anatomy - vessels, nerves and lymphatics of abdomen

Question 1

where does the hepatic portal vein arise

Answer 1

behind the neck of the pancreas at the level of L2

Question 1

why is there a difference in where pain is referred to above and below the mid-sigmoid colon

Answer 1

visceral afferents pass to the same spinal cord segment involved in SNS innervation up to the mid sigmoid level, but beyond there they run with PNS

Question 3

which veins anastomose in the anal region

Answer 3

superior rectal veins anastomose with middle and inferior rectal veins

Question 4

what does the gastroduodenal artery split into

Answer 4

posterior superior pancreaticoduodenal artery supraduodenal artery right epiploic

Question 4

where is the IVC in relation to the liver

Answer 4

it sits in a groove in the visceral surface of the liver, just immediately inferior to the diaphragm

Question 4

which veins anastomose in the anterior abdominal region

Answer 4

cutaneuos veins around the umbilicus anastomose with tributries of the portal vein

Question 6

what is the remnant of the ventral mesentry of the foetus

Answer 6

falsiform ligament (extending from the diaphragmatic surface of the liver to the anterior abdominal wall - dividing the liver into R and L functional lobes

Question 7

what do the anterior unpaired branches of the abdominal aorta supply (in general)

Answer 7

GI tract and derivities

Question 7

route of the inferior mesenteric artery

Answer 7

heads to the left side of the colon and then heads downwards and to the left, towards the left iliac fossa - gives off colic branches (left colic for descending colon and sigmoidal colic for sigmoidal colon) - then becomes the superior rectal artery -> passes into the pelvis

Question 7

route of the hepatic portal vein

Answer 7

passes being the first part of the duodenum ascends in the free edge of the lesser omentum behind the proper hepatic artery enters the liver and empties its blood into the IVC

Question 7

PNS innervation to GI

Answer 7

vagus –> foregut and midgut pelvic splanchnics –> hindgut

Question 7

2 groups of aortic lymph nodes

Answer 7

pre-aortic and para-aortic

Question 8

what are the derivatives of the midgut

Answer 8

from the major duodenal papilla all the way down to supply most of the transverse colon nearly up to the splenic flexure (2nd part of the 2nd part of the duodenum, J and I, appendix, cecum, ascending colon and most of the transverse colon)

Question 9

what structures do para-aortic lymph nodes receive lymph from

Answer 9

from the structures from the side and back of the abdominal aorta

Question 10

abdominal aorta starts and finishes

Answer 10

starts at the level of T12-L1 and ends at the level of L4 by dividing into the L and R common iliac arteries

Question 10

which visceral organs have venous drainage to the IVC directly

Answer 10

paired organs and organs supplied from posterior branches off the abdominal aorta (abdominal walls and diaphragm)

Question 11

vertebral levels of post ganglionic fibres passing to viscera in the foregut, midgut and hindgut

Answer 11

foregut - T6-9 midgut - T8-12 hindgut - T12- L2

Question 12

branches of the colic arteries

Answer 12

iliocolic - at the beginning of the large intestine right colic - to the ascending colon middle colic - up to the transverse colon

Question 13

what does the splenic artery supply

Answer 13

spleen and pancreas proximal half of the greater curvature of the stomach (from gastric arteries up and left epiploic artery down)

Question 14

which veins anastomose at the lower end of the oesophagus around the cardiac orifice

Answer 14

tributries of the left gastric vein anastomose with tributries of the azygous vein

Question 15

what are the abdominal viscera innervated by

Answer 15

both branches of the ANS

Question 17

what are the derivatives of the hindgut

Answer 17

supplies from just short of the splenic flexure, descending colon, sigmoid colon, rectum and top of the anal canal

Question 18

what do the lateral paired branches of the abdominal aorta supply (in general)

Answer 18

the paired viscera (kidneys, ureters, gonads)

Question 19

at what levels of vertebrae are the preganglionic sympathetic fibres derived from

Answer 19

T6-L2

Question 20

what are the derivatives of the forgut

Answer 20

from the abdominal oesophagus down to the level of the major duodenal papilla (half way down the 2nd part of the duodenum on the posteriomedial wall) - also: liver, pancreas, gall bladder and spleen

Question 20

route of the left gastric artery

Answer 20

heads up and left towards the abdominal oesophagus (gives off oesophageal branches to the cardioesophageal junction and the abdominal part of the oesophagus and then turns to run along the lesser curvature)

Question 21

where does the mesenteric artery run

Answer 21

along the route of the mesentry

Question 22

where do the pre and para-aortic lymph nodes then go

Answer 22

create lymph trunks either side of the aorta - intestinal lymph trunk - R and L lumbar lymphatic

Question 23

what does the left gastric artery supply

Answer 23

abdominal oesophagus and lesser curvature of the stomach

Question 25

where is the celiac trunk

Answer 25

short, wide trunk visible at the upper border of the pancreas at T12

Question 27

where does the superior mesenteric artery arise

Answer 27

1cm below the ciliac trunk at the level of L1

Question 28

what does the supraduodenal artery supply

Answer 28

the top of the duodenum

Question 30

3 vessels that come off the foetal aorta and what do they supply

Answer 30

celiac trunk –> supplies the GI derivatives from the foregut superior mesenteric artery –> supplies the GI derivatives from the midgut inferior mesenteric artery –> supplies the GI derivatives from the hindgut

Question 32

route of the proper hepatic artery

Answer 32

heads up wards and runs as part of the portal triad in the free edge of the lesser omentum on the right hand side, then divides again into the R and L hepatic arteries (one for each functional half of the liver) - also supplies the gall bladder by the cystic artery

Question 33

3 groups of branches from the abdominal aorta

Answer 33

anterior unpaired branches lateral paired branches posterior unpaired branches

Question 34

what does the cisterna chyli drain into

Answer 34

the thoracic duct (traverses the diaphragm with the aorta –> emptying into the junction of the L subclavein and L internal jugular vein)

Question 35

around which vessels do sympathetic ganglion cluster around

Answer 35

unpaired branches of the aorta and renal arteries

Question 36

branches of the superior mesenteric artery supply..

Answer 36

• branches to the left - create vascular arcades and vasa recta for the J and I - branches to the right are colic arteries - inferior pancreaticoduodenal artery (supplies the last part of the duodenum)

Question 37

what do the 3 abdominal lymph trunks drain into and where is it

Answer 37

the cisterna chyli immediately beneath the diaphragm lying adjacent to the aortic hiatus of the diaphragm

Question 39

where does the right epiploic artery go

Answer 39

runs down the greater curvature of the stomach to anastomose with the lieft

Question 40

what does the posterior superior pancreaticoduodenal artery supply

Answer 40

the head of the pancreas and the top of the duodenum

Question 41

venous drainage from which organs unite to form the hepatic portal vein? and what are the veins?

Answer 41

GI tract, pancreas, gall bladder, spleen - inferior mesenteric vein joins the splenic vein which then meets the superior mesenteric vein –> hepatic portal vein

Question 42

sites of portal-caval anastomoses

Answer 42

• lower end of the oesophagus around the cardiac orifice of the stomach - anal region - anterior abdominal wall - retroperitoneal viscous - bare area of the liver

Question 43

what do the posterior unpaired branches of the abdominal aorta supply (in general)

Answer 43

the diaphragm and posterior abdominal wall

Question 44

what does the common hepatic artery split into

Answer 44

the proper hepatic artery and the gastroduodenal artery

Question 46

where will pain be referred to above and below the mid-sigmoid colon

Answer 46

above - referred to midline of anterior abdominal wall (dermatomes T6-L2) below - perineal region

Question 47

where does the inferior mesenteric artery arise

Answer 47

corresponds to the inferior broder of the horizontal part of the duodenum, opposite L3

Question 48

where are pre-aortic lymph nodes and what do they receive their lymph from

Answer 48

organised around the unpaired 3 branches and receive their lymph from the GI tract and its derivities

Question 49

3 branches of the celiac trunk

Answer 49

splenic left gastric common hepatic

Question 50

route of the splenic artery

Answer 50

turns left and runs across the superior border of the pancreas to the hilum of the spleen - gives off short gastric arteries along the greater curvature of the stomach and the left gastroepiploic artery