1. Aorta – ascending, arch and thoracic

2. Aorta Arises from Left ventricle

3. Aorta Divisions Ascending aorta Arch of aorta Descending aorta Descending aorta subdivided into Thoracic Abdominal

4. Ascending aorta Begins at Aortic orifice Course (in Middle mediastinum) Ascends upwards, forwards & to right Reaches right side of sternal angle Ends At sternal angle level Continues as arch of aorta Has 3 dilatations (Aortic sinuses) Lies above the valves

5. Ascending aorta - Relations Anterior Pulmonary trunk Right auricle Left lung & pleura

6. Ascending aorta - Relations Posterior Left atrium Right pulmonary artery Right principal bronchus

7. Ascending aorta - Relations Right side SVC Right atrium Left side Pulmonary trunk Left atrium

8. Ascending aorta - Branches Arise from aortic sinuses Right coronary Arises from anterior aortic sinus of the Ascending Aorta Left coronary Arises from left posterior aortic sinus of the Ascending Aorta Right posterior aortic sinus – nonarterial sinus Produces a bulging in septal wall of right atrium Torus aorticus

9. Arch of Aorta Extent From - Sternal angle To – Lower border of T4 Location In superior mediastinum Behind manubrium sternum

10. Arch of Aorta - Course Arch over root of left lung Begins From ascending aorta Right 2 nd chondro-sternal joint Passes Upwards, backwards and left In front of bifurcation of trachea Continues Backwards & downwards Behind left bronchus As descending aorta At lower border of Thoracic 4 vertebra Sternal angle Lower border of T4 Lies behind lower half of manubrium

11. Arch of Aorta Relations - Anterior & to left Left pleura & lung Left phrenic nerve Superior cervical cardiac nerve Branch of Sympathetic nerve Inferior cervical cardiac nerve Branch of Vagus Left recurrent laryngeal nerve hooks Left superior intercostal vein

12. Arch of Aorta Relations - Posterior & to right Trachea with deep cardiac plexus Oesophagus Left recurrent laryngeal nerve Thoracic duct Vertebral column

13. Arch of Aorta Relations - Superior Brachiocephalic trunk Left common carotid Left subclavian Left brachiocephalic vein

14. Arch of Aorta Relations - Inferior Left bronchus Bifurcation of pulmonary trunk Ligamentum arteriosum Superficial cardiac plexus Left recurrent laryngeal nerve

15. Arch of Aorta Branches Right Brachiocephalic Left common carotid Left subclavian Occasionally Thyroidea ima

16. Aortic knuckle Arch shows A convex projection on left side At left side of sternal angle Aortico pulmonary window In anterior oblique view of plain X-ray Radiolucent area in between Arch of aorta & pulmonary trunk

17. Coarctation of aorta Constriction (stenosis) of the aorta Typically occurs Distal to origin of left subclavian Near Ligamentum arteriosum (ductus arteriosus - congenital) Types Preductal Postductal Juxtaductal Presentation High blood pressure in upper extremities Low blood pressure in lower extremities

18. Aortic aneurysm Localized dilatation of aorta Due to weakness of wall Risk of rupture Compression may cause Hoarse voice Due to recurrent laryngeal nerve Dysphagia (difficult in swallowing) Due to oesophagus Dry cough Due to trachea Horner’s syndrome Due to sympathetic trunk

19. Descending aorta Extends from Lower border of T4 Extends to L4 2 common iliac arteries Divisions T12 – aortic opening(diaphragm) Thoracic Abdominal

20. Thoracic aorta Downward continuation of Arch of aorta Location Posterior mediastinum

21. Location Posterior mediastinum Anterior Root of left lung Pericardium Oesophagus Diaphragm Posterior Vertebral column Thoracic aorta - Relations

22. Right side Oesophagus Thoracic duct Azygos vein Right lung & pleura Left side Left lung & pleura

23. Thoracic aorta - Branches Posterior intercostal 3 rd – 11 th intercostal spaces Subcostal Left bronchial (2) Upper Lower Oesophageal Pericardial Mediastinal Superior phrenic