10/25: Aorta/IVA/Lymphatics Flashcards
What is primarily retroperitoneal?
Abdominal aorta
Where does the aorta enter the abdomen through?
The aortic hiatus at T12
Where does the aorta descend to?
Left of the midline before dividing into common iliac arteries at L4
What are the three categories of the branches of the abdominal aorta?
- Branches to the body wall
- Branches to the kidneys and to glans
- branches to the gut
What are the branches to the body wall?
Inferior phrenic a
Lumbar arteries
Medial sacral a
What do the inferior phrenic arteries supply?
Body wall (Diaphragm) and visceral structures (suprerenal gland, supplied by branched superior suprarenal arteries)
What do the lumbar arteries supply?
Posterior abdominal wall
What occurs at L4?
Bifurcation
Where does the medial sacral artery run and lie?
At midline of body; on anterior surface of sacrum
All vessels are ____________ but _____________
Bilateral; asymmetric
What supply the kidneys?
Renal arteries (1 pair)
What supplies the suprarenal glands?
Suprarenal arteries (3 pairs (superior, middle, inferior))
What supply either the testes (testicular aa.) or the ovaries (ovarian aa)
Gonadal arteries (1 pair)
What glands have no functional relationship with kidney?
Suprarenal glands
Describe the right suprarenal glands
Right is triangular in shape and right is curved
Describe the left renal and suprarenal arteries in comparison to right
SHORTER than right (aorta lies slightly leftwards)
All three branches to the gut are _______________
unpaired
What supplies foregut derivatives?
celiac artery (upper L1 body)
What supplies midgut derivatives?
superior mesenteric artery (Lower L1 body)
What supplies hindgut derivatives?
inferior mesenteric artery (L3 body)
What does the inferior vena cava return?
nearly all of the venous blood from structures below the diaphragm
What doesn’t the inferior vena cava drain directly?
The gut
Where does the inferior vena cava form?
At L5 region from joining common iliac veins
Where does the inferior vena cava ascend slightly to?
The right of the midline (and right of aorta)
What does the inferior vena cava pierce?
The diaphragm at T8 and enters the right atrium
The inferior vena cava has no direct branches from the ____________
gut
What do hepatic veins drain?
Venous blood form liver into IVC
What are the exceptions of the inferior vena cava being similar to abdominal aorta?
- only one pair of suprarenal veins
- right suprarenal and gonadal vein drains directly to IVC
- Left suprarenal and left gonadal vein drain into left renal vein (avoid crossing over aorta where they could potentially be compressed)
Where do the hemiazygous and azygous start from?
Vertical connections of veins from posterior abdominal wall
What veins are asymmetric?
Suprarenal and gonadal vv
How many pairs of the suprarenal vv are there?
One
Where does the R. suprarenal vein drain into?
Directly to IVC
Where does the right gonadal vein drain into?
Gonadal vein
Where does the L. suprarenal vein drain into?
Renal vein
Where does the L. gonadal vein drain into
renal vein
What do the subcostal and lumbar veins connect by?
Vertically running ascending lumbar vein
Where does the varicocele form from?
Left pampiniform plexus of veins
in vas deferens, when veins enlarge and swell it feels like…
bag of worms
Where is varicocele common on?
Left side because left renal vein is susceptible to be compressed by superior mesenteric
What leis to the right of the aorta?
IVC
Where does the left renal vein cross?
Anterior to the aorta with SMA running anterior to that
Where does the right testicular/ovarian artery pass?
Anterior to the IVC
Where does the IVC form (bifurcate)?
At L5, one level inferior to the division of the aorta
Where does the aorta bifurcate?
L4
Where do the common iliac veins lie?
Posterior to the common iliac a
Where does the median sacral artery lie?
Behind the left common iliac vein
Where does the lymph from gut follow arteries?
Backwards
Where does lymph from gut collect and drain?
Collect into large intestinal trunks, drain into cisterna chyli
Where is the cisterna chyli?
Between aorta and vertebral column at L1
Beginning of thoracic duct
Where does lymph from body wall drain into?
Aortic lymph nodes which then drain into thoracic duct
Where does lymph from gonads drain?
Through nodes distributed with the arteries
Where does lymph from skin above umbilicus drain into?
Axillary nodes
Where does lymph from below the umbilicus drain into?
Superficial inguinal nodes and then deep to inguinal and aortic nodes
Where does the bare area of the liver drain some of the liver’s lymph?
Through the diaphragm to the thoracic lymph odes
**important route of metastasis
Where does the descending and sigmoid colon drain some lymph?
Into posterior abdominal wall
**important route of metastasis
