Blood Vessels of the Abdomen and
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The pancreas | Main Anatomy Index | Innervation & lymphatics of abdomen and
Last updated 30 March 2006
Blood Vessels of the Abdomen and Pelvis
of the Abdomen
The Abdominal Aorta
- This is obviously the continuation of the thoracic aorta.
- It begins at the aortic hiatus in the diaphragm at the level of the intervertebral disc between T12 and L1.
- It ends around the level of L4 vertebra by dividing
into two common iliac arteries.
- Throughout its course, it lies against the vertebral bodies.
Relations of the
- Anteriorly, the abdominal aorta is related to:
- The coeliac trunk and its branches;
- The coeliac plexus;
- The omental bursa;
- The pancreas;
- The left renal vein;
- The ascending part of the duodenum;
- The root of the mesentery;
- And the intermesenteric plexus of nerves.
- Posteriorly, the abdominal aorta descends
- The bodies of L1 to L4 vertebrae;
- The intervening intervertebral discs;
- And the corresponding part of the anterior longitudinal ligament.
- On the right, of the abdominal aorta is the IVC. Related superiorly to the abdominal aorta on the right is:
- The cisterna chyli;
- The thoracic duct;
- And the right crus of the diaphragm.
- On the left, the abdominal aorta is related superiorly
to the left crus of the diaphragm and the left coeliac ganglion.
- The duodenojejunal flexure is on its left, opposite L2 vertebra.
- The sympathetic trunk runs along its left side.
Anatomy of the Abdominal Aorta
- This is represented by a broad band (about 2 cm wide),
extending from a median point, about 2.5
cm superior to the transpyloric plane, to a
point slightly inferior and to the
left of the umbilicus.
- The latter point represents the level of bifurcation of
the aorta to the common iliac arteries.
- The aortic bifurcation is just to the left of the midpoint of the line joining the highest points of the iliac
Branches of the
Abdominal Aorta (from Ashwell)
Ventral Branches (unpaired)
Click here to go to the ventral
- Coeliac trunk
- Superior mesenteric artery
- Inferior mesenteric artery
Click here to go to the lateral
- Inferior phrenic
- Middle suprarenal
- Gonadal (ovarian or testicular)
Posterior (paired and unpaired)
Click here to go to the posterior
- Lumbar (paired)
- Median sacral (unpaired)
- Common iliac
- There are anastomoses between these arteries and with their branches.
- Left gastric artery branches with the aortic oesophageal branches around the lower oesophagus.
- Anterior and posterior superior pancreaticoduodenal arteries
(coeliac trunk) with the inferior pancreaticoduodenal
(superior mesenteric branch) around the head of
the pancreas and 2nd part of
- The marginal artery anastomosis between the middle colic and the left colic.
- The superior rectal artery (inferior mesenteric) with
the middle rectal (internal iliac) and/or the inferior rectal (internal pudendal from internal iliac).
Inferior Phrenic Artery
- These are two small arteries that help supply the diaphragm and some small parts of the spleen and liver.
- They arise separately, as a common trunk or from the coeliac trunk.
- Each artery ascends anterior to the crus of the
diaphragm medial to the suprarenal gland.
- These arteries anastomose with the musculophrenic, posterior intercostal, and pericardiacophrenic
- They give off the superior suprarenal arteries.
Middle Suprarenal Artery
- These arise level with the superior mesenteric artery.
- The right passes behind the IVC.
- Both are related to the coeliac ganglion of the
- These anastomose with the suprarenal branches of the inferior phrenic and renal arteries.
- These two larger arteries branch from the aorta, just inferior
to the level of the superior mesenteric artery.
- Each renal artery gives off an inferior suprarenal branch
and supplies the ureter in its upper extent.
- The testicular artery supplies the testis, perirenal fat, ureter, iliac lymph nodes and cremaster.
- These correspond to the testicular arteries but are obviously in the female.
- They enter the pelvis to supply the ovaries.
- After entering the suspensory ligament of the ovary,
they continue into the broad ligament of the uterus.
- Branches are given off to the ovary, ureter,
uterine tubes and one branch passes to the side of the
uterus to anastomose with the uterine artery.
- Other branches follow the round ligament of the uterus
to the inguinal ligament and supply the skin of the labium majus.
- There are usually 4 on each side.
- These pass anterior to the 4
upper lumbar vertebral bodies, pass behind the
sympathetic trunks to the posterior abdominal wall.
- The right arteries pass posterior to the IVC.
- The branches of each artery include:
- Spinal (to the vertebral canal and contents)
- Ventral (to body wall)
- Dorsal (to dorsal muscles, joints and skin)
Median Sacral Artery
- This is a small posterior branch.
- It leaves the aorta slightly above its bifurcation and descends
anterior to the midline of L4, L5, the sacrum and ends in the
Branches of the Abdominal Aorta
- The abdominal aorta bifurcates anterior to the left side of L4 into the common iliac
- These two arteries diverge and further divide into the internal
and external iliac arteries on each side at the level of
the lumbosacral intervertebral disc.
the External Iliac Artery
Inferior Epigastric Artery
- This arises from the external iliac just proximal to the inguinal
- It ascends medial to the deep inguinal ring (raising the
parietal peritoneum as it does so to form the lateral umbilical fold).
- It then pierces the transversalis
fascia passing anterior the posterior layer of
the rectus sheath.
- It divides into numerous branches, some of which anastomose with the superior
epigastric and posterior intercostal arteries.
Deep Circumflex Iliac Artery
- This arises almost opposite the inferior
- It ascends the iliac crest anastomosing with the ascending branches of the lateral
circumflex femoral, lumbar and inferior epigastric arteries.
Branches from the
Anterior Trunk of Internal Iliac Artery
- The superior vesical artery with several branches. It
was derived from the umbilical artery of the foetus.
- The inferior vesical artery (in males).
- The middle rectal artery.
- The uterine artery (in females).
- The vaginal artery (corresponds to the inferior vesical
artery of males).
- The obturator artery. This leaves to the pelvis via the
- The internal pudendal artery. This leaves the pelvis
between the piriformis and coccygeus
- It passes deep to the sacrotuberous ligament to enter
the pudendal canal in the lateral wall of the ischiorectal fossa.
- The artery has several branches including the inferior rectal
- The inferior gluteal artery. This leaves the pelvis
below the piriformis muscle through the greater sciatic foramen.
Branches of the
Posterior Trunk of the Internal Iliac Artery
- The iliolumbar trunk ascends to the medial
border of the psoas major muscle.
- The lateral sacral arteries.
- The superior gluteal artery. This leaves the greater sciatic foramen above the piriformis
of the Abdomen
- There is general portal circulation for the intraperitoneal part.
- In contrast, there are systemic veins for the extraperitoneal part.
The Portal Vein
- The portal vein is about 8 cm long and valveless, as are its tributaries, in adult life.
- It begins at the level of L2 by the junction of the splenic and superior mesenteric veins.
- As it reaches the porta hepatis it divides into left and right branches, which
supplies the corresponding halves of the liver.
- The right branch supplies the right half of the liver and usually receives the cystic vein.
- The left branch divides into branches to the caudate, quadrate and left lobes.
- As the left branch enters the living, it is joined by paraumbilical
veins, the ligamentum teres and is
connected to the IVC by the ligamentum
- The tributaries of the portal vein are the splenic, superior mesenteric, left gastric,
right gastric, paraumbilical
and cystic veins.
Tributaries of the Splenic
- Short gastric vein
- Left gastro-omental (gastroepiploic) vein
- Pancreatic veins
- Inferior mesenteric (receives the left colic and sigmoid veins)
the Superior Mesenteric Vein
- Right gastro-omental (gastroepiploic) vein
- Pancreaticoduodenal vein
- Jejunal and ileal veins
- Ileocolic vein
- Right colic vein
- Middle colic vein
||Left gastric oesophageal branches
||Oesophageal branches to azygos, accessory hemiazygos veins
veins (paraumbilical veins)
||Superior rectal veins
||Middle and inferior rectal veins
||Venous radicles of colon
and bare area of liver
||Patent ductus venosus (branch of left portal vein branch)
- This consists of the inferior vena cava and its
tributaries in the abdomen.
- There are 4 pairs of these draining the lumbar region and posterior abdominal
- Near the vertebral column, they drain the vertebral venous plexus
and are connected by the ascending lumbar veins to the common iliac and iliolumbar veins.
- These drain the epididymis and testis.
- They unite to form the pampiniform plexus and ascend with the testicular artery.
- The right one enters the IVC
just below the renal veins.
- The left one enters the left
- These arise from a plexus in the broad ligament to
ascend with the ovarian artery much like the testicular veins.
- These enter the IVC as it passes through the superior aspect of the liver.
- The renal veins.
- The suprarenal veins.
- The inferior phrenic veins.