Blood and Nerve Supply to Abdominal Organs I

Question 1

abdominal aorta begins where?

Answer 1

T12

Question 2

where does the abdominal aorta terminate?

Answer 2

L4

Question 3

what crosses the anterior surface of the abdominal aorta

Answer 3

duodenum, pancreas, root of mesentery, left renal vein

Question 4

abdominal aortic aneurysm usually occurs where

what is main cause

Answer 4

• between bifurcation of aorta and the renal arteries

- atherosclerosis

Question 5

aorta should be no larger than __ cm on palpation and major complication is rupture especially when above __ cm

Answer 5

3, 5

Question 6

vertebral level location for celiac trunk?

Answer 6

T12-L1

Question 7

vertebral level SMA?

Answer 7

L1

Question 8

vertebral level IMA?

Answer 8

L3

Question 9

structures supplied by celiac artery

Answer 9

LSD GPS

Liver, spleen, duodenum (1st and 2nd part), gallbladder, pancreas, stomach

Question 10

structures supplied by SMA (midgut)

Answer 10

3rd and 4th part of duodenum to proximal 2/3 transverse colon

Question 11

splenic artery runs posterior to __ and superior to __

Answer 11

stomach, pancreas

Question 12

splenic artery is within what ligament?

Answer 12

splenorenal (ends as several splenic arteries)

Question 13

arrangement of the portal triad?

Answer 13

bile duct (right), portal vein (posterior), proper hepatic artery (left)

Question 14

cholecystectomy: calot’s triangle

Answer 14

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

Question 15

where does the superior mesenteric artery emerge from?

Answer 15

from aorta posterior to the neck of the pancreas

Question 16

right colic artery supplies?

Answer 16

ascending colon up to hepatic flexure

Question 17

branch of superior mesenteric artery that supplies the pancreas

Answer 17

first branch off SMA and is inferior pancreaticoduodenal a (anterior and posterior)
-anastomste from branches off the gastroduodenal arteries

Question 18

the SMA emerges ______ to the left of the ___

Answer 18

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

Question 19

features of jejunal arteries

Answer 19

long vasa recta, simple arcades, well vascularized, tall, close plicae circulares, wide diameter

Question 20

features of ileal arteries

Answer 20

short vasa recta, complex arcades, less vascularized and less plicae circulares

Question 21

ileocolic artery branches

Answer 21

ileal branches, cecal branches (anterior and posterior), ascending colic, and appendicular

Question 22

branches off inferior mesenteric artery

Answer 22

left colic artery (ascending and descending branches), sigmoid arteries, superior rectal artery

Question 23

risk factors of ischemic colitis

Answer 23

advanced age, clotting abnormalities, hypercholesterolemia, severe hypotension, adhesions, marathons, lupus or sickle cell, cocaine

Question 24

complication of ischemic colitis

Answer 24

tisue death, bowel perforates so then there is fecal matter around in the abdomen and pt can become septic

Question 25

superior rectal arterires and veins drain to

Answer 25

inferior mesenteric vein

Question 26

middle rectal arteries drain into

Answer 26

internal iliac veins

Question 27

inferior rectal arteries and veins drain

Answer 27

into internal pudendal vein

Question 28

where is sympathetic trunk located in relation to the aorta?

Answer 28

lateral to it

Question 29

hirschsprung disease

Answer 29

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

Question 30

where do most cases of hirschsprung disease occur (location in tract) and who is at higher risk?

Answer 30

rectosigmoid junction and down syndrome babies have higher risk

Question 31

chagas disease

Answer 31

T. cruzi, destorys ANS, mainly myenteric plexus

Question 32

nerves of the superior mesenteric plexus

pregang and post gang

Answer 32

sympathetic fibers from the greater, lesser, and lowest splanchnic nerves synapse in the SM ganglia. postganglionic fibers follow branches of SMA to target organs

Question 33

what to general visceral afferent pain fibers follow?

Answer 33

sympathetics

Question 34

part of the large intestine distal to the splenic flexure is derived from ___ and its parasympathetics are from what levels

Answer 34

hindgut, S2-4