Blood supply and venous drainage of the Gut

Question 1

The gut consists of

Answer 1

Foregut
Midgut
Hindgut

Question 2

Foregut gives rise to what organs

Answer 2

Liver

pancreas

spleen

Stomach

Duodenum- upper half

Question 3

Mid gut gives rise to

Answer 3

lower half of duodenum

jejunum

ileum

ascending colon

proximal two third of transverse colon

Question 4

Hindgut gives rise to

Answer 4

distal one third of transverse colon

descending colon

sigmoid colon

rectum

upper part of anal canal

Question 5

Artery of foregut

Answer 5

The celiac trunk

Question 6

Celiac trunk arises from

Answer 6

the ant aspect of the abdominal aorta at the aortic hiatus of the diaphragm (T12 level) as the second branch.

Question 7

Branches of celiac trunk

Answer 7

left gastric- left

splenic- left

common hepatic-right

Question 8

Left gastric

Answer 8

It ascends across the diaphragm, giving rise
to oesophageal branches.

It then continues anteriorly
along the lesser curvature of the stomach and it anastomoses with the right gastric artery here and supplies it

Question 9

Splenic

Answer 9

It arises from the coeliac trunk just inferior to the left gastric artery.

It then travels left towards the spleen, running posterior
to the stomach and along the superior margin of the
pancreas contained in the lienorenal ligament

Gives rise to the following branches:

Left gastroepiploic artery: supplies the greater
curvature of the stomach. Anastomoses with the right
gastroepiploic artery.

Short gastrics arteries: 5-7 small branches supplying
the fundus of the stomach.

Pancreatic branches: supply the body and tail of the
pancreas.

Question 10

Common hepatic

Answer 10

As it travels past the superior aspect of the duodenum, it
divides into its two terminal branches – the proper
hepatic and gastroduodenal arteries.

Question 11

Branches of proper hepatic

Answer 11

Right gastric: supplies the pylorus and lesser curvature of
the stomach.

Right and left hepatic: supply their respective lobes of the liver.

Cystic: It is a branch of the right hepatic artery – supplies the
gall bladder.

Question 12

Branch of gastroduodenal

Answer 12

Right gastroepiploic: supplies the greater
curvature of the stomach.

Superior pancreaticoduodenal: supplies the head of the pancreas.

Question 12

Artery of midgut

Answer 12

SMA- arises from abdominal aorta

Question 13

Branches of SMA

Answer 13

inferior pancreaticoduodenal artery

Jejunal artery

Ileal Arteries

right colic artery

middle colic artery

ileocolic artery

Question 14

Inferior pancreaticoduodenal

Answer 14

It anastomose with branches of the superior pancreaticoduodenal artery.

This network supplies the inferior region of the
head of the pancreas, the uncinate process, and
the duodenum.

Question 15

Jejunal

Answer 15

Supplies jejunum
Characterized by small number of arterial arcades and long vasa recta.

Question 16

Ileal

Answer 16

supplies ileum
Characterized by large number of arterial arcades and short vasa recta

Question 17

Right colic

Answer 17

supplies the ascending colon

Question 18

Middle colic

Answer 18

supplies the transverse
colon.

Question 19

Ileocolic

Answer 19

Supplies the following:

ascending colon
appendix
cecum
ileum.

Question 20

Artery of hindgut

Answer 20

IMA

Question 21

Origin of IMA

Answer 21

It arises at L3, near the inferior border of the duodenum, 3-4 cm above where the aorta bifurcates into the common iliac arteries.

Question 22

Branches of IMA

Answer 22

left colic artery

sigmoid artery

superior rectal artery.

Question 23

Left colic

Answer 23

Has 2 branches:
Ascending branch: It supplies the distal 1/3 of the transverse colon and the upper part of the descending colon.

Descending branch – supplies
the lower part of the descending colon. It
anastomoses with the superior sigmoid artery.

Question 24

Sigmoid

Answer 24

supply the descending colon
and the sigmoid colon.

Question 25

Superior rectal

Answer 25

Supplies rectum

Question 27

Venous drainage of foregut

Answer 27

SMV

prepyloric vein of mayo

Left gastric vein

short gastric vein

left gastroepiploic veins

right gastric vein

azygos system of veins

Question 28

Venous drainage of midgut

Answer 28

SMV

Question 29

Venous drainage of hindgut

Answer 29

Superior rectal veins form IMV that drain the hindgut

Question 30

Clinical correlates

Answer 30

Celiac trunk compression syndrome

Occlusion of the Superior Mesenteric Artery

Question 31

Celiac trunk compression syndrome

Answer 31

If the median arcuate ligament lies anterior to the coeliac trunk, rather than its usual superior position, it can cause compression of the coeliac trunk.

It presents pathologically as pain and this pain is said to be caused by the ischemia of some visceral organs.

Treatment includes surgical division of the median
arcuate ligament.

Question 32

Occlusion of SMA

Answer 32

Caused by thrombosis, embolism, abdominal aortic aneurysm and aortic dissection.

It restricts blood flow to the midgut, resulting in intestinal ischemia.

Common in old people.