Digestive system Part II week 4

Question 1

what are the four lobes of the liver?

Answer 1

Right, left, quadrate(next to gallbladder), and caudate(may have right and left hepatic artery feeding it).

Question 2

Why is there a bare spot on the superior portion of the liver?

Answer 2

it is where the diaphragm is sitting and this area is lacking visceral and parietal peritoneum

Question 3

what is the boundary of the foregut?

Answer 3

the esophagus to the end of the descending duodenum or number 2 portion

Question 4

what is the boundary of the midgut?

Answer 4

Horizontal duodenum (number 3 spot) to the end of the transverse colon near the splenic flexure

Question 5

what is boundary of the hindgut?

Answer 5

starts at the splenic flexure descending colon to the rectum

Question 6

what major artery serves the foregut?

Answer 6

the celiac trunk (L1)

Question 7

what major artery serves the midgut?

Answer 7

the Superior mesenteric artery (SMA) (L1)

Question 8

what major artery serves the hindgut?

Answer 8

the Inferior mesenteric artery (IMA) (L2)

Question 9

what are the three branches that come off the celiac artery?

Answer 9

common hepatic
splenic
left gastric

Question 10

What organs are supplied via the celiac artery?

Answer 10

foregut, liver, gall bladder, and spleen

Question 11

what are the three branches of the splenic artery?

Answer 11

left gastro omental artery
pancreatic artery
splenic artery

Question 12

what three branches come off the common hepatic artery?

Answer 12

right gastric
gastroduodenal
proper hepatic

Question 13

what three branches come off the gastroduodenal artery?

Answer 13

right gastro omental
anterior/posterior superior pancreaticodoudenal artery
duodenal branches

Question 14

what arteries have three branches?

Answer 14

celiac
common hepatic
gastrodoudenal

Question 15

What artery supplies the midgut?

Answer 15

SMA aka superior mesenteric artery

Question 16

what are the six arteries for the SMA?

Answer 16

Inferior pancratico duodenal artery
jejunal and ileal arteries
ileocolic artery
right colic artery 
middle colic artery

Question 17

What artery supplies the hindgut?

Answer 17

IMA inferior mesenteric artery

Question 18

what are the three arteries of the IMA?

Answer 18

Left colic (most superior)
sigmoid (middle)
superior rectal (inferior/medial)

Question 19

name 3 anastomoses within the GI

Answer 19

• Marginal artery of drummond-artery that runs the length of colon(has similar collaterals for veins)
• watershed: left colic flexure or splenic flexure (SMA and IMA) risk for ischemia
• middle and inferior rectal arteries with superior rectal arteries (internal iliac and IMA)

Question 20

where does the external iliac feed?

Answer 20

the legs

Question 21

where does the internal iliac feed?

Answer 21

rectum, inguinal region

Question 22

What does the common iliac artery branch into?

Answer 22

internal and external iliac arteries

Question 23

What are the two paths for veinous drainage of the GI tract?

Answer 23

caval (systemic) and portal

Question 24

If it is not in the GI tract, it is drained by what veinous pathway?

Answer 24

caval (systemic) i.e. the IVC

thus GI all others goes to the portal vein!!

Question 25

What is the difference between the right and left testicular/ovarian veins?

Answer 25

the right drain directly into the IVC and the left drain into the left renal vein.

Question 26

Where does the IMV drain into?

Answer 26

the splenic vein

Question 27

where does the splenic vein drain?

Answer 27

the portal vein

Question 28

where does the SMV drain into

Answer 28

directly into the portal vein

Question 29

Blood flows ____the liver via the portal vein. Blood flow ____ the liver by draining into the _____?

Answer 29

into out IVC

Question 30

what are the 3 portal-caval anastomoses?

Answer 30

1. Esophagus 2. Rectum 3. Superfical abdomen *** no valves, flow can be in any direction

Question 31

Components of esophagus portal-caval anastomoses | and what cirrhosis causes?

Answer 31

Portal: Gastric vein to HPV (hepatic portal vein) Caval: Esophageal vein to Azygos vein ** (Gut)Esophageal varices

Question 32

Components of rectal portal-caval anastomoses | and what cirrhosis causes?

Answer 32

portal: Sup. rectal v to HPV caval: Mid and Inf. rectal vv to Internal iliac veins. *** (Butt) internal hemorrhoids

Question 33

components of superficial abdomen portal-caval anastomoses? | and what cirrhosis causes?

Answer 33

portal: paraumbilical veins to HPV Caval: epigastric veins to femoral veins **(caput) medusa

Question 34

What is distal splenorenal shunt? (DSRS) and what does it do?

Answer 34

surgical procedure that connects the splenic vein to left renal vein the relieve portal hypertension. Decreases blood volume delivered to the liver through bypassing the HPV and delivering blood from the splenic vein into left renal vein.