 We are going to demonstrate the abdominal aorta and the inferior vena cava with a few important surgical correlations Good day everybody Welcome to our next section. Dr. Sanjay Sanyal. So let's start up with the great vessels first The most prominent structure that you see here in front of you and you have already guessed it This is the abdominal aorta The abdominal aorta comes out from the aortic hiatus and you can see this is the right crust of the diaphragm and The left crust is there. So this is the aortic hiatus where my finger is going in So it is at the level of T12 It starts at the level of T12 and you can see it is bifurcating at the level of L4 So this is the segment of the abdominal aorta And it bifurcates into the left and the right common iliac arteries Which I will dissect further to show you the divisions in the pelvis So this is the abdominal aorta It is situated to the left of the inferior vena cava, which is going to be my next now Let's take a look at the branches the main branches of the abdominal aorta If I lift it up, you can see there are certain branches which are going from the abdominal aorta down here These are the lumbar arteries So these are the ones these are the lumbar arteries You can see them here and you can see them here you can see them here These are the lumbar arteries. They run segmentally on both the sides. These are the parietal branches the paired parietal branches Now let's take the look at the unpaired visceral branches of the abdominal aorta, which all of you have been waiting for Straight away, you can see in front of you This is the superior miscentric artery I've completely dissected out the superior miscentric artery. This is approximately at the level of L1 And you can see that this these are the branches of the superior miscentric artery Which had been given off and you can see the cut ends of the branches here These are the branches which were given off to the intestines which we had removed when we took out the intestine The next important point. I would like you to notice is that the superior miscentric artery was crossing Like this it was crossing in front of the Uncinate process This is the pancreas Then it was crossing in front of the third part of the duodenum and it is also crossing the left renal vein And we have mentioned repeatedly That the superior miscentric artery can sometimes compress the left renal vein Producing what is known as left renal vein entrapment syndrome. So you can see that superior miscentric artery here Having seen the superior miscentric artery, naturally you would like to see the other unpaired visceral branch and that is this one here This is the celiac trunk The celiac trunk is at the level of T12 and it's a very short trunk, but it's got three very important branches This is one branch This is the second branch This is the largest branch and I have completely exposed it and you can see that this is the very tortuous splenic artery which was running along the upper border of the pancreas and it is going towards the spleen So this is the splenic artery This is the spleenic artery and I'll tell you about this spleenic vein just a little while later This is the largest branch the second branch of the celiac trunk is the Common hepatic artery and I'd already traced the common hepatic artery to you so therefore quickly this is the common hepatic artery and Common hepatic artery After it gives off the gastro duodenal artery which runs behind the duodenum It turns up and it becomes the hepatic artery proper and it is running in the Porter triad, which I had already shown you but I'm going to show you again This is the hepatic artery and the third branch of the celiac trunk is The left gastric which is this one and the left gastric artery we had also seen last time it was running along the lesser momentum of the stomach and this is here This is the lesser momentum of the stomach and the left gastric artery is running like this So these are the three branches of the celiac trunk. So we have seen the celiac trunk We have seen the common hepatic the splenic the left gastric. We have seen the superior miscentric artery The third important unpaid visceral branch is this is the opening I had to cut it because I was removing the intestinal contents But the other part is still here and you have already guessed it. This is the inferior miscentric artery This is the inferior miscentric artery, which is supplying the hindgut and This arises from the level of L3 So these are the parts the important branches which you see of the abdominal aorta last but definitely not the least This is the under this You can see the left and the right renal artery This is the left renal artery going to the kidney which I'm going to tell you in the next Demonstration and this is the right renal artery, which is coming under the inferior venequeva Both the arteries are under the respective waves and they're going to the respective kidneys So these are the major branches of the abdominal aorta Okay, just to mention one or two points of clinical correlation One important clinical correlation for the abdominal aorta is an aneurysm which usually occurs below the by below the renal arteries so the renal arteries here and here and Just above the bifurcation So it is in this region that we get abdominal aorta and win aneurysm and when that happens The inferior miscentric artery arises from the apex of the aneurysm and it produces an expansion pulsation of the abdomen So that is about the abdominal aorta. This is a retroperitoneal structure By the way, this was covered by the parietal peritoneum and it was covered by the abdominal fascia, which I have removed Now let's come to the next major vessel, which is situated just to the right of the abdominal aorta And that is this structure that you see here This is the inferior vena kiva Let's trace the inferior vena kiva. See where it is disappearing up here. You can see it is disappearing into the liver So it goes and goes into the fissure for the inferior vena kiva, which we had seen in the Bay Area of the liver So here after this we cannot see the inferior vena kiva It is inside the liver or it is forming a groove on the posterior superior aspect of the liver And after that it goes through the central tendon of the diaphragm at the level of T8 And it goes into the thorax and immediately after that it enters into the right atrium. So from here onwards Till it enters the right atrium. You do not see the inferior vena kiva at all So the actual extent of the inferior vena kiva within the abdomen is from T8 All the way down and it bifurcates a little below the abdominal aorta at the level of L5 And it also bifurcates into the same two named structures namely the left and the right common idea Now let's look at the tributaries that we can see in this particular. So let's start off with the Most important ones that we can see here We can see the left renal vein here and you notice that the left renal vein is crossing in front of the abdominal aorta I had already mentioned that the veins are anterior left renal vein is Longer because it has to cross a longer distance Right renal vein is smaller because has to go smaller distance and for the renal arteries It was the opposite the left was smaller the right was longer So this is the renal vein and I had just now mentioned that this is where you get renal vein and trapments in Rome. I had mentioned So since we mentioned that now let's take a look at the other important venous drainage Can you see this structure coming here and the other cut end is located here? This is I'm sure you have guessed it. This is the right testicular vein Or the right bone adult vein. This is a male patient. So therefore this is the testicular vein So this is the other cut in I had to cut it because I had to remove the structures So this is the testicular vein on the right side Then what about the left side? You would want to see the left testicular vein and the left testicular vein is Opening into the left renal vein and we can see it here. This is the left testicular vein It's opening into the left renal vein. This is the left bone adult vein So this is the right and this is the left testicular vein So this is about the inferior vena cava while I lift it up You can see a few of these veins which are draining into the inferior vena cava These are the same the lumber veins which I was referring to and we had already mentioned in class that these lumber veins They also unite to form the a zygous vein on the right side and the accessory him a zygous on the left side But that is further deep and further posterior. We have not exposed that So that's that's about these two major vessels the abdominal aorta and the inferior vena cava Thank you very much for watching. Stay tuned for the next video