profunda femoris artery (deep femoral artery) is most significant deep branch. It further branches into medial and lateral circumflex femoral arteries, which supply the thigh muscles and hip joint.
• Femoral artery

  • originates from external iliac artery at the level of inguinal ligament. Ends at level pf abductor hiatus where it becomes continuous with popliteal artery

  
• Popliteal artery

  • direct continuation of the femoral artery. It begins at the adductor hiatus, a gap in the adductor magnus muscle, as the femoral artery exits the thigh and enters the popliteal fossa at the back of the knee.
• Popliteal artery

  Muscular Branches: Supply the hamstring, gastrocnemius, soleus, and plantaris muscles.

  Genicular Branches: These are important for providing blood to the knee joint. They include:

  • Superior lateral genicular artery
  • Superior medial genicular artery
  • Middle genicular artery
  • Inferior lateral genicular artery
  • Inferior medial genicular artery

  Terminal Branches: The popliteal artery bifurcates into the anterior tibial artery (supplying the anterior compartment of the leg) and the posterior tibial artery (supplying the posterior compartment of the leg).

  
• Major arteries of leg

  • Femoral artery
  • popliteal artery
  • Anterior tibial artery
  • posterior tibial artery
  • peroneal artery
• Major arteries of foot

  • Dorsalis pedis artery
  • medial plantar artery
  • lateral plantar artery
• Major arteries of foot


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• Superior vena cava

  • drain upper half of body
  • formed by convergence of left and right brachiocephalic veins, which receives blood from upper limbs, head and neck
  • Located in upper chest just behind right side of sternum.
  • Tributaries: left and right brachiocephalic veins + azygous vein

  
• superior vena cava

  
• Tributaries of superior vena cava

  • right brachiocephalic
  • left brachiocephalic
  • pericardial veins
  • mediastinal veins

  
• • Superior vena cava beings at lower border of 1st right costal cartilage, descends vertically to drain into right atrium at level of 3rd costal cartilga
  • pierces pericardium at level of second costal cartilage

  
• Femoral artery: from external iliac artery at level of inguinal ligament.

  • sup. branches: superficial pudendal a. + superficial epigastric a. + superficial circumflex iliac a.
  • deep branches: profunda femoris artery + descending geniculate artery + deep external pudendal a.
  • deep femoral a passes deep to abductor longus and gives 3 perforating branches and ends by becoming 4 perforating a.
  • Medial and Lateral Circumflex Femoral A: branches of deep femoral a. and encircle femur, forming an anastomotic network around hip joint.

  
• Popliteal artery

  
• Popliteal artery

  
• • subclavian a originates from aortic arch on left side and brachiocephalic trunk on right side. Arches laterally onto 1st ribe passing btw ant amd middle scalene m. Ends becomes axillary artery.
  • Branches
  • Vertebral a: runs upwards, enters cranium.
  • Internal thoracic a: supply chest wall + breasts
  • thyrocervical trunk: gives inferior thyroid, transverse cervical and suprascapular arteries
  • costocervical trunk: gives deep cervical and supreme intercostal arteries.

  
• Celiac trunk