Abdomen 3 - blood supply, venous drainage, innervation Flashcards
1
Q
Branches of Ab Aorta
A
Celiac a -> superior mesenteric a -> inferior mesenteric a -> bifurcation @ L4 into R/L common iliac a
2
Q
Celiac Trunk
A
- Left Gastric a
- Splenic a
- Common Hepatic a
- branches @ L1 superior border, below aortic hiatus of diaphragm, btwn R/L crura
3
Q
Splenic A
A
- posterior to stomach, superior border of pancreas
- dorsal pancreatic a
- short gastric a -> go to fundus of stomach
- greater pancreatic a
- L gastroepiploic (gastro-omental) a -> along greater curve, supplies stomach + greater omentum
4
Q
Left Gastric A
A
- up to L of cardia
- supplies esophagus + lesser curve of stomach
- runs along lesser curve in lesser omentum to anastamose w/R gastric a.
5
Q
Common Hepatic A
A
- upper border of pancreas
- proper hepatic, R gastric, gastroduodenal arteries
6
Q
Proper Hepatic A
A
- divides near porta hepatis
- R/L hepatic arteries (liver)
- Cystic a (from R hepatic, gall bladder)
- R gastric a
7
Q
R Gastric A
A
from proper/common hepatic -> pylorus -> lesser curve of stomach -> anastamoses w/L gastric
8
Q
Gastroduodenal A
A
- behind 1st part of duodenum
- right gastro-omental (gastroepiploic) a. -> along greater curve, supplies stomach + greater omentum
- supraduodenal a.
- posterior + anterior superior pancreaticoduodenal a.
- if cut, still get blood to stomach via inf panc duodenal a.
9
Q
Superior Mesenteric A
A
- behind neck of pancreas, jejunal and ileal
- Inferior pancreaticoduodenal a
- middle + right colic
- ileocolic a.
10
Q
Inferior pancreaticoduodenal a
A
- passes to right, divides into anterior-inferior + posterior-inferior pancreaticoduodenal a
- posterior surrounds pancreas
- anastamose w/ superior pancreaticoduodenal a.
11
Q
Middle Colic A
A
- supplies transverse colon
- divides into R branch - anastomoses w/R colic A
- and L branch - anastomoses w/L colic A
12
Q
Right Colic A
A
- right of and behind peritoneum
- divides into ascending + descending branches
- supplies ascending colon
13
Q
Ileocolic A.
A
- divides into ascending colic a (anastamoses w/R colic)
- and ileal artery (ileum) which divides into
- anterior + posterior cecal a (cecum)
- appendicular a. (supplies appendix)
14
Q
Inferior Mesenteric A
A
- to left behind peritoneum, supplies descending + sigmoid colon, upper rectum
- L colic A
- Sigmoid A
- Superior Rectal A
15
Q
L Colic A
A
- supplies descending colon, comes of at L3
- Ascending + descending branch of L colic a.
16
Q
Sigmoid A
A
- several, supply sigmoid colon
- ascending + descending branches
17
Q
Superior Rectal A
A
- termination of inferior mesenteric A.
- descends into pelvis + rectum
18
Q
Portal Vein (3)
A
- drains ab part of gut, spleen, pancreas, gall bladder
- tributaries from splenic vein and superior mesenteric vein (and inferior mesenteric)
- cap bed #1 (intestine) -> portal vein -> cap bed #2 (liver) -> IVC
19
Q
Splenic Vein tributaries (3)
A
- Inferior mesenteric vein -> splenic
- Short gastric veins -> left gastro-omental vein -> splenic vein
- Pancreatic vein -> splenic vein
20
Q
Superior Mesenteric Vein (5)
A
- runs with sup mes a
1. Colic veins
2. Jejunal and ileal veins
3. Right gastro-omental vein
4. Anterior + posterior inferior pancreaticoduodenal veins
21
Q
Inferior Mesenteric Veins
A
- Superior rectal vein
- L colic vein
22
Q
Lymphatics
A
Pre-aortic lymph nodes:
- Celiac nodes→ Cisterna chyli
- Superior mesenteric nodes → Celiac nodes
- Inferior mesenteric nodes → Superior mesenteric nodes
Inferior -> superior -> celiac -> cisterna chyli -> thoracic duct
These are JUST digestive nodes
23
Q
Thoracic Splanchnic Nerve Symp Innervation
A
- GVE, GVA fibers
- Greater splanchnic (T5-9) → celiac ganglion by celiac trunk, synapses to go from pre to post gang
- Lesser splanchnic (T10-11) → aorticorenal ganglion
- Least splanchnic (T12) → renal plexus; no ganglia that it goes to
24
Q
Lumbar + Sacral Splanchnic Nerve Symp Innervation
A
- Lumbar splanchnic (L1-2or 4) → pre vertebral plexus (no specific ganglia assoc. with)
- Sacral splanchnic → inferior hypograstric plexus; for pelvis
25
Parasymp Innervation
1. Pelvic splanchnics (S2-4) → inferior hypogastric plexus
| 2. Anterior and posterior vagal trunks → abdominal pre vertebral plexus
26
Sup Mes A Branches
All of branches go to edge that runs all the way around = marginal artery that runs entire length
Marginal A anastamoses inferior + superior mesenteric A
27
Pre-Vertebral Plexus
1. Celiac plexus - btwn celiac trunk + renal arteries
2. Aortic plexus: intermesenteric plexus; on aorta
3. Superior hypogastric plexus: hypogastric nerve + inferior hypogastric plexus
Bifurcation of R/L common iliacs into external and internal iliac, form two cord like structures= superior hypogastric nerves leading into superior hypogastric plexus
28
Received Vagus Nerve
- enters abdomen, assoc w/ esophagus to provide parasymp innervation to foregut + midgut
- ant + post vagal trunks -> pre-vert plexus -> has pre-gang parasymp fibers (GVA)
29
Received Thoracic, Lumbar, Sacral Splanchnic Nerves
- carry pre-gang symp fibers from symp trunk/chain to pre-vert plexus and GVAs
30
Received Pelvic Splanchnic Nerves
- carry pre-gang parasymp fibers from S2-4, enter inferior hypogastric plexus in pelvis
- some fibers move up into inferior mesenteric part of pre-vertebral plexus to innervate hindgut
31
Innervation: Enteric System (5)
- Motor + sensory neurons in GI tract wall
- Brain of gut
- Controls: GI blood flow, contractions (peristalsis), and gastric secretion
- Input from symp and parasymp to control (only for mod of activity)
- if cut, enteric system will work w/o them aka independent of CNS
32
Hepatic Portal Vein Tributaries
1. R/L gastric veins
2. Cystic vein
3. Paraumbilical veins
