15. Blood Supply to the Gut Flashcards
What is the main blood supply to the GI system?
What are some other abdominal arteries?
What are the spinal levels of the main branches coming off the abdominal aorta that supply the GI system?
3 unpaired arteries that supply the 3 embryological areas of the gut: foregut = coeliac trunk, midgut = superior mesenteric artery, hindgut = inferior mesenteric artery
Paired: renal, gonadal, lumbar
T12: coeliac trunk, L1: superior mesenteric artery, (L2: renal arteries), L3: inferior mesenteric artery, (L4 = aortic bifurcation into common iliacs)
Describe the blood supply from the coeliac trunk.
Coeliac trunk: L is splenic artery, gives off L gastroepiploic
Up is left gastric
R is common hepatic which gives off hepatic artery proper and gastroduodenal. Gastroduodenal gives off R gastroepiploic which anastamoses with LGE along greater curvature of stomach.
R gastric from hepatic artery proper. anastamoses with L gastric along lesser curvature of stomach
Branches coming off LGE and RGE up to stomach and down to greater omentum
Label A-F
A: L gastric
B: R gastric
C: gastroduodenal
D: R gastroepiploic
E: L gastroepiploic
F: short gastric (off of splenic artery)
NB: splenic artery = retroperitoneal
Label the celiac arteriogram.
A: hepatic artery proper
B: gastroduodenal
C: common hepatic
D: L gastric
E: splenic
F: coeliac trunk
What does the superior mesenteric artery supply?
Where doe SMA arise?
What is the difference between the walls of the jejunum and ileum?
Is the graduation between the jejunum and ileum distinct?
The midgut. Jejunum and ileum via jejunal and ileal arteries in mesentary. Ascending and transverse colon via the ileocolic, R and middle colic arteries.
L1 between mesentey layers. Very big.
Jejunum: v. vascular, vasa recta longer, higher and bigger, thick walls. Ileum: much thinner walls, more vasa recta but smaller, fewer mucosal folds and villi (b/c most absorption in jejunum)
No - progressive
NB: arterial arcades = loops of arteries around jejunum and ileum
Label A-E of the superior mesenteric artery.
A: marginal artery (forms anastomoses between superior and inferior mesenteric)
B: middle colic
C: R colic
D: ileocolic (artery to caecum)
E: appendicular
F: jejunal and ileal branches
Label A-E on this angiogram of the superior mesenteric artery.
A: middle colic
B: R. colic
C: iliocolic
D: SMA
E: arterial arcades
F: jejunal branches
Label A-D of the inferior mesenteric artery.
A: marginal artery
B: L colic (goes to descending colon)
C: sigmoid
D: superior rectal
Label A-E on this angiogram of the inferior mesenteric artery.
A: L colic
B: IMA
C: Marginal artery
D: sigmoidal branches
E: superior rectal
What 2 veins meet to form the portal vein?
What do the following parasympathetic vagal trunks supply in the gut:
a) anterior vagal trunk (continuation of L vagus)
b) posterior vagal trunk (continuation of R vagus)
Where do the sympathetic postganglionic fibres to the gut come from?
Splenic (retroperitoneal) and superior mesenteric (in mesentry) veins meet posterior to head of pancreas.
a) gastric and hepatic branches
b) gastric and coeliac branches
Coeliac ganglion, superior mesenteric ganglion or inferior mesenteric ganglion
Label A-D
A: hepatic portal vein
B: superior mesenteric vein (goes behind pancreas and up to liver)
C: splenic vein
D: inferior mesenteric vein
What is the sympathetic and parasympathetic innervation in the:
a) foregut
b) midgut
c) hindgut
a) Sympathetic: greater splanchnic nerve Parasympathetic: vagus
b) Sympathetic: lesser and least splanchnic nerve Parasympathetic: vagus
c) Sympathetic: lumbar splanchnic nerve Parasympathetic: sacral outflow (S2-4)
