Blood Supply to the Abdominal Viscera Flashcards
(97 cards)
0
Q
Where does the aorta enter the abdomen?
A
Through the aortic hiatus
1
Q
Where does the abdominal aorta begin?
A
T12
2
Q
The abdominal aorta is in front of or behind the peritoneum?
A
IT is behind the peritoneum: retroperitoneal
3
Q
The abdominal aorta is (posterior/anterior) to the vertebral bodies
A
Anterior
4
Q
What does the abdominal aorta relate to?
A
L1-L4
5
Q
Where does the aorta terminate?
A
At L4
6
Q
At L4, the aorta divides into what?
A
Into left and right common iliac arteries
7
Q
The IVC is to the (right/left) of the aorta
A
Right
8
Q
The left renal vein crosses (anterior/posterior) to the aorta
A
Anterior
9
Q
What forms the aortic hiatus?
A
The left and right crus of the diaphragm
10
Q
The anterior longitudinal ligament and vertebral bodies are (anterior/posterior) to the aorta
A
Posterior
11
Q
Celiac, superior mesenteric, inferior mesenteric plexi, renal plexi and autonomic nerves are located on the (anterior/posterior) and (lateral/medial) surfaces
A
anterior
lateral
12
Q
Sympathetic trunks are (medial/lateral) to the abdominal aorta
A
lateral
13
Q
The thoracic duct with the cisterna chyli is usually to the (right/left) of the abdominal aorta
A
right
14
Q
The pancreas, duodenum and root of THE mesentery are (anterior/posterior) to the abdominal aorta
A
Anterior
15
Q
What are the paired branches of the abdominal aorta?
A
Inferior phrenic aa subcostal and lumbar aa (middle) suprarenal aa renal aa (L2) gonadal aa (testicular/ovarian)
16
Q
What are the unpaired branches of the abdominal aorta?
A
Celiac artery (trunk) (T12, L1)
Superior mesenteric a (L1)
Inferior mesenteric a (L3)
Median (middle) sacral a (L4)
17
Q
What is an aortic aneurysm?
A
Abdominal aortic aneurysms occur in the part of the aorta that passes through the middle to low abdomen.
Thoracic aortic aneurysms occur on the aorta as it passes through the chest cavity. These are less common than abdominal aneurysms.
Some causes: Atherosclerosis, or hardening of the arteries, which weakens arterial walls.
Hypertension (high blood pressure).
Local injury to the artery.
Congenital abnormality.
18
Q
What are the branches from the aorta immediately below aortic hiatus?
A
The celiac trunk
19
Q
The celiac trunk runs directly (anteriorly/posteriorly)
A
Anteriorly
20
Q
What is the diameter of the celiac trunk?
A
1cm
21
Q
What is the celiac trunk surrounded by?
A
Celiac plexus and ganglia
22
Q
What are the 3 major branches of the celiac trunk?
A
Left gastric a (superior)
Common hepatic (right)
Splenic (left)
23
Q
What is the standard description of the left gastric a?
A
esophageal branches
24
What will the branches of the left gastric a. to the lesser curvature anastomose with?
Branches of the right gastric along the lesser curvature
25
The common hepatic a. branches into what 2 arteries?
(proper) hepatic a. and gastroduodenal a.
26
The common hepatic a -> proper hepatic a which gives off what branches
The right gastric artery that anastomoses with left gastric a. along the lesser curvature of the stomach.
The proper hepatic a itself ends as the right and left hepatic arteries
27
What artery usually branches off of the right hepatic a?
Cystic artery
28
The common hepatic artery-> gastroduodenal a which gives off:
```
May give off a supraduodenal a.
The rest of the gastroduodenal runs posterior to the duodenum
Terminal branches
-right gastro-omental a.
-superior pancreaticoduodenal branches
```
29
The splenic artery runs (anterior/posterior) to the stomach, (superior/inferior) to the pancreas
Posterior
| superior
30
The splenic artery is a very (straight/twisted) artery
Twisted. It is very tortuous
31
The splenic artery ends as what?
Several splenic aa (branches that do not anastomose)
32
What are the branches of the splenic artery?
Short gastric aa. to the upper part of the greater curvature
| Left gastro-omental a. that anastomoses with the right gastro-omental on the greater curvature of the stomach
33
The portal triad is within the _______ ligament
Hepatoduodenal
34
What are the contents of the hepatoduodenal ligament?
```
The typical arrangement:
Hepatic artery (proper)(left)
Portal vein (posterior)
Bile duct (right)
```
35
What is the function of the portal vein?
Brings deoxygenated, nutrient-rich blood from GI tract to the liver
36
What is the function of the hepatic artery (proper)?
Supplies oxygenated blood (a branch of the common hepatic artery)
37
What does the hepatic artery (proper) further divide into?
Left and right hepatic arteries
38
What is the venous drainage of the liver?
Right and left hepatic veins drain into right and left sides of IVC
39
The hepatic veins (do/ do not) follow the branching patterns of the portal veins, hepatic ducts and hepatic artery
DO NOT
40
The gall bladder lies in the ____ fossa
Hepatic
41
The lowest, and widest part of the gall bladder and contacts the anteriorr abdominal wall at the midclavicular line, 9th or 10th costal cartilage is the ______
Fundus
42
Define Major duodenal papilla
The major duodenal papilla is an opening of the pancreatic duct into the duodenum. The major duodenal papilla is, in most people, the primary mechanism for the secretion of bile and other enzymes that facilitate digestion.
43
The superior mesenteric artery is ____ inferior to celiac trunk
1 cm
44
The superior mesenteric artery emerges from what?
The the aorta posterior to the neck of the pancreas
45
The pancreas receives blood supply from branches of what arteries?
Both the celiac and superior mesenteric arteries
46
The celiac branches that supplies the pancreas is the ____
Superior pancreaticoduodenal branches
47
The gastroduodenal artery branches into the anterior and posterior superior ______
Pancreaticoduodenal a
48
What is usually the first branch of the superior mesenteric a?
Inferior pancreaticoduodenal a
49
The two pancreaticoduodenal arteries that branch off of the superior mesenteric are:
Anterior inferior and posterior inferior pancreaticoduodenal
50
The branches from the superior mesenteric artery meet the branches from the _______, forming anastomosing arcades on the ______ and _____ surfaces of the head of the pancreas
Gastroduodenal
| Anterior and posterior
51
The branches of the superior mesenteric artery to the small intestine are the :
```
Inferior pancreaticoduodenal a
Jejunal arteries (long vasa recta, simple arcades)
Ileal arteries (short vasa recta, complex arcades)
```
52
The superior mesenteric artery branches to the large intestine are:
ileocolic artery (ileal branch(es), colic branch)
Right colic artery
Middle colic artery
53
What are the branches of the ileocolic artery?
Posterior cecal branch
Anterior cecal branch
Ileal branch(es)
appendicular branch
54
The inferior mesenteric artery supplies derivaties of the ___ gut
Hindgut
55
The branches of the inferior mesenteric artery are:
left colic artery (ascending and descending branch)
Sigmoid arteries
Superior rectal artery
56
The inferior mesenteric vein branches are:
Superior rectal veins (drain to inferior mesenteric vein)
Middle rectal vein (drain to internal iliac veins)
Inferior rectal veins (drain to external pudendal veins)
57
The hepatic portal system begins as ______ in the digestive system and ends as ______ in the liver
Capillaries
| Capillaries
58
What system drains oxygen poor, nutrient-rich blood from the esophagus to the upper anal canal?
Hepatic portal system
59
Describe the portal vein
2 inches long and valveless.
Formed by the splenic vein, superior mesenteric vein, and the inferior mesenteric vein (either enters the superior mesenteric or splenic veins)
60
Where does the hepatic portal system form?
Posterior to the neck of the pancreas
61
How does the hepatic portal system end?
As right and left branches in the liver
62
What does the hepatic portal system run through to enter the liver at the porta hepatis?
The hepatoduodenal ligament
63
What are direct tributaries of the portal vein?
Paraumbilical vv (anterior wall)
Cystic v
left gastric v
right gastric v
64
What are tributaries of the splenic v?
Splenic vv (proper)
Short gastric vv
Left gastro-omental v
Pancreatic vv
65
What are tributaries of the superior mesenteric
Right gastro-omental v
| Panccreaticoduodenal vv
66
What contributes to the superior mesenteric v?
Intestinal vv (ileal and jejunal vv)
Ileocolic v (cecal and appendicular vv)
right colic v
middle colic v
67
What are clinically important overlaps between veins of the esophagus?
Blood can drain superiorly into the azygous system
| Blood can drain inferiorly into the portal system
68
What plexus is int he esophagus?
Submucous venous plexus
69
What are veins draining the liver?
Right hepatic vein
| Left hepatic vein
70
Hepatic veins are _____
Intersegmental
71
Common iliac veins join to form IVC at __
L5
72
Formation of the inferior vena cava is ______ and_____ to the aortic bifurcation
posterior and inferior
73
The inferior vena cava lies to the _____ of the lumbar and thoracic verebrae
Right
74
The inferior vena cava lies to the ___ and____ to the aorta
right and parallel
75
The inferior vena cava passes through the ___
liver
76
The inferior vena cava pierces the central tendon of the diaphragm at ___
T8
77
The inferior vena cava drains the:
Posterior body wall
- -Posterior body wall muscles
- -genitourinary system (internal iliac vv)
- -lower limbs (external iliac vv)
78
What are the main tributaries of the inferior vena cava?
```
right and left common iliacs
lumbar (paired, segmental) veins
renal veins
hepatic veins
middle sacral v
right gonadal v
right suprarenal v
inferior phrenic vv
```
79
What does the left suprarenal and gonadal veins enter instead of the IVC?
The left renal vein
80
Where do veins of the gastrointestinal tract normally drain into?
The portal veins, either directly or indirectly
81
Veins from posterior structures, such as kidneys, normally drain into the ____
IVC
82
What are porta-caval "anastomoses"?
Connections between the portal venous system and the inferior vena cava system
83
When do the portal-caval anastomoses become important?
When the liver is blocked from diseases such as cirrhosis
84
Blood flows back through what to return to the heart?
| portal caval section
Through the portal system and through the interconections with the inferior vena cava to return to the heart
85
How is it possible for the blood to flow back to the heart from the portal venous system?
Because the portal system does NOT HAVE VALVES.
86
What can back-up of blood in the caval system cause?
Varicosities which are at risk for hemorrhage
87
What are the 4 main ways for blood to bypass the liver?
1. esophageal branches of left gastric vein connect with veins on lower thoracic esophagus
2. paraumbilical veins in the falciform ligament with subcutaneous veins around umbilicus in the anterior wall
3. colic veins to retroperitoneal veins
4. between superior rectal veins and middle and inferior rectal veins
88
What is related to esophageal varicosities and usually result from portal hypertension (cirrhosis)?
When esophageal branches of left gastric vein connect with veins on lower thoracic esophagus
89
What veins run in the base of the falciform ligament and drain umbilical area?
The paraumbilical veins
90
When the liver is blocked, ____ veins dilate, and blood flows towards caval system
paraumbilical veins
91
Inferior epigastric and superficial epigastric veins of the anterior abdominal wall empty into the _____ and ______
External iliac and femoral veins
92
What causes caput medusae?
Distended paraumbilical veins radiated across abdomen
| portal hypertension
93
Veins draining the ascending colon (______) and descending colon (________) connect with _______ veins that drain the posterior body wall (veins of retzius)(lumbar)
Superior mesenteric vein
Inferior mesenteric vein
Retroperitoneal veins
94
The ________ drain into lumbar veins which in turn drain into the inferior vena cava
Veins of Retzius
95
The ____ and ____ rectal veins empty into the internal iliac veins witch int turn empty into the common iliac veins
Middle and inferior
96
When blood bypasses the liver between superior rectal veins and middle and inferior rectal veins this can cause what?
Rectal varicosities/hemorrhoids
