Cardiorespiratory system
Helen Butler, Neel Sharma, Tiago Villanueva in Student Success in Anatomy - SBAs and EMQs, 2022
11 Which of the following statements concerning the great vessels is correct? Branches of the aortic arch include the right common carotid, right subclavian and left brachiocephalic arteries.Ligamentum arteriosum is an embryological remnant of the foramen ovale.The right recurrent laryngeal nerve wraps around the ligamentum arteriosum, which is attached to the superior surface of the pulmonary trunk.The common carotid arteries bifurcate into internal and external branches at the level of the superior border of the thyroid cartilage.The external carotid artery lies posteriorly in the carotid sheath and its branches include the ophthalmic and inferior hypophyseal arteries.
General Thermography
James Stewart Campbell, M. Nathaniel Mead in Human Medical Thermography, 2023
Temporal arteritis is an insidious but dangerous autoimmune disease that causes headache, malaise, and localized tenderness over the arteries coursing up the sides of the cranium.105 Pain on chewing may lead to an incorrect diagnosis of TMJ pain. The disease mainly attacks the temporal, cranial, and other carotid branch arteries. The aortic arch and arteries of the upper extremity may also be involved. Venous phlebitis may accompany the arterial inflammation.106 In GCA, NO is generated by macrophages that accumulate in all layers of the inflamed vessel wall.107 It is this excess NO that dilates the skin arterioles near the diseased artery, creating local areas visibly warmer than the background heat of the scalp (Figure 10.40). Thermography is reported to detect this condition without resorting to biopsy of the involved arteries, and the effectiveness of therapy may be followed by serial thermograms.108 Thermographers should promptly warn of the possibility of temporal arteritis on finding warm scalp arteries.
Cardiovascular system
A Stewart Whitley, Jan Dodgeon, Angela Meadows, Jane Cullingworth, Ken Holmes, Marcus Jackson, Graham Hoadley, Randeep Kumar Kulshrestha in Clark’s Procedures in Diagnostic Imaging: A System-Based Approach, 2020
The arteries of the neck have their origins from the aortic arch. At roughly the level of the right sternoclavicular joint the brachiocephalic trunk bifurcates into the right common carotid and the right subclavian arteries. The left common carotid branches directly from the aortic arch. Both right and left common carotid arteries ascend up the neck lateral to the trachea and the oesophagus. The common carotid arteries divide into the external and internal carotid arteries (ECA and ICA respectively) at the level of the superior margin of the thyroid cartilage. The ECA supplies the areas of the head and neck external to the cranium and divides into six branches before terminating, including the facial, maxillary and superficial temporal arteries. The ICA passes through the skull base and eventually divides into the anterior and middle cerebral arteries, which provide the major blood supply to the brain. There is a swelling at the bifurcation of the common carotid artery known as the carotid bulb; turbulent flow in the bulb increases the risk of atheroma formation and it is therefore a common site of carotid artery stenosis.
A bullet through the aortic arch
Published in Acta Cardiologica, 2018
Thomas Nguyen, Martine Antoine, Frédéric Vanden Eynden, Guido Van Nooten, Bachar El Oumeiri
A 45-year-old male was admitted in shock at the emergency department with a gunshot wound to the chest. The entry wound was located in the middle of the sternum at the level of the 3rd intercostal space. Surprisingly, emergency echocardiography detected no pericardial effusion. The aortic CT-angiography revealed two separate perforations of the aortic arch: one at the base of the brachio-cephalic trunk (Panels A, B, C, D, arrow), another at the origin of the left subclavian artery (Panels A, B, C, D, arrowhead) and a rupture of the superior thoracic artery and a pulmonary contusion of the right upper lobe. The bullet fragments were found lodged in the body of the 4th thoracic vertebra after having perforated the oesophagus (Panel C, curved arrow). The patient was rushed to the operating room and the aortic arch was successfully repaired under deep hypothermia and circulatory arrest without major blood loss. A stent was placed in the oesophagus. The patient recovered completely and was discharged after 10 days.
Risk reduction and pharmacological strategies to prevent progression of aortic aneurysms
Published in Expert Review of Cardiovascular Therapy, 2021
Gabe Weininger, Shin Mei Chan, Mohammad Zafar, Bulat a Ziganshin, John A. Elefteriades
Importantly, aortic aneurysms can be categorized by their location. The thoracic aorta refers to the section between the aortic annulus and the diaphragm; this can be further divided into the ascending aorta, the aortic arch, and the descending aorta. When any of these segments are affected by an aneurysm, they qualify as ‘thoracic aortic aneurysms’ (TAAs) which differ substantially from abdominal aortic aneurysms (AAAs), which occur below the diaphragm. Anatomically, the more distal aorta contains less elastin and fewer lamellar units than the proximal aorta [5]. Atherosclerosis is also more likely to affect the aorta below the diaphragm for reasons that are still unclear [6] (Figure 1). There exist formal screening strategies in to detect AAAs [7,8] by abdominal ultrasound, but unfortunately no such protocol for screening the general population exists for TAAs (which are often not accessible to ultrasonic detection), adding to the challenge of detecting and treating this potentially devastating disease.
Operative repair of three ascending aortic dissections in one day at Baylor University Medical Center
Published in Baylor University Medical Center Proceedings, 2022
Charles Stewart Roberts, Lauren Zammerilla Westcott
The operation for ascending aortic dissection involves several formidable perfusion challenges. Replacement of the ascending aorta and proximal arch is generally necessary in ascending aortic dissection, and so the circulation must be artificially supported, on either side (heart side and arch side), to accomplish this surgical task. On the proximal side of the entry aortic tear, the heart must remain viable through cardioplegia and its function replaced by CPB. On the distal side is the aortic arch and its branches to the brain, and the descending aorta and its branches to the spine, abdomen, and legs. This requires various circulatory support measures, including CPB, cerebral perfusion, and, at times, complete cessation of perfusion, along with body hypothermia. The operation can extend easily beyond 6 hours without an efficient plan.
Related Knowledge Centers
- Aorta
- Ascending Aorta
- Bronchus
- Descending Aorta
- Pulmonary Artery
- Trachea
- Atrium
- Sternocostal Joints
- Ventricular Outflow Tract
- Pericardium