Blood supply of the PAW

at what level is the aortic hiatus

T12

at what level is the caval hiatus

T8

at what level is the oesophageal hiatus

T10

at what level does the A.A end

L4

what does the AA bifurcate into

the right and left common iliac arteries

Anterior to the AA:

• Coeliac plexus

• Body of the pancreas and splenic vein

• Left renal vein

• Third part of duodenum

Posterior to the AA:

• Bodies of L1 to L4 and discs

• Anterior longitudinal ligament

To the right of the AA:

• IVC

• Cisterna chyli  (a dilated sac at the lower end of the thoracic duct into which lymph drains)

• Start of the thoracic duct

• Right crus

To the left of AA:

• Left crus

• Left sympathetic trunk

• Inferior mesenteric vein

What are the unpaired visceral branches of the aorta

• Coeliac

• Superior mesenteric

• Inferior mesenteric

What are the paired visceral branches of the aorta

• Middle suprarenal

• Renal

• Gonadal

what are the paried parietal branches of the aorta

• Inferior phrenic

• Lumbar

what are the paried parietal branches of the aorta

median sacral

what supplies to foregut

celiac trunk

what supplies the midgut

superior mesenteric trunk

what supplies the hindgut

inferior mesenteric

1

right common carotid artery

2

right subclavian a

3

Brachiocephalic a

4

Ascending Aorta

5

inferior phrenic a

6

right renal a

7

right ovarian/testicular a

8

right common iliac a

9

right internal iliac a

10

right external iliac a.

11

Medial sacral a.

12

left external iliac a

13

left internal iliac a

14

left common iliac a

15

lumbar a.

16

left ovarian/testicular a.

17

inferior mesenteric a.

18

left renal a.

19

superior mesenteric a.

20

celiac trunk

21

thoracic aorta

22

aortic arch

23

left subclavian a

24

left common carotid artery

Inferior Vena cava tributaries

right testicular/ovarian vein

right suprarenal vein

inferior phrenic vein

hepatic vein

what is different between the venous drainage and arterial supply

arterial supply is symmetrical while right sided structures of venous drainage drain directly into IVC and left sided drain via renal vein

clinical relevance of venous drainage of the PAW (gonadal vein)

darins into left renal vein at a right angle and higher up so it supports a taller column of blood leading to more common varicocele

clinical relevance of venous drainage of the PAW (left renal vein)

crosses the midline in the gap between the aorta behind and the superior mesenteric artery in front leading to possible flank pain and haematuria

clinical relevance of venous drainage of the PAW (left common iliac vein)

crosses the midline beneath the right common iliac artery which pins it against the body of L5 leading to May-Thurner:left leg DVT