ARTERIAL SUPPLY OF ORGANS

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ARTERIAL SUPPLY OF ORGANS

• David Kachlík

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Organs with complicated supply

• 5 supplying vessels stomach
• 4 supplying vessels vagina
• 3 supplying vessels pancreas, duodenum, rectum,
  suprarenal gland
• many small branches oesophagus, trachea, ureter
• lungs and liver (functional and nutritive
  circulation)

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Brain
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Pharynx

• a. carotis externa
• a. maxillaris ? r. pharyngeus, a. canalis
  pterygoidei, a. palatina descendens
• a. pharyngea ascendens
• a. facialis ? a. palatina ascendends. rr.
  tonsillares
• a. lingualis ? rr. dorsales linguae
• a. subclavia
• a. thyroidea inferior

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Tonsillae

• Tonsilla pharyngea
• a. maxillaris ? r. pharyngeus, a. canalis
  pterygoidei, a. palatina descendens
• a. facialis ?a. palatina ascendens
• a. pharyngea ascendens
• Tonsilla palatina
• r. tonsillaris a. facialis / sometimes from a.
  pharyngea ascendens
• additional branches from all surrounding arteries
• a. pharyngea asc. ? r. tonsillaris
• a. lingualis ? rr. dorsales linguae
• a. maxillaris ? a. palatina major
• a. facialis ? a. palatina ascendens

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Oesophagus

• a. thyroidea inferior ? pars cervicalis
• (arcus aortae)
• aorta thoracica ? 4-5 branches? pars thoracica
• a. gastrica sinistra ? pars abdominalis
• a. phrenica inferior sinistra ? pars abdominalis

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Stomach

• truncus coeliacus
• ? aa. gastrica sin.
• ? a. hepatica communis
• ? a. hepatica propria ? a. gastrica dx.
• ? a. gastroduodenalis ? a. gastroomentalis dx.
• ? a. splenica ? a. gastroomentalis sin., aa.
  gastricae breves (fundus), a. gastrica posterior
  (80 )

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Duodeum pancreas

• truncus coeliacus ? a. hepatica communis ? a.
  gastroduodenalis ? a. pancreaticoduodenalis sup.
  post. sup. ant. aa. retroduodenales
• a. mesenterica sup. ? a. pancreaticoduodenalis
  inf. ? ramus ant. r. post.
• Body and tail of pancreas
• truncus coelicacus ? a. splenica ? rr.
  pancreatici
• a. pancreatica magna, posterior et inferior,
• a. caudae pancreatis, a. prepancreratica

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Small intestine

• a. mesenterica superior ?
• aa. jejunales ileales aa. ileocolica
• ? arcades (parallel artery of Dwight)
• ? arteriolae rectae

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Colon

• a. mesenterica sup.
• ? a. ileocolica ? a. ceacalis ant. post., a.
  appendicularis
• ? a. colica dx. (colon ascendens)
• ? a. colica media (colon transversum)
• a. mesenterica inf.
• ? a. colica sin. (colon descendens)
• ? aa. sigmoideae (3-4)
• arteria marginalis Drummondi
• anastomosis magna Halleri arcus Riolani

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Rectum

• a. mesenterica sup. ? a. rectalis sup.
• a. iliaca int. ? a. rectalis media
• (tunica adventitia only)
• a. iliaca int. ? a. pudenda int. ? a. rectalis
  inf.

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Liver and gallbladder

• truncus coeliacus ? a. hepatica communis ? a.
  hepatica propria ? r. dx.sin. ? aa.
  interlobulares
• a. hepatica accessoria/aberrans
• Gallbladder
• truncus coelicacus ? a. hepatica communis ? a.
  hepatica propria ? r. dx. ? a. cystica

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BORDERS

• border of the liver
• ductus cysticus
• ductus hepaticus communis
• CONTENT
• a. cystica
• ligation

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Kidneys

• arteria renalis
• paired visceral branch of the abdominal aorta, at
  the level of the intervertebral disc L1/L2
• the left artery is slightly higher
• arteria renalis accessoria (30)
• branch of the abdominal aorta / a. iliaca
  communis / a. iliaca interna
• flow rate 1,2-1,3 l blood/min
• the arteries are terminal no arterio-arterial
  anastomosis
• ? segments (r. ant post)

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Suprarenal glandfrom aorta abdominalis

• a. phrenica inferior ? a. suprarenalis superior
• a. suprarenalis media branch of the abdominal
  aorta
• a. renalis ? a. suprarenalis inferior
• vena suprarenalis only one vein
• on the left into v. renalis sinistra
• on the right directly into do v. cava inferior

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Ureter

• a. renalis
• aorta abdominalis
• a. testicularis ? / ovarica ?
• a. ductus deferentis ? / uterina ?
• a. vesicalis inferior
• ? rr. ureterici

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Urinary bladder

• a. iliaca interna
• a. umbilicalis ? aa. vesicales superiores
• a. vesicalis inferior
• (a. obturatoria, a. glutea inf., a. uterina, a.
  vaginalis) ? rr. vesicales

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Ovaries and uterine tubes

• aorta abdominalis ? a. ovarica / r. tubarius
• a. iliaca int. ? r. ovaricus / r. tubarius
• both rami ovarici anastomose to form the ovarian
  arcade

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Uterus

• a. iliaca interna ? a. uterina
• ventral to the ureter
• water under the bridge
• approaching the cervix laterally, then courses
  superiorly on the lateral aspect of the uterus
• sinusoid course
• bleeding in rupture

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Vagina

• a. iliaca interna
• ? a. vaginalis (sometimes missing)
• ? a. uterina ? r. vaginalis
• ? a. rectalis media ? r. vaginalis
• ? a. pudenda interna ? r. vaginalis

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Testes epididymis

• aorta abdominalis
• a. testicularis
• the branches enter the lobules in the periphery,
  not from the center !
• a. iliaca interna
• a. umbilicalis
• ? a. ductus deferentis
• a. iliaca externa
• a. epigastrica inferior
• ? a . cremasterica
• mutual anastomoses

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Prostate vesiculous glands

• a. iliaca interna
• a. ductus deferentis
• a. vesicalis inferior
• a. rectalis media

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Penis / clitoris

• a. pudenda interna
• ? a. dorsalis penis / clitoridis
• a. profunda penis / clitoridis
• a. urethralis
• a. bulbi penis / vestibuli
• 3 last ? aa. helicinae ( Ebners cushions) ? vv.
  cavernosae

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Nasal cavity

• arteria carotis interna
• a. ophthalmica ? a. ethmoidalis ant. post.
• arteria carotis externa
• a. maxillaris ? a. sphenopalatina ? rr. nasales
  posteriores lat. rr. septales posteriores
• a. maxillaris ? a. palatina descendens ? a.
  palatina major ? vetev pres canalis incisivus
• a. facialis ? a. labialis superior (vestibulum)

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Thyroid gland and larynx

• a. carotis ext. ? a. thyroidea sup. ? a. laryngea
  sup.
• a. subclavia ? a. thyroidea inf. (crossing n.
  laryngeus recurrens) ? a. laryngea inf.
• r. cricothyroideus of both sides anastomose under
  the cricoid cartilage (! tracheotomia superior !)
• a. thyroidea ima (2 ) - !! tracheotomia superior
  !!
• from arcus aortae (70 )
• truncus brachiocephalicus, a. carotis communis,
  a. thoracica interna, a. subclavia dextra, a.
  thyroidea inferior, truncus thyrocervicalis

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Trachea

• a. thyroidea inferior ? rr. tracheales
• aorta thoracica ? rr. bronchiales
• (a. thyroidea ima 2 )
• neonates and children branches from thymic
  arteries

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Bronchi and lungs nutritive circulation

• aorta thoracica
• rami bronchiales
• 1 on the right most often from a. intercostalis
  tertia
• 2 on the left from the aorta thoracica
• ? along the bronchi up to the respiratory
  bronchi
• (rami bronchiales accessorii in lig. pulmonale)

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Lungs functional circulation

• right atrium ? truncus pulmonalis ? arteriae
  pulmonales dx. sin. ? the branching corresponds
  to the bronchi
• hypoarterial bronchus on the left, eparterial
  bronchus on the right
• elastic (low-pressure circulation, muscle only in
  fetus, in adults only in calibers lt 1mm),
  deoxygenated blood !!!

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Lungs functional circulation

• capillaries ? veins independent on the arteries
  in the septi between alveoles ? 4 venae
  pulmonales (2 dx., 2 sin.) ? left atrium
  (oxygenated blood!!!)
• arteriovenous ( a-a, v-v) anastomoses
• in hypoxic states in the adult, the muscular
  layer of the pulmonary arteries proliferates ?
  pulmonary hypertension ? right ventricular
  hypertrophy

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Heart

• arteria coronaria dextra (ACD)
• sinus aortae (Valsalvae) dexter ?
• r. coni arteriosi ? Vieussens circle
• r. nodi sinuatrialis (65)
• rr. atriales
• r. marginalis dexter (RMD)
• r. interventricularis posterior (RIP)
• r. nodi atrioventricularis (80)
• r. posterolateralis dexter (RPLD)

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Heart

• arteria coronaria sinistra (ACS)
• sinus aortae (Valsalvae) sinister ? short?
• r. interventricularis ant. (RIA)
• r. coni arteriosi ? Vieussens ring
• r. diagonalis (RD)
• r. circumflexus (RC)
• rr. atriales
• r. marginalis sinister (RMS)
• r. intermedius (RIM) 25, from ACS bifurcation

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Heart coronary arteries
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Spleen

• truncus coeliacus ? a. splenica
• ? rr. splenici ? aa. trabeculares ? aa. vaginatae
  (within PALS) ? aa. centrales (within noduli
  lymphoidei) ? aa. penicillares (Schweigger-Seidel
  s sheath) ? sinus splenis (within red pulp)

Thymus

• branches from a. thyroidea inferior, arcus
  aortae, thoracica interna
• (? a. pericardiacophranica)

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Diaphragm

• arcus aortae ? a. subclavia ? a. thoracica
  interna
• a. pericardiacophrenica
• a. musculophrenica, (a. epigastrica superior)
• aorta thoracica
• aa. intecostales posteriores IX.-XI.
• aa. phrenicae superiores (rudimentary)
• aorta abdominalis
• aa. phrenicae inferiores
• aa. lumbales (3 on the left, 2 on the right)

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Intercostal spaces

• arcus aortae ? a. subclavia ? a. thoracica
  interna
• aa. intercostales anteriores (I.-VI.)
• a. musculophrenica
• aa. intercostales anteriores (VII.-IX.)
• arcus aortae ? a. subclavia ? truncus
  costocervicalis ? a. intercosalis suprema
• aa. intercostales posteriores (I.,II.)
• (arcus aortae ? a. subclavia ? a. axillaris ? a.
  thoracica superior ? I. a II. intercostal spaces)
• aorta thoracica
• aa. intercostales posteriores (III.-IX.)

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Mammary gland

• arcus aortae ? a. subclavia ? a. thoracica
  interna
• aa. intercostales anteriores (I.-V./VI.) ? rr.
  perforantes
• arcus aortae ? a. subclavia ? a. axillaris
• ? a. thoracica superior
• ? (r. pectoralis a. thoracoacromialis, a.
  thoracica lat., a. subscapularis)
• aorta thoracica
• aa. intercostales posteriores (II.-V.) ? rr.
  perforantes /II. strongest/

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Pituitary glandbranches from arteria carotis
interna

• a. hypophysialis superior
• (pars cerebralis a. carotis internae)
• primary capillary network in the infundibulum
• secondary portal network in the anterior lobe
• hypothalamo-hypophyseal portal system
• a. hypophysialis inferior
• (pars cavernosa a. carotis internae)
• capillary network in the posterior lobe

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Pituitary gland
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Spinal cord

• longitudinal vessels
• a. spinalis anterior
• unpaired, ventrally
• originate from short paired branches from a.
  vertebralis
• anterior 2/3 of spinal cord
• aa. sulcocommissurales ? gray matter
• aa. spinales posteriores
• paired, dorsally (sometimes doubled)
• branch from a. basilaris ? a. inf. post.
  cerebelli
• transverse vessels (segmental)
• rr. spinales ? a. radicularis anterior et
  posterior ? join the longitudinal arteries ?
  vasocoronae (encircling the medulla spinalis)
• aa. periphericae ? white matter

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Origins of rr. spinales

• a. vertebralis
• a. cervicalis ascendens
• a. cervicalis profunda
• aa. intercostales posteriores
• aa. lumbales
• a. iliolumbalis
• aa. sacrales laterales
• aa. radiculares
• irregular
• 5-9
• a. radicularis magna Adamkiewiczi

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? Tympanic cavity ?

• arteria carotis externa
• a. maxillaris /pars mandibularis/? fissura
  petrotympanica Glaseri ? a. tympanica anterior
• a. maxillaris /pars mandibularis/ ? a. meningea
  media ? foramen spinosum ? canalis nervi petrosi
  minoris ? a. tympanica superior
• a. pharyngea ascendens ? canaliculus tympanicus
  Jacobsoni ? a. tympanica inferior
• a. auricularis posterior ? a. stylomastoidea ?
  canalis nervi facialis Falloppii ? canaliculus
  chordae tympani (posterior) ? a. tympanica
  posterior
• arteria carotis interna (pars petrosa) ?
  canaliculi caroticotympanici ? rr.
  caroticotympanici

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