Branches of the Thoracic Aorta

In addition to the coronary arteries and the common brachiocephalic trunk (which have been described), the thoracic part of the aorta gives off branches to the thoracic walls and viscera and to the spinal cord and its membranes. The visceral branches (Rami viscerales) are the bronchial and œsophageal, which arise by a broncho-œsophageal trunk. The parietal branches (Rami parietales) are the intercostal and phrenic arteries.

1. The broncho-œsophageal (Truncus broncho-œsophageus) is a short, usually bulbous, trunk which arises at the sixth thoracic vertebra from the aorta or in common with the first aortic intercostal arteries. It passes (under cover of the vena azygos) down the right face of the aorta toward the bifurcation of the trachea and divides into bronchial and œsophageal branches.

(a) The bronchial artery (A. bronchialis) crosses the left face of the œsophagus to the bifurcation of the trachea, where it divides into right and left branches. Each enters the hilus of the corresponding lung above the bronchus, which it accompanies in its ramification. It supplies the lung tissue and also detaches twigs to the bronchial lymph glands and the mediastinum.

(b) The œsophageal artery (A. œsophagea) (Fig. ) is a small vessel which passes backward above the œsophagus in the posterior mediastinum and anastomoses with the œsophageal branch of the gastric artery. It detaches twigs to the œsophagus and the mediastinal lymph glands and pleura, and also gives off two branches which pass between the layers of the ligaments of the lungs and ramify in the subpleural tissue. Very commonly there is another artery which runs backward ventral to the œsophagus.

In some cases there is no broncho-œsophageal trunk, the bronchial and œsophageal arising separately. In other cases the second aortic intercostal arises in common with them also.

2. The intercostal arteries (Aa. intercostales) (Figs. , ) number eighteen pairs. The first arises from the deep cervical artery, the next three from the subcostal branch of the dorsal artery, and the remainder from the aorta. The aortic intercostals arise from the dorsal face of the aorta in pairs close together; the fifth and sixth usually spring from a common stem. Each passes across the body of a vertebra to the corresponding intercostal space, detaches twigs to the vertebræ and the pleura, and divides into dorsal and ventral branches. The dorsal branch (Ramus dorsalis) gives off a spinal branch (Ramus spinalis) which passes through the intervertebral foramen, gives twigs to the membranes of the spinal cord, perforates the dura, and reinforces the ventral spinal artery. A muscular branch passes to the muscles and skin of the back. The ventral branch (Ramus ventralis) is much the larger. It passes downward, at first almost in the middle of the intercostal space between the intercostal muscles, then gains the posterior border of the rib and is subpleural. Each is accompanied by a vein and nerve, the artery being in the middle and the vein in front. At the lower part of the space it unites with a ventral intercostal branch of the internal thoracic or the asternal artery. It supplies the intercostal muscles, the ribs and the pleura, and gives off perforating branches which pass out to the serratus magnus, the abdominal muscles, and the skin.

3. The phrenic arteries (Aa. phrenicæ) are two or three small vessels which arise at the hiatus aorticus from the ventral aspect of the aorta, often by a common trunk. They supply the crura of the diaphragm. In some cases they arise in common with an intercostal artery.