Origin
Continuation of thoracic aorta through aortic hiatus of diaphragm at T12
Course
Descends retroperitoneally along the anterior vertebral column, slightly left of midline
Termination
Bifurcation into common iliac arteries at L4
Parietal Branches
Inferior Phrenic Artery
- Origin: Paired anterior branches
- Course:
- Ascends anterolateral to crura of diaphragm near medial border of adrenal gland on inferior surface of diaphragm
- Left inferior phrenic artery – passes posterior to oesophagus then runs anteriorly on left side of oesophageal hiatus
- Right inferior phrenic artery – passes posterior to IVC then runs anteriorly on right side of vena caval foramen
- Branches:
- Medial and lateral branches near posterior border of central tendon
- Superior suprarenal arteries
- Relations:
- Superior: diaphragm
- Anterior: posterior surface of liver, lesser sac, lesser omentum, stomach, IVC (right), oesophagus (left)
- Lateral: adrenal gland
- Inferior: kidneys
- Supply:
- Diaphragm, oesophagus, liver (capsule, segments 2, 3 and 7, bare area)
Lumbar arteries
- Origin: 4 paired posterolateral branches from levels L1-4
- Course:
- Runs posterolaterally along vertebral bodies and pass under sympathetic trunk and tendinous arches of psoas major
- Continues behind quadratus lumborum into anterolateral abdominal wall between transversus abdominis and internal oblique muscles
- Branches:
- Dorsal branch to muscles of back
- Spinal branch to vertebral column and nerve roots
- Relations:
- Anterior: lumbar lymphatic chains, lumbar sympathetic trunks, psoas and quadratus lumborum, IVC (right)
Median sacral artery
- Origin: single posterior branch, just above bifurcation
- Course:
- Descends in the midline over L4 and L5, then sacral promontory toward coccyx
- Branches:
- Minute branches to posterior surface of rectum
- 5th lumbar artery, anastomosing with iliolumbar artery (variant)
- Branches anastomosing with lateral sacral artery into sacral foramina
- Relations:
- Posterior: L4-5 vertebra, sacral promontory, coccyx
- Anterior: left common iliac vein, rectum
- Right lateral: median sacral vein
Relations
- Posterior to median arcuate ligament
- Anterior and slightly left of lumbar vertebral bodies
- Descends with IVC on its right
- Cross anterior by splenic vein, pancreatic body.
- Located in between origin of Coeliac and SMA
- Crossed anteriorly by left renal vein, uncinate process of pancreas, and 3rd part of duodenum between SMA and IMA origins.
Variants
- Inferior phrenic arteries from coeliac trunk
- Superior suprarenal arteries arise from aorta
- 5th lumbar artery from median sacral artery