5. Arterial, Venous and Lymphatics of GI Tract Flashcards
EMBRYOLOGY
FOREGUT becomes:
- Lower Oesophagus
- Stomach
-1st and 2nd parts Duodenum - Liver
- Gallbladder
- Pancreas
EMBRYOLOGY
MIDGUT becomes:
- 3rd and 4th parts Duodenum and rest of Small Intestine (jejunum and ileum)
- Caecum
- Ascending Colon
- 3/4 Transverse Colon
EMBRYOLOGY
HINDGUT becomes:
- last 1/4 Transverse Colon
- Descending Colon
- Sigmoid Colon
- Rectum
what are the 3 MAJOR ARTERIES that supply the GI TRACT
- COELIAC TRUNK (CT)
- SUPERIOR MESENTERIC ARTERY (SMA)
- INFERIOR MESENTERIC ARTERY (IMA)
(from anterior abdominal aorta)
which ARTERY Supplies the FOREGUT DERIVATIVES of GI Tract
COELIAC TRUNK
(T12)
at what vertebral LEVEL does the COELIAC TRUNK ARISE / come off the anterior abdominal aorta
T12
which ARTERY Supplies the MIDGUT DERIVATIVES of GI Tract
SUPERIOR MESENTERIC ARTERY
L1
at what vertebral LEVEL does the SUPERIOR MESENTERIC ARTERY (SMA) ARISE / come off the anterior abdominal aorta
L1
which ARTERY Supplies the HINDGUT DERIVATIVES of GI Tract
INFERIOR MESENTERIC ARTERY (IMA)
at what vertebral LEVEL does the INFERIOR MESENTERIC ARTERY (IMA) ARISE / come off the anterior abdominal aorta
L3
CT, SMA, IMA are paired or unpaired ?
UNPAIRED
COELIAC TRUNK (CT) is a SHORT trunk that SPLITS into 3 BRANCHES:
- LEFT GASTRIC ARTERY
- SPLENIC ARTERY
- COMMON HEPATIC ARTERY
the LEFT GASTRIC ARTERY (branch of CT) SUPPLIES:
- LESSER CURVATURE of STOMACH (LGA)
- LOWER OESOPHAGUS (oesophageal branches)
the SPLENIC ARTERY (branch of CT) SUPPLIES:
- whole SPLEEN
- most of PANCREAS (runs along top to the spleen)
- STOMACH fundus and greater curvature (posterior, up towards spleen) (short gastric and left gastro-omental arteries)
which BRANCHES of the SPLENIC ARTERY (CT) supply the STOMACH
- SHORT GASTRIC ARTERY (to FUNDUS)
- LEFT GASTRO-OMENTAL ARTERY (stomach and greater omentum)
the CONVOLUTED shape of the SPLENIC ARTERY does what
SLOWS RATE for the SPLEEN
the COMMON HEPATIC ARTERY (branch of CT) SUPPLIES:
- whole LIVER (proper hepatic, left hepatic, right hepatic)
- whole GALLBLADDER (proper hepatic, right hepatic)
- Right 1/2 STOMACH (right gastric, right gastro-omental, gastroduodenal)
- Upper 1/2 DUODENUM (gastroduodenal)
- part of PANCREAS (gastroduodenal)
which BRANCHES of the COMMON HEPATIC ARTERY SUPPLY the STOMACH
- RIGHT GASTRIC artery
- RIGHT GASTO-OMENTAL artery
- GASTRODUODENAL
Branches of the SUPERIOR MESENTERIC ARTERY (SMA) that supply MIDGUT derivatives:
- INFERIOR PANCREATICODUODENAL
pancreas & duodenum (3rd,4th) - JEJUNUL ARTERIES
(church wall appearance, vasorecta, arcade) - ILEAL ARTERIES
(honeycomb appearance) - ILIOCOLIC Artery
Ileocaecal junction - ANTERIOR CAECAL Artery
anterior caecum - POSTERIOR CAECAL Artery
posterior caecum - APPENDICULAR Artery
appendix - RIGHT COLIC Artery
Ascending colon - MIDDLE COLIC Artery
Transverse Colon (3/4)
which BRANCH of the SMA SUPPLIES the ASCENDING COLON
RIGHT COLIC ARTERY
which BRANCH of the SMA SUPPLIES the TRANSVERSE COLON (first 3/4)
MIDDLE COLIC ARTERY
which BRANCHES of the SMA SUPPLY the CAECUM
- ILIOCOLIC ARTERY (for iliocaecal junction)
- ANTERIOR CAECAL ARTERY (anterior caecum)
- POSTERIOR CAECAL ARTERY (posterior caecum)
which BRANCHES of the SMA SUPPLY the SMALL INTESTINE
- PANCREATICODUODENUM
3rd and 4th parts duodenum & pancrease - JEJUNAL ARTERIES
- ILIAL ARTERIES
BRANCHES of the INFERIOR MESENTERIC ARTERY (IMA) that supply HINDGUT derivatives:
- LEFT COLIC ARTERY:
ASCENDING BRANCH
(1/4 transverse and descending colon)
DESCENDING BRANCH (descending colon) - SIGMOID ARTERIES
(sigmoid colon) - SUPERIOR RECTAL ARTERY
(Upper rectum)
what branch of the IMA, LEFT COLIC ARTERY supplies the 1/4 TRANSVERSE COLON and DESCENDING COLON
ASCENDING BRANCH of left colic artery
SUPERIOR RECTAL ARTERY of the IMA Supplies:
UPPER RECTUM
APPENDICULAR ARTERY is a BRANCH of which Major artery
SUPERIOR MESENTERIC ARTERY (SMA)
which part of the EMBRYONIC GUT TUBE does the ASCENDING COLON DERIVE from
MIDGUT
the SHORT GASTRIC ARTERIES SUPPLY which PART of the STOMACH
and are a BRANCH of which ARTERY
FUNDUS of STOMACH
from SPLENIC ARTERY of the COELIAC TRUNK
which BRANCH of the COELIAC TRUNK SUPPLY oxygenated blood to the GALLBLADDER
and which artery specifically
COMMON HEPATIC ARTERY
- proper hepatic, RIGHT HEPATIC ARTERY
RIGHT GASTRIC ARTERY is a BRANCH of which ARTERY
COELIAC TRUNK
-> COMMON HEPATIC ARTERY
LEFT GASTRIC ARTERY is a BRANCH of..
and supplies what PART of the STOMACH?
COELIAC TRUNK
- LESSER CURVATURE of Stomach
(& has oesophageal branches)
which ARTERY supplies the GREATER CURVATURE of the STOMACH?
what is it a branch of?
LEFT GASTRO-OMENTAL ARTERY
- SPLENIC Artery (CT)
RIGHT GASTRO-OMENTAL ARTERY is a BRANCH of..
COMMON HEPATIC ARTERY (CT)
GASTRODUODENAL is a BRANCH of which CT ARTERY
COMMON HEPATIC ARTERY
INFERIOR PANCREATICODUODENAL ARTERY is a BRANCH of..
SUPERIOR MESENTERIC ARTERY (SMA)
LEFT COLIC ARTERY is a BRANCH of…
INFERIOR MESENTERIC ARTERY (IMA)
RIGHT COLIC ARTERY is a BRANCH of..
SUPERIOR MESENTERIC ARTERY (SMA)
(ascending colon)
BRANCHES of the LEFT COLIC ARTERY
ASCENDING BRANCH
(transverse and descending colon)
DESCENDING BRANCH
(descending colon)
SPLENIC ARTERY DRAINS into..
SMA DRAINS into…
IMA DRAINS into…
SPLENIC VEIN
SMV
IMV
what does the IMV DRAIN INTO
SPLENIC VEIN
what FORMS the HEPATIC PORTAL VEIN
3 veins unite:
IMV –> SPLENIC VEIN
SPLENIC VEIN + SMV -> Hepatic Portal Vein
HEPATIC PORTAL VEIN goes to..
to LIVER CELLS
eventually into the IVC
HEPATIC PORTAL VEIN Structure?
BIG but THIN WALLED
what is an ANASTOMOSIS
CONNECTION between 2 VESSELS that ALLOW BLOOD to FLOW BETWEEN THEM (shared flow)
what is a PORTOSYSTEMIC ANASTAMOSIS
COMMUNICATION between VEINS in HEPATIC SYSTEM and CAVAL SYSTEM
/ connection between
SYSTEMIC VEINS and PORTAL VEINS
occurs where adjacent structures come from different embryonic origins
3 MAIN SITES of PORTOSYSTEMIC ANASTOMOSES:
- OESPHAGUS
(below diaphragm, part of GI tract, above diaphragm not GI, drains into systemic) - ANTERIOR ABDOMINAL WALL
- RECTUM
in cases such as LIVER FAILURE what can occur at PORTOSYSTEMIC ANASTOMOSES and what can it RESULT in
PORTAL HYPERTENSIVE
- FORCE BLOOD through Anastomoses
Hepatic Portal veins are Small and THIN so can become VARISCOSE (DILATED)
-> VARICES MAY BURT - HAEMORRHAGE
can be fatal
secondary bleeds are common
how much of LYMPH FORMATION in the body is in the GI TRACT
50%
(1-4L per day)
LYMPHATIC DRAINAGE of GI TRACT FACILITATES what functions:
- TRANSPORT of LIPIDS
- MUCOSAL IMMUNE FUNCTION because GI ABSORPTION SURFACE is VAST
because the GI ABSORPTION SURFACE is VAST what FUNCTION does is facilitate in LYMPHATIC DRAINAGE
MUCOSAL IMMUNITY
what is the MAJOR LYMPH DUCT in the ABDOMEN
CISTERNA CHYLI (CC)
Most LYMPH BELOW the DIAPHRAGM DRAINS into…
CISTERNA CHYLI
CYSTERNA CHYLIE BECOMES the …. after passing UP THROUGH DIAPHRAGM
THORACIC DUCT
(Main vessel in the body)
the HEPATIC PORTAL VEIN is formed by the UNION of which 2 VEINS
SUPERIOR MESENTERIC (SMV) and SPLENIC VEIN
what is ANGIOGRAPHY
a technique used to VISUALISE BLOOD VESSELS with
X-RAYS by use of radiocontrast medium
ADVANTAGES and DISADVANTAGES of using CT ANGIOGRAPHY over CT SCAN
ADV-
- LESS INVASIVE
- QUICK to acquire Arterial and Venous Phase IMAGES
- 3D Date may be EASIER to REVIEW
DISADV-
- HIGHER RADIATION dose
- NOT suitable for SOME patients/situations
does CONVENTIONAL ANGIOGRAPHY or CT ANGIOGRAPHY have HIGHER RESOLUTION
CONVENTION - HIGHER
CTA - LOWER RESOLUTION but more soft tissue detail
