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Gastroinstetinal > Arteries, Veins And Nerves Of GIT > Flashcards

Arteries, Veins And Nerves Of GIT Flashcards

1
Q

Blood supply of GIT

A

-branches of abdominal aorta
▪️foregut-coeliac trunk
-oesophagus, stomach, 1 1/2 parts of duodenum, liver, gallbladder, spleen, pancreas
▪️midgut -superior mesenteric artery
-2 1/2 parts of duodenum, jejunum, ileum, caecum, A colon, 2/3 transverse colon
▪️hindgut-inferior mesenteric artery
-1/3 transverse colon, D colon, sigmoid colon, rectum

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2
Q

Branches of coeliac trunk

A 
▪️branches off T12
▪️very short, branches off immediately into:
-left gastric artery
-splenic artery
-common hepatic artery
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3
Q

Left gastric artery

A

▪️1st branch of coeliac trunk
▪️ runs up to oesophagus hiatus and branches into oesophageal branches
▪️forms a loop going back down along lesser curvature of stomach giving off branches as it goes
▪️anastomoses with right gastric artery as it goes down LC

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4
Q

Splenic artery

A

▪️2nd and biggest branch of coeliac trunk
▪️runs behind stomach, superior to pancreas towards hilum of spleen
▪️gives off short gastric branches suppling fundus of stomach
▪️gives off left gastricepiploic/gastricomental artery which runs down along greater curvature of the stomach
▪️anastomoses with right GE artery

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5
Q

Common hepatic artery

A

▪️3rd branch of coeliac trunk
▪️gives off right gastric artery which runs up the lesser curvature and anastomoses with left gastric artery
▪️gives off hepatic artery proper which runs along with portal vein (hepatoduodenal ligament) and splits into L and R hepatic artery to supply L and R lobes of the liver
▪️gives off gastroduodendal artery which passes behind pylorus of the stomach then divides into right gastricepiploic artery which anastomoses with LGEA on the GC, and superior pacreaticoduodendal artery which supplies head of pancreases and parts of the duodenum
▪️

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6
Q

Branches of the superior mesenteric artery

A 
▪️branches off just below CT, L1
▪️branches off into:
-inferior pancreaticoduodenal artery
-right colic artery 
-middle colic artery 
-ileocolic artery 
-jejunal arteries
-ileal arteries
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7
Q

Inferior pacreaticoduodenal artery

A

▪️anastomoses with superior pancreaticoduodenal artery from CT
▪️supplies head of pancreas and parts of the duodenum

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8
Q

Right colic artery

A

▪️right side of colon

▪️splits into ascending and descending part to supply all of AC

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9
Q

Ileocolic artery

A

▪️towards ileocolic junction between SI and LI
▪️gives off anterior and posterior cecal arteries which go in front and behind ceacum
▪️appendicular artery can sometimes branch directly of ileocolic artery or AorP cecal artery

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10
Q

Jejunal and ileal arteries

A

▪️arterial arcades are less prominent in J but vasta recta are longer
▪️arterial arcades are more extensive in I and vasta recta are shorter
▪️run in between sheets of mesentery

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11
Q

Middle colic artery

A

▪️supply 2/3 of transverse colon
▪️branches both R and L and anastomoses with both the R and L colic arteries
▪️always an alternative root for blood in LI

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12
Q

Branches of the inferior mesenteric artery

A 
▪️branches off at L3
▪️branches off into:
-left colic artery 
-sigmoid arteries 
-superior rectal artery 
-marginal artery
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13
Q

Left colic artery

A

▪️supplies 1/3 of transverse colon and D colon

▪️anastomoses with middle colic artery

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14
Q

Sigmoidal arteries

A

▪️supplies sigmoid colon

▪️very extensive branches

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15
Q

Superior rectal artery

A

▪️IMA terminates here

▪️supplies rectum

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16
Q

Marginal artery

A

▪️big anastomoses that connects right, middle and left colic arteries
▪️runs along the margin of the D colon and part of transverse colon

17
Q

Portal venous system of the GIT

A

▪️venous blood from parts of foregut and all of midgut and hindgut
▪️portal vein, sinusoids, hepatic veins, IVC
▪️portal vein is the union of SMV and splenic veins, IMV also drains but does not contribute to PV

▪️

18
Q

First pass effect

A

▪️drugs absorbed through GIT are metabolised by the liver before reaching systemic circulation
▪️only a small amount of drug reached circulation
▪️other routes to avoid this:
-intramuscular
-suppository-through rectum

19
Q

Portal systemic communications

A

▪️small communications between portal and systemic systems
-oesophageal anastomoses -lower 1/3
-rectal anastomoses- S rectal vein from IMV, M and I rectal veins from internal iliac vein
-paraumbilical anastomoses- if redirected here can lead to capital medusae around umbilicus
-colic anastomoses
▪️not designed for large amount of blood-secondary connection in case of problems with portal system
▪️back flow of blood from portal system to anastomoses-causes dilation of veins or rupture

20
Q

Innervation of GIT

A 
▪️autonomic 
-sympathetic trunk- thoracolumbar 
-parasympathetic nerves- craniosaccral 
▪️enteric 
-only for GIT
▪️work together 
-PSN increases activity in ENS
-SNS inhibits activity of GIT
21
Q

Autonomic nervous system of GIT

A

▪️sympathetic -regulation of blood flow
-sympathetic ganglia (T5-L2), thoracic and lumbar splanchnic nerves
-greater splanchnic nerve-foregut
-lesser splanchnic nerve- midgut
-lumbar splanchnic nerve- hindgut
▪️parasympathetic-peristalsis
-cranial parasympathetic nerve from vagus nerve- foregut and midgut
-sacral parasympathetic nerves from pelvic splanchnic nerves- hindgut

▪️both distributed by pre-vertebral plexuses

22
Q

Greater splanchnic nerve GIT

A

▪️T5-T9/10
▪️synapses at coeliac ganglion
▪️foregut organs

23
Q

Lesser splanchnic nerve GIT

A

▪️T9-11
▪️synapses at aorticorenal ganglion/superior mesenteric ganglion
▪️supplies midgut organs

24
Q

Lumbar splanchnic nerves GIT

A

▪️L1-L2
▪️synapses at inferior mesenteric ganglion
▪️innervates smooth muscle and gland of hindgut and pelvic organs

25
Q

Vagus nerve GIT

A

▪️Cn10
▪️supplies foregut and midgut
▪️synapses close to target organ

26
Q

Pelvic splanchnic nerves GIT

A

▪️S2-S4

▪️supplies hindgut viscera and pelvic viscera

27
Q

Enteric nervous system

A 
▪️myenteric plexus 
-PS and S input 
-innervates muscular layers of GIT
-gut motility 
▪️submucosal plexus- deeper, closer to lumen 
-PS only 
-secretion of substances in gut
28
Q

Visceral abdominal pain

A

▪️visceral peritoneum is innervates by autonomic nerves-only pick up stretching/distension
▪️pain is normally referred to the midline
▪️dull and poorly localised
-appendix pain-movement from umbilicus to lower left quadrant
-stomach pain-upper right quadrant continues posteriorly

Gastroinstetinal (13 decks)

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