Posterior Abdominal

Wall

W.G

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Vessels of Posterior Abdominal Wall

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 Abdominal Aorta

• Most arteries supplying the posterior abdominal wall

arise from the abdominal aorta

• The subcostal arteries arise from the thoracic aorta and

distribute inferior to the 12th rib

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 Abdominal Aorta…
• It is approximately 13 cm in

length

• It begins at the aortic hiatus in

the diaphragm at the level of the

T12 vertebra and

• Ends at the level of the L4

vertebra by dividing into the

right and left common iliac

arteries 4
 Abdominal Aorta…

 The common iliac arteries

• Diverge and run inferolaterally,

following the medial border of the

psoas muscles to the pelvic brim.

• Here each common iliac artery

divides into the internal and

external iliac arteries.

• The internal iliac artery enters the

pelvis.
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 Abdominal Aorta…

 The common iliac arteries…

• The external iliac artery follows

the iliopsoas muscle.

• Just before leaving the

abdomen, the external iliac

artery gives rise to the inferior

epigastric and deep circumflex

iliac arteries, which supply the

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anterolateral abdominal wall.
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 Relations of Abdominal Aorta
• From superior to inferior, the important anterior
relations of the abdominal aorta are the:
Celiac plexus and ganglion

Body of the pancreas and splenic vein

Left renal vein

Horizontal part of the duodenum.

Coils of small intestine

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 Branches of the Abdominal Aorta
• The branches of the descending
(thoracic and abdominal) aorta may be
described as arising and coursing in
three “vascular planes”

• And can be classified as being visceral

or parietal and paired or unpaired

• Paired parietal branches of the aorta

serve the diaphragm and posterior
abdominal wall
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 Branches of the Abdominal Aorta…

 The median sacral artery

• An unpaired parietal branch

• May be said to occupy a fourth

(posterior) plane because it arises
from the posterior aspect of the
aorta just proximal to its
bifurcation.

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 Branches of the Abdominal Aorta…

• Although markedly smaller, it

could also be considered a
midline “continuation” of the
aorta,

• In which case its lateral branches,

the small lumbar arteries and
lateral sacral branches, would
also be included as part of the
paired parietal branches 15
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 Inferior Vena Cava
• The IVC begins anterior to the L5
vertebra by the union of the common
iliac veins.

• The union occurs approximately 2.5 cm

to the right of the median plane,

• Inferior to the aortic bifurcation and

posterior to the proximal part of the right
common iliac artery.
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 Inferior Vena Cava…
• The IVC ascends on the right side of

the bodies of the L3–L5 vertebrae

and on the right psoas major to the

right of the aorta.

• The IVC leaves the abdomen by

passing through the caval opening

in the diaphragm and enters the

thorax at the T8 vertebral level 18

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 Tributaries of the IVC
• The tributaries of the IVC
correspond to the paired visceral
and parietal branches of the
abdominal aorta.

• The veins that correspond to the

unpaired visceral branches of
the aorta are instead tributaries of
the hepatic portal vein. 20
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Tributaries of the IVC…
• The branches corresponding to the
paired visceral branches of the
abdominal aorta include
 The right suprarenal vein

 The right and left renal veins

 The right gonadal (testicular or

ovarian) vein

• The left suprarenal and gonadal

veins drain indirectly into the IVC
because they are tributaries of the
left renal vein. 22
 Tributaries of the IVC…
• Paired parietal branches of the
IVC include
 The inferior phrenic veins

 The 3rd (L3) and 4th (L4) lumbar

veins
 The common iliac veins

• The ascending lumbar and azygos

veins connect the IVC and SVC,
either directly or indirectly
providing collateral pathways 23
LYMPHATIC VESSELS AND LYMPH NODES
OF POSTERIOR ABDOMINAL WALL

• Lymphatic vessels and

lymph nodes lie along
the aorta, IVC, and
iliac vessels

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 LYMPHATIC VESSELS AND LYMPH NODES
OF…
• The common iliac lymph
nodes receive lymph from
the external and internal
iliac lymph nodes.

• Lymph from the common

iliac lymph nodes passes to
the right and left lumbar
lymph nodes
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 LYMPHATIC VESSELS AND LYMPH NODES
OF…

• The right and left lumbar (caval and aortic) lymph nodes
lie on both sides of the IVC and aorta.

• These nodes receive lymph directly from the posterior

abdominal wall, kidneys, ureters, testes or ovaries, uterus,
and uterine tubes.

• Efferent lymphatic vessels from the large lumbar lymph

nodes form the right and left lumbar lymphatic trunks.
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 LYMPHATIC VESSELS AND LYMPH NODES OF…

• Lymph from the alimentary

tract, liver, spleen, and
pancreas passes along the
pre-aortic lymph nodes
(celiac and superior and
inferior mesenteric nodes)

• Scattered around the origins

of these arteries from the
aorta. 28
 LYMPHATIC VESSELS AND LYMPH NODES
OF…
• Efferent vessels from pre aortic
lymph nodes form the intestinal
lymphatic trunks

• Which may be single or multiple,

and participate in the confluence
of lymphatic trunks that gives
rise to the thoracic duct.

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 Thoracic Duct

• The thoracic duct begins

with the convergence of the
main lymphatic ducts of the
abdomen, thin-walled sac
or dilation called the
cisterna chyli (chyle
cistern).

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 Thoracic Duct…

• The inferior end of the

thoracic duct lies anterior to
the bodies of the L1 and L2
vertebrae

• Between the right crus of the

diaphragm and the aorta.

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 Thoracic duct…

• The thoracic duct ascends through

the aortic hiatus in the diaphragm
into the posterior mediastinum

• The duct ultimately ends by

entering the venous system at the
junction of the left sub clavian and
internal jugular veins (the left
venous angle).
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Thank You

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