10/27: Portal-Caval Venous System

Question 1

What do gut derivatives drain?

Answer 1

Blood to the liver first because they are carrying deoxygenated blood and nutrients that need to go to the liver
The liver then passes venous drainage to the IVC

Question 2

What is the function of the portal vein in the gut?

Answer 2

Nearly all venous blood from the gut is drained to the liver via portal vein

Question 3

What is the (obliterated) umbilical vein used for?

Answer 3

To carry blood in from the umbilical cord

Question 4

What is the umbilical vein accompanied by?

Answer 4

Tiny paraumbilical veins, which remain patent

Question 5

What do the paraumbilical veins drain?

Answer 5

Blood form skin around the umbilicus so that blood goes into portal vein

Question 6

What does the hepatic vein drain?

Answer 6

Blood from the liver to the IVC

Question 7

Splenic v and other foregut v have same names as arteries EXCEPT?

Answer 7

The celiac artery

Question 8

What does the superior mesenteric vein drain?

Answer 8

Midgut

Question 9

What does the inferior mesenteric vein drain?

Answer 9

Hindgut

Question 10

What does the inferior mesenteric vein join and empty into?

Answer 10

Splenic vein

Question 11

Where does the splenic vein run?

Answer 11

From hilum of spleen behind pancreas and stomach (inferior of a)

Question 12

What is the portal vein formed by and run?

Answer 12

Splenic and superior mesenteric vein; behind neck of pancreas

Question 13

Where does the pancreaticoduodenal veins drain?

Answer 13

Into portal vein and superior mesenteric

Question 14

Further you are to the left of the foregut, the more likely you are to drain into the ____________. On the right side, you are more likely to drain into the ______________.

Answer 14

Splenic vein; portal vein

Question 15

Where do foregut veins drain?

Answer 15

1. To the portal vein
2. to the splenic vein
3. to the superior mesenteric vein

Question 16

What veins drain to the portal vein?

Answer 16

Left/right gastric vv
Cystic v
Pancreaticduodenal vv (superficial veins around umbilicus)

Question 17

What veins drain into the splenic vein?

Answer 17

Short gastric vv
Left gastroomental v

Question 18

What veins drain into superior mesenteric vein?

Answer 18

Right gastroomental v
Pancreaticduodenal vv

Question 19

Tiny veins in the anastomoses can become engorged as a response to _____________

Answer 19

Portal hypertension

Question 20

What is portal hypertension?

Answer 20

Passage of venous blood from the portal vein through liver is impeded

Question 21

What are engorged veins called?

Answer 21

Varices

Question 22

What can portal hypertension be caused by?

Answer 22

Cancer, cirrhosis, thrombosis, or congenital malformation of the IVC

Question 23

What do anastomoses of the left gastric vein (branch of portal v) with the azygos vein (branch of SVC) result in?

Answer 23

Esophageal rupturing when food is swallowed and internal bleeding

*Most common cause of death in patients with hypertension

Question 24

What do anastomoses of the superior rectal vein (branch of portal v) with the middle and inferior rectal veins (branches of IVC) result in?

Answer 24

Rectal varices, of which bright red bleeding is a symptom. Upper GI bleeding is tar-colored stool

Question 25

What do anastomoses of the paraumbilical vein (branches of portral v) and thoracoepigastric and the inferior and superior epigastric veins (branches of IVC) result in?

Answer 25

Form caput medusae (Medusa’s head) pattern out from the umbilicus

Question 26

What do anastomoses between the inferior mesenteric vein (branch of portal v) and veins of the posterior abdominal wall, which are IVC branches and which are connected to the hemiazygos vein (branch of SVC) result in?

Answer 26

Very deep in the body, rarely becomes symptomatic

Question 27

Visceral pain axons for the thorax and abdomen follow sympathetic pathways ________________

Answer 27

Backwards, as far as the spinal nerve proper

Question 28

After passing through the sympathetic pathway backwards, where do they pass through?

Answer 28

Dorsal root

Question 29

Where are the cell bodies found?

Answer 29

In the dorsal root ganglia

Question 30

Where is somatic pain felt?

Answer 30

By the abdominal walls, including parietal peritoneum which is pain sensitive (particularly when inflamed and stretched)

Question 31

What carries somatic pain?

Answer 31

Ventral rami of spinal nerves

Question 32

What is visceral pain felt by?

Answer 32

Internal organs and brought about by ischemia, prolonged smooth muscle contraction, and distention

Question 33

What is visceral pain carried by?

Answer 33

Visceral pain axons that run alongside sympathetics

Question 34

Where isn’t pain felt by?

Answer 34

Visceral peritoneum that covers mesenteric arteries
Nor is pain felt by mesenteries