Descarga la aplicación para disfrutar aún más
Vista previa del material en texto
Slide 1 1 _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _____ Slide 2 2 ARTERIA AORTA Principal arteria del cuerpo. Distribuye la sangre a todo el organismo. ORIGEN: A la derecha y detrás del tronco pulmonar Su origen está marcado por las valvas semilunares y senos aórticos de Valsalva. Ventrículo izquierdo Aorta Valvas semilunares _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _____ Slide 3 3 El origen de la aorta está situado: Detrás, debajo y a la derecha del orificio del tronco pulmonar Delante y a la derecha del orificio auriculoventricular izquierdo y en el mismo plano que éste TC P M Ao _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _____ Slide 4 4 TRAYECTO: Nace en el tórax y termina en el abdomen. Asciende oblicua adelante, arriba y a la derecha (porción ascendente) Se curva hacia la izquierda y atrás describiendo un arco de concavidad inferior (arco aórtico) Alcanza la VT4 y desciende verticalmente delante de la columna vertebral (porción torácica) Atraviesa el diafragma y llega al abdomen donde termina (porción abdominal) Ao ascendente Arco aórtico Ao torácica Ao abdominal _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _____ Slide 5 5 TERMINACIÓN: La bifurcación de la aorta se encuentra a nivel de la VL4 o el disco L4 – L5 (a la izquierda de la línea media) Termina por bifurcación en dos arterias ilíacas comunes (derecha e izquierda) Ao abdominal Arteria ilíaca común derecha Arteria ilíaca común izquierda VCI _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _____ Slide 6 6 Entre la salida de la arteria subclavia izquierda y el ligamento arterioso presenta un estrechamiento: istmo aórtico En su origen, la aorta presenta una dilatación: bulbo aórtico Bulbo aórtico Istmo aórtico _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _____ Slide 7 7 Aorta ascendente Arco aórtico (cayado) Aorta descendente (porción torácica y porción abdominal) SEGMENTOS: _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _____ Slide 8 8 AORTA ASCENDENTE Es totalmente intrapericárdica Originalas dos arterias coronarias Constituye la pared anterior del seno transverso de Theile A la derecha se relaciona con: VCS Borde superior de la orejuela derecha Limita el orificio derecho del seno transverso A la izquierda se relaciona con: Tronco pulmonar VCS TPAorta Orejuela derecha _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _____ Slide 9 9 ARCO AÓRTICO CAYADO DE LA AORTA Se dirige atrás y a la izquierda Curvatura principal: concavidad inferior, por encima de la raíz pulmonar izquierda Curvatura accesoria: concavidad derecha, sobre la tráquea y el esófago Describe una curva de doble concavidad: _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _____ Slide 10 10 RELACIONES: VCS A la derecha Tráquea Esófago NLRI Atrás y a la derecha se relaciona con: También se relaciona con: Conducto torácico Nervios cardíacos posteriores _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _____ Slide 11 11 RELACIONES: Adelante y a la izquierda se relaciona con: Nervio vago izquierdo Nervio frénico izquierdo y vasos pericardiofrénicos También se relaciona con: Nervios cardíacos anteriores Pleura mediastínica _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _____ Slide 12 12 RELACIONES: Abajo se relaciona con: Raíz pulmonar izquierda Ligamento arterioso NLRI _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _____ Slide 13 Cuadrilátero de Wrisberg Arco aórtico Ligamento arterioso Arteria pulmonar derecha Contiene al ganglio cardíaco superior de WrisbergArteria pulmonar derecha Ligamento arterioso Arco aórtico 13 _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _____ Slide 14 14 RAMAS DEL ARCO AÓRTICO: 3 ramas Tronco arterial braquiocefálico Arteria carótida primitiva izquierda Arteria subclavia izquierda ARCO AÓRTICO(+ voluminosa) _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _____ Slide 15 Cuadrilátero de Bourgery Arco aórtico CPI SI VBCI Contiene al nervio vago izquierdo CPI SI Arco aórtico VBCI 15 _______________________________________________________________________________________________ ______________________________________________________________________________________________________________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _____ Slide 16 16 AORTA TORÁCICA 2 segmentos: Desde la VT4 hasta el diafragma Superior o laterovertebral Inferior o prevertebral Superior (laterovertebral) Inferior (prevertebral) _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _____ Slide 17 17 Segmento superior (laterovertebral) Adelante: Raíz pulmonar izquierda Pericardio Nervio vago izquierdo Atrás: Cadena simpática VHAA _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _____ Slide 18 18 Segmento superior (laterovertebral) A la derecha: A la izquierda: Esófago Conducto torácico Pleura mediastínica _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _____ Slide 19 19 Segmento inferior (prevertebral) En el centro del mediastino posterior Adelante: Pericardio Esófago Atrás: Conducto torácico _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _____ Slide 20 20 Segmento inferior (prevertebral) A la derecha: VHA Vena ácigos A la izquierda: Cadena simpática _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _____ Slide 21 21 RAMAS COLATERALES: Ramas mediastínicas Arterias intercostales posteriores (9 últimas) Ramas esofágicas medias Ramas bronquiales Ramas pericárdicas “ME INTERESAN ESOS BRONQUIOS PERIFERICOS” _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _____ Slide 22 22 TRONCO ARTERIAL BRAQUIOCEFÁLICO ORIGEN: Arco aórtico Delante de tráquea TRAYECTO: Se dirige arriba, a la derecha y algo atrás TERMINACIÓN: Detrás de articulación esternoclavicular derecha Por bifurcación en 2 ramas: Carótida primitiva derecha (anterior y medial) Subclavia derecha (posterior y lateral) TBC CPD SD 3 cm _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ ______________________________________________________________________________________________________________________________________________________________________________________________ _______________________________________________________________________________________________ _____ Slide 23 23 RELACIONES: VBCD VBCI CPI TráqueaNervio vago derecho Atrás Atrás Adelante A la izquierda A la derecha NO DA RAMAS COLATERALES. Puede originar a la arteria tiroidea ima y a la arteria tímica. _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _____ Slide 24 24 CARÓTIDA PRIMITIVA IZQUIERDA CARÓTIDA COMÚN IZQUIERDA ORIGEN: TRAYECTO: TERMINACIÓN: Arco aórtico Borde superior del cartílago tiroides (borde inferior de la VC4) Por bifurcación en 2 ramas: En el cuello Arteria carótida interna Arteria carótida externa Torácico Cervical CPI _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _____ Slide 25 25 RELACIONES INTRATORÁCICAS: Arteria subclavia izquierda NLRI Nervio vago izquierdo Tráquea A la derecha Atrás Atrás Atrás TBC Adelante _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _____ Slide 26 26 RELACIONES INTRATORÁCICAS: Nervio frénico izquierdo VBCI Adelante A la izquierda NO DA RAMAS COLATERALES. _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _____ Slide 27 27 ARTERIA SUBCLAVIA IZQUIERDA ORIGEN: TRAYECTO: TERMINACIÓN: Arco aórtico Torácico Cervical SI Debajo de la parte media de la clavícula (borde lateral de la 1ª costilla) Se continúa como arteria axilar _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _____ Slide 28 28 RELACIONES INTRATORÁCICAS: Nervio vago izquierdo CPI Conducto torácico Esófago NLRI Pleura mediastínica Adelante Adelante Atrás A la izquierda A la derecha A la derecha _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _____ Slide 29 29 RAMAS COLATERALES: Arteria vertebral Arteria torácica interna (mamaria interna) Tronco tirocervical Tronco costocervical Arteria torácica interna SISD _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _____ Slide 30 30 ARTERIA TORÁCICA INTERNA ORIGEN: TRAYECTO: TERMINACIÓN: Arteria subclavia Penetra en tórax detrás del CC1 Desciende paralela al borde lateral del esternón (a 1,5 cm). Pasa delante del músculo transverso del tórax Está acompañada por 2 venas torácicas internas A nivel del 6º espacio intercostal Por bifurcación en 2 ramas: arteria epigástrica superior (rama abdominal) arteria musculofrénica (toracofrénica) _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _____ Slide 31 31 RAMAS COLATERALES: Ramas mediastínicas Ramas tímicas Ramas esternales Arteria pericardiofrénica (diafragmática superior) 6 primeras arterias intercostales anteriores Acompaña al nervio frénico Arteria pericardiofrénica _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _____ Slide 32 32 Arteria epigástrica superior Atraviesa el triángulo esternocostal del diafragma (∆ de Larrey) Llega al abdomen donde se une con la arteria epigástrica inferior a nivel del ombligo Arteria musculofrénica Sigue las inserciones del diafragma Origina las 6 últimas arterias intercostales anteriores _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _____ Slide 33 33 ARTERIAS INTERCOSTALES Anteriores: 6 primeras: torácica interna 6 últimas: musculofrénica Posteriores: 3 primeras: arteria intercostal suprema 9 últimas: aorta torácica (del tronco costocervical de la subclavia) Las arterias intercostales posteriores son los elementos más posteriores del mediastino. _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _____ Slide 34 34 Arteria torácica interna Aorta torácica Arteria intercostal posterior Arteria intercostal anterior _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _____ Slide 35 35 Casos particulares: 3ª arteria intercostal posterior derecha: origina a la arteria bronquial derecha 4 últimas: irrigan a los músculos anchos del abdomen Uno de las últimas puede originar la arteria medular segmentaria de Adamkiewicz A partir de la 5ª por delante y la 8ª por detrás irrigan al diafragma Arteria subcostal: es la última intercostal posterior Tronco broncointercostal 3ª intercostal posterior derecha Arteria bronquial derecha _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _____ Slide 36 36 Relaciones con los músculos intercostales: Delante del músculo intercostal externo Entre los músculos intercostales externo e íntimo Atrás: Lateralmente: Entre los músculos intercostales interno e íntimo Detrás del músculo intercostal interno Adelante: _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ ______________________________________________________________________________________________________________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _____ Slide 37 ARTERIA AORTA Aorta ascendente Arco aórtico Aorta descendente (porción torácica) Arteria coronaria derecha Arteria coronaria izquierda Tronco braquiocefálico Arteria carótida primitiva izquierda Arteria subclavia izquierda Arterias mediastínicas Arterias intercostales posteriores Arterias esofágicas medias Arterias bronquiales Arterias pericárdicas 37 _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ Slide 38 RAMAS AURICULARES RAMA DEL NSA RAMA DEL NAV RAMAS VENTRICULARES ARTERIA DEL CONO ARTERIOSO RAMA MARGINAL DERECHA ARTERIA INTERVENTRICULAR POSTERIOR RAMAS SEPTALES 38 Aorta ascendente Arteria coronaria derecha Arteria coronaria izquierda Arteria circunflejaArteria interventricular anterior Rama lateral (para el VI) Rama del cono arterioso Rama anastomótica para la marginal derecha Ramas septales Ramas auriculares Rama marginal izquierda Rama posterior del ventrículo izquierdo Slide 39 Arco aórtico Tronco braquiocefálico Arteria carótida primitiva izquierda Arteria subclavia izquierda Arteria pericardiofrénica Arterias intercostales anteriores (6 primeras) Arteria epigástrica superior Arteria musculofrénica Arteria vertebral Arteria torácica interna Tronco tirocervical Tronco costocervical Arteria intercostal suprema 6 últimas intercostales anteriores 3 primeras intercostales posteriores 39 Arteria carótida primitiva derecha Arteria subclavia derecha _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ Slide 40 Aorta descendente (porción torácica) Arterias mediastínicas 9 últimas arterias intercostales posteriores Arterias esofágicas medias Arterias bronquiales Arterias pericárdicas 40 Slide 41 41 Arterias intercostales anteriores Arterias intercostales posteriores 6 primeras 6 últimas 3 primeras 9 últimas Arteria torácica interna Arteria musculofrénica Arteria intercostal suprema del tronco costocervical de la subclavia Aorta torácica _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________
Compartir