 It's going to be a demonstration of the aorta and the inferior vena cava with all the branches and tributaries This is a supine cadaver outstanding the right side camera person. Can the whole combo batch is on the left side? So this structure that we see in front of us. This is the abdominal aorta The extent of the abdominal aorta is from t12 at the aerotake hiatus to its bifurcation Over l4 into common aliax just to the right of the abdominal aorta. We have this is the inferior vena cava The full extent of the inferior vena cava in the abdomen is from t8 this opening To L5 at its bifurcation into the two common aliax veins the length of the inferior vena cava is Technically more than the length of the aorta in the abdomen. However We cannot see the full length of the inferior vena cava and you can see the cut portion of the inferior vena cava here and You can see the other cut portion here. This segment was inside the liver Therefore once the IVC enters the liver and then we cannot see it anymore And thereafter it immediately penetrates through the diaphragm cable hiatus and it goes straight into the right atrium Let's take a look at the branches of the aorta and wherever relevant We will not mention the tributaries of the inferior vena cava best way to remember the branches of the aorta in the Drummen are the rule of three three paired Parietal branches three paired visceral branches and three unpaired visceral branches This is the celiac trunk, which I have lifted up here unpaired visceral branch number one Superior miscentric trunk unpaired visceral branch number two Inferior miscentric unpaired visceral number three now. Let's come to the paired visceral the first paired visceral this one the largest the left renal artery and the right renal artery the next paired visceral this small one The right supra renal artery and the next paired visceral is this one the right goonadal artery and The left goonadal artery now. Let's come to the paired parietal branches top post pair parietal branch is the subcostal Arte which you cannot see here because it's under the 12th row the next one is the inferior phrenic artery We can see only the right inferior phrenic artery and I have retracted here to show This is the one of the other paired parietal branches And we can see the other portion of the inferior phrenic here On the left side, we cannot see it very clearly and the third set of paired parietal branches are these I Have retracted the outer To show these branches. These are the lumber arteries. We can see one here We can see another one here We can see another one here and we can see that they're accompanied by the lumber veins So these are the paired branches and we can see them on the other side also So these are the branches now. Let's mention a quick word about each of them But this is the celiac trunk. The celiac trunk arises from T12 very close to the aortic hiatus. This is the aortic hiatus My instrument is tracing the aortic hiatus The celiac trunk is a very short trunk and the moment it arises It gives three major branches the largest is this one The spleenic artery and we can recognize the spleenic artery by its extreme Torchucity because it is forming part of the bed of the stomach and it runs on the superior part of the pancreas Which has been removed the second largest branch. We have cut it This is the common hepatic artery This common hepatic artery runs to the right and then it makes a curve up and becomes a hepatic artery proper After it gives off the gastrodural artery and this hepatic artery proper enters into the liver Which also has been removed smallest branch of the celiac trunk is this one here this is the left gastric artery and We can see that it is also giving a Branch to the ease of vagus here. This is the ease of vigil branch the vein accompanying the ease of vigil branch That forms part of the site of portal systemic anastomosis which gets enlarged in cirrhosis with portal hypertension So that's about the celiac trunk. Now. Let's take a look at the pyramid centric trunk This is the superior centric trunk Which arises from l1 level and we can see these numerous branches here So, let's take them sequentially the first branch is the Inferior pancreatic odeodenal We have removed the pancreas and the diodenum and this goes from below divides into anti-impostory divisions and it's anastomosis with the superior pancreatic odeodenal and Supplies the head of the pancreas and the C loop of the diodenum This cut section that we see here is the next branch This is the middle colic artery then we can see these other numerous branches These are respectively the gisinal and the elial branches. This is the terminal branch The elio colic artery which supplies the heliosecal junction. We see it one branch Which I have not named yet this one here. This was an aberration in this particular cadaver This came out from the superior mesentric artery It went behind like this and it went in supplied the right anatomical lobe of the liver So this is an aberrant supply to the right lobe of the liver from the superior mesentric artery So these are the distributions of the superior mesentric artery. Now, let's take a look at this one here This is the inferior mesentric artery which arises from the level of L3 and we can see these branches here We have regained a few of them. This one is the supply of the hind cut So therefore it gives the left colic artery which divides into ascending descending and supplies the descending colon And we can see some other branches also and these are the other branches These were the ones which were supplying the sigmoid colon namely sigmoid 1, sigmoid 2, sigmoid 3 And thereafter the rest of the inferior mesentric continues down as we can see Into the pelvis as the superior rectal artery So these are the distributions of the three unpaired visceral branches now Let's come to the paired visceral branches the largest one namely the renal arteries This is the right renal artery and this is the left renal artery Renal arteries arise approximately at the level of L1. In this particular cadaver We see two renal arteries So I have lifted up the kidney right kidney and we can see that before it enters it has become one and Tear and one posterior. These renal arteries in this particular case 2 They enter the hyalum of the kidney and thereafter they divide into five segmental arteries And that's what allows us to do what is known as segmental nephrectomy In this particular cadaver we can also see The renal artery is giving a branch to the right supradrenal gland and this is the supradrenal gland Which is located right behind the inferior vena keva very close to it This is the left renal artery and here also we can see that before it enters It divides into two branches. This is one branch and this is the other branch and here also The anterior one divides into an anterior superior anterior inferior and the posterior one divides into three other branches at the renal hyalum and these are the five segmental arteries which supply the kidney This is the renal artery in this case. We cannot see a clear branch going to the left supradrenal gland This is the left supradrenal gland This is the right gonadal vessel and we can see the vein is coming from the Pelvis in this case It's a female cadaver and the vein drains into the inferior vena keva on the right side. The corresponding artery is here This is the gonadal artery on the left side. This is the Left ovarian gonadal artery and this vein that we can see here This is the left gonadal ovarian vein in the case of the left side It is not drained into the inferior vena keva. Instead, it drains directly into the left renal vein So that is about the paired visceral branches I have retracted the outer to the left and the inferior vena keva to the right to show the lumbar vessels I would draw your attention to these veins here. These are the lumbar veins which accompany the lumbar arteries These lumbar veins as they go to the inferior vena keva They communicate with each other and a vein runs up and that is known as the ascending lumbar vein Which is more prominent on the right side However, a small one will also be present on the left side in this particular case We can see it's giving a tributary to the left kidney These ascending lumbar veins will then continue up especially on the right side It will unite with the subcostal vein and then it will form the azygous vein and the azygous vein then runs With the aorta through the aortic hiatus. I have retracted the aorta at the aortic hiatus And this is the beginning of the azygous vein at the aortic hiatus. So the ascending lumbar veins Especially on the right side unites with the subcostal vein and forms the azygous vein Which travels to the right of the aorta through the aortic hiatus and it enters into the thorax and where it becomes bigger And it continues and opens into the superior vena keva The next structure which I want to bring to your attention which I have not mentioned till now is this branch here Which is arising from the posterior aspect of the aorta This is an unpaired branch a parietal branch called the median sacral artery the median sacral artery arises from the bifurcation of the aorta where it bifurcates into the two common aliax and we can see that one here and This descends down like a tail exactly in the midline and it continues down and it supplies the pelvic structures Very tenastomosis with the sacral arteries So this median sacral artery is also an unpaired parietal branch Which does not conform to the rule which I mentioned in the beginning now Let me mention a few other points which I have not mentioned till now What we are seeing here is a very clean out dissection, but in actual life This is not the case. This entire segment of the aorta was completely thickly enmeshed with the plexus No plexus, which is a composite of sympathetic and parasympathetic. There was a C-deck plexus here There was a superior mesentric plexus here There was an inter mesentric plexus here and there was an inferior mesentric plexus here and there was an aortic or renal plexus Here all those have been removed the other thing which has been removed were numerous lymph nodes These were the aorta cavel or the Lumbar lymph nodes which ultimately drain everything from the pelvis and from the lower limb and they go into the cisterna chaeli So these two structures have been removed now Let me mention a few important clinical correlations pertaining to the abdominal aorta Aneurysm of the abdominal aorta is well documented especially atherosclerotic aneurysm It usually arises between the origin of the renal arteries and Stops the bifurcation of the aorta into the common iliac So this is the region where the abdominal aortic aneurysm takes place And arising from the apex of the aneurysm will be the inferior mesentric artery If you can see and feel an expensive sensation on the abdomen then it is very significant of an abdominal aortic aneurysm And if it is more than six centimeters, then there's a very high likelihood of rupture in a thin World or a thin individual with a very thin abdominal wall We can sometimes normally feel the pulsation of the abdominal aorta just before it's bifurcation at the level of l4 Against the lumbar vertebra where it makes a curve forwards. That is normal The abdominal aorta is a very common root and a very useful root for Angiogram the usual procedure is to cannulate the femoral artery and here you can see that they had cannulated the femoral artery for the purpose of embalming Femoral artery pulsation is felt in the femoral triangle and it is cannulated from here and the catheter is then passed up Through the external iliac through the common iliac into the abdominal aorta and depending on which vessel we want to visualize We can cannulate either the inferior mesentric artery the renal artery The superior mesentric artery or the celiac artery and we can do the corresponding Angiogram another important clinical correlation that we can see in this cadaver if you go to feel it here You will get a crunchy feeling and perhaps it can be heard also This is a sign of advanced age and this is a particularly aged cadaver. This is calcific medial sclerosis Calcification of the tunica media and that is also referred to as monkeybergs medial calcific sclerosis The inferior vena kiva also can be cannulated through the femoral vein and it can be used for cardiac catheterization Procedures so these were some of the points which I want to mention about the outer cable Structures which are visible and the distribution and the branches and the tributaries in the abdomen Thank you very much for watching. If you have any questions or comments, please put them in the comment section below Dr. Sanjay Sanyal signing out. Have a nice day