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The thoracic aorta is a continuation of the descending aorta and becomes the abdominal aorta when it passes through the diaphragm. The initial part of the aorta , the ascending aorta , rises out of the left ventricle, from which it is separated by the aortic valve .
The descending aorta begins at the aortic arch and runs down through the chest and abdomen. The descending aorta anatomically consists of two portions or segments, the thoracic and the abdominal aorta, in correspondence with the two great cavities of the trunk in which it is situated.
A thoracic aorta greater than 4.5 cm is generally defined as aneurysmal, while a size greater than 5.5 cm is the distinction for treatment, which can be either endovascular or surgical, with the former reserved for pathology at the descending aorta.
The vast majority of aortic dissections originate with an intimal tear in either the ascending aorta (65%), the aortic arch (10%), or just distal to the ligamentum arteriosum in the descending thoracic aorta (20%). [clarification needed] As blood flows down the false lumen, it may cause secondary tears in the intima.
Major aorta anatomy displaying ascending aorta, brachiocephalic trunk, left common carotid artery, left subclavian artery, aortic isthmus, aortic arch, and descending thoracic aorta. 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.
Aortic unfolding is an abnormality visible on a chest X-ray, that shows widening of the mediastinum which may mimic the appearance of a thoracic aortic aneurysm. [1]With aging, the ascending portion of the thoracic aorta increases in length by approximately 12% per decade, whereas the diameter increases by just 3% per decade.
Between the mobile ascending aorta and the relatively fixed descending thoracic aorta is the aortic isthmus. When there is a sudden deceleration the mobile ascending aorta pushes forward creating a whiplash effect on the aortic isthmus. [9] However, a different mechanism is involved when the ascending aorta proximal to the isthmus is torn.
The aortic hiatus is a midline [1]: 185 opening in the posterior part of the diaphragm giving passage to the descending aorta as well as the thoracic duct, and variably the azygos and hemiazygos veins. [2] It is the lowest and most posterior of the large apertures. [citation needed]
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