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Aorta and Supra-Aortic Trunks 4 Aorta and Supra-aortic Trunks 4 Amelia Sparano, Gennaro Barbato L. Romano, M. Silva, S. Fulciniti, A. Pinto (eds.) MDCT Anatomy – Body 23 © Springer-Verlag Italia 2011 24 A. Sparano, G. Barbato Anonymous trunk Ascending aorta Descending thoracic aorta a Pulmonary trunk Aortic root Left ventricle b Anonymous trunk Left subclavian Aortic arch artery c Fig. 4.1 a The thoracic aorta arises from the left cardiac ventricle through the semilunar valve, at the level of the lower border of the third left costal cartilage. b The ascending aorta passes upwards towards the right until it reaches the level of the lower border of the right second costal cartilage. From above downwards, it is related anteriorly with the right ventricle and posteriorly with the left atrium and right pulmonary artery. c The aortic arch describes a curve that is concave forwards; it passes behind to the left, remaining in front of the trachea on its left side. The supra-aortic trunks arise from the aortic arch 4 Aorta and Supra-aortic Trunks 25 Aorta Aortopulmonary window a Esophagus Descending aorta b Liver dome Descending aorta c Fig. 4.2 a The aortic arch begins at the level of the second costal cartilage and runs behind the tra- chea until it reaches the fourth thoracic vertebra (TIV). b The descending thoracic aorta is contin- uous with the aortic arch. c It runs from the body of TIV to TXII, where it is continuous with the abdominal aorta. The descending aorta gives rise to visceral (bronchial, pericardial, esophageal, and mediastinal) and parietal (intercostal, subcostal, superior phrenic) branches 26 A. Sparano, G. Barbato Right common carotid Left Anonymous common carotid trunk a Right Left common carotid common carotid b Right external carotid Carotid bulb Right common carotid c Fig. 4.3 a The supra-aortic trunks are the principal arteries supplying the head, neck, arms, and part of the thorax. The first branch arising from the right side of the aortic arch is the brachiocephalic (or anonymous) trunk; it ascends obliquely to the right and divides into the right subclavian and right common carotid arteries. b Both common carotid arteries arise from the superior thoracic outlet and run upwards through the neck. c At the level of the upper border of the thyroid cartilage, the com- mon carotid artery divides into the internal and external carotid arteries. The bifurcation of the com- mon carotid artery is somewhat dilated and is called the carotid bulb 4 Aorta and Supra-aortic Trunks 27 Right external carotid Superior thyroid artery a Right internal carotid b Right vertebral artery c Fig. 4.4 a The external carotid artery initially lies more medially and anteriorly to the internal carotid artery, then posteriorly and somewhat laterally, passing through the mastoid process and mandibular an- gle. b The vessel gives off multiple branches to both deep and superficial neck structures. The internal carotid is the principal artery supplying the brain; it enters the skull through the carotid foramen, at the apex of the os petrosum, and runs upwards into the cavernous sinus. c The vertebral arteries arise from the subclavian artery, on the left side, and the brachiocephalic trunk, on the right side. These arteries run upwards and back, laterally through the vertebral foramina, from C6 to C1, and then enter the skull through the occipital foramen. They finally join at the base of the skull to form the basilar artery.
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