Vessels of the major circulation

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Vessels of the major circulation . The aorta represents the main trunk of the arteries of the major circulation, it transports blood from the left ventricle of the heart

Summary

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  • 1 Three portions are distinguished in the aorta
  • 2 Ramos of the ascending aorta
  • 3 Ramos of the aortic arch
    • 1 Brachiocephalic trunk.
    • 2 Common carotid artery
    • 3 External carotid artery.
    • 4 The previous group
    • 5 The posterior group is made up of the following arteries
    • 6 The middle group is made up of remains of the branchial arteries
    • 7 Internal carotid artery
    • 8 Ramos of the internal carotid artery
    • 9 Subclavian artery
    • 10 Ramos of the first portion of the subclavian
    • 11 Axillary artery
    • 12 Branches of the axillary artery
    • 13 Brachial artery
    • 14 Branches of the brachial artery
    • 15 Radial artery
    • 16 Ramos of the radial artery
    • 17 Ulnar artery
    • 18 Ramos of the ulnar artery
    • 19 Hand arteries
  • 4 Branches of the descending aorta
    • 1 Ramos of the thoracic aorta
    • 2 Ramos of the abdominal aorta
    • 3 Odd visceral bouquets
    • 4 Parallel visceral branches
    • 5 Parietal branches of the abdominal aorta
  • 5 Arteries of the free portion of the lower limb
    • 1 Femoral artery
    • 2 Ramos of the femoral artery
    • 3 Popliteal artery
    • 4 Ramos of the popliteal artery
    • 5 Anterior tibial artery
    • 6 Ramos of the anterior tibial artery
    • 7 Posterior tibial artery
    • 8 Foot arteries
    • 9 Ramos of the foot artery
  • 6 Sources

Three portions are distinguished in the aorta

Aortic arch, derived from the IV left arterial arch

Descending aorta, which develops from the dorsal arterial trunk of the embryo .

The ascending aorta begins with a considerable bulbous dilation (aortic bulb), its length is about 6 cm. Along with the pulmonary trunk, behind which it extends, the ascending aorta is covered by the pericardium. The arch of the aorta continues behind the handle of the sternum, which curves back and to the left, surrounding the left main bronchus in its initial section, then continuing in the descending aorta at the level of the IV thoracic vertebra.

The descending aorta is in the posterior mediastinum, firstly to the left of the vertebral column, then deviating slightly to the right, so that when passing through the aortic hiatus of the diaphragm, at the level of the thoracic vertebra, the trunk of the aorta already extends in front of the spine at the midline.

The descending aorta until it passes through the aortic hiatus is called the thoracic aorta and below, and the abdominal aorta is already in the abdomen.

At the level of the IV lumbar vertebra, the aorta emits two large lateral branches (the common iliac arteries), at its aortic bifurcation, and continues its journey to the pelvis in the form of a thin vessel (middle sacral artery).

Ramos of the ascending aorta

According to the law of the shortest distance, the heart is the closest organ to the aorta, which begins in it, the first vessels that start from this are the branches destined for the heart, the right and left coronary arteries.

Ramos of the aortic arch

From the concave side of the arch of the aorta, the arteries destined for the bronchi and thymus depart, and on the convex side three arterial trunks emerge that are from right to left:

  • Brachiocephalic trunk.
  • Common carotid artery.
  • Left subclavian artery.

Brachiocephalic trunk.

It is 3 to 4 cm long and represents the remnant of the embryo’s ventral aorta. It runs obliquely up, back and to the right, in front of the trachea, where it sometimes emits a branch for the thyroid gland, dividing behind the right external clavicular joint in its terminal branches.

Common carotid artery

Known as the artery of the head, it develops from the ventral aorta on the path from III to IV branchial arteries; the right part of the brachiocephalic trunk and the left independently of the arch of the aorta. The common carotid arteries run up the sides of the trachea and esophagus. The right artery is shorter than the left since the latter consists of two parts: the thoracic and the cervical.

The common carotid artery passes through the carotid trigone and at the level of the upper edge of the thyroid cartilage or the body of the hyoid bone is divided into two terminal branches: the external carotid and internal carotid arteries (bifurcation).

Sometimes the internal and external carotids do not start from a common trunk, but directly from the aorta, reflecting the character of their development.

External carotid artery.

It irrigates the external part of the head and neck and for this reason it is called external as opposed to the internal one that penetrates into the skull cavity. From its origin, the external carotid is directed upward medially to the posterior digastric belly, and in the hyoid style, it pierces the parotid gland and behind the neck the condylar process of the mandible is divided into its terminal branches.

The branches of the external carotid are mostly remnants of the branchial arteries and irrigate the organs originating from the visceral arches, they extend in number of nine as the rays of a circle corresponding to the head and are classified into three groups, with three arteries in each of them: anterior group, middle group, and posterior group.

The previous group

It is conditioned by the development and position of the organs irrigated by the arteries of this group, which are derived from visceral arches: the thyroid gland and the larynx, by the superior thyroid artery, the tongue by the lingual artery and the face by the artery. facial.

Superior thyroid artery: it leaves the external carotid immediately above its beginning and goes down and forward to the thyroid gland where it anastomoses with the other thyroid arteries.

  • Lingual artery: part of the external carotid at the level of the greater horns of the hyoid, and it is directed upwards through the Pirogov triangle, covered by the hyoglossus muscle, towards the tongue. Before entering it, it emits ramifications for the hyoid bone.
  • Facial artery: it begins somewhat above the previous one, at the level of the angle of the jaw, it passes medially to the posterior belly of the digastric and reaches the anterior edge of the planter, where, stooping at a right angle over the edge of the jaw, it is directed to face. At this point in front of the planter, it can be compressed against the bone. Later it is directed towards the medial angle of the eye where, due to its terminal branch, it anastomoses with the dorsal artery of the nose. Before its curvature through the mandible it emits branches for the neighboring formations: the pharynx and the soft palate, the palatine tonsil, the submandibular gland, the diaphragm of the mouth and the salivary glands; after curving it emits bouquets for the upper lip and for the lower lip.

The posterior group is made up of the following arteries

  1. Occipital Artery: It begins below the posterior belly of the digastric, it is applied to the groove of the mastoid process, exteriorizing subcutaneously in the occipital region, where it branches to the parietal region.
  2. Posterior auricular artery: It begins at the level of the posterior belly of the digastric, it goes up and back to the retro auricular cutaneous region, reaching the region of the parietal eminence, the skin and the muscles of the occipital region, as inside of the same, in the tympanic cavity, where one of its branches penetrates through the mastoid-style hole.
  3. Sternocleidomastoid artery: It is intended for the homonymous muscle.

The middle group is made up of remains of the branchial arteries

Ascending pharyngeal artery: Part of the trunk of the external carotid near its beginning, is directed up the wall of the pharynx , irrigating it, the soft palate, the palatine tonsil, the auditory tube, the tympanic cavity and the dura.

  • Superficial temporal artery: One of the two terminal branches of the external carotid that, as a prolongation of the trunk of said artery, extends in front of the external acoustic meatus towards the temple, passing through the subcutaneous space, over the facia of the temporal muscle. At the supraorbital border, it is divided into two important branches, one anterior, the frontal branch and one posterior, the parietal branch that branches in the temporal and parietal regions.
  • Maxillary Artery: it is the other terminal branch of the external carotid, its short trunk is subdivided into three parts: the first surrounds the mandibular neck, the second passes into the infra temporal fossa through the surface of the lateral pterygoid muscle and the third penetrates the pterygopalatine fossa.

Internal carotid artery

It begins in the common carotid, goes up to the base of the skull, and enters the carotid canal of the temporal bone. In the cervical region it does not emit ramifications, in its initial segment it is in front of the external carotid artery, in correspondence with the development of the trunk of the thoracic aorta located laterally. According to the configuration of the carotid canal, it continues vertically and then It flexes in the anteromedial direction and penetrates the skull through the internal carotid orifice.

Ramos of the internal carotid artery

  1. Carotyotympanic branches: Very thin branches that penetrate the tympanic cavity through the posterior wall of the carotid canal.
  2. Ophthalmic artery: penetrates through the optic conduit into the orbital cavity accompanying the optic nerve, dividing into its terminal branches.
  3. Anterior cerebral artery: It is the smallest one, it goes to the longitudinal fissure of the brain outlining the corpus callosum.
  4. Middle cerebral artery: It is directed laterally, entering the lateral sulcus, where on the surface of the insula it is subdivided into branches that come out to the surface of the hemisphere, ensuring the irrigation of the frontal, temporal and parietal lobes, except for the posterior area of ​​the same which is irrigated by the vertebral artery system.
  5. Anterior choroidal artery: it is directed back and laterally and after reaching the surface of the temporal lobe it penetrates the foot of the hippocampus of the lateral ventricle, ending in the choroid plexus.
  6. Posterior communicating artery: Part of the internal carotid almost immediately after the start of the ophthalmic and is directed back to empty into the posterior cerebral artery.

Subclavian artery

It is the only one that belongs to the group of branches that start from the arch of the aorta.

It forms a superior convex arch that outlines the dome of the pleura. It leaves the thoracic cavity through its upper opening and when it reaches the clavicle it extends through the subclavian groove of the first rib, later on the subclavian extends to the axillary fossa where from the external edge of the first rib it is called Artery axillary.

Ramos of the first portion of the subclavian

  • Vertebral artery.
  • Anterior spinal artery.
  • Posterior spinal artery.
  • Lower posterior cerebellar artery.
  • Thyrocervical trunk.
  • Internal thoracic artery.
  • Costocervical trunk

Axillary artery

It is a direct extension of the subclavian, which in turn continues in the branchial branch.

The proximal limit of the axillary trunk is indicated by the outer edge of the first rib and its distal limit by the lower edge of the major round muscle. The artery extends through the axillary cavity medial to the humeral joint and the humerus; The axillary vein extends anteriorly and medially.

In the axillary path three parts are distinguished:

  • From the clavicle to the upper edge of the pectoralis minor.
  • Behind said muscle.
  • From the lower edge of the pectoralis minor to the lower edge of the pectoralis major

Axillary artery branches

  • Superior thoracic artery.
  • Achromiothoracic artery.
  • Lateral thoracic artery.
  • Subscapular artery.
  • Posterior humeral circumflex artery.
  • Anterior humeral circumflex artery.

Brachial artery

It is a direct continuation of the axillary, it begins at the lower edge of the major round muscle, it extends through the medial intertuberal groove to the elbow fold, where at the level of the neck of the radius it divides into its terminal branches, during its journey through the The intertubercular sulcus is accompanied by two brachial veins and the median, ulnar, medial brachiocutaneous, and medial antebrachiocutaneous nerves. Apart from the small ramifications for the humerus and muscles, the brachial artery emits the following branches.

Brachial artery branches

  • Deep brachial artery
  • Superior ulnar collateral artery.
  • Lower ulnar collateral artery.

Radial artery

It is by its direction the prolongation of the brachial artery, it extends medially to the brachioradial muscle, initially covered by it and then by the radial groove in the lower third of the forearm, where the muscles continue in its tendons, it is superficially covered only by the fascia and the skin, which provides optimal conditions for pulse exploration.

Ramos of the radial artery

  • Recurrent radial artery.
  • Muscular branches.
  • Palmar carpal bouquet.
  • Dorsal carpal bouquet.
  • Dorsal first metacarpal artery.
  • Main artery of the thumb.

Ulnar artery

It is one of the two terminal branches of the brachii (the one with the largest caliber), from its origin in the ulnar fossa it passes under the round pronator and up to the middle third of the forearm it extends obliquely, deviating towards the ulnar side. In the lower two thirds it runs parallel to the ulna, initially between the superficial flexor digitorum and the flexor ulnaris carpus.

Ramos of the ulnar artery

  • Recurrent ulnar artery.
  • Common interosseous artery.
  • Palmar carpal bouquet.
  • Dorsal carpal bouquet.
  • Deep palmar bouquet.

Hand arteries

In the carpal region there are two arterial networks: a palmar (palpal carpal network) and a dorsal (dorsal carpal network).

The palmar carpal network, is formed by the union of the palmar carpal branches of the radial and ulnar arteries and by small ramifications of the anterior interosseous, the palmar carpal network is located in the ligamentous apparatus of the carpus, below the tendons of the flexor muscles, its branches nourish the ligaments and the middle carpal and radio carpal joints.

In the palm of the hand there are two arterial branches: superficial and deep.

Ramos of the descending aorta

According to the existence in the organism of formations of animal life (body walls), and of vegetative life (viscera), the set of branches of the descending aorta are classified into parietals, intended for the walls of the cavities ( parietal branches), and visceral, intended for the content of these cavities, that is, the viscera (visceral branches).

Ramos of the thoracic aorta

The thoracic portion of the descending aorta emits the following branches:

  • Bronchial branches: They enter the lungs following the path of the bronchi. and it carries arterial blood to the lymph nodes and lung parenchyma, reaching the alveoli.
  • Esophageal branches: In the esophageal walls, they are anastomosed in the upper segment with the branches of the lower thyroid.
  • Mediastinal branches: Intended for lymph nodes and connective tissue of the posterior mediastinum.
  • Pericardial branches: Intended for the pericardium.

Ramos of the abdominal aorta

The abdominal aorta emits parietal branches that are even, except the medial sacral, representing the caudal portion of the aorta delayed in its development and visceral branches that are divided into even and odd.

Odd visceral bouquets

Celiac trunk. It is a short, but thick gauge artery, which starts from the aorta at the level of the 12th thoracic vertebra, in the diaphragm’s aortic hiatus.

It is divided into three branches (the place of division is called a celiac tripod),

  • Left gastric artery
  • Common hepatic artery.
  • Splenic linear artery.
  • Superior mesenteric artery: Part of the anterior aspect of the aorta, immediately below the celiac trunk, runs down and forward towards the cleft between the lower edge of the pancreas and the horizontal portion of the duodenum behind, and penetrates the mesentery from the small intestine to the iliac fossa.
  • Inferior mesenteric artery: Part at the level of the inferior border of the III lumbar vertebra and it is directed downwards and somewhat to the left, standing behind the peritoneum on the anterior aspect of the left psoas muscle.

 

Paired visceral bouquets

The even visceral branches start from the aorta according to the order of position of the organs that determined their origin.

  • Renal artery.
  • Testicular artery

Parietal branches of the abdominal aorta

  • Lower phrenic artery: Irrigates the lumbar portion of the diaphragm.
  • Lumbar arteries: Usually four in number on each side, it corresponds to the intercostal segmental arteries of the lumbar portion, supplying the corresponding vertebrae, the spinal cord, muscles and skin of the lumbar and abdominal regions.
  • Median sacral artery: Represents the continuation of the aorta, descends along the midline, extending over the anterior aspect of the two lower lumbar vertebrae
  • Common iliac artery: right and left, they are two terminal branches in which the aorta is divided at the level of the IV lumbar vertebra, it is divided into two terminal branches: the internal iliac artery and the external iliac artery.

Arteries of the free portion of the lower limb

Femoral artery

It represents the prolongation of the external iliac, receiving this name from its passage below the inguinal ligament, through the vascular lagoon, approximately in the middle part of said path.

Ramos of the femoral artery

  • Superficial epigastric artery.
  • Superficial iliac circumflex artery.
  • External pudendal arteries.
  • Deep femoral artery.

Popliteal artery

It is a direct extension of the femoral, in the popliteal hollow it is located on the bone, on the posterior aspect of the articular capsule somewhat in front and medially to the popliteal vein.

Popliteal artery bouquets

  • Superior lateral and medial artery of the knee.
  • Lower lateral and medial arteries of the knee.
  • Middle artery of the knee.

Anterior tibial artery

It is one of the two terminal branches of the popliteal, immediately after its origin it passes through the deep muscles of the flexor aspect of the leg, and through a hole in the interosseous membrane, passes to the anterior region of the leg, extending between the muscle tibialis anterior and the extensor digitorum longus muscle, and lower between the tibialis anterior muscle and the extensor muscle proper to the great toe.

Ramos of the anterior tibial artery

  • Recurrent posterior tibial artery.
  • Recurrent anterior tibial artery.
  • Antero-medial and anterolateral malleolar arteries

Posterior tibial artery

Represents the extension of the popliteal artery, descending through the femoral canal, when it reaches the limit between the middle third and the lower third of the leg, it comes out below the medial border of the soleus, becoming superficial, in the lower third of the leg the Artery runs between the flexor of the fingers and the flexor of the bone.

The most important branch of the posterior tibial is the peroneal artery, part of it in its upper third and directed down and laterally to the lower peroneal muscle canal, ending in the calcaneus bone.

Foot arteries

The dorsal artery of the foot is the prolongation of the anterior tibia, it is located over the bones and ligaments of the foot, between the tendon of the extensor digitorum longus, medially and the medial belly of the extensor digitorum brevis, plus two or three small skin branches that irrigate the skin on the back and the inside of the foot.

Foot artery bouquets

  • Medial tarsal arteries.
  • Lateral tarsal artery.
  • Arched artery
  • Dorsal first metatarsal artery.
  • Deep planting bouquet.

 

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