Abdomen 05: GI Tract Innervation and Blood Supply Flashcards

1
Q

What structures compose the foregut?

A

Esophagus, stomach, pancreas, gallbladder, liver, half of the duodenum

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2
Q

Nerves that go to the foregut leave the CNS where?

A

T5-T9

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3
Q

What nerve goes to the foregut and leaves from the sympathetic trunk?

A

Greater splanchnic nerve

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4
Q

Where does the greater splanchnic nerve synapse in the foregut?

A

Celiac plexus

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5
Q

What structures compose the midgut?

A

Half of the duodenum, small intestine, cecum, appendix, ascending colon, 2/3 of the transverse colon

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6
Q

Nerves that go to the midgut leave the CNS where?

A

T9-T12

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7
Q

What nerve goes to the midgut and leaves from the sympathetic trunk?

A

Lesser splanchnic nerve

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8
Q

Where do the nerves of the midgut synapse?

A

Superior mesenteric plexus

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9
Q

Nerves that go to the ascending colon leave the CNS where?

A

T10/T11

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10
Q

Nerves that go to the midgut part of the transverse colon leave the CNS where?

A

T11/T12

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11
Q

What arteries supply the ascending colon?

A

Right colic artery and ileocolic artery

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12
Q

What arteries supply the midgut transverse colon?

A

Middle colic artery from the superior mesenteric artery

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13
Q

Nerves that go to the hindgut leave the CNS where?

A

L1/L2

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14
Q

What is the nerve that goes from the sympathetic trunk to the hindgut?

A

Lumbar splanchnic nerve

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15
Q

Where do nerves to the hindgut synapse?

A

Inferior mesenteric plexus

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16
Q

What structures constitute the hindgut?

A

1/3 of the transverse colon, descending colon, sigmoid colon, anal canal

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17
Q

What arteries supply the hindgut part of the transverse colon?

A

Left colic artery and marginal artery of Drummond from the inferior mesenteric artery

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18
Q

What arteries supply the descending colon?

A

Inferior mesenteric artery

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19
Q

What arteries supply the sigmoid colon?

A

Sigmoid artery

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20
Q

What is the basic pattern of visceral innervation of the foregut?

A

Ventral root -> anterior ramus -> white ramus communicans -> sympathetic trunk (does NOT synapse at paravertebral ganglion) -> greater splanchnic nerve -> Celiac plexus

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21
Q

Least splanchnic nerve

A

A nerve that comes off of T12-L2 and goes mostly to the kidneys and other suprarenal structures

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22
Q

Where do greater, lesser, and least splachnic nerves arise?

A

They all arise in the thorax and pierce the diaphragm

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23
Q

Where does the lumbar splanchnic arise?

A

It arises in the abdominal cavity and goes to the hindgut

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24
Q

What is the pathway of parasympathetic nerves to the hindgut?

A

They leave the CNS on S2, S3, S4

Ventral root -> spinal nerve -> ventral ramus -> pelvic splanchnic -> hypogastric plexus

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25
Q

Celiac plexus

A

A neural plexus of the foregut located at the base of the celiac trunk

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26
Q

Superior mesenteric and aorticorenal plexus

A

A plexus located on top of the superior mesenteric artery

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27
Q

Inferior mesenteric plexus

A

A plexus located on top of the inferior mesenteric artery

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28
Q

Where is the referred pain of the foregut?

A

Epigastric region

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29
Q

Where is the referred pain of the midgut?

A

Umbillicus region

30
Q

Where is the referred pain of the hindgut?

A

Pubic region

31
Q

What is the nerve supply of the stomach?

A

P: Vagus
S: Greater splanchnic

32
Q

What is the spinal cord sympathetic origin and sensory afferent destination of the stomach?

A

T5-T7

33
Q

What is the referred pain region of the stomach?

A

Epigastric and left hypochondric regions

34
Q

What is the nerve supply of the foregut?

A

P: Vagus
S: Greater splanchnic

35
Q

What is the spinal cord sympathetic origin and sensory afferent destination of the foregut?

A

T7-T9

36
Q

What is the referred pain region of the duodenum?

A

Epigastric region and right shoulder

37
Q

What is the referred pain region of the pancreatic head

A

Inferior epigastric region

38
Q

What is the referred pain region of the spleen?

A

Left hypochondric region

39
Q

What is the referred pain region of the gallbladder and the liver?

A

Epigastric and right hypochondric regions; also right shoulder and posterior thoracic walls

40
Q

What is the nerve supply of the small intestine

A

P: Vagus
S: Lesser splanchnic

41
Q

What is the spinal cord sympathetic origin and sensory afferent destination of the small intestine?

A

T9-T12

42
Q

What is the referred pain region of the small intestine?

A

Umbillicus

43
Q

What is the nerve supply of the colon?

A

P: Vagus up to 2/3 of the transverse colon, and then the pelvic splanchnics

44
Q

What is the spinal cord sympathetic origin and sensory afferent destination of the colon?

A

T9-T12 up to 2/3 of the transverse colon, and then L1-L2

45
Q

What is the referred pain region of the colon?

A

Pubic region; left groin for sigmoid colon

46
Q

What is the nerve supply of the kidney and ureters?

A

P: Vagus
S: Least splanchnics

47
Q

What is the spinal cord sympathetic origin and sensory afferent destination of the kidneys are ureters?

A

T12-L2

48
Q

What is the referred pain region of the kidneys and ureters?

A

Small of back, both flanks, both groinds, genitals

49
Q

McBurney’s Point

A

A point 2/3 the distance from umbilicus to ASIS; where somatic pain of appendicities is felt

50
Q

What are the four midline arteries of the abdomen?

A

Celiac, superior mesenteric, inferior mesenteric, median sarcal

51
Q

What are the four paired arteries of the abdomen?

A

Inferior phrenics, middle suprarenals, renals, gonadals

52
Q

What are the four paired lumbar arteries of the abdomen?

A

They do not have names. They are just lumbar arteries

53
Q

What are the three main branches of the celiac trunk?

A

Left gastric artery, common hepatic artery, and splenic artery

54
Q

What are the main branches of the superior mesenteric artery?

A

Inferior pancreatoduodenal, middle colic, right colic, ileocolic, jejunal, ileal

55
Q

What are the important branches of the inferior mesenteric artery?

A

Left colic, sigmoid, superior rectal

56
Q

Where do the inferior phrenic arteries branch off of the aorta?

A

As soon as the aorta pierces the diaphragm

57
Q

What is the asymmetric relationship between the two renal arteries?

A

The right one is slightly lower, while the left one is at the transpyloric plane

58
Q

What are the venous systems that drain the abdomen

A

Hepatic portal, caval, systemtic

59
Q

Hepatic portal system

A

A venous system that drains blood through the liver to the ICV

60
Q

Caval system

A

A venous system that drains blood to the IVC without going through the liver

61
Q

Systemic venous system

A

A venous system that drains blood from the body walls of the abdomen to the azygous veins

62
Q

What are the five main portal-systemic/caval anastamoses

A

Para-umbilical, anorectal, retroperitoneal, gastro-esophageal, hepatic

63
Q

What are the two main anastomoses of the celiac trunk?

A

1) Right gastric and left gastric arteries

2) Right gastro-omental and left gastro-omental arteries

64
Q

What are the two main anastomoses between the celiac trunk and the superior mesenteric artery?

A

1) Superior and inferior pancreaticoduodenalarteries

2) Arc of Buhler

65
Q

What are the two main anastomoses between the superior and inferior mesenteric arteries?

A

1) Marginal artery of Drummond

2) Arc of Riolan

66
Q

What structure does the superior mesenteric artery arch over as it leaves the aorta?

A

The left renal vein

67
Q

Which kidney is higher?

A

Left kidney

68
Q

From superior, what are the arteries that supply the ureters?

A

Renal arteries, gonadal arteries, common iliac artery, internal illiac artery

69
Q

What arteries supply the adrenal glands?

A

1) Superior suprarenal arteries through inferior phrenics
2) Middle suprarenal arteries through the aorta
3) Inferior suprarenal arteries through the renal arteries

70
Q

What nerve innervates the cremaster muscle?

A

The genital branch of the genitofemoral nerve