Variations and abnormalities of the arteries

Variants and anomalies of arteries in most cases can be divided into four groups:

1. absence of an artery and replacement by its branches of the next arteries;
2. change in the location of the arteries;
3. unusual topography of the arteries;
4. presence of an additional artery.

The venous arteries of the heart can often depart from the aorta directly above its semilunar valves (12% of cases). Sometimes coronary arteries start from the left subclavian artery. Often there is one or two additional coronary arteries.

The arch of the aorta can sometimes be shortened, rarely bends to the right, settling over the right main bronchus. Very rarely, the aortic arch is doubled, both aortas span from both sides of the esophagus and trachea. In 7-12% of cases there are variants of branches departing from the arch of the aorta. The number of branches from 1 to 7. Sometimes both common carotid arteries leave a single trunk. Often the right common carotid and right subclavian artery separate from the arch of the aorta. From the aorta, one or two vertebral arteries can depart.

The common carotid artery in the place of its origin in 77% of cases has an extension (bulb). In 33% of cases, the enlargement is at the site of the beginning of the internal carotid artery, 45% at the level of its middle part, 33% at the beginning of the external carotid artery.

The upper thyroid artery is sometimes doubled, rarely absent, on the one hand, replaced by the branches of the same-named artery of the opposite side. There is the lowest thyroid artery, starting directly from the arch of the aorta.

The lingual artery is changeable in relation to the place of origin. In 55% of cases, it starts from the external carotid artery at the level of the hyoid bone. Very rarely a lingual artery is absent. In 14-20% of cases, it begins with a common trunk in conjunction with the facial artery.

The occipital, posterior ear and ascending pharyngeal arteries can begin at a different level from the external carotid artery, and have a different diameter. Each of these arteries can sometimes be absent.

The maxillary artery is variable with respect to the place of origin, caliber. Often has additional branches (the uppermost pharyngeal artery, etc.).

The superficial temporal artery sometimes doubles, is rarely absent, often gives additional branches that extend in different directions.

The internal carotid artery is sometimes absent from one side. Rare branches of the internal carotid artery include the pharyngeal artery, occipital, lingual artery, transverse artery of the face, palatine and other arteries. From the internal carotid artery, the lower thyroid artery, the inferior lower thyroid artery, the bronchial artery, the lateral artery of the mammary gland can depart.

The subclavian artery sometimes passes in the thickness of the anterior staircase. From the subclavian artery, additional branches can branch to the main bronchus, the lower thyroid artery (in 10% of cases), the transverse artery of the scapula, the ascending cervical artery, the upper intercostal artery, the deep cervical artery (in 5% of cases), the additional vertebral artery, the inner thyroid, the lower additional thyroid, the lateral artery of the breast, often - the dorsal artery of the scapula.

The vertebral artery rarely departs from the subclavian artery by two trunks, which then merge into one. Sometimes one trunk of the vertebral artery departs from the subclavian artery, and the other - from the arch of the aorta. Very rarely there is an additional (third) vertebral artery that extends from the lower thyroid artery. Sometimes the vertebral artery enters the canal of the transverse processes at the level of V, IV or even II-III cervical vertebrae. From the vertebral artery, the lower thyroid, the upper intercostal, the deep cervical artery occasionally depart. The lower posterior cerebellar artery is often absent.

The optic trunk often gives the transverse artery of the neck. Rarely, the vertebral artery, the medial artery of the mammary gland (in 5% of cases), the deep artery of the neck, the upper intercostal artery, the inner thyroid artery disappear from it. The ascending cervical artery is often very thin, starts with a short common trunk together with the superficial cervical artery. The costal cervical trunk is often absent.

The transverse artery of the neck is often absent, often leaves directly from the subclavian artery. The branches of the transverse artery of the neck may be the medial thyroid and deep cervical arteries.

The number of branches of the axillary artery, their topography are variable. The posterior artery circumscribing the humerus often departs together with the deep arteries of the shoulder. The anterior and posterior arteries surrounding the humerus often move away from the axillary artery together. Lateral thoracic and chest cavity arteries can leave 3-4 trunks each, sometimes one of these arteries is absent. The following additional branches of the axillary artery are known: the transverse artery of the scapula, the superior collateral ulnar artery, the deep artery of the shoulder, the radial artery.

The brachial artery rarely divides into the radial and ulnar arteries very low (on the forearm), in 8% of cases - unusually high. In 6% of cases, the radial and ulnar arteries are divided not by the brachial, but by the axillary artery; with a brachial artery absent. Sometimes there is an additional branch of the brachial artery - the superficial middle artery of the forearm. Upper and lower collateral ulnar arteries may be absent, each of them is variable in degree of severity, topography. From the brachial artery rarely subscapular artery, anterior and posterior arteries, circumscribing the humerus (individually or both together), an additional radial collateral artery, an additional deep artery of the shoulder.

The radial artery is rarely absent or is superficial than normal. Sometimes the radial artery reaches only the middle of the forearm, more often it exceeds the elbow artery in diameter. From the radial artery, sometimes the right rear artery of the index finger extends.

The ulnar artery is sometimes located directly on the fascia of the forearm, subcutaneously. From the ulnar artery, as an additional branch, sometimes an additional recurrent ulnar artery, an interosseous recurrent artery, an average ulnar artery, an additional interosseous artery, a median artery, the first and second common palmar finger arteries. With high division of the brachial artery, the interosseous anterior artery (branch of the common interosseous artery) is sometimes absent.

Variants of the arteries of the hand are numerous. They manifest themselves in the form of different combinations of arteries that make up the superficial and deep arterial arch. The most frequent variants of the arteries of the hand are the following:

1. the superficial palmar arc is absent. Common palmar finger arteries to the elevation of the thumb and the index finger (sometimes the middle finger) extend directly from the palmar branch of the radial artery. The branches to the other fingers move away from the arcuate elbow artery. The deep palmar arc is usually poorly expressed;
2. the superficial palmar arc is very thin, the deep palmar arch is well expressed. The branches of the superficial palmar arc supply blood of the third and fourth fingers, the rest of the blood supply from the deep palmar arc;
3. the superficial palmar arc is well expressed, the end of the radial artery and the deep palmar arc are very thin. Common palmar finger arteries move away from the surface arc to all fingers;
4. the superficial palmar arc is doubled. From the palmar surface branch of the radial artery, the common palmar finger arteries extend to the II-IV fingers, to the remaining fingers - from the deep palmar arch.

The thoracic part of the aorta often gives unstable branches: the upper intercostal, right renal, lower right bronchial artery. Very rarely, the right subclavian artery departs from the thoracic part of the aorta. The esophageal and mediastinal branches of the thoracic part of the aorta are variable in number and position, the posterior intercostal arteries by number. Sometimes one intercostal artery supplies two or three adjacent intercostal spaces. The lower two intercostal arteries can begin with a common trunk. Sometimes the bronchial artery departs from the third posterior intercostal artery.

The abdominal part of the aorta can give an additional left gastric artery (a frequent variant), an additional hepatic, an additional spleen, an additional lower diaphragm artery. From the ventral part of the aorta, the upper artery of the pancreas, the lower adrenal, and additional testicle (ovarian) arteries can depart. Variable amount of lumbar arteries (from 2 to 8). Sometimes there is an additional middle sacral artery. From the area of the aortic bifurcation, sometimes extend the additional renal arteries, the lower epigastric artery, the right external iliac artery.

The celiac trunk can be absent, its branches depart from the aorta independently. Sometimes the celiac trunk is divided into a common hepatic and splenic artery. Additional branches of the celiac trunk may be the superior mesenteric, additional spleen arteries, the superior artery of the pancreas. From the left gastric artery sometimes leaves the lower diaphragmatic artery, a branch to the left lobe of the liver, an additional artery to the spleen. The common hepatic artery is rarely absent, it can be very thin, sometimes it starts from the superior mesenteric artery. A common hepatic artery can give an edge branch to the tailed lobe of the liver, a branch to the gastric pyloric, lower diaphragm artery, left gastric artery, an extra artery of the gallbladder, an additional spleen artery. The gastroduodenal artery sometimes gives up the left hepatic branch or the right gastric artery. The right hepatic branch of the hepatic artery in 10% of cases is located in front, and not behind the hepatic duct. The splenic artery is sometimes doubled, left gastric, middle, and hepatic arteries can depart from it.

The non-permanent branches of the superior mesenteric artery are their own hepatic artery (very rarely), its left branch, 1-2 arteries of the gallbladder, splenic, gastro-spleen or right (rarely left) gastric-gland arteries, right gastric artery. Sometimes, from the anterior semicircumference of the superior mesenteric artery, the secondary middle artery extends.

The lower mesenteric artery is variable in its level of origin, sometimes absent. From it may be an additional secondary medullary, additional hepatic, additional rectal, vaginal arteries. The connection of the inferior mesenteric and middle colonic artery (rhyolane arch) is often absent.

The middle adrenal artery departs from the ovarian artery (often on the right). The right and left ovary (ovarian) arteries can move away from the aorta with a common trunk. Rarely, the ovarian (ovarian) arteries are doubled from one or both sides. Sometimes they start from the renal or middle adrenal artery.

The renal arteries often go above or below their normal position, their number can be up to 3-5. Additional renal arteries extend from the inferior mesenteric or common iliac artery. From the renal artery, the lower diaphragmatic, intrinsic hepatic, jejunus and ileo-intestinal arteries, middle adrenal, ovarian (arterial) arteries, branches to the pancreas, additional lower adrenal arteries, additional branches to the diaphragm legs can depart from the renal artery.

Common iliac arteries sometimes give additionally additional mesenteric, renal arteries, 2-4 lumbar, middle sacral, additional renal, ilio-lumbar, upper lateral sacral, umbilical and obstructive arteries.

The external iliac artery is extremely rarely doubled. Its length can be from 0.5 to 14 cm. The lower epigastric artery may be absent, sometimes doubled, its length varies from 0.5 to 9 cm. The deep artery surrounding the iliac bone is often doubled. Additional branches of the external iliac artery may be the occlusion artery (in 1.7% of cases), ilio-lumbar, superficial epigastric artery, deep femur artery, external genital artery.

The internal iliac artery is rarely doubled, it can have a twisted course.

The ilio-lumbar artery is sometimes doubled, rarely absent. Both lateral sacral arteries can branch out with a common trunk.

The obstructive artery gives additional branches: the ilio-lumbar artery, the additional hepatic, the lower vesicle, the vesicle-prostate, the uterine, the vaginal, the back artery of the penis, the artery of the bulb of the penis, etc. The occlusive artery may depart from the lower epigastric artery, in 10% of cases is formed from the fusion of two branches extending from the lower epigastric and deep artery surrounding the iliac bone (the two-rooted blockage artery).

The upper gluteal artery sometimes begins with a joint trunk with a blockage artery or with the lower rectal artery, uterine or internal genital artery. The umbilical artery is seldom absent on one side. The inconsistent branches of the umbilical artery are the middle rectum artery, the vaginal, the inferior lower rectal artery. Additional branches of the lower vesicovirus artery may be an additional internal sexual and prostate arteries. From the uterine artery, the average rectal and unpaired artery of the vagina may depart.

The internal sexual artery often begins in conjunction with the lower gluteal artery, sometimes with the occlusal, umbilical or lower urinary artery. The non-permanent branches of the internal sexual artery can be: lower urinary bladder artery, middle rectal artery, uterine artery, prostatic artery, sciatic nerve artery.

The internal thoracic artery is sometimes doubled. From the femoral artery, the iliopsoas artery, seldom - the dorsal artery of the penis, the lower epigastric (in 8% of cases), (the blocking in 2% of cases), the additional superficial epigastric artery, the perforating artery, the hypodermic artery of the femur, and the anterior in 11% of cases) and the posterior (in 22% of cases) arteries enveloping the femur. External genitalia are sometimes absent, replaced by the branches of the deep thigh artery.

The deep thigh artery sometimes starts unusually high, directly under the inguinal ligament, or below the usual one. Rarely, the deep thigh artery originates from the external iliac artery. From the deep thigh artery, the lower epigastric artery (in 0.5% of cases), the occlusion artery, the posterior artery of the penis, the superficial epigastric and other arteries can additionally leave. The medial artery circumscribing the femur, sometimes starts with a common trunk with a blockage artery.

The popliteal artery is very rarely doubled in a short space. Its additional branches are: peroneal artery, additional posterior tibial, recurrent posterior bulio-iliac artery, small subcutaneous artery. In 6% of cases, the middle artery of the knee departs from the upper lateral and medial artery of the knee.

The anterior tibial artery sometimes is very thin, ending above the lateral ankle joint with the branch of the peroneal artery. Additional branches of the anterior stenotic artery may be the middle artery of the knee, the common peroneal artery, additional lateral arteries of the tarsus, the medial artery of the tarsus.

The posterior tibial artery is rarely absent. In 5% of cases, it is very thin and reaches only the middle third of the shin. Additional branches of the posterior tibial artery may be an additional fibular artery, a large subcutaneous artery (accompanying the epithelium with the same vein). The fibular artery is absent in 1.5% of cases.

Variants of the arteries of the foot are more rare than the arteries of the hand, most of them are due to the change in position, the presence or absence of the main branches of the anterior and posterior tibial arteries, the peroneal artery, their branches.