St.

Georges Medical Programme at University of Nicosia Medical School

Aorta and the Great Vessels

PE
Teaching Objectives
By the end of this teaching session you
should be able to describe:
the course of the aorta

the great vessels, their origin and course

the branches and tributaries of the great

vessels
the hepatic portal system

the coronary circulation

General Structure
Mediastinum
 The superior mediastinum
Contents: the great vessels:
arch of aorta:
brachiocephalic trunk
left common carotid artery
left subclavian artery
left and right brachiocephalic veins
(L) subclavian vein
(L) vein
(L) internal jugular vein

(R) subclavian vein

(R) vein
(R) internal jugular vein

(L) and (R) brachiocephalic veins join to

form the superior vena cava
Look at the main
nerves and their
relations (phrenic,
vagus recurrent
laryngeal,
syphathetic trunk
Look at the main
nerves and their
relations (phrenic,
vagus, syphathetic
trunk
Branches of the aorta
 Principal arteries
Arch of aorta:
coronary arteries
brachiocephalic trunk
right subclavian artery
right common carotid artery
left common carotid artery
left subclavian artery
Common carotid artery goes to the head

external carotid face, head and neck

internal carotid inside cranial cavity

Subclavian artery goes to the upper limb

it becomes the
axillary artery and then the
brachial artery which supplies the arm and
divides into the
radial artery (terminal branch)
which supply the
ulnar artery (terminal branch) forearm and hand
Thoracic aorta supplies tissues in the thorax and
then becomes the

Abdominal aorta supplies abdominal organs and

the gut via three main branches
Celiac
superior mesenteric
inferior mesenteric
Note that the abdominal aorta has many other branches
including the renal and gonadal
In the pelvis it becomes the
Common iliac It splits into two main branches
Internal iliac supplies the pelvic organs
external iliac goes to the lower limb
and becomes the
Femoral artery
Femoral artery enters the thigh which it supplies
(front and back) and then goes to
the back of the knee and becomes
Popliteal artery which divides into its two
terminal branches
anterior tibial and
posterior tibial which supply the leg and foot
There is also a peroneal artery
that supplies the leg
Veins
Major veins in the body
Deep veins in the leg
anastomose with
superficial veins, the long
and short saphenous, to
drain the lower limb. Most
veins from the lower limb
will eventually drain into
the
femoral vein which
becomes the external iliac
vein.
Major veins in the body
The external iliac vein joins
the internal iliac vein which
drains the pelvis to form the

common iliac vein which

meets its opposite to form
the

inferior vena cava which

drains the abdominal cavity

The inferior vena cava

drains into the right atrium
In the arm deep veins join superficial
veins to drain the upper limb. The
superficial veins are:
the basilic vein
the cephalic vein
These last two are usually connected
by the median cubital vein in front of
the elbow joint.
When eventually superficial and deep
veins have joined they form the
axillary vein.
The axillary vein then becomes the
subclavian vein.
Blood from the head and
Neck drains through the:
internal jugular vein and
external jugular vein.

The external usually

Drains into the internal.

On either side,
the internal jugular vein joins the
subclavian vein to form the
brachio-cephalic vein

The two brachio-cephalic veins join together to form the

superior vena cava which drains into the right atrium.
 Azygos

Accessory
azygos

Thoracic
duct

Hemiazygos
Notice the anastomoses
between the inferior
vena cava azygos
superior vena cava
Portal circulation
 The hepatic portal system
Blood from the gut and the spleen does not drain directly into
the inferior vena cava.

The three major vessels draining the gastrointestinal tract are:

superior mesenteric vein
splenic vein These open in the
inferior mesenteric vein portal vein

The portal vein takes the blood and the

nutrients from the digestive tract to the liver.

In the liver these nutrients are

stored processed and metabolised.
Coronary Circulation
BLOOD SUPPLY TO
THE HEART
BLOOD SUPPLY TO THE HEART
 BLOOD SUPPLY TO THE HEART

Left
Coronary
Circumflex Coronary sinus
Right Anterior
Coronary Cardiac
Anterior Great
Interven Cardiac
tricular

Marginal Small
Branch Cardiac Middle Cardiac
BLOOD SUPPLY TO THE HEART
 DISTRIBUTION
Right Coronary Artery (dominant in 67% post
interventricular branch)
Walls of right atrium and inter-atrial septum
Inferior wall of left ventricle
SA node in 60% of people
AV node in 80% of people
Walls of right ventricle
1/ of inter-ventricular septum
3

Left Coronary Artery

Posterior wall of left atrium
The rest including the AV bundle
Cinically Oriented Anatomy page 145
Summary
In this teaching session you have been
taught:
the course of the aorta

the great vessels, their origin and course

the branches and tributaries of the great

vessels
the hepatic portal system

the coronary circulation

The illustrations and slides for this presentation were taken from:

Netter, atlas of human anatomy

Moore & Dalley, clinically oriented anatomy
Snell, clinical anatomy for medical students
Tortora & Grabowski, principles of anatomy and
physiology
Dr Menos Lagopoulos
Thank you