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Block 3 Week 1 > Hulka; Abdominal Blood Supply and Stomach > Flashcards

Hulka; Abdominal Blood Supply and Stomach Flashcards

1
Q

What is the abdominal aorta?

A

continuation of thoracic aorta

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2
Q

Where does the abdominal aorta begin and at what vertebral level?

A

begins at aortic hiatus (enters abdomen through diaphragm)

T12-L1

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3
Q

How does the abdominal aorta end, where does it end, and at what vertebral level does it end?

A

ends by dividing into 2 common iliac arteries above the pelvis at the L4-5 vertebral level

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4
Q

The key to understanding the blood supply in the abdomen is (blank)

A

collateral circulation

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5
Q

What is collateral flow

A

it means that an organ can get blood supply in more than one way.

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6
Q

Describe the phrenic branches

A

first branch off aorta
runs inferior to diaphragm
gives rise to an adrenal artery and gives blood to inferior surface of diaphragm

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7
Q

What are mesentaric arteries?

A

arteries that go to the bowel (systemic go to all other organs that are not part of GI tract)

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8
Q

Describe the celiac trunk

A

first mesentaric branch of aorta
arises at T12 vertebral level
Three branches off of it

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9
Q

What are the three branches off the celiac trunk?

A

Left gastric
common hepatic
splenic

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10
Q

Describe the left gastric artery

A

1) exists celiac trunk to the left and goes toward the right side of stomach
2) provides blood to lower esophagus and lesser curvature of the stomach
3) gives off esophageal branches

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11
Q

Describe the common hepatic artery

A

1) exits celiac trunk to right, courses behind stomach to the liver
2) provides blood supply to the lower stomach, liver and duodenum

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12
Q

What does the common hepatic artery further branch into?

A 
Gastroduodenal artery(branches to duodenum and pancreas)
Proper Hepatic artery (arterial supply to liver)
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13
Q

Describe the splenic artery

A

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

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14
Q

What does the splenic artery branch into and where do they go?

A
  • Pancreatic branches (along superior portion of pancrease)
  • Short gastric branches (to greater curvature of stomach)
  • Left gastro-omental artery (greater curvature of stomach)
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15
Q

Describe the superior mesentaric artery and at what vertebral level it arises

A

second mesentaric branch of abdominal aorta , located behind pancreas
provides blood to the duodenum all the way to transverse colon
arises at level L1

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16
Q

What branch of the superior mesentaric artery (SMA) goes to the head of the pancreas and first part of the duodenum (C loop)?

A

the inferior pancreaticduodenal artery

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17
Q

Where is the superior pancreaticduodenal artery?

A

comes off of the common hepatic

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18
Q

the C loop of the small intestine has collateral flow provided by what two major arteries?

A

celiac trunk and SMA

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19
Q

What are the branches off o the superior mesentaric artery that are found within the mesentary of the bowl, provide blood supply to the bowel and have app. 15-18 branches.

A

jejunal and ileal arteries

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20
Q

The jejunal branches become the (blank) branches 2/3rds of the way down

A

ileal

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21
Q

What is the most distal branch anatomically of the SMA that is found within the mesentery of the bowel and provides blood supply to the terminal ileum and cecum.

A

illiocolic artery

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22
Q

What is the second colonic branch of the SMA anatomically and is found within the mesentary of the bowel and provides blood supply to the right colon?

A

The right colic artery

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23
Q

What is the first colonic branch of the SMA anatomically that provides the last part of the colon provided by the SMA which is found within the mesentary of the bowel and provides blood supply to the transverse colon?

A

middle colic artery

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24
Q

If you have a clot in your SMA,what will happen

A

you will lose your SMA and 1/3 of your colon

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25
Q

What is the third mesentaric branch of the abdominal aorta and what level of vertebrae does it arise?

A

inferior mesentaric artery

L3

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26
Q

What is the first branch of the IMA that is found within the mesentary of the bowel that provides blood supply to the left colon, from splenic flexure to sigmoid colon.

A

Left colic artery

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27
Q

What is the second branch of the IMA found within the mesentary of the bowel that provides blood supply to the sigmoid colon?

A

Sigmoid branches

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28
Q

What is the terminal branch of the IMA that is found within the mesentary of the bowel and provides blood supply to the superior rectum

A

superior rectal branch

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29
Q

What 2 arteries allow for collaterol flow to the pancreas and duodenum?

A 
Celiac trunk (superior pancreaticduodenal)
SMA (inferior pancreatic duodenal)
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30
Q

What 2 arteries allow for the collateral flow to the splenic flexure?

A 
the SMA (middle colic artery)
the IMA (left colic artery)
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31
Q

What 2 arteries allow for collateral flow around the rectum?

A 
IMA (superior rectal artery)
Iliac arteries (middle and inferior rectal arteries)
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32
Q

What arteries arise off aorta between the SMA and IMA that give arterial supply to the kidneys and usually single branches but may have up to 3 branches to each kidney? What vertebral level is this at?

A

Renal arteries

L2

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33
Q

What arteries branch off the aorta or less often the renal arteries, if it branches off the aorta what vertebral level is it at. This artery supplies the testicles/ovaries.

A

Gonadal arteries

L2

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34
Q

What arteries have anterior and posterior branches to the lumbar spine and spinal cord. The arise off the aorta at each lumbar vertebral level and supply the musculature in the back and to the spinal cord?

A

Lumbar arteries

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35
Q

What arteries supply the anterior and lateral abdominal wall and passes around the abdominal wall. IT collateralizes to inferior epigastric artery in anterior abdominal wall.

A

Anterior branches of lumbar arteries

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36
Q

What arteries supplies the spinal cord,and the erector spinae musces. Spinal arteries come off of this.

A

posterior branches of lumbar arteries

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37
Q

What arteries give rise to radicular arteries (each nerve level) between T7 and T11

A

spinal arteries

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38
Q

What is the largest radicular artery?

A

the spinal artery of adamkiewicz

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39
Q

What begins at the confluence of the common iliac veins at the level of L5 and ascends to the right of the abdominal aorta and runs posterior to liver, through diaphragm into right atrium?

A

the inferior vena cava

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40
Q

What veins drain into the IVC from each kidney (usually one branch) and run anterior to renal arteries usually at L2?

A

renal veins

41
Q

What vein drains into the left renal vein usually at L2

A

left gonadel vein

42
Q

What vein drains into the IVC from the gonads at L2?

A

the right gonadel vein

43
Q

What vein has three branches that drain directly into the IVC along the superior aspect of the liver just below the diaphragm.

A

The hepatic veins with the right, the left, and the middle hepatic veins

44
Q

At what point does the mesentaric blood flow into the IVC?

A

at the hepatic veins

45
Q

What veins have four to five paired branches from each vertebral level and usually united into what?

A

lumbar veins

ascending lumbar vein

46
Q

How does the azygous and hemiazygous begin?

A

with lumbar veins

47
Q

What does the right ascending lumbar vein become?

A

the azygos vein

48
Q

What enters the thorax and central circulation from the right ascending lumbar vein?

A

azygos vein

49
Q

What vein enters the thorax and central circulation and comes from the left ascending lumbar vein?

A

hemiazgous vein

50
Q

What allows venous drainage from the mesentary (bowel) to be cleared by the hepatic system before entering systemic circulation?

A

mesenteric drainage

51
Q

What drains sigmoid and descending colon and unites with the splenic vein?

A

inferior mesentaric vein (IMV)

52
Q

What drains the small bowel, right and transverse colon and unites with the splenic vein/IMV to form the portal vein?

A

Superior mesenteric vein

53
Q

What drains the lower esophagus?

A

esophageal veins

54
Q

What drains the stomach and drains into the portal vein?

A

the gastric veins

55
Q

What happens when you have cirrhosis?

A

impede hepatopedal flow to liver and increase pressure in venous system-> portal hypertension

56
Q

When you have portal hypertension what happens?

A

you will get veins enlarged (varices) in esophagus, stomach, spleen and intestines

57
Q

What functions in the storage of food during intake and provides reservoir for food to mix with digestive juices and is a distesible organ

A

stomach

58
Q

The stomach begins at gastro-esophageal junction just below the diaphragm also known as (blank)

A

cardiac orifice

59
Q

What is the superior portion of the stomach above the cardiac orifice?

A

fundus of stomach

60
Q

What is between the fundus and antrium (from cardiac orifice to vein of mayo)

A

body of stomach

61
Q

What is the acid producing portion of the stomach that goes from the angular incisure to pyloric canal (where the vein of mayo crosses the stomach)?

A

antrum of stomach

62
Q

What is the end of the stomach with a canal and sphincter (thickened, circular muscle that forms sphincter which controls gastric emptying)?

A

pylorus

63
Q

(blank) is a defect in the lining of the stomach or the first part of the small intestine, an area called the duodenum.

A

peptic ulcer

64
Q

What were the symptoms of PUD? What is the surgical treatment of this?

A

bleeding, perforation

removal of the acid forming portion of the stomach (antrectomy) and vagotomy (cutting of vagus)

65
Q

(blank) is Hypertrophy of the pyloric muscle that causes a gastric outlet obstruction. It is Seen in infants 2 to 8 weeks old, boys more frequently than girls
What is the treatment?

A

pyloric stenosis

pyloromyotomy (cutting of the muscle to open the pyloric canal)

66
Q

Where does the stomach sit?

A

in the upper abdomen

67
Q

(blank) covers the upper stomach.

A

the left liver lobe

68
Q

The (blank) of the stomach sits next to the diaphragm and spleen

A

fundus

69
Q

The (blank) attaches along the greater curvature

A

omentum

70
Q

The pancreas sits behind the (blank)

A

stomach

71
Q

The area behind the stomach is the (blank)

A

lesser sac

72
Q

arterial supply to the stomach is provided by all three branches of the (blank)

A

celiac axis

73
Q

(blank) enters the stomach along the lesser curvature in hepatogastric ligament (mesentary along the lesser curvature)

A

Left gastric artery

74
Q

What artery supplies the upper stomach and lower esophagus?

A

left gastric artery

75
Q

What is the hepatogastric ligament?

A

the mesentary along the lesser curvature of the stomach

76
Q

What artery branches off the gastroduodenal artery and enters the stomach along the greater curvature, also it supplies this greater curvature from antrum to mid body of stomach?

A

Right gastro-omental artery

77
Q

The R. gastroepiploic artery is the same thing as the R (blank) artery

A

gastro-omental

78
Q

What are branches of the splenic artery that enter the stomach along the greater curvature at the fundus and upper body in the gastrolienal ligament. This artery supplies the greater curvature from fundus to upper body of stomach.

A

short gastric arteries

79
Q

What artery is a branch off the splenic artery that 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 artery anastomoses with the R gastro-omental. This supplies the greater curvature from fundus to upper body of stomach

A

Left gastro omental artery

80
Q

What parallels the arterial supply of the stomach?

A

the venous drainage

81
Q

THe veins of the stomach coalesce and drain into the (blank) which drains into the liver

A

portal vein

82
Q

The right and left gastric veins drain into which vein?

A

the portal vein

83
Q

THe right gastro-omental vein drains into the (blank)

A

SMV

84
Q

The left gastro-omental vein drains into the (Blank)

A

splenic vein

85
Q

Where do you find the left gastric lymph nodes?

A

along left gastric artery

86
Q

Where do you find the gastro-omental lymph nodes?

A

along the greater curvature

87
Q

Where do you find the pyloric lymph nodes?

A

anterior surface of pancreas, near pylorus

88
Q

What lymph nodes are along the splenic artery, superior aspect of pancreas?

A

pancreaticolienal lymph nodes

89
Q

What lymph nodes are along right gastric artery?

A

right gastric lymph nodes

90
Q

All lymph nodes ultimately drain into (Blank) lymph nodes

A

celiac axis

91
Q

What is the ligament found between the spleen and stomach?

A

gastrolienal ligament (part of mesentary)

92
Q

After draining into the celiac (aortic) lymph nodes, the lymphatic ducts drain into the (Blank)

A

cisterna chyle

93
Q

(blank) is a dilation of the convergence of the lymphatic channels and drains into the thoracic duct.

A

cisterna chyle

94
Q

(blank) has two branches that run along the esophagus (left and right)

A

vagus nerve

95
Q

(blank) provides motor neurons to stomach and stimulation for acid production and specifically stimulates the antrum to secrete acid

A

vagus nerve

96
Q

(blank) becomes the anterior vagus trunk at the stomach and enters along the lesser curvature and branches to anterior stomach, liver and duodenum

A

left vagus nerve

97
Q

(blnk) becomes the posterior vagus trunk and enters the lesser curvature and branches to posterior stomach.

A

right vagus nerve

98
Q

Side effect of (blank) is problem with gastric emptying

A

vagotomy

Block 3 Week 1 (18 decks)

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