Hulka: abd arteries stomach Flashcards by Megan Foggia

Where does the abdominal aorta begin?

at the aortic hiatus; enters the diaphragm at T12-L1 vertebral level

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Where does the abdominal aorta end?

Divides into 2 iliac arteries above the pelvis at L4-5

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1st branch off of the aorta
Inferior to the diaphragm
Gives rise to adrenal artery and supplies the inferior surface of the diaphragm

Phrenic branches

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1st mesenteric branch of aorta
At level T12
Has 3 branches

Celiac trunk

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3 branches of the celiac trunk

left gastric
common hepatic artery
splenic artery

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Exits the celiac trunk to the left and courses toward the right side of stomach
Provides blood supply to lower esophagus and lesser curvature of the stomach

Left gastric artery

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The left gastric artery gives off (blank) branches

esophageal

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Exits the celiac trunk to the right, courses behind stomach to the liver
Provides blood supply to the lower stomach, liver and duodenum

Common hepatic artery

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The common hepatic artery further branches to give off what two arteries?

Gastroduodenal artery

Proper hepatic artery

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Exits the celiac trunk to the left, courses behind stomach along the top of the pancreas to the spleen
Provides blood supply to the upper stomach, pancreas and spleen

Splenic artery

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3 branches of splenic artery (PSL)

Pancreatic branches along superior portion of pancreas
Short gastric branches - to greater curvature of stomach
Left gastro-omental artery - greater curvature of stomach

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Second mesenteric branch of abdominal aorta

Arises at about L1 vertebral level - usually directly behind pancreas

Superior mesenteric artery

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Branch of SMA
Anterior and posterior arteries
Around C-loop of duodenum and head of pancreas
Provide blood supply to duodenum and head of pancreas

Inferior pancreaticoduodenal arteries

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Branch of SMA
Approximately 15-18 branches
Found within the mesentery of the bowel
Provide blood supply to small bowel

Jejunal and ileal arteries

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Branch of SMA
Most distal branch anatomically of the SMA
Found within the mesentery of the bowel
Provide blood supply to the terminal ileum and cecum

ileocolic artery

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Second colonic branch of the SMA anatomically
Found within the mesentery of the bowel
Provide blood supply to the right colon

Right colic artery

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First colonic branch of the SMA anatomically
Last part of the colon whose blood supply provided by SMA
Found within the mesentery of the bowel
Provide blood supply to the transverse colon

Middle colic artery

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Third mesenteric branch of abdominal aorta

Arises at approximately L3 vertebral level, inferior to renal arteries

Inferior mesenteric artery

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First branch of the IMA
Found within the mesentery of the bowel
Provide blood supply to the left colon, from splenic flexure to sigmoid colon

Left colic artery

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Second branch of the IMA
Found within the mesentery of the bowel
Provide blood supply to the sigmoid colon

Sigmoid branches

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Terminal branch of the IMA
Found within the mesentery of the bowel
Provide blood supply to the superior rectum

Superior rectal branch

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Areas of collateral circulation

Celiac axis to SMA
SMA to IMA
IMA to iliac arteries

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Usually arise off aorta between SMA and IMA branches at approximately L2
Arterial supply to the kidneys
Usually single branches but may have up to three branches to each kidney

Renal arteries

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Usually branches off aorta or less often the renal arteries
If branches off aorta, usually at L2 vertebral level
Arterial supply to the testicles/ovaries

Gonadal arteries

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There are anterior and posterior branches to the lumbar spine and spinal cord Arise off aorta at each lumbar vertebral level Arterial supply to the musculature in back and to the spinal cord

Lumbar arteries

Supplies anterior and lateral abdominal wall Passes around abdominal wall Collateralizes to inferior epigastric artery in anterior abdominal wall

anterior branch of lumbar arteries

Supplies spinal cord, erector spinae muscles

posterior branches of lumbar arteries

Where does the IVC begin?

Where the common iliac veins meet, at the L5 level

The IVC ascends to the (blank) of the abdominal aorta | Runs (blank) to liver, through diaphragm into right atrum

right; posterior

Drains into the IVC from each kidney, usually one branch

Renal veins

The renal veins run (blank) to the renal arteries and arise at what level of the spinal cord?

anterior; L2

The (blank) gonadal drains directly into the (blank) renal vein and the (blank) gonadal drains into the IVC Usually at L2 level

left; left; right

Three branches drain directly into the IVC along the superior aspect of the liver just below the diaphragm Three branches are the right, middle and left

Hepatic veins

Four to five paired branches from each vertebral level

lumbar veins

The lumbar veins usually unite into the (blank)

Ascending lumbar vein

Right ascending lumbar vein becomes the (blank); Left ascending lumbar vein becomes the (blank). They both enter the thorax and central circulation.

azygos vein | hemiazygos vein

Venous draining from mesentery is cleared by the (blank) before entering systemic circulation

hepatic system

3 veins that enter into the portal vein

splenic superior mesenteric inferior mesenteric

Drains sigmoid and descending colon | Unites with splenic vein

inferior mesenteric vein

Drains small bowel, right and transverse colon | Unites with splenic vein/IMV to form the portal vein

superior mesenteric vein

Drains lower esophagus

esophageal veins

Drains stomach | Drains into portal vein

gastric veins

Cirrhosis of the liver can lead to (blank) pressure in the venous system, which leads to distention and ultimately (blank).

increased; portal hypertension

How much can the stomach hold when fully distended?

2-3 L of fluid

What is the name for the beginning of the stomach at the gastro-esophageal junction?

cardiac orifice

Four portions of the stomach

Fundus Body Antrum Pylorus

Acid producing portion of stomach From angular incisure (notch/indentation on lesser curve) to pyloric canal Where the Vein of Mayo crosses the stomach

antrum

Canal and sphincter - end of stomach | Thickened, circular muscle --> forms sphincter which controls gastric emptying

pylorus

Hypertrophy of the pyloric muscle that causes a gastric outlet obstruction Seen in infants 2 to 8 weeks old, boys more frequently than girls

pyloric stenosis

What covers the upper stomach?

the left liver lobe

What does the fundus of the stomach sit next to?

the diaphragm and spleen

Where does the greater omentum attach to the stomach?

along the greater curvature

What does the pancreas sit behind?

the stomach

What is the area behind the stomach?

the lesser sac

Enters the stomach along the lesser curvature in hepatogastric ligament (mesentery along the lesser curvature) This supplies the upper stomach and lower esophagus

left gastric artery

Branch of the proper hepatic artery Enters the stomach along the lesser curvature in hepatogastric ligament (mesentery along the lesser curvature) This supplies the antrum and pylorus

right gastric artery

Branch of the gastroduodenal artery (branch of common hepatic artery) Enters the stomach along the greater curvature This supplies the greater curvature from antrum to mid body of stomach

Right gasto-omental artery

Branches of the splenic artery Enters the stomach along the greater curvature at the fundus and upper body in the gastrolienal ligament This supplies the greater curvature from fundus to upper body of stomach

Short gastric arteries

Branch of the splenic artery Runs inferior to short gastric arteries and enters the stomach along the greater curvature at the fundus and upper body in the gastrolienal ligament. This supplies the greater curvature from fundus to upper body of stomach

left gasto-omental artery

Where do the right and left gastric veins drain?

portal vein

Where does the right gastro-omental vein drain?

SMV

Where does the left gastro-omental vein drain?

Splenic vein

Where does the left gastric lymph node drain?

along the left gastric artery

Where do the gastro-omental lymph nodes drain?

along the greater curvature

Where do the pyloric lymph nodes drain?

Anterior surface of the pancreas, near pylorus

All lymph nodes ultimately drain into (blank) lymph nodes and then to the (blank) and ultimately to the (blank)

celiac axis; cisterna chyle; thoracic duct

Main nerve to stomach; specifically stimulates antrum to secrete acid

Vagus nerve

Left vagus nerve becomes the (blank) vagal trunk at the stomach

Right vagus nerve becomes the (blank) vagal trunk at the stomach

posterior

What two vessels are ultimately responsible for collateral flow between the celiac trunk and the SMA?

superior and inferior pancreaticoduodenal arteries

What two vessels are essentially responsible for collateral flow between the SMA and IMA?

left colic and middle colic which becomes the marginal artery of Drummond and the Arc of Riolan

What arteries are responsible for collateral flow between the IMA and the iliac arteries?

superior rectal and middle/inferior rectal arteries

What are the boundaries of the "body" of the stomach?

cardiac orifice to the Vein of Mayo

Trace the right gastro-omental artery back to the aorta.

Right gastro-omental-->gastroduodenal-->common hepatic artery-->celiac trunk-->aorta

Trace the short gastric arteries back to the aorta.

Short gastric-->splenic-->celiac trunk-->aorta

Trace the right gastric artery back to the aorta.

Right gastric-->proper hepatic-->common hepatic-->celiac trunk-->aorta

Trace the left gastro-omental artery back to the aorta.

left gastro-omental-->splenic-->celiac trunk-->aorta