Vascular anatomy and pathology Flashcards
(42 cards)
What are the three arterial branches off the aortic arch and their tributaries?
There are three arterial branches off the aortic arch; Brachiocephalic, left common carotid and left subclavian. The brachiocephalic artery branches into the right common carotid and right subclavian.
Where do the vertebral arteries originate?
The left and right vertebral arteries branch off the left and right subclavian arteries respectively.
Which veins drain the head, neck, upper limbs, upper thorax and mammary glands?
The subclavian and internal jugular veins drain the head, neck upper limbs, mammary glands & superior thorax.
Once they unite, they become the brachiocephalic vein.
Once the brachiocephalic veins unite they become the superior vena cava.
Describe the arteries of the upper limb.
The axillary artery is a continuation of the subclavian artery and begins when it passes the first rib. It supplies the lateral thorax, axilla and upper limb. It has three parts based on its location to the pectoralis minor muscle. Medial, behind and lateral.
The brachial artery begins once it passes teres major.
The radial and ulnar arteries arise from the bifurcation of the brachial artery. As the radial artery runs distally it winds around the lateral aspect of the wrist.
What is special about deep veins?
Deep veins accompany all major arteries and share the same name. The often occur as pairs (venae comitantes) and are contained in the vascular sheath.
Describe superficial veins
Superficial veins are closer to the surface and connect to the deep veins via perforating vessels. Veins drain superficial to deep and valves are often present just below the branch of a perforating vessel.
Describe the course of upper limb veins
The radial part proceeds as the cephalic vein while the ulnar part proceeds as the basilic vein.
Most of the course of the basilic vein is superficial. About half way up the arm it travels deep under the muscles.
Around the lower border of teres major the anterior and posterior humeral veins feed into it before it joins the brachial vein to become the axillary vein.
The axillary vein continues as the subclavian vein after the first rib.
The cephalic vein is on the radial side and crosses the snuff box superficial to the radial styloid.
The cephalic vein moves medially as it approaches the cubital fossa where it gives off the medial cubital vein. It then continues along the lateral border of the biceps.
It joins the axillary vein inferior to the clavicle.
Describe the course of lower limb arteries
The femoral artery is a continuation of the external iliac artery. It supplies to lower limb.
The profunda femoris is also known as the deep femoral artery. It is the main blood supply to the thigh and terminates in the 4th perforating artery.
The femoral artery itself continues down the thigh and into the popliteal fossa where it becomes the popliteal artery.
At the inferior border of the popliteus muscle the popliteal artery divides into two branches; The anterior and posterior tibial artery.
The posterior tibial artery is larger and more direct. It supplies the posterior compartment of the leg and foot. Its main branch is the fibular or peroneal artery. It passes inferior to the medial malleolus where it divides into the medial and lateral plantar arteries that supply the sole of the foot.
The anterior tibial artery is smaller and passes through the superior gap in the interosseus membrane supplying the anterior compartment of the leg. At the ankle it becomes the dorsalis pedis artery and can be palpated anterior to the ankle joint.
Describe the veins of the lower leg
Deep veins in the leg accompany all major arteries and their branches. They often occur as pairs (venae comitantes) and are contained within the vascular sheath Major deep veins in the leg are: Anterior tibial vein, Posterior tibial vein and the Posterior fibular vein. These three veins drain into the popliteal vein posterior to the knee.
The two major superficial veins are the great and small saphenous.
The great saphenous vein forms the dorsal venous network and travels anterior to the medial malleolus.
It passes posterior to the medial femoral condyle, anastomoses with the small saphenous vein and drains into the femoral vein.
The small saphenous vein ascends posterior to lateral malleolus and passes along lateral border of calcaneal tendon, ascends between the heads of gastrocnemius and empties into the popliteal vein in popliteal fossa.
List the major superficial veins of the body and their location
Basilic (ulna), cephalic (radial), greater saphenous (medial lower leg) and small saphenous (postero lateral lower leg).
List the arteries the thoracic aorta gives rise to
The descending aorta gives rise to the intercostals, superior phrenics, bronchials, subcostals and oesophageals.
List the arteries the abdominal aorta gives rise to
The abdominal aorta gives rise to:
- Inferior phrenic artery
- Celiac trunk
- superior mesenteric artery
- Middle suprarenal arteries
- Renal arteries
- Gonadal arteries
- Inferior mesenteric artery
- Lumbar and median sacral arteries
What organs does the celiac artery supply?
The celiac trunk is the artery of the foregut. It supplies all organs of the foregut that arose during development. Distal oesophagus, stomach, liver, gall bladder, pancreas, spleen, duodenum.
What organs does the superior mesenteric artery supply?
The superior mesenteric artery supplies the midgut. From the proximal duodenum to the transverse colon. This includes the caecum, appendix and ascending colon.
What organs does the inferior mesenteric artery supply?
The inferior mesenteric artery supplies the hindgut. This stretches from the splenic flexure up to and including the rectum.
Why is the transverse colon more prone to ischaemia?
Prox 2/3 of transverse colon is supplied by SMA while later 1/3 by IMA –watershed area between these 2 areas-sensitive to ischaemia)
Describe the azygous system
Most thoracic structures are drained by a network of veins called the azygous system. This is a network of veins on each side of the vertebral column
- Azygous
- Hemiazygous
- Accessory Hemiazygous
They show considerable variation. The azygous has small connections with the IVC and may serve also as bypass for the IVC
It receives deoxygenated blood from the posterior thorax and abdomen
What are the three layers of blood vessels?
Blood vessels have three layers; Tunica intima, tunica media and tunica externa.
Describe the cellular make up of the vessel layers
Tunica intima is made up of squamous epithelial cells. Tunica media consists of smooth muscle and elastic connective tissue. Tunica externa (adventitia) consists of loosely arranged connective tissue.
Explain how arteries are different to veins
Arteries carry blood away from the heart and veins carry blood toward the heart.
The tunica media is thicker in an artery (which also has a smaller lumen)
Some major arteries such as the aorta have a large elastic connective tissue component in the tunica media to cope with the systolic blood pressure.
Veins have a thinner tunica media and a larger lumen and also may contain valves to prevent backflow.
What is the difference between superficial and deep veins?
Deep Veins accompany all major arteries and their branches and share the same name. They often occur as pairs (venae comitantes) and are contained within the vascular sheath. Venae comitantes are usually found with certain smaller arteries, especially those in the extremities. Larger arteries, on the other hand, generally do not have venae comitantes. They usually have a single, similarly sized vein which is not as intimately associated with the artery.
Superficial veins are closer to the surface & connect to the deep veins by perforating vessels. Venous blood moves from the superficial to the deep. Venous valves & skeletal muscle contraction help move the venous blood towards the heart.
List the venae comitantes in the body
Examples of arteries and their venae comitantes:
• Radial artery and radial veins
• Ulnar artery and ulnar veins
• Brachial artery and brachial veins
• Anterior tibial artery and anterior tibial veins
• Posterior tibial artery and Posterior tibial veins
• Fibular artery and Fibular veins
What are some examples of arteries without venae comitantes
Examples of arteries that do not have venae comitantes (i.e. those that have “regular” veins):
• Axillary artery and the axillary vein
• Subclavian artery and the subclavian vein
Briefly describe atheroscleorsis and list the vessels it affects
Atherosclerosis is a common degenerative disorder affecting walls of medium to large arteries - (the aorta, coronary vessels, and carotid vessels but also large arteries to the lower limb & the renal artery). The pathological process involves chronic inflammation and deposition of lipids and cellular debris within the walls
