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Anatomy of the Abdomen, Pelvis & Perineum > Arterial supply and Venous drainage > Flashcards

Arterial supply and Venous drainage Flashcards

1
Q

Abdominal aorta

A
  1. begins at the aortic hiatus
  2. anterior to the lower border of vertebrae TXII
  3. descends through the abdomen slightly to the left of the midline
  4. terminal branches of the aorta are the two common iliac arteries

Branches;

Anterior

  1. celiac trunk
  2. superior mesenteric artery
  3. inferior mesenteric artery
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2
Q

Division of the primitive gut

A

Foregut

  1. begins with the abdominal esophagus
  2. ends just inferior to the major duodenal papilla
  3. includes;
    • abdominal esophagus
    • stomach
    • duodenum
    • liver
    • pancreas
    • gallblader
  4. it is supplied by the celiac trunk

Midgut

  1. begins just inferior to the major duodenal papilla, in the descending part of the duodenum
  2. ends at the junction between the proximal two-thirds of the transverse colon
  3. includes;
    • duodenum
    • jejunum
    • ileum
    • cecum
    • appendix
    • ascending colon
    • two thirds of the transverse colon
  4. supplied by the superior mesenteric artery

Hindgut;

  1. begins just before the colic flexure
  2. ends midway through the anal canal
  3. includes;
    • the left one thrid of the transverse colon
    • descending colon
    • sigmoid colon
    • rectum
    • upper part of the anal canal
  4. supplied by the inferior mesenteric artery
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3
Q

Celiac trunk

A
  • suplies the forgut
  • arises from the abdominal aorta immediatly bellow the aortic hiatus
  • at the anterior part of the LI vertebrae
  • divides into;
    1. left gastric
    2. splenic
    3. common hepatic arteries
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4
Q

Left gastric artery

A
  • smallest branch of the celiac trunk
  • ascends to the cardioesophageal junctions and sends esophageal branches upwards to the abdominal part of the esophagus
  • some of those branches continue through the esophangeal hiatus of the diaphgram and anastomose with esophangeal branches from the thoracic aorta
  • left gastric artery turns to the right and descends to the lesser curvature of the stomach in the lesser omentum
  • it anastomoses with the right gastric artery
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5
Q

Splenic artery

A
  • largest branch of the celiac trunk
  • travels in the splenorenal ligament and divides into numerous branches which enter the hillium of the spleen
  • as it passes along the superior border of the pancreas it gives off numerous small branches to supply the neck, body and tail of the pancreas
  • approching the spleen it gives off
    1. short gastric arteries; whoch pass through the gastrosplenic ligament to supply the fundus of the stomach
    2. left gastro-omental artery; which runs to the right along the greater curvature of the stomach and anastomoses with the right gastro-omental artery
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6
Q

Common Hepatic Artery

A
  • medium sized branch
  • divides into its terminal branches;
    1. hepatic artery proper
    2. gastroduodenal artery

Hepatic artery proper

  • ascends towards the liver
  • runs to the left of the bile duct and anterior to the portal vein
  • divides into the right and left hepatic arteries

the right hepatic artery near the liver gives off the cystic artery to the gallbadder

Gastroduodenal artery

  • it might give off the supraduodenal artery and then the posterior superior pancreaticoduodenal artery to supply the upper body of the superior part of the duodenum
  • after these branches is descends untill it reaches the lower border of the superior part of the duodenum where it divides into its terminal branches
    • right gastro-omental artery ( passes along the greater curvature of the stomach enentually anastomosing with the left gastro omental artery)
    • anterior superior pancreaticoduodenal artery ( supplies the head of the pancreas and the duodenum, these vessels eventually anastomose with the anterior and posterior branches of the inferior pancreaticoduodenal artery)
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7
Q

Superior mesenteric Artery

A
  • anterior branch of the abdominal aorta
  • supplies the midgut
  • anterior to the lower part of L1

Branches;

  1. inferior pancreaticoduodenal artery
  2. on its left
    1. jejunal arteries
    2. ileal arteries
  3. on its right
    1. middle colic
    2. right colic
    3. ileocolic artery
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8
Q

Inferior pancreoduodenal artery

A
  • first branch of the superior mesenteric artery
  • divides into anterior and posterior branches which assend on the corresponding sides of the head of the pancreas
  • they anasotmose with the anterior and posterior branches of the superior pancreoduodenal artery ( from the common hepatic artery)
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9
Q

Jejunal and ileal arteries

A
  • they are distal to the inferior pancreaticoduodenal artery
  • on the left side
  • there is a large number of jejunal and ileal arteries supplying the jejnum and most of the ileum
  • these branches leave the trunk and pass between the two layers of the mesentery and form anastomosing arches or arcades as they pass outward to supply the small intestine
  • number of artetial arcades increase distally along the gut
  • the last from the terminal arcade are the VASA RECTA (straight arteries) which provide the final direct supply to the walls of the small intestine
  • they are usually short and far apart forming low broad windows
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10
Q

Middle colic artery

A
  • first of the three branches from the right side of the main trunk of the superior mesenteric artery
  • it enters the transverse mesocolon and divides into right and left branches
    1. right branch anastomoses with the right colic artery
    2. left branch anastomoses with the left colic artery ( which is a branch of the inferior mesenteric artey)
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11
Q

Right colic artery

A
  • second of the three branches
  • from the right site of the main truck of the superior mesenteric arteries
  • passes to the right in a retroperitoneal position to supply the ascending colon
  • divides into
    1. descending branch; which anastomoses with the ileocolic artery
    2. ascending branch; which anastomoses with the middle colic artery
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12
Q

Ileocolic Artery

A
  • final branch arising from the right side of the superior mesenteric vein
  • passes down and to the right towards the right iliac fossa where it divides into superior and inferior branches;
    1. superior; passes upwards to the ascending colon and anastomoses with the right colic artery
    2. inferior branch; continues toward the ileocolic jucntion dividing into colic, cecal, appendicular and ileal branches

Colic branch–> first part of the ascending colon

Anterior and posterior cecal branches supply the corresponding sides of the cecum

appendicular branch–> supplies the mesoappendix and the appendix

ileal branch–> supplies the final part of the ileum before anastomosing with the superior mesenteric artery

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13
Q

Inferior mesenteric artey

A
  • it is the anterior branch of the abdominal aorta and supplies the hindgut
  • it is the smallest of the three anterior branches
  • and arises anterior to the to the body of vertebrae LIII
  • branches;
  1. left colic artery
  2. several sigmoid arteries
  3. superior rectal artery
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14
Q

Left colic artery

A
  1. first branch of the inferior mesenteric artery
  2. ascending and descending branches

Ascending;

  • supplies the upper part of the descending colon and distal part of the transverse colon
  • it anastomoses with branches of the middle colic artery

Descending;

  • supplies the lower part of the descending colon
  • anastomoses with the first sigmoid arteries
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15
Q

Sigmoid Arteries

A
  • consist of two to four branches which descend to the left, in the sigmoid mesocolon
  • they supply the lowest part of the descending colon and the sigmoid colon
  • they anastomose;
    1. superiorly–> with branches from colic artery
    2. inferiorly–> with branches from the superior rectal arltery
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16
Q

Superior rectal artery

A
  • it is the terminal branch of the inferior mesenteric artery
  • oposite veterbae SIII the superior rectal artery divides on each side of the rectum
  • which further divide into smaller branches in the walls of the vessels
  • the smaller branches continue to the anal sphincter anastomosing along the way with branches from the middle rectal arteries and the inferior rectal arteries
17
Q

Venous drainage

A

Venous drainage of spleen, pancreas, gallbladder and abdominal part of the gastrointestinal tract (except for inferior part of the rectum) is through the portal system of veins which deliver blood from these structures to the liver

Once blood passes through the haptic sinusoids it passes through the progressively larger veins until it enters the hepatic veins just inferior to the diaphgram

18
Q

Portal Vein

A
  • It is the final common pathway for the transport of venous blood from the spleen, gallbladder, pancreas, and abdominal part of the gastrointestinal tract
  • It is formed by the union of the SPLENIC VEIN and the SUPERIOR MESENTERIC VEIN at the level of LII
  • when approaching the liver the portal vein divides into right and left branches which enter the liver parenchyma

Tributaries to the portal vein include;

  1. right and left gastric veins; draining the lesser curvature of the stomach and abdominal esophagus
  2. cystic veins; from the gallbladder
  3. para-umbilical veins; connect to veins on the anterior abdominal wall
19
Q

Splenic Veins

A
  • forms from numerous smaller vessels leaving the hillium of the spleen
  • posterior to the neck of the pancreas the splenic vein joins the superior mesenteric vein to form the portal vein

Tributaries to the splenic vein include

  1. short gastric veins; from the fundus and the left part of the greater curvature of the stomach
  2. the left gastro-omental vein;l from the greater curvature of the stomach
  3. the pancreatic veins; draining the body and tail of the pancreas
  4. usually the inferior mesenteric vein
20
Q

Superior Mesenteric vein

A
  • drains blood from the small intestine, cecum, ascending colon, and transverse colon
  • It begins in the right iliac fossa and ascends in the mesentary to the right of the superior mesenteric artery

Tributaries to the superior mesenteric vein;

  1. right gastro-omental vein –> draining the right part of the greater curvature
  2. anterior and posterior inferior pancreaticoduodenal veins
  3. jejunal vein
  4. ileal vein
  5. ileolic vein
  6. right colic vein
  7. middle colic veins
21
Q

Inferior mesenteric veins

A
  • drains blood from the rectum, sigmoid colon, descending colon and splenic flexure
  • begins as the superior rectal vein and ascends receiving tributaries from the sigmoid veins and the left colic vein
  • ascending it passes posterior to the body of the pancreas and usually joins the splenic vein
  • usually it ends at the jucntion of the splenic and superior meseneric veins or joins the superior mesenteric vein

Anatomy of the Abdomen, Pelvis & Perineum (5 decks)

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