Abdominal Contents: Viscera and Blood Supply Flashcards
What is the flow of bile?
Bile made in the liver exits each lobe via the right and left hepatic ducts –> common hepatic duct –> cystic duct –> gallbladder. When stimulated, the bile then moves back into the cystic duct –> common bile duct –> hepatopancreatic ampulla of Vater (where common bile duct and pancreatic duct meet) –> into major duodenal papilla –> hepatopancreatic sphincter or sphincter of Oddi
What does the pancreas do? What is the flow of its duct?
Makes and secretes hormones and digestive enzymes; has main pancreatic duct that meets with common bile duct at hepatopancreatic ampulla of Vater and exits into duodenal papilla
What are the branches of the abdominal aorta?
The celiac trunk, the superior mesenteric artery, and the inferior mesenteric artery.
What are the branches of the celiac artery?
The left gastric artery, the splenic artery, and the common hepatic artery.
What are the branches of the common hepatic artery?
The gastroduodenal artery, the right gastric artery, and the hepatic artery proper.
What are the branches of the hepatic artery proper?
The right and left hepatic arteries and the cystic artery.
What are the branches of the left gastric artery and what do they supply?
The esophageal branch that supplies the esophagus.
What is the branch of the gastroduodenal artery and what does it supply?
The right gastroepiploic artery, which anastmoses with the left gastroepiploic artery and supplies the greater curvature of the stomach.
What are the branches of the superior mesenteric artery?
The middle colic, the right colic, and the ileocolic artery.
What does the ileocolic artery branch into and what does it supply?
The ileocolic artery branches into the colic and ileal branch. They supply the cecum. They also supply the appendix via the appendicular artery.
The left colic, sigmoid, and superior rectal arteries are branches of which artery?
The inferior mesenteric artery.
Why are portal-Systemic Anastomoses important?
These are the sites at which communication between the portal system and the circulatory system can communicate. So, if one system is compromised, blood can still get to the heart via the anastomoses.
What can occur due to portal hypertension? And where do these conditions occur?
- Esophageal varices - lower part of esophagus
- Caput medusae - para-umbilical region
- Hemorrhoids - lower part of anal canal (venous backflow to IMV and superior rectal veins)
- Ascites - abdomen (colic veins)
Which nerves innervate the esophagus?
Parasympathetic: Vagus nerve –> Esophageal plexus
Sympathetic: Splanchnic nerves
Which nerves innervate the stomach?
Parasympathetic: Gastric nerves/Vagus nerve (gastric joins vagus)
Sympathetic: Celiac plexus/Sympathetic trunk (chain)
What does the mnemonic ‘Cecelia Stopped Playing Golf Last night’ mean?
This refers to the innervation of the Spleen, Pancreas, Gallbladder, and Liver. They are innervated by the celiac plexus (sympathetic trunk and vagus nerve)
What does the mnemonic ‘Superior men Think Anything like Apples Can Seem cool - but superior men are full of sh**’ mean?
This refers to the innervation of the first 2/3 of the Transverse colon, Ascending colon, Appendix, Cecum, Small intestine. They are innervated by the Superior mesenteric plexus.
TEST QUESTION: What does the mnemonic ‘Inferior to the 1/3 transverse colon is the descending colon, sigmoid colon, and rectum’ mean?
This refers to the innervation of the distal 1/3 transverse colon, descending colon, sigmoid colon, and rectum. They are innervated by the inferior mesenteric plexus - sympathetic trunk and pelvic splanchnic nerves. *The vagus nerve no longer innervates the transverse colon, and the pelvic splanchnic nerve has taken over parasympathetic innervation.
What is peptic ulcer disease?
Parietal cell –> HCl –> PUD of stomach and/or duodenum
What can longstanding GERD cause?
GERD –> Barrett’s esophagus –> Esophageal carcinoma
What is Barrett’s esophagus?
The digestive enzyme of the stomach come up into the esophagus, causing the simple columnar cells to change and eventually divide. The lining of the esophagus is changed.
What is cirrhosis?
It is the end stage of liver disease in which the normal liver architecture is destroyed by fibrous septa.
How can long time alcohol abuse cause liver issues or cancer?
- Alchohol –> inflammatory cytokines, oxidative stress –> inflammation and fibrosis
- Alcohol dehydrogenase –> Acetaldehyde –> Class 1 Carinogen
What is ductular adenocarcinoma? What factors can cause it?
This is the most common type of pancreatic cancer. Factors such as smoking, age, BMI, and high fructose corn syrup affect it.
What is a Whipple procedure?
This is the pancreaticoduodenectomy, which is the removal of the distal stomach, 1st and 2nd parts of the duodenum, head of the pancreas-common bile duct, and gallbladder
What branches from the splenic artery?
The left gastroepiploic artery, which anastmoses with the right gastroepiploic artery, and supplies the greater curvature of the stomach.
