Blood Supply of the Abdomen

Question 1

three pairs of embryonic ___ arteries (blood supply to yolk sac) fuse at the ___ during closure of the lateral body folds

this results in the formation of three unpaired, midline arteries arising from the ___, which supply respectively the derivatives of the embryonic ___, ___, & ___

Answer 1

vitelline, midline

abdominal aorta, foregut, midgut, hindgut

Question 2

the three unpaired arteries & structures supplied are as follows:

foregut - ___ trunk (6)

Answer 2

celiac

distal 1/3 of the esophagus
stomach
1st & 2nd parts of duodenum
liver & gallbladder
pancreas
spleen

Question 3

the three unpaired arteries & structures supplied are as follows:

migut - ___ artery (5)

Answer 3

superior mesenteric

3rd & 4th parts of duodenum
jejunum & ileum
cecum & appendix
ascending colon
proximal 2/3 of the trasnverse colon

Question 4

the three unpaired arteries & structures supplied are as follows:

hindgut - ___ artery (5)

Answer 4

inferior mesenteric

distal 1/3 of the transverse colon
descending colon
sigmoid colon
rectum
superior 1/2 of the anal canal

Question 5

celiac trunk:

branches off of the ___ at the level of ___

it lies ___ & is surrounded by the ___

it gives rise to three branches: ___, ___, & ___

Answer 5

abdominal aorta, T12

retroperitoneally, celiac plexus

left gastric, splenic, common hepatic

Question 6

celiac trunk:
left gastric artery:

ascends ___ to the level of the ___

here, it gives off ___ & descends along the lesser curvature of the stomach within the ___

within this, the left gastric artery anastomses w/ the ___ (branch of the common hepatic, hepatic artery proper, or right hepatic artery)

it is relatively common for the left gastric artery to give rise to an ___ artery

Answer 6

retroperitoneally, gastroesophageal junction

esophageal branches, lesser omentum

right gastric artery

accessory hepatic

Question 7

celiac trunk:
splenic artery:

runs ___ along the upper border of the ___ & reaches the ___ within the ___ligament

it gives off the following important branches:

___ - along its course

___ - supply the fundus of the stomach reaching it within the ___ ligament

___ - runs along the greater curvature of the stomach within the ___ ligament & anastomoses with the ___ (branch of the gastroduodenal artery)

___ branches

Answer 7

retroperitoneally, pancreas, spleen, lienorenal

pancreatic branches

short gastric arteries, gastrolienal

left gastro-omental (gastroepiploic) artery, gastrocolic, right gastro-omental (gastroepiploic) artery

splenic

Question 8

celiac trunk:
common hepatic artery:

descends ___ to the right until it lies above the ___

divides into two branches: ___ & ___

Answer 8

retroperitoneally, first segment of the duodenum

hepatic artery proper, gastroduodenal

Question 9

celiac trunk:
branches of the common hepatic:
hepatic artery proper:

enters the ___ ligament & ascends immediately to the left of the ___ duct

gives rise to 4 important branches: ___, ___, ___, & ___

Answer 9

hepatoduodenal, common bile

right hepatic artery - right lobe of liver
left hepatic artery - left lobe of liver
cystic artery
right gastric artery

Question 10

celiac trunk:
branches of the common hepatic:
branches of the hepatic artery proper:
cystic artery:

usually a branch of the ___

may arise from the ___, right or left ___, or the ___

it may pass in front or in back of the ___ & ___ ducts

there may be ___ arteries (important to surgeons during cholecystectomy)

Answer 10

right hepatic artery

hepatic proper, hepatic, gastroduodenal

common bile, cystic

accessory cystic

Question 11

celiac trunk:
branches of the common hepatic:
branches of the hepatic artery proper:
right gastric artery:

may arise from the ___, the ___, or the ___

Answer 11

common hepatic artery, hepatic artery proper, right hepatic artery

Question 12

celiac trunk:
branches of the common hepatic:
gastroduodenal proper:

passes ___ the first segment of the duodenum

divides into two principal branches: ___ & ___

Answer 12

behind

right gastro-omental (gastroepiploic) artery, superior pancreaticoduodenal artery

Question 13

celiac trunk:
branches of the common hepatic:
branches of the gastroduodenal proper:
right gastro-omental (gastroepiploic) artery:

anastomses w/ the ___ along the greater curvature of the stomach within the ___ ligament

Answer 13

left gastro-omental (gastroepiploic) artery

gastrocolic

Question 14

celiac trunk:
branches of the common hepatic:
branches of the gastroduodenal proper:
superior pancreaticoduodenal artery:

there are usually ___ & ___ superior pancreaticoduodenal arteries

runs b/n the ___ & the ___

anastomoses w/ the ___ artery (also usually the ___ & ___ branches) from the superior mesenteric artery

Answer 14

anterior, posterior

2nd segment of the duodenum, head of the pancreas

inferior pancreaticoduodenal, anterior, posterior

Question 15

celiac trunk:
summary of the blood supply to the foregut:
stomach (5)

Answer 15

left gastric artery - lesser curvature of stomach & distal 1/3 esophagus

right gastric artery - lesser curvature of the stomach

short gastric arteries - fundus of the stomach

right gastro-omental (gastroepiploic) artery - greater curvature of the stomach

left gastro-omental (gastroepiploic) artery - greater curvature of the stomach

Question 16

celiac trunk:
summary of the blood supply to the foregut:
pancreas (3)

Answer 16

pancreatic branches from the splenic artery

superior pancreaticoduodenal artery

inferior pancreaticoduodenal artery

Question 17

celiac trunk:
summary of the blood supply to the foregut:
spleen (1)

Answer 17

splenic artery

Question 18

celiac trunk:
summary of the blood supply to the foregut:
liver (2)

Answer 18

right & left hepatic arteries (30% of the blood)
portal vein (70% of the blood)

Question 19

celiac trunk:
summary of the blood supply to the foregut:
gallbladder (1)

Answer 19

cystic artery

Question 20

celiac trunk:
summary of the blood supply to the foregut:
duodenum (2)

Answer 20

superior pancreaticoduodenal artery

inferior pancreaticoduodenal artery

Question 21

superior mesenteric artery:

originates ___ form the ___ at the level of ___

runs ___ & to the right behind the ___, but in front of the ___

Answer 21

retroperitoneally, abdominal aorta, L1

downward, neck of the pancreas, 3rd segment of the duodenum

Question 22

superior mesenteric artery:
important branches (5)

Answer 22

inferior pancreaticoduodenal artery

jejunal & ileal branches (12-15 branches)

ileocolic artery

right colic artery

middle colic artery

Question 23

superior mesenteric artery:
important branches:
inferior pancreaticoduodenal artery:

anastomses w/ the ___ artery to supply the ___ & ___

Answer 23

superior pancreaticoduodenal

pancreas

duodenum

Question 24

superior mesenteric artery:
important branches:
jejunal & ileal branches (12-15 branches):

arise from the ___ side of the ___ artery

each divides into two & unites w/ adjacent division of other branches to form a series of ___ in the ___

these are ___ developed along the ileum than along the jejunum

these give rise to ___ arteries (___)

Answer 24

left, superior mesenteric

arcades, mesenteries

more

straight, arteria recta

Question 25

superior mesenteric artery: important branches: ileocolic artery: arises from the ___ side of the __ artery passes in the ___ directly towards the ___ gives rise to 4 branches: ___, ___, ___, & ___

Answer 25

right, superior mesenteric mesentery, cecum colic ileal cecal appendicular

Question 26

superior mesenteric artery: important branches: right colic artery: supplies the ___

Answer 26

ascending colon

Question 27

superior mesenteric artery: important branches: middle colic artery: supplies the ___

Answer 27

proximal 2/3 of the transverse colon

Question 28

inferior mesenteric artery: arises ___ 3-4cm proximal to the ___ at the level of ___ gives rise to 3 branches: ___

Answer 28

retroperitoneally, bifurcation of the aorta, L3 left colic artery sigmoidal arteries (usually 3 or 4) superior rectal artery

Question 29

superior mesenteric artery: branches: left colic artery: supplies the distal 1/3 of the ___ colon & the upper part of the ___ colon

Answer 29

transverse descending

Question 30

superior mesenteric artery: branches: sigmoidal arteries (usually 3 or 4): supply the lower part of the ___ colon & the ___ colon

Answer 30

descending sigmoid

Question 31

superior mesenteric artery: branches: superior rectal artery: this is the direct continuation of the ___ supplies the ___ & proximal 1/3 of the ___ anastomoses w/ the ___ & ___ arteries

Answer 31

infeiror mesenteric artery rectum, anal canal middle, inferior rectal

Question 32

marginal artery of drummond complex anastomses of branches of the ___ arteries which frames the entire ___ the anastomses includes connections b/n 6 arteries: ___

Answer 32

superior & inferior mesenteric, large intestine ``` ileocolic right colic middle colic left colic sigmoidal superior rectal ```

Question 33

blood supply to the primary retroperitoneal organs: unlike the abdominal digestive system & associated digestive glands, the primary retroperitoneal organs & structures are supplied by ___ arteries this is the case for the entire ___ system, the ___ glands, & the ___ wall it is not true for the ___ portions of the digestive system

Answer 33

paired urogenital, suprarenal, posterior abdominal secondary retroperitoneal

Question 34

secondary retroperitoneal structures are those portions of the digestive system & associated digestive glands which begin embryonic development as ___ structures & later lose their mesenteries when they fuse w/ the ___ of the ___ wall the 6 secondary retropertioneal structures are: ___

Answer 34

intraperitoneal, parietal peritoneum, posterior abdominal ``` distal 3/4 of the duodenum pancreas ascending colon descending colon rectum ```

Question 35

blood supply to the primary retroperitoneal organs: in the abdomen, the primary retroperitoneal structures are all supplied by ___ arteries which are direct branches of the ___ in the pelvis, the ___ arteries are direct branches of the ___ arteries all of these retroperitoneal structures are drained by branches of the ___

Answer 35

paired, abdominal aorta paired, internal iliac inferior vena cava

Question 36

blood supply to the primary retroperitoneal organs: suprarenal glands: arteries: ___ - branches of the inferior phrenic artery ___ - from abdominal aorta ___ - from renal artery

Answer 36

superior suprarenals middle suprarenal inferior suprarenal

Question 37

blood supply to the primary retroperitoneal organs: suprarenal glands: veins: each suprarenal gland is usually drained by a ___ the right suprarenal vein drains directly into the ___ the left suprarenal vein drains into the ___, which then drains into the ___glands:

Answer 37

single vein inferior vena cava left renal vein, inferior vena cava

Question 38

blood supply to the primary retroperitoneal organs: the gonads: the testes & ovaries receive their respective blood supplies ___ by way of branches of the ___ which then descend to their respective targets this is in accordance w/ the embryonic principal whereby structures which begin development in one location & subsequently migrate to a different location carry their ___ supply, ___ supply, & ___ drainage w/ them arteries - one artery from the ___ below the origin of the ___ arteries veins - one vein following same pattern as the suprarenal glands - ___ vein drains into the inferior vena cava - ___ vein drains into the left renal vein

Answer 38

directly, abdominal aorta blood, nerve, lymphatic abdominal aorta, renal right gonadal left gonadal

Question 38

the hepatic portal system: a portal system is a system of veins interposed b/n two ___ the ___ & ___ blood does not return directly to the heart, but rather, passes through specialized capillary networks in the ___ (hepatic sinusoids) the hepatic portal system consists of 6 vessels: ___

Answer 38

capillary networks intestinal, splenic venous, liver ``` portal vein superior & inferior mesenteric veins splenic vein right & left gastric veins cystic vein paraumbilical veins ```

Question 39

the hepatic portal system: the portal vein: formed behind the ___ by the union of the ___ & ___ veins it then ascends behind the first segment of the ___ & enters the free margin of the ___ ligament lying behind & between the ___ duct & the ___ (these three structures are known as the ___) it ascends in the ___ ligament in front of the ___ foramen & then enters the porta hepatis of the ___

Answer 39

neck of the pancreas, superior mesenteric, splenic duodenum, hepatoduodenal, common bile, hepatic artery proper, portal triad hepatoduodenal, epiploic (of WInslow), liver

Question 40

the hepatic portal system: the portal vein: within the substance of the liver, the ___ vein branches into many generations of vessels which eventually open into the ___ the blood is recollected into the ___ veins which drain into the ___ on the posterior surface of the ___ blood from the right & left ___ veins, the ___ veins, & the ___ veins (superficial abdomen) drains directly into the portal vein just before it enters the ___

Answer 40

portal, hepatic sinusoids hepatic, inferior vena cava, liver gastric, systic, paraumbilical, porta hepatis

Question 41

the hepatic portal system: the splenic vein: forms at the ___ & runs along the upper border of the ___ w/ the ___ artery it usually receives the ___ vein

Answer 41

hilus of the spleen, pancreas, splenic inferior mesenteric

Question 42

the portal-systemic anastomoses: under normal conditions, the portal venous blood traverses the ___ & drains into the ___ of the system circulation by way of the ___ veins however, following injury & death of the ___ cells (hepatocytes) caused by infection, toxins, alcohol, poisons, etc., excessive scarring may result through ___ of connective tissue the resulting fibrosus exhibits a variety of patterns & is known as ___ of the ___

Answer 42

liver, inferior vena cava, hepatic liver parenchymal, proliferation cirrhosis, liver

Question 43

the portal-systemic anastomoses: resistance to blood flow through the ___ results in a build up of pressure known as ___ alternate routes of blood flow back to the heart exist which connect the portal & systemic venous systems & are known as the ___ these routes are possible b/c there are no ___ in any of the tributaries of the ___ system & they form anastomoses w/ branches of the ___ circulation under conditions of portal hypertension, these anastomoses become greatly ___ & act as major ___

Answer 43

liver, portal hypertension portal-systemic anastomoses valves, hepatic portal, systemic venous dilated, venous channels

Question 44

the portal-systemic anastomoses: | 4 major communications b/n the portal & systemic venous systems

Answer 44

at the lower end of the esophagus the anterior abdominal wall the anal canal the posterior abdominal wall

Question 45

the portal-systemic anastomoses: 4 major communications b/n the portal & systemic venous systems: at the lower end of the esophagus: esophageal branches of the ___ vein (portal) esophageal branches of the ___ vein (systemic) dilation of channels - ___

Answer 45

left gastric azygous esophageal varices

Question 46

the portal-systemic anastomoses: 4 major communications b/n the portal & systemic venous systems: the anterior abdominal wall: ___ veins (portal) ___ veins of the ___ wall (systemic) dilation of channels - ___ ("Medusa's head")

Answer 46

paraumbilical superficial caput medusae

Question 47

the portal-systemic anastomoses: 4 major communications b/n the portal & systemic venous systems: the anal canal: ___ veins (portal) ___ veins (systemic) dilation of channels - ___ (often have causes other than portal hypertension)

Answer 47

superior rectal middle & inferior rectal hemorrhoids

Question 48

the portal-systemic anastomoses: 4 major communications b/n the portal & systemic venous systems: the posterior abdominal wall: tributaries of ___ organs (portal) tributaries of ___ organs (systemic)

Answer 48

secondary retroperitoneal primary retroperitoneal