Trunk vessels (aorta, vena cava, abdominal branches)
Ascending aorta
Aorta ascendens
- Origin
- Arises from the aortic orifice of the left ventricle at the level of the 3rd left costal cartilage, containing the aortic sinuses of Valsalva
- Insertion
- Ascends approximately 5 cm anterosuperiorly to the right to terminate at the sternal angle (T4 level), continuing as the aortic arch
- Function
- Initial conduit of the systemic arterial tree, receiving total left ventricular stroke volume and dampening pulsatile flow via elastic Windkessel recoil
- Innervation
- Thoracic aortic plexus and vagal baroreceptor afferents
- Movement & chain
- Systolic radial expansion and diastolic elastic recoil
- Palpation
- Assessed at the 2nd right intercostal space (aortic auscultation area)
- Clinical
- Stanford type A aortic dissection (surgical emergency presenting with sudden severe tearing chest pain radiating to the back), ascending aortic aneurysm (associated with Marfan syndrome, bicuspid aortic valve, tertiary syphilis), aortic rupture.
- Segmental innervation
- T1-T4 cardiac spinal levels
- In clinical practice
- Emergency detection of bilateral blood pressure discrepancy (>20 mmHg systolic), aggressive anti-impulse therapy (IV beta-blockers reducing shear stress), immediate cardiothoracic surgical transfer
- Region in the model
- Trunk vessels (aorta, vena cava, abdominal branches)