anatomy - vessels, nerves and lymphatics of abdomen Flashcards
where does the hepatic portal vein arise
behind the neck of the pancreas at the level of L2
why is there a difference in where pain is referred to above and below the mid-sigmoid colon
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
which veins anastomose in the anal region
superior rectal veins anastomose with middle and inferior rectal veins
what does the gastroduodenal artery split into
posterior superior pancreaticoduodenal artery supraduodenal artery right epiploic
where is the IVC in relation to the liver
it sits in a groove in the visceral surface of the liver, just immediately inferior to the diaphragm
which veins anastomose in the anterior abdominal region
cutaneuos veins around the umbilicus anastomose with tributries of the portal vein
what is the remnant of the ventral mesentry of the foetus
falsiform ligament (extending from the diaphragmatic surface of the liver to the anterior abdominal wall - dividing the liver into R and L functional lobes
what do the anterior unpaired branches of the abdominal aorta supply (in general)
GI tract and derivities
route of the inferior mesenteric artery
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
route of the hepatic portal vein
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
PNS innervation to GI
vagus –> foregut and midgut pelvic splanchnics –> hindgut
2 groups of aortic lymph nodes
pre-aortic and para-aortic
what are the derivatives of the midgut
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)
what structures do para-aortic lymph nodes receive lymph from
from the structures from the side and back of the abdominal aorta
abdominal aorta starts and finishes
starts at the level of T12-L1 and ends at the level of L4 by dividing into the L and R common iliac arteries
which visceral organs have venous drainage to the IVC directly
paired organs and organs supplied from posterior branches off the abdominal aorta (abdominal walls and diaphragm)
vertebral levels of post ganglionic fibres passing to viscera in the foregut, midgut and hindgut
foregut - T6-9 midgut - T8-12 hindgut - T12- L2
branches of the colic arteries
iliocolic - at the beginning of the large intestine right colic - to the ascending colon middle colic - up to the transverse colon
what does the splenic artery supply
spleen and pancreas proximal half of the greater curvature of the stomach (from gastric arteries up and left epiploic artery down)
which veins anastomose at the lower end of the oesophagus around the cardiac orifice
tributries of the left gastric vein anastomose with tributries of the azygous vein
what are the abdominal viscera innervated by
both branches of the ANS
what are the derivatives of the hindgut
supplies from just short of the splenic flexure, descending colon, sigmoid colon, rectum and top of the anal canal
what do the lateral paired branches of the abdominal aorta supply (in general)
the paired viscera (kidneys, ureters, gonads)
at what levels of vertebrae are the preganglionic sympathetic fibres derived from
T6-L2
what are the derivatives of the forgut
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
route of the left gastric artery
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)
where does the mesenteric artery run
along the route of the mesentry
where do the pre and para-aortic lymph nodes then go
create lymph trunks either side of the aorta - intestinal lymph trunk - R and L lumbar lymphatic
what does the left gastric artery supply
abdominal oesophagus and lesser curvature of the stomach
where is the celiac trunk
short, wide trunk visible at the upper border of the pancreas at T12
where does the superior mesenteric artery arise
1cm below the ciliac trunk at the level of L1
what does the supraduodenal artery supply
the top of the duodenum
3 vessels that come off the foetal aorta and what do they supply
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
route of the proper hepatic artery
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
3 groups of branches from the abdominal aorta
anterior unpaired branches lateral paired branches posterior unpaired branches
what does the cisterna chyli drain into
the thoracic duct (traverses the diaphragm with the aorta –> emptying into the junction of the L subclavein and L internal jugular vein)
around which vessels do sympathetic ganglion cluster around
unpaired branches of the aorta and renal arteries
branches of the superior mesenteric artery supply..
- 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)
what do the 3 abdominal lymph trunks drain into and where is it
the cisterna chyli immediately beneath the diaphragm lying adjacent to the aortic hiatus of the diaphragm
where does the right epiploic artery go
runs down the greater curvature of the stomach to anastomose with the lieft
what does the posterior superior pancreaticoduodenal artery supply
the head of the pancreas and the top of the duodenum
venous drainage from which organs unite to form the hepatic portal vein? and what are the veins?
GI tract, pancreas, gall bladder, spleen - inferior mesenteric vein joins the splenic vein which then meets the superior mesenteric vein –> hepatic portal vein
sites of portal-caval anastomoses
- lower end of the oesophagus around the cardiac orifice of the stomach - anal region - anterior abdominal wall - retroperitoneal viscous - bare area of the liver
what do the posterior unpaired branches of the abdominal aorta supply (in general)
the diaphragm and posterior abdominal wall
what does the common hepatic artery split into
the proper hepatic artery and the gastroduodenal artery
where will pain be referred to above and below the mid-sigmoid colon
above - referred to midline of anterior abdominal wall (dermatomes T6-L2) below - perineal region
where does the inferior mesenteric artery arise
corresponds to the inferior broder of the horizontal part of the duodenum, opposite L3
where are pre-aortic lymph nodes and what do they receive their lymph from
organised around the unpaired 3 branches and receive their lymph from the GI tract and its derivities
3 branches of the celiac trunk
splenic left gastric common hepatic
route of the splenic artery
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
