WordNet

a major thoroughfare that bears important traffic
a blood vessel that carries blood from the heart to the body (同)arteria, arterial blood vessel
of or relating to or constituting vertebrae
one of the bony segments of the spinal column

PrepTutorEJDIC

Veterans Administration 在郷軍人局 / Vice Admiral
動脈 / (道路・水路・鉄道などの)勘線,(通信の)主チャンネル
脊椎骨の;脊椎骨から成る
脊椎骨

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出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2017/01/11 04:05:40」(JST)

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The vertebral arteries are major arteries of the neck. They arise as branches from the subclavian arteries and merge to form the single midline basilar artery. As the vertebrobasilar system, they supply blood to the upper spinal cord, brainstem, cerebellum, and posterior part of brain.

Structure

Arteries of the neck. The vertebral arteries arise from the subclavian arteries and join to form the basilar artery

The vertebral arteries arise from the subclavian arteries, one on each side of the body, then enter deep to the transverse process at the level of the 6th cervical vertebrae (C6),^[1] or occasionally (in 7.5% of cases) at the level of C7. They then proceed superiorly, in the transverse foramen of each cervical vertebra.^[1] Once they have passed through the transverse foramen of C1 (also known as the atlas), the vertebral arteries travel across the posterior arch of C1 and through the suboccipital triangle^{[citation needed]} before entering the foramen magnum.^[1]

Nunziante Ippolito, a Neapolitan physician, identified the "angle of Nunziante Ippolito" to find the vertebral artery, between the anterior scalene muscle and the longus colli muscle.^[2]

Inside the skull, the two vertebral arteries join to form the basilar artery at the base of the Pons. The basilar artery is the main blood supply to the brainstem and connects to the Circle of Willis to potentially supply the rest of the brain if there is compromise to one of the carotids. At each cervical level, the vertebral artery sends branches to the surrounding musculature via the anterior spinal arteries.

Segments

The vertebral artery may be divided into four parts:

The first part runs upward and backward between the Longus colli and the Scalenus anterior. In front of it are the internal jugular and vertebral veins, and it is crossed by the inferior thyroid artery; the left vertebral is crossed by the thoracic duct also. Behind it are the transverse process of the seventh cervical vertebra, the sympathetic trunk and its inferior cervical ganglion
The second part runs upward through the foramina in the transverse processes of the C6 to C2 vertebræ, and is surrounded by branches from the inferior cervical sympathetic ganglion and by a plexus of veins which unite to form the vertebral vein at the lower part of the neck. It is situated in front of the trunks of the cervical nerves, and pursues an almost vertical course as far as the transverse process of the axis.
The third part issues from the C2 foramen transversarium on the medial side of the Rectus capitis lateralis. It is further subdivided into the vertical part V3v passing vertically upwards, crossing the C2 root and entering the foramen transversarium of C1, and the horizontal part V3h, curving medially and posteriorly behind the superior articular process of the atlas, the anterior ramus of the first cervical nerve being on its medial side; it then lies in the groove on the upper surface of the posterior arch of the atlas, and enters the vertebral canal by passing beneath the posterior atlantoöccipital membrane. This part of the artery is covered by the Semispinalis capitis and is contained in the suboccipital triangle—a triangular space bounded by the Rectus capitis posterior major, the Obliquus superior, and the Obliquus inferior. The first cervical or suboccipital nerve lies between the artery and the posterior arch of the atlas.
The fourth part pierces the dura mater and inclines medialward to the front of the medulla oblongata; it is placed between the hypoglossal nerve and the anterior root of the first cervical nerve and beneath the first digitation of the ligamentum denticulatum. At the lower border of the pons it unites with the vessel of the opposite side to form the basilar artery.

Variation

The left vertebral artery is usually larger and carries more blood.^[3] In 3-15% of the population, a bony bridge called the arcuate foramen covers the groove for the vertebral artery on vertebra C1.

Function

The three major arteries of the cerebellum: the SCA, AICA, and PICA. (Vertebrals labeled at bottom.)

Upper spinal cord, brainstem, cerebellum, posterior part of brain.^[1]

References

^ ^a ^b ^c ^d editor-in-chief, Susan Standring ; section editors, Neil R. Borley; et al. (2008). Gray's anatomy : the anatomical basis of clinical practice (40th ed.). London: Churchill Livingstone. ISBN 978-0-8089-2371-8.
^ http://www.treccani.it/enciclopedia/nunziante-ippolito_%28Dizionario_Biografico%29/^{[full citation needed]}
^ Albayrak, Ramazan; Degirmenci, B; Acar, M; Haktanir, A; Colbay, M; Yaman, M (2007). "Doppler sonography evaluation of flow velocity and volume of the extracranial internal carotid and vertebral arteries in healthy adults". J Clin Ultrasound. 35 (1): 27–33. doi:10.1002/jcu.20301. PMID 17149761.

Additional images

The arteries of the base of the brain.
Diagram of the arterial circulation at the base of the brain.
Relationship of the vertebral artery to the suboccipital muscles.

External links

Anatomy photo:28:09-0201 at the SUNY Downstate Medical Center
http://neuroangio.org/anatomy-and-variants/vertebral-artery/
MedEd at Loyola Neuro/neurovasc/navigation/vert.htm
Atlas image: n3a8p1 at the University of Michigan Health System
lesson5 at The Anatomy Lesson by Wesley Norman (Georgetown University) (vertebralcolumnfromleftweb)
Anatomy diagram: 13048.000-1 at Roche Lexicon - illustrated navigator, Elsevier
Anatomy diagram: 13048.000-3 at Roche Lexicon - illustrated navigator, Elsevier

UpToDate Contents

全文を閲覧するには購読必要です。 To read the full text you will need to subscribe.

1. 後方循環系の脳血管症候群 posterior circulation cerebrovascular syndromes
2. 特発性脳動脈および頚動脈の解離：臨床的特徴および診断 spontaneous cerebral and cervical artery dissection clinical features and diagnosis
3. 回転性めまいの病態生理、病因、および鑑別診断 pathophysiology etiology and differential diagnosis of vertigo
4. 特発性脳動脈および頚動脈の解離：治療および予後 spontaneous cerebral and cervical artery dissection treatment and prognosis
5. 虚血性脳卒中および一過性脳虚血発作の特定の原因に対する二次予防 secondary prevention for specific causes of ischemic stroke and transient ischemic attack

English Journal

Endovascular management of blunt aortic injury with an associated aberrant right subclavian artery: a report of three cases.

Reynolds TS, Donayre CE, Somma CG, Poggio WG, Kim KM, Nguyen T, White R.SourceDivision of Vascular and Endovascular Surgery, Department of Surgery, Harbor-UCLA Medical Center, Torrance, CA.
Annals of vascular surgery.Ann Vasc Surg.2011 Oct;25(7):979.e7-979.e12. Epub 2011 Jul 20.
Traumatic rupture of the aorta in the rare setting of the aberrant right subclavian artery (ARSA) requires special consideration to prevent the occurrence of a devastating posterior cerebral circulation stroke. We present three cases managed by using an endovascular approach, with a discussion of im
PMID 21764549

Hybrid treatment of aberrant subclavian artery aneurysm. Case report.

Rispoli P, Varetto G, Conforti M, Tallia C, Rossato D, Gandini G.SourcePostgraduate School of Vascular Surgery, University of Turin, Turin, Italy - pietro.rispoli@unito.it.
The Journal of cardiovascular surgery.J Cardiovasc Surg (Torino).2011 Oct;52(5):735-7. Epub 2008 Oct 24.
A 62-year-old man was incidentally diagnosed with a completely asymptomatic aberrant right subclavian artery (ARSA) aneurysm with a maximum diameter of 4.5 cm. This condition presents a postrupture mortality rate of 50% and the morbidity-mortality rates reported in the literature with traditional op
PMID 18948865

Japanese Journal

手術アプローチに工夫を要した頭蓋頚椎移行部脊索腫の2症例

寺西裕,河野道宏,野村征司,降旗真理子,金中直輔,阿部肇,三輪博志,楚良繁雄,佐藤博明
脳神経外科ジャーナル 20(5), 392-398, 2011-05-20
頭蓋頚椎移行部脊索腫の手術は頭蓋底外科の総合力が要求される.われわれはアプローチ方法を十分に検討し,満足できる切除をしえた2症例を経験した.症例1は斜台中部-C_1レベルの高さに位置し,左右への広がりが少ない腫瘍であり,前方からのアプローチを選択し,病変部の高さからLe Fort I型のtransmaxillar approachを採用した.症例2は斜台中部-C_2レベルの高さに位置し,外側への強 …
NAID 110008608124

非外傷性後頭蓋窩解離性脳動脈瘤における先行頭頚部痛の性状の重要性 : 当院における連続57例の検討

渡邊水樹,田中篤太郎,太田仲郎,中戸川裕一,釼持博昭,千村学,小泉慎一郎,藤本礼尚,稲永親憲,平松久弥,山本貴道,杉浦康仁,難波宏樹,花北順哉,堺常雄
脳神経外科ジャーナル 20(5), 381-390, 2011-05-20
非外傷性後頭蓋窩解離性脳動脈瘤の連続57例で,診断時の発症形式と平均年齢,先行頭頚部痛の時期と性状などを後方視的に検討した.頭頚部痛のみで全体の40%が診断され,SAHや脳梗塞で診断された症例の65%に血管解離痛と思われる先行頭頚部痛を認めた.SAH例と脳梗塞例では先行痛の特徴が異なったが,解離腔の伸展方向の相違とサブスタンスP線維の局在から説明可能である.先行痛を有する症例や,頭頚部痛のみの症例 …
NAID 110008608122

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★リンクテーブル★

リンク元	「椎骨動脈」「VA」
拡張検索	「traumatic vertebral artery dissection」
関連記事	「vertebral」

「椎骨動脈」

Vertebral artery
	The vertebral arteries arise from the subclavian arteries, unite as the basilar artery, and supplies blood to parts of the brain
	The branches of the subclavian artery and the course of the vertebral artery in the neck (schematic).
Details
Source	subclavian arteries
Branches	Meningeal branches; Posterior spinal; Anterior spinal; PICA; Basilar artery
Vein	vertebral vein
Supplies	Upper spinal cord, brainstem, cerebellum, posterior part of brain
Identifiers
Latin	arteria vertebralis
MeSH	A07.231.114.839
TA	A12.2.08.002
FMA	3956
	Anatomical terminology; [edit on Wikidata]