Anatomy MCQ 0004

In post-ductal coarctation of the aorta, blood flow to the lower limbs in maintained by increased blood flow through:

1. Inferior Phrenic and pericardio phrenic vessels
2. Intercostal and Superior epigastric
3. Sub costal and Umbilical
4. Umbilical and superior gastric

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The Correct option is B

Explanation with High Yield Facts :

Coarctation (stenosis/narrowing) of aorta is due to defect in the tunica media, which forms a shelf like projection into the lumen, most commonly in the region of the ductus arteriosus.

• A collateral circulation develops distal to the obstruction between subclavian artery (internal thoracic artery) & descending aorta (posterior intercostal arteries).
• This anastomosis produces characteristic notching of the ribs on X-RAY.
• Superior epigastric is a branch of internal thoracic artery and gives the anterior intercostal arteries in the lower intercostal spaces.
• Coarctation of the aorta is of three types:

1. Pre-ductal coarctation: The narrowing is proximal to the ductus arteriosus. If severe, blood flow to the aorta distal (to lower body) to the narrowing is dependent on a patent ductus arteriosus, and hence its closure can be life-threatening.
2. Ductal coarctation: The narrowing occurs at the insertion of the ductus arteriosus. This kind usually appears when the ductus arteriosus closes.
3. Post-ductal coarctation: The narrowing is distal to the insertion of the ductus arteriosus. Even with an open ductus arteriosus blood flow to the lower body can be impaired. Newborns with this type of coarctation may be critically sick from the birth.

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