Abdomen V Flashcards
1
Q
What are suprarenal glands?
A
Endocrine glands - produce hormones
2
Q
Where do the suprarenal glands lie?
A
Between sup pole kidney and diaphragm
3
Q
Describe the differences in shape of the right and left gland
A
Right - pyramidal
Left - semilunar
4
Q
What is the significance of the renal fascia surrounding the suprarenal glands?
A
Separates the glands from the kidneys, if kidneys are disturbed suprarenal gland is protected
5
Q
What are the 2 parts of the suprarenal glands?
A
Cortex (outer) - yellow
derived from mesoderm and secretes corticosteroids and androgens
Medulla (inner) - brown
derived from neural crest
main source catecholamines - adrenaline and noradrenaline
6
Q
Which 3 arteries supply the suprarenal glands?
A
Superior suprarenal arteries - off inferior phrenic (off aorta)
Middle suprarenal artery - off abdominal aorta
Inferior suprarenal artery - off renal artery
7
Q
Why do the suprarenal glands have such a good blood supply?
A
As produce hormones need to go into blood
8
Q
What is the venous drainage of the suprarenal glands?
A
Via left and right renal suprarenal veins
Left -> left renal veins
as aorta in way, safer to join renal vein instead of going over
Right -> IVC directly
9
Q
What are the functions of the kidney?
A
Excretes most waste products of metabolism
Acts as sieve to filter blood
Controls water and electrolyte balance of body
Maintains acid-base balance body
Secretes hormones and renin into blood stream
10
Q
How much blood does the kidney filter?
A
113-144 pints blood/hour
Blood flow to kidney is higher than to heart
Blood filtered 400x/day
11
Q
Where are the waste products of metabolism from urine stored?
A
Stored in the bladder and expelled from body via urethra
12
Q
What are the different functioning parts of the kidney?
A
Including medulla and cortex
13
Q
What is the location of the kidneys?
A
Primary retroperitoneal organs Located at level of T12 - L3 Ribs 11+12 left Ribs 12 right Hila kidney - L1 Closely related to diaphragm and move with it on inspiration
14
Q
Why is the right kidney slightly inferior to the left kidney?
A
A liver is on the RHS
15
Q
What are the anterior relations of the left and right kidney?
A
Right - hepator-enal pouch + greater sac
fluid can build here
Liver
Left - stomach bed (lesser sac)
16
Q
What are the posterior relations of the kidney?
A
Closely related to 11th and 12th rib
Muscles of the posterior abdominal wall
Medially have psoas minor if present + psoas major
Laterally have quadratus laborum
Lateral edge have transversus abdominis
Superior ribs are related to the diaphragm
17
Q
What is the function of the renal coverings?
A
Fascial layers that
support the kidney
hold the kidneys in position against the posterior abd wall
18
Q
What are the layers of the renal coverings?
A
- Renal capsule - closely adherent to surface
- Perinephric fat - w/in perineal space
- Renal fascia - condensation areolar connective tissue
Continuous with transversalis fascia and fascia over diaphragm - Paranephric fat - external to capsule (lots of it hence removed in donors)
19
Q
What is the hilum of the kidney?
A
Entrance point of structures in the kidney
Vein, artery, ureter (anterior to posterior)
+ lymph vessels + sympathetic fibres
20
Q
What does the renal cortex extend into?
A
Outer layer of kidney = renal cortex
Renal cortex extends into renal columns
21
Q
Where are the renal columns located?
A
Renal columns located laterally to renal pyramids - extensions of cortex
22
Q
Describe the renal pyramids
A
Each pyramid has a base - closely related to the cortex
Contains loops of nephrons and collecting ducts
Apex - tip of pyramid and runs into minor callices through papilla
Papilla is at the tip of the triangle opening into minor calyx
23
Q
What is the renal space filled with?
A
Filled with perinephric fat
24
Q
What structure does the minor callices come to form?
A
Come together as major calyx
25
What do the major callices come to form?
Form renal pelvis = Dilated superior portion ureter
26
What is the renal sinus?
Contains renal pelvis
Upper extended part of urethra
Perinephric fat continued into hilum, sinus and surrounds all structures
27
What happens to the renal artery after it enters the kidney?
Splits into 5 segmental arteries
4 anterior segmental arteries
1 posterior segmental artery
Segmental arteries give rise to lobar arteries
Interlobar arteries - run towards cortex
Arcuate arteries - arch over base pyramid
Interlobular arteries
Give off afferent glomerular arterioles - Bowman's capsule
28
What are the segments of the kidney supplied by the different segmental arteries?
1. Apical
2. Caudal
3. Anterior superior
4. Anterior inferior
5. Posterior
29
What is a lobe of the kidney?
Made of renal pyramid and corresponding superior cortex
30
Describe the venous drainage of the kidney
Follow arteries
Efferent glomerular venules drain interlobular veins -> arcuate -> interlobar veins -> multiple renal veins
Renal veins contribute to formation of L+R renal vein - don't necessarily align to segmental arteries
31
Where does the right renal vein pass?
Passes posterior to the second part of duodenum and head of pancreas
All vessels of RHS go straight to IVC
32
What are the discrepancies of the left and right renal veins?
Left enters the iVC superior to the right renal vein
Left is 3x larger than the right renal veins
Left may be compressed by aortic/sup. mesenteric aneurysms as closely related
Receives left gonadal vein, inferior phrenic and suprarenal vein
33
What is nephroptosis?
Dropped kidney
Layers of renal fascia don't fuse firmly inferiorly
hence, abnormally mobile kidneys may descend >3cm when body is erect
Suprarenal glands stay in place as lie in separate fascial compartment and more firmly attached to diaphragm
Symptoms intermittent pain in renal region
Relieved by lying down - appears to result from traction on renal vessels
34
List some congenital abnormalities?
Bifid renal pelvis and ureter (fairly common) - results from division ureteric bud - primordial renal pelvis + ureter
May be unilateral/bilateral - separate openings into bladder are uncommon
Horseshoe kidney -
when kidneys first formed, kidneys are close together in pelvis, 1/6000 fetuses inf. pole kidney fuse to form horseshoe
35
Describe the lymphatic drainage of the kidneys
Follow the renal veins
Drain into L+R lumbar nodes (caval + aortic)
near origin of renal artery
36
Where do the sympathetic nerves
| arise and what is their function?
T10 - L2
Post ganglionic sympathetic from renal plexus - which follows renal arteries
Fn = vasomotor regulating blood flow and renin secretion
37
Is there PS nerve supply to the kidneys?
No evidence of PS supply
| Some say from vagus nerve
38
Is renal function dependent on innervation?
Not dependent on innervation as regulated by hormones
| Displayed by kidney transplants, kidneys still work despite nervous innervation being severed
39
What is staghorn canaliculi?
Build up of struvite - solid mass takes formation kidney itself
Caused by recurrent UTI that increase ammonia production, increase pH and decrease phosphate solubility
40
What is a ureter and its function?
Long, muscular tube
20-30cm
3mm diameter
Transports urine from kidney to urinary bladder (pelvis)
Begin as continuation renal pelvis - susceptible to damage as travel long way
41
Are the ureters intra or retroperitoneal?
Retroperitoneal lined w/ stratified transitional epithelium
42
What is the course of the ureters in the abdomen?
1. Descends anterior to psoas major muscle - opposite tips lumbar transverse process
2. Crosses anterior to genitofemoral nerve - nerve runs anterior to psoas major
3. Obliquely crossed by gonadal vessels - as travel from abdominal aorta to pelvis
4. Enters pelvis anterior to bifurcation common iliac artery to enter pelvis - L4/5
43
Describe the course of the ureter through the pelvis?
1. Runs downward in front, on internal iliac artery to reach ischial spine
2. Turns medially opposite ischial spine and forward to enter base bladder (upper lateral angle)
3. Near termination (before enters bladder) crossed by:
- vas deferens
- uterine artery - water under the bridge, ureter lies underneath artery
4. Passes obliquely through wall bladder for 3/4 inch before opening into bladder cavity
44
What is the importance of the ureters entering the bladder at an angle?
Helps prevent back-flow urine
45
What bony structures can be used to trace the ureters?
On film sacroiliac joint and ischial spine help to trace the course of the ureter
46
What are the 3 points of constriction on the ureters and their significance?
1. Ureteropelvic junction - connection between renal pelvis and ureter
2. Crossing ureter over external iliac/ common iliac artery
3. Ureterovesical junction - site of entrance into bladder
Stones can get stuck at these points
47
What are kidney stones?
Common clinical solid mass
| Formed in kidney - may pass into ureter and impinge flow urine ->complete intermittent
48
What is the passage of kidney stones?
kidney -> renal pelvis -> ureter
| Can cause excessive distension muscular tube
49
What is a ureteric calculus?
Causes sever pain (ureteric colic)
As it's gradually forced down ureter by waves contraction to overcome obstruction
Pain referred from loin -> groin
Also lumbar region, hypogastric region, external genetalia, testes
Referred cutaneous areas that are also innervated by spinal cord segments and sensory ganglia, also supply ureter (T11-T12)
50
What is the arterial supply of the ureter?
Pick up branches from (sup to inf)
- renal artery
- gonadal artery
- common iliac artery
- internal iliac artery
51
What is the venous drainage of the ureters?
Occurs in corresponding veins to arteries
52
Where does the bladder originate?
Endodermal origin and develops from urogenital sinus
53
What is the bladder?
Distensible hollow organ capable holding 1L urine
| Size, shape, position and relations vary according to content + content surrounding organs
54
What is the shape of the bladder?
3 Sided pyramid - apex points toward pubic symphysis
55
What does the apex of the bladder give rise to?
Median umbilical ligament
Runs towards umbilicus = remnant urachus - fibrous remnant of allantois
Fn - drain foetal urinary bladder
56
What is the direction of the base of the bladder?
Faces postero-inferiorly .˙. bladder has 2 inferolateral surfaces
57
What structure does the neck of the bladder surround?
Surrounds the urethra - fixed in position
58
What are the structures surrounding the bladder?
Bladder is on inside the anterior abdominal wall
At back can see seminal vesicles
Under bladder have prostrate
59
What is the function of the fibromuscular bands?
Ligaments hold the bladder neck in place
Sits above the pelvic fold
Neck supported by endopelvic fascia + levator ani muscle
Important as allows for continence
60
What is the pubovesical ligament?
Holds bladder in place in females
| Wraps around neck + urethra - attaches it to pubic symphysis
61
How is stress incontinence after parturition caused?
May cause ligaments and pelvic floor to be weakened .˙. neck prolapses below floor
Occurs when intra-abdominal pressure is increased eg. coughing, sneezing
62
What is the puboprostatic ligament?
Wraps around prostate and attached to pubic symphysis
| Neck surrounded by internal urethral sphincter (smooth muscle)
63
What muscle forms the walls of the bladder?
Detrusor muscles
64
What is the inner surface of the bladder lined by?
Transitional epithelium
65
Where are the attachments of the vesical mucosa?
Attached loosely to detrusor muscle
| Except at trigone region
66
Describe the mucosa when the bladder is full and empty
Full - mucosa stretched out
| Empty - mucosal folds
67
Describe the detrusor muscle and how it works to expel urine
Muscular layer urinary bladder - trabeculated appearance
When bladder stretched PS nervous stimulation occurs - causes contraction detrusor muscle
Causes bladder to expel urine through urethra
68
What is the trigone region?
Upside down triangular shaped smooth region
Mucosa stretched out and tightly adhered to underlying detrusor muscles
Least mobile part of bladder and is mesodermal in origin
69
What are the entrance points of the ureters into the bladder called?
Ureteric orifices
Encircled by loops of detrusor muscles - prevents reflux
Slit like openings - ureter opens into bladder obliquely to prevent reflux
70
What is the exit point of the bladder?
1 exit - internal urethral orifice (inf portion of bladder)
Involuntary muscle
Males have internal urethral sphincter which contracts during ejaculation to prevent backflow semen
71
What is the inter-ureteric bar?
Smooth muscle is extended as inter-ureteric bar connecting 2 ureteric orifices
72
What is the blood supply of the bladder?
Supplied by branches from internal iliac arteries:
i. Sup vesical artery (branch umbilical artery from ant trunk internal iliac)
Antero superior surface bladder
ii. Inf vesical artery (males only) - branch ant trunk internal iliac
Fundus + neck bladder
Vaginal artery equiv in females
73
What is the venous drainage of bladder?
Vesical venous plexus
Drains into internal iliac veins
Communicates inferiorly w/ inferior prostatic plexus (males)
w/ uterovaginal plexus (females)
74
Describe the PS innervation of the bladder + its function in bladder emptying
PS innervation causes micturition
Pelvic splanchnic nerves - S2-S4, pass through inf hypogastric to vesical plexus (surrounding bladder)
Synapses on/near bladder wall
Stimulates micturition
Motor supply to detrusor muscle
Inhibitory to internal urethral sphincter
75
Describe the sympathetic innervation and its function relating to the emptying of the bladder
T10 - L2 (spinal nerves)
Run through and synapse pre-vertebral plexus to reach inferior hypogastric plexus + coeliac and superior hypogastric
Then goes to vesical plexus
Urine retention
Contracts internal urethral sphincter during ejaculation (prevents back-flow semen)/ self-consciousness (shy bladder)
76
What do the visceral afferent fibres (sensory/pain) travel with?
Travel with both sympathetic fibres (sup. bladder) + PS fibres (inf. bladder)
Stimulated by stretching + over-distension bladder
77
How does stretching of the bladder lead to the expulsion of urine?
Detrusor muscle stretched, bladder contracts + internal urethral sphincter relaxes .˙. urine flows into urethra
Overcome reflux during toilet training - babies can't control going to toilet
reflex for bladder to automatically empty when full
78
What is a vesicovaginal fistula/colovesical fistula?
Abnormal connection between bladder and vagina/rectum
| Linked to gynaecological cancer or can occur during surgery
79
How can bladder calculi occur?
Stones may pass into bladder
Stones get larger because of precipitation of salts on stones
Insufficient bladder emptying
Urine becomes infected
80
Why is the bladder susceptible to cancer?
As lined w/ transitional epithelium
| Cancer can spread to local structures
81
What is stress incontinence?
Weakness pelvis floor (levator ani muscles) predisposed to 'pelvic region prolapse'
82
Describe the development of the urethra in a female
Develops from urogenital sinus
| Corresponds to male urethra proximal opening of prostatic utricle and ejaculatory ducts
83
What is the function of the urethra in females?
Transports urine from internal urethral meatus to external urethral meatus - passes through opening pelvic floor muscles
84
Describe the urethra in females and its clinical significance
4cm long + 6mm diameter
| .˙. UTI infection prone
85
What is the cell lining of the female ureter
proximal 2/3 = transitional epithelium
| distal 1/3 = stratified squamous epithelium
86
In females, what is below the pelvic floor?
Deep perineal pouch - potential space in perineam
| External urethral sphincter muscle lies in deep perineal pouch
87
Describe the passage of the urethra in females
Passes through perineal membrane - inf border of perineal pouch
leaves body through external urethral orifice
Opens into vestibule vagina - cleft between labia majora
88
What is the equivalent of the male prostate in females?
Equivalent = 2 paraurethral glands
| Open into distal urethra
89
Where does the urethral opening lie?
Lies posterior to clitoris and anterior to vaginal opening
| Vestibule = area 2 labia majora
90
What are the functions of the male urethra?
Transports urine + semen from bladder and ejaculatory ducts (vas deferens + duct seminal vesicle) respectively to external meatus of penis
91
Describe the male urethra
20cm long
| bends twice when flaccid
92
What are the 4 parts of the urethra?
1. preprostatic - just after neck bladder
2. prostatic
3. membranous
4. spongy
93
What does the preprostatic portion of the penis contain?
Contains internal urethral sphincter - not present in female
94
What is voluntary control of the urethra by?
ANS
95
Which part of the prostate does the urethra pass through?
Travels through part of anterior part of prostate gland - where prostatic + ejaculatory ducts open
96
What is the ejaculatory duct?
Unification vas deferens (transports sperm) + seminal vesicle (prod. sperm)
Carried out of body, passage allowed through prostatic part
Maybe - prostatic part urine + semen travel through urethra at same time
97
What is the function of the bulbourethral gland?
Produce pre-ejaculatory fluid
| doesn't enter membranous urethra, instead enters spongy urethra
98
Describe the spongy layer of the penis
Runs through corpus spongiosum
| Looks like sponge as during erection fills w/ blood + forms erection
99
Where are the 2 bends in a flaccid penis and what is the clinical significance?
i. Below membranous urethra
ii. Distally to it
Important as if inserting catheter up to urethra need to know bend so not forcing catheter into penis
100
What structure is distal to the spongy urethra?
Distally forms the navicular fossa (expansion)
101
Where does urine/semen leave the penis?
Urine/semen will leave through external urethral orifice
102
What are the boundaries of the posterior abdominal wall?
Superior boundary - floating ribs 11+12
significant portion abd cavity overlapped by thoracic wall
Midline - lumbar vertebrae (5) - support weight body
103
What does the articulated lumbar skeleton form?
Lumbar lordosis = curving spine
| They protrude into abdominal cavity + create paravertebral gutter
104
Describe the lumbar vertebrae
Have large vertebral bodies - kidney shaped
No transverse foramina, costal facets, bifid spinous process
Have triangular shaped vertebral foramina
105
What does the lumbar vertebral column articulate with?
Articulate with inferior sacrum
Inferior end spinal cord, formed by fusion sacral vertebral bodies (5)
Sacrum tapers inferiorly at apex
106
What does the apex articulate with?
Articulates w/ coccyx
107
What is the sacral promentary?
Top ridge between lumbar vertebrae + 1st sacral vertebrae
108
What is the sacral canal?
Continuation spinal canal + runs through greater part sacrum
109
What is the sacral foramina?
Holes in sacrum
110
Where are the sacroiliac joints?
Lateral to the sacrum
| Sacrum articulates with ilium
111
Describe the ilium?
Upper part each ilium flares outwards as iliac fossa
Iliac crest = top ridge (L4) - where lumbar puncture taken
ASIS - gives attachment inguinal ligament
AIIS - gives attachment to quadricep muscles
112
Which 3 bones make up the pelvis?
Ilium
Ischium
Pubis
113
Where do the 2 pubis bones articulate?
Articulate at pubic symphysis - secondary cartilaginous joint
114
Describe the ischium
Flared inferiorly at ischial tuberosity because sitting bone
115
What do the bilateral + symmetrical (paired) groups of muscles connect?
Connect thoracic cage + thoracic vertebrae superiorly to the thoracic cage lower limb inferiorly
116
What is the quadratus laborum?
Square shaped muscles
Lateral to lumbar transverse processes, psoas major + minor attaches to medial aspect iliac crest
Attachment - iliac crest, 12th rib, transverse process L1-L4
Nerves - T12 + L1-L4
Action - extends + laterally flexes vertebral column
117
What is the psoas major?
Most medial and most prominent
Origin - transverse process T12-L4 (wide origin)
As fibres descend, fuse with fibres iliacus
Nerves - L1 - L3
Action - flexes thigh @ hip joint
flexes trunk ->lumbar plexus embedded in middle muscle belly
118
What is the psoas minor?
```
Not always present (absent 50%)
Runs in front of psoas major
Attachment - vertebral bodies T12-L1
Nerves - L1
Action - assists flexion trunk
```
119
What is the iliacus?
Lies w/in iliac fossa
Nerves - L2-L4
Action - flexion thigh at hip joint + flexion trunk
Inferiorly fibres join w/ psoas major to form iliopsoas muscle = primary flexor thigh
120
Where does the iliopsoas insert?
Inserts into lesser trochanter
121
What does the diaphragm bound?
Superior boundary of posterior abdominal region
| Separates thoracic + abd cavities
122
What are some features of the diaphragm?
Central tendon - has close relationship w/ pericardium heart
Domes - Lateral sides diaphragm have rounded appearances
Right dome higher than left because liver on RHS
123
Where does the diaphragm attach posteriorly?
Posteriorly attached to bony landmarks eg. floating ribs
124
Where does the midline of the diaphragm attach to?
Attached to lumbar vertebrae via extensions = crus
Left crus - slightly shorter than right crus
Right attached to L1 - L3/4
Left arises from L1-L2/3
125
What does the right crus form?
Oesophageal hiatus
| Fibres diaphragm forms sphincter of oesophagus through diaphragm
126
What is the median arcuate ligament?
Where L+R crus connected @ midline
| Forms aortic hiatus
127
What is the medial arcuate ligament?
Lateral to median arcuate ligament - fascia psoas major
128
What is the lateral arcuate ligament?
Further lateral - fascia quadratus laborum
129
Describe the oesophageal hiatus
T10
Ant + post vagal trunks pass on top oesophagus + reach stomach
If have hiatus hernia of stomach through diaphragm, ant + post vagal trunk may be compressed
Formed by right crus
130
Describe the caval opening
T8 - allows IVC through
In central tendon - right phrenic nerve travels through w/it
Goes through diaphragm to enter heart (right atrium)
131
Describe the aortic hiatus
T12
Aorta runs behind median arcuate ligament
Entrence thoracic duct (lymph vessels)
Azygous vein comes in
132
Describe how the left phrenic nerve attaches to the diaphragm
Has own entrance point on LHS central tendon
133
What is the name of the plexus of somatic nerves of the posterior abdominal wall?
Lumbar plexus
134
Where does the lumbar plexus arise?
From ventral rami - anterior branches of lumbar spinal nerves
L1-L3 (+part L4)
135
What does the remainder of the ventral ramus of 4th + (All) 5th lumbar nerve unite to form?
Lumbosacral trunk
| Joins ventral rami of 1st 4 sacral nerves to form sacral plexus (L4-S4)
136
Which muscle do a majority of the nerves pass through?
Found in the bulk of the psoas major muscle
| Branches arise from lateral border or come through anterior surface and run through neurovascular plane
137
What does the neurovascular plane go through?
Transversus abdominis + along internal oblique
138
Where is the subcostal nerve located?
Lies on quadratus laborum muscle
| Below 12th rib
139
Where does the iliohypogastric nerve lie?
Arises L1 - over surface quadratus laborum
140
What is the function of the iliohypogastric nerve?
Gives off anterior cutaneous branch - innervation to skin @ L1
Gives motor innervation to transverse abdominis and internal oblique
141
What level does the iliolingual nerve lie?
L1 - below iliohypogastric
142
Describe the course of the ilioinguinal nerve and the functions
Takes oblique course + runs towards iliac crest
Pierces through and goes in between transversus abdominis + internal oblique - gives motor innervation to transversus abdominis + internal oblique
Travels through inguinal canal (superficial inguinal ring)
.˙. gives innervation (cutaneous) to:
labia + mons pubis female
root penis + scrotum males
143
Where does the genitofemoral nerve arise?
L1/2 - Lies on top of psoas major
144
What are the branches of the genitofemoral nerve and their functions?
Divides to give genital + femoral branches
Genital gives cutaneous + motor innervation to cremaster muscle scrotum
Femoral gives cutaneous innervation to anterior thigh
Enters into ilioinguinal canal + comes out superficial inguinal ring - gives cutaneous innervation to scrotum + labia majora
145
Describe the lateral femoral cutaneous nerve
L2/3
Traversus iliacus muscle = passes posterior to inguinal ligament to enter thigh
Cutaneous innervation to lateral part thigh
146
Describe the femoral nerve
L2-4
Travels between iliacus + psoas major
Descends laterally to external iliac artery
Supplies structures of lower limb - motor + sensory
147
Describe the obturator nerve
L2-4 - emerges medial border of psoas major
| Supplies muscles in lower limb and gives cutaneous innervation to medial thigh
148
What is significant about the lumbosacral trunk?
Fibres L4/5 fuse and contribute to sacral plexus
149
What are the 2 divisions of the ANS in abdomen?
Sympathetic NS - thoracolumbar outflow T1-L2/3
PS NS - Craniosacral outflow
CN3,7,9, X - S2-4
150
List the nerve roots
Greater thoracic splanchnic nerves - T5-T9 (SNS)
Lesser thoracic splanchnic nerves - T10-T11 (SNS)
Least splanchnic nerves - T12 (SNS)
Lumbar splanchnic nerves - L1-L2(SNS)
Sacral splanchnic nerves (SNS)
Pelvic splanchnic nerves S2-S4 - (PNS)
151
What is significant about the paravertebral ganglia?
```
Contains both sympathetic and PS fibres
Lie anterior and lateral to aorta + vertebral column
• Coeliac plexus
• Superior mesenteric
plexus
• Renal plexus
• Inferior mesenteric
plexus
• Superior hypogastric
plexus – level of aortic
bifurcation
• Inferior hypogastric
plexus – L+R on either
side of rectum
```
152
Describe the abdominal aorta
Enters abdomen by travelling through diaphragm
Passes inferiorly on posterior abdominal wall + deviates slightly to left + midline
Aorta - 13cm long
Terminates at L4
Main source blood in abdomen + pelvis - paired and unpaired vessels
153
What are the unpaired arteries of the abdominal aorta?
```
• Coeliac trunk – T12
• Median sacral artery –
L4
• Superior mesenteric
artery - L1
• Inferior mesenteric artery
– L3
```
154
What is the function and the branches of the coeliac artery?
```
T12
Gives blood to structures of the foregut
Common hepatic artery
Splenic artery
Left gastric artery
```
155
What is the location of the median sacral artery?
L4
Remains retroperitoneal
Bottom in midline
156
What is the function and the branches of the superior mesenteric artery?
```
L1
Supplies midgut
Inferior pancreaticoduodenal artery
Jejunal and ileal branches
Iliocolic + iliocaecal artery
Appendicular artery
Right colic artery
Middle colic artery
```
157
What is the function and the branches of the inferior mesenteric artery?
```
L3
Supplies structures of hindgut
Left colic artery
Sigmoid branches
Superior rectal artery
```
158
Where do the paired branches begin?
Superior aspect
159
What are the paired branches of the aorta?
Inferior phrenic artery - T12
Supplies undersurface of diaphragm
Middle suprarenal arteries - supply suprarenal glands
Renal arteries - supply kidney
Lumbar arteries
Gonadal arteries - develop in abdomen + descend into pelvis
Take BS w/ them
160
What does the aorta bifurcate into?
L+R common iliac arteries @ L4
| Common iliac arteries split into the internal and external iliac arteries
161
What do the internal and external iliac arteries supply?
Internal supplies structures inside pelvis
Gives rise to anterior and posterior division
External iliac travels under iinguinal ligament + becomes femoral artery which supplies structures of lower limb
Give off different arteries to supply pelvic organs
162
What is the positioning of the IVC?
Travels to right of aorta + transports deoxygenated blood to right atrium
163
At what level does the IVC arise?
Formed at L5 - by union common iliac veins
164
At what level does the iVC pierce the diaphragm?
T8 - Caval opening
| to enter right atrium of heart
165
What are the branches of the IVC?
Inf phrenic veins - drains inferior aspect diaphragm + enters directly into IVC
RIght suprarenal veins
Paired renal veins
Right gonadal veins - drain into IVC
Left gonadal veins - enters left renal vein
```
Median sacral vein
Lumbar veins
Hepatic veins - 3
Venous blood from main GI tract gets transported through portal vein to get processed in liver
Enters back into IVC via 3 hepatic veins
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What is an aortic aneurysm?
Dilation of blood vessel
Causes weakening on aortic wall
Increased occurrence w/ ageing population as have atherosclerosis, high BP, diabetes
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Why does the aorta weaken as time goes on?
Abd aorta has lot of pressure - receives blood from LV all throughout life - as become older, vessel can weaken and bulge outwards
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Does an aneurysm have any symptoms?
Found by chance - wall weaker, can rupture - if happens very likely person will die
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Possible treatments of aneurysms or weakened vessels?
Can try to surgically repair w/ grafts
