8.2: Neurovasculature of the Abdomen

Question 1

which vessel supplies the abdominal viscera and most of the anterior abdominal wall? Where does it enter through the spinal cord?

Answer 1

the abdominal aorta.

It enters the abdomen at T12 through the aortic hiatus of the diaphragm and descends along the vertebral column to the left of the midline.

It terminates at the L4 vertebral level, where it bifurcates into two common iliac arteries.

A single median sacral artery arises near the bifurcation.

Question 2

which arteries (branches of the abdominal aorta) supply the structures of the posterior abdominal wall

Answer 2

Paired segmental parietal branches including inferior phrenic and lumbar arteries

Question 3

Paired visceral branches supply organs of the retroperitoneum, these are:

Answer 3

1. middle suprarenal
2. testicular or ovarian
3. renal arteries

Question 4

The celiac trunk, a short trunk that arises at _____ and supplies the abdominal foregut. Its branches, the ___, left _____, and ____ ____arteries, anastomose extensively with each other

Answer 4

The celiac trunk, a short trunk that arises at T12/L1 and supplies the abdominal foregut. Its branches, the splenic, left gastric, and common hepatic arteries, anastomose extensively with each other

Question 5

The superior mesenteric artery (SMA), which arises at ____, posterior to the neck of the pancreas. It supplies ___ structures, and its major branches include the ____ ____, ___ colic, ____ colic, and ____ arteries, as well as a series of ___ and ____branches

Answer 5

The superior mesenteric artery (SMA), which arises at L1, posterior to the neck of the pancreas. It supplies midgut structures, and its major branches include the inferior pancreaticoduodenal, middle colic, right colic, and ileocolic arteries, as well as a series of jejunal and ileal branches

Question 6

The inferior mesenteric artery (IMA), which arises at ___ and has the smallest caliber of the three visceral trunks. It supplies the ____ through its left ___, ____, and ___ ____ branches

Answer 6

The inferior mesenteric artery (IMA), which arises at L3 and has the smallest caliber of the three visceral trunks. It supplies the hindgut through its left colic, sigmoidal, and superior rectal branches

Question 7

Answer 7

Question 8

Answer 8

Question 9

Answer 9

Question 10

Answer 10

Question 11

2 major branches of the common iliac artiers that pass along the brim of the pelvis

Answer 11

1. internal iliac artery, which descends into the pelvis
2. external iliac artery, which gives off the inferior epigastric and deep circumfex iliac arteries before passing into the lower limb as the femoral artery.

Question 12

outline the anastomoses of the celiac trunk, superior and inferior mesenteric arteries whihc provide collateral blood supply to the intestinal organs

Answer 12

celiac trunk and superior mesenteric artery: anastomose in the head of the pancreas through the pancreaticoduodenal arteries and in the body and tail of the pancreas through dorsal pancreatic and inferior pancreatic arteries.

superior and inferior mesenteric arteries anastomose near the junction of the transverse and descending colons through the middle and left colic arteries. The marginal artery runs along the mesenteric border of the largest intestine and connects the ileocolic, right colic, middle colic, and left colic arteries.

The inferior mesenteric artery anastomoses with arteries of the rectum through its superior rectal artery

Question 13

where do abdominal aortic aneurysms most comonly occur

Answer 13

Abdominal aortic aneurysms (AAAs) most commonly occur between the renal arteries and the bifurcation of the aorta. When small they can remain asymptomatic, but large aneurysms can be palpated through the abdominal wall to the left of the midline. Ruptured AAAs present with severe abdominal pain that radiates to the abdomen or back. Mortality rates for ruptured aneurysms approach 90% due to overwhelming hemorrhage

Question 14

outline the branches of the branches of the abdominal aorta:

1. inferior phrenic artery (paired)
2. celiac trunk
3. middle suprarenal
4. superior mesenteric artery
5. renal artery
6. lumbar artery
7. testicular/ovarian artery
8. inferior mesenteric artery
9. common iliac artery
10. median sacral artery

Answer 14

The celiac trunk, a short trunk that arises at T12/L1 and supplies the abdominal foregut. Its branches, the splenic, left gastric, and common hepatic arteries, anastomose extensively with each other (Figs. 8.10 and 8.11).

The superior mesenteric artery (SMA), which arises at L1, posterior to the neck of the pancreas. It supplies midgut structures, and its major branches include the inferior pancreaticoduodenal, middle colic, right colic, and ileocolic arteries, as well as a series of jejunal and ileal branches (Fig. 8.12).

The inferior mesenteric artery (IMA), which arises at L3 and has the smallest caliber of the three visceral trunks. It supplies the hindgut through its left colic, sigmoidal, and superior rectal branches

Question 15

The ___ ___ ____ receives blood from retroperitoneal and pelvic organs, walls of the abdomen and pelvis, and the lower limbs

Answer 15

The inferior vena cava (IVC) receives blood from retroperitoneal and pelvic organs, walls of the abdomen and pelvis, and the lower limbs

Question 16

the ingerior vena cava originates along the ____ vertebral level where the __ ___ veins merge

Answer 16

It originates at the L5 vertebral level where the common iliac veins merge.

It ascends along the right side of the vertebral column, passes posterior to the liver, and pierces the central tendon of the diaphragm at the T8 vertebral level, where it enters the right atrium of the heart.

Question 17

direct tributaries of the inferior vena cava

Answer 17

Question 18

Paired common iliac veins drain the _____ ____ and ___ ____ ___.

Paired ____ ____ and ____ veins drain the posterior abdominal wall and diaphragm and accompany the arteries of similar name.

Veins of the retroperitoneal organs include the right and left ____ veins, the right ___ vein, and the right ____ or ____ (gonadal) vein. The suprarenal and gonadal veins on the left side drain to the ____ ____ ____.

Typically three hepatic veins enter the IVC from the liver immediately below the diaphragm.

Answer 18

Paired common iliac veins drain the external iliac and internal iliac veins.

Paired inferior phrenic and lumbar veins drain the posterior abdominal wall and diaphragm and accompany the arteries of similar name.

Veins of the retroperitoneal organs include the right and left renal veins, the right suprarenal vein, and the right testicular or ovarian (gonadal) vein. The suprarenal and gonadal veins on the left side drain to the left renal vein.

Typically three hepatic veins enter the IVC from the liver immediately below the diaphragm.

Question 19

The ___ ___ vein (usually known as the portal vein), part of the ____ ____ ___, shunts nutrient-rich venous blood from the capillary beds of the gastrointestinal tract and its associated organs to sinusoids of the liver. This blood eventually enters the ___ ____ ___through the ____ veins.

Answer 19

The hepatic portal vein (usually known as the portal vein), part of the hepatic portal system, shunts nutrient-rich venous blood from the capillary beds of the gastrointestinal tract and its associated organs to sinusoids of the liver (Figs. 8.17 and 8.18). This blood eventually enters the inferior vena cava through the hepatic veins.

Question 20

what’re the portosystemic pathways

Answer 20

normal connections between the systemic (caval) venous systems and portal venous systems.

Question 21

Answer 21

Question 22

the splenic vein drains most of fthe ____ structures, the superior mesenteric vein drains most of the ____ structures, and the inferior mesenteric vein drains most of the ____ structures and drains into the _____ vein

the splenic vein and the superior mesenteric vein meet to form the ___ ____ vein

Answer 22

the splenic vein drains most of fthe FOREGUT structures, the superior mesenteric vein drains most of the MIDGUT structures, and the inferior mesenteric vein drains most of the HINDGUT structures and drains into the SPLENIC vein

the splenic and superior mesenteric veins meet to form the hepatic portal vein.

Question 23

Answer 23

Question 24

8.17 label

Answer 24

Question 25

anatomically explain esophageal varices

Answer 25

Submucosal veins of the esophagus drain superiorly to the systemic system (through the azygos veins) and inferiorly to the portal system. When flow through the portal vein is obstructed (as in portal hypertension), these portosystemic anastomoses allow blood in the lower esophagus to drain to the systemic veins. The esophageal varices, enlarged veins that result from this increased flow, can rupture, causing severe hemorrhaging.

Question 26

symptoms of portal hypertension includes ascites and caput medusa (enlargement of the ___ veins on the anterior abdominal wall), varices of the ____ veins (hemorrhoids), and esophageal varices.

Answer 26

Symptoms of portal hypertension include ascites, caput medusa (enlargement of **periumbilical** veins on the anterior abdominal wall), varices of the **rectal** veins (hemorrhoids), and esophageal varices. Symptoms may be relieved by surgically creating a portocaval shunt between the portal and systemic circulations (portal vein to the inferior vena cava or splenic vein to the left renal vein).

Question 27

Lymph from abdominal and pelvic regions drains through lymphatic vessels that usually accompany the arteries supplying those regions. The lymph passes through one or more lymph node groups that can include primary, or \_\_\_\_, nodes and secondary, or \_\_\_\_\_\_, nodes.

Answer 27

Lymph from abdominal and pelvic regions drains through lymphatic vessels that usually accompany the arteries supplying those regions. The lymph passes through one or more lymph node groups that can include **primary, or regional, nodes and secondary, or collecting**, nodes.

Question 28

what are lumbar lymph nodes?

Answer 28

secondary or collecting nodes that receive lymph from multiple regions and in the abdomen and pelvis.

Question 29

8.20 label

Answer 29

Question 30

5 main abdominal lymph node groups and collecting lymph nodes outline their location and the organ segments that drain to these lymph node groups (tributary regions)

Answer 30

Preaortic nodes, which lie anterior to the abdominal aorta. They receive lymph from the gastrointestinal tract (as far as the midrectum) and associated organs. Nodes surrounding the base of the major arteries form collecting nodal groups, such as the superior and inferior mesenteric nodes. These drain to celiac nodes, which drain to intestinal lymph trunks. Right and left lumbar nodes (lateral aortic and caval nodes), which lie along the medial border of the psoas muscles, the crura of the diaphragm, the aorta, and the inferior vena cava. They drain the abdominal and pelvic walls and the viscera of the retroperitoneum, including the ovaries and testes. They also receive lymph from the common iliac nodes, which drain the pelvic viscera and the lower limb. Drainage from these lumbar nodes forms a lumbar trunk on each side. Common iliac nodes drain organs of the pelvis and the lower limbs. Lymph from these nodes drain to the right and left lumbar nodes. The cisterna chyli is an elongated, lobulated, thin-walled dilation that, when present, gives rise to the thoracic duct. It lies to the right of the T12 vertebral body and receives the lumbar and intestinal trunks.

Question 31

the cisterna chyli is a dilation that gives rise to the _____ \_\_\_\_

Answer 31

thoracic duct. it lies to the right of the T12 ventral bodiy and receives the lumbar and intestinal trunks

Question 32

The lymph node groups in the abdomen and pelvis: lymph from organs of the abdomen and pelvis is filtered first by ____ LNs and then drains to the _____ nodes, which service many lymph node groups. From the collectiing nodes, lymph drains to the lymphatic trunks. In the abdomen these are the _____ and ____ trunks.

Answer 32

The lymph node groups in the abdomen and pelvis: lymph from organs of the abdomen and pelvis is filtered first by REGIONAL LNs and then drains to the COLLECTING nodes, which service many lymph node groups. From the collectiing nodes, lymph drains to the lymphatic trunks. In the abdomen these are the LUMBAR and INTESTINAL trunks.