Blood Supply to Gut

Question 1

• coeliac trunk arises from the abdominal aorta at which vertebral level?
• what does it trifurfacte into? (3)

Answer 1

- coeliac trunk arises from the abdominal aorta at T12

• trifurcates into:
  i) left gastric artery
  ii) splenic artery
  iii) common hepatic artery

Question 2

desribe the pathway of the left gastric artery, splenic artery and common hepatic artery

Answer 2

left gastric -> supplies the lesser curvature of the stomach, gives off oesphogeal branhces

splenic artery --> short gastric arteries (supplies the fundus), left gastric epiploic (runs around greater curvature of stomach), terminates at spleen

• *common hepatic artery** –> gastroduodenal artery, which branches to give right gastroepiploic artery - which anastamoses with left gastroepiploic artery.
• -> right gastric artery (goes to less curvature of stomach). anastamoes with left gastric artery
• –> after these two have gone, becomes the hepatic artery proper

Question 3

Answer 3

Question 4

Answer 4

Question 5

describe pathway of common hepatic artery –> hepatic artery proper —> ?? :)

Answer 5

common hepatic artery: branches into

• gastroduodenal artery, which branches to give right gastroepiploic artery - which anastamoses with left gastroepiploic artery.
• right gastric artery (goes to less curvature of stomach). anastamoes with left gastric artery

after these two: becomes the hepatic artery proper; branches into:

• **right hepatic artery –> cystic artery (gall bladder)
• left hepatic artery**

Question 6

what is the name of the artery outlined in green?

Answer 6

cysteic artery

Question 7

the spleen is the site of ? (2)

is it intraperitoneal / retroperiotneal? why is the answer clincally significant?

Answer 7

lymphocyte proliferation (1)
rbc filtration, destruction and storage(1)

spleen is intraperitoneal. able to move around. means that during blunt trauma to peritoneum, can be torn away from the splenic artery and cause internal bleeding

Question 8

A-D?

Answer 8

A: coeliac trunk
B: splenic artery
C: hepatic artery proper
D: gastroduodenal

Question 9

where does the midgut start? and run to?

supplied by?

Answer 9

2nd part of duodenum –> 2/3 of transverse colon

supplied by SMA

Question 10

describe the branches of the SMA (6)

Answer 10

1. inferior pancreaticoduedenal artery
2. jejnunal and ileal branches

3 middle colic artery

4. right colic artery
5. ileocolic artery -> appendicular artery

MRI !

Question 11

1. jejnunal and ileal branches of SMA are found where??
2. is this photo from jejunum or ileum? how do u tell

Answer 11

jejnunal and ileal branches of SMA are found in the mesentary?

• photo = jejunum

Question 12

Answer 12

A: jenunal
B: superior mesentric
C ileocolic

Question 13

what are the 3 branches of the IMA?

what connects the SMA & IMA?

Answer 13

inferior mesenteric artery branches:

- left colic artery

- sigmoidal artery

- superior rectal artery

• SMA & IMA connected by marginal artery

Question 14

rectal blood supply:

rectum gets supply from which 3 main arteries? where do each of these come from?

Answer 14

• superior rectal artery: from SMA
• *- middle rectal artery:** internal iliac artery
• *- inferior rectal artery:** from pudendal artery

Question 15

Answer 15

Question 16

Answer 16

Question 17

Answer 17

Question 18

Answer 18

Question 19

what happens to all of the blood from your gut? (for / mid / hind)

Answer 19

goes to

foregut -> splenic vein

midgut -> Superior mesenteric vein

hindgut -> inferior mesenteric vein

= all go into the hepatic portal vein -> liver (blood is filtered) –> IVC

Question 20

which veins dont go to liver & directly drain into IVC? (4)

Answer 20

• gonadal vein
• renal vein
• internal iliac vein
• external iliac vein

Question 21

explain the Para and sympathetic nerve supply to the gut. what do they normally do

Answer 21

(motor component (Parasymp and Sym) of autonomic:)

sympathetic nerves effect (T1-L2)

• pass through sympathetic trunk & synapse in the abdomen = splachnic nerves
• inhibits digestion

**parasym nerves (CN III, VII, IX, X & s2-s4)

• vagus nerve**
  runs up to 2/3 transvers colon. after which sacral nerves take over and supply the hindgut: pelvic splachnic nerves
• salivation
• stimulates digestion
• colon motility
• urinatin / defecation

Question 22

the splanchinc and pelvic splachnic nerves contribute to the nerve supply of the gut. which one is from parasympathetic and which is sympathetic?

Answer 22

splanchnic nerves are sympathetic ! S4S

pelvic splachnic nerves are paraysm ! P4P!

Question 23

what are the 3 locations of the ganglia where splachnic nerves (sympathetic NS) synapse?

(ie for foregut ? midgut? hindhut?)

Answer 23

if innervating the:

foregut -> coelaic ganglia

midgut -> superior mesenteric ganglia

hindut -> inferior mesenteric ganglia

Question 24

Answer 24

Question 25

Answer 25

hepatic artery proper and hepatic portal vein

Question 26

Answer 26

A: left colic
B: sigmoidal
C: superior rectal