Aorta

Arch of aorta (supra-aortic vessels):The aorta (/eɪˈɔːrtə/ ay-OR-tə) is the main and largest artery in the human body, originating from the left ventricle of the heart and extending down to the abdomen, where it splits into two smaller arteries (the common iliac arteries). The aorta distributes oxygenated blood to all parts of the body through the systemic circulation. The aorta (/eɪˈɔːrtə/ ay-OR-tə) is the main and largest artery in the human body, originating from the left ventricle of the heart and extending down to the abdomen, where it splits into two smaller arteries (the common iliac arteries). The aorta distributes oxygenated blood to all parts of the body through the systemic circulation. In anatomical sources, the aorta is usually divided into sections. One way of classifying a part of the aorta is by anatomical compartment, where the thoracic aorta (or thoracic portion of the aorta) runs from the heart to the diaphragm. The aorta then continues downward as the abdominal aorta (or abdominal portion of the aorta) diaphragm to the aortic bifurcation. Another system divides the aorta with respect to its course and the direction of blood flow. In this system, the aorta starts as the ascending aorta, travels superiorly from the heart, and then makes a hairpin turn known as the aortic arch. Following the aortic arch, the aorta then travels inferiorly as the descending aorta. The descending aorta has two parts. The aorta begins to descend in the thoracic cavity and is consequently known as the thoracic aorta. After the aorta passes through the diaphragm, it is known as the abdominal aorta. The aorta ends by dividing into two major blood vessels, the common iliac arteries and a smaller midline vessel, the median sacral artery.:18 The ascending aorta begins at the opening of the aortic valve in the left ventricle of the heart. It runs through a common pericardial sheath with the pulmonary trunk. These two blood vessels twist around each other, causing the aorta to start out posterior to the pulmonary trunk, but end by twisting to its right and anterior side.:191,204The transition from ascending aorta to aortic arch is at the pericardial reflection on the aorta.:Plate 211 At the root of the ascending aorta, the lumen has three small pockets between the cusps of the aortic valve and the wall of the aorta, which are called the aortic sinuses or the sinuses of Valsalva. The left aortic sinus contains the origin of the left coronary artery and the right aortic sinus likewise gives rise to the right coronary artery. Together, these two arteries supply the heart. The posterior aortic sinus does not give rise to a coronary artery. For this reason the left, right and posterior aortic sinuses are also called left-coronary, right-coronary and non-coronary sinuses.:191 The aortic arch loops over the left pulmonary artery and the bifurcation of the pulmonary trunk, to which it remains connected by the ligamentum arteriosum, a remnant of the fetal circulation that is obliterated a few days after birth. In addition to these blood vessels, the aortic arch crosses the left main bronchus. Between the aortic arch and the pulmonary trunk is a network of autonomic nerve fibers, the cardiac plexus or aortic plexus. The left vagus nerve, which passes anterior to the aortic arch, gives off a major branch, the recurrent laryngeal nerve, which loops under the aortic arch just lateral to the ligamentum arteriosum. It then runs back to the neck. The aortic arch has three major branches: from proximal to distal, they are the brachiocephalic trunk, the left common carotid artery, and the left subclavian artery. The brachiocephalic trunk supplies the right side of the head and neck as well as the right arm and chest wall, while the latter two together supply the left side of the same regions. The aortic arch ends, and the descending aorta begins at the level of the intervertebral disc between the fourth and fifth thoracic vertebrae.:209