Blood and Nerve Supply to Abdominal Organs I Flashcards
abdominal aorta begins where?
T12
where does the abdominal aorta terminate?
L4
what crosses the anterior surface of the abdominal aorta
duodenum, pancreas, root of mesentery, left renal vein
abdominal aortic aneurysm usually occurs where
what is main cause
- between bifurcation of aorta and the renal arteries
- atherosclerosis
aorta should be no larger than __ cm on palpation and major complication is rupture especially when above __ cm
3, 5
vertebral level location for celiac trunk?
T12-L1
vertebral level SMA?
L1
vertebral level IMA?
L3
structures supplied by celiac artery
LSD GPS
Liver, spleen, duodenum (1st and 2nd part), gallbladder, pancreas, stomach
structures supplied by SMA (midgut)
3rd and 4th part of duodenum to proximal 2/3 transverse colon
splenic artery runs posterior to __ and superior to __
stomach, pancreas
splenic artery is within what ligament?
splenorenal (ends as several splenic arteries)
arrangement of the portal triad?
bile duct (right), portal vein (posterior), proper hepatic artery (left)
cholecystectomy: calot’s triangle
dissection through hepatoduodenal ligament to reach cystic artery to ligate before removing gall bladder
-medial border = common hepatic duct
lateral border = cystic duct
superior border = edge of liver
-cystic artery crosses the middle of the triangle
where does the superior mesenteric artery emerge from?
from aorta posterior to the neck of the pancreas
right colic artery supplies?
ascending colon up to hepatic flexure
branch of superior mesenteric artery that supplies the pancreas
first branch off SMA and is inferior pancreaticoduodenal a (anterior and posterior)
-anastomste from branches off the gastroduodenal arteries
the SMA emerges ______ to the left of the ___
posterior to the neck of the pancreas, to the left of the SMV, enters the mesentery and runs between its layers to reach the ileum and jejunum
features of jejunal arteries
long vasa recta, simple arcades, well vascularized, tall, close plicae circulares, wide diameter
features of ileal arteries
short vasa recta, complex arcades, less vascularized and less plicae circulares
ileocolic artery branches
ileal branches, cecal branches (anterior and posterior), ascending colic, and appendicular
branches off inferior mesenteric artery
left colic artery (ascending and descending branches), sigmoid arteries, superior rectal artery
risk factors of ischemic colitis
advanced age, clotting abnormalities, hypercholesterolemia, severe hypotension, adhesions, marathons, lupus or sickle cell, cocaine
complication of ischemic colitis
tisue death, bowel perforates so then there is fecal matter around in the abdomen and pt can become septic
superior rectal arterires and veins drain to
inferior mesenteric vein
middle rectal arteries drain into
internal iliac veins
inferior rectal arteries and veins drain
into internal pudendal vein
where is sympathetic trunk located in relation to the aorta?
lateral to it
hirschsprung disease
failure of NC cells to migrate during intestinal development
- no myenteric plexus, must take biopsy all the way down to this level in order to diagnose
- no parasympathetics so gut cannot relax causing constriction and megacolon of proximal colon segments
where do most cases of hirschsprung disease occur (location in tract) and who is at higher risk?
rectosigmoid junction and down syndrome babies have higher risk
chagas disease
T. cruzi, destorys ANS, mainly myenteric plexus
nerves of the superior mesenteric plexus
pregang and post gang
sympathetic fibers from the greater, lesser, and lowest splanchnic nerves synapse in the SM ganglia. postganglionic fibers follow branches of SMA to target organs
what to general visceral afferent pain fibers follow?
sympathetics
part of the large intestine distal to the splenic flexure is derived from ___ and its parasympathetics are from what levels
hindgut, S2-4
