Anatomy - Aortobifemoral bypass for peripheral arterial disease Fontaine stage IIb–III - vascular surgery
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Abdominal aorta
Origin
- From the thoracic aorta after its passage through the aortic hiatus in the diaphragm at the level of T12
Course
- Retroperitoneal
- Left to the median plane and anterior to the spine
- Bifurcation into the common iliac arteries (bifurcatio aortae) at the level of the umbilicus / L4
Branches from superior to inferior
- Inferior phrenic artery, left and right
- Celiac trunk
- Middle suprarenal artery, left and right
- Superior mesenteric artery
- Renal artery, left and right
- Ovarian / testicular artery, left and right
- Lumbar arteries
- Inferior mesenteric artery
- Median sacral artery
Distribution
- Paired branches: Abdominal wall, paired retroperitoneal organs, gonads
- Unpaired branches: Spleen, unpaired intestinal organs
Paired branches of the abdominal aorta
Main branches
Course
Branches/rami and distribution
Inferior phrenic artery
- Travels craniad along the underside of the diaphragm towards the diaphragmatic dome
- Network-like division into several terminal branches
Superior suprarenal artery: Suprarenal gland
Terminal branches: Underside of the diaphragm
Middle suprarenal artery
- Travels laterad to the suprarenal glands
Terminal branches: Suprarenal glands
Renal artery
- Arises at the level of L1–2
- Right renal artery: Travels posterior to the vena cava and pancreatic head to the right kidney
- Left renal artery: Travels posterior to the body of the pancreas to the left kidney
Inferior suprarenal artery: Suprarenal gland
Ovarian artery
Testicular artery
- Arises from the anterior wall of the aorta inferior to the renal arteries / L2
- Travels across the psoas muscle, ureter, and external iliac artery to the suspensory ligament of ovary / deep inguinal ring and testis
Ovarian arteries: Ovaries, parts of the uterine tubes
Testicular arteries: Testes, epididymides
Lumbar arteries (4 bilat.)
- Travels lateroposteriad to the psoas muscle across L1–4
- Anastomose with the arteries of the anterior abdominal wall (superior and inferior epigastric arteries; liliolumbar artery; deep circumflex iliac artery)
Spinal rami: Spinal canal
Terminal branches: Abdominal wall, back muscles
Unpaired branches of the abdominal aorta
Arterial blood supply of the lesser pelvis
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