Abdominal Blood Vessels (Anatomy) Flashcards
Location of Unpaired Visceral Arteries
Celiac Trunk (T12)
Superior Mesenteric Trunk (L1)
Inferior Mesenteric Trunk (L3)
Location of Paired Parietal Arteries
Inferior Phrenic Arteries (T12)
Subcostal Arteries (T12)
Paired Lumbar Arteries (L1-L4)
Location of Paired VIsceral Arteries
Suprarenal Arteries (Superior, Middle, Inferior)- L1 Renal Arteries (L1/L2) Gonadal Arteries (L2)
Foregut (feeds: esophagus, stomach, liver and pancreas, biliary apparatus, proximal duodenum)
Artery: Celiac Trunk
Parasympathetic Innervation: Vagus Nerve
Sympathetic Innervation: Thoracic Sphlancnic Nerves (T5-T9)
Referred Pain: Epigastrium Region
Midgut (feeds: small intestine, cecum, vermiform appendix, ascending colon, right half of transverse colon)
Artery: Superior Mesenteric Artery Parasympathetic Innervation: Vagus Nerve Sympathetic Innervation: thoracic sphlancnic nerves (T8-T12) Referred Pain: Umbilical Region
Hindgut (feeds: left half of transverse colon, descending colon, sigmoid colon, rectum, superior anal canal)
Artery: Inferior Mesenteric Artery
Parasympathetic Innervation: pelvic sphlancnic nerves
Sympathetic Innervation: Lumbar sphlancnic nerves (L1-L2)
Referred Pain: Hypogastric Region
Celiac Trunk Variations
Variation 1: Celiac Trunk has additional Left/Right Inferior Phrenic Arteries branching of the trunk superiorly
Variation 2: Left Hepatic Artery coming off of Left Gastric Artery
Variation 3: Everything is coming off of the celiac trunk
Variation 4: Right Hepatic Artery comes off of the superior mesenteric artery
Variation 5: Celiac Trunk is divided into 2 regions:
Region 1–> Left Gastric + Splenic Artery are divided on left side
Region 2–> Common Hepatic Artery branches to gastroduodenal a., right gastric, left hepatic a. , right hepatic a.
Vascular Variations of the Liver
Variation 1: Left hepatic Artery coming off of the celiac trunk & right hepatic artery comes off the superior mesenteric artery
Variation 2: Left gastric artery may give a branch to form the left hepatic artery
Dual Blood Supply of the Liver
Hepatic Portal Vein (sustains the liver parenchyma)
&
Right/Left Hepatic Artery
(sustains non-parenchymal structures) intrahepatic ducts
Blood Supply to the Gallbladder
Cystic Artery
Blood Supply to the stomach
Left Gastric Artery
Right Gastric Artery
Right Gastroepiploic Artery
Left gastroepiploic artery
Short gastric Arteries
Blood Supply to the Pancreas
Superior pancreaticoduodenal artery (comes off celiac trunk)
\+ divides into
anterior and
posterior
divisions
inferior pancreaticoduodenal artery (comes off below the celiac trunk)
\+ divides into
anterior and
posterior
divisions
Superior Mesenteric Artery Branches
Right Branch:
Middle Colic Artery
Right Colic Artery
Ileocolic Artery
- Appendicular
Artery
Left Branch:
Jejunal Artery
Ileal Artery
Nutcracker Syndrome
Nutcracker syndrome occurs when there is a loss of fat in between the SMA Trunk and the Left Renal Vein that causes compression of the vein & 3rd part of the duodenum
-This results in ischemia of the 3rd part of the duodenum and compression of the left renal vein and blood pooling
Inferior Mesenteric Artery
Predominantly on the left side–>
+ Left Colic Artery (ascending & descending branches)
+Sigmoid Artery
+Superior Rectal Artery
Rectal Artery Origins
Inferior Mesenteric Artery–> Superior Rectal Artery
Internal Iliac Artery –> Middle Rectal Artery
Internal Pudendal Artery–> Inferior Rectal Artery
Venous Drainage of the Rectum
Superior Rectal Vein
Middle Rectal Vein
Inferior Rectal Vein
Hemmorhoids
Internal Hemmorhoids: damage to the internal venous plexus
*NOT PAINFUL- above pectinate line
External Hemmorhoids: *damage to the external venous plexus
*painful- because located below the pectinate line and innervated by somatic sensory fibers (inferior anal nerves)
Inferior Vena Cava
*On right side of the abdominal aorta:
- 2.5cm to the right
of midline - passes through caval opening of the diaphragm at T8
Hepatic portal and Caval Anastomoses
- ) Esophageal Arteries of Left Gastric Artery + +Azygos Vein
- ) Superior Rectal Veins with middle/inferior rectal veins
- ) Paraumbilical Veins with the Epigastric veins
- ) Retroperitoneal- Colic Veins + systemic retroperitoneal veins
Portal Hypertension
1.) Esophageal Varices
2.) Caput Madusae
(paraumbilical
vein blood build
up)
3.) Rectal Varices-> Hemorrhoids
Abdominal Innervations
Parasympathetic: Vagus Nerve + Pelvic Sphlancnic Nerves (descending colon onwards)
Sympathetic:
Greater Sphlancnic Nerves–> Liver, Gallbladder, Pancreas
Lesser Sphlancnic Nerves–> suprarenal gland, kidneys, ileum, ascending colon, transverse colon
Least Sphlancnic Nerves–> suprarenal glands
Lumbar Sphlancnic Nerves–> descending colon, sigmoid colon, rectum
Abdominal innervation synapses and target organs
Greater Sphlancnic Nerves–> Celiac Ganglion–> Liver, Gallbladder, pancreas
Lesser Sphlancnic Nerves–> Aorticorenal Ganglion–> kidneys, suprarenal glands, gonads
Least Sphlancnic Nerves–> aorticorenal ganglion–> kidneys, suprarenal glands
Lumbar Sphlancnic Nerves–> Inferior Mesenteric Ganglion–> descending colon, sigmoid colon, rectum
Pelvic Sphlancnic Nerves (parasympathetic innervations)
**Convey presynaptic parasympathetic fibers to the inferior hypogastric plexus which goes to:
+Descending Colon, Sigmoid Colon, Rectum
Sympathetic Innervation
lateral horn through to the anterior horn of ganglions down the abdominopelvic sphlancnic nerves–> a general prevertebral ganglion (celiac, aorticorenal, superior mesenteric, inferior mesenteric)–> nerves to the abdominal organs
Sympathetic Innervation functions
Vasoconstriction & Inhibition of the Peristalsis along the GI Tract
Complete set of sympathetic nerve fibers and plexuses
cardiopulmonary sphlancnic nerves–> heart & lungs (bronchi, trachea, larynx)
greater sphlancnic nerves–> celiac ganglion–> liver, gallbladder, pancreas, spleen, stomach
lesser sphlancnic nerves–> aorticorenal ganglion–> kidney & suprarenal glands
least sphlancnic nerves–> superior mesenteric ganglion–> large intestine, small intestine, part of the kidney, rectum, internal anal sphincter
lumbar sphlancnic nerves–>
Inferior mesenteric ganglion–> bladder, penis, gonads
Visceral Afferents & Association with Pain
All visceral afferents above the pectineal line run with sympathetic innervations for pain
Below the pectineal line–> all visceral afferents encoding for pain run through the parasympathetic innervations
Visceral Reflexes
Visceral Reflexes run with parasympathetics
