Hulka; Abdominal Blood Supply and Stomach

Question 1

What is the abdominal aorta?

Answer 1

continuation of thoracic aorta

Question 2

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

Answer 2

begins at aortic hiatus (enters abdomen through diaphragm)

T12-L1

Question 3

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

Answer 3

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

Question 4

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

Answer 4

collateral circulation

Question 5

What is collateral flow

Answer 5

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

Question 6

Describe the phrenic branches

Answer 6

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

Question 7

What are mesentaric arteries?

Answer 7

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

Question 8

Describe the celiac trunk

Answer 8

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

Question 9

What are the three branches off the celiac trunk?

Answer 9

Left gastric
common hepatic
splenic

Question 10

Describe the left gastric artery

Answer 10

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

Question 11

Describe the common hepatic artery

Answer 11

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

Question 12

What does the common hepatic artery further branch into?

Answer 12

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

Question 13

Describe the splenic artery

Answer 13

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

Question 14

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

Answer 14

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

Question 15

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

Answer 15

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

Question 16

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

Answer 16

the inferior pancreaticduodenal artery

Question 17

Where is the superior pancreaticduodenal artery?

Answer 17

comes off of the common hepatic

Question 18

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

Answer 18

celiac trunk and SMA

Question 19

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.

Answer 19

jejunal and ileal arteries

Question 20

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

Answer 20

ileal

Question 21

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.

Answer 21

illiocolic artery

Question 22

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?

Answer 22

The right colic artery

Question 23

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?

Answer 23

middle colic artery

Question 24

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

Answer 24

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

Question 25

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

Answer 25

inferior mesentaric artery | L3

Question 26

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.

Answer 26

Left colic artery

Question 27

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

Answer 27

Sigmoid branches

Question 28

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

Answer 28

superior rectal branch

Question 29

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

Answer 29

``` Celiac trunk (superior pancreaticduodenal) SMA (inferior pancreatic duodenal) ```

Question 30

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

Answer 30

``` the SMA (middle colic artery) the IMA (left colic artery) ```

Question 31

What 2 arteries allow for collateral flow around the rectum?

Answer 31

``` IMA (superior rectal artery) Iliac arteries (middle and inferior rectal arteries) ```

Question 32

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?

Answer 32

Renal arteries | L2

Question 33

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.

Answer 33

Gonadal arteries | L2

Question 34

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?

Answer 34

Lumbar arteries

Question 35

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.

Answer 35

Anterior branches of lumbar arteries

Question 36

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

Answer 36

posterior branches of lumbar arteries

Question 37

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

Answer 37

spinal arteries

Question 38

What is the largest radicular artery?

Answer 38

the spinal artery of adamkiewicz

Question 39

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?

Answer 39

the inferior vena cava

Question 40

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

Answer 40

renal veins

Question 41

What vein drains into the left renal vein usually at L2

Answer 41

left gonadel vein

Question 42

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

Answer 42

the right gonadel vein

Question 43

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

Answer 43

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

Question 44

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

Answer 44

at the hepatic veins

Question 45

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

Answer 45

lumbar veins | ascending lumbar vein

Question 46

How does the azygous and hemiazygous begin?

Answer 46

with lumbar veins

Question 47

What does the right ascending lumbar vein become?

Answer 47

the azygos vein

Question 48

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

Answer 48

azygos vein

Question 49

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

Answer 49

hemiazgous vein

Question 50

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

Answer 50

mesenteric drainage

Question 51

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

Answer 51

inferior mesentaric vein (IMV)

Question 52

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

Answer 52

Superior mesenteric vein

Question 53

What drains the lower esophagus?

Answer 53

esophageal veins

Question 54

What drains the stomach and drains into the portal vein?

Answer 54

the gastric veins

Question 55

What happens when you have cirrhosis?

Answer 55

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

Question 56

When you have portal hypertension what happens?

Answer 56

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

Question 57

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

Answer 57

stomach

Question 58

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

Answer 58

cardiac orifice

Question 59

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

Answer 59

fundus of stomach

Question 60

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

Answer 60

body of stomach

Question 61

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)?

Answer 61

antrum of stomach

Question 62

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

Answer 62

pylorus

Question 63

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

Answer 63

peptic ulcer

Question 64

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

Answer 64

bleeding, perforation | removal of the acid forming portion of the stomach (antrectomy) and vagotomy (cutting of vagus)

Question 65

(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?

Answer 65

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

Question 66

Where does the stomach sit?

Answer 66

in the upper abdomen

Question 67

(blank) covers the upper stomach.

Answer 67

the left liver lobe

Question 68

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

Answer 68

fundus

Question 69

The (blank) attaches along the greater curvature

Answer 69

omentum

Question 70

The pancreas sits behind the (blank)

Answer 70

stomach

Question 71

The area behind the stomach is the (blank)

Answer 71

lesser sac

Question 72

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

Answer 72

celiac axis

Question 73

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

Answer 73

Left gastric artery

Question 74

What artery supplies the upper stomach and lower esophagus?

Answer 74

left gastric artery

Question 75

What is the hepatogastric ligament?

Answer 75

the mesentary along the lesser curvature of the stomach

Question 76

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?

Answer 76

Right gastro-omental artery

Question 77

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

Answer 77

gastro-omental

Question 78

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.

Answer 78

short gastric arteries

Question 79

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

Answer 79

Left gastro omental artery

Question 80

What parallels the arterial supply of the stomach?

Answer 80

the venous drainage

Question 81

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

Answer 81

portal vein

Question 82

The right and left gastric veins drain into which vein?

Answer 82

the portal vein

Question 83

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

Answer 83

SMV

Question 84

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

Answer 84

splenic vein

Question 85

Where do you find the left gastric lymph nodes?

Answer 85

along left gastric artery

Question 86

Where do you find the gastro-omental lymph nodes?

Answer 86

along the greater curvature

Question 87

Where do you find the pyloric lymph nodes?

Answer 87

anterior surface of pancreas, near pylorus

Question 88

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

Answer 88

pancreaticolienal lymph nodes

Question 89

What lymph nodes are along right gastric artery?

Answer 89

right gastric lymph nodes

Question 90

All lymph nodes ultimately drain into (Blank) lymph nodes

Answer 90

celiac axis

Question 91

What is the ligament found between the spleen and stomach?

Answer 91

gastrolienal ligament (part of mesentary)

Question 92

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

Answer 92

cisterna chyle

Question 93

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

Answer 93

cisterna chyle

Question 94

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

Answer 94

vagus nerve

Question 95

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

Answer 95

vagus nerve

Question 96

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

Answer 96

left vagus nerve

Question 97

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

Answer 97

right vagus nerve

Question 98

Side effect of (blank) is problem with gastric emptying

Answer 98

vagotomy