Dr. Ahmed Fathalla Ibrahim

ABDOMINAL AORTAABDOMINAL AORTA

BEGINNING:BEGINNING: A continuation of descending thoracic

aorta after passing through aortic opening of diaphragm (opposite T12)(opposite T12)

TERMINATION:TERMINATION: Divides into 2 common iliac arteries

(opposite lower part of L4)(opposite lower part of L4)

ANTERIOR RELATIONS OF ANTERIOR RELATIONS OF ABDOMINAL AORTAABDOMINAL AORTA

ANTERIOR RELATIONS OF ANTERIOR RELATIONS OF ABDOMINAL AORTAABDOMINAL AORTA

2 pancreas, 2 intestine, 2 veins, 2 2 pancreas, 2 intestine, 2 veins, 2 superior mesentericsuperior mesenteric

Body & uncinate process of pancreas

Splenic & left renal veins Third part of duodenum Coils of small intestine Superior mesenteric vessels

RELATIONS OF RELATIONS OF ABDOMINAL ABDOMINAL

AORTAAORTA

POSTERIOR:POSTERIOR: Bodies of Bodies of lumbar vertebraelumbar vertebrae

RELATIONS OF RELATIONS OF ABDOMINAL ABDOMINAL

AORTAAORTARIGHT:RIGHT:IVCIVCCysterna chyliCysterna chyliAzygos veinAzygos veinRight crusRight crus

LEFT:LEFT:Left sympathetic Left sympathetic trunktrunkLeft psoas majorLeft psoas majorLeft crusLeft crus

BRANCHES OF ABDOMINAL BRANCHES OF ABDOMINAL AORTAAORTA

SINGLE BRANCHES OF SINGLE BRANCHES OF ABDOMINAL AORTAABDOMINAL AORTA

Three arising from anterior aspect of Three arising from anterior aspect of aorta:aorta:

1)Celiac trunk (upper part of L1)(upper part of L1)

2)Superior mesenteric (lower part of L1)(lower part of L1)

3)Inferior mesenteric (L3)(L3)One arising from termination of aorta:One arising from termination of aorta:

1)Median sacral (lower part of L4)(lower part of L4)

PAIRED BRANCHES OF PAIRED BRANCHES OF ABDOMINAL AORTAABDOMINAL AORTA

Three pairs arising from anterior Three pairs arising from anterior aspect of aorta:aspect of aorta:

1)Inferior phrenic (upper part of L1)(upper part of L1)

2)Suprarenal (lower part of L1)(lower part of L1)

3)Gonadal (testicular or ovarian) (L3)(L3)One pair arising from lateral aspect of One pair arising from lateral aspect of

aorta:aorta:

1)Renal (L2)(L2)

PAIRED BRANCHES OF PAIRED BRANCHES OF ABDOMINAL AORTAABDOMINAL AORTA

Four pairs arising from posterior Four pairs arising from posterior aspect of aorta:aspect of aorta:

1)LumbarOne pair arising from termination of One pair arising from termination of

aorta:aorta:

1)Common iliac (Lower part of L4)(Lower part of L4)

COMMON ILIAC ARTERIESCOMMON ILIAC ARTERIESBEGINNING:BEGINNING:

• Terminal branches of abdominal aorta (lower part of L4)(lower part of L4)

TERMINATION:TERMINATION:

• Each one bifurcates into external & bifurcates into external & internal iliac arteries (lower part of L5) internal iliac arteries (lower part of L5)

COURSE & RELATIONS:COURSE & RELATIONS:

• Descend along medial border of psoas medial border of psoas

• End anterior to sacroiliac jointanterior to sacroiliac joint

• The bifurcation is crossed by uretercrossed by ureter

EXTERNAL ILIAC ARTERYEXTERNAL ILIAC ARTERY

BEGINNING:BEGINNING:

• One of 2 terminal branches of common iliac artery (lower part of L5)(lower part of L5)

TERMINATION:TERMINATION:

• Continues as femoral artery, behind inguinal ligament

BRANCHES:BRANCHES:

1)Deep circumflex iliac

2)Inferior epigastric

INFERIOR VENA CAVAINFERIOR VENA CAVA

BEGINNING:BEGINNING:

• Formed by union of 2 common iliac veins (L5)(L5)

TERMINATIONTERMINATION:

• Pierces central tendon of diaphragm at level of T8T8

• Opens in the right atrium at level of right 6right 6thth costal cartilage costal cartilage

RELATIONS OF INFERIOR RELATIONS OF INFERIOR VENA CAVAVENA CAVA

RELATIONS OF INFERIOR RELATIONS OF INFERIOR VENA CAVAVENA CAVA

ANTERIOR:ANTERIOR:

• Liver

• Epiploic foramen,

• First part of duodenum,

• Head of pancreas

• Third part of duodenum

• Superior mesenteric vessels

• Right gonadal vessels

• Coils of small intestine

RELATIONS RELATIONS OF INFERIOR OF INFERIOR VENA CAVAVENA CAVA

POSTERIOR:POSTERIOR:•Bodies of lumbar Bodies of lumbar vertebraevertebrae•Right crusRight crus•Right renal Right renal arteryartery•Right Right sympathetic sympathetic trunktrunk

RELATIONS OF INFERIOR RELATIONS OF INFERIOR VENA CAVAVENA CAVA

RIGHT:RIGHT:

• Right psoas major

• Right ureterLEFT:LEFT:

• Abdominal aorta

TRIBUTARIES OF INFERIOR TRIBUTARIES OF INFERIOR VENA CAVAVENA CAVA

TRIBUTARIES OF INFERIOR TRIBUTARIES OF INFERIOR VENA CAVAVENA CAVA

• Right & left Right & left inferior phrenic veins

• Right & left Right & left renal veins

• Right & left Right & left lumbar veins

• Right & left Right & left common iliac veins

• RightRight suprarenal vein

• RightRight gonadal vein

• Hepatic veins

N.B.N.B.

Left suprarenal vein & left gonadal vein Left suprarenal vein & left gonadal vein drain into left renal veindrain into left renal vein

Median sacral vein drains into left Median sacral vein drains into left common iliac veincommon iliac vein

Superior mesenteric vein joins splenic Superior mesenteric vein joins splenic vein to form portal veinvein to form portal vein

Inferior mesenteric vein drains into Inferior mesenteric vein drains into splenic veinsplenic vein

There is no celiac veinThere is no celiac vein

N.B.N.B.

Tributaries of IVC = paired branches of Tributaries of IVC = paired branches of abdominal aortaabdominal aorta

- Left suprarenal & left gonadal veinsLeft suprarenal & left gonadal veins

+ hepatic veins+ hepatic veins