Lecture 13 - Alimentary 5 Flashcards

1
Q

Which three arteries supply the foregut, midgut and hindgut?

A

Coeliac trunk, SMA and IMA

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2
Q

Which two arteries overlap in their supply to the pancreas?

A

coeliac trunk (superior pancreaticoduodenal arteries) and SMA (inferior pancreaticoduodenal arteries)

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3
Q

What does the foregut consist of? (6)

A

Stomach, liver, gallbladder, pancreas, spleen and first + half of second part of the duodenum

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4
Q

Give for the foregut:
Blood supply
Blood drainage
Lymph drainage

A

Coeliac trunk
Splenic vein
Coeliac nodes

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5
Q

What group are the coeliac lymph nodes part of?

A

The preaortic nodes

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6
Q

What does the midgut consist of? (3)

A
Distal duodenum (below greater duodenal papilla)
Rest of the small intestine
Large intestine to approximately two thirds of the transverse colon
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7
Q

Give for the midgut:
Blood supply
Blood drainage
Lymph drainage

A

SMA
SMV
SMN

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8
Q

What does the hindgut consist of?

A

Rest of the larger intestine to the upper rectum

Also lower rectum + anus

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9
Q

What are the lower rectum + anus mostly supplied by though

A

The internal iliac arter

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10
Q

Give for the hindgut:
Blood supply
Blood drainage
Lymph drainage

A

IMA
IMV
IMN

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11
Q

Where do the sympathetic ganglia (coeliac, superior and inferior mesenteric) receive preganglionic fibres from?

A

Thoracic and lumbar splanchnic nerves

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12
Q

What are the sympathetic ganglia associated with?

A

The origins of the arteries of the same name

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13
Q

Give the for the foregut:
Sympathetic
Parasympathetic

A
Coeliac ganglion (paired) - thoracic splanchnic
Vagus
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14
Q

Give the for the midgut:
Sympathetic
Parasympathetic

A

SMG - thoracic splanchnic

Vagus

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15
Q

Give the for the hindgut:
Sympathetic
Parasympathetic

A

IMG - lumbar splanchnic

Pelvic splanchnics

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16
Q

What are the sensory fibres most sensitive to?

A

Stretch or distension/colic

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17
Q

What does sympathetic stimulation of the gut do?

A

Reduce motility and vasoconstrict

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18
Q

What does parasympathetic stimulation of the gut do>

A

Increase motility and secretion

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19
Q

What are the three branches of the coeliac trunk?

A

Splenic artery, left gastric artery and common hepatic artery

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20
Q

What are the 6 divisions of the SMA/

What are the parts of the gut supplied by branches of the SMA

A
Inferior pancreaticoduodenal
Jejunal
Ileal
Ileocolic
Right colic
Middle colic
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21
Q

What are the parts of the gut supplied by branches of the inferior mesenteric artery? (3)

A

Left colic
Sigmoid
Superior rectal

22
Q

What is the marginal artery?

A

An arterial arcade which runs parallel to the large and intestine and forms side to side anastomoses

23
Q

What does the marginal artery anastomose with?

A

Branches of the SMA and IMA

24
Q

Where does the marginal artery extend from?

A

The sigmoid branch of interior mesenteric artery to the ileocolic branch of the SMA

25
Q

What does the marginal artery allow for?

A

Retrograde flow from the IMA to supply areas normally supplied by the SMA/coeliac trunk if they become blocked

26
Q

Where does the IMV join the splenic vein

A

Behind the body of the pancreas

27
Q

Where does the SMV join the splenic vein

A

Behind the head of the pancreas

28
Q

What is the portal vein formed by

A

The confluence of splenic and SMV

29
Q

What are the arteries that supply the rectum and anus (4)?

A
Superior rectal (Branch of IMA)
Middle rectal (Branch of internal iliac)
Inferior rectal (Branch of internal iliac)
Middle sacral artery (from bifucation of aorta into common iliac)
30
Q

What is the collective name for all the interconnecting venous plexuses either within the wall or outside muscle of the rectum?

A

Rectal venous plexuses

31
Q

Where does the internal rectal plexus drain into?

A

IMV

32
Q

Where does the external rectal plexus drain into (3)

A

upper IMV
Middle internal iliac vein
Lower internal pudendal (tributary of the IIV)

33
Q

What causes haemorrhoids

A

Dilation of the veins of the internal plexus

34
Q

What does the lymph drainage of the rectum follow?

A

The arteries to the pre-aortic and internal iliac nodes.

Exception: lower anal canal to superficial inguinal nodes

35
Q

All the lymph drainage of the rectum goes to the pre-aortic and internal iliac nodes true or false?

A

False

36
Q

The innervation of the rectum is completely autonomic true or false?

A

False, in the lower anal canal it is somatic

37
Q

Where does the sympathetic innervation of the rectum originate from?

A

Lumbar sympathetic trunk

38
Q

Where does the parasympathetic innervation of the rectum originate from?

A

Pelvic splanchnics (S2-4)

39
Q

What can the rectum sense?

A

Stretch above the pectinate line

Pain and temperature below

40
Q

What supplies the pancreas? (3)

A

Splenic (most)

Superior + inferior pancreaticoduodenal arteries (head+uncinate process)

41
Q

The splenic arteries anastomose with the superior and inferior pancreaticoduodenal arteries, true or false?

A

True

42
Q

What is venous drainage of the pancreas?

A
Mostly splenic vein 
Pancreaticoduodenal veins (head + uncinate process)
43
Q

What is the lymph drainage of the pancreas like?

A

Pancreatic lymph nodes and vessels located along the splenic artery and its branches. Drain into the coeliac nodes

44
Q

What is the nervous supply of the pancreas like?

A

Parasympathetic - vagal

Sympathetic - thoracic splanchnic

45
Q

How does blood enter the liver?

A

Into the hilus via left and right branches of the hepatic artery and portal vein.

46
Q

What else travels with the arteries into the hilum?

A

A plexus of sympathetic and parasympathetic nerves derived from the coeliac plexus

47
Q

What do both sets of vessels branch and branches travel together through?

A

Portal canals, portal areas or portal ‘triads’ along with:

bile duct and lymph vessels

48
Q

Where do the sinusoids run in the liver?

A

From the outside of the lobules to central veins

49
Q

How do the central veins of the liver eventually drain?

A

They anastomose to form larger veins (usually 3 larger upper and several smaller veins

50
Q

How does lymph pass through the liver

A
  1. Pores in the walls of sinusoids
  2. Space of Disse (between sinusoids and hepatocytes)
  3. Small lymph capillaries in portal areas
  4. Hilum
  5. Empty into the thoracic duct