Blood Flow Pathways

Anterior cerebral artery

Origin:

• Internal carotid

Course:

• Passes anteriorly along medial aspect of frontal lobe of cerebral cortex

Distribution:

• Medial aspect of frontal lobe of cerebral cortex

Anterior cerebral artery and branches

Origin:

• Internal carotid

Course:

• Passes anteriorly along medial aspect of frontal lobe of cerebral cortex

Comment:

• Medial aspect of frontal lobe of cerebral cortex

Basilar artery

Origin:

• Junction of paired vertebral arteries

Course:

• Unpaired (midline) vessel ascends on anterior (ventral) surface of pons

Distribution:

• Pons

• Cerebellum

Cerebral arterial circle

Origin:

• Internal carotid and basilar arteries

Course:

• Circular anastomosis on ventral surface of brain

Internal carotid artery

Origin:

• Common carotid

Course:

• Ascends in neck to base of cranium

• Enters cranial cavity via carotid canal

Distribution:

• Eye

• Cerebrum

• Cerebral arterial circle (of Willis)

Posterior cerebral artery and branches

Origin:

• Basilar

Course:

• Paired vessels pass laterally around cerebral peduncles

Distribution:

• Temporal and occipital lobes of cerebral cortex

Vertebral artery

Origin:

• Subclavian

Course:

• Paired vessel ascends through neck, via transverse foramina in cervical vertebrae

• Enters cranial cavity via foramen magnum

Distribution:

• Brain

• Spinal cord

• Vertebral column

Carotid Pulse

Location:

• Neck (lateral)

• Between thyroid cartilage and sternocleidomastoid muscle

Description:

• Surface projection of pulse in common carotid artery

Common carotid artery

Origin:

• Right: brachiocephalic trunk from arch of aorta

• Left: arch of aorta

Course:

• Exits thorax and ascends in neck

Distribution:

• Structures of head and neck

External carotid artery

Origin:

• Common carotid (at bifurcation)

Course:

• Ascends in neck

Distribution:

• Exterior of head (except orbit)

• Face

• Meninges

• Neck structures

External jugular vein

Drainage:

• Scalp

• Face

Course:

• Subcutaneous vessel formed by union of retromandibular and posterior auricular veins near angle of mandible

• Descends toward middle of clavicle

• Crosses anterior surface of sternocleidomastoid muscle

Internal carotid artery

Origin:

• Common carotid

Course:

• Ascends in neck to base of cranium

• Enters cranial cavity via carotid canal

Internal jugular vein

Drainage:

• Cranial cavity, including brain

• Face

• Neck

Tributaries:

• Sigmoid sinus

• Inferior petrosal sinus

• Facial

• Lingual

• Pharyngeal

• Superior and middle thyroid

Axillary artery

Origin:

• Subclavian (at lateral border of rib 1)

Course:

• Passes through axilla surrounded by cords and branches of brachial plexus

• Divided into 3 parts by pectoralis minor m. First part is proximal to pectoralis minor m., second part is posterior to muscle, and third part is distal to muscle

Axillary vein

Drainage:

• Pectoral, shoulder, and scapular regions

Brachial artery

Origin:

• Axillary (at inferior border of teres major m.)

Course:

• Passes inferiorly along medial aspect of arm

External Jugular vein (2nd view)

Drainage:

• Scalp

• Face

Course:

• Subcutaneous vessel formed by union of retromandibular and posterior auricular veins near angle of mandible

• Descends toward middle of clavicle

• Crosses anterior surface of sternocleidomastoid muscle

Internal jugular vein (2nd view)

Drainage:

• Cranial cavity, including brain

• Face

• Neck

Tributaries:

• Sigmoid sinus

• Inferior petrosal sinus

• Facial

• Lingual

• Pharyngeal

• Superior and middle thyroid

Left subclavian artery

Origin:

• Arch of aorta

Course:

• Arches over rib 1

Left subclavian vein

Drainage:

• Upper limb

• Superficial back and neck

Brachial pulse

Location:

• Medial arm

Description:

• Surface projection of pulse in brachial artery

Brachial vein

Drainage:

• Arm muscles

• Humerus

• Elbow joint

Brachial pulse

Location:

• Medial arm

Description:

• Surface projection of pulse in brachial artery

Ulnar pulse

Location:

• Anterior medial wrist

• Deep to tendon of flexor carpi ulnaris muscle

Description:

• Surface projection of pulse in ulnar artery

Ulnar vein

Drainage:

• Medial forearm muscles

• Hand muscles and joints

• Elbow and wrist joints

Brachiocephalic trunk

Origin:

• Arch of aorta

Course:

• Ascends posterior to right margin of manubrium (sternum)

• Ends posterior to right sternoclavicular joint

Left braciocephalic vein

Drainage:

• Head and neck (left side)

• Upper limb (left)

Left common carotid artery

Origin:

• Arch of aorta

Course:

• Exits thorax and ascends in neck

Pulmonary artery

Origin:

• Pulmonary trunk

Course:

• Left: laterally, inferior to arch of aorta and anterior to left main bronchus

• Right: laterally, posterior to ascending aorta and superior vena cava

• Through root and hilum of respective lungs

Right brachiocephalic vein

Drainage:

• Head and neck (right side)

• Upper limb (right)

Right common carotid artery

Origin:

• Brachiocephalic trunk from arch of aorta

Course:

• Exits thorax and ascends in neck

Right subclavian artery

Origin:

• Brachiocephalic trunk from arch of aorta

Course:

• Arches over rib 1

subclavian vein

Drainage:

• Upper limb

• Superficial back and neck

Abdominal Aorta

Origin:

• Thoracic aorta

Course:

• Parallels vertebral column, slightly left of midline

• Divides into common iliac arteries on body of L4 vertebra

Distribution:

• Abdominal and pelvic viscera

• Walls of abdomen and pelvis

• Ovaries and testis

Common illiac artery

Origin:

• Abdominal aorta

Course:

• Begins anterior to L4 vertebral body

• Passes obliquely across L4-5 vertebral bodies

• Ends at the level of the sacro-iliac joint (L5-S1)

Inferior vena cava

Drainage:

• Everything inferior to diaphragm, except posterior abdominal wall, which drains into azygos system

Left renal artery

Origin:

• Abdominal aorta

Course:

• Passes laterally to enter kidney

Left renal vein

Drainage:

• Kidney

• Ureter (upper)

• Suprarenal gland

• Left testis/ovary

Right renal artery

Origin:

• Abdominal aorta

Course:

• Passes laterally to enter kidney

Right renal vein

Drainage:

• Kidney

• Ureter (upper part)

Kidney

Location:

• Abdomen (posterior wall)

• Retroperitoneal

• Left kidney higher than right

Description:

• Paired, bean-shaped organ

• Concave, medial border is point of entrance/exit of renal vessels and ureter

• Contains cortex, medulla, and renal sinus

External iliac artery

Origin:

• Common iliac

Course:

• Descends laterally along medial border of psoas muscle from level of sacro-iliac joint to inguinal ligament

Femoral artery

Origin:

• External iliac

Course:

• Descends in anterior and medial thigh

• Extends from inguinal ligament to adductor hiatus

Femoral artery pulse

Location:

• Proximal anterior thigh

• Midway between anterior superior iliac spine and pubic symphysis

• Superficial location in femoral triangle

Description:

• Surface projection of pulse in femoral artery

Internal iliac artery

Origin:

• Common iliac

Course:

• Begins at the level of the sacro-iliac joint (L5-S1)

• Descends into pelvis and passes posteriorly toward superior margin of greater sciatic notch (ilium)

Common iliac vein

Drainage:

• Pelvis

• Perineum

• Lower limb

External iliac vein

Drainage:

• Lower limb

• Anterior abdominal wall (inferior)

Tributaries:

• Femoral

• Inferior epigastric

• Deep circumflex iliac

Femoral vein

Drainage:

• Abdominal wall (anterior inferior)

• External genitalia

• Thigh muscles

• Femur

• Hip and knee joints

Great saphenous vein

Drainage:

• Dorsum of foot

• Subcutaneous medial leg and thigh

Infreior vena cava

Drainage:

• Everything inferior to diaphragm, except posterior abdominal wall, which drains into azygos system

Internal iliac vein

Drainage:

• Pelvis

• Perineum

• Gluteal region

• Posterior abdominal wall

Adductor magnus m

Action:

• Adduction of thigh

• Extension of thigh

Origin:

• Pubis (inferior ramus)

• Ischium (ramus and tuberosity)

Piriformis m

Action:

• Lateral rotation of thigh

Origin:

• Sacrum (anterior surface)