Blood And Nerve Supply Flashcards by Alex Hamidi

Where does the aorta terminate?

Intra or Retroperitoneal?

Retro

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Where does the thoracic duct drain into?

Left subclavian vein

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What is an abdominal aortic aneurysm due to?

Where does it normally arise?

What is the major complication?

Atherosclerosis

Below renal arteries and above aortic bifurcation

Rupture when > 5cm

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What is the false lumen of AAA?

Media coming apart and getting engorged with blood

Appears as 2 lumens in CT scan

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What PS innervation supplies the foregut?

Vertebral level location?

Sympathetic innervation levels?

Vagus

T12-L1

T5-9 Greater Splanchnic n.

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What PS innervation supplies the midgut?

Vertebral level location?

Sympathetic innervation levels?

Vagus

T10-11 Lesser Splanchnic n.

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What PS innervation supplies the hindgut?

Vertebral level location?

Sympathetic innervation levels?

Pelvic splanchnic

T12-L2 Least splanchnic n.

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Where does the celiac trunk branch from the aorta?

T12-L1

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What are the 3 branches off of the celiac trunk?

Left gastric
Splenic
Common hepatic a

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Where is the splenic artery located?

What branches does it have?

Within the splenorenal ligament

Short gastric a, left gastro-omental, pancreatic branches

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What does the left gastric a. give off?

What does it anastomoses with and where?

Esophageal branches

Right gastric artery along the lesser curvature of the stomach

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The common hepatic a. turns into the proper hepatic artery and gives off what?

What does the proper hepatic a. terminate as?

Right gastric artery

Right and left hepatic arteries

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What does the right hepatic a. give off?

Cystic artery

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Where does the gastro-duodenal artery arise from?

What does it bifurcate into?

Common hepatic artery

Right gastro-omental a. And superior pancreaticoduodenal a.

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What does the superior pancreaticoduodenal artery branch into?

Anterior pancreaticoduodenal a. And posterior pancreaticoduodenal a.

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What surrounds the portal triad?

Hepatoduodenal ligament

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What is the portal triad with spatial relationships?

Proper hepatic artery (left)
Portal vein (posterior)
Bile duct (right)

What structures form the portal vein?

Splenic vein and superior mesenteric vein

What does a cholecystectomy dissect through?

To reach what?

Hepatoduodenal ligament

Cystic artery

What are the boundaries of Calot’s Triangle?

Medially - common hepatic duct
Laterally - cystic duct
Superiorly - liver

MLS Come Cheer Losers

What is Calot’s node for?

Main route of lymphatic drainage of the gallbladder

Where does the superior mesenteric artery emerge from the aorta?

Posterior to the neck of the pancreas

1cm below celiac trunk

What is usually the 1st branch off the SMA?

What does this artery branch into?

Inferior pancreaticoduodenal a.

anterior inferior pancreaticoduodenal a. And posterior inferior pancreaticoduodenal a.

What branch off the celiac trunk supplies the pancreas?

Superior pancreaticoduodenal a.

What is a major branch off the SMA that supplies the large intestine?

Ileocolic artery

What are the branches off the SMA?

Ileocolic a. Right colic a. Middle colic a.

What are the branches of the ileocolic a.?

``` Ileal branch Colic branch Anterior and posterior Cecil branches Appendicular branch Ascending colic branch ```

What does the marginal artery (of Drummond) supply? Why is it important?

Parallels the margin of the colon formed by anastomoses of colic arteries Makes it possible to cut out parts of the colon and re-anastomose them while maintaining blood supply

What are the branches of the IMA?

Left colic a. (Asc and desc branches) Sigmoid arteries Superior rectal a. Marginal a.

What are the risk factors for ischemic colitis? Etiology? Complications?

Old age, clotting problems, hypercholesterolemia, HTN, marathons Atherosclerosis, severe HTN, clot, DVT, lupus, sickle cell, cocaine Tissue death, perforation, bowel obstruction

Where do superior rectal arteries and veins drain to? Middle rectal a. And v.? Inferior rectal a. And v.?

Inf. Mesenteric v. Internal iliac v. Internal pudendal v.

Where do sympathetic preganglionic fibers arise from? Where do they travel in? Where do they synapse?

T5-L1 Splanchnic nerves Prevertebral sympathetic ganglia

Where do PS nerve fibers synapse?

Nerve PLEXH of enteric nervous system contained in gut wall

What drains to the cisterna chyli?

Intestinal lymphatic trunk | Lumbar lymphatic trunk

Where is the Myenteric (Auerbach's) plexus located? What is the function?

Between outer longitudinal and inner circular muscle layers Motility

Where is Meissner's plexus located? Function?

Submucosal Secretions, blood flow, absorption

What causes Hirschsprung Disease? Results in absence of what? What kind of autonomics are missing? Where does it occur?

Failure of neural crest cells to migrate No Myenteric Plexus No PS, therefore gut cannot relax Occurs in recto sigmoid junction

What is Chagas' disease? Result?

T. Cruzi destroys the ANS, mainly Myenteric plexus Mega colon

What do GVA pain fibers follow?

Sympathetics

What are PS GVA fibers for?

Visceral (stretch) reflexes

Where does the abdominal aorta begin? Where does it enter the abdomen?

T12 Aortic hiatus formed by L and R crus of the diaphragm