Abdominal Vasculature

Question 1

3 branches of aorta travel through what?

Answer 1

mesentery

Question 2

3 branches of celiac trunk

Answer 2

stump right under diaphragm

1. common hepatic (R twd liver)
2. splenic (L twd spleen)
3. L gastric (around lesser curvature)

Question 3

branches of L gastric

Answer 3

no major branches

some small branches to lower esophagus

Question 4

branches of common hepatic 3

Answer 4

1. right gastric (R half of lesser curvature)
2. proper hepatic –> left hepatic (L lobe) & right hepatic (R lobe) –> cystic
3. gastroduodenal –> R gastroepiploic (to R half of greater curvature) & superior pancreaticoduodenal (to panc and duo)

Question 5

anastomoses of R/L gastric arteries

Answer 5

L gastric from celiac trunk
R gastric either from common/proper hepatic
along lesser curvature

Question 6

portal triad

Answer 6

1. common bile duct (common hepatic duct + cystic duct) to duodenum
2. proper hepatic artery
3. hepatic portal vein

@ hilus of liver

Question 7

branches of gastroduodenal

Answer 7

runs along greater omentum
R gastroepiploic
superior pancreaticduodenal
supplies pancreas, duodenum, stomach

Question 8

splenic artery

Answer 8

curly/coiled
left gastroepiploic
short gastric arteries (stomach)
segmental branches (spleen)
pancreatic branches (direct to pancreas)

Question 9

does stomach receive blood from all three branches of celiac trunk? what are they?

Answer 9

yes
short gastric (from splenic)
lesser: L/R gastric
greater: L gastroepi (from splenic), R gastroepi (from gastroduodenal/common hepatic

Question 10

vessels on lesser curvature

Answer 10

L/R gastric (from common/proper hepatic)

Question 11

vessels on greater curvature

Answer 11

L gastroepi (from splenic)
R gastroepi (from gastroduodenal/common hep)

Question 12

superior mesenteric (4 right-side branches, 1 L side branch)

Answer 12

runs over L renal vein

inferior pancreaticoduodenal (off of R side to pancreas and duodenum)
3 colic arteries (middle, right, iliocolic)

L side: intestinal artery branches

Question 13

loops off of intestinal arteries aka? then become?

Answer 13

intestinal arteries –> arcades –> vasa recta

*if one of these blocked that section of gut dies

Question 14

3 colic arteries

Answer 14

middle colic (to transverse colon)
right colic (to ascending colon)
ileocolic (ileocecal jxn and appendix)

Question 15

superior/inferior mesenteric artery borders?

Answer 15

where transverse colon bends to last part

Question 16

inferior mesenteric artery branches 3?

Answer 16

descending colon (L colic artery)
sigmoid (sigmoid arteries)
rectum (superior rectal artery)

Question 17

all colic arteries and sigmoid artery feed into what?

Answer 17

marginal artery (runs around length of colon)
this is the anastomotic cnxn btwn SMA and IMA

Question 18

variations

Answer 18

common hepatic branches from sup mesenteric

proximal bifurcation of common hepatic

Question 19

pancreas location

Answer 19

behind stomach (2ndarily peritoneal)

Question 20

3 sources of pancreatic blood supply?

Answer 20

sup pancreaticduodenal
inf pancreaticduodenal
panc branches off of splenic

Question 21

anastomosis between celiac trunk and SMA

Answer 21

pacreaticoduodenal arcade

Question 22

2 paths of venous drainage from abdominopelvic cavity

Answer 22

hepatic protal vein (to liver)

inferior vena cava (to heart)

Question 23

hepatic portal system gets from?

Answer 23

gut tube (thru superior rectum)
pancreas
spleen

peritoneal and 2ndarily retroperitoneal organs

Question 24

inferior VC gets from?

Answer 24

kidney
gonads
inferior rectum

PRIMARILY RETROPERITONEAL organs

Question 25

hepatic vein gets from (4)?

Answer 25

L/R gastric veins splenic inf mesenteric sup mesenteric

Question 26

3 areas of body that are clinically important (drained by both portal/IVC system)

Answer 26

lower esophageal veins paraumbilical veins rectal veins

Question 27

what's significant about portal system veins?

Answer 27

no valves! blood can flow backward and pushed into IVC without passing through liver varicosities (swollen veins) indicate portal hypertension

Question 28

hemorrhoids "butt"

Answer 28

portal vein --> inf mesenteric --> sup rectal veins --> middle/inf rectal --> int iliac (systemic) dilation and swelling in rectal venous plexus

Question 29

esophageal varices "gut"

Answer 29

portal vein --> L gastric --> esophageal --> azygos (systemic) dilation and rupture when swallowing most difficult to detect, substantial bleeding

Question 30

paraumbilical varices "caput"

Answer 30

portal vein --> paraumbilical (flank round ligament) --> superficial epigastric --> ext iliac (systemic) dilate and form Caput Medusae

Question 31

what is the hepatic triangle and what traverses it?

Answer 31

liver cystic duct common hepatic duct cystic artery goes thru here to supply GB

Question 32

what pathologies can cause narrowing of hepatic vessels?

Answer 32

congenital stenosis thrombosis liver disease e.g. hepatitis or cirrhosis ALL cause portal hypertension