Blood and Nerve Supply of the GIT

Question 1

Which organs make up the foregut?

Answer 1

Distal part of oesophagus
Stomach
Duodenum before the major duodenal papilla
Superior portion of pancreas
Spleen
Gallbladder
Liver

Question 2

Which organs make up the hindgut?

Answer 2

Duodenum after the major duodenal papilla
Inferior portion of pancreas
Jejunum
Ileum
Caecum
Appendix
Ascending colon
Proximal 2/3 of transverse colon

Question 3

Which organs make up the foregut?

Answer 3

Distal 1/3 of the transverse colon
Descending colon
Sigmoid colon
Rectum
Upper part of the anal canal

Question 4

What is the blood supply of foregut?

Answer 4

Coeliac trunk

Question 5

What is the blood supply of the midgut?

Answer 5

Superior mesenteric artery

Question 6

What is the blood supply of the hindgut?

Answer 6

Inferior mesenteric artery

Question 7

At which vertebral level does the coeliac trunk arise?

Answer 7

T12

Question 8

What are the main branches of the coeliac trunk?

Answer 8

Left gastric artery
Splenic artery
Common hepatic artery

Question 9

What is the course of the splenic artery to reach the hilum of the spleen after arising from the splenic hilum?

Answer 9

It runs in the stomach bed, along the superior aspect of the tail of the pancreas to pass to the splenorenal ligament to enter the hilum of the spleen

Question 10

What are the branches of the splenic artery?

Answer 10

Short gastric arteries
Left gastroepiploic (gastro-omental) artery
Pancreatic branches

Question 11

What are the branches of the common hepatic artery?

Answer 11

Hepatic artery proper
Gastroduodenal artery

Question 12

What are the branches of the hepatic artery proper?

Answer 12

Right and left branches to the liver
Right gastric artery

Question 13

What are the branches of the gastroduodenal artery?

Answer 13

Supraduodenal artery
Anterior superior pancreaticoduodenal artery
Posterior superior pancreaticoduodenal artery

Question 14

Which arteries supply to stomach?

Answer 14

Left and right gastric arteries
Left and right gastroepiploic/-omental arteries
Short gastric artery

Question 15

What is the origin of the left gastric artery?

Answer 15

Coeliac trunk

Question 16

What is the course of the left gastric artery?

Answer 16

After arising, it runs in the lesser omentum to pass to the cardia of the stomach to course along the lesser curvature of the stomach

Question 17

What does the left gastric artery supply?

Answer 17

Left part of lesser curvature of the stomach
Distal end of oesophagus through oesophageal arteries

Question 18

What does the left gastric artery anastomose with?

Answer 18

Right gastric artery

Question 19

Where does the right gastric artery originate from?

Answer 19

Hepatic artery proper

Question 20

What is the course of the right gastric artery?

Answer 20

It courses along to the left on the lesser curvature of the stomach

Question 21

What does the right gastric artery supply?

Answer 21

Right portion of lesser curvature of the stomach

Question 22

What does the right gastric artery anastomose with?

Answer 22

Left gastric artery

Question 23

Where does the right gastroepiploic/-omental artery arise from?

Answer 23

Gastroduodenal artery

Question 24

What is the course of the right gastroepiploic/-omental artery?

Answer 24

It runs to the left along the greater curvature of the stomach

Question 25

What does the right gastroepiploic/-omental artery supply?

Answer 25

Right portion of the greater curvature of the stomach

Question 26

What does the right gastroepiploic/-omental artery anastomose with?

Answer 26

Left gastroepiploic/-omental artery

Question 27

Where does the left gastroepiploic/-omental artery arise from?

Answer 27

Splenic artery

Question 28

What is the course of the left gastroepiploic/-omental artery?

Answer 28

It courses to the right along the greater curvature of the stomach

Question 29

What does the left gastroepiploic/-omental artery supply?

Answer 29

Left portion of the greater curvature of the stomach

Question 30

What does the left gastroepiploic/-omental artery anastomose with?

Answer 30

Right gastroepiploic/-omental artery

Question 31

Where does the short gastric artery arise from?

Answer 31

Splenic artery at its distal end

Question 32

What is the course of the short gastric artery?

Answer 32

It passes between the layers of the gastrosplenic ligament to the fundus of the stomach

Question 33

What does the short gastric artery supply?

Answer 33

Fundus of the stomach

Question 34

Which arteries supply the dudoenum?

Answer 34

Branches of the coeliac trunk proximal to the entry of the major duodenal papilla Branches of the SMA distal to the entry of the major duodenal papilla

Question 35

Which branches of the coeliac trunk supply the duodenum?

Answer 35

Anterior superior and posterior superior pancreaticoduodenal artery Supraduodenal artery

Question 36

Which branches of the superior mesenteric artery supply the duodenum?

Answer 36

Anterior inferior and posterior inferior pancreaticoduodenal artery

Question 37

Where do the pancreaticoduodenal arteries lie?

Answer 37

They lie in the curve between the duodenum and the head of the pancreas?

Question 38

Where does the superior pancreaticoduodenal artery arise from?

Answer 38

Gastroduodenal artery

Question 39

Which part of the duodenum is supplied by the superior pancreaticoduodenal artery?

Answer 39

Duodenum proximal to the entry of the bile duct into its second part

Question 40

Where does the supraduodenal artery arise from?

Answer 40

Gastroduodenal artery

Question 41

Which part of the duodenum does the inferior pancreaticoduodenal artery arise from?

Answer 41

The duodenum distal to the entry of the bile duct into its second part

Question 42

Which arteries supply the pancreas?

Answer 42

Superior and inferior pancreaticoduodenal arteries Pancreatic branches of splenic artery

Question 43

What supplies the body and tail of the pancreas?

Answer 43

Small pancreatic arteries arising from the splenic artery

Question 44

What is the largest of the pancreatic branches arising from the splenic artery?

Answer 44

Greater pancreatic artery or pancreatic magma artery

Question 45

What is the most distal pancreatic branch arising from the splenic artery?

Answer 45

Dorsal pancreatic artery

Question 46

Which arteries supply the head of the pancreas?

Answer 46

Anterior and posterior superior pancreaticoduodenal arteries Anterior and posterior inferior pancreaticoduodenal arteries

Question 47

Where does the liver receive its blood supply from?

Answer 47

Hepatic artery proper Portal vein

Question 48

Where does the common hepatic artery divide into the gastroduodenal artery and hepatic artery proper?

Answer 48

Superior part of the duodenum at the omental foramen

Question 49

What is the relations of the hepatic artery proper in relation to the structures in the portal triad?

Answer 49

It is anterior to the portal vein It lies left to the bile duct

Question 50

What forms the portal vein?

Answer 50

The union of the splenic vein and superior mesenteric vein

Question 51

How does the inferior mesenteric vein join the portal system?

Answer 51

It can drain into the splenic vein It can drain into the SMV It can drain into the junction between the splenic vein and SMV

Question 52

Which artery supplies the gallbladder and cystic duct?

Answer 52

Cystic artery

Question 53

Where does the cystic artery arise from?

Answer 53

Right hepatic artery

Question 54

At what vertebral level does the superior mesenteric artery arise?

Answer 54

L1

Question 55

What does the SMA pass anterior to after arising?

Answer 55

Uncinate process of pancreas 3rd part of duodenum Left renal vein

Question 56

What does the SMA pass within?

Answer 56

The root of the mesentery

Question 57

What are the branches of the superior mesenteric artery?

Answer 57

Inferior pancreaticoduodenal artery Intestinal artery - jejunal and ileal Ileocaecal artery Right colic artery Middle colic artery

Question 58

Which artery supplied the jejunum?

Answer 58

Jejunal artery

Question 59

Which artery supplies the ileum?

Answer 59

Ileal artery

Question 60

What are the intestinal arteries arranged in as they pass through the layers of the mesentery?

Answer 60

Anastomotic/Arterial arcades

Question 61

What do the arterial arcades form?

Answer 61

They form smaller, straight arteries known as the vasa recta

Question 62

How does the arterial arcades and vasa recta differ between the jejunal and ileal arteries?

Answer 62

Jejunum = smaller number of arterial arcades but longer vasa recta Ileum = large number of arterial arcades but shorter vasa recta

Question 63

Which artery supplies the caecum?

Answer 63

Ileocaecal artery

Question 64

Which artery supplies the appendix?

Answer 64

Appendicular artery

Question 65

Where does the appendicular artery arise from?

Answer 65

Ileocaecal artery

Question 66

Which artery supplies the ascending colon?

Answer 66

Right colic artery

Question 67

Which artery supplies the proximal 2/3 of the transverse colon?

Answer 67

Middle colic artery

Question 68

What are the branches of the inferior mesenteric artery?

Answer 68

It gives of the left colic artery and sigmoid arteries It then continues as the superior rectal artery

Question 69

At which vertebral level does the inferior mesenteric arise from?

Answer 69

L3

Question 70

Which artery supplies the descending colon?

Answer 70

Left colic artery

Question 71

Which artery supplies the distal 1/3 of the transverse colon?

Answer 71

Marginal branch of left colic artery

Question 72

Which artery supplies the sigmoid colon?

Answer 72

Sigmoid arteries

Question 73

Which artery supplies the superior 1/3 of the rectum and superior anal canal?

Answer 73

Superior rectal artery

Question 74

What does parasympathetic innervation of the GIT stimulate?

Answer 74

Peristalsis Sphincter relaxation Secretomotor to glands

Question 75

What does sympathetic innervation to the GIT provide?

Answer 75

Slows/inhibits peristalsis, urination and defaecation Vasoconstriction Pain sensation

Question 76

What provides sympathetic nervous supply to the GIT?

Answer 76

Thoracolumbar segment of spinal cord (T1-L2/3) Thoracic splanchnic nerves Lumbar splanchnic nerve Hypogastric nerve

Question 77

Which nerves provide parasympathetic innervation to the GIT?

Answer 77

Craniosacral Vagus nerve Pelvic splanchnic nerves

Question 78

What is the 2 neuronal pathway of the sympathetic nerves?

Answer 78

A neuronal pathway that begins in the spinal cord with a preganglionic nerve that synapses with a postganglionic nerve outside the spinal cord

Question 79

Where does the preganglionics of the sympathetic NS begin?

Answer 79

They begin in the lateral horn of grey matter in the spinal cord in the thoracolumbar segment (T1-L2/3)

Question 80

What is the paravertebral ganglia?

Answer 80

These are ganglia situated on either side of the vertebral column, beginning at the base of the skull and ending inferiorly at the coccyx as the ganglion impar, which contain postganglionic cell bodies

Question 81

What does the paravertebral ganglia make up?

Answer 81

Sympathetic chain

Question 82

How do the sympathetic preganglionics leave the spinal cord?

Answer 82

Via the ventral horn

Question 83

What are the different synapsing pathways that sympathetic preganglionics have once inside the paraverterbal ganglia?

Answer 83

It can synapse with the ganglia at that level It can ascend to synapse with a postganglionic nerve at a higher level It can descend to synapse with a postganglionic nerve at a lower level, forming splanchnic nerves

Question 84

What are the root values of the greater thoracic splanchnic nerve?

Answer 84

T5-T9

Question 85

What is the root value for the lesser thoracic splanchnic nerve?

Answer 85

T10-T11

Question 86

What is the root value for the least thoracic splanchnic nerve?

Answer 86

T12

Question 87

Where to the preganglionic thoracic splanchnic nerves synapse with the postganglionic nerve?

Answer 87

At the prevertebral ganglia situated around the branches of the aorta

Question 88

What are prevertebral ganglia?

Answer 88

These are ganglia situated around the abdominal aorta and its branches

Question 89

What are the prevertebral ganglia?

Answer 89

Coeliac ganglion Superior mesenteric ganglion Inferior mesenteric ganglion

Question 90

Which ganglia/plexus supplies the foregut structures?

Answer 90

Coeliac ganglion/plexus

Question 91

Which nerves contribute sympathetic innervation to the coeliac plexus?

Answer 91

Greater splanchnic nerve

Question 92

Which nerve contributes parasympathetic innervation to the coeliac plexus?

Answer 92

CN X