AORTA AND PERIPHERAL

ARTERIES
ANATOMY &
VISUALIZATION
Presented By; Dr Rakesh Jain

The Aorta

1.
2.
3.

After originating from LV (about 3 cm in

diameter ), it ascending for a short
distance, arches backward and to the left
side, descends within the thorax on the
left side of the vertebral column
Portions of aorta
Ascending aorta
Arch of the aorta and
Descending aorta (thoracic and abdominal aorta)

Ascending Aorta (Aorta

Ascendens)

About 5 cm. in length

Passes obliquely upward, forward, and to the
right, as high as the upper border of the second
right costal cartilage
At its origin, three small dilatations called the
aortic sinuses
At the union of the ascending aorta with the
aortic arch, the caliber of the vessel is increased,
owing to a bulging of its right wall. This
dilatation is termed the bulb of the aorta
Only branches of the ascending aorta are the two
coronary arteries

Arch of the Aorta

Begins at the level of the upper border of

the Rt 2nd sternocostal joint
First runs upward, backward, and to the
left, infront of the trachea, then directed
backward on the left side of the trachea
and finally passes downward on the left
side of the body of T4, at lower border of
which it becomes continuous with the
descending aorta
Forms two curvatures: one with its
convexity upward, the other with its
convexity forward and to the left

Branches of arch of aorta

Three in number

Innominate artery
Left common carotid artery
Left subclavian artery

LEFT ANTERIOR OBLIQUE VIEW

CCA= common carotid artery

VA= vertebral artery
SCA= subclavian artery

Variations of the
supraaortic vessel
origins
Vertibral
Rt CC
Rt Subclavian
Inominate A

Lt CC
Lt Subclavian

Lt CC
Vertibral
Lt
Subclavian
Rt CC
Rt Subclavian

Descending Aorta
Thoracic Aorta

Contained in the posterior

mediastinal cavity
Begins at the lower border of the T4
Ends in front of the lower border of
the T12 vertebra, at the aortic hiatus
in the diaphragm

Branches of the Thoracic

Aorta

Visceral

1.

Pericardial
Bronchial
Esophageal
Mediastinal

2.
3.
4.

Parietal

1.
2.

Intercostal.- usually 9 pairs

Subcostal.

3.

Superior Phrenic.

LEFT ANTERIOR OBLIQUE VIEW

RCC

LCC

Lt Subclavian
Rt Subclavian

Brachiocephalic A

Abdominal
aorta

Begins

at aortic
hiatus of diaphragm
In front of lower
border of T12
Descending in front
of the vertebral column
Ends on L4-body,
a little to Left of midline
Summit of the convexity
corresponding to the L3

Branches of the
abdominal aorta
Visceral Branches
Celiac.
Superior Mesenteric.
Inferior Mesenteric.
Middle Suprarenals.
Renals.
Internal Spermatics.
Ovarian (in the female)

Parietal Branches
Inferior Phrenics.
Lumbars.
Middle Sacral.

Terminal Branches
Common Iliacs.

AP
VIEW
1.Abdo
Aorta
2.Coeliac
trunk
a.Lt
gastric A
b.Splenic
A
c.Hepatic
A
3. S M A

6
1

4. I M A
5. Lt Renal
A
6. Rt Renal
A

LATERAL VIEW

Catheter
Celiac trunk

Superior mesenteric artery

Abdominal aorta

Coeliac Artery

Short thick trunk

1.25 cm length
Arises from the front of the aorta, just below

the aortic hiatus of the diaphragm

Between T12 & L1

Passing nearly horizontally forward
3 large branches

Left gastric A - smallest

Hepatic A
Splenic A - largest

ANTERIO-POSTERIOR VIEW

1.Coeliac
A

2.Lt
gastric A
3.Hepati
cA
4.Splenic
A
5.Gastro
duodenal
A

3
4

1
4

Superior Mesenteric Artery

Large vessel
Arises from front of aorta, at L1,
~1.25 cm below Coeliac A
Passes downward and forward, to
the right iliac fossa
Supply small intestine (expt superior
Duo),
Cecum, Asc Colon & Rt
Transverse Colon

SMA-Branches

Inferior Pancreatico-duodenal
Middle Colic
Right Colic
Ileocolic
Intestinal

1.Abd Aorta

2.S M A

3.Middle
colic A

4.Rt colic A
5.Ileocolic A

6. Intestinal
A
7.Appendicu
lar

Inferior Mesenteric Artery

Smaller than SMA

Arises from aorta at L3, about 3 or 4 cm
above its division
Passes downward, posterior to the
peritoneum
Continued into pelvis as Superior
hemorrhoidal artery & ends on the upper
rectum
Supply Lt transverse colon, descending
& sigmoid colon, and most of the rectum

Inferior Mesenteric Artery

branches

Left Colic A
Sigmoid branches
Superior Hemorrhoidal A

1.Inf
mesentric A
2.Lt colic A

3.Marginal A

4.Sigmoid A
5.Superior
hemorrhoidal
A

Superior Hemorrhoidal
Artery

Form a series of loops around lower

rectum
Communicate with
Middle hemorrhoidal branches of
Internal Iliac A
and
Inferior hemorrhoidal branches of
Internal pudendal A (branch of Internal
Iliac A)

1.Two large arteries

2.Arises arteries
from side of
Renal
aorta,
immediately below
SMA
3.Nearly a right
angle with the
aorta
4.Right is longer than
left
5.Before reaching
hilus of the kidney,
each artery divides
into four or five
branches
6.Left is somewhat

AP VIEW

Lt Renal
arteries
Rt Renal
arteries

Common Iliac Arteries

Abdominal Aorta divides, on Lt side of L4

Each about 5 cm length
Rt Common Iliac A -somewhat longer than
the Lt
Each divide, opposite the intervertebral
fibrocartilage between L5 & S1
2 branches
External Iliac A
&
Internal Iliac A (Hypogastric A )

AP VIEW

1.Abd Aorta
2.Common iliac
A
3.External iliac
A
4.Internal iliac A

3
4

The External Iliac Artery

Larger than Internal Iliac A

Passes obliquely downward and
lateralward along the medial border
of the Psoas major
Beneath the inguinal ligament,
midway between anterior superior
iliac spine and symphysis pubis
entering the thigh & becomes
Femoral A

EIA-Branches

2 branches

Inferior epigastric
Deep iliac circumflex

Continues as femoral A

The Internal Iliac A

(Hypogastric A )

Short, thick vessel, smaller than EIA

Arises at the bifurcation of the common
iliac, opposite the lumbosacral
articulation
Abt 4 cm length, on medial side of the
thigh
The lengths of the CIA & IIA bear an
inverse proportion to each other IIA
being long when CIA is short, and vice
versa.
Divides into 2 large trunks at upper

Branches of Internal
Iliac
A
Anterior Trunk

Superior Vesical
Middle Vesical
Inferior Vesical
Vaginal (in females)
Middle Hemorrhoidal
Obturator
Inferior Gluteal
Internal Pudendal
Inf Hemorrhoidal A
Uterine

Posterior Trunk
Iliolumbar
Lateral Sacral
Superior Gluteal

Femoral Artery

Begins behind inguinal ligament, midway

between ASIS & symphysis pubis,
Ends at junction of upper & lower of
thigh, to become Popliteal A
First 4 cm -enclosed, together with
Femoral V, in a fibrous sheaththe
Femoral Sheath
In the upper of thigh Femoral A is
contained in the Femoral Triangle
(Scarpas triangle)
In the middle of thigh, in the Adductor
Canal (Hunters canal)

Profunda Femoris A

Large vessel arising from lateral & back

part of Femoral A, 2-5 cm below inguinal
ligament

Ends at the lower of thigh

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

Lateral Femoral Circumflex,

Medial Femoral Circumflex,

AP VIEW
Catheter
Common femoral
artery

Superficial femoral
artery

AP VIEW

1
1.Profnda F A
2.Femoral
artery

Popliteal Artery

Continuation of Femoral A
Extends from the opening in the Adductor
magnus, at the junction of middle &
lower of thigh
Courses downward and lateralward to the
intercondyloid Popliteal fossa of the femur,
then vertically downward to the lower
border of the Popliteus
Divides into Anterior tibial A and
tibioperoneal trunk.
Tibioperoneal trunk is the direct
continuation of the popliteal artey, arises

Superficial femoral
artery

Popliteal
artery
Anterior tibial artery

Popliteal
artery
Anterior tibial arter

Posterior tibial artery

Posterior tibial arte

Peroneal artery

Peroneal
artery

Tibioperoneal trunk

Posterior Tibial A

Begins at lower border of Popliteus,

opposite the interval betw tibia & fibula
Descends, approaching tibial side of leg
In the lower part, situated midway betw
med malleolus & med process of calcaneal
tuberosity
Divides into Medial & Lateral plantar A

Anterior Tibial A

Begins at bifurcation of Popliteal A,

at the lower border of Popliteus
Passes forward through aperture
above upper border of interosseous
memb
Descends on anterior surface of
interosseous memb, gradually
approaching the tibia
On the front of ankle-joint (more
superficial), becomes Dorsalis Pedis

AP VIEW

Tibioperoneal
Trunk
Anterior Tibial
Peroneal
Posterior Tibial

Ankle and Foot Vascular

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

Lateral view

Peroneal
Anterior Tibial

Posterior
Tibial

Medial & lateral

Plantar A
Dorsalis Pedis

Foot arteries
front view
A. tibialis anterior

A. dorsalis pedis

Foot arteries
down view
Arcus plantaris profundus
A. plantaris medialis
A. plantaris lateralis
A. tibialis posterior

Innominate Artery

Largest branch of arch of the aorta

4 to 5 cm. in length
Arises, on a level with the upper
border of the second right costal
cartilage
Ascends obliquely upward,
backward, and to the right to the
level of the upper border of the right
sternoclavicular articulation, where
it divides into the right common
carotid and right subclavian arteries.

Common Carotid Artery

2 in number (Rt & Lt)

Differ in length and mode of origin
The right begins at bifurcation of
innominate A, behind sternoclavicular
joint and is confined to the neck.
The left springs from the highest part of
arch of the aorta to the left of, on a plane
posterior to the innominate artery
Each vessel passes obliquely upward
Divides into the ECA & ICA, at the level of
upper border of the thyroid cartilage

The Subclavian Artery

Right side: arises from the

innominate artery behind right
sternoclavicular articulation
Left side: arises directly from the
arch of the aorta
Extends to the outer border of the
first rib, where it becomes the
axillary artery

branches of the
subclavian artery

Vertebral.
Internal mammary
Thyrocervical
Costocervical

LEFT ANTERIOR OBLIQUE VIEW

RCC

LCC

Lt Subclavian
Rt Subclavian

Brachiocephalic A
Rt Axillary A

Axillary Artery

Commences at the outer border of

the first rib
Ends at lower border of the tendon
of the Teres major, where it takes
the name of brachial
At its origin the artery is very deeply
situated, but near its termination is
superficial

ANTERIO-POSTERIOR VIEW

Brachial Artery

Commences at the lower margin of the

tendon of the Teres major
Passing down the arm
Ends about 1 cm. below the bend of the
elbow, where it divides into the radial and
ulnar arteries
Course; At first the brachial artery lies
medial to the humerus; as it runs down
the arm it gradually gets in front of the
bone, and at the bend of the elbow it lies
midway between its two epicondyles

Radial Artery

Continuation of the brachial

Smaller in caliber than ulnar.
Commences at bifurcation of the brachial,
just below the bend of the elbow
Passes along the radial side of the
forearm to the wrist
Then winds backward, around the lateral
side of the carpus, forward toward thumb
and index finger into the palm of the hand
and unite with the deep volar branch of
the ulnar artery to form the deep volar

Ulnar Artery

Larger than radial A.

Begins a little below the bend of the
elbow
Passing obliquely downward, reaches
ulnar side of the forearm, midway
between the elbow and the wrist. It then
runs along the ulnar border to the wrist
Immediately beyond pisiform bone, it
divides into two branches, which enter
into the formation of the superficial and
deep volar arches

ANTERIO-POSTERIOR VIEW

POSTERIO-ANTERIOR VIEW

Thanks