arteries and veins Flashcards
where does the internal thoracic vein arise from? where does it terminate?
superior epigastric vein.
Brachiocephalic vein.
where does the internal thoracic artery arise from?
subclavian artery
What does the internal thoracic artery terminate in?
Musculophrenic artery and Superior epigastric artery
Where does the internal thoracic vein drain into?
Brachiocephalic vein
Where is the internal thoracic artery postioned?
Runs down posterolateral sides of sternum, outside parietal pleura
What are the branches of the internal thoracic artery?
- Pericardiophrenic
- Thymic
- perforating (to skin)
- to upper 6 anterior intercostal spaces
Branches that anastomose with post. intercostals & bronchial arteries to form SUBPLURAL MEDIASTINAL PLEXUS - sternal
- mediastinal
- pericardial
What do the inf. & sup. epigastric arteries supply blood to?
Anterior abdominal wall
What anastomoses to form the subpleural mediastinal plexus?
Sternal, mediastinal and pericardial branches of INTERNAL THORACIC ARTERY & posterior intercostal & bronchial arteries
What does the musculophrenic artery supply?
Diaphragm.
7th -9th intercostal spaces.
What are the branches of the external iliac artery?
Inferior epigastric artery, deep circumflex iliac artery, Femoral artery (terminal branch) when enters the femoral canal
Where do the bronchial arteries arise from?
Thoracic aorta
What are the branches of the thoracic aorta?
Lateral - Posterior intercostal arteries
Anterior - Branches to bronchi, lungs, oesophagus, mediastinum, pericardium
What are the branches of the abdominal aorta?
- Inferior phrenic arteries x2
- Coeliac trunk (1.5m above sup mes)
L1 3. (lateral) Middle suprarenal arteries x2 - Superior mesenteric artery
L2. 5. Renal arteries x2 - Gonadal x2 (directed inferiorly)
L3. 7. Inferior mesenteric - Lumbar (4 pairs) posterolateral
- Medial sacral artery x 1
L4. 10. terminate as 2x common iliac arteries
- Coeliac trunk (1.5m above sup mes)
Where do the suprarenal arteries arise from?
Superior - inferior phrenics
Middle - abdominal aorta
Inferior - Renal arteries
What are the branches of the coeliac trunk?
- Left gastric
- Splenic
- Common hepatic
Example of artery to artery anastamoses?
Inferior & superior epigastric arteries,
Portal system?
Vein or arteriole connects two capillary networks. e.g. hepatic portal vein - connects capillaries of intestine to liver sinusoids.
Features of arteries?
Vasa vasorum, No valves (exceptions: pulmoary trunk and aorta), Nerves
Verves assoicated with arteres?
Vasomotor - contraction of muscle in wall - penetrate adventitia & are mostly SYMPATHETIC
‘hitch hikers’ - travel with arteries to organs - remain outside the adventitia (SYMPATHETIC or PARASYMPATHETIC)
- Sensory accompany both.
Embryonic vessel to bypass pulmonary circulation?
ligamentum arteriosum (ductus arteriosis) Root of left pulmonary art to inf surface of arch of aorta.
Location of right pulmonary artery?
POSTERIOR to aortic arch & SVC.
ANTERIOR to trachea & bronchi.
Location of left pulmonary artery?
ANTERIOR to descending aorta & left principle bronchus.
Branches of right coronary artery?
Right marginal branch, posterior interventricular artery.
Branches of left coronary artery?
Circumflex, anterior interventricular artery
What level does aorta divide into common iliac arteries?
L4
What level is superior mesenteric artery?
L1
Tributaries of SVC?
Left and right brachiocephalic veins & single azygos vein.
How many hepatic veins? drain into what?
3 (usually) IVC.
Difference between left and right renal veins?
Right - short.
Left - long (receives sometimes inferior phrenic veins, L suprarenal vein, L gonadal vein)
What is the azygos vein when it crosses the diaphragm?
Right ascending lumbar vein
Where does the inferior mesenteric vein drain into?
The splenic vein.
What forms the hepatic portal vein?
The splenic and Superior mesenteric veins.
What drains the foregut?
The splenic vein.
What drains the midgut?
The superior mesenteric vein.
What drains the hindgut?
The inferior mesenteric vein.
Where do the ascending lumbar veins arise from?
Common iliac veins
Which side is the azygos vein located?
The right side.
Where does the hemiazygos vein drain?
anastamoses with the azygos.
Where does the accessroy hemiazygous vein arise?
Upper posterior intercostals or brachiocephalic vein.
Where does brachiocephalic veins become SVC?
behind first costal cartilage
Common iliac veins join to form IVC at what level?
L5
Where does the internal pudendal artery arise from?
Anterior trunk of iINTERNAL ILIAC ARTERY
where does internal pudendal vein drain into? (tributary of)
INTERNAL ILIAC VEIN
what are the tributaries of internal pudendal vein? (what does it drain)
drains prostatic venous plexus –> drains penis & inferior rectal vessels.
Blood vessels of bladder?
Arteries - vesicular arteries from internal iliac artery
Veins- vesicular veins (multiple, small) drain into internal iliac veins.
BLOOD SUPPLY TO SUPRARENALS?
Arteries - superior (branch of inferior phrenics), middle (branch abdominal aorta), inferior (branch renal arteries).Spread out over capsule.
Veins - Left goes into left renal vein. Right drains directly to IVC.
What is the cremasteric artery a branch of?
The inferior epigastric artery
Blood supply to testis?
Testicular arteries (abdominal aorta), creamasteric arteries ( inferior epigastric artery) Testicular veins (right to IVC, left to renal vein)
Ductus deferens features.
30-45cm. Thick muscular wall. Extends from tail of epididymus through spermatic cord. Leaves spermatic cord at deep inguinal ring. Passes medially over externla iliac vessels onto lateral wall of pelvis. Cross superior to ureter at base of bladder.
What is the dillation of the ductus deferens? What is it for?
The ampulla. SPerm storage.
Seminal vesicles.
Paired. Between base of bladder and rectum. single tubes 15cm long coiled to 5cm. Ampulla of ductus deferens is medial. Pathologies uncommon.
What is the innervation to the seminal vesicles?
Sympathetic - smooth muscle in wall -
What does the seminal vesicle secrete?
Thick alkaline secretion rich in fructose. Also contains coagulation agents. (temp coag of semenn in vagina - protective against acid vagina)
Ejactulatory ducts.
2cm long. antero-inferiorly into prostate and join prostatic urethra at seminal colliculus.
Where do ejacaulatory duct and prostatic urethra join?
seminal colliculus
Prostate (location)
embedded in pelvic fascia and surrounded by venous & nerve plexus. Base (superior) attached to neck of bladder, apex (inferior) to urogenital diaphragm.
Prostate features.
fibrous capsule and fibromuscular stroma containing network of branched glands and ducts. Lobes or zones. Pathologies common.
Lobes of prostate.
- Two lateral lobes.
- Median lobe - posterosuperior. may bulge into bladder to form uvula.
- Posterior lobe - below ejaculatory ducts.
- Anterior lobe (isthmus) less glandular and less fibromuscular.
T or F: The anterior lobe of the prostate is more glandular and fibromuscular.
False.
Zones in prostate.
peripheral zone, inner/submucosal zone (subd. into internal and innermost), anterior zone (isthmus), few, if any glands
Prostate relationships.
anterior to rectal ampulla, inferior to bladder and seminal vesicles.
(Prostate) The ____ ____ extends from apex to base. There is a longitudinal ridge, the ___ ___ with ___ ___ on either side into which empty the prostatic ducts. The widest part of the crest is called the ___ with opening of the ejeaculatory ducts laterally and blindy ending sac called the ____ medially.
prostatic urethra, urethral crest, prostatic sinuses, colliculus, utricle.
What is the utricle.
1cm lomg, remmnant of fused paramesonephric ducts.
What is the colliculus?
The widest part of the urethral crest.
What produces PSA?
Prostate, bulbourethral glands, littre (spongy urethra).
What is the function of PSA?
involved in the liquefaction of semen coagulum in vagina.
What is the blood supply to the prostate and seminal vesicles? AND LYMPH NODES
Arteries - internal pudendal, inferior vesical, middle rectal arteries.
Veins- prostatic venous plexus draining into internal iliac veins.
Lymph - internal iliac nodes
Arteries and veins of penis?
Arteries: Internal pudendal artery (branch internal iliac artery) supplies 2x deep dorsal arteries sends separate branches to each corpera.
Veiins: 1x deep dorsal vein. (drains into prostatic plexus, then internal iliac vein)
What is the blood supply to the ovaries?
Ovarian artery (off abdominal aorta) - eners suspensory ligament. pampiniform plexus forms 2 ovarian veins in susp. lig. Join to form SINGLE ovarian vein - empty into IVC (right), left renal (left)
What is blood supply to the uterine tubes?
Lateral 1/3 - art: Uterine tube branch of ovarian artery.
vein: ovarian veins
Medial 2/3 - art: uterine branch of internal iliac art. veins: uterine veins.
What is the blood supply to the uterus?
art: uterine branches of internal iliac art.
vein: uterine plexus –> uterine veins –> internal iliac veins
What is the blood supply to the vagina?
Art: vaginal branch (internal iliac art) 1-3 per side
Vein: vaginal plexus –> vaginal veins –> internal iliac veins
Blood supply to female ext genitalia?
Internal pudendal artery.
Blood supply to trachea?
Inferior thyroid vessels.
Where do bronchial veins drain into?
Either azygos system or pulmonary veins.
What is the blood supply to the spleen?
Art: Splenic artery - terminates in 2-3 branches from which a number of smaller branches enter the spleen.
Vein: tributaries of splenic vein
What is the blood supply to the liver?
Dual blood supply. Nutrient rich and oxygen poor from portal vein. Oxygen rich from hepatic artery proper.
Drained by: Heaptic veins - into IVC - 3 large upper veins and variable number of lower veins.
Inferior mesenteric vein joins splenic/superior mesenteric vein ____ (where)
Splenic, behind body of the pancreas
Sperior mesenteric vein joins splenic vein where?
Behind head of pancreas
What forms the portal vein?
Splenic vein and superior mesenteric vein
What is the blood supply to the ductus deferens?
Artery to ductus deferens, branch of sup or inf vesicular branch of internal iliac
What are the branches of the internal iliac artery?
Uterine & vaginal, middle & inferior rectal, Vesical (bladder), internal pudendal (penis, ext female genit)
Anastomosis in rectum and anal blood supply?
Good anastomosis between all except middle rectal where anastomosis is Poor.
Artery blood supply to rectum and anus?
1) inferior mesenteric artery - branch superior rectal. 2) Internal iliac artery - branches: middle & inferior rectal. 3) Middle sacral artery (bifurcation of aorta).
Veins - rectum & anus?
Venous plexus within wall (internal) or outside muscle (external). Numerous anastomoses —> RECTAL VENOUS PLEXUS
Rectal venous plexus - drainage?
Internal (inferior mesenteric vein).
External: Upper External (inferior mesenteric vein), Middle External (internal iliac vein), Lower external (internal pudendal vein)
What drains the Upper external rectal plexus?
Inferior mesenteric vein
What drains the middle external rectal plexus?
Internal iliac vein
What drains the lower external rectal plexus?
Internal pudendal vein
What are middle rectal arteries a branch of? What do they supply blood to?
Internal iliac artery, supply to rectum and anus and prostate.
Blood supply to gall bladder? branch of?
Cystic artery, branch of RIGHT hepatic artery. Cystic vein, to right branch portal vein.
Blood supply liver?
Portal areas - (heaptic artery, portal vein, bile duct + lymph, hepatocytes etc) - Blood leaves artery and portal vein, passes though SINUSOIDS, (running from outside lobules to CENTRAL VEINS), then anastomose to larger veins - eventually leave as HEPATIC VEINS (3 largers, many smaller), to IVC