GA 5 Flashcards
Celiac Trunk
T12/Upper L1
-supplies foregut + spleen
SMA
Lower L1
-supplies midgut
IMA
L3
-supplies hindgut
Aortic Hiatus
T12
Aorta splits to R/L Common Iliacs
L4
Unpaired Visceral Arteries
Celiac - T12
IMA - L3
SMA - L1
Paired Visceral Arteries
Suprarenal - L1
Renal - L1/2
Gonadal (testicular/ovarian) - L2
Paired Parietal Arteries
Inferior phrenic - T12
Subcostal - T12
Lumbar - L1-4
What is the parasympathetic innervation of the foregut? midgut? hindgut?
- Vagus
- Vagus
- Pelvic Splanchnic
What is the sympathetic innervation of the foregut? midgut? hindgut?
- Thoracic splanchnic T5-9
- Thoracic splanchnic T8-12
- Lumbar splanchnic L1-2
How does the right hepatic artery typically relate to the portal vein? what is a common variation?
91% - anterior
9% - posterior
An accessory or replaced right hepatic artery may originate from where? left hepatic artery?
a. SMA
b. left gastric artery
What supplies the liver with blood?
75% - hepatic portal vein (supplies parenchyma)
25% - hepatic artery (supplies non-parenchyma)
What supplies the gall bladder?
cystic artery
What are four variations of the cystic artery?
- 2% - cystic off of left hepatic artery
- 1% - cystic off of right hepatic artery + anterior to common hepatic duct
- 1% - cystic off of proper hepatic + anterior to common hepatic duct
- 6% -cystic off of gastroduodenal artery
What does the ileo colic artery supply? appendix?
- ileocecal junction
- appendicular artery (comes from IC artery)
What does the middle colic artery supply?
transverse colon
What does the right coli artery supply?
ascending colon
What does the left colic artery supply?
descending colon
What are some common variations of the SMA?
- common trunk for right and middle colic arteries
- common trunk for right and ileocolic arteries
- absent middle colic replaced by a large branch from left colic
- absent right colic artery
Nutcracker Syndrome
- left renal vein (possible the 3rd part of the D) can become entrapped between the SMA and aorta an
- hematuria, proteinuria, nausea, bilious vomit, left flank pain, left scrotal pain, varicocele
What arteries contribute to the marginal artery?
middle, right, left, and ileo colic arteries
What three arteries supply the rectum? where do they come from?
superior rectal artery - IMA
middle rectal artery - internal iliacs
inferior recta artery - internal pudendal
Hemorrhoid Pain: Internal vs. External
Internal are NOT painful because they are under autonomic control, while external are painful because they are under somatic control
What causes internal hemorrhoids? external?
- prolapse of the rectal mucosa that contains the normally dilated veins of the internal venous plexus
- thromboses or blood clots in veins of the external venous plexus
When does the IVC enter the abdomen?
at T8 through the canal opening
What are the four portal canal anastomoses? what comprises them?
esophageal - left gastric/azygous
rectal - superior rectal/middle or inf recta
paraumbilical - paraumbilical/epigastric
retroperitoneal - colic veins/systemic retroperitoneal veins
Esophageal varices
due to portal hypertension
-if they rupture, it can be life threatening
What causes portal hypertension?
scarring and fibrosis from cirrhosis obstruct the hepatic portal vein in the liver, and pressure rises in the vein
Caput Medusae
due to portal obstruction, veins of the anterior abdominal wall that anastomose with the paraumbilical veins become varicose
