Celiac Trunk and Targets Flashcards
3 main arterial trunks off the aorta that supply G.I. tract
celiac, inferior and superior mesenteric
gut region supplied by celiac, inferior and superior mesenteric
foregut, midgut, hindgut respectively
tubular gut divisions
foregut-proximal duodenum
midgut-distal duodenum, proximal transverse colon
hindgut–distal transverse colon, descending and sigmoid colon
arterial supply to the esophagus
celiac trunk–>left gastric artery–>esophageal arteries (anastomose with esophageal arteries from aorta)
left inferior phrenic
venous drainage of the esophagus
esophageal veins–>azygous system
left and right gastric veins–>hepatic portal vein
arterial supply to stomach
celiac trunk–>left gastric artery (superior) anastomoses with right gastric artery from common hepatic artery
celiac trunk–>splenic artery–>short gastric arteries and L gastro-omental artery (anastomoses with right gastro-omental)
celiac trunk–>proper hepatic–>right gastro-omental and right gastric artery
anastomoses of stomach arterial supply
right and left gastric anastomose in less curvature. left gastric from celiac trunk, right gastric from common hepatic.
left and right gastro-omental arteries anastomose in greater curvature. right gastro-mental from common hepatic, left gasro-omental from splenic.
venous drainage of stomach
left gastro-omental–>splenic –>hepatic portal
right gastro-omental–>inferior mesenteric–>hepatic portal
right and left gastric–>hepatic portal
venous drainage and arterial supply to spleen
splenic artery and vein.
artery from celiac trunk
vein into hepatic portal
arterial supply to liver
celiac trunk–>common hepatic artery–>proper hepatic artery–>right and left hepatic arteries
venous drainage of liver
right, middle, and left hepatic veins. (hepatic veins FROM liver) (hepatic portal TO liver)
spleen in relationship to stomach and liver
posterolateral to the body of the stomach. recycles RBGs
portal triad and location
1)common bile duct
2)proper hepatic artery
3)hepatic portal vein
located in the thickened left lateral edge of the lesser omentum in the hepatoduodenal ligament
structures within the hepatoduodenal ligament
posterior to everything–hepatic portal vein
left lateral–common bile duct
medial–proper hepatic artery
biliary tree
right and left hepatic ducts–>common hepatic duct + cystic duct–> common bile duct + pancreatic duct–>hepatopancreatic ampulla through the duodenum via the major duodenal papilla
function of the gallbladder
stores, concentrates biles. and muscular so it releases it’s bile into cystic duct in response to chyme. bile that made in the liver while the major duodenal papilla is closed due to no creation of chyme/no digestion.
collects bile via cystic duct.
bile from liver into gallbladder
through right and left hepatic ducts to the common bile duct and the hepatopancreatic ampulla. when closed, bile is sent back up the common bile duct into the cystic duct and into the gallbladder
gallstones
cholelithiasis. crystallization of cholesterol, bile salts. stuck in the proximal opening of the cystic duct.
triangle of calot
lateral--cystic duct inferior--common hepatic duct superior-inferior edge of liver. contains the cystic artery contains Lund's node. (enlarged due to cholecystitis)
hepatic portal vein formation
splenic vein + inferior mesenteric and superior mesenteric vein and right and left gastric arteries–>hepatic portal vein
function of hepatic portal system
return all digestive blood into the liver
portocaval anastomoses
esophageal veins of left gastric with Esophageal branches of Azygos vein.
superior rectal veins from inferior mesenteric with inferior veins
paraumbilical with superior epigastric
portal blood backs up into systemic system because they are two way valves.
portal hypertension
blockage of blood flow into liver increases liver upstream, forces blood into systemic anastomoses. usually obstruction of portal vein
ribs that spleen has relationship to
9-12th
enlarged spleen palpated
below the costal arches, below 12th rib, laterally.
gastroesophageal junction
no anatomical sphincter. tone of diaphragm stops reflux
division of right and left lobes of liver when viewed from anterior aspet
falciform ligament
peritoneum of liver
parietal/visceral reflection at falciform ligament. no peritoneum at the bare area, above the right lobe. comes in contact with diaphragm above the right pleural cavity.
lymphatic drainage of foregut
flow towards splenic lymph nodes (left lateral), pyloric nodes (right lateral) and collect in celiac nodes at the base of the celiac trunk. from celiac trunk, it goes superior into cistern chyli and then thoracic duct. all lymphatics inferior to diaphragm
parasympathetic supply of foregut
vagal trunks (from right and left vagus nerve).
parasympathetic supply of midgut
vagal trunks (from right and left vagus nerves)
parasympathetic supply of hindgut
pelvic splanchnic nerves (S2-S4)
sympathetic innervation of abdominal viscera
pre-ganglionic from IMLs through thoracic and lumbar splanchnic nerves to the prevertebral ganglion
three prevertebral ganglion and their innervations of abdominal viscera
celiac–foregut
superior mesenteric–midgut
inferior mesenteric–hindgut
fibers after prevertebral ganglion
post-ganglionic sympathetic and they blend with parasympathetic
visceral pain felt where?
celiac–mid back, high gut (all foregut organs)
superior mesenteric–flanks (all midgut organs)
inferior mesenteric– lower back/groin (all hindgut organs)
autonomic plexus
preganglionic parasympathetic and postganglionic sympathetics running alongside vessels in the mesenteries
splanchnic nerve for foregut
thoracic splanchnic
transition of esophagus into stomach
z line
anatomical aspects of stomach
intraperitoneal; anchored by greater and lesser omenta and esophagus
peptic ulcers
dueodenum and stomach … a lot of arterial supply so a lot of bleeding, and low pH in abdominal cavity
erosion of mucosa by acid, bacterial.
can cause damage to nearby structures (pancreas and splenic arteries)
structures damaged by peptic ulcers
pancreas and splenic arteries
division of quadrate lobe of liver
falciform to the left, gall bladder to the right
division of caudate love of liver
IVC on left and IVC on right
how does portal triad enter liver
porta hepatis
embryological precursor of ligamentum venosum and ligamentum teres
ductus venosus and umbilical vein
complications of cirrhosis
replacement of liver by fibers tissue results in jaundice, portal hypertension, and ascites
process of esophageal varices
portal veing blocked, build up in gastric veins which go to esophageal veins
how does bile exit liver
bile is produced by hepatocytes and exits the portal hepatic via bile ducts
