GREAT VESELS OF THE

ABDOMEN
 Abdominal Aorta
The thoracic aorta passes through the aortic hiatus to
become the abdominal aorta and extends between the
T12 – L4 vertebra levels

Abdominal aorta terminates at the aortic bifurcation

by giving its two terminal branches, right and left
common iliac arteries

Branches of the aorta are classified as unpaired and

paired branches
 Abdominal aorta

 Can be compressed against vertebral column

in children and thin adults at L4 level.
 Unpaired branches
• Celiac trunk
– Left gastric artery
• Esophageal branches
– Splenic (lienal artery)
• Short gastric aa
• Posterior gastric
• Pancreatic branches
• Left gastroepiploic artery
– Common hepatic artery
• Gastroduodenal artery
– Superior
pancreaticoduodenal artery
– Right gastroepiploic artery
• Proper hepatic artery
– Right gastric artery
– Right and left hepatic aa
• Middle sacral artery
• Superior mesenteric artery
– Inferior pancreaticoduodenal
artery
– Jejunal branches
– Ileal branches
– Ileocolic artery
• Anterior and posterior caecal aa
• Appendicular artery
– Right colic artery
– Middle colic artery
• Inferior mesenteric artery
– Left colic artery
– Sigmoid aa
– Superior rectal artery
(abdominal)Aortic aneurysm

• This angiogram picture shows a typical

aortic aneurysm. As the aneurysm gets
larger, the risk of rupture increases greatly.
 Clinical note

 Asaorta lies posterior to the pancreas and
stomach, tumors of these organs may
transmit the pulsations of the aorta, mimicking
an aneurysm
 INFERIOR VENA CAVA

•The two common iliac veins join at

L5 to form IVC.
•IVC pierces(passes through) the
diaphragm at T8 level
•Receives all the systemic veins
from the abdomen except left
gonadal and left supra renal veins
 Tributaries
 The two common iliac veins
 Right gonadal vein
 Both renal veins
 Right suprarenal vein
 Inferior phrenic veins
 Hepatic veins
•In some instances the vena cava crosses anterior
to (instead of posterior to) the ureter.It is called
•pre-ureteric vena cava and may cause
• ureteric obstruction
Extensive anastomoses among the caval, azygos,
and vertebral systems provide multiple routes
for the return of blood to the heart.
In effect, the azygos and vertebral systems
bypass
the caval system.
 POSTERIOR ABDOMINAL
WALL
Bears the following structures
 Five lumbar vertebrae and intervertebral discs between
them
 Posterior abdominal wall muscles; psoas, quadratus
lumborum, iliacus, transverse and oblique abdominal
muscles
 Part of diaphragm
 Fascia, including the thoracolumbar fascia
 Lumbar plexus and its branches
 Fat, lumbar sympathetic trunks, vessels (i.e. aorta, IVC)
Posterior abdominal wall
 The psoas sheath, attached to the lumbar
transverse processes and bodies, allows
the spread of infection (e.g., a tuberculous
abscess from a vertebral body) into the
thigh (psoas abscess).
 Lumbar plexus
 L1
 L2
 L3
 L4
 L5
 L1 gives rise to the iliohypogastric and
ilioinguinal nerves.
 L1 + L2 gives rise to the genitofemoral nerve
 L2 + L3 gives rise to the lateral femoral
cutaneous
 L2 + L3 + L4 give rise to the femoral and
obturator nerves
 L4 + L5 give rise to the lumbosacral trunk which
joins sacral nerves to form the sacral plexus.
 DIAPHRAGM
(dia = in between, phragma = partition)

 Formed of skeletal muscles

 Muscle fibers converge at the center to form
the central tendon
 Lies between the thoracic and abdominal
cavities
 The chief muscle of inspiration
DIAPHRAGM (continued)

Parts of the diaphragm

 Central tendon (has no bony attachments)
 Right and left domes
 Strenal part (attaches to the xiphoid process)
 Costal part (attaches to the inferior six ribs)
 Lumbar part (forms the and right and left crura,
lateral attachments are through the medial and
lateral arcuate ligaments)
DIAPHRAGM (continued)

Arteries
- Pericardiophrenic and musculophrenic arteries (from
the internal thoracic artery)
- Superior phrenic arteries (branches of the thoracic
aorta)
- Inferior phrenic arteries (first branches of the
abdominal aorta)

Veins
- Follow the arteries of same name
DIAPHRAGM (continued)

Lymphatics
- Drain into the parasternal, posterior mediastinal and
phrenic lymph nodes

Nerves
- Phrenic nerves (from the cervical plexus)
DIAPHRAGM (continued)

Diaphragmatic apertures

Caval opening
- Transmits the IVC and right phrenic nerve

Esophageal hiatus
- Transmits the esophagus, anterior and posterior
vagal trunks, esophageal branches of the left gastric
vessels and some lymph vessels

Aortic hiatus
- Transmits the aorta, thoracic duct, and the azygos and
hemiazygos veins
POSTERIOR ABDOMINAL WALL (continued)

Fascia of the posterior abdominal wall

- Lies between the parietal peritoneum and the muscles
- Continuous with the transversalis fascia laterally

Parts of the fascia of the posterior abdominal wall

- Psoas fascia (covers the psoas muscle)
- Forms the medial arcuate ligaments on each side
- Quadratus lumborum fascia (covers quadratus lumborum muscle)
- Forms the lateral arcuate ligaments on each side
- Thoracolumbar fascia (medially splits into two and encloses the
deep back muscles
- Laterally attaches to the internal oblique and transverse abdominal
muscles
POSTERIOR ABDOMINAL WALL (continued)

Lymphatics of the posterior abdominal

wall
 Common iliac lymph nodes
 Lumbar (aortic) lymph nodes
 Preaortic lymph nodes (celiac, superior
mesenteric and inferior mesenteric lymph nodes)
 Efferent vessels from the preaortic lymph nodes
form the intestinal lymphatic trunk and drain into
the cisterna chyle (the begining of the
thoracic duct)