Blood And Nerve Supply Flashcards
Where does the aorta terminate?
Intra or Retroperitoneal?
L4
Retro
Where does the thoracic duct drain into?
Left subclavian vein
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
What is the false lumen of AAA?
Media coming apart and getting engorged with blood
Appears as 2 lumens in CT scan
What PS innervation supplies the foregut?
Vertebral level location?
Sympathetic innervation levels?
Vagus
T12-L1
T5-9 Greater Splanchnic n.
What PS innervation supplies the midgut?
Vertebral level location?
Sympathetic innervation levels?
Vagus
L1
T10-11 Lesser Splanchnic n.
What PS innervation supplies the hindgut?
Vertebral level location?
Sympathetic innervation levels?
Pelvic splanchnic
L3
T12-L2 Least splanchnic n.
Where does the celiac trunk branch from the aorta?
T12-L1
What are the 3 branches off of the celiac trunk?
Left gastric
Splenic
Common hepatic a
Where is the splenic artery located?
What branches does it have?
Within the splenorenal ligament
Short gastric a, left gastro-omental, pancreatic branches
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
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
What does the right hepatic a. give off?
Cystic artery
Where does the gastro-duodenal artery arise from?
What does it bifurcate into?
Common hepatic artery
Right gastro-omental a. And superior pancreaticoduodenal a.
What does the superior pancreaticoduodenal artery branch into?
Anterior pancreaticoduodenal a. And posterior pancreaticoduodenal a.
What surrounds the portal triad?
Hepatoduodenal ligament
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
