Blood and Nerve supply to abdominal organs

Question 1

what forms the aortic hiatus?

Answer 1

the left and right crura of the diaphragm

Question 2

is the aorta intra or retroperitoneal?

Answer 2

retro

Question 3

What vertebral level does the aorta bifurcate at?

Answer 3

L4

-splits into left and right common iliac arteries

Question 4

What big vein crosses the aorta anteriorly?

Answer 4

the left renal v.

Question 5

What is an abdominal aortic aneurysm?

Answer 5

dilation of the aorta

• primarily due to atherosclerosis
• presents as pulsatile abdominal mass that grows w/ time
• aorta should never be larger than 3 cm

Question 6

Where do we see the celiac trunk come off?

Answer 6

immediately inferior to the aortic hiatus at T12-L1

Question 7

What are the 3 major branches of the celiac trunk?

Answer 7

• left gastric a
• common hepatic a.
• splenic a.

Question 8

What surrounds the base of the celiac trunk?

Answer 8

the celiac plexus and ganglion

Question 9

What do the branches of the celiac trunk supply?

Answer 9

derivatives of the foregut and the spleen

-remember that the spleen is not part of the the digestive tube

Question 10

What are the branches off of the left gastric a.

Answer 10

• esohageal branches

- L gastric anastamoses with the right gastric along the lesser curvature of the stomach

Question 11

What are the branches of the splenic A.

Answer 11

short gastric, left gastroomental, and pancreatic branches (split into dorsal and inferior branches

Question 12

What ligament is the splenic A. in?

Answer 12

the splenorenal L.

Question 13

What ligament is the short gastric a. in?

Answer 13

the gastrosplenic L.

okay, this one makes sense because this is a branch off of the SPLENIC artery and it is going to the STOMACH

Question 14

What are the 2 main arteries that the common hepatic a. branches into?

Answer 14

proper hepatic and gastroduodenal

Question 15

What does the proper hepatic A. branch into?

Answer 15

• right gastric a. (anastamoses with left gastrci on the lesser curvature)
• right and left hepatic A.’s (cystic a. comes off of right)

Question 16

What does the gastroduodenal a. branch into?

Answer 16

right gastroomental and superior pancreaticoduodenal

-may give off supraduodenal a.

Question 17

If the abdominal aorta is blocked between the celiac trunk and the SMA, what will be the vessels compensating for that?

Answer 17

SPDA and IPDA

Question 18

What two vessels come together to form the portal vein?

Answer 18

the splenic v and SMV

-splenic or IMV?

Question 19

What drains the liver itself?

Answer 19

the hepatic veins

-not the portal vein

Question 20

What surrounds the structures of the portal triad?

Answer 20

hepatoduodenal ligament

-the other part of the lesser omentum is the hepatogastric ligament

Question 21

What branch of the aorta is located posterior tot he hepatogastric L. within the lesser peritoneal sac?

Answer 21

the celiac trunk

Question 22

What is the typical arrangement of the portal triad?

Answer 22

portal vein is posterior, proper hepatic on the left, and bile duct on the right

Question 23

Cholecystectomy, what is it?

Answer 23

a dissection through the hepatoduodenal ligament to reach the cystic A. which must be ligated before removing the gall bladder

Question 24

What is the main route of lymphatic drainage for the gallbladder?

Answer 24

calot’s node

Question 25

What is a branch from the SMA that supplies the pancreas?

Answer 25

the inferior pancreatico duodenal a

• branches into anterior and posterior and anastamoses with the branches from the gastroduodenal a.
• makes vascular arcades on the anterior and posterior of the HEAD of the pancreas

Question 26

Where does the SMA emerge from the aorta?

Answer 26

posterior to the neck of the pancreas to the left of the SMV

Question 27

What does the SMA enter in order to get to the the ileum and jejunum?

Answer 27

THE mesentery

Question 28

What are the branches of the SMA to the small intestine?

Answer 28

jejunal and ileal a.’s

-remember that the jejunum is more well vascularized

Question 29

What are the branches of the SMA to the large intestine?

Answer 29

Ileocolic A.
Right colic A.
middle colic A.
marginal A. kind of goes all the way around everything

Question 30

What are the branches of the ileocolic a.

Answer 30

ileal branch
colic branch
ant and post cecal branches
appendicular branch

Question 31

Where is the SMV and how does it run?

Answer 31

on the right and parallel with the SMA

• drains all of the same parts that are supplied by the SMA
• joins splenic V to form the portal vein posterior to the neck of the pancreas

Question 32

What the the SMA generally supply?

Answer 32

derivatives of the midgut

Question 33

What does the IMA generally supply?

Answer 33

derivatives of the hind gut

Question 34

What are the branches of the IMA

Answer 34

Left colic A. (ascending and desceding)
sigmoid A’s
superior rectal A.
marginal A.

Question 35

What does the IMV drain?

Answer 35

the exact same things that the IMA supplies

But, branches of the IMV do not parallel the IMA

Question 36

What does the IMV form to make the portal vein?

Answer 36

either the splenic V. or the SMV

Question 37

Where doe superior rectal veins drain to?

Answer 37

the IMV

Question 38

Where doe middle rectal veins drain to ?

Answer 38

internal iliac V.’s

Question 39

Where do inferior rectal veins drain to?

Answer 39

the internal pudendal V.’s

Question 40

What provides parasympathetic innervation to the foregut to midgut

Answer 40

the vagus nerve

Question 41

What provides parasympathetic innervation to the hind gut?

Answer 41

Pelvic splanchnic N.’s

Question 42

In the enteric nervous system, where is the myenteric plexus located?

Answer 42

between the outer longitudinal and inner circular muscular layers
-controls motility

Question 43

Where is the submucosal (meissner’s) plexus?

Answer 43

it’s the one that’s more superficial

-controls secretions, blood flow, and absorption