The aorta ( ) is the main and largest
artery
An artery (plural arteries) () is a blood vessel in humans and most animals that takes blood away from the heart to one or more parts of the body (tissues, lungs, brain etc.). Most arteries carry oxygenated blood; the two exceptions are the pul ...
in the
human body
The human body is the structure of a Human, human being. It is composed of many different types of Cell (biology), cells that together create Tissue (biology), tissues and subsequently organ systems. They ensure homeostasis and the life, viabi ...
, originating from the
left ventricle
A ventricle is one of two large chambers toward the bottom of the heart that collect and expel blood towards the peripheral beds within the body and lungs. The blood pumped by a ventricle is supplied by an atrium, an adjacent chamber in the upper ...
of the
heart
The heart is a muscular organ in most animals. This organ pumps blood through the blood vessels of the circulatory system. The pumped blood carries oxygen and nutrients to the body, while carrying metabolic waste such as carbon dioxide t ...
and extending down to the
abdomen
The abdomen (colloquially called the belly, tummy, midriff, tucky or stomach) is the part of the body between the thorax (chest) and pelvis, in humans and in other vertebrates. The abdomen is the front part of the abdominal segment of the torso. ...
, where it
splits
A split (commonly referred to as splits or the splits) is a physical position in which the legs are in line with each other and extended in opposite directions. Splits are commonly performed in various athletic activities, including dance, figu ...
into two smaller arteries (the
common iliac arteries
The common iliac artery is a large artery of the abdomen paired on each side. It originates from the aortic bifurcation at the level of the 4th lumbar vertebra. It ends in front of the sacroiliac joint, one on either side, and each bifurcates in ...
). The aorta distributes
oxygenated blood to all parts of the body through the
systemic circulation
The blood circulatory system is a system of organs that includes the heart, blood vessels, and blood which is circulated throughout the entire body of a human or other vertebrate. It includes the cardiovascular system, or vascular system, tha ...
.
Structure
Sections
In anatomical sources, the aorta is usually divided into sections.
One way of classifying a part of the aorta is by anatomical compartment, where the
thoracic aorta
The descending thoracic aorta is a part of the aorta located in the thorax. It is a continuation of the aortic arch. It is located within the posterior mediastinal cavity, but frequently bulges into the left pleural cavity. The descending thoracic ...
(or thoracic portion of the aorta) runs from the
heart
The heart is a muscular organ in most animals. This organ pumps blood through the blood vessels of the circulatory system. The pumped blood carries oxygen and nutrients to the body, while carrying metabolic waste such as carbon dioxide t ...
to the
diaphragm. The aorta then continues downward as the
abdominal aorta
In human anatomy, the abdominal aorta is the largest artery in the abdominal cavity. As part of the aorta, it is a direct continuation of the descending aorta (of the thorax).
Structure
The abdominal aorta begins at the level of the thoracic d ...
(or abdominal portion of the aorta) from the diaphragm to the
aortic bifurcation
The aortic bifurcation is the point at which the abdominal aorta bifurcates (forks) into the left and right common iliac arteries. The aortic bifurcation is usually seen at the level of L4, just above the junction of the left and right common i ...
.
Another system divides the aorta with respect to its course and the direction of blood flow. In this system, the aorta starts as the
ascending aorta
The ascending aorta (AAo) is a portion of the aorta commencing at the upper part of the base of the left ventricle, on a level with the lower border of the third costal cartilage behind the left half of the sternum.
Structure
It passes obliqu ...
, travels
superiorly from the heart, and then makes a
hairpin turn
A hairpin turn (also hairpin bend or hairpin corner) is a bend in a road with a very acute inner angle, making it necessary for an oncoming vehicle to turn about 180° to continue on the road. It is named for its resemblance to a bent metal hai ...
known as the
aortic arch
The aortic arch, arch of the aorta, or transverse aortic arch () is the part of the aorta between the ascending and descending aorta. The arch travels backward, so that it ultimately runs to the left of the trachea.
Structure
The aorta begins a ...
. Following the aortic arch, the aorta then travels
inferiorly
Standard anatomical terms of location are used to unambiguously describe the anatomy of animals, including humans. The terms, typically derived from Latin or Greek language, Greek roots, describe something in its standard anatomical position. Th ...
as the descending aorta. The descending aorta has two parts. The aorta begins to descend in the thoracic cavity and is consequently known as the thoracic aorta. After the aorta passes through the
diaphragm, it is known as the abdominal aorta. The aorta ends by dividing into two major blood vessels, the
common iliac arteries
The common iliac artery is a large artery of the abdomen paired on each side. It originates from the aortic bifurcation at the level of the 4th lumbar vertebra. It ends in front of the sacroiliac joint, one on either side, and each bifurcates in ...
and a smaller midline vessel, the
median sacral artery
The median sacral artery (or middle sacral artery) is a small artery that arises posterior to the abdominal aorta and superior to its bifurcation.
Structure
The median sacral artery arises from the abdominal aorta at the level of the bottom qu ...
.
Ascending aorta
The ascending aorta begins at the opening of the
aortic valve
The aortic valve is a valve in the heart of humans and most other animals, located between the left ventricle and the aorta. It is one of the four valves of the heart and one of the two semilunar valves, the other being the pulmonary valve. The ...
in the left ventricle of the heart. It runs through a common
pericardial sheath with the
pulmonary trunk
A pulmonary artery is an artery in the pulmonary circulation that carries deoxygenated blood from the right side of the heart to the lungs. The largest pulmonary artery is the ''main pulmonary artery'' or ''pulmonary trunk'' from the heart, and t ...
. These two blood vessels twist around each other, causing the aorta to start out
posterior to the pulmonary trunk, but end by twisting to its right and
anterior
Standard anatomical terms of location are used to unambiguously describe the anatomy of animals, including humans. The terms, typically derived from Latin or Greek roots, describe something in its standard anatomical position. This position prov ...
side.
The transition from ascending aorta to aortic arch is at the pericardial reflection on the aorta.
At the root of the ascending aorta, the
lumen has three small pockets between the
cusps of the
aortic valve
The aortic valve is a valve in the heart of humans and most other animals, located between the left ventricle and the aorta. It is one of the four valves of the heart and one of the two semilunar valves, the other being the pulmonary valve. The ...
and the wall of the aorta, which are called the
aortic sinus
An aortic sinus, also known as a sinus of Valsalva, is one of the anatomic dilations of the ascending aorta, which occurs just above the aortic valve. These widenings are between the wall of the aorta and each of the three cusps of the aortic val ...
es or the sinuses of Valsalva. The left aortic sinus contains the origin of the
left coronary artery
The left coronary artery (LCA) is a coronary artery that arises from the aorta above the left cusp of the aortic valve, and feeds blood to the left side of the heart muscle. It is also known as the left main coronary artery (LMCA) and the left ma ...
and the right aortic sinus likewise gives rise to the
right coronary artery
In the blood supply of the heart, the right coronary artery (RCA) is an artery originating above the right cusp of the aortic valve, at the right aortic sinus in the heart. It travels down the right coronary sulcus, towards the crux of the hear ...
. Together, these two arteries supply the heart. The
posterior aortic sinus does not give rise to a coronary artery. For this reason the left, right and posterior aortic sinuses are also called left-coronary, right-coronary and non-coronary sinuses.
Aortic arch
The
aortic arch
The aortic arch, arch of the aorta, or transverse aortic arch () is the part of the aorta between the ascending and descending aorta. The arch travels backward, so that it ultimately runs to the left of the trachea.
Structure
The aorta begins a ...
loops over the left
pulmonary artery
A pulmonary artery is an artery in the pulmonary circulation that carries deoxygenated blood from the right side of the heart to the lungs. The largest pulmonary artery is the ''main pulmonary artery'' or ''pulmonary trunk'' from the heart, and t ...
and the bifurcation of the
pulmonary trunk
A pulmonary artery is an artery in the pulmonary circulation that carries deoxygenated blood from the right side of the heart to the lungs. The largest pulmonary artery is the ''main pulmonary artery'' or ''pulmonary trunk'' from the heart, and t ...
, to which it remains connected by the
ligamentum arteriosum
The ligamentum arteriosum (arterial ligament), also known as the Ligament of Botallo or Harvey's ligament, is a small ligament attaching the aorta to the pulmonary artery. It serves no function in adults but is the remnant of the ductus arteriosus ...
, a remnant of the
fetal circulation In humans, the circulatory system is different before and after birth. The fetal circulation is composed of the placenta, umbilical blood vessels encapsulated by the umbilical cord, heart and systemic blood vessels. A major difference between the ...
that is obliterated a few days after birth. In addition to these blood vessels, the aortic arch crosses the
left main bronchus
A bronchus is a passage or airway in the lower respiratory tract that conducts air into the lungs. The first or primary bronchi pronounced (BRAN-KAI) to branch from the trachea at the carina are the right main bronchus and the left main bronchus. ...
. Between the aortic arch and the pulmonary trunk is a network of autonomic nerve fibers, the
cardiac plexus
The cardiac plexus is a plexus of nerves situated at the base of the heart that innervates the heart.
Structure
The cardiac plexus is divided into a superficial part, which lies in the concavity of the aortic arch, and a deep part, between the ao ...
or ''aortic plexus''. The left
vagus nerve
The vagus nerve, also known as the tenth cranial nerve, cranial nerve X, or simply CN X, is a cranial nerve that interfaces with the parasympathetic control of the heart, lungs, and digestive tract. It comprises two nerves—the left and right ...
, which passes
anterior
Standard anatomical terms of location are used to unambiguously describe the anatomy of animals, including humans. The terms, typically derived from Latin or Greek roots, describe something in its standard anatomical position. This position prov ...
to the aortic arch, gives off a major branch, the
recurrent laryngeal nerve
The recurrent laryngeal nerve (RLN) is a branch of the vagus nerve (cranial nerve X) that supplies all the intrinsic muscles of the larynx, with the exception of the cricothyroid muscles. There are two recurrent laryngeal nerves, right and le ...
, which loops under the aortic arch just lateral to the ligamentum arteriosum. It then runs back to the neck.
The aortic arch has three major branches: from
proximal
Standard anatomical terms of location are used to unambiguously describe the anatomy of animals, including humans. The terms, typically derived from Latin or Greek roots, describe something in its standard anatomical position. This position pro ...
to
distal
Standard anatomical terms of location are used to unambiguously describe the anatomy of animals, including humans. The terms, typically derived from Latin or Greek roots, describe something in its standard anatomical position. This position pro ...
, they are the
brachiocephalic trunk
The brachiocephalic artery (or brachiocephalic trunk or innominate artery) is an artery of the mediastinum that supplies blood to the right arm and the head and neck.
It is the first branch of the aortic arch. Soon after it emerges, the brachi ...
, the
left common carotid artery
In anatomy, the left and right common carotid arteries (carotids) (Entry "carotid"
in
subclavian artery
In human anatomy, the subclavian arteries are paired major arteries of the upper thorax, below the clavicle. They receive blood from the aortic arch. The left subclavian artery supplies blood to the left arm and the right subclavian artery supplie ...
. The brachiocephalic trunk supplies the right side of the head and neck as well as the right arm and
chest wall
The thoracic wall or chest wall is the boundary of the thoracic cavity.
Structure
The bone, bony human skeleton, skeletal part of the thoracic wall is the rib cage, and the rest is made up of muscle, skin, and fasciae.
The chest wall has 10 lay ...
, while the latter two together supply the left side of the same regions.
The aortic arch ends, and the descending aorta begins at the level of the
intervertebral disc
An intervertebral disc (or intervertebral fibrocartilage) lies between adjacent vertebrae in the vertebral column. Each disc forms a fibrocartilaginous joint (a symphysis), to allow slight movement of the vertebrae, to act as a ligament to hold t ...
between the fourth and fifth
thoracic vertebrae
In vertebrates, thoracic vertebrae compose the middle segment of the vertebral column, between the cervical vertebrae and the lumbar vertebrae. In humans, there are twelve thoracic vertebra (anatomy), vertebrae and they are intermediate in size b ...
.
Thoracic aorta
The thoracic descending aorta gives rise to the
intercostal and
subcostal arteries, as well as to the superior and inferior
left bronchial arteries and variable branches to the
esophagus
The esophagus (American English) or oesophagus (British English; both ), non-technically known also as the food pipe or gullet, is an organ in vertebrates through which food passes, aided by peristaltic contractions, from the pharynx to the ...
,
mediastinum
The mediastinum (from ) is the central compartment of the thoracic cavity. Surrounded by loose connective tissue, it is an undelineated region that contains a group of structures within the thorax, namely the heart and its vessels, the esophagu ...
, and
pericardium
The pericardium, also called pericardial sac, is a double-walled sac containing the heart and the roots of the great vessels. It has two layers, an outer layer made of strong connective tissue (fibrous pericardium), and an inner layer made of ...
. Its lowest pair of branches are the superior phrenic arteries, which supply the diaphragm, and the subcostal arteries for the twelfth rib.
Abdominal aorta
The abdominal aorta begins at the aortic hiatus of the diaphragm at the level of the twelfth thoracic vertebra.
It gives rise to
lumbar
In tetrapod anatomy, lumbar is an adjective that means ''of or pertaining to the abdominal segment of the torso, between the diaphragm and the sacrum.''
The lumbar region is sometimes referred to as the lower spine, or as an area of the back i ...
and musculophrenic arteries,
renal
The kidneys are two reddish-brown bean-shaped organs found in vertebrates. They are located on the left and right in the retroperitoneal space, and in adult humans are about in length. They receive blood from the paired renal arteries; blood ...
and
middle suprarenal arteries
The middle suprarenal artery (middle capsular artery) is a paired artery in the abdomen. It is a branch of the aorta. It supplies the adrenal gland.
Structure
Origin
The middle suprarenal artery (usually) arises from lateral aspect of the ...
, and visceral arteries (the
celiac trunk
The celiac () artery (also spelled ''coeliac''), also known as the celiac trunk or truncus coeliacus, is the first major branch of the abdominal aorta. It is about 1.25 cm in length. Branching from the aorta at thoracic vertebra 12 (T12) i ...
, the
superior mesenteric artery
In human anatomy, the superior mesenteric artery (SMA) is an artery which arises from the anterior surface of the abdominal aorta, just inferior to the origin of the celiac trunk, and supplies blood to the intestine from the lower part of the ...
and the
inferior mesenteric artery
In human anatomy, the inferior mesenteric artery, often abbreviated as IMA, is the third main branch of the abdominal aorta and arises at the level of L3, supplying the large intestine from the distal transverse colon to the upper part of the ana ...
). It ends in a bifurcation into the
left and right common iliac arteries. At the point of the bifurcation, there also springs a smaller branch, the
median sacral artery
The median sacral artery (or middle sacral artery) is a small artery that arises posterior to the abdominal aorta and superior to its bifurcation.
Structure
The median sacral artery arises from the abdominal aorta at the level of the bottom qu ...
.
Development
The ascending aorta develops from the outflow tract, which initially starts as a single tube connecting the heart with the
aortic arches
The aortic arches or pharyngeal arch arteries (previously referred to as branchial arches in human embryos) are a series of six paired embryological vascular structures which give rise to the great arteries of the neck and head. They are ventral ...
(which will form the great arteries) in early development but is then separated into the aorta and the pulmonary trunk.
The
aortic arches
The aortic arches or pharyngeal arch arteries (previously referred to as branchial arches in human embryos) are a series of six paired embryological vascular structures which give rise to the great arteries of the neck and head. They are ventral ...
start as five pairs of symmetrical arteries connecting the heart with the
dorsal aorta
The dorsal aortae are paired (left and right) embryological vessels which progress to form the descending aorta. The paired dorsal aortae arise from aortic arches that in turn arise from the aortic sac.
The primary dorsal aorta is located deep t ...
, and then undergo a significant remodelling to form the final asymmetrical structure of the
great arteries The great arteries are the primary arteries that carry blood away from the heart, which include:
* ''Pulmonary artery'': the vessel that carries oxygen-depleted blood from the right ventricle to the lungs.
* ''Aorta'': the blood vessel through whic ...
, with the 3rd pair of arteries contributing to the
common carotids, the right 4th forming the base and middle part of the right
subclavian artery
In human anatomy, the subclavian arteries are paired major arteries of the upper thorax, below the clavicle. They receive blood from the aortic arch. The left subclavian artery supplies blood to the left arm and the right subclavian artery supplie ...
and the left 4th being the central part of the
aortic arch
The aortic arch, arch of the aorta, or transverse aortic arch () is the part of the aorta between the ascending and descending aorta. The arch travels backward, so that it ultimately runs to the left of the trachea.
Structure
The aorta begins a ...
. The smooth muscle of the great arteries and the population of cells that form the
aorticopulmonary septum that separates the aorta and pulmonary artery is derived from
cardiac neural crest. This contribution of the neural crest to the great artery smooth muscle is unusual as most smooth muscle is derived from
mesoderm
The mesoderm is the middle layer of the three germ layers that develops during gastrulation in the very early development of the embryo of most animals. The outer layer is the ectoderm, and the inner layer is the endoderm.Langman's Medical E ...
. In fact the smooth muscle within the abdominal aorta is derived from mesoderm, and the coronary arteries, which arise just above the
semilunar valves
A heart valve is a one-way valve that allows blood to flow in one direction through the chambers of the heart. Four valves are usually present in a mammalian heart and together they determine the pathway of blood flow through the heart. A heart v ...
, possess smooth muscle of mesodermal origin. A failure of the aorticopulmonary septum to divide the great vessels results in
persistent truncus arteriosus
Persistent truncus arteriosus (PTA), often referred to simply as truncus arteriosus, is a rare form of congenital heart disease that presents at birth. In this condition, the embryological structure known as the truncus arteriosus (embryology), t ...
.
Microanatomy
![An opened aorta](https://upload.wikimedia.org/wikipedia/commons/4/40/An_opened_aorta.jpg)
The aorta is an
elastic artery
An elastic artery (conducting artery or conduit artery) is an artery with many collagen and elastin filaments in the tunica media, which gives it the ability to stretch in response to each pulse. This elasticity also gives rise to the Windkess ...
, and as such is quite distensible. The aorta consists of a heterogeneous mixture of
smooth muscle
Smooth muscle is an involuntary non-striated muscle, so-called because it has no sarcomeres and therefore no striations (''bands'' or ''stripes''). It is divided into two subgroups, single-unit and multiunit smooth muscle. Within single-unit mus ...
, nerves, intimal cells, endothelial cells, fibroblast-like cells, and a complex extracellular matrix. The vascular wall is subdivided into three layers known as the
tunica externa
The tunica externa (New Latin "outer coat"), also known as the tunica adventitia (New Latin "additional coat"), is the outermost tunica (layer) of a blood vessel, surrounding the tunica media. It is mainly composed of collagen and, in arteries, i ...
,
tunica media
The tunica media (New Latin "middle coat"), or media for short, is the middle tunica (layer) of an artery or vein. It lies between the tunica intima on the inside and the tunica externa on the outside.
Artery
Tunica media is made up of smooth m ...
, and
tunica intima
The tunica intima (New Latin "inner coat"), or intima for short, is the innermost tunica (layer) of an artery or vein. It is made up of one layer of endothelial cells and is supported by an internal elastic lamina. The endothelial cells are in ...
. The aorta is covered by an extensive network of tiny blood vessels called
vasa vasora, which feed the tunica externa and tunica media, the outer layers of the aorta.
The aortic arch contains
baroreceptor
Baroreceptors (or archaically, pressoreceptors) are sensors located in the carotid sinus (at the bifurcation of external and internal carotids) and in the aortic arch. They sense the blood pressure and relay the information to the brain, so that a ...
s and
chemoreceptor
A chemoreceptor, also known as chemosensor, is a specialized sensory receptor which transduces a chemical substance (endogenous or induced) to generate a biological signal. This signal may be in the form of an action potential, if the chemorecept ...
s that relay information concerning blood pressure and blood pH and carbon dioxide levels to the
medulla oblongata
The medulla oblongata or simply medulla is a long stem-like structure which makes up the lower part of the brainstem. It is anterior and partially inferior to the cerebellum. It is a cone-shaped neuronal mass responsible for autonomic (involun ...
of the brain. This information along with information from baroreceptors and chemoreceptors located elsewhere is processed by the brain and the
autonomic nervous system
The autonomic nervous system (ANS), formerly referred to as the vegetative nervous system, is a division of the peripheral nervous system that supplies viscera, internal organs, smooth muscle and glands. The autonomic nervous system is a control ...
mediates appropriate homeostatic responses.
Within the tunica media, smooth muscle and the extracellular matrix are quantitatively the largest components, these are arranged concentrically as musculoelastic layers (the elastic lamella) in mammals. The elastic lamella, which comprise smooth muscle and elastic matrix, can be considered as the fundamental structural unit of the aorta and consist of
elastic fiber
Elastic fibers (or yellow fibers) are an essential component of the extracellular matrix composed of bundles of proteins (elastin) which are produced by a number of different cell types including fibroblasts, endothelial, smooth muscle, and air ...
s,
collagen
Collagen () is the main structural protein in the extracellular matrix found in the body's various connective tissues. As the main component of connective tissue, it is the most abundant protein in mammals, making up from 25% to 35% of the whole ...
s (predominately type III),
proteoglycan
Proteoglycans are proteins that are heavily glycosylated. The basic proteoglycan unit consists of a "core protein" with one or more covalently attached glycosaminoglycan (GAG) chain(s). The point of attachment is a serine (Ser) residue to whic ...
s, and
glycoaminoglycan
Glycosaminoglycans (GAGs) or mucopolysaccharides are long, linear polysaccharides consisting of repeating disaccharide units (i.e. two-sugar units). The repeating two-sugar unit consists of a uronic sugar and an amino sugar, except in the case o ...
s.
The elastic matrix dominates the biomechanical properties of the aorta. The smooth muscle component, while contractile, does not substantially alter the diameter of the aorta, but rather serves to increase the stiffness and viscoelasticity of the aortic wall when activated.
Variation
Variations may occur in the location of the aorta, and the way in which arteries branch off the aorta. The aorta, normally on the left side of the body, may be found on the right in
dextrocardia
Dextrocardia (from Latin ''dextro'', meaning "right hand side," and Greek ''kardia'', meaning "heart") is a rare congenital condition in which the apex of the heart is located on the right side of the body, rather than the more typical placement t ...
, in which the heart is found on the right, or
situs inversus
Situs inversus (also called situs transversus or oppositus) is a congenital condition in which the major visceral organs are reversed or mirrored from their normal positions. The normal arrangement of internal organs is known as situs solitus. Al ...
, in which the location of all organs are flipped.
Variations in the branching of individual arteries may also occur. For example, the left
vertebral artery
The vertebral arteries are major arteries
An artery (plural arteries) () is a blood vessel in humans and most animals that takes blood away from the heart to one or more parts of the body (tissues, lungs, brain etc.). Most arteries carry o ...
may arise from the aorta, instead of the left
common carotid artery
In anatomy, the left and right common carotid arteries (carotids) (Entry "carotid"
in
patent ductus arteriosus
''Patent ductus arteriosus'' (PDA) is a medical condition in which the ''ductus arteriosus'' fails to close after birth: this allows a portion of oxygenated blood from the left heart to flow back to the lungs by flowing from the aorta, which has ...
, a congenital disorder, the fetal
ductus arteriosus
The ''ductus arteriosus'', also called the ''ductus Botalli'', named after the Italian physiologist Leonardo Botallo, is a blood vessel in the developing fetus connecting the trunk of the pulmonary artery to the proximal descending aorta. It allo ...
fails to close, leaving an open vessel connecting the
pulmonary artery
A pulmonary artery is an artery in the pulmonary circulation that carries deoxygenated blood from the right side of the heart to the lungs. The largest pulmonary artery is the ''main pulmonary artery'' or ''pulmonary trunk'' from the heart, and t ...
to the proximal
descending aorta
In human anatomy, the descending aorta is part of the aorta, the largest artery in the body. The descending aorta begins at the aortic arch and runs down through the chest and abdomen. The descending aorta anatomically consists of two portions o ...
.
[MedlinePlus > Patent ductus arteriosus]
Update Date: 21 December 2009
Function
![Aorta Anatomy](https://upload.wikimedia.org/wikipedia/commons/a/a0/Aorta_Anatomy.jpg)
The aorta supplies all of the systemic circulation, which means that the entire body, except for the
respiratory zone of the lung, receives its blood from the aorta. Broadly speaking, branches from the ascending aorta supply the heart; branches from the aortic arch supply the head, neck, and arms; branches from the thoracic descending aorta supply the chest (excluding the heart and the respiratory zone of the lung); and branches from the abdominal aorta supply the
abdomen
The abdomen (colloquially called the belly, tummy, midriff, tucky or stomach) is the part of the body between the thorax (chest) and pelvis, in humans and in other vertebrates. The abdomen is the front part of the abdominal segment of the torso. ...
. The pelvis and legs get their blood from the common iliac arteries.
Blood flow and velocity
The contraction of the heart during systole is responsible for ejection and creates a (pulse) wave that is propagated down the aorta, into the
arterial tree
In anatomy, arterial tree is used to refer to all arteries and/or the branching pattern of the arteries. This article regards the human arterial tree. Starting from the aorta:
the following are the parts
Ascending aorta
It is a portion of the a ...
. The wave is reflected at sites of impedance mismatching, such as
bifurcations reflected waves rebound to return to semilunar valves and the origin of the aorta. These return waves create the
dicrotic notch displayed in the aortic pressure curve during the
cardiac cycle
The cardiac cycle is the performance of the human heart from the beginning of one heartbeat to the beginning of the next. It consists of two periods: one during which the heart muscle relaxes and refills with blood, called diastole, following ...
as these reflected waves push on the
aortic semilunar valve
The aortic valve is a valve in the heart of humans and most other animals, located between the left ventricle and the aorta. It is one of the four valves of the heart and one of the two semilunar valves, the other being the pulmonary valve. The ...
.
With age, the aorta stiffens such that the pulse wave is propagated faster and reflected waves return to the heart faster before the semilunar valve closes, which raises the blood pressure. The stiffness of the aorta is associated with a number of diseases and pathologies, and noninvasive measures of the pulse wave
velocity
Velocity is the directional speed of an object in motion as an indication of its rate of change in position as observed from a particular frame of reference and as measured by a particular standard of time (e.g. northbound). Velocity is a ...
are an independent indicator of
hypertension
Hypertension (HTN or HT), also known as high blood pressure (HBP), is a long-term medical condition in which the blood pressure in the arteries is persistently elevated. High blood pressure usually does not cause symptoms. Long-term high bl ...
. Measuring the pulse wave velocity (invasively and non-invasively) is a means of determining
arterial stiffness
Arterial stiffness occurs as a consequence of biological aging and arteriosclerosis. Inflammation plays a major role in arteriosclerosis development, and consequently it is a major contributor in large arteries stiffening. Increased arterial stiff ...
. Maximum aortic velocity may be noted as V
max or less commonly as AoV
max.
Mean arterial pressure
In medicine, the mean arterial pressure (MAP) is an average blood pressure in an individual during a single cardiac cycle. MAP is altered by cardiac output and systemic vascular resistance.
Testing
Mean arterial pressure can be measured direct ...
(MAP) is highest in the aorta, and the MAP decreases across the circulation from aorta to arteries to arterioles to capillaries to veins back to atrium. The difference between aortic and right atrial pressure accounts for blood flow in the circulation. When the left ventricle contracts to force blood into the aorta, the aorta expands. This stretching gives the potential energy that will help maintain blood pressure during
diastole
Diastole ( ) is the relaxed phase of the cardiac cycle when the chambers of the heart are re-filling with blood. The contrasting phase is systole when the heart chambers are contracting. Atrial diastole is the relaxing of the atria, and ventric ...
, as during this time the aorta contracts passively. This
Windkessel effect
Windkessel effect is a term used in medicine to account for the shape of the arterial blood pressure waveform in terms of the interaction between the stroke volume and the compliance of the aorta and large elastic arteries (Windkessel vessels) an ...
of the great elastic arteries has important biomechanical implications. The elastic recoil helps conserve the energy from the pumping heart and smooth out the pulsatile nature created by the heart. Aortic pressure is highest at the aorta and becomes less pulsatile and lower pressure as blood vessels divide into arteries, arterioles, and capillaries such that flow is slow and smooth for gases and nutrient exchange.
Clinical significance
*
Aortic aneurysm
An aortic aneurysm is an enlargement (dilatation) of the aorta to greater than 1.5 times normal size. They usually cause no symptoms except when ruptured. Occasionally, there may be abdominal, back, or leg pain. The prevalence of abdominal aortic ...
– mycotic, bacterial (e.g.
syphilis
Syphilis () is a sexually transmitted infection caused by the bacterium ''Treponema pallidum'' subspecies ''pallidum''. The signs and symptoms of syphilis vary depending in which of the four stages it presents (primary, secondary, latent, an ...
), senile, genetic, associated with
valvular heart disease
Valvular heart disease is any cardiovascular disease process involving one or more of the four valves of the heart (the aortic and mitral valves on the left side of heart and the pulmonic and tricuspid valves on the right side of heart). These ...
*
Aortic coarctation
Coarctation of the aorta (CoA or CoAo), also called aortic narrowing, is a congenital condition whereby the aorta is narrow, usually in the area where the ductus arteriosus (ligamentum arteriosum after regression) inserts. The word ''coarctation' ...
– pre-
ductal
Lafarge is a French industrial company specialising in cement, construction aggregates, and concrete. It is the world's largest cement manufacturer. It was founded in 1833 by Joseph-Auguste Pavin de Lafarge and is a part of the Holcim Group.
...
, post-ductal
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Aortic dissection
Aortic dissection (AD) occurs when an injury to the innermost layer of the aorta allows blood to flow between the layers of the aortic wall, forcing the layers apart. In most cases, this is associated with a sudden onset of severe chest or ...
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Aortic stenosis
Aortic stenosis (AS or AoS) is the narrowing of the exit of the left ventricle of the heart (where the aorta begins), such that problems result. It may occur at the aortic valve as well as above and below this level. It typically gets worse ove ...
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Abdominal aortic aneurysm
Abdominal aortic aneurysm (AAA) is a localized enlargement of the abdominal aorta such that the diameter is greater than 3 cm or more than 50% larger than normal. They usually cause no symptoms, except during rupture. Occasionally, abdominal, ...
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Aortitis
Aortitis is the inflammation of the aortic wall. The disorder is potentially life-threatening and rare. It is reported that there are only 1–3 new cases of aortitis per year per million people in the United States and Europe. Aortitis is most com ...
, inflammation of the aorta that can be seen in trauma, infections, and autoimmune disease
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Atherosclerosis
Atherosclerosis is a pattern of the disease arteriosclerosis in which the wall of the artery develops abnormalities, called lesions. These lesions may lead to narrowing due to the buildup of atheroma, atheromatous plaque. At onset there are usu ...
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Ehlers–Danlos syndrome
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Marfan syndrome
Marfan syndrome (MFS) is a multi-systemic genetic disorder that affects the connective tissue. Those with the condition tend to be tall and thin, with long arms, legs, fingers, and toes. They also typically have exceptionally flexible joints a ...
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Trauma
Trauma most often refers to:
* Major trauma, in physical medicine, severe physical injury caused by an external source
* Psychological trauma, a type of damage to the psyche that occurs as a result of a severely distressing event
*Traumatic i ...
, such as
traumatic aortic rupture
Traumatic aortic rupture, also called traumatic aortic disruption or transection, is a condition in which the aorta, the largest artery in the body, is torn or ruptured as a result of trauma to the body. The condition is frequently fatal due to th ...
, most often thoracic and distal to the left subclavian artery and often quickly fatal
*
Transposition of the great vessels
Transposition of the great vessels (TGV) is a group of congenital heart defects involving an abnormal spatial arrangement of any of the great vessels: superior and/or inferior venae cavae, pulmonary artery, pulmonary veins, and aorta. Congenita ...
, see also
dextro-Transposition of the great arteries
dextro-Transposition of the great arteries (d-Transposition of the great arteries, dextro-TGA, or d-TGA) is a potentially life-threatening birth defect in the large arteries of the heart. The primary arteries (the aorta and the pulmonary artery) ...
and
levo-Transposition of the great arteries
Levo-Transposition of the great arteries is an acyanotic congenital heart defect in which the primary arteries (the aorta and the pulmonary artery) are transposed, with the aorta anterior and to the left of the pulmonary artery; the morphological ...
Other animals
All
amniote
Amniotes are a clade of tetrapod vertebrates that comprises sauropsids (including all reptiles and birds, and extinct parareptiles and non-avian dinosaurs) and synapsids (including pelycosaurs and therapsids such as mammals). They are disti ...
s have a broadly similar arrangement to that of humans, albeit with a number of individual variations. In
fish
Fish are aquatic, craniate, gill-bearing animals that lack limbs with digits. Included in this definition are the living hagfish, lampreys, and cartilaginous and bony fish as well as various extinct related groups. Approximately 95% of li ...
, however, there are two separate vessels referred to as aortas. The ventral aorta carries de-oxygenated blood from the heart to the
gill
A gill () is a respiratory organ that many aquatic organisms use to extract dissolved oxygen from water and to excrete carbon dioxide. The gills of some species, such as hermit crabs, have adapted to allow respiration on land provided they are ...
s; part of this vessel forms the ascending aorta in tetrapods (the remainder forms the
pulmonary artery
A pulmonary artery is an artery in the pulmonary circulation that carries deoxygenated blood from the right side of the heart to the lungs. The largest pulmonary artery is the ''main pulmonary artery'' or ''pulmonary trunk'' from the heart, and t ...
). A second, dorsal aorta carries oxygenated blood from the gills to the rest of the body and is
homologous with the descending aorta of tetrapods. The two aortas are connected by a number of vessels, one passing through each of the gills.
Amphibian
Amphibians are tetrapod, four-limbed and ectothermic vertebrates of the Class (biology), class Amphibia. All living amphibians belong to the group Lissamphibia. They inhabit a wide variety of habitats, with most species living within terres ...
s also retain the fifth connecting vessel, so that the aorta has two parallel arches.
History
The word ''aorta'' stems from the
Late Latin
Late Latin ( la, Latinitas serior) is the scholarly name for the form of Literary Latin of late antiquity.Roberts (1996), p. 537. English dictionary definitions of Late Latin date this period from the , and continuing into the 7th century in t ...
' from
Classical Greek
Ancient Greek includes the forms of the Greek language used in ancient Greece and the ancient world from around 1500 BC to 300 BC. It is often roughly divided into the following periods: Mycenaean Greek (), Dark Ages (), the Archaic peri ...
''aortē'' (), from ''aeirō'', "I lift, raise" () This term was first applied by
Aristotle
Aristotle (; grc-gre, Ἀριστοτέλης ''Aristotélēs'', ; 384–322 BC) was a Greek philosopher and polymath during the Classical period in Ancient Greece. Taught by Plato, he was the founder of the Peripatetic school of phil ...
when describing the aorta and describes accurately how it seems to be "suspended" above the heart.
The function of the aorta is documented in the
Talmud
The Talmud (; he, , Talmūḏ) is the central text of Rabbinic Judaism and the primary source of Jewish religious law (''halakha'') and Jewish theology. Until the advent of modernity, in nearly all Jewish communities, the Talmud was the cente ...
, where it is noted as one of three major vessels entering or leaving the heart, and where perforation is linked to death.
References
External links
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{{Authority control
Arteries of the thorax
Arteries of the abdomen
Cardiac anatomy