Abdominal Neurovasculature

Question 1

Blood supply to abdominal viscera and wall

Answer 1

Superior and inferior epigastric and aorta (on posterior wall)

Off aorta- 3 unpaired celiac, superior and inferio mesenteric, numerous paired somactic, and paired visceral (for retroperitoneal organs)

Question 2

Answer 2

Question 3

Primary blood suppl to the abdominal wall

Answer 3

Superior epigastric artery that runs deep to the rectus abdominus and joins the inferior epigastric (off the external iliac)

Also contributing femoral artery branches, thoracic intercostal and lumbar arteries

Question 4

Venous drainage of the GI system

Answer 4

1. Usually follows artery
2. The Hepatic Portal drains the stomach, SI and LI into the liver
3. Paired veins deep to viscera (like the kidney) go straight to the IVC

Question 5

Major points of ulcerations– clinical problems

Answer 5

1. Posterior abdominal wall can have a penetrating ulcer that causes erosion of the splenic artery
2. The left gastric artery may get erosion due to ulceratio in the lesser curvature of the stoamch
3. The gastroduodenal artery may get erosion due to pentrating ulcer in posterior wall of the firt part of the duodenum

Question 6

Most common site of an (Define) anuerysm and telll tail signs

Answer 6

Ballooning of blood vessel

Between the renal arteries and the bifurcation of the aorta

Hypotension (low circulation) pain radiating down the back of the lwoer libs

Question 7

The bifurcation of the abdominal aorta is the most common site of

Answer 7

Atherosclerotic plaques

Question 8

Define aortic aneurysm

Answer 8

Dilation of the aorta (in excess of 4cm diameter) and can contiune to dilate and rupture

Question 9

What is the portal system?When does it anastomoses with the caval system

Answer 9

Portal System- is a network of veins that drains the stomach, LI and SI (GI tract) in the liver. Portal can anatomose with the Caval (systemic) venous system when the flow to portal is reduced (due to hemorrage, esophageal varices, caput medusa (portal hypertension))

Question 10

Nerve supply to the abdominal wall and viscera

Answer 10

T7-12 and L1

T10 (umbliicus) is an important landmark

Question 11

What are the two sources of Parasym innervation to the abdominal viscera and what do they each supply

Answer 11

Vagus Nerve in through vagal trunk passes throguh the preveretebral ganglia and synapses on the terminal ganglia. Supples all viscera except descending colon, sigmoid and rectum

Those are pelvic spalanchi nerve

Question 12

Where do the pelvic splanachnic nerves arise from, where do they symapse and what (and how) do they innervate?

Answer 12

Arise from 2-4th sacral segements

Send pregangion parasym fibers that go to the postganglia neuson in the terminal ganglia of the descending colon, sigmoid and rectum

Fibers ascend to the hypogastric and superior hypogastric plexus to the parts of the colon they innervate

Question 13

Sympathetic of the viscera?

Answer 13

Splanchnic nerves from thoracic and lumbar (pelvic splanchnic is parasym) travel to the preveretebral ganglia

Sympathetic innervation of abdominal viscera is from preganglionic sympathetic splanchnic nerves which synapse with postganglionic sympathetic neurons located inprevertebral ganglia .

Exit through the Autonomic plexuses which is mixed with para and sympathetic.

Question 14

Dicuss lymphatic drainage of the abdominal wall.

Answer 14

Pre (above)- aortic and para(tight and left( or aorta)

Pre-aortic- 3 unpaired abdominal aorta branches– they drain the organs that get blood from the aorta– stomach, spleen, SI, colon, pancrease, gallbladder, liver

Para receive lymph from abdominal wall, kidneys, suprarenal, testes and ovaries and form from the right and left lumbar trunk

Question 15

What happens to the trunks of lymphatic drainage

Answer 15

Right and left lumbar (from para-arotic) and the intestinal trunk (from pre aortic) coalesce to the from the cisterna chyli that empties into the thoracic duct