Arthritis 

Aortic branches diagram. Aorta, branches of the aorta: description and photo

The aorta is the largest vessel in the human body, which carries blood out of and is the beginning of the systemic circulation.

There are several departments in the aorta:

  • ascending (pars ascendens aortae) department;
  • arch and branches of the aortic arch;
  • descending (pars descendens aortae) department, which, in turn, is divided into thoracic and abdominal parts.

Aortic arch and its branches

  1. Truncus brachiocephalicus branches off from the aortic arch at the level of the cartilage of the 2nd right rib. In front of it is the right brachiocephalic vein, and behind it is the trachea. After discharge, it goes up and to the right, giving out two branches in the region of the sternoclavicular right joint: the subclavian right and the common carotid right artery.
  2. (left) - one of the branches of the aortic arch. As a rule, this branch is longer than the carotid common right artery by 20-25 millimeters. The path of the artery runs behind the scapular-hyoid and sternocleidomastoid muscle, then up the transverse processes of the cervical vertebrae. Outside the vessel are nervus vagus and the jugular (internal) vein, the esophagus, trachea, pharynx, larynx, parathyroid and thyroid glands run medially from it. In the area (its upper part), each of the common carotid arteries gives off the internal and external carotid arteries, which have approximately the same diameter. The place of division of the artery is called bifurcation, in this place also lies the intersonic glomerulus (sleepy glomus, carotid gland) - an anatomical formation with dimensions of 1.5 x 2.5 mm, which is equipped with many chemoreceptors and a network of capillaries. In the area of \u200b\u200borigin of the carotid external artery, there is a small expansion called the carotid sinus.
  3. The external carotid artery is one of the two terminal branches of the common carotid artery. It branches off from the latter in the region of the carotid triangle (the upper edge of the thyroid cartilage). At first, it is located slightly medial to the carotid internal artery, and then lateral to it. The beginning of the carotid external artery lies under the sternocleidomastoid muscle, and in the area of \u200b\u200bthe carotid triangle - under the subcutaneous muscle of the neck and the cervical fascia (its surface plate). Located inwardly from the digastric muscle (its posterior abdomen) and the carotid (external) artery in the region of the mandibula neck (in the parotid layer) is divided into a pair of terminal branches: the maxillary and temporal superficial artery. In addition, in its course, the carotid external atrium gives rise to a number of branches: the anterior group - the facial, thyroid superior and lingual arteries, the posterior group - the posterior ear, occipital and sternocleidomastoid arteries, and the pharyngeal ascending artery departs to the middle.

Branches of the thoracic aorta

This segment, as already mentioned, is part of the descending aorta. It is located in the region of the posterior mediastinum, passing along the spinal column.

The branches of the thoracic aorta are presented in two groups: parietal and visceral (visceral).

Internal branches

The visceral branches of the aorta are represented by the following groups:

  1. Bronchial branches (2-4 pieces). They start from the anterior wall of the aorta in the area of \u200b\u200bthe branch of the intercostal third arteries. Entering the gates of both lungs, they form an arterial intrabronchial network that supplies blood to the bronchi, connective tissue formations (frame) of the lungs, esophagus, pericardium, walls of pulmonary vessels (veins and arteries). In the lung tissue, the bronchial branches form anastomoses with the branches of the pulmonary arteries.
  2. Esophageal branches (3-4 pieces). They have a length of about 1.5 cm and end in the walls of the esophagus (its thoracic segment). These branches start from the thoracic aorta in the region of the 4-8 thoracic vertebra. Anastomoses are formed with the upper diaphragmatic, lower and upper thyroid, mediastinal arteries, as well as with the coronary left cardiac artery.
  3. The mediastinal branches (mediastinal) can have a varied location, not constant. Often included in the pericardial branches. Carry out blood supply to the tissue, lymph nodes and the wall (back) of the pericardium. Anastomoses are formed with the above-described branches.
  4. Pericardial branches (1-2 pieces) thin and short. They branch off from the anterior aortic wall, supplying blood to the pericardium (its posterior wall). Anastomoses are formed with the mediastinal and esophageal arteries.

Parietal branches

  1. The diaphragmatic upper arteries extending from the aorta supply blood to the pleura and the lumbar segment of the aorta. They are combined into anastomoses with the diaphragmatic lower, internal thoracic and intercostal lower arteries.
  2. The posterior intercostal arteries (10 pairs) branch off from the posterior aortic wall and follow in the 3-11 intercostal spaces. The last pair passes under the 12th rib (that is, it is subcostal) and enters into anastomosis with the lumbar arterial branches. The first and second intercostal spaces are supplied with blood by the subclavian artery. The intercostal right arteries are slightly longer than the left ones and run under the pleura up to the costal angles, located posterior to the posterior mediastinum, lying on the anterior surfaces of the vertebral bodies. At the costal heads, dorsal branches extend from the intercostal arteries to the muscles and skin of the back, to the spinal cord (including its membranes) and the spine. From the costal corners, the arteries run between the internal and external intercostal muscles, lying in the costal groove. Arteries in the area of \u200b\u200bthe 8th intercostal space and below it lie under the corresponding rib, branch into lateral branches to the muscles and skin of the lateral parts of the chest, and then form anastomoses with the intercostal anterior branches from the thoracic (internal) artery. 4-6 intercostal arteries give branches to the mammary glands. The upper intercostal arteries supply blood to the chest, and the lower three - the diaphragm and the abdominal wall (anterior). The third right intercostal artery gives off a branch that goes to the right bronchus, and branches depart from the 1-5 intercostal arteries that supply the left bronchus with blood. The 3-6th intercostal arteries give rise to the esophageal arteries.

Branches of the abdominal aorta

The abdominal segment of the aorta is a continuation of its thoracic part. It starts from the level of the 12th thoracic vertebra, passes through the aortic diaphragmatic opening and ends in the region of the 4th vertebra of the lower back.

The abdominal region is located in front of a little to the left of the midline, lies retroperitoneally. To the right of it lies in front - the pancreas, a horizontal segment of the duodenum and the mesenteric root of the small intestine.

Parietal branches

The following parietal branches of the abdominal part of the aorta are distinguished:

  1. The diaphragmatic inferior arteries (right and left) branch off from the abdominal aorta after leaving the aortic diaphragmatic opening and follow the diaphragm (its lower plane) forward, upward and along the sides.
  2. Lumbar arteries (4 pieces) start from the aorta in the upper 4 region and supply blood to the anterolateral surfaces of the abdomen, spinal cord and lower back.
  3. The sacral median artery departs from the aorta in the area of \u200b\u200bits division into the iliac common arteries (5th lumbar vertebra), follows along the pelvic part of the sacrum, supplying blood to the tailbone, sacrum and m. iliopsoas.

Visceral branches

The following visceral branches of the abdominal aorta are distinguished:


Atherosclerosis of the aorta

Atherosclerosis of the aorta and its branches is a pathology characterized by the proliferation of plaques in the lumen of the vessels, which subsequently leads to a narrowing of the lumen and the formation of blood clots.

The pathology is based on an imbalance in the ratio of lipid fractions, towards an increase in cholesterol, which is deposited in the form of plaques of the aorta and aortic branches.

The provoking factors are smoking, diabetes, heredity, physical inactivity.

Manifestations of atherosclerosis

Quite often, atherosclerosis proceeds without obvious symptoms, which is associated with the large size of the aorta (as well as sections, branches of the aorta), developed muscle and elastic layers. The overgrowth of plaques leads to overloading of the heart, which is manifested by pressure surges, fatigue, and increased heartbeat.

With the progression of the pathology, the process spreads to the branches of the aortic arch of the descending and ascending sections, including the arteries that feed the heart. In this case, the following symptoms occur: angina pectoris (chest pain that radiates to the scapula or arm, shortness of breath), impaired digestion and kidney function, blood pressure jumps, cold extremities, dizziness, headaches, frequent fainting, weakness in the hands.

Aorta (aorta) - the largest arterial vessel in a person, the main highway from which all the arteries of the body originate.

Departments... In the aorta, the ascending part, the arch, the descending part are distinguished. In the descending part, the thoracic part of the aorta and the abdominal part are distinguished.

Topography, areas of blood supply... The ascending part of the aorta begins with the aortic bulb, its length is about 6 cm, behind the sternum it goes up and to the right and at the level of the cartilage of the II rib passes into the aortic arch. The coronary arteries branch off from the ascending part of the aorta. The aortic arch is convex upward and at the level of the III thoracic vertebra passes into the descending part of the aorta. The descending part of the aorta lies in the posterior mediastinum, passes through the aortic opening of the diaphragm and in the abdominal cavity is located in front of the spine. The descending part of the aorta to the diaphragm is called the thoracic part of the aorta, below - the abdominal part. The thoracic region runs along the thoracic cavity in front of the spine. Its branches nourish internal organs this cavity, the walls of the chest and abdominal cavities. The abdominal part lies on the surface of the bodies of the lumbar vertebrae, behind the peritoneum, behind the pancreas, duodenum and the root of the mesentery of the small intestines. Large branches of the aorta go to the abdominal viscera. At level IV of the lumbar vertebra, the aorta is divided into the right and left common iliac arteries, which feed the walls and insides of the pelvis and the lower extremities, and a small trunk continues into the pelvis - the median sacral artery.

Aorta and pulmonary trunk (part). 1 - semilunar aortic valves; 2 - the right coronary artery; 3 - opening of the right coronary artery; 4 - left coronary artery; 5 - opening of the left coronary artery; 6 - grooves (sinuses) between the semilunar valves and the aortic wall; 7 - ascending aorta; 8 - aortic arch; 9 - descending aorta; 10 - pulmonary trunk; 11 - left pulmonary artery; 12 - right pulmonary artery; 13 - shoulder-head trunk; 14 - the right subclavian artery; 15 - right common carotid artery; 16 - left common carotid artery; 17 - left subclavian artery

Aortic branches... I. The ascending part of the aorta. 1. Right coronary artery - a. coronariadextra. 2. Left coronary artery - a. coronariasinistra. II. Aortic arch. 1. Brachiocephalic trunk - truncus brachiocephalicus. 2. Left common carotid artery - a. carotiscommunissinistra. 3. Left subclavian artery - a. subclaviasinistra. III. The descending part of the aorta. The thoracic part of the aorta. 1. Bronchial branches - rr. bronchiales. 2. Esophageal branches - rr. esophageales. 3. Mediastinal branches - rr. mediastinales. 4. Pericardial branches - rr. pericardiaci. 5. Posterior intercostal arteries - aa. intercostalesposteriores. 6. Superior diaphragmatic arteries - aa. phrenicaesuperiores. The abdominal part of the aorta. A. Internal branches. a) Unpaired: 1) celiac trunk - truncusceliacus; 2) superior mesenteric artery - a.mesenterica superior; 3) inferior mesenteric artery - a.mesenterica inferior. b) Paired: 1) middle adrenal arteries - aa. suprarenalesmediae; 2) renal arteries - aa. renales; 3) testicular (ovarian) arteries - aa. testiculars (ovaricae). B. Parietal branches. 1. Lower diaphragmatic arteries - aa. phrenicaeinferiores. 2. Lumbar arteries - aa. lumbales. B. Terminal branches. 1. Common iliac arteries - aa. iliacaecommunes. 2. Median sacral artery - a. sacralismediana.


Arteries extending from the aorta (diagram): 1 - aortic arch; 2 - the descending aorta; 3 - celiac trunk; 4 - left testicular artery; 5 - left common iliac, 6 - left internal and 7 - external iliac; 8 - left femoral; 9 - middle sacral; 10 - lower mesenteric; 11 - lumbar; 12 - right renal; 13 - superior mesenteric; 14 - shoulder; 15 - intercostal; 16 - axillary; 17 - brachiocephalic trunk; 18 - subclavian; 19 - general sleepy

Arteries of the neck and head. Blood supply to the brain... Three large vessels extend from the convex surface of the aortic arch: the brachiocephalic trunk, the left common carotid artery, and the left subclavian artery.

The common carotid artery (a. Carotiscommunis) departs to the right of the brachiocephalic trunk, to the left of the aortic arch. Both arteries run up the sides of the windpipe and esophagus and at the level of the upper edge of the thyroid cartilage are divided into the internal and external carotid arteries.


Head and neck arteries... 1 - occipital artery (a.occipitalis); 2 - superficial temporal artery (a. Temporalis superficial! S); 3 - posterior ear artery (a. Auricularis posterior); 4 - internal carotid artery (a. Carotis interna); 5 - external carotid artery (a. Carotis externa); 6 - ascending cervical artery (a.cervicalis ascendens); 7 - thyroid trunk (truncus thyrocervicalis); 8 - common carotid artery (a. Carotis communis); 9 - the upper thyroid artery (a. Thyreoidea superior); 10 - lingual artery (a. Lingualis); 11 - facial artery (a. Facialis); 12 - lower alveolar artery (a.alveolaris inferior); 13 - maxillary artery (a.maxillaris); 14 - infraorbital artery (a. Infraorbitalis)

The external carotid artery (a. Carotisexterna) supplies blood to the outer parts of the head and neck. In the course of the external carotid artery, the following anterior branches branch off from it: the superior thyroid artery to the thyroid gland and larynx; lingual artery to the tongue and sublingual salivary gland; the facial artery bends through the base of the lower jaw to the face and goes to the corner of the mouth, the wings of the nose and to the medial corner of the eye, supplying blood along the way to the pharyngeal wall and palatine tonsil, the submandibular salivary gland and the face area. The posterior branches of the external carotid artery are: the occipital artery, which feeds the skin and muscles of the occiput; the posterior auricular artery leading to the auricle and the external auditory canal. On the inside of the external carotid artery, the ascending pharyngeal artery departs from it, feeding the pharyngeal wall. Then the external carotid artery rises up, pierces the parotid salivary gland and behind the branch of the lower jaw is divided into terminal branches: the superficial temporal artery, located under the skin of the temporal region, and the maxillary artery, lying in the lower temporal and pterygopalatine fossa and supplying blood to the external ear, chewing muscles, teeth , the walls of the nasal cavity, the hard and soft palate, the dura mater.

The internal carotid artery (a. Carotisinterna) rises to the base of the skull and through the carotid canal enters the cranial cavity, where it lies on the side of the Turkish saddle. The ophthalmic artery departs from it, which, together with the optic nerve, passes into the orbit and supplies blood to its contents, as well as the dura mater and nasal mucosa, anastomoses with the branches of the facial artery.

From the internal carotid artery, the anterior and middle cerebral arteries depart, which supply blood to the inner and outer surfaces of the cerebral hemispheres, give branches to the deep parts of the brain and vascular plexuses. The right and left anterior cerebral arteries are connected by the anterior communicating artery.

At the base of the brain, the right and left internal carotid arteries, connecting with the posterior cerebral arteries (from the basilar artery), with the help of the posterior connecting arteries, form a closed arterial ring (circle of Willis).

The subclavian artery (a.subclavia) on the right departs from the brachiocephalic trunk, on the left - from the aortic arch, rises to the neck and passes in the groove of the first rib, passing in the interscalene space along with the brachial plexus trunks. The following branches extend from the subclavian artery: 1) the vertebral artery passes through the openings of the transverse processes of the cervical vertebrae and through the large (occipital) opening enters the cranial cavity, where it merges with the artery of the same name on the other side into the unpaired basilar artery lying at the base of the brain. The terminal branches of the basilar artery are the posterior cerebral arteries that feed the occipital and temporal lobes of the cerebral hemispheres and participate in the formation of the arterial circle. In the course of the vertebral artery, branches depart from it to the spinal cord, medulla oblongata and cerebellum, from the basilar artery to the cerebellum, brain stem and inner ear; 2) the shield-cervical trunk - a short trunk, branching into four branches at once. Supplies blood to the thyroid gland and larynx, muscles of the neck and scapula; 3) the internal thoracic artery descends along the inner surface of the anterior chest wall, nourishing the muscles, mammary gland, thymus, pericardium and diaphragm, its final branch reaches in the anterior abdominal wall to the level of the navel; 4) the costal trunk supplies blood to the muscles of the neck and the upper two intercostal spaces; 5) the transverse artery of the neck feeds the muscles of the occiput and scapula.


Arteries of the brain... 1 - anterior communicating artery (a.communicans anterior); 2 - anterior cerebral artery (a. Cerebri anterior); 3 - internal carotid artery (a. Carotis interna); 4 - middle cerebral artery (a. Cerebri media); 5 - posterior connecting artery (a.communicans posterior); 6 - posterior cerebral artery (a. Cerebri posterior); 7 - the main artery (a. Basilaris); 8 - vertebral artery (a.vertebralis); 9 - posterior lower cerebellar artery (a. Inferior posterior cerebelli); 10 - anterior lower cerebellar artery (a. Inferior anterior cerebelli); 11 - superior cerebellar artery (a. Superior cerebelli)

An important role in the functioning of the body is played by the circulatory system, which consists of the heart - a kind of muscle pump that continuously pumps blood, and vessels, which are divided into arterial, venous and capillary according to their structure and functions.

The main trunk, which gives rise to all arterial vessels, is the aorta. And what vessels depart from the aortic arch: we will analyze in our review and the video in this article.

Anatomy and topography of the aorta

The aorta is the largest arterial trunk of the large (main) circle of blood circulation. It starts in the left ventricle of the heart and continues to the level of the body of the IV lumbar vertebra.

In the structure of the aortic wall, there are:

  • endothelium - the inner shell, which ensures the selective permeability of substances from the blood to the vascular wall;
  • the muscle layer, which is composed of smooth muscle cells;
  • the outer layer, which includes a large number of elastic fibers, nerve endings and supply vessels.

Thanks to control from the central nervous system, smooth muscle fibers are regularly contracted and relaxed. This promotes the physiological blood flow and its active distribution from the center to peripheral tissues. Learn more what vessels depart from the aortic arch is possible only by reading this article in full.

It is interesting. The speed of blood flow through the aorta averages 0.5-1.3 m / s.

In anatomy and clinical medicine, it is customary to distinguish the following parts in the structure of the aorta:

  • the ascending part is about 6 cm long;
  • arc;
  • descending part:
    1. thoracic region, which extends 16-17 cm;
    2. abdominal region.

The ascending part of the aorta leaves the left ventricle of the heart, continuing its arterial cone. At its very beginning, the vessel forms an expansion - a bulb (bulbus) with a diameter of 25-30 mm. Behind the sternum, it goes up and gradually turns into an arc.

The aortic arch is characterized by deviation to the left and posteriorly. At the level of the fourth thoracic vertebra, it narrows slightly, forming an isthmus, and passes into the thoracic region.

The descending part of the aorta is the longest section of the arterial vessel. It continues from the thoracic (IV vertebra) to the lumbar (IV vertebra) of the spine and, when the diaphragm passes, is divided into two parts - the thoracic and abdominal.

All vessels extending from the aorta are shown in the table below.

Part of the aorta (see photo) Outgoing vessels

Coronary arteries (right, left)

Brachiocephalic trunk
General a. carotis (left)
Subclavian a. (left)
Descending

Intercostal branches
Esophageal branches
Tracheal branches
Pleural branches
Pericardial branches, etc.

Celiac trunk
Mesenteric a.
Renal a. and etc.

Note! The vessels of the ascending part of the aorta nourish the heart muscle itself, ensuring its stable work. Narrowing of the coronary arteries leads to such serious pathologies as ischemic heart disease, angina pectoris, acute coronary syndrome (infarction).

Outgoing arteries

According to anatomical structure human body, three large arteries depart from the arc (see).

Brachiocephalic trunk

Truncus (tr.) Brachiocephalicus, or brachiocephalic trunk, is the first and largest artery extending from the aortic arch. It is a short and thick vessel: its length is 3-5 cm on average, and its diameter is 7 mm.

The vessel is located approximately along the midline of the body and goes up, at the level of the sternoclavicular joint, it is divided into the right arteries - brachiocephalic, subclavian.

Left common carotid artery

Arteria carotis communis sinistra, or the left carotid artery (common) - an artery, in contrast to its right pair, extending directly from the arch. It is responsible for adequate blood supply to the brain, eyeball, neck and head tissue.

A. carotis communis goes straight up, not giving branches along its entire length, and at the level of the upper border of the thyroid cartilage it divides into the following arteries:

  • external sleepy;
  • internal sleepy.

Note! The indicator of normal blood flow in the vessels of the brain is 55 ml / 100 g. The main reason for its decrease (in more than 90% of cases) is considered to be atherosclerotic lesions of the arteries.

A. subclavia sin.

Arteria subclavia sinistra, the left subclavian artery is the main vessel supplying the upper shoulder girdle, as well as the organs of the neck and head.

Has three departments:

  • the first, starting from the aortic arch, enveloping the dome of the pleura, extending to the neck and ending in the interscalene space;
  • the second, passing along the interstellar space and the groove of the same name of the right rib;
  • the third, starting at the point of exit from the interstellar space and at the level of the edge of the first rib, continuing into the axillary artery.

From the first section A. subclavia departs:

  • the vertebral artery that feeds the spine and spinal cord;
  • internal thoracic artery, which supplies blood to the thyroid gland, mediastinal organs, large bronchi, pericardium, diaphragm, sternum and other organs of the thoracic and upper abdominal cavity;
  • the thyroid trunk, which ensures uninterrupted supply of oxygen and nutrients to the thyroid gland, the tissues of the neck and part of the back.

In about 30% of all people, the thyroid artery (inferior) also branches off from the arch, feeding the accessory pyramidal part of the thyroid gland. If a conicotomy or tracheotomy is necessary, the likelihood of damage is high, therefore it is important that these manipulations are carried out by an experienced doctor.

The vessels extending from the aortic arch play a key role in the blood supply to the organs of the head and neck, including the brain. Any changes in their work lead to symptoms of hypoxia and functional disorders of the central nervous system.

That is why the medical instruction recommends that patients with headaches, dizziness attacks, memory impairment and other cognitive disorders undergo an examination as soon as possible and begin treatment of vascular problems, because the deterioration of the condition - the price of delay - progresses every day.

Aorta (aorta;fig. 181) is the largest arterial vessel in the human body. There are three sections in the aorta: ascending part, arcand descending part.The descending part distinguishes chest part(pars thoracica) and abdomen(pars abdominalis) aorta.

Ascending aorta(pars ascendens aortae), about 6 cm long, has an expansion in the form of a bulb (bulbus aortae) in the initial section, covered with a pericardium. Behind the sternum, it goes up and to the right and at the level of the cartilage of the II rib passes into the aortic arch. From the ascending part (in the area of \u200b\u200bthe bulb), the right and left coronary arteries depart.

Aortic arch(arcus aortae), facing upward with a bulge, bends back and to the left and at the level of III-IV thoracic vertebra passes into the descending part of the aorta. Three large vessels branch off from the convex surface of the aortic arch: brachiocephalic trunk(truncus brachiocephalicus), left common carotid artery(a. carotis communis sinistra) and left subclavicular artery(a. subclavia sinistra).

Descending aorta(pars descendens aortae; see Fig. 181) - this is the longest section of the aorta, runs from the level IV of the thoracic vertebra to the IV lumbar, where it is divided into the right and left common iliac arteries (aortic bifurcation). In the descending part of the aorta, the thoracic and abdominal parts are distinguished.

Aortalocated to the left of the midline of the body and with its branches supplies blood to all organs and tissues of the body. A part of it, about 6 cm long, directly leaving the heart and rising up, is called the ascending part of the aorta. It begins with the expansion - the bulb - of the aorta, inside which there are three aortic sinuses, located between the inner surface of the aortic wall and the flaps of its valve. The right and left coronary arteries extend from the aortic bulb. Bending to the left, the aortic arch lies over the pulmonary arteries diverging here, spreads over the beginning of the left main bronchus and passes into the descending part of the aorta. From the concave side of the aortic arch, branches begin to the trachea, bronchi and to the thymus gland, three large vessels depart from the convex side of the arch: the shoulder-head trunk lies on the right, the common carotid and left subclavicular arteries on the left.

Shoulder-head trunkabout 3 cm long, it departs from the aortic arch, goes up, back and to the right, in front of the trachea. At the level of the right sternoclavicular joint, it is divided into the right common carotid and subclavian arteries. The left common carotid and left subclavian arteries extend directly from the aortic arch to the left of the shoulder-head trunk.

Common carotid artery(right and left) goes up next to the trachea and esophagus. At the level of the upper edge of the thyroid cartilage, it divides into the external carotid artery, which branches outside the cranial cavity, and the internal carotid artery, which runs inside the skull and goes to the brain.

External carotid arterygoes up, passes through the tissue of the parotid gland and in its thickness behind the neck of the condylar process of the lower jaw is divided into its terminal branches: the maxillary and superficial temporal arteries. On its way, the artery gives off lateral branches and supplies blood to the outer parts of the head and neck, mouth and nose, thyroid gland, larynx, tongue, palate, tonsils, sternocleidomastoid and occipital muscles, submandibular, sublingual and parotid salivary glands, skin, bones and muscles of the head (mimic and chewing), teeth of the upper and lower jaws, dura mater, outer and middle ear.

Internal carotid arterygoes up to the base of the skull without giving up branches, enters the cranial cavity through the carotid artery canal in the temporal bone, rises along the carotid sulcus sphenoid bone, lies in the cavernous sinus and, passing through the hard and arachnoid membranes, is divided into a number of terminal branches. The artery supplies the brain and the organ of vision.

Subclavian arteryon the left, it departs directly from the aortic arch, on the right - from the shoulder-head trunk, bends around the dome of the pleura, passes between the collarbone and the 1st rib, lies in the groove of the same name of the 1st rib, heading towards the axillary cavity. The subclavian artery and its branches supply blood to the cervical spinal cord frommeninges, brain stem, occipital and partially temporal lobes of the cerebral hemispheres, deep and partly superficial muscles of the neck, cervical vertebrae, intercostal muscles of the first and second intervals, part of the muscles of the occiput, back and shoulder blades, diaphragm, skin of the chest and upper abdomen, rectus abdominis muscle, mammary gland, throat, trachea, esophagus, thyroid and thymus glands.

On the basis of the brain, due to the connection of the anterior cerebral arteries with the anterior communicating artery, as well as the posterior connecting and posterior cerebral arteries, a circular arterial anastomosis is formed - the arterial (Willis) circle of the large brain. The subclavian artery in the axillary region becomes axillary artery,which lies in the axillary fossa medially from the shoulder joint and the humerus next to the vein of the same name, and is surrounded by the trunks of the brachial plexus. The artery supplies the muscles of the shoulder girdle, the skin and muscles of the lateral chest wall, the shoulder and clavicular-acromial joints, the contents of the axillary fossa.

Brachial arteryis a continuation of the axillary, it passes in the medial groove of the biceps brachii and in the ulnar fossa is divided into the radial and ulnar arteries. The brachial artery supplies blood to the skin and muscles of the shoulder, the humerus and the elbow joint.

Radial arterylocated on the forearm laterally in the radial groove, parallel to the radius. In the lower section, near its styloid process, the artery is easily palpable, being covered only by the skin and fascia. The radial artery passes to the hand under the tendons of the long muscles of the thumb, bends around the first metacarpal bone from the back. It supplies blood to the skin and muscles of the forearm and hand, radius, elbow and wrist joints.

Ulnar arteryis located on the forearm medially in the ulnar groove parallel to the ulna, passes to the palmar surface of the hand. It supplies blood to the skin and muscles of the forearm and brush, the ulna, the elbow and wrist joints. The ulnar and radial arteries form two arterial networks of the wrist on the hand: the dorsal and palmar, which feed the ligaments and joints of the wrist, the second, third, fourth interosseous spaces and fingers, and two arterial palmar arches - deep and superficial. The superficial la-bottom arch is formed mainly due to the ulnar artery and the superficial palmar branch of the radial artery. From the superficial arch, four common palmar digital arteries extend downward, going to the P-III-IV-V fingers. Each of the I, II, III arteries supply blood to the sides of the II-V fingers facing each other, IV - supply blood to the ulnar side of the V finger.

The deep palmar arch is located somewhat proximal to the superficial one. It lies under the flexor tendons at the level of the base of the metacarpal bones. In the formation of the deep palmar arch, the main role belongs to the radial artery, which is connected to the deep ^ palmar branch of the ulnar artery. Three palmar metacarpal arteries depart from the deep arch, which are sent to the second, third and fourth interosseous spaces. These arteries connect to the common palmar digital arteries. Due to the presence of arcs and networks anastomosed among themselves, during numerous and complex movements of the hand and fingers, its blood supply does not suffer.

The descending part of the aorta is divided into two parts: thoracic and abdominal... The thoracic part of the aorta is located asymmetrically on the spine, to the left of the midline and supplies blood to the internal organs located in the chest cavity and its walls. From the thoracic aorta, there are 10 pairs of posterior intercostal arteries, the upper diaphragmatic and internal branches (bronchial, esophageal, pericardial, mediastinal). From the thoracic cavity, the aorta passes into the abdominal through the aortic opening of the diaphragm. Downward, the aorta gradually displaces medially, especially in the abdominal cavity, and at the site of its division into two common iliac arteries at the level of the IV lumbar vertebra (aortic bifurcation) is located along the midline and continues in the form of a thin median sacral artery, which corresponds to the tail artery of mammals ... The abdominal part of the aorta supplies blood to the abdominal viscera and abdominal walls.

From the thoracic aortathe visceral and parietal branches depart, which supply blood to the organs lying in the chest cavity and the walls of the chest cavity.

From the abdominal aortaboth paired and unpaired vessels leave. Among them are internal and parietal. The first include three very large unpaired arteries: celiac trunk, superior and inferior mesenteric arteries. Paired branches are represented by the middle adrenal, renal and testicular (ovarian arteries in women). Parietal branches: lower phrenic, lumbar and below the median sacral artery.

Celiac trunkdeparts immediately under the diaphragm at the level of CP of the thoracic vertebra and immediately divides into three branches that supply blood to the abdominal esophagus, stomach, duodenum, pancreatic gland, liver with gallbladder, spleen, small and large omentums.

Superior mesenteric arterydeparts directly from the abdominal part of the aorta and goes to the root of the mesentery of the small intestine. A large number of branches depart from it, which supply blood to the pancreas, small intestine, and the right part of the colon, including the right part of the transverse colon.

Inferior mesenteric arterystarts from the left semicircle of the abdominal part of the aorta, goes retroperitoneally down and to the left and gives off a number of branches that supply blood to the left part of the transverse colonic, descending, sigmoid colon, upper and middle sections of the rectum. The branches of the superior mesenteric artery are anastomosed with the branches of the celiac trunk and the inferior mesenteric artery, due to which all three large vessels of the abdominal cavity are connected to each other.

Common iliac artery- This is the largest human artery (with the exception of the aorta). Having passed some distance at an acute angle to each other, each of them is divided into two arteries: the internal iliac and the external iliac.

Internal iliac arterystarts from the common iliac artery at the level of the sacroiliac joint, is located retroperitoneally, goes to the small pelvis, adjacent to its lateral wall. The internal iliac artery feeds the pelvic bone, sacrum and the entire mass of the muscles of the small, large pelvis, gluteal region and partly the adductor muscles of the thigh, as well as the viscera located in the small pelvis: the rectum, bladder; in men - seminal vesicles, vas deferens, prostate; in women - the uterus and vagina, external genitals and perineum.

External iliac arterybegins at the level of the sacroiliac joint from the common iliac artery, goes retroperitoneally down and forward, passes under the inguinal ligament and passes into the femoral artery. The external iliac artery supplies the muscles of the thigh, in men, the scrotum, in women, the pubis and labia majora.

Femoral arteryis a direct continuation of the external iliac artery. It passes in the femoral triangle, between the muscles of the thigh, enters the popliteal fossa, where it continues into the popliteal artery. The femoral artery supplies blood to the femur, skin and muscles of the thigh, skin of the anterior abdominal wall, external genitalia, and the hip joint.

Popliteal arteryis a continuation of the femoral. It lies in the fossa of the same name, passes to the lower leg, where it immediately divides into the anterior and posterior tibial arteries. The artery supplies blood to the skin and nearby muscles of the thigh and back of the lower leg, knee joint.

Posterior tibial arterygoes down, in the area of \u200b\u200bthe ankle joint it passes to the sole behind the medial ankle under the flexor muscle retainer, after which it is divided into its terminal branches: the medial and lateral plantar arteries. The largest branch of the posterior tibialis is the peroneal artery. The posterior tibial artery supplies blood to the skin of the posterior surface of the leg, bones, leg muscles, knee and ankle joints, and foot muscles.

Anterior tibial arterygoes down along the anterior surface of the interosseous membrane of the lower leg. The artery supplies blood to the skin and muscles of the anterior surface of the lower leg and dorsum of the foot, knee and ankle joints, and on the foot passes into the dorsal artery of the foot. Both tibial arteries form a plantar arterial arch on the foot, which lies at the level of the base of the metatarsal bones. Arteries that feed the skin and muscles of the foot and toes extend from the arch.

Lecture 11. Venous system. Lymphatic system... Morphofunctional features of the venous and lymphatic systems.

Aorta and its divisions. Branches of the aortic arch, their anatomy, topography, areas of branching (blood supply).

Aorta, aorta(fig.

42), is the largest unpaired arterial vessel of the systemic circulation. The aorta is subdivided into three sections: the ascending part of the aorta, the arch of the aorta, and the non-descending part of the aorta, which in turn is divided into the thoracic and abdominal parts.

The ascending part of the aortapars ascendens aortae,leaves the left ventricle behind the left edge of the sternum at the level of the third intercostal space; in the initial section, it has an extension - the aortic bulb, bulbus aortae(25-30 mm across).

At the location of the aortic valve on the inner side of the aorta, there are three sinuses, sinus aortae.Each of them is located between the corresponding semilunar valve and the wall of the aorta. From the beginning of the ascending part of the aorta, the right and left coronary arteries depart.

The ascending part of the aorta lies in the back and partly to the right of the pulmonary trunk, rises up and at the level of the junction of the II right costal cartilage with the sternum passes into the aortic arch (here its diameter decreases to 21-22 mm).

Aortic arch,arcus aortae,turns to the left and back from the posterior surface of the II costal cartilage to the left side of the body of the IV thoracic vertebra, where it passes into the descending part of the aorta.

There is a slight narrowing in this place - the isthmus of the aorta, isthmus aortae.The edges of the corresponding pleural sacs fit to the anterior semicircle of the aorta on its right and left sides.

The structure of the aorta and its branches

To the convex side of the aortic arch and to the initial sections of the large vessels extending from it (brachiocephalic trunk, left common carotid and subclavian arteries), the left brachiocephalic vein is adjacent in front, and the right pulmonary artery begins under the aortic arch, below and slightly to the left is the bifurcation of the pulmonary trunk ... Behind the aortic arch is the trachea bifurcation. Between the concave semicircle of the aortic arch and the pulmonary trunk or the beginning of the left pulmonary artery there is arterial ligament, tig.

arteriosum. In this place, thin arteries branch off from the aortic arch to the trachea and bronchi. Three large arteries originate from the convex semicircle of the aortic arch: the brachiocephalic trunk, the left common carotid and the left subclavian arteries.

The descending part of the aortapars descendens aortae,- this is the longest section of the aorta, passing from the level IV of the thoracic vertebra to the IV lumbar, where it is divided into the right and left common iliac arteries; this place is called the aortic bifurcation, bifurcdtio aortae.

Thoracic part of the aorta, pars thordcica aortae,located in the chest cavity in the posterior mediastinum.

Its upper section is located in front of and to the left of the esophagus. Then, at the level of VIII-IX of the thoracic vertebrae, the aorta bends around the esophagus on the left and goes to its posterior surface. To the right of the thoracic part of the aorta are the azygos vein and the thoracic duct, to the left is the parietal pleura, at the place of its transition to the posterior part of the left mediastinal pleura. In the thoracic cavity, the thoracic part of the aorta gives off paired parietal branches; posterior intercostal arteries, as well as visceral branches to the organs of the posterior mediastinum.

The abdominal part of the aorta pars abdomindlis aortae,being a continuation of the thoracic part of the aorta, it begins at the level of the XII thoracic vertebra, passes through the aortic opening of the diaphragm and continues to the level of the middle of the body of the IV lumbar vertebra.

The abdominal part of the aorta is located on the anterior surface of the bodies of the lumbar vertebrae, to the left of the midline; lies retroperitoneally. To the right of the abdominal aorta is the lower hollow vein, anteriorly - the pancreas, the horizontal (lower) part of the duodenum and the root of the mesentery of the small intestine. The abdominal part of the aorta gives off paired parietal branches to the diaphragm and to the walls of the abdominal cavity, and itself continues directly into the thin median sacral artery.

The visceral branches of the abdominal part of the aorta are the celiac trunk, the superior and inferior mesenteric arteries (unpaired branches), and the paired ones - the renal, middle adrenal and testicular (ovarian) arteries.

Branches of the aortic arch

Brachiocephalic trunk,truncus brachlocephdlicus,departs from the aortic arch at level II of the right costal cartilage.

In front of him is the right brachiocephalic vein, behind - the trachea. Heading up and to the right, the brachiocephalic trunk does not give off any branches and only at the level of the right sternoclavicular joint is divided into two terminal branches - the right common carotid and right subclavian arteries.

Right common carotid artery a.

carotis communis dextra, is a branch of the brachiocephalic trunk, and the left common carotid artery, a. carotis communis sinistra,departs directly from the aortic arch (Fig.

43, 44). The left common carotid artery is usually 20-25 mm longer than the right one. The common carotid artery lies behind the sternocleidomastoid and scapular-hyoid muscles, follows vertically upwards in front of the transverse processes of the cervical vertebrae, without giving out branches along the way.

Outside the common carotid artery are the internal jugular vein and the vagus nerve, medially - first the trachea and esophagus, and above - the larynx, pharynx, thyroid and parasitic glands.

At the level of the upper edge of the thyroid cartilage, each common carotid artery is divided into the external and internal carotid arteries, which have approximately the same diameter. This place is called the bifurcation of the common carotid artery. A slight expansion at the beginning of the external carotid artery - carotid sinus, sinus caroticus.In the area of \u200b\u200bthe bifurcation of the common carotid artery, there is a small body 2.5 mm long and 1.5 mm thick - a carotid glomus, glomus caroticum(carotid gland, intersonic glomerulus), containing a dense capillary network and many nerve endings (chemoreceptors).

External carotid arterya.

carotis externa, is one of the two terminal branches of the common carotid artery. It is separated from the common carotid artery within the carotid triangle at the level of the upper edge of the thyroid cartilage. At first, it is located medial to the internal carotid artery, and then lateral to it. The initial part of the external carotid artery of the carotid artery is covered by the sternocleidomastoid muscle, and in the area of \u200b\u200bthe carotid triangle - by the superficial plate of the cervical fascia and the subcutaneous muscle of the neck.

Located inwardly from the stylohyoid muscle and the posterior abdomen of the digastric muscle, the external carotid artery at the level of the mandible neck (in the thickness of the parotid gland) divides into its terminal branches - the superficial temporal and maxillary arteries. On its way, the external carotid artery gives off a number of branches that depart from it in several directions.

The anterior group of branches is made up of the superior thyroid, lingual and facial arteries. The posterior group includes the sternocleidomastoid, occipital and posterior auricular arteries.

The ascending pharyngeal artery is directed medially.

Anterior branches of the external carotid artery:

1 Superior thyroid artery,and. thyreoidea superior,

2Lingual artery,a. lingualis,

3 . Facial artery,a. facidlis,

Posterior branches of the external carotid artery:

1. Occipital artery,a.

2. Posterior ear arterya. auriculdris posterior

The medial branch of the external carotid artery - ascending pharyngeal artery,a.

pharyngea ascendens. This is a relatively thin vessel, departs from the inner semicircle of the external carotid artery at its beginning, rises up to the lateral wall of the pharynx. From the ascending pharyngeal artery depart: 1) pharyngeal branches, rr. pharyngedles,to the muscles of the pharynx and to the deep muscles of the neck; 2) back meningeal artery, a. meningea poste-rior,follows into the cranial cavity through the jugular opening; 3) inferior tympanic artery, a.

tympdnica inferior, through the lower opening of the tympanic tubule penetrates into the tympanic cavity.

Terminal branches of the external carotid artery:

1. Superficial temporal arterya. tempordlis superficid-lis,

Maxillary artery,a. maxilldris,

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Aorta

Aorta- the largest unpaired arterial vessel of the systemic circulation. The aorta is divided into three sections: the ascending part of the aorta, the arch of the aorta and the descending part of the aorta, which in turn is divided into the thoracic and abdominal parts.

Ascending aorta leaves the left ventricle behind the left edge of the sternum at the level of the third intercostal space; in the initial section, it has an extension - the aortic bulb (25-30 mm in diameter).

At the location of the aortic valve, there are three sinuses on the inside of the aorta. Each of them is located between the corresponding semilunar valve and the aortic wall. From the beginning of the ascending part of the aorta, the right and left coronary arteries depart. The ascending part of the aorta lies behind and partly to the right of the pulmonary trunk, rises up and at the level of the junction of the 2 right costal cartilage with the sternum passes into the aortic arch (here its diameter decreases to 21-22 mm).

Aortic arch turns left and back from the posterior surface of the costal cartilage 2 to the left side of the body 4 of the thoracic vertebra, where it passes into the descending part of the aorta.

In this place there is a slight narrowing - the isthmus. The edges of the corresponding pleural sacs fit to the anterior semicircle of the aorta on its right and left sides. To the convex side of the aortic arch and to the initial sections of the large vessels extending from it (brachiocephalic trunk, left common carotid and subclavian arteries), the left brachiocephalic vein lies in front, and the right pulmonary artery begins under the aortic arch, below and slightly to the left is the pulmonary trunk bifurcation.

Behind the aortic arch is the tracheal bifurcation. There is an arterial ligament between the bent semicircle of the aortic arch and the pulmonary trunk or the beginning of the left pulmonary artery. At this point, thin arteries extend from the aortic arch to the trachea and bronchi.

12. Aorta and its departments. Branches and arches of the aorta, their topography.

Three large arteries begin from the convex semicircle of the aortic arch: the brachiocephalic trunk, the left common carotid and the left subclavian arteries.

Descending aorta - this is the longest section of the aorta, passing from the level of the 4th thoracic vertebra to the 4th lumbar vertebra, where it is divided into the right and left common iliac arteries; this place is called the aortic bifurcation.

The descending part of the aorta, in turn, is divided into thoracic and abdominal parts.

Thoracic aorta located in the chest cavity in the posterior mediastinum. Its upper section is located in front of and to the left of the esophagus. Then, at the level of 8-9 thoracic vertebrae, the aorta bends around the esophagus on the left and goes to its posterior surface. To the right of the thoracic part of the aorta are the azygos vein and the thoracic duct, to the left is the parietal pleura, at the place of its transition to the posterior part of the left mediastinal pleura.

In the chest cavity, the thoracic part of the aorta gives off paired parietal branches; posterior intercostal arteries, as well as visceral branches to the organs of the posterior mediastinum.

Abdominal aorta, being a continuation of the thoracic part of the aorta, begins at the level of the 12th thoracic vertebra, passes through the aortic opening of the diaphragm and continues to the level of the middle of the body of the 4th lumbar vertebra. The abdominal part of the aorta is located on the anterior surface of the bodies of the lumbar vertebrae, to the left of the midline; lies retroperitoneally.

To the right of the abdominal part of the aorta are the inferior vena cava, anteriorly - the pancreas, the horizontal (lower) part of the duodenum and the root of the mesentery of the small intestine. The abdominal part of the aorta gives off paired parietal branches to the diaphragm and to the walls of the abdominal cavity, and itself continues directly into the thin median sacral artery.

The visceral branches of the abdominal part of the aorta are the celiac trunk, the superior and inferior mesenteric arteries (unpaired branches) and paired - the renal, middle adrenal and ovarian arteries.

Right and left coronary arteries (see above);

ARORT BRANCHES

Brachiocephalic trunk:departs from the aortic arch at the level of the 2nd costal cartilage. At the level of the right sternoclavicular joint, it is divided into the right common carotid and right subclavian arteries;

Left common carotid artery

Left subclavian artery

Blood supply area.The branches of the aortic arch provide blood supply to the head, neck and upper limb

BRANCHES OF THE CHEST AORTIC

PARIETAL BRANCHES (branches supplying blood to the walls of the body).

These include:

Superior phrenic artery- participates in the blood supply to the diaphragm

Posterior intercostal arteries (10 pairs of right and left arteries). Sent to the intercostal spaces, at the level of the rib heads are divided into dorsal and ventral branches

— Dorsal branches:supply blood to the spinal column, spinal cord, trunk extensor muscle and back skin;

— Ventral branches:follow in the intercostal spaces between the external and internal intercostal muscles.

They supply blood to the walls and skin of the chest; the lower five pairs go to the abdominal muscles and supply them with blood;

VISCERAL BRANCHES (branches supplying blood to the internal organs). These include:

Esophageal branches -blood supply to the esophagus

Bronchial branches -supply blood to the trachea, bronchi and lung parenchyma

Pericardial branches -blood supply to the pericardium

Mediastinal branches -supply blood to the tissue and lymph nodes of the mediastinum

TEST QUESTIONS

  1. Links of the cardiovascular system.

    Main arteries and veins. Microcirculatory bed, its parts and function. Vascular anastomoses. Collateral vessels and collateral blood flow;

  2. Heart, its location. The projection of the borders of the heart on the anterior chest wall. Parts and surfaces of the heart, furrows;
  3. Departments (chambers) of the heart, their openings, walls and messages.

    Septa of the heart;

  4. Fibrous skeleton of the heart, its structure and function;
  5. Heart valves. Flap valves, their location and structure;
  6. Semilunar valves, their location and structure. Heart valve function;
  7. Shells of the heart. Endocardium, its function. Myocardium, its structure in the atria and ventricles;
  8. Pericardium, its structure.

    Fibrous and serous pericardium, pericardial cavity

  9. Blood supply to the heart. Coronary arteries: places of their origin, course, branches, areas of blood supply and anastomoses;
  10. Veins of the heart: places of their beginning, course, place of end.

    Coronary sinus of the heart, its location

  11. Conductive system of the heart: its formation, structure and function;
  12. Aorta: its parts, boundaries between them, location, beginning and end; branches of the aortic arch, their location;
  13. Parietal branches of the thoracic aorta: their course, branches and areas of blood supply;
  14. Visceral branches of the thoracic aorta: their course, branches and areas of blood supply;
  1. Human anatomy.

    Ed. M.R. Sapina (all editions);

  2. Human anatomy. Ed. M. G. Prives (all editions);
  3. Human Anatomy, Ed. S. S. Mikhailova (all editions);
  4. Atlas of human anatomy. Ed.

    Aorta and its divisions. Branches of the aortic arch, their anatomy, topography, areas of branching (blood supply).

    R.D. Sinelnikova (all editions)

Lesson number 13

Topic 213. ARTERIES OF THE HEAD AND NECK (GENERAL DATA). SUBCLUSIVE AND UNMUSCULAR ARTERIES. UPPER LIMB ARTERIES

Knowledge of the material on this topic is important for further study. topographic anatomy, operative surgery, a course of general surgery and traumatology, a course of vascular and nervous diseases

Previously, the location and structure of the following anatomical structures should be repeated:

The structure of the cervical spine;

  1. Occipital bone:basilar part, clivus, foramen magnum;
  2. Sphenoid bone:lesser wing, optic canal, anterior tilted process;
  3. Temporal bone:stony part, sleepy canal;
  4. Lower jaw:branch of the lower jaw, condylar process, neck of the lower jaw;
  5. Rib cage:upper and lower apertures;
  6. Back muscles:trapezius muscle, latissimus dorsi, rhomboid muscles;
  7. Chest muscles:pectoralis major, pectoralis minor, serratus anterior muscle;
  8. Abdominal muscles;
  9. Muscles of the shoulder girdle:deltoid muscle, supraspinatus muscle, infraspinatus muscle, subscapularis muscle;
  10. Shoulder muscles;
  11. Forearm muscles:pronator round, brachioradialis muscle, radial flexor of the wrist, ulnar flexor of the wrist, superficial flexor of the fingers, deep flexor of the fingers,
  12. radial extensors of the wrist, extensors of the thumb of the hand, extensors of the thumb of the hand;
  13. Neck muscles:sternocleidomastoid muscle, digastric muscle, stylohyoid muscle, scapular-hyoid muscle, anterior scalene muscle, middle scalene muscle, posterior scalene muscle, long head muscle, long neck muscle;
  14. Neck organs: larynx, pharynx, trachea, esophagus, their location;
  15. Neck triangles; the lower jaw fossa and the interstellar space;
  16. Elements of the topography of the upper limb: armpit, its walls; front wall triangles; medial groove of the shoulder, brachomuscular canal, ulnar fossa, radial, median and ulnar grooves of the forearm;
  17. The brain, its departments, their parts and structure
  18. Aorta, its parts, branches of the aortic arch

GENERAL CAROTID ARTERY

Start:the right artery - from the brachiocephalic trunk, the left artery - from the aortic arch;

Location:located in the anterior region of the neck.

Attached to her:

- Sternocleidomastoid and scapular-hyoid muscles (in front),

- Trachea, esophagus, pharynx and larynx (from the medial side);

- Prevertebral plate of the cervical fascia (back);

Ending:within the carotid triangle, at the level of the upper edge of the thyroid cartilage of the larynx.

It is divided into external and internal carotid arteries;

EXTERNAL CAROTID ARTERY

Start:from the common carotid artery within the carotid triangle, at the level of the upper edge of the thyroid cartilage;

Location:within the carotid triangle, then it passes inwardly from the stylohyoid and digastric muscles into the thickness of the parotid gland;

Ending:at the level of the neck of the lower jaw, it is divided into terminal branches.

Groups of branches of the external carotid artery:anterior group, posterior group, medial group, end group

INTERNAL CAROTID ARTERY

Start:from the common carotid artery at the level of the upper edge of the thyroid cartilage within the carotid triangle

Ending:small wing of the sphenoid bone.

At this level, it divides into brain branches

Parts:

- the cervical part - lies from the place of origin to the external opening of the carotid canal

- stony part - located in the sleepy canal

- the cavernous part - passes through the cavernous sinus of the dura mater of the brain

- the brain part - lies at the level of the visual canal

Branches:

- Ocular artery.

It supplies blood to the eyeball, its auxiliary apparatus, the nasal cavity and soft tissue faces;

- Anterior cerebral artery. Supplies blood medial surface cerebral hemispheres

- Middle cerebral artery. Blood supply to the upper lateral surface of the cerebral hemisphere

- Posterior communicating artery. Anastomoses with the posterior cerebral artery (a branch of the basilar artery)

SUBCLUSIVE ARTERY

Start:brachiocephalic trunk (right subclavian artery), aortic arch (left subclavian artery);

Ending:at the level of the outer edge of the 1st rib passes into the axillary artery;

Location:passes through the superior aperture of the chest, bends around the dome of the pleura from above,

Passes through the interstellar space in the groove of the subclavian artery of 1 rib;

Parts:

1st section: from the origin to the inner edge of the anterior scalene muscle;

2nd department: located in the space between the stairs;

3rd section: from the exit from the interstellar space to the outer edge of the 1st rib

Aorta (aorta) - the largest arterial vessel in a person. It serves as the beginning of a large circle of blood circulation. In the aorta, three parts are distinguished: ascending (aorta ascendens), arch (arcus aortae) and descending (aorta descendens) (Fig. 385).

The aorta belongs to the elastic type arteries, in which the number of elastic fibers of the middle layer prevails over collagen ones. Elastic fibers in the aortic wall are folded into plates, where the fibers have a circular and longitudinal direction.

Its inner shell is thickened, contains all types of fibers and fibrocytes capable of phagocytosis. With age, in various parts of the aortic wall, there is a significant deposition of calcium salts, the formation of atherosclerotic plaques and partial destruction of the elastic base.

On radiography, contrast agent is injected intravenously or by puncture of the left ventricle of the heart.

The picture reveals an intense shadow of the aorta and its branches.

The ascending aorta has a diameter of 22 mm, originates from the arterial cone of the left ventricle and extends from the mouth of the semilunar valve of the aorta to the point of origin of the brachiocephalic trunk (truncus brachiocephalicus), projecting to the place of attachment of the right rib II to the sternum.

Above the semilunar valve, a part of the aorta is expanded over 1.5 cm, has a diameter of up to 30 mm and is called a bulb (bulbus aortae), in which there are three protrusions - sinuses (sinus dexter, sinister et posterior). In the right and left sinuses, the corresponding coronary heart arteries begin (Fig. 391). This design of the initial part of the aorta arose because when the aortic valve leafs collapse during the diastole period of the ventricles, additional blood pressure is created, as a result of which blood flow into the coronary vessels of the heart improves.

The ascending aorta is initially located behind the pulmonary trunk and then to the right of it.

The posterior wall of the aorta is in contact with the right pulmonary artery, left atrium and left pulmonary veins; in front and on the right, it is covered by the auricle of the right atrium.

The ascending aorta runs obliquely from left to right up and anteriorly. Its opening is projected to the place of attachment of the left III rib to the sternum. From the body of the sternum, the pericardium, covering the ascending aorta, is separated by the costal-mediastinal sinuses of the pleura, cellulose and the thymus gland.


385. Thoracic aorta (front view). 1 - a. carotis communis sinistra; 2 - arcus aortae; 3 - rr.

bronchiales aortae thoracicae; 4 - bronchus principalis sinister; 5 - aa. intercostales; 6 - esophagus; 7 - aa. coronariae cordis dextra et sinistra.

386. Abdominal aorta. 1 - a. phrenica inferior sinistra; 2 - truncus celiacus; 3 - a. lienalis; 4 - gl. suprarenalis sinistra; 5 - a. mesenterica superior; 6 - a.

renalis sinistra; 7 - a. testicularis sinistra; 8 - a. lumbalis; 9 -a. mesenterica inferior; 10 - a. sacralis media; 11 - a. iliaca communis sinistra; 12 - a. iliaca interna sinistra; 13 - a. iliaca externa sinistra.

Aortic arch.

The aortic arch corresponds to the part located between the beginning of the brachiocephalic trunk (truncus brachiocephalicus) and the left subclavian artery (a. Subclavia sinistra). There is a narrowing of the aorta (isthmus), located at the level of the IV thoracic vertebra. In shape, the aortic arch resembles a part of the spiral, since it is directed from front to back and from right to left, bends around the left bronchus from above and the site of division of the pulmonary trunk.

At 25-35 years of age, the upper edge of the aortic arch is located at the level of the upper edge of the III thoracic vertebra, at 36-50 years - at the level of the upper edge of the IV thoracic vertebra, and in persons over 50 years of age - between the IV and V thoracic vertebrae. At the level of the IV thoracic vertebra behind the aortic arch is the thoracic duct. From the convex part of the aortic arch in the direction of apertura thoracis superior, the brachiocephalic trunk (truncus brachiocephalicus), the left common carotid artery (a.

carotis communis sinistra) and left subclavian (a. subclavia sinistra).

The descending aorta extends from the level IV of the thoracic vertebra to the IV lumbar vertebra and consists of two parts: the thoracic and abdominal.

The thoracic aorta (aorta thoracica) has a length of about 17 cm, a diameter in the initial part of 22 mm, in the final part - 18 mm.

It is located to the left of the bodies of the V-VIII thoracic vertebrae and in front of the bodies of the IX-XII vertebrae. Through the hiatus aorticus of the diaphragm, the aorta enters the abdominal cavity. The thoracic aorta lies in the posterior mediastinum and is in close topographic relationships with the blood vessels and organs of the chest cavity. To the left of the aorta are the semi-unpaired vein and the left mediastinal pleura, the azygous vein on the right, the thoracic duct, covered by the right mediastinal pleura along the X-XII thoracic vertebrae, in front - the left vagus nerve, left bronchus and pericardium.

The relationship of the esophagus with the aorta is different: at the level of the IV-VII thoracic vertebrae, the aorta lies on the left and is half-covered by the esophagus, at the level of the VIII-XII vertebrae - behind the esophagus.

The abdominal aorta (aorta abdominalis) has a length of 13-14 cm, an initial diameter of 17-19 mm and is located to the left of the midline of the body (Fig. 386). The abdominal aorta begins at level XII of the thoracic vertebra and divides into two common iliac arteries at level IV of the lumbar vertebra.

It is covered by the parietal peritoneum, stomach, pancreas and duodenum. At the level of the II lumbar vertebra, the abdominal aorta is crossed by the mesenteric root of the transverse colon, the left splenic and renal veins, as well as the mesentery root of the small intestine.

The autonomic nerve plexuses, lymphatic vessels and nodes are located around the abdominal aorta.

Behind the aorta in the area of \u200b\u200bhiatus aorticus lies the beginning of the thoracic duct (cisterna), the inferior vena cava is adjacent to it on the right. At the level of the IV lumbar vertebra, the abdominal aorta is divided into paired common iliac arteries and an unpaired median sacral arteries.

The internal and parietal branches begin from the abdominal aorta.


387. Vascular anomalies. Coarctation (narrowing) of the aorta.


388. Double aortic arch.


389. Aorto-pulmonary communication (Scott).

Developmental anomalies. Aortic anomalies occur in 0.3% of cases. One of the abnormalities is narrowing of the aorta (coarctation).

More often it occurs in the descending part of the aortic arch and the degree of narrowing is not the same (Fig. 387).

38. Aorta, parts, branches of the aortic arch.

Coarctation of the aorta causes severe circulatory disorders.

Another anomaly is a change in the direction of the aortic arch and its doubling (Fig. 388). These defects do not interfere with blood flow, but compression of the esophagus, trachea or bronchi and recurrent nerves occurs.

With the aorto-pulmonary window, an opening is formed between the aorta and the pulmonary trunk (Fig.

389). This anomaly can be easily eliminated by surgery.

A rare anomaly is narrowing of the aortic opening. With a significant narrowing, blood circulation is disrupted already in the prenatal period and early fetal death occurs. With this anomaly, only children with a slight narrowing remain viable.

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From the convex side of the aortic arch, the brachiocephalic trunk, the left common carotid and the left subclavian arteries branch out sequentially from right to left (see Fig. 2.1).

Fig. 2.12.

Fig. 2.12. Branches of the initial section and aortic arch

A - arteries extending from the ascending aorta and arch;

B - projections of the branches of the aorta on the surface of the body;

1 - left common carotid artery;
2 - left subclavian;
3 - aortic arch;
4 - descending aorta;
5 - aortic bulb;
6 - left and
7 - right coronary arteries;
8 - ascending aorta;
9 - brachiocephalic trunk;
10 - right subclavian;
11 - the right common carotid artery;
12 - internal and
13 - external carotid arteries

Brachiocephalic trunk

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Brachiocephalic trunk (truncus brachiocephalicus)has a length of about 3 cm, goes up and to the right and at the level of the right sternoclavicular joint is divided into the right common carotid and right subclavian arteries (see Fig. 2.12.).

Common carotid artery

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Common carotid artery (a. Carotis communis)on the right it departs from the brachiocephalic trunk, on the left - from the aortic arch. The length of the right artery is 6–12 cm, the left one is 2–3 cm longer.

Coming out of the chest cavity, the common carotid artery rises as part of the neurovascular bundle of the neck lateral to the trachea and esophagus along the anterior surface of the transverse processes of the cervical vertebrae; does not give branches. At the level of the upper edge of the thyroid cartilage, it is divided into the internal and external carotid arteries. At the place of division of the common carotid artery into external and internal, there is an accumulation of chemoreceptor nerve endings and capillaries - the carotid body. Close to the site of division, the artery passes in front of the transverse process of the VI cervical vertebra, to which it can be pressed to stop bleeding.

External carotid artery

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External carotid artery (a. Carotis externa), rising along the neck under the superficial plate of the cervical fascia, and above it passes through the thickness of the parotid salivary gland.

In the course of the artery, several large branches branch off from it: the upper thyroid and lingual arteries go to the thyroid gland and tongue and give branches to the hyoid bone and associated muscles, muscles of the neck, pharynx, larynx, epiglottis, tongue, floor of the mouth, gums and large facial artery.

Facial artery

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Facial artery (a. Facialis)bends over the edge of the lower jaw in front of the masseter muscle and can be pressed against the bone here in case of bleeding in the face. It supplies blood to the pharynx, soft palate, lingual and palatine tonsils, submandibular and sublingual salivary glands, facial skin and muscles, chin, lips, outer nose, lower eyelid and forms plexuses in the thickness of the cheek. The facial artery anastomoses with the branches of the artery of the same name on the opposite side, forming a perioral arterial circle, as well as with the temporal, maxillary and lingual arteries and the orbital artery - one of the large branches of the internal carotid artery.

Even higher from the external carotid artery branches to the back of the head, blood supplying muscles and skin of the neck and occiput, dura mater, auricle, and tympanic cavity depart.

Medial to the temporomandibular joint external carotid artery divides into two terminal branches.
One of them - superficial temporal artery (a. temporalis superficiales) -located directly under the skin of the temple, in front of the external auditory opening, where it can be pressed against the bones; it nourishes the parotid salivary gland, the facial and temporal muscles, the auricle, the skin of the forehead and scalp.
Another deep branch - maxillary artery (a. maxillaris),nourishes the mandibular joint, upper and lower jaws and teeth, chewing and facial muscles, walls of the orbit, nasal and oral cavities and adjacent organs, external and middle ear; gives away middle artery of the meninges (a. meningea media),which enters the skull through the spinous foramen and supplies the temporal, frontal and parietal areas of the dura mater, the trigeminal node, and the auditory tube with blood.

Internal carotid artery

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Internal carotid artery (a.crotis interna)rises from the side of the pharynx to the base of the skull, enters it through the eponymous canal of the temporal bone and, piercing the dura mater, gives off a large branch - the orbital artery, and then at the level of the optic nerve intersection is divided into its terminal branches: the anterior and middle cerebral arteries.

Orbital artery

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Orbital artery (a. Ophthalmic)enters the orbit through the optic canal and splits into end branches at the medial corner of the eye. They go to the eyeball, its muscles, upper and lower eyelids, and the lacrimal gland. Several branches enter the eyeball along with the optic nerve.
One of them, central retinal artery, near the retina splits into several branches. Other branches are directed to the choroid and tunica albuginea and the iris. The terminal branches of the orbital artery extend beyond the orbit, supply the skin and muscles of the forehead and dorsum of the nose, anastomosing with the terminal branches of the facial artery. In addition, some branches leave the orbit through its medial wall and supply blood to the anterior cranial fossa. (anterior meningeal artery - a. meningea anterior)and the walls of the nasal cavity.

Subclavian artery

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Subclavian artery (a. Subclavia),starting to the right of the brachiocephalic trunk, and to the left of the aortic arch, it bends around the apex of the lung and exits through the upper opening of the chest. On the neck, the subclavian artery appears along with the brachial plexus and lies superficially, which can be used to stop bleeding and administer pharmacological drugs. The artery bends through 1 rib and, passing under the collarbone, enters the axillary pit, where it is already called axillary. Having passed the hole, the artery under the new name - the brachial artery - extends to the shoulder and in the region of the elbow joint is divided into its terminal branches - the ulnar and radial arteries.

The subclavian artery gives off a number of branches. One of them - vertebral artery (a. vertebralis)- departs at the level of the transverse process of the VII cervical vertebra, rises vertically upward and through the openings of the transverse costal processes of the VI – I cervical vertebrae and through the foramen magnum enters the cranial cavity into the subarachnoid space. Along the way, it gives off branches that penetrate through the vertebral foramen to the spinal cord and its membranes.

The remaining branches of the subclavian artery feed their own muscles of the trunk and neck. At the level of the divergence of the vertebral artery from the lower surface of the subclavian artery originates internal mammary artery (a. thoracica interna).It goes to the sternum and descends along the inner surface of the I-VII costal cartilage. The branches of this artery are directed to the scalene muscles of the neck, muscles of the shoulder girdle, thyroid gland, thymus, sternum, diaphragm, to the intercostal spaces, muscles of the chest, pericardium, anterior mediastinum, to the trachea and bronchi, mammary gland, pharynx, larynx, esophagus, rectus muscle abdomen, ligaments of the liver, skin of the chest and in the navel.

Below from the subclavian artery branches extend to the back of the neck and back muscles, as well as individual branches to the spinal cord, which in the spinal canal form anastomoses with the branches of the vertebral arteries.

Axillary artery

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Axillary artery (a.axillaris) is a direct continuation of the subclavian artery, lies in the axillary fossa, surrounded by the nerves of the brachial plexus. The vessel is covered only by the fascia, skin and lymph nodes. Its superficial location can be used for clamping to stop bleeding.

Branches that supply the clavicle, scapula, shoulder girdle muscles, intercostal and serratus muscles, shoulder and clavicular-acromial joints, as well as axillary lymph nodes and the mammary gland depart from the axillary artery. The axillary artery continues into the brachial artery.

Brachial artery

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Brachial artery (a. Brachialis) begins at the lower edge of the pectoralis major muscle and lies on the shoulder superficially, medial to the biceps muscle. The pulsation of an artery can be felt almost all the way, and it is easy to find it to stop bleeding.

The brachial artery within its upper third gives deep artery of the shoulder, which bends around the humerus and feeds the triceps muscle, and then gives branches to the muscles of the anterior group of the shoulder (coracohumeral, humerus, biceps, deltoid) and to the humerus. In addition, the brachial artery gives off branches descending to the elbow joint - the superior and inferior ulnar circumferential arteries.

Ulnar artery

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Ulnar artery (a. ulnaris) a larger diameter than the radius, descends along the ulna to the wrist joint. It is located between the superficial and deep layers of the muscles of the forearm. Lateral to the pisiform bone, the artery gives off a branch to the deep palmar arch, and itself passes into the superficial palmar arch, connecting by anastomoses with the branches of the radial artery. The branches of the ulnar artery supply the muscles of the anterior and posterior groups of the forearm, participate in the formation of the dorsal and palmar network of the wrist, nourish the radius and ulna, called ulnar recurrent arteryrise to the area of \u200b\u200bthe elbow joint.

Thus, in the area of \u200b\u200bthe elbow joint, a rich network of roundabout (collateral) circulation is formed. In the formation of the network, the branches of all three arteries anastomosed with each other - brachial, ulnar and radial - take part.

There are two arterial arches on the palm.

Superficial palmar arch formed mainly by the end of the ulnar artery and a small superficial palmar branch of the radial artery. This branch is very thin and only when the movement of blood through the ulnar artery is disturbed does it participate in the formation of the superficial palmar arch. The arch lies approximately in the middle of the palm, under its superficial aponeurosis. The common palmar arteries of the fingers extend from the convex side of the arc; each of them is divided into two branches, which form numerous anastomoses at the ends of the fingers.

Deep palmar arch thinner than the superficial palmar arch and is formed mainly by the end of the radial artery, and only a small branch enters from the ulnar artery. The deep palmar arch lies on the palmar interosseous muscles and gives up its arteries, which flow into the common palmar arteries of the fingers.

In addition to the arches, the palmar and dorsal carpal networks are formed on the hand. The dorsal metacarpal arteries extend from the latter into the interosseous spaces. Each of them is divided into two thin arteries of the fingers.

So, the hand as a whole and the fingers in particular are abundantly supplied with blood from many sources, which, due to the presence of arcs and nets, anastomose well with each other. This, as well as the location of the finger's own arteries on their protected surfaces facing each other, can be considered an adaptation of the hand to complex manipulations.

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