Aorta branches of the branch. The structure of the aorta and its branches

The date: 04.03.2020

Aorta, aorta, is the largest arterial vessel in the human body. It exits the left ventricle; its beginning is the opening of the aorta, ostium aortae. All arteries that form the systemic circulation depart from the aorta.

In the aorta, the ascending part of the aorta (ascending aorta), pars ascendens aortae (aorta ascendens), the arch of the aorta, arcus aortae, and the descending part of the aorta (descending aorta), pars descendens aortae (aorta descendens) are distinguished. The latter, in turn, is divided into the thoracic part of the aorta (thoracic aorta), pars thoracica aortae (aorta thoracica), and the abdominal part of the aorta (abdominal aorta), pars abdominalis aortae (aorta abdominalis).

Ascending part of the aorta, pars ascendens aortae, originates in the left ventricle from the aortic opening. Behind the left half of the sternum, at the level of the third intercostal space, it goes up, slightly to the right and forward and reaches the level of the cartilage of the second rib on the right, where it continues into the arch of the aorta.

The beginning of the ascending part of the aorta is enlarged and is called the aortic bulb, bulbus aortae. The wall of the bulb forms three protrusions - the sinuses of the aorta, sinus aortae, corresponding to the position of the three semilunar valves of the aorta.

Like flaps, these sinuses stand for right, left, and back.

A originates from the right sine. coronaria dextra, and from the left - a. coronaria sinistra.

Aortic arch, arcus aortae, convex upward and directed from front to back, passing into the descending part of the aorta. At the transition site, a slight narrowing is noticeable - the isthmus of the aorta, isthmus aortae. The aortic arch has a direction from the cartilage of the II rib on the right to the left surface of the bodies of the III-IV thoracic vertebrae.

Three large vessels depart from the aortic arch: the brachiocephalic trunk, truncus brachiocephalicus, the left common carotid artery, a. carotis communis sinistra, and the left subclavian artery, a. subclavia sinistra.

The brachiocephalic trunk, truncus brachiocephalicus, departs from the initial part of the aortic arch. It is a large vessel up to 4 cm long, which goes up and to the right and at the level of the right sternoclavicular joint is divided into two branches: the right common carotid artery, a. carotis communis dextra, and the right subclavian artery, a. subclavia dextra. Sometimes the lower thyroid artery departs from the brachiocephalic trunk, a. thyroidea ima.

Development options are rare: 1) the brachiocephalic trunk is absent, the right common carotid and right subclavian arteries depart in this case directly from the aortic arch; 2) the brachiocephalic trunk departs not to the right, but to the left; 3) there are two brachiocephalic trunks, right and left.

Descending part of the aorta, pars descendens aortae, is a continuation of the aortic arch and lies along the length from the body of the III-IV thoracic vertebra to the level IV of the lumbar vertebra, where it gives the right and left common iliac arteries, aa. iliacae communes dextra et sinistra, and itself continues into the pelvic cavity in the form of a thin stem - the median sacral artery, a. sacralis mediana, which runs along the anterior surface of the sacrum.

At the level of the XII thoracic vertebra, the descending part of the aorta passes through the aortic opening of the diaphragm and descends into the abdominal cavity. Before the diaphragm, the descending part of the aorta is called the thoracic part of the aorta, pars thoracica aortae, and below the diaphragm, the abdominal part of the aorta, pars abdominalis aortae.

Aorta (aorta; rice. 181) is the largest arterial vessel in the human body. There are three sections in the aorta: ascending part, arc and descending part. The descending part distinguishes chest part(pars thoracica) and abdomen(pars abdominalis) of the aorta.

Ascending part of the aorta(pars ascendens aortae), about 6 cm long, has an expansion in the form of a bulb (bulbus aortae) in the initial section, covered with a pericardium. Behind the sternum, it goes up and to the right and at the level of the cartilage of the II rib passes into the aortic arch. The right and left coronary arteries depart from the ascending part (in the area of the bulb).

Aortic arch(arcus aortae), facing upward with a bulge, bends back and to the left and at the level of III-IV of the thoracic vertebra passes into the descending part of the aorta. Three large vessels extend from the convex surface of the aortic arch: brachiocephalic trunk(truncus brachiocephalicus), left common carotid artery(a. carotis communis sinistra) and left subclavicular artery(a. subclavia sinistra).

Descending part of the aorta(pars descendens aortae; see Fig. 181) - this is the longest section of the aorta, runs from the level IV of the thoracic vertebra to the IV lumbar, where it is divided into the right and left common iliac arteries (aortic bifurcation). In the descending part of the aorta, the thoracic and abdominal parts are distinguished.

Aorta located to the left of the midline of the body and with its branches supplies blood to all organs and tissues of the body. A part of it, about 6 cm long, directly leaving the heart and rising up, is called the ascending part of the aorta. It begins with the expansion - the bulb - of the aorta, inside which there are three aortic sinuses, located between the inner surface of the aortic wall and the flaps of its valve. The right and left coronary arteries extend from the aortic bulb. Bending to the left, the aortic arch lies over the pulmonary arteries diverging here, spreads over the beginning of the left main bronchus and passes into the descending part of the aorta. From the concave side of the aortic arch, branches begin to the trachea, bronchi and to the thymus gland, three large vessels depart from the convex side of the arch: the shoulder-head trunk lies on the right, the left common carotid and left subclavicular arteries are on the left.

Shoulder-head trunk about 3 cm long departs from the aortic arch, goes up, back and to the right, in front of the trachea. At the level of the right sternoclavicular joint, it is divided into the right common carotid and subclavian arteries. The left common carotid and left subclavian arteries extend directly from the aortic arch to the left of the shoulder-head trunk.

Common carotid artery(right and left) goes up next to the trachea and esophagus. At the level of the upper edge of the thyroid cartilage, it is divided into the external carotid artery, which branches outside the cranial cavity, and the internal carotid artery, which passes inside the skull and goes to the brain.

External carotid artery goes up, passes through the tissue of the parotid gland and in its thickness behind the neck of the condylar process of the lower jaw is divided into its terminal branches: the maxillary and superficial temporal arteries. On its way, the artery gives off lateral branches and supplies blood to the outer parts of the head and neck, mouth and nose, thyroid gland, larynx, tongue, palate, tonsils, sternocleidomastoid and occipital muscles, submandibular, hyoid and parotid salivary glands, skin, bones and muscles of the head (mimic and chewing), teeth of the upper and lower jaws, dura mater, outer and middle ear.

Internal carotid artery goes up to the base of the skull, without giving up branches, enters the cranial cavity through the carotid artery canal in the temporal bone, rises along the carotid groove of the sphenoid bone, lies in the cavernous sinus and, passing through the hard and arachnoid membranes, is divided into a number of terminal branches. The artery supplies blood to the brain and the organ of vision.

Subclavian artery on the left it departs directly from the aortic arch, on the right - from the shoulder-head trunk, bends around the dome of the pleura, passes between the clavicle and the 1st rib, lies in the groove of the same name of the 1st rib, heading towards the armpit. The subclavian artery and its branches supply blood to the cervical spinal cord with meninges, brain stem, occipital and partially temporal lobes of the cerebral hemispheres, deep and partly superficial muscles of the neck, cervical vertebrae, intercostal muscles of the first and second intervals, part of the muscles of the occiput, back and shoulder blades, diaphragm, skin of the chest and upper abdomen, rectus abdominis muscle, mammary gland, throat, trachea, esophagus, thyroid and thymus glands.

On the basis of the brain, due to the connection of the anterior cerebral arteries with the anterior communicating artery, as well as the posterior connecting and posterior cerebral arteries, a circular arterial anastomosis is formed - the arterial (Willis) circle of the large brain. The subclavian artery in the axillary region becomes axillary artery, which lies in the axillary fossa medially from the shoulder joint and the humerus next to the vein of the same name, and is surrounded by the trunks of the brachial plexus. The artery supplies blood to the muscles of the shoulder girdle, the skin and muscles of the lateral chest wall, the shoulder and clavicular-acromial joints, the contents of the axillary fossa.

Brachial artery is a continuation of the axillary, it passes in the medial groove of the biceps brachii and is divided into the radial and ulnar arteries in the ulnar fossa. The brachial artery supplies blood to the skin and muscles of the shoulder, the humerus and the elbow joint.

Radial artery located on the forearm laterally in the radial groove, parallel to the radius. In the lower section, near its styloid process, the artery is easily palpable, being covered only by the skin and fascia. The radial artery passes to the hand under the tendons of the long muscles of the thumb, bends around the back of the first metacarpal bone. It supplies blood to the skin and muscles of the forearm and hand, the radius, ulna and wrist joints.

Ulnar artery located on the forearm medially in the ulnar groove parallel to the ulna, passes to the palmar surface of the hand. It supplies blood to the skin and muscles of the forearm and brush, the ulna, the elbow and wrist joints. The ulnar and radial arteries form two arterial networks of the wrist on the hand: the back and the palmar, feeding the ligaments and joints of the wrist, the second, third, fourth interosseous spaces and fingers, and two arterial palmar arches - deep and superficial. The superficial la-bottom arch is formed mainly due to the ulnar artery and the superficial palmar branch of the radial artery. From the superficial arch, four common palmar digital arteries extend downward, going to the P-III-IV-V fingers. Each of the I, II, III arteries supply blood to the sides of the II-V fingers facing each other, IV - supply blood to the ulnar side of the V finger.

The deep palmar arch is located somewhat proximal to the superficial one. It lies under the flexor tendons at the level of the base of the metacarpal bones. In the formation of the deep palmar arch, the main role belongs to the radial artery, which connects to the deep palmar branch of the ulnar artery. Three palmar metacarpal arteries depart from the deep arch, which are sent to the second, third and fourth interosseous spaces. These arteries connect to the common palmar digital arteries. Due to the presence of arcs and networks anastomosed among themselves, with numerous and complex movements of the hand and fingers, its blood supply does not suffer.

The descending part of the aorta is divided into two parts: thoracic and abdominal... The thoracic part of the aorta is located asymmetrically on the spine, to the left of the midline and supplies blood to the internal organs located in the chest cavity and its walls. From the thoracic aorta, there are 10 pairs of posterior intercostal arteries, the upper diaphragmatic and internal branches (bronchial, esophageal, pericardial, mediastinal). From the thoracic cavity, the aorta passes into the abdominal cavity through the aortic opening of the diaphragm. Down the aorta is gradually displaced medially, especially in the abdominal cavity, and at the place of its division into two common iliac arteries at the level of the IV lumbar vertebra (aortic bifurcation) is located in the midline and continues in the form of a thin median sacral artery, which corresponds to the tail artery of mammals ... The abdominal part of the aorta supplies blood to the abdominal viscera and abdominal walls.

From the thoracic aorta the visceral and parietal branches depart, which supply blood to the organs lying in the chest cavity and the walls of the chest cavity.

From the abdominal aorta both paired and unpaired vessels leave. Among them, there are internal and parietal. The first include three very large unpaired arteries: celiac trunk, superior and inferior mesenteric arteries. Paired branches are represented by the middle adrenal, renal and testicular (ovarian arteries in women). Parietal branches: lower phrenic, lumbar and below the median sacral artery.

Celiac trunk departs immediately under the diaphragm at the level of CP of the thoracic vertebra and immediately divides into three branches that supply blood to the abdominal part of the esophagus, stomach, duodenum, subgastric gland, liver with gallbladder, spleen, small and large omentums.

Superior mesenteric artery departs directly from the abdominal part of the aorta and goes to the root of the mesentery of the small intestine. A large number of branches depart from it, which supply blood to the pancreas, the small intestine, the right part of the colon, including the right part of the transverse colon.

Inferior mesenteric artery starts from the left semicircle of the abdominal part of the aorta, goes retroperitoneally down and to the left and gives off a number of branches that supply blood to the left part of the transverse colonic, descending, sigmoid colonic, upper and middle sections of the rectum. The branches of the superior mesenteric artery are anastomosed with the branches of the celiac trunk and the inferior mesenteric artery, due to which all three large vessels of the abdominal cavity are connected to each other.

Common iliac artery- This is the largest human artery (with the exception of the aorta). Having passed some distance at an acute angle to each other, each of them is divided into two arteries: the internal iliac and the external iliac.

Internal iliac artery starts from the common iliac artery at the level of the sacroiliac joint, is located retroperitoneally, goes to the small pelvis, adjacent to its lateral wall. The internal iliac artery feeds the pelvic bone, sacrum and the entire mass of the muscles of the small, large pelvis, gluteal region and partly the adductor muscles of the thigh, as well as the viscera located in the small pelvis: rectum, bladder; in men - seminal vesicles, vas deferens, prostate; in women - the uterus and vagina, external genitals and perineum.

External iliac artery begins at the level of the sacroiliac joint from the common iliac artery, goes retroperitoneally down and forward, passes under the inguinal ligament and passes into the femoral artery. The external iliac artery supplies the muscles of the thigh, in men, the scrotum, in women, the pubis and labia majora.

Femoral artery is a direct continuation of the external iliac artery. It passes in the femoral triangle, between the muscles of the thigh, enters the popliteal fossa, where it continues into the popliteal artery. The femoral artery supplies blood to the femur, skin and muscles of the thigh, skin of the anterior abdominal wall, external genitalia, hip joint.

Popliteal artery is a continuation of the femoral. It lies in the fossa of the same name, passes to the lower leg, where it immediately divides into the anterior and posterior tibial arteries. The artery supplies blood to the skin and nearby muscles of the thigh and back of the lower leg, knee joint.

Posterior tibial artery goes down, in the area of the ankle joint it passes to the sole behind the medial ankle under the flexor muscle retainer, after which it is divided into its terminal branches: the medial and lateral plantar arteries. The largest branch of the posterior tibialis is the peroneal artery. The posterior tibial artery supplies blood to the skin of the posterior surface of the leg, bones, leg muscles, knee and ankle joints, and foot muscles.

Anterior tibial artery descends down the anterior surface of the interosseous membrane of the lower leg. The artery supplies blood to the skin and muscles of the anterior surface of the lower leg and dorsum of the foot, knee and ankle joints, and on the foot passes into the dorsal artery of the foot. Both tibial arteries form a plantar arterial arch on the foot, which lies at the level of the base of the metatarsal bones. Arteries that feed the skin and muscles of the foot and toes extend from the arch.

Lecture 11. Venous system. The lymphatic system. Morphofunctional features of the venous and lymphatic systems.

The aorta and its divisions. Branches of the aortic arch, their anatomy, topography, areas of branching (blood supply).

Aorta, aorta(rice.

42), is the largest unpaired arterial vessel of the systemic circulation. The aorta is subdivided into three sections: the ascending part of the aorta, the arch of the aorta and the non-descending part of the aorta, which in turn is divided into the thoracic and abdominal parts.

The ascending part of the aortapars ascendens aortae, leaves the left ventricle behind the left edge of the sternum at the level of the third intercostal space; in the initial section, it has an extension - the aortic bulb, bulbus aortae(25-30 mm across).

At the location of the aortic valve on the inner side of the aorta, there are three sinuses, sinus aortae. Each of them is located between the corresponding semilunar valve and the wall of the aorta. From the beginning of the ascending part of the aorta, the right and left coronary arteries depart.

The ascending part of the aorta lies in the back and partly to the right of the pulmonary trunk, rises up and at the level of the junction of the II right costal cartilage with the sternum passes into the aortic arch (here its diameter decreases to 21-22 mm).

Aortic arch,arcus aortae, turns to the left and back from the posterior surface of the II costal cartilage to the left side of the body of the IV thoracic vertebra, where it passes into the descending part of the aorta.

In this place there is a slight narrowing - the isthmus of the aorta, isthmus aortae. The edges of the corresponding pleural sacs fit to the anterior semicircle of the aorta on its right and left sides.

The structure of the aorta and its branches

To the convex side of the aortic arch and to the initial sections of the large vessels extending from it (brachiocephalic trunk, left common carotid and subclavian arteries), the left brachiocephalic vein lies in front, and the right pulmonary artery begins under the aortic arch, below and slightly to the left - bifurcation of the pulmonary trunk ... The trachea bifurcation is located behind the aortic arch. Between the concave semicircle of the aortic arch and the pulmonary trunk or the beginning of the left pulmonary artery there is arterial ligament, tig.

arteriosum. In this place, thin arteries branch off from the aortic arch to the trachea and bronchi. Three large arteries begin from the convex semicircle of the aortic arch: the brachiocephalic trunk, the left common carotid and the left subclavian arteries.

The descending part of the aorta,pars descendens aortae,- this is the longest section of the aorta, passing from the level IV of the thoracic vertebra to the IV lumbar, where it is divided into the right and left common iliac arteries; this place is called the bifurcation of the aorta, bifurcdtio aortae.

The thoracic part of the aorta, pars thordcica aortae, located in the chest cavity in the posterior mediastinum.

Its upper section is located in front of and to the left of the esophagus. Then, at the level of VIII-IX thoracic vertebrae, the aorta bends around the esophagus on the left and goes to its posterior surface. To the right of the thoracic part of the aorta are the azygos vein and the thoracic duct, to the left is the parietal pleura, at the place of its transition to the posterior part of the left mediastinal pleura. In the thoracic cavity, the thoracic part of the aorta gives off paired parietal branches; posterior intercostal arteries, as well as visceral branches to the organs of the posterior mediastinum.

The abdominal part of the aorta pars abdomindlis aortae, being a continuation of the thoracic part of the aorta, it begins at the level of the XII thoracic vertebra, passes through the aortic opening of the diaphragm and continues to the level of the middle of the body of the IV lumbar vertebra.

The abdominal part of the aorta is located on the anterior surface of the bodies of the lumbar vertebrae, to the left of the midline; lies retroperitoneally. To the right of the abdominal part of the aorta are the inferior vena cava, anteriorly - the pancreas, the horizontal (lower) part of the duodenum and the mesentery root of the small intestine. The abdominal part of the aorta gives paired parietal branches to the diaphragm and to the walls of the abdominal cavity, and itself continues directly into the thin median sacral artery.

The visceral branches of the abdominal part of the aorta are the celiac trunk, the superior and inferior mesenteric arteries (unpaired branches) and paired - the renal, middle adrenal and testicular (ovarian) arteries.

Branches of the aortic arch

Brachiocephalic trunk,truncus brachlocephdlicus, departs from the aortic arch at level II of the right costal cartilage.

In front of him is the right brachiocephalic vein, behind - the trachea. Heading up and to the right, the brachiocephalic trunk does not give up any branches and only at the level of the right sternoclavicular joint is divided into two terminal branches - the right common carotid and right subclavian arteries.

Right common carotid artery a.

carotis communis dextra, is a branch of the brachiocephalic trunk, and the left common carotid artery, a. carotis communis sinistra, departs directly from the aortic arch (Fig.

43, 44). The left common carotid artery is usually 20-25 mm longer than the right one. The common carotid artery lies behind the sternocleidomastoid and scapular-hypoglossal muscles, follows vertically upward in front of the transverse processes of the cervical vertebrae, without giving out branches along the way.

Outside of the common carotid artery are the internal jugular vein and the vagus nerve, medially - first the trachea and esophagus, and above - the larynx, pharynx, thyroid and parasitic glands.

At the level of the upper edge of the thyroid cartilage, each common carotid artery is divided into the external and internal carotid arteries, which have approximately the same diameter. This place is called the bifurcation of the common carotid artery. A slight expansion at the beginning of the external carotid artery - carotid sinus, sinus caroticus. In the area of the bifurcation of the common carotid artery, there is a small body 2.5 mm long and 1.5 mm thick - a carotid glomus, glomus caroticum(carotid gland, intersonic glomerulus), containing a dense capillary network and many nerve endings (chemoreceptors).

External carotid arterya.

carotis externa, is one of the two terminal branches of the common carotid artery. It is separated from the common carotid artery within the carotid triangle at the level of the upper edge of the thyroid cartilage. At first, it is located medial to the internal carotid artery, and then lateral to it. The initial part of the external carotid artery of the carotid artery is covered by the sternocleidomastoid muscle, and in the area of the carotid triangle - by the superficial plate of the cervical fascia and the subcutaneous muscle of the neck.

Located inwardly from the stylohyoid muscle and the posterior abdomen of the digastric muscle, the external carotid artery at the level of the mandible neck (in the thickness of the parotid gland) divides into its terminal branches - the superficial temporal and maxillary arteries. On its way, the external carotid artery gives off a number of branches that depart from it in several directions.

The anterior group of branches is made up of the upper thyroid, lingual and facial arteries. The posterior group includes the sternocleidomastoid, occipital and posterior ear arteries.

The ascending pharyngeal artery is directed medially.

Anterior branches of the external carotid artery:

1 Superior thyroid artery,but. thyreoidea superior,

2Lingual artery,a. lingualis,

3 . Facial artery,a. facidlis,

Posterior branches of the external carotid artery:

1. Occipital artery,a.

2. Posterior ear arterya. auriculdris posterior

The medial branch of the external carotid artery - ascending pharyngeal artery,a.

pharyngea ascendens. This is a relatively thin vessel, departs from the inner semicircle of the external carotid artery at its beginning, rises up to the lateral wall of the pharynx. From the ascending pharyngeal artery depart: 1) pharyngeal branches, rr. pharyngedles, to the muscles of the pharynx and to the deep muscles of the neck; 2) posterior meningeal artery, a. meningea poste-rior, follows into the cranial cavity through the jugular opening; 3) inferior tympanic artery, a.

tympdnica inferior, through the lower opening of the tympanic tubule penetrates into the tympanic cavity.

Terminal branches of the external carotid artery:

1. Superficial temporal arterya. tempordlis superficid-lis,

Maxillary arterya. maxilldris,

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Aorta

Aorta- the largest unpaired arterial vessel of the systemic circulation. The aorta is divided into three sections: the ascending part of the aorta, the arch of the aorta, and the descending part of the aorta, which in turn is divided into the thoracic and abdominal parts.

Ascending part of the aorta leaves the left ventricle behind the left edge of the sternum at the level of the third intercostal space; in the initial section, it has an extension - the aortic bulb (25-30 mm in diameter).

At the location of the aortic valve, there are three sinuses on the inner side of the aorta. Each of them is located between the corresponding semilunar valve and the wall of the aorta. From the beginning of the ascending part of the aorta, the right and left coronary arteries depart. The ascending part of the aorta lies behind and partly to the right of the pulmonary trunk, rises up and at the level of the junction of the 2 right costal cartilage with the sternum passes into the aortic arch (here its diameter decreases to 21-22 mm).

Aortic arch turns left and back from the posterior surface of costal cartilage 2 to the left side of the body 4 of the thoracic vertebra, where it passes into the descending part of the aorta.

In this place there is a slight narrowing - the isthmus. The edges of the corresponding pleural sacs fit to the anterior semicircle of the aorta on its right and left sides. To the convex side of the aortic arch and to the initial sections of large vessels extending from it (brachiocephalic trunk, left common carotid and subclavian arteries), the left brachiocephalic vein is adjacent in front, and the right pulmonary artery begins under the aortic arch, below and slightly to the left is the bifurcation of the pulmonary trunk.

Behind the aortic arch is the tracheal bifurcation. There is an arterial ligament between the bent semicircle of the aortic arch and the pulmonary trunk or the beginning of the left pulmonary artery. At this point, thin arteries extend from the aortic arch to the trachea and bronchi.

12. Aorta and its departments. Branches and arches of the aorta, their topography.

Three large arteries begin from the convex semicircle of the aortic arch: the brachiocephalic trunk, the left common carotid and the left subclavian arteries.

Descending part of the aorta- this is the longest section of the aorta, passing from the level of the 4th thoracic vertebra to the 4th lumbar vertebra, where it is divided into the right and left common iliac arteries; this place is called the aortic bifurcation.

The descending part of the aorta, in turn, is divided into thoracic and abdominal parts.

Thoracic aorta located in the chest cavity in the posterior mediastinum. Its upper section is located in front of and to the left of the esophagus. Then, at the level of 8-9 thoracic vertebrae, the aorta bends around the esophagus on the left and goes to its posterior surface. To the right of the thoracic part of the aorta are the azygos vein and the thoracic duct, to the left is the parietal pleura, at the place of its transition to the posterior part of the left mediastinal pleura.

In the thoracic cavity, the thoracic part of the aorta gives off paired parietal branches; posterior intercostal arteries, as well as visceral branches to the organs of the posterior mediastinum.

Abdominal aorta, being a continuation of the thoracic part of the aorta, begins at the level of the 12th thoracic vertebra, passes through the aortic opening of the diaphragm and continues to the level of the middle of the body of the 4th lumbar vertebra. The abdominal part of the aorta is located on the anterior surface of the bodies of the lumbar vertebrae, to the left of the midline; lies retroperitoneally.

To the right of the abdominal part of the aorta are the inferior vena cava, anteriorly - the pancreas, the horizontal (lower) part of the duodenum and the mesentery root of the small intestine. The abdominal part of the aorta gives off paired parietal branches to the diaphragm and to the walls of the abdominal cavity, and itself continues directly into the thin median sacral artery.

Right and left coronary arteries (see above);

ARORT BRANCHES

Brachiocephalic trunk: departs from the aortic arch at the level of the 2nd costal cartilage. At the level of the right sternoclavicular joint, it is divided into the right common carotid and right subclavian arteries;

Left common carotid artery

Left subclavian artery

Blood supply area. The branches of the aortic arch provide blood supply to the head, neck and upper limb

BRANCHES OF THE CHEST AORTE

PARIETAL BRANCHES (branches supplying blood to the walls of the body).

These include:

Superior phrenic artery- participates in the blood supply to the diaphragm

Posterior intercostal arteries ( 10 pairs of right and left arteries). They are sent to the intercostal spaces, at the level of the heads of the ribs they are divided into dorsal and ventral branches

— Dorsal branches: supply blood to the vertebral column, spinal cord, the extensor muscle of the trunk and the skin of the back;

— Ventral branches: follow in the intercostal spaces between the external and internal intercostal muscles.

They supply blood to the walls and skin of the chest; the lower five pairs go to the abdominal muscles and supply them with blood;

VISCERAL BRANCHES (branches supplying blood to the internal organs). These include:

Esophageal branches - blood supply to the esophagus

Bronchial branches - supply blood to the trachea, bronchi and lung parenchyma

Pericardial branches - blood supply to the pericardium

Mediastinal branches - supply blood to the tissue and lymph nodes of the mediastinum

TEST QUESTIONS

Links of the cardiovascular system.
Main arteries and veins. Microcirculatory bed, its parts and function. Vascular anastomoses. Collateral vessels and collateral blood flow;
Heart, its location. The projection of the borders of the heart on the anterior chest wall. Parts and surfaces of the heart, furrows;
Departments (chambers) of the heart, their openings, walls and messages.
Septa of the heart;
Fibrous skeleton of the heart, its structure and function;
Heart valves. Flap valves, their location and structure;
Semi-lunar valves, their location and structure. Heart valve function;
Shells of the heart. Endocardium, its function. Myocardium, its structure in the atria and ventricles;
Pericardium, its structure.
Fibrous and serous pericardium, pericardial cavity
Blood supply to the heart. Coronary arteries: places of their origin, course, branches, areas of blood supply and anastomoses;
Veins of the heart: places of their beginning, course, place of end.
Coronary sinus of the heart, its location
Conductive system of the heart: its formation, structure and function;
Aorta: its parts, boundaries between them, location, beginning and end; branches of the aortic arch, their location;
Parietal branches of the thoracic aorta: their course, branches and areas of blood supply;
Visceral branches of the thoracic aorta: their course, branches and areas of blood supply;

Human anatomy.
Ed. M.R. Sapina (all editions);
Human anatomy. Ed. M. G. Prives (all editions);
Human Anatomy, Ed. S. S. Mikhailova (all editions);
Atlas of human anatomy. Ed.
The aorta and its divisions. Branches of the aortic arch, their anatomy, topography, areas of branching (blood supply).

R.D. Sinelnikova (all editions)

Lesson number 13

Topic 213. ARTERIES OF THE HEAD AND NECK (GENERAL DATA). SUBCLUSIVE AND UNMUSCULAR ARTERIES. UPPER LIMB ARTERIES

Knowledge of the material on this topic is important for further study of topographic anatomy, operative surgery, a course of general surgery and traumatology, a course of vascular and nervous diseases.

Previously, the location and structure of the following anatomical structures should be repeated:

The structure of the cervical spine;

Occipital bone: basilar part, clivus, foramen magnum;
Sphenoid bone: lesser wing, optic canal, anterior tilted process;
Temporal bone: stony part, sleepy canal;
Lower jaw: ramus of the lower jaw, condylar process, neck of the lower jaw;
Rib cage: upper and lower apertures;
Back muscles: trapezius muscle, latissimus dorsi, rhomboid muscles;
Chest muscles: pectoralis major muscle, pectoralis minor, serratus anterior muscle;
Abdominal muscles;
Muscles of the shoulder girdle: deltoid muscle, supraspinatus muscle, infraspinatus muscle, subscapularis muscle;
Shoulder muscles;
Forearm muscles: pronator round, brachioradialis muscle, radial wrist flexor, ulnar wrist flexor, superficial flexor of the fingers, deep flexor of the fingers,
radial extensors of the wrist, extensors of the thumb of the hand, extensors of the thumb of the hand;
Neck muscles: sternocleidomastoid muscle, digastric muscle, stylohyoid muscle, scapular-hyoid muscle, anterior scalene muscle, middle scalene muscle, posterior scalene muscle, long head muscle, long neck muscle;
Neck organs: larynx, pharynx, trachea, esophagus, their location;
Neck triangles; lower jaw fossa and interscalene space;
Elements of the topography of the upper limb: armpit, its walls; front wall triangles; medial groove of the shoulder, brachomuscular canal, ulnar fossa, radial, median and ulnar grooves of the forearm;
The brain, its departments, their parts and structure
Aorta, its parts, branches of the aortic arch

GENERAL CAROTID ARTERY

Start: the right artery - from the brachiocephalic trunk, the left artery - from the aortic arch;

Location: located in the anterior region of the neck.

Attached to her:

- Sternocleidomastoid and scapular-hyoid muscles (in front),

- Trachea, esophagus, pharynx and larynx (from the medial side);

- Prevertebral plate of the cervical fascia (behind);

The ending: within the carotid triangle, at the level of the upper edge of the thyroid cartilage of the larynx.

Divided into external and internal carotid arteries;

EXTERNAL CAROTID ARTERY

Start: from the common carotid artery within the carotid triangle, at the level of the upper edge of the thyroid cartilage;

Location: within the carotid triangle, then passes inwardly from the stylohyoid and digastric muscles into the thickness of the parotid gland;

The ending: at the level of the neck of the lower jaw, it is divided into terminal branches.

Groups of branches of the external carotid artery: anterior group, posterior group, medial group, end group

INTERNAL CAROTID ARTERY

Start: from the common carotid artery at the level of the upper edge of the thyroid cartilage within the carotid triangle

The ending: small wing of the sphenoid bone.

At this level, it divides into brain branches

Parts:

- the cervical part - lies from the place of origin to the external opening of the carotid canal

- stony part - located in the sleepy canal

- the cavernous part - passes through the cavernous sinus of the dura mater of the brain

- the brain part - lies at the level of the visual canal

Branches:

- Ocular artery.

It supplies blood to the eyeball, its auxiliary apparatus, the nasal cavity and soft tissues of the face;

- Anterior cerebral artery. Blood supply to the medial surface of the cerebral hemisphere

- Middle cerebral artery. Blood supply to the upper lateral surface of the cerebral hemisphere

- Posterior communicating artery. Anastomoses with the posterior cerebral artery (a branch of the basilar artery)

SUBCLUSIVE ARTERY

Start: brachiocephalic trunk (right subclavian artery), aortic arch (left subclavian artery);

The ending: at the level of the outer edge of the 1st rib passes into the axillary artery;

Location: passes through the superior aperture of the chest, bends around the dome of the pleura from above,

Passes through the interstellar space in the groove of the subclavian artery of 1 rib;

Parts:

1st section: from the origin to the inner edge of the anterior scalene muscle;

2nd department: located in the space between the stairs;

3rd section: from the exit from the interstellar space to the outer edge of the 1st rib

The aorta (aorta) is the largest arterial vessel in a person. It serves as the beginning of a large circle of blood circulation. In the aorta, three parts are distinguished: ascending (aorta ascendens), arch (arcus aortae) and descending (aorta descendens) (Fig. 385).

The aorta belongs to the elastic type arteries, in which the number of elastic fibers of the middle layer prevails over collagen ones. Elastic fibers in the aortic wall are folded into plates, where the fibers have a circular and longitudinal direction.

Its inner shell is thickened, contains all types of fibers and fibrocytes capable of phagocytosis. With age, in various parts of the aortic wall, there is a significant deposition of calcium salts, the formation of atherosclerotic plaques and partial destruction of the elastic base.

On X-ray, contrast agent is injected intravenously or by puncture of the left ventricle of the heart.

The image reveals an intense shadow of the aorta and its branches.

The ascending aorta has a diameter of 22 mm, originates from the arterial cone of the left ventricle and extends from the mouth of the semilunar valve of the aorta to the point of origin of the brachiocephalic trunk (truncus brachiocephalicus), projecting to the place of attachment of the right II rib to the sternum.

Above the semilunar valve, part of the aorta is expanded over 1.5 cm, has a diameter of up to 30 mm and is called a bulb (bulbus aortae), in which there are three protrusions - sinuses (sinus dexter, sinister et posterior). In the right and left sinuses, the corresponding coronary cardiac arteries begin (Fig. 391). This design of the initial section of the aorta arose because when the aortic valve flaps collapse during the diastole period of the ventricles, additional blood pressure is created, as a result of which blood flow into the coronary vessels of the heart improves.

The ascending aorta is initially located behind the pulmonary trunk and then to the right of it.

The posterior wall of the aorta is in contact with the right pulmonary artery, left atrium and left pulmonary veins; in front and on the right, it is covered by the auricle of the right atrium.

The ascending aorta runs obliquely from left to right up and anteriorly. Its opening is projected to the place of attachment of the left III rib to the sternum. From the body of the sternum, the pericardium, covering the ascending aorta, is separated by the costal-mediastinal sinuses of the pleura, cellulose and the thymus gland.

385. Thoracic aorta (front view). 1 - a. carotis communis sinistra; 2 - arcus aortae; 3 - rr.

bronchiales aortae thoracicae; 4 - bronchus principalis sinister; 5 - aa. intercostales; 6 - esophagus; 7 - aa. coronariae cordis dextra et sinistra.

386. Abdominal aorta. 1 - a. phrenica inferior sinistra; 2 - truncus celiacus; 3 - a. lienalis; 4 - gl. suprarenalis sinistra; 5 - a. mesenterica superior; 6 - a.

renalis sinistra; 7 - a. testicularis sinistra; 8 - a. lumbalis; 9 -a. mesenterica inferior; 10 - a. sacralis media; 11 - a. iliaca communis sinistra; 12 - a. iliaca interna sinistra; 13 - a. iliaca externa sinistra.

Aortic arch.

The aortic arch corresponds to the part located between the beginning of the brachiocephalic trunk (truncus brachiocephalicus) and the left subclavian artery (a. Subclavia sinistra). There is a narrowing of the aorta (isthmus), located at the level of the IV thoracic vertebra. In shape, the aortic arch resembles a part of the spiral, since it is directed from front to back and from right to left, bends around the top of the left bronchus and the site of division of the pulmonary trunk.

At the age of 25-35, the upper edge of the aortic arch is located at the level of the upper edge of the III thoracic vertebra, at 36-50 years - at the level of the upper edge of the IV thoracic vertebra, and in persons over 50 years of age - between the IV and V thoracic vertebrae. At the level of the IV thoracic vertebra behind the aortic arch is the thoracic duct. From the convex part of the aortic arch in the direction of the apertura thoracis superior, the brachiocephalic trunk (truncus brachiocephalicus), the left common carotid artery (a.

carotis communis sinistra) and left subclavian (a. subclavia sinistra).

The descending aorta extends from the level IV of the thoracic vertebra to the IV lumbar vertebra and consists of two parts: the thoracic and abdominal.

The thoracic aorta (aorta thoracica) has a length of about 17 cm, a diameter in the initial part of 22 mm, in the final part - 18 mm.

It is located to the left of the bodies of the V-VIII thoracic vertebrae and in front of the bodies of the IX-XII vertebrae. Through the hiatus aorticus of the diaphragm, the aorta enters the abdominal cavity. The thoracic aorta lies in the posterior mediastinum and is in close topographic relationships with the blood vessels and organs of the chest cavity. To the left of the aorta are the semi-unpaired vein and the left mediastinal pleura, on the right, the unpaired vein, the thoracic duct, covered by the right mediastinal pleura along the X-XII thoracic vertebrae, in front - the left vagus nerve, left bronchus and pericardium.

The relationship of the esophagus with the aorta is different: at the level of the IV-VII thoracic vertebrae, the aorta lies on the left and is half-covered by the esophagus, at the level of the VIII-XII vertebrae - behind the esophagus.

The abdominal aorta (aorta abdominalis) has a length of 13-14 cm, an initial diameter of 17-19 mm and is located to the left of the midline of the body (Fig. 386). The abdominal aorta begins at level XII of the thoracic vertebra and divides into two common iliac arteries at level IV of the lumbar vertebra.

It is covered by the parietal peritoneum, stomach, pancreas and duodenum. At the level of the II lumbar vertebra, the abdominal aorta is crossed by the mesentery root of the transverse colon, the left splenic and renal veins, as well as the mesentery root of the small intestine.

The autonomic nerve plexuses, lymphatic vessels and nodes are located around the abdominal aorta.

Behind the aorta in the area of hiatus aorticus lies the beginning of the thoracic duct (cisterna), the inferior vena cava is adjacent to it on the right. At the level of the IV lumbar vertebra, the abdominal aorta is divided into paired common iliac arteries and unpaired median sacral arteries.

The internal and parietal branches begin from the abdominal aorta.

387. Vascular anomalies. Coarctation (narrowing) of the aorta.

388. Double aortic arch.

389. Aorto-pulmonary communication (according to Scott).

Developmental anomalies. Aortic anomalies occur in 0.3% of cases. One of the abnormalities is narrowing of the aorta (coarctation).

More often it occurs in the descending part of the aortic arch and the degree of narrowing is not the same (Fig. 387).

38. Aorta, parts, branches of the aortic arch.

Coarctation of the aorta causes severe circulatory disorders.

Another anomaly is a change in the direction of the aortic arch and its doubling (Fig. 388). These defects do not interfere with blood flow, but compression of the esophagus, trachea or bronchi and recurrent nerves occurs.

With the aorto-pulmonary window, an opening is formed between the aorta and the pulmonary trunk (Fig.

389). This anomaly is easily eliminated by surgery.

A rare anomaly is narrowing of the aortic opening. With a significant narrowing, blood circulation is disrupted already in the prenatal period and early fetal death occurs. With this anomaly, only children with a slight narrowing remain viable.

The aorta is the largest vessel in the body, both in length and diameter, and in terms of blood flow, therefore the proper blood supply to all organs and systems of the body depends on it. The pathology of this largest artery in the human body negatively affects the work of all organs, the vessels to which branch off below the level of the lesion.

Anatomy of the aorta

Conventionally, this large vessel is divided into three parts, based on its direction:

Ascending department.
The aortic arch, the anatomy of which is considered separately.
Descending part. This section is the longest. It ends when approaching the fourth lumbar vertebra. Here the common ones begin into which the abdominal aorta is divided.

Anatomy and topography

The ascending part of the aorta extends from the left ventricle. Having reached the second rib, it passes into the so-called arc, which, bending to the left, at the level of the fourth vertebra of the thoracic spine, passes into the descending part.

The anatomy of the aorta and the location of its sections and main branches relative to other internal organs at various levels is of great importance in the study of the structure of the chest and abdominal cavities.

Thoracic department

Starting at the level of the fourth thoracic vertebra, the thoracic segment of the aorta is directed almost vertically downward, being located in the region to the right of the aorta in this place and the azygos vein; on the left - the parietal pleura.

Abdominal region

This section begins when the aortic vessel passes through the corresponding opening in the diaphragm and extends to the level of the fourth lumbar vertebra. In the abdominal cavity, the anatomy of the aorta has its own peculiarity: it lies in the retroperitoneal cellular tissue space, on top of the lumbar vertebral bodies, surrounded by the following organs:

to the right of it lies the inferior vena cava;
from the front, the posterior surface of the pancreas, the horizontal segment of the duodenum, and part of the mesentery root of the small intestine are adjacent to the abdominal aorta.

Having reached the level, the abdominal aorta divides into two iliac arteries. They provide blood supply to the lower extremities (this place is called bifurcation, bifurcation of the aorta, and is its end).

In accordance with the location of the parts of this large vessel, the anatomy of the aorta and its branches is examined by division.

Ascending branches

This is the initial section of the vessel. Its duration is short: from the left ventricle of the heart to the cartilage of the second rib on the right.

At the very beginning of the ascending part of the aorta, the right and left areas of the blood supply of which are the heart branch off from it.

Branches of the aortic arch

The anatomy of the arch has the following feature: from its convex part, large arteries originate, carrying blood supply to the skull and upper limbs. The concave part gives off an insignificant size of branches that do not have a permanent location.

The following branches extend from the convex side of the aortic arch (from right to left):

brachiocephalic trunk ("brachiocephalic");
left common carotid artery;
left subclavicular artery.

The concave part of the arc gives off thin arterial vessels that fit the trachea and bronchi. Their number and location may vary.

Descending branches

The descending aorta, in turn, is divided into sections:

Thoracic, located above the diaphragm;
Abdominal, located below the diaphragm.

Chest section:

Parietal arterial vessels for blood supply to the chest walls: the superior diaphragmatic arteries, the branching surfaces of the diaphragm from the side of the chest cavity, and the posterior intercostal arterial vessels supplying blood to the intercostal and rectus abdominal muscles, mammary gland, spinal cord, and soft tissues of the back.
Visceral vessels extending from the thoracic region branch out in the organs of the posterior mediastinum.

Abdominal region:

Parietal branches branching into the walls of the abdominal cavity (four pairs of lumbar arteries that supply blood to the muscles and skin of the lumbar region, abdominal walls, lumbar spine and spinal cord) and the lower surface of the diaphragm.
The visceral arterial branches going to the abdominal organs are paired (to the adrenal glands, kidneys, ovaries and testicles; moreover, the names of the arteries correspond to the names of the organs supplied by them) and unpaired. The names of the visceral arteries correspond to the names of the organs supplied by them.

Vessel wall structure

The concept of "anatomy of the aorta" also includes the structure of the wall of this largest arterial vessel in the body. The structure of its wall has certain differences from the structure of the wall of all other arteries.

The structure of the aortic wall is as follows:

Inner shell (intima). It is a basement membrane lined with endothelium. The endothelium actively reacts to signals received from the blood circulating in the vessel, transforms them and transmits them to the smooth muscle layer of the vascular wall.
Middle shell. At the aorta, this layer consists of circularly located elastic fibers (unlike other arterial vessels in the body, where collagen, smooth muscle, and elastic fibers are represented - without a clear predominance of any of them). The anatomy of the aorta has a peculiarity: the middle sheath of the aortic wall is formed mainly by elastic fibers. The function of the middle shell is to maintain the shape of the vessel, and also provides its motility. The middle layer of the vascular wall is surrounded by interstitial substance (fluid), the main part of which penetrates here from the blood plasma.
Adventitia (outer shell of the vessel). This connective tissue layer contains mainly perivascular fibroblasts. It is permeated with blood capillaries and contains a large number of endings of autonomic nerve fibers. The perivascular connective tissue layer is also a conductor of signals directed to the vessel, as well as impulses emanating from it.

Functionally, all layers of the vascular wall are interconnected and are able to transmit an information impulse to each other - both from the intima to the middle layer and adventitia, and in the opposite direction.

Aorta, aorta , is divided into three sections: the ascending part of the aorta, the arch of the aorta and the descending part of the aorta, which in turn is divided into the thoracic and abdominal parts.

Ascending part of the aorta

pars ascendens aortae, leaves the left ventricle behind the left edge of the sternum at the level of the third intercostal space; in the initial section, it has an extension - the aortic bulb, bulbus aortae. At the location of the aortic valve on the inner side of the aorta, there are three sinuses, sinus aortae. From the beginning of the ascending, part of the aorta, the right and left coronary arteries depart.

Aortic arch

arcus aortae, turns to the left and back from the posterior surface of the II costal cartilage to the left side of the body of the IV thoracic vertebra, where it passes into the descending part of the aorta. In this place there is a slight narrowing - the isthmus of the aorta, isthmus aortae. The edges of the corresponding pleural sacs fit to the anterior semicircle of the aorta on its right and left sides. The left brachiocephalic vein is adjacent to the convex side of the aortic arch, and the right pulmonary artery begins under the aortic arch, below and slightly to the left is the bifurcation of the pulmonary trunk. Behind the aortic arch is the tracheal bifurcation. Three large arteries begin from the convex semicircle of the aortic arch: the brachiocephalic trunk, the left common carotid and the left subclavian arteries.

Descending part of the aorta

pars descendens aortae, divided into right and left common iliac arteries; this place is called the bifurcation of the aorta, bifurcatio aortae. The descending part of the aorta, in turn, is divided into thoracic and abdominal parts.

The thoracic part of the aorta, pars thoracica aortae, located in the chest cavity in the posterior mediastinum. In the thoracic cavity, the thoracic part of the aorta gives off paired parietal branches; posterior intercostal arteries, as well as visceral branches to the organs of the posterior mediastinum.

The abdominal part of the aorta pars abdomindlis aortae, located on the front surface of the bodies of the lumbar vertebrae. The abdominal part of the aorta gives off paired parietal branches to the diaphragm and to the walls of the abdominal cavity. The visceral branches of the abdominal part of the aorta are the celiac trunk, the superior and inferior mesenteric arteries (unpaired branches) and paired - the renal, middle adrenal and testicular (ovarian) arteries.

Branches of the aortic arch

Brachiocephalic trunk,truncus brachiocephalicus, departs from the aortic arch at level II of the right costal cartilage. In front of him is the right brachiocephalic vein, behind - the trachea. The brachiocephalic trunk is divided into two terminal branches - the right common carotid and right subclavian arteries.

External carotid artery a. carotis externa, is one of the two terminal branches of the common carotid artery.

The external carotid artery is divided into its terminal branches - the superficial temporal and maxillary arteries. On its way, the external carotid artery gives off a number of branches that branch off from it in several directions. The anterior group of branches is made up of the superior thyroid, lingual and facial arteries. The posterior group includes the sternocleidomastoid, occipital and posterior ear arteries. The ascending pharyngeal artery is directed medially.

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From the convex side of the aortic arch, the brachiocephalic trunk, the left common carotid and the left subclavian arteries branch out sequentially from right to left (see Fig. 2.1).

Rice. 2.12.

Rice. 2.12. Branches of the initial section and aortic arch

A - arteries extending from the ascending aorta and arch;

B - projections of the branches of the aorta on the surface of the body;

1 - left common carotid artery;
2 - left subclavian;
3 - aortic arch;
4 - the descending aorta;
5 - aortic bulb;
6 - left and
7 - right coronary arteries;
8 - ascending aorta;
9 - brachiocephalic trunk;
10 - right subclavian;
11 - the right common carotid artery;
12 - internal and
13 - external carotid arteries

Brachiocephalic trunk

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Brachiocephalic trunk (truncus brachiocephalicus) has a length of about 3 cm, goes up and to the right and at the level of the right sternoclavicular joint is divided into the right common carotid and right subclavian arteries (see Fig. 2.12.).

Common carotid artery

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Common carotid artery (a. Carotis communis) on the right it departs from the brachiocephalic trunk, on the left - from the aortic arch. The length of the right artery is 6–12 cm, the left one is 2–3 cm longer.

Coming out of the chest cavity, the common carotid artery rises as part of the neurovascular bundle of the neck lateral to the trachea and esophagus along the anterior surface of the transverse processes of the cervical vertebrae; does not give branches. At the level of the upper edge of the thyroid cartilage, it is divided into the internal and external carotid arteries. At the site of the division of the common carotid artery into the external and internal, there is an accumulation of chemoreceptor nerve endings and capillaries - the carotid body. Close to the site of division, the artery passes in front of the transverse process of the VI cervical vertebra, to which it can be pressed to stop bleeding.

External carotid artery

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External carotid artery (a. Carotis externa), rising along the neck under the superficial plate of the cervical fascia, and above it passes through the thickness of the parotid salivary gland.

In the course of the artery, several large branches branch off from it: the upper thyroid and lingual arteries go to the thyroid gland and tongue and give branches to the hyoid bone and associated muscles, muscles of the neck, pharynx, larynx, epiglottis, tongue, floor of the mouth, gums and large facial artery.

Facial artery

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Facial artery (a. Facialis) bends over the edge of the lower jaw in front of the masseter muscle and can be pressed against the bone here in case of bleeding in the face. It supplies blood to the pharynx, soft palate, lingual and palatine tonsils, submandibular and sublingual salivary glands, facial skin and muscles, chin, lips, outer nose, lower eyelid and forms plexuses in the thickness of the cheek. The facial artery anastomoses with the branches of the opposite side of the artery of the same name, forming a perioral arterial circle, as well as with the temporal, maxillary and lingual arteries and the orbital artery - one of the large branches of the internal carotid artery.

Even higher from the external carotid artery branches to the back of the head, supplying the muscles and skin of the neck and occiput, the dura mater, the auricle, the tympanic cavity, branch off.

Medial to the temporomandibular joint external carotid artery is divided into two terminal branches.
One of them - superficial temporal artery(a. temporalis superficiales) - located directly under the skin of the temple, in front of the external auditory opening, where it can be pressed against the bones; it nourishes the parotid salivary gland, facial and temporal muscles, the auricle, the skin of the forehead and scalp.
Another deep branch - maxillary artery(a. maxillaris), nourishes the mandibular joint, the upper and lower jaws and teeth, chewing and facial muscles, the walls of the orbit, the nasal and oral cavities and adjacent organs, the outer and middle ear; gives away middle artery of the meninges (a. meningea media), which enters the skull through the spinous foramen and supplies the temporal, frontal and parietal areas of the dura mater, the trigeminal node, and the auditory tube with blood.

Internal carotid artery

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Internal carotid artery (a.crotis interna) rises from the side of the pharynx to the base of the skull, enters it through the eponymous canal of the temporal bone and, piercing the dura mater, gives off a large branch - the orbital artery, and then at the level of the optic nerve intersection it divides into its terminal branches: the anterior and middle cerebral arteries.

Orbital artery

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Orbital artery (a. Ophthalmic) enters the orbit through the optic canal and splits into terminal branches at the medial corner of the eye. They go to the eyeball, its muscles, upper and lower eyelids, and the lacrimal gland. Several branches enter the eyeball along with the optic nerve.
One of them, central retinal artery, near the retina splits into several branches. Other branches are directed to the choroid and tunica albuginea and the iris. The terminal branches of the orbital artery extend beyond the orbit, supply the skin and muscles of the forehead and nasal dorsum, anastomosing with the terminal branches of the facial artery. In addition, some branches leave the orbit through its medial wall and supply blood to the anterior cranial fossa. (anterior meningeal artery- a. meningea anterior) and the walls of the nasal cavity.

Subclavian artery

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Subclavian artery (a. Subclavia), starting to the right of the brachiocephalic trunk, and to the left of the aortic arch, it bends around the apex of the lung and exits through the upper opening of the chest. On the neck, the subclavian artery appears along with the brachial plexus and lies superficially, which can be used to stop bleeding and administer pharmacological drugs. The artery bends over 1 rib and, passing under the collarbone, enters the axillary pit, where it is already called axillary. Having passed the hole, the artery under the new name - the brachial - goes to the shoulder and in the region of the elbow joint is divided into its terminal branches - the ulnar and radial arteries.

The subclavian artery gives off a number of branches. One of them - vertebral artery(a. vertebralis)- departs at the level of the transverse process of the VII cervical vertebra, rises vertically upward and through the openings of the transverse costal processes of the VI – I cervical vertebrae and through the foramen magnum enters the cranial cavity into the subarachnoid space. On the way, it gives off branches that penetrate through the vertebral foramen to the spinal cord and its membranes.

The remaining branches of the subclavian artery feed their own muscles of the trunk and neck. At the level of the divergence of the vertebral artery from the lower surface of the subclavian artery originates internal thoracic artery(a. thoracica interna). It goes to the sternum and descends along the inner surface of the I-VII costal cartilage. The branches of this artery are directed to the scalene muscles of the neck, muscles of the shoulder girdle, thyroid gland, thymus, sternum, diaphragm, to the intercostal spaces, muscles of the chest, pericardium, anterior mediastinum, to the trachea and bronchi, mammary gland, pharynx, larynx, esophagus, rectus muscle abdomen, liver ligaments, breast skin and navel.

Below from the subclavian artery branches to the back of the neck and back muscles, as well as individual branches to the spinal cord, which in the spinal canal form anastomoses with the branches of the vertebral arteries.

Axillary artery

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Axillary artery (a.axillaris) is a direct continuation of the subclavian artery, lies in the axillary fossa, surrounded by the nerves of the brachial plexus. The vessel is covered only by the fascia, skin and lymph nodes. Its superficial location can be used for clamping to stop bleeding.

Branches supplying the clavicle, scapula, muscles of the shoulder girdle, intercostal and serratus muscles, shoulder and clavicular-acromial joints, as well as axillary lymph nodes and the mammary gland depart from the axillary artery. The axillary artery continues into the brachial artery.

Brachial artery

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Brachial artery (a. Brachialis) begins at the lower edge of the pectoralis major muscle and lies on the shoulder superficially, medial to the biceps muscle. The pulsation of the artery can be felt almost all the way, and it is easy to find it to stop bleeding.

The brachial artery, within its upper third, gives off deep artery of the shoulder, which bends around the humerus and feeds the triceps muscle, and then gives branches to the muscles of the anterior group of the shoulder (coracohumeral, humerus, biceps, deltoid) and to the humerus. In addition, the brachial artery gives off branches descending to the elbow joint - the superior and inferior ulnar circumferential arteries.

Ulnar artery

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Ulnar artery (a. ulnaris) of a larger diameter than the radius, descends along the ulna to the wrist joint. It is located between the superficial and deep layers of the muscles of the forearm. Lateral to the pisiform bone, the artery gives off a branch to the deep palmar arch, and itself passes into the superficial palmar arch, connecting by anastomoses with the branches of the radial artery. The branches of the ulnar artery supply the muscles of the anterior and posterior groups of the forearm, participate in the formation of the dorsal and palmar network of the wrist, nourish the radius and ulna, called ulnar recurrent artery rise to the area of the elbow joint.

Thus, in the area of the elbow joint, a rich network of roundabout (collateral) blood circulation is formed. In the formation of the network, the branches of all three arteries anastomosed with each other - brachial, ulnar and radial - take part.

There are two arterial arches on the palm.

Superficial palmar arch formed mainly by the end of the ulnar artery and a small superficial palmar branch of the radial artery. This branch is very thin and only when the movement of blood through the ulnar artery is disturbed does it participate in the formation of the superficial palmar arch. The arch lies approximately in the middle of the palm, under its superficial aponeurosis. The common palmar arteries of the fingers extend from the convex side of the arc; each of them is divided into two branches, which form numerous anastomoses at the ends of the fingers.

Deep palmar arch thinner than the superficial palmar arch and is formed mainly by the end of the radial artery, and only a small branch enters from the ulnar artery. The deep palmar arch lies on the palmar interosseous muscles and gives up its arteries, which flow into the common palmar arteries of the fingers.

In addition to the arches, the palmar and dorsal carpal networks are formed on the hand. The dorsal metacarpal arteries extend from the latter into the interosseous spaces. Each of them is divided into two thin arteries of the fingers.

So, the hand as a whole and the fingers in particular are abundantly supplied with blood from many sources, which, due to the presence of arcs and nets, anastomose well with each other. This, as well as the location of the finger's own arteries on their protected surfaces facing each other, can be considered an adaptation of the hand to complex manipulations.