anatomy - abdo Flashcards
branches of coeliac artery - T12
1. left gastric - supplying the lesser curvature or the lower part of the oesophagus
- splenic artery (runs behing stomach and in the splenoRENAL ligament)–> left gastroepiploic, short gastric and pancreatic branches
- common hepatic –> a. gastroduodenal (right gastroepiploic and superior pancreaticoduodenal) b. hepatic proper(right gastric, right and left hepatic and cystic (branch of right hepatic))
arterial supply to thoracic oesophagus
venous supply?
- inferior thyroid artery
- thoracic aorta
- inferior thyroids vein
- azygous veins
bloods supply to abdominal oesophagus?
arterial -left gastric artery
left inferior phrenic artery
left inferior phrenic vein –>systemic
left gastric vein –> portal system
sma suuplies the mid gut which ends?
2/3 along the transverse colon
the ascending colon is supplied by?
ileocolic artery –> anterior and posterior caecal arteries and
right colic artery
transverse colon is supplied by?
descending colon supplied by?
SMA- right and middle colics
IMA - left colic
IMA - left colic
sigmoid colon is supplied by?
IMA -sigmoid arteries
venous drainage of the colon?
ascending-ileo and right colic vein –> smv
transverse -middle colic–> smv
descending –> left colic –> imv
sigmoid -sigmoid veins –>imv
all draining into the portal vein
duodenum
which parts of the duodenum are intra and retro peritoneal?
1st part (superior) is intra
the other 3 parts are retro periotoneal
what are the 4 part of the duodenum?
- superior (L1) - connect to the liver by hepatoduodenal ligament and is most common site of perforation
- descending (L1-3) - site of ampulla of vater. behind the transverse colon but in front of the right kidney
- infeiror - under the pancreas. passes over ivc and aortsa but posterior to sma and smv
- ascending -joins jejunum at sharp flexure called dj flexure.
differences between jejunum and ileum?
jej=in the LUQ red, thicker wall, less arcades and straigter vasa recta
ileum - RLQ
What is the arterial blood supply to the rectum?
superior rectal artery -terminal continuation of the IMA
middle rectal artery - branch of the internal iliac artery
inferior rectal artery - from the internal pudendal artery
venous blood supply to rectum?
superior rectal vein-draining to the portal system
middle and inferior rectal veins draining into the systemic system
anastomoses of these systems are in the ANAL wall therefore creating a portocaval anastomoses.
innervation to the rectum?
sesnory and autonomic
- sympathetic- lumbar sphlancnic nerves and superior and inferior hypogastric plexus
- parasympthetic - pelvic splanchnic nerve - S2-4
- sensory - same as parasympathetic
lympathic drainage of the rectum?
drain into the pararectal nodes–>inferior mesenteric nodes
the inferior aspect drains directly inot the internal iliac nodes
above the pectineal line …
artery - superior rectal artery (IMA)
vein -superior rectal vein(IMV) to portal venous system
nerves - visceral from inferior hypogastric plexus
lymph - internal iliac lymph nodes
below the pectineal line ….
artery - inferior rectal artery - from internal pudenal artery
vein - inferior rectal vein –> internal pudendal vein –>systemic ciculation
nerves - via inferior anal nerves–> pudendal nerve
lymphatics - superificial INGUINAL lymph nodes
4 posterolateral abdo muscles?
Quadratus lumborum
psoas major
psoas minor
iliacus
ps and iliacus make iliopsoas and flex the hip. iliacus is innervated by L2-4.
positive psoas sign when flexing the hip causes lower abdo pain due to inflamed appendix.
borders of hesselbach’s triangle?
medial - lateral border of rectus abdominis
Lateral - inferior epigastric vessels
inferior - inguinal ligament
borders of the inguinal canal?
anterior - external oblique aponeurosis
roof - internal oblique and transversus abdominis
posterior - tranversalis fascia
floor - inguinal ligament
midpoint of the inguinal ligament?
mid inguinal point?
- site of hernia and just above it is the deep ring. between the asis and pubic tubercle
- site of the femoral pulse
between the asis and pubic symphisis
indirect hernias in relation to inferior epigastrics?
lateral
