



THE ABDOMINAL AORTA 603 



Relations. The abdominal aorta is covered, anteriorly, by the lesser omentum and stomach, 

 behind which are the branches of the celiac artery and the celiac plexus; below these, by the 

 lienal vein, the pancreas, the left renal vein, the inferior part of the duodenum, the mesentery, 

 and aortic plexus. Posteriorly, it is separated from the lumbar vertebrae and intervertebral 

 fibrocartilages by the anterior longitudinal ligament and left lumbar veins. On the right side 

 it is in relation above with the azygos vein, cisterna chyli, thoracic duct, and the right crus of 

 the diaphragm the last separating it from the upper part of the inferior vena cava, and from 

 the right celiac ganglion; the inferior vena cava is in contact with the aorta below. On the 

 left side are the left crus of the diaphragm, the left celiac ganglion, the ascending part of the 

 duodenum, and some coils of the small intestine. 



Collateral Circulation. The collateral circulation would be carried on by the anastomoses 

 between the internal mammary and the inferior epigastric; by the free communication between 

 the superior and inferior mesenteries, if the ligature were placed between these vessels; or by the 

 anastomosis between the inferior mesenteric and the internal pudendal, when (as is more common) 

 the point of ligature is below the origin of the inferior mesenteric ; and possibly by the anastomoses 

 of the lumbar arteries with the branches of the hypogastric. 



Branches. The branches of the abdominal aorta may be divided into three 

 sets: visceral, parietal, and terminal. 



Visceral Branches. Parietal Branches. 



Celiac. Inferior Phrenics. 



Superior Mesenteric. Lumbars. 



Inferior Mesenteric. Middle Sacral. 

 Middle Suprarenals. 

 Renals. 



Internal Spermatics. Terminal Branches. 

 Ovarian (in the female). Common Iliacs. 



Of the visceral branches, the celiac artery and the superior and inferior mes- 

 enteric arteries are unpaired, while the suprarenals, renals, internal spermatics, 

 and ovarian are paired. Of the parietal branches the inferior phrenics and lumbars 

 are paired; the middle sacral is unpaired. The terminal branches are paired. 



The celiac artery (a. cceliaca; celiac axis} (Figs. 532, 533) is a short thick trunk, 

 about 1.25 cm. in length, which arises from the front of the aorta, just below 

 the aortic hiatus of the diaphragm, and, passing nearly horizontally forward, 

 divides into three large branches, the left gastric, the hepatic, and the splenic; it 

 occasionally gives off one of the inferior phrenic arteries. 



Relations. The celiac artery is covered by the lesser omentum. On the right side it is in 

 relation with the right celiac ganglion and the caudate process of the liver; on the left side, with 

 the left celiac ganglion and the cardiac end of the stomach. Below, it is in relation to the upper 

 border of the pancreas, and the lienal vein. 



1. The Left Gastric Artery (a. gastrica sinistra; gastric or coronary artery), the 

 smallest of the three branches of the celiac artery, passes upward and to the left, 

 posterior to the omental bursa, to the cardiac orifice of the stomach. Here it dis- 

 tributes branches to the esophagus, which anastomose with the aortic esophageal 

 arteries ; others supply the cardiac part of the stomach, anastomosing with branches 

 of the lienal artery. It then runs from left to right, along the lesser curvature of the 

 stomach to the pylorus, between the layers of the lesser omentum; it gives branches 

 to both surfaces of the stomach and anastomoses with the right gastric artery. 



2. The Hepatic Artery (a. hepatica) in the adult is intermediate in size between 

 the left gastric and lienal; in the fetus, it is the largest of the three branches of 

 the celiac artery. It is first directed forward and to the right, to the upper margin 

 of the superior part of the duodenum, forming the lower boundary of the epiploic 

 foramen (foramen of Winslow). It then crosses the portal vein anteriorly and 

 ascends between the layers of the lesser omentum, and in front of the epiploic fora- 

 men, to the porta hepatis, where it divides into two branches,. right and left, which 

 supply the corresponding lobes of the liver, accompanying the ramifications of the 





