innervation, venous and lymph drainage of the posterior abdomenal wall Flashcards
what is the largest circulatory system?
systemic
why is the portal system important?
to collect all venous blood from the GIT and bring it to the liver to filter it
what composes the portal triad
hepatic a. proper
hepatic duct
portal vein
what does the inferior mesenteric vein drain into?
into the splenic V
does the IMV sit next to the IMA?
no
where is the IMV found?
ascending on the left hand side of the body
where is the SMV located?
on the right side of SMA
what does the splenic vein meet up with?
with the SMV
Where is the splenic vein located?
posterior to the neck of the pancreas
what is formed by the meet up of the SMV, IMV and splenic vein?
the portal vein
what type of blood is collected in the splenic v?
venous blood from the foregut
blood from where is collected in the liver?
blood from the hepatic veins (right, left & intermediate)
blood from the hepatic veins drains into what?
IVC
what systemic and portal anastomose takes place in the esophagus?
Branches from azygous vein (systemic) anastomose with left gastric vein (portal)
what happens in the case of portal hypertension in the esophagus?
azygous wants to take over but doesn’t do so well which leads to a build up of venous blood
what systemic and portal anastomose takes place in the umbilicus
Branches of epigastric veins (systemic) anastomoses with periumbilical veins (portal)
what are caput meduase? in whom is it more prominent?
snakey appearence present on the abdomen prominent in population of 3rd world countries
what systemic and portal anastomose takes place in the rectum
Rectal veins from internal iliac V (systemic) anastomoses with superior rectal vein (portal)
what happens if pressure builds up if portal hypertension in rectum?
Buildup of venous blood in the veins of the anal junction
what systemic and portal anastomose takes place in the posterior abdominal wall?
retroperitoneal veins (Systematic) anastomose with Colic veins (portal)
what can portal hypertension cause?
o Can cause filtration at portal/systemic anastomoses
what can portal hypertension lead to?
Esophageal varices
Caput medusa
Anorectal varices
Blockage from the liver
how does the abdominal and pelvic organs get sympathetic innervation?
Preganglionic neurons enter white ramus communicans through the splanchnic nerves where they synapse with prevertebral ganglion (sit on top of vertebra and aorta), they will synapse with postganglionic neurons and reach their target organ
what is the sympathetic pathway of the adrenal glands?
Preganglionic neuron doesn’t synapse at all with a postganglionic neuron and simply synapses directly
what portion of the GIT is innervated by the Vagus N?
foregut and midgut
what organs are parasympathetically innervated by the vagus N
Kidneys
Celiac plexus
Superior mesenteric plexus
Renal plexus
what type of innervation do the adrenals lack?
parasympathetic
where does the pelvic splanchnic N arise from?
sacral spinal N (S2-S4)
what does the pelvic splanchnic N innervate?
hindgut
through what plexus do the preganglionic neurons travel trough to reach the hindgut?
inferior hypogastric plexus
where do fibers of the splanchnic pelvic N travel to reach the hindgut
along the hypogastric N to the superior hypogastric plexus and inferior mesenteric plexus where they will travel along the IMA
what organs are innervated by the pelvic splanchnic nerve?
hindgut, pelvis and pelvic organs
where does the sympathetic chain enter the abdomen from?
via the medial arcuate ligament
what is the pathway of the preganglionic neurons of the thoracic splanchnic nerve?
o Preganglionic neurons targeting pre-aortic ganglia synapse with postganglionic neurons
what branches come from the thoracic splanchnic nerve?
- greater splanchnic nerve
- lesser splanchnic nerve
- least splanchnic nerve
what contributes tot he greater splanchnic N?
T5-T9
What is the pathway of the greater splanchnic nerve?
Preganglionic neurons synapse in celiac ganglion with post ganglionic neurons. Fibers travel through the celiac plexus and along the arteries to get to the target organs in the foregut and the kidneys
what type of neuron is absent in the adrenal glands?
postganglionic neurons
what is the aorticortical ganglion specific for?
specific for sympathetic input that goes to the kidney and ureters
what contributes to the lesser splanchnic nerve?
T10-T11
what is the nervous pathway of the lesser splanchnic nerve?
Preganglionic neuron synapses in the superior mesenteric ganglion s with postganglionic neurons that travel through the superior mesenteric plexus and along the arteries of the SMA t0 innervate the midgut structures and synapses in the aorticorenal ganglion with postganglionic neurons that target the kidney via the renal plexus
what contributes to the least splanchnic N?
T12
what is the pathway of the least splanchnic nerve?
Preganglionic neurons synapses in the aorticorenal ganglia with postganglionic neurons that travel to the kidneys via the renal plexus
what contributes to the lumbar splanchnic n?
contributions from L1-L2
What is the nerve pathway of the lumbar splanchnic nerve?
• Preganglionic neurons synapse in the inferior mesenteric ganglion with postganglionic neurons that travels through inferior mesenteric plexus to target organs of the hindgut
at what level does the white ramus communicans end?
ends at L2
what are plexuses?
combination of sympathetic and parasympathetic innervation
where does the superior hypogastric plexus travel?
travels through the bifurcation of the aorta
what does the superuor hypogastric plexus splut into?
splits into the right and left branches
what nerves provide sympathetic innervation to the kidneys and adrenals?
lesser splanchnic N
least splanchnic N
greater splanchnic N
what nerves provide parasympathetic innervation to the kidneys and adrenals?
vagus n
pelvic splanchnic N
what is responsible for the drainage of the abdomen and pelvic structures?
cisterna chyli
lymph from cisterna chylie is transported to what?
thoracic duct
what lymph nodes of the abdomen is drained directly?
celiac LN
Superior mesenteric LN
what lymph nodes of the abdomen is drained indirectly?
-lateral aortic LN
what do the lateral aortic LN drain into?
into kidney and gonads
what is drained by the inferior mesenteric LN?
hindgut
what do the nodes from the common iliac drain?
pelvic viscera
