Arch of Aorta

• Origin and course:
  • Begins at the level of the upper border of the second sternocostal articulation on the right side
  • Arches upward, backward, and to the left in front of the trachea  .
  • At the lower border of fourth thoracic vertebra it becomes the descending aorta.
• Relationship
• Its upper border is usually about 2.5 cm. below the superior border of the manubrium sterni.Anteriorly and to the left
• The left lung and pleura
• Posteriorly and right
• Trachea
• Esophagus
• Spine 
• Superiorly
• Brachiocephalic arteryLCCALeft subclavian artery
• Left brachiocephalic vein
• Inferiorly
  • Bifurcation of the pulmonary artery
  • The left main bronchus
• Branches
  • Three vessels arise from the arch of the aorta
    • Brachiocephalic
      • First branch
      Left common carotid
      • Middle branch
    • Left subclavian
      • Last branch
• Appearance in
  • CXR PA view: Only Aoreic knob is identifiable.
  • CXR Lateral
  • CT angiogram
  • Angiogram