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FA - Gastrointestinal > GI - Anatomy (GI vasculature) > Flashcards

GI - Anatomy (GI vasculature) Flashcards

Pg. 338-340 in First Aid 2014 Sections include: -Abdominal aorta and its branches -GI blood supply and innervation -Celiac trunk -Collateral arterial circulation -Portosystemic anastomoses

1
Q

Where do arteries supplying GI versus non-GI structures branch from the abdominal aorta?

A

Arteries supplying GI structures branch anteriorly. Arteries supplying non-GI structures branch laterally.

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2
Q

In what context does superior mesenteric artery (SMA) syndrome occur?

A

Superior mesenteric artery (SMA) syndrome occurs when the transverse portion (third segment) of the duodenum is entrapped between SMA and aorta, causing intestinal obstruction

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3
Q

What artery supplies the foregut? With what vertebral level is it associated?

A

Celiac artery; T12/L1

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4
Q

What artery supplies the midgut? With what vertebral level is it associated?

A

SMA; L1

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5
Q

What artery supplies the hindgut? With what vertebral level is it associated?

A

IMA; L3

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6
Q

Again, what artery supplies the foregut? What is the parasympathetic innervation of the foregut? What foregut structures are supplied?

A

Celiac artery; Vagus nerve; Pharynx to proximal duodenum, liver, gallbladder, pancreas, spleen (mesoderm)

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7
Q

Again, what artery supplies the midgut? What is the parasympathetic innervation of the midgut? What midgut structures are supplied?

A

SMA; Vagus nerve; Distal duodenal to proximal 2/3 of transverse colon

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8
Q

Again, what artery supplies the hindgut? What is the parasympathetic innervation of the hindgut? What hindgut structures are supplied?

A

IMA; Pelvic nerve; Distal 1/3 of transverse colon to upper portion of rectum, Splenic flexure is a watershed region

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9
Q

What is a watershed region associated with the hindgut?

A

Splenic flexure is a watershed region

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10
Q

Draw the abdominal aorta, including and labeling the following branches/parts: (1) “BiFOURcation” of abdominal aorta (L4) (2) Celiac trunk (T12) (3) Median sacral artery (4) Left inferior phrenic artery (5) Left middle suprarenal artery (6) Left renal artery (L2) (7) Left testicular (ovarian) artery (8) Left common iliac artery (9) Inferior mesenteric artery (L3) (10) Right renal artery (11) Right internal iliac artery (12) Right external iliac artery (13) Superior mesenteric artery (L1).

A

See p. 338 in First Aid 2014 for visual

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11
Q

What are the branches of the celiac trunk? What collective purpose do they serve?

A

Branches of celiac trunk: hepatic, splenic, left gastric. These constitute the main blood supply of the stomach.

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12
Q

What effect does a blocked splenic artery have?

A

Short gastrics have poor anastomoses if splenic artery is blocked

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13
Q

What are 2 locations where strong anastomoses exist?

A

Strong anastomoses exist between: (1) Left and right gastroepiploics (2) Left and right gastrics

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14
Q

What anastomoses occur between internal thoracic/mammary and external iliac arteries?

A

Superior epigastric (internal thoracic/mammary) inferior epigastric (external iliac)

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15
Q

What anastomoses occur between celiac trunk and SMA?

A

Superior pancreaticoduodenal (celiac trunk) inferior pancreaticoduodenal (SMA)

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16
Q

What anastomoses occur between SMA and IMA?

A

Middle colic (SMA) Left colic (IMA)

17
Q

What anastomoses occur between IMA and internal iliac artery?

A

Superior rectal (IMA) middle and inferior rectal (internal iliac)

18
Q

What supplies the superior epigastric artery? What is its collateral arterial circulation, and supplies this?

A

Superior epigastric (internal thoracic/mammary) inferior epigastric (external iliac)

19
Q

What supplies the superior pancreaticoduodenal artery? What is its collateral arterial circulation, and supplies this?

A

Superior pancreaticoduodenal (celiac trunk) inferior pancreaticoduodenal (SMA)

20
Q

What supplies the middle colic artery? What is its collateral arterial circulation, and supplies this?

A

Middle colic (SMA) Left colic (IMA)

21
Q

What supplies the superior rectal artery? What is its collateral arterial circulation, and supplies this?

A

Superior rectal (IMA) middle and inferior rectal (internal iliac)

22
Q

What supplies the inferior epigastric artery? What is its collateral arterial circulation, and supplies this?

A

Superior epigastric (internal thoracic/mammary) inferior epigastric (external iliac)

23
Q

What supplies the inferior pancreaticoduodenal artery? What is its collateral arterial circulation, and supplies this?

A

Superior pancreaticoduodenal (celiac trunk) inferior pancreaticoduodenal (SMA)

24
Q

What supplies the left colic artery? What is its collateral arterial circulation, and supplies this?

A

Middle colic (SMA) Left colic (IMA)

25
Q

What supplies the middle and inferior rectal arteries? What is their collateral arterial circulation, and supplies this?

A

Superior rectal (IMA) middle and inferior rectal (internal iliac)

26
Q

What are the 3 sites of portosystemic anastomoses? What is the relevant presentation of portal hypertension?

A

(1) Esophagus (2) Umbilicus (3) Rectum; Think: “varices of GUT, BUTT, & CAPUT (medusae, clinical sign of portosystemic anastomoses at umbilicus) are commonly seen with portal hypertension”

27
Q

What is the clinical sign associated with the portosystemic anastomoses at the esophagus?

A

Esophageal varices

28
Q

What is the clinical sign associated with the portosystemic anastomoses at the umbilicus?

A

Caput medusae

29
Q

What is the clinical sign associated with the portosystemic anastomoses at the rectum?

A

Anorectal varices (not internal hermorrhoids)

30
Q

What are the portal & systemic vessels that anastomose at the esophagus?

A

Portal Systemic: Left gastric Esophageal

31
Q

What are the portal & systemic vessels that anastomose at the umbilicus?

A

Portal Systemic: Paraumbilical Small epigastric veins of the anterior abdominal wall

32
Q

What are the portal & systemic vessels that anastomose at the rectum?

A

Portal Systemic: Superior rectal middle and inferior rectal

33
Q

What is used to relieve portal hypertension, and how does this work?

A

Treatment with a transjugular intrahepatic portosystemic shunt (TIPS) between the portal vein and hepatic vein percutaneously relieves portal hypertension by shunting blood to the systemic circulation

34
Q

Draw the liver, stomach, spleen, umbilicus, colon, anus, labeling the portosystemic vessels related to each. Use color-coded arrows to indicate pathologic blood flow in portal HTN versus flow through TIPS. Label the sites of the following clinical factors related to portal hypertension: (1) Esophageal varices (2) Caput medusae (3) Rectal varices (4) TIPS.

A

See p. 340 in First Aid 2014 for visual

FA - Gastrointestinal (24 decks)

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