![]() : 216 An anatomical variation is that the left vertebral artery can arise from the aortic arch instead of the left subclavian artery. Finally, the left subclavian artery comes off of the aortic arch to the left of the left common carotid artery and ascends, with the left common carotid, through the superior mediastinum and along the left side of the trachea. ![]() Next, the left common carotid artery originates from the aortic arch to the left of the brachiocephalic trunk, then ascends along the left side of the trachea and through the superior mediastinum. The first, and largest, branch of the arch of the aorta is the brachiocephalic trunk, which is to the right and slightly anterior to the other two branches and originates behind the manubrium of the sternum. The aortic arch has three main branches on its superior aspect. Arch of aorta continues as the descending aorta after T4 vertebral body. Inferiorly, the arch of aorta is connected to ligamentum arteriosum while superiorly, it gives rise to three main branches. Apart from T4 vertebral body, other structures such as trachea, oesophagus, and thoracic duct (from front to back) also lies to the left of the aorta. The aorta then passes posteriorly and to the left, anterior to the trachea, and arches over left main bronchus and left pulmonary artery, and reaches to the left side of the T4 vertebral body. The right lung and sternum lies anterior to the aorta at this point. and runs at first upward, arches over the pulmonary trunk, right pulmonary artery, and right main bronchus to lie behind the right second coastal cartilage. The first few centimeters of the ascending aorta and pulmonary trunk lies in the same pericardial sheath. The aorta begins at the level of the upper border of the second/third sternocostal articulation of the right side, behind the ventricular outflow tract and pulmonary trunk. The arch travels backward, so that it ultimately runs to the left of the trachea. 1, 2, 4 More than 20 different aortic arch configurations have been described, but those specifically described previously are by far the most commonly encountered.The aortic arch, arch of the aorta, or transverse aortic arch ( English: / eɪ ˈ ɔːr t ɪ k/ ) is the part of the aorta between the ascending and descending aorta. Both variants of left common carotid artery origin have been called in various textbooks and medical articles a “bovine-type arch,” though this term is most commonly ascribed to the common trunk variety. 1- 4 A similar but less common variant occurs when the left common carotid artery originates directly from the innominate artery rather than as a common trunk ( Fig 3). ![]() This variant is most often termed a “bovine aortic arch” ( Fig 2). Rather than arising directly from the aortic arch as a separate branch, the left common carotid artery origin is moved to the right and merges with the origin of the innominate artery. 3 The second most common variant of aortic arch branching occurs when the left common carotid artery has a common origin with the innominate artery. The final configuration of the aortic arch and its branches is probably related to different growth rates in the various arteries and the associated “migration” and “merging” of the branches. The second branch in the most common pattern is the left common carotid artery, and the last branch is the left subclavian artery. The first branch is the innominate artery, which branches into the right subclavian artery and the right common carotid artery. The most common aortic arch branching pattern in humans consists of 3 great vessels originating from the arch of the aorta ( Fig 1). We describe the specific anatomic appearance of human and bovine aortic arch branching patterns and propose a simple nomenclature scheme that should supplant the use of the term “bovine aortic arch” in humans. However, the bovine aortic arch configuration ascribed to the most common human aortic arch variants bears no resemblance to the aortic arch branching pattern found in cattle. By its name, the bovine aortic arch in humans would presumably resemble the aortic arch branching pattern found in the family of ruminant animals, including cattle and buffalo. 1, 2 This term refers to a common anatomic configuration of the aortic arch. One of the most widely used misnomers in the medical literature is that of the “bovine aortic arch” in humans. We describe the most common human aortic arch branching patterns and compare these with the bovine aortic arch. This so-called bovine aortic arch has no resemblance to the bovine aortic arch. SUMMARY: The term “bovine arch” is widely used to describe a common anatomic variant of the human aortic arch branching.
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