Introduction Lecture Big Red 05 25 21 Acute Aortic Syndrome 7/6/21 Case Presentations 7/8/21 AORTA The abdominal aorta ids divided into the suprarenal and infra-renal portionAshley Davidoff The Aorta Aorta and CirculationThe heart and lungs are positioned at the centre of all the organs in the body and they are understandably considered vital organs. Think of yourself as a little red cell within the vast and powerful environment of the circulatory system. Listen and feel the power of the pulse and the rush of all the rivers going back and forth, hither and thither, and around and around – imagine what goes on inside the system all the time – it is probably like walking through a rain forest with huge waterfalls, winding rivers and rivulets – a mixture of gushing power and calm meandering flow- but the colors are reds and blues instead of greens and yellows! Courtesy Ashley Davidoff MD 32059 Aorta and CirculationThe heart and lungs are positioned at the centre of all the organs in the body and they are understandably considered vital organs. Think of yourself as a little red cell within the vast and powerful environment of the circulatory system. Listen and feel the power of the pulse and the rush of all the rivers going back and forth, hither and thither, and around and around – imagine what goes on inside the system all the time – it is probably like walking through a rain forest with huge waterfalls, winding rivers and rivulets – a mixture of gushing power and calm meandering flow- but the colors are reds and blues instead of greens and yellows!Ashley Davidoff MD 32059d01 key words cardiac heart circulation artery vein introduction drawing Davidoff art Red White and Blue39533 This image combines the coronal view with the axial view and reflects the intimate relationships that the adrenals have with the kidneys as well as the great vessels of the abdomen. They literally have their fingers on the pulse of the aorta (red overlay)and the inferior vena cava (IVC) (blue overlay)Ashley Davidoffkeywordsadrenal kidney relations anatomy End Point of the Arterial Circulation is at the Capillaries and is also the Beginning of the Venous Circulation32368b05.800Ashley Davidoff MD A Simple Tube72845.800 aorta flow principles structure laminar flow turbulent flow normalAshley Davidoff MD 72835.800 72839 72831.800 72845.800 49483b01 The aorta is curved in shape and elastic in nature while blood is not a simple fluid and hence special circumstances exist72831.800 aorta flow principles structure laminar flow turbulent flow normal tube Davidoff Art Courtesy Ashley Davidoff MD 72835.800 72839 72831.800 72845.800 49483 Note the difference in the pressures between the left side of the circulation and the right. The left ventricular pressure reaches a systolic of 120mmHg, while the right atrial pressure is close to zero. This large difference allows blood to flow through the circulation. pressure principles49483b01key wordsheart cardiac LV left ventricle aorta aortic systemic circulation capillary capillaries arterioles venules right atrium RA right ventricle RV normal physiology pressures hemodynamicsAshley Davidoff Note the difference in the pressures between the left side of the circulation and the right. The left ventricular pressure reaches a systolic of 120mmHg, while the right atrial pressure is close to zero. This large difference allows blood to flow through the circulation. pressure principles49483b01 heart cardiac LV left ventricle aorta aortic systemic circulation capillary capillaries arterioles venules right atrium RA right ventricle RV normal physiology pressures hemodynamics Ashley Davidoff Laminar flowThis diagram reflects the laminar flow showing the almost parallel lines of flow that is characteristic of flow in the smaller tubes. Under resting conditions, laminar flow exists from the medium-sized bronchi onward down to the bronchioles. During exercise, the air flow is accelerated, and laminar flow may be confined only to the very small airways.Ashley Davidoff MD 42433b04.jpg Parabolic Flow – Highest Velocity in Center and Lowest on the Endotheliumkeywords velocity parabolic Laminar flow is the normal condition for blood flow throughout most of the circulatory system. characterized by concentric layers of blood move in parallel down the length of a blood vessel. highest velocity (Vmax) isin the center of the vessel. lowest velocity (V=0) is along the vessel wall. T flow profile is parabolic occurs in long, straight blood vessels, under steady flow conditions. Davidoff art Courtesy Ashley Davidoff MD47678d05 Parabolic Flow – Highest Velocity in Center and Lowest on the Endotheliumkeywords velocity parabolic Laminar flow is the normal condition for blood flow throughout most of the circulatory system. characterized by concentric layers of blood move in parallel down the length of a blood vessel. highest velocity (Vmax) isin the center of the vessel. lowest velocity (V=0) is along the vessel wall. T flow profile is parabolic occurs in long, straight blood vessels, under steady flow conditions. Davidoff art Courtesy Ashley Davidoff MD47678f12.800 Turbulent flowThis drawing shows the lines and circles of noisy turbulent flow, which is characteristic of flow in the larger airways.Courtesy of Ashley Davidoff M.D. 42434b07 Histology – Key to Aortic Function is its Elastic Layer (teal)The Innermost Layer is the Endothelium and Outermost is the Adventitia47678.800Ashley Davidoff MD Histology – Key to Aortic Function is its Elastic Layer (teal)The Innermost Layer is the Endothelium and Outermost is the Adventitia47678.800 Ashley Davidoff MD The Shape of Big Redkeywords aorta aortic valve sinotubular junction ascending aorta aortic arch brachiocephalic artery left common carotid artery left subclavian artery descending aorta normal TCVAshley Davidoff MD47676 Candy Cane Shape of the ArchKey Wordscandy cane shape aorta aortic valve sino-tubular junction ascending aorta aortic arch descending aorta normalAshley Davidoff47677c03 The Aortic Valve – 3 cusps thickened at the Edges Forming Commissures and Sinuses and Attached to the Annulus (red)The aortic valve (AV) lies central to many structures including the right ventricular outflow tract (RVOT), pulmonary valve (PV), left atrium (LA), right atrium (RA), and superior vena cava (SVC). aorta from above. In this diagram, the commissures are overlaid in green, the crescent shaped lunulae reflect the free edge of the leaflets and are overlaid in yellow, and the nodules of Arantii are overlaid in orange. The sinuses of Valsalva are like cups and are positioned between the free edges. (gray)47681d07Ashley Davidoff MD Aortic Annulus is attached to the Crux of the Heart heart cardiac embryology conal septum line drawing right atrium left atrium left ventricle right ventricle interatrial septum interventricular septum atrioventricular septum crux of the heart embryology anatomy01669b04Ashley Davidoff MD 01667b04 01667b04 01667b06 01667b07 01667b09 01667b14 01669b03