Arterial System Anatomy

Question 1

Arteries

Answer 1

-transport gases, nutrients, and other essential substances to capillaries
-progressively decrease in size from the aorta to the arterioles

Question 2

Arterioles

Answer 2

-considered resistance vessels
-assist with regulating with blood flow through contraction and relaxation

Question 3

Capillaries

Answer 3

-nutrients and waste products are exchanged between the tissue and blood

Question 3

Venules

Answer 3

-collect blood from the capillary beds
-assist with regulating blood flow through contraction and relaxation

Question 4

Vein

Answer 4

-collect blood from the venules and return it to the heart
-get progressively larger from the venules to the heart

Question 5

What is the microscopic anatomy of the vessel walls? (Layers)

Answer 5

Tunica intima
Tunica media
Tunica adventitia/externa

Question 6

Tunica intima

Answer 6

innermost layer, consisting of smooth endothelial cells and is supported by an internal elastic lamina
-subendothelial space is the site of proliferative activity: atherosclerosis

Question 7

Tunica media

Answer 7

middle layer, thickest layer, composed of smooth muscle cells intermingled with elastic fibers

Question 8

Tunica adventitia/externa

Answer 8

the outer layer, thinner than the tunica media, contains fibrous connective tissue, some muscle fibers
-contains nerve fibers and lymphatics which remove metabolic waste and nourish the vessel
-also contains the VASA VASORUM-(“blood supply within the blood supply”)- a network of small vessels that supply the walls of large blood vessels, wall

Question 9

Parts of the aorta

Answer 9

-ascending aorta
-aortic arch
-descending thoracic aorta
-abdominal aorta

Question 10

Ascending aorta

Answer 10

from the aortic valve to the first branch

Question 11

Aortic arch

Answer 11

3 main branches (brachiocephalic trunk/innominate artery, left common carotid artery, left subclavian artery)

Question 12

Descending thoracic aorta

Answer 12

-generally not evaluated w/ vascular ultrasound - cannot insonate

Question 13

Abdominal aorta

Answer 13

-begins at the diaphragm
-terminates at the aortic bifurcation into the iliac arteries

Question 14

Branches of the aortic arch

Answer 14

-Brachiocephalic trunk (Inominate) Artery - first and largest branch (directly off the aortic arch), bifurcates into the right subclavian and right common carotid arteries
-Left common carotid artery- 2nd branch directly off the aortic arch
-Left subclavian artery - 3rd branch directly off the aortic arch

Question 15

Upper extremity arteries

Answer 15

-Subclavian, axillary, brachial, radial, ulnar, deep plamar (volar) arch, superficial palmar (volar) arteries

Question 16

Subclavian artery

Answer 16

terminates in the axillary artery at the border of the first rib

Question 17

Axillary artery

Answer 17

-passes behind the clavicle
-terminates into the brachial artery at the axilla

Question 18

Brachial artery

Answer 18

-begins at the axilla as the continuation of the axillary artery
-travels through the medial upper arm to the elbow/antecubital fossa
-main blood supply to the arm, forearm, and hand
-divides into the radial and ulnar arteries (usually near the elbow but the bifurcation location varies)

Question 19

Radial artery

Answer 19

-travels down LATERAL side of the forearm into the hand
-terminal branch - deep palmar arch

Question 20

Ulnar artery

Answer 20

-begins at the brachial artery and travels down MEDIAL side of forearm into hand
-terminal branch - superficial palmar arch

Question 21

Deep palmar (volar) arch

Answer 21

-Source - radial artery w/ contribution from the ulnar artery
-courses along the palm of the hand

Question 22

Superficial palmar (volar) arch

Answer 22

Source - ulnar artery w/ contribution from the radial artery
-courses along the back of the hand

Question 23

Palmar arch

Answer 23

-not always complete

Question 24

Visceral branches of the abdominal aorta

Answer 24

-celiac artery (left gastric artery, common hepatic artery, splenic artery) -superior mesenteric artery -renal arteries -inferior mesenteric artery

Question 25

Celiac artery

Answer 25

-visceral branch of aorta -supplies STOMACH, liver, pancreas, duodenum, spleen -divides into LEFT GASTRIC ARTERY (supplies stomach and esophagus), COMMON HEPATIC Artery (supplies liver), and SPLENIC artery (supplies spleen)

Question 26

Superior mesenteric artery (SMA)

Answer 26

-visceral branch of aorta - located ~ 1 cm distal to the celiac artery - supplies the small intestine, cecum, parts of the colon -SMA and CELIAC may have a COMMON TRUNK

Question 27

Renal arteries

Answer 27

-visceral branch of aorta -origin just below SMA -w/ aorta in transverse, left renal vein is a "landmark" for identifying renal arteries -supply blood to the kidneys, suprarenal glands, ureters -right longer than left; passes behind the IVC -multiple renal arteries are common

Question 28

Inferior mesenteric artery

Answer 28

-visceral branch of aorta -arises from the abdominal aorta ~ 2-4 cm above the abdominal aorta bifurcation -supplies transverse and descending colon, part of the rectum -potential collateral pathway

Question 29

What are two potential collateral connections between the SMA and SMV?

Answer 29

-Marginal artery of the colon (Marginal artery of Drummond) -Arc of Riolan

Question 30

Common iliac arteries (CIA)

Answer 30

-supply the pelvis, abdominal wall, and lower limbs -divides into the internal iliac arteries and external iliac arteries

Question 31

Internal iliac artery (IIA) (hypogastric artery)

Answer 31

supplies the pelvis and inner thigh

Question 32

External iliac artery (EIA)

Answer 32

-supplies the leg -terminates into the common femoral artery (CFA) at the inguinal ligament -Landmark - Psoas Major Muscle

Question 33

Lower extremity arteries

Answer 33

-Common femoral, superficial femoral, deep femoral (profunda femoris), politeal, anterior tibial, tibial/peroneal trunk, posterior tibial, peroneal, and plantar arch/ digital arteries

Question 34

Common femoral artery (CFA)

Answer 34

-becomes the CCFA at the inguinal ligament -the inguinal ligament is superior to the inguinal (groin) crease

Question 35

Superficial femoral artery (SFA)

Answer 35

-courses the length of the medial thigh -terminates in the adductor hiatus and becomes the popliteal artery

Question 36

Deep femoral artery (profunda femoris) DFA

Answer 36

-more lateral and posterior as compared to the SFA -supplies thigh -collateral pathway via connections to the popliteal artery (genicular branches)

Question 37

Popliteal artery (Pop A)

Answer 37

-continuation of the SFA as it passes through the adductor hiatus (hunter's canal) where there is an opening in the adductor magnus muscle -Many genicular branches (connect w/ the profunda branches)- this is why many SFA occlusions reconstitute in the distal thigh -terminal branches anterior tibial and tibial/peroneal trunk

Question 38

Anterior tibial artery (ATA)

Answer 38

-first branch of the distal popliteal artery -passes through the interosseous membrane to the anterior lateral aspect (front) of the leg where it lies close to the inner side of the fistula -the distal segment is on the surface of the interosseous membrane near the tibia -as it crosses the ankle, the ATA becomes the dorsalis pedis artery (DPA)