Abdominal aorta - Gross anatomy ( Orign , Course , Branches ) : usmle videos

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Abdominal aorta
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The abdominal aorta is the main blood vessel in the abdominal cavity that transmits oxygenated blood from the thoracic cavity to the organs within the abdomen and to the lower limbs.

Summary
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Origin : anterior to the lower border of vertebra T12

course : descends through the abdomen, anterior to the vertebral bodies, and ends at the level of vertebra L4 it is slightly to the left of midline.

The terminal branches of the abdominal aorta are the two common iliac arteries.

This bifurcation can be visualized on the anterior abdominal wall as a point approximately 2.5 cm below the umbilicus or even with a line extending between the highest points of the iliac crest.

As the abdominal aorta passes through the posterior abdominal region, the prevertebral plexus of nerves and ganglia covers its anterior surface.

branches (unpaired)
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coeliac artery (anterior to the upper part of vertebra LI)
• It immediately divides into the left gastric, splenic, and common hepatic arteries.
superior mesenteric artery (arises from anterior to the lower part of vertebra L1)
inferior mesenteric artery (anterior to the body of vertebra L3)
median sacral artery

branches (paired)
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middle adrenal arteries
renal arteries (L1-L2)
gonadal arteries (between L2 and L3)
inferior phrenic arteries
lumbar arteries

Visceral branches
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The visceral branches are either unpaired or paired vessels.
The three unpaired visceral branches that arise from the anterior surface of the abdominal aorta are
• Celiac trunk, which supplies the abdominal foregut .
 The foregut begins with the abdominal esophagus and ends just inferior to the major duodenal papilla,midway along the descending part of the duodenum.It includes the abdominal esophagus , stomach, duodenum (superior to the maj or papilla) , liver, pancreas,and gallbladder. The spleen also develops in relationto the foregut region.
 The foregut is supplied by the celiac trunk.
• Superior mesenteric artery, which supplies the abdominal midgut .
 The midgut begins just inferior to the maj or duodenal papilla, in the descending part of the duodenum, and ends at the junction between the proximal two-thirds and distal one-third of the transverse colon. It includes the duodenum (inferior to the maj or duodenal papilla),jejunum, ileum, cecum, appendix, ascending colon, and right two-thirds of the transverse colon.
 The midgut is supplied by the superior mesenteric artery
• Inferior mesenteric artery, which supplies the abdominal hindgut.
The paired visceral branches of the abdominal aorta include :
Middle suprarenal arteries - small, lateral branches of the abdominal aorta arising just above the renal arteries that are part of the multiple vascular supply to the suprarenal gland .
Renal arteries - lateral branches of the abdominal aorta that arise just inferior to the origin of the superior mesenteric artery between vertebrae LI and L2, and supply the kidneys .
Testicular or ovarian arteries - anterior branches of the abdominal aorta that arise below the origin of the renal arteries , and pass downward and laterally on the anterior surface of the psoas major muscle.

Posterior branches
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The posterior branches of the abdominal aorta are vessels supplying the diaphragm or body wall. They consist of the inferior phrenic arteries , the lumbar arteries , and the median sacral artery.
Inferior phrenic arteries

The inferior phrenic arteries arise immediately inferior to the aortic hiatus of the diaphragm either directly from the abdominal aorta, as a common trunk from the abdominal aorta, or from the base of the celiac trunk.

Whatever their origin, they pass upward, provide some arterial supply to the suprarenal gland, and continue onto the inferior surface of the diaphragm.

Lumbar arteries
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There are usually four pairs of lumbar arteries arising from the posterior surface of the abdominal aorta to supply posterior abdominal wall and also by providing segmental branches that supply the spinal cord.

Median sacral artery
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The final posterior branch is the median sacral artery .
This vessel arises from the posterior surface of the abdominal aorta just superior to the bifurcation and passes in an inferior direction, first over the anterior surface of the lower lumbar vertebrae and then over the anterior surface of the sacrum and coccyx.

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