Posterior Abdominal Blood Vessels and LymphaticsAorta
- Passes through the aortic hiatus in the diaphragm at the level of T12, descends anterior to the vertebral bodies, and bifurcates into the right and left common iliac arteries anterior to L4.
- Gives rise to the following:
- Inferior phrenic arteries
- Arise from the aorta immediately below the aortic hiatus, supply the diaphragm, and give rise to the suprarenal arteries.
- Diverge across the crus of the diaphragm, with the left artery passing posterior to the esophagus and right artery passing posterior to the IVC.
- Middle suprarenal arteries
- Arise from the aorta and run laterally on the crus of the diaphragm just superior to the renal arteries.
- Renal arteries
- Arise from the aorta inferior to the origin of the superior mesenteric artery. The right artery is longer and a little lower than the left and passes posterior to the IVC; the left artery passes posterior to the left renal vein
- Give rise to the inferior suprarenal and ureteric arteries.
- Divide into the superior, anterosuperior, anteroinferior, inferior, and posterior segmental branches.
- Testicular or ovarian arteries
- Descend retroperitoneally and run laterally on the psoas major muscle and across the ureter.
- The testicular artery accompanies the ductus deferens into the scrotum, where it supplies the spermatic cord, epididymis, and testis.
- The ovarian artery enters the suspensory ligament of the ovary, supplies the ovary, and anastomosis with the ovarian branch of the uterine artery.
- Lumbar arteries
- Consist of four or five pairs that arise from the back of the aorta.
- Run posterior to the sympathetic trunk, the IVC (on the right side), the psoas major muscle and the quadratus lumborum.
- Divide into smaller anterior branches (to supply adjacent muscles) and larger posterior branches, which accompany the dorsal primary rami of the corresponding spinal nerves and divide into spinal and muscular branches.
Inferior vena cava
- Middle sacral artery
- Arises from the back of the aorta, just above its bifurcation; descends on the front of the sacrum; and end at the coccygeal body.
- Supplies the rectum and anal canal, and anastomoses with the lateral sacral and superior and inferior rectal arteries.
- Is formed on the right side of L5 by the union of the two common iliac veins , below the bifurcation of the aorta.
- Is longer than the abdominal aorta and ascends along the right side of the aorta.
- Passes through the opening for the IVC in the central tendon of the diaphragm at the level of T8 and enters the right atrium of the heart.
- Receives the right gonadal, suprarenal, and inferior phrenic veins.
- Also receives the three (left, middle, and right) hepatic veins.
- Receives the right and left renal veins. The left renal vein runs posterior to the superior mesenteric artery anterior to the abdominal aorta.
- Is the lower dilated end of the thoracic duct and lies just to the right and posterior to the aorta, usually between two crura of the diaphragm.
- Is formed by the intestinal and lumbar lymph trunks.
Lymph nodes related to the aortaPreaortic nodes
Para-aortic, lumbar, or lateral aortic lymph nodes
- Include the celiac, superior mesenteric, and inferior mesenteric nodes; drain the lymph from the GI tract, spleen, pancreas, gallbladder, and liver; and their efferent vessels form the intestinal trunk.
- Drain lymph from the kidneys, suprarenal glands, testes or ovaries, uterus, and uterine tubes; receive lymph from the common, internal, or external iliac; and their efferent vessels form the right and left lumbar trunk
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