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