Lecture 16 - Nerves and Vessels of Abdomen

Question 1

Abdo viscera are innervated by the

Answer 1

ANS

Question 2

The preganglionic, sympathetic fibres are derived from __-___

Answer 2

T6-L2 - they are pre ganglionic, the ganglion is assocaited with the main branches of the abdo aorta

Question 3

The sympathetic ganglion cluster around …

Answer 3

unpaired branches of aorta and renal arteries

Question 4

where is parasympathetic innervation from for foregut and midgut

Answer 4

vagus

Question 5

where is parasympathetic innervation from for hindgut

Answer 5

pelvic splanchnics

Question 6

The postganglionic symp. fibres run with ..

Answer 6

the vessels dervides from the abdo aorta

Question 7

wbere are the pelvic splanchnics derived from?

Answer 7

sacral plexus

Question 8

What are the regions of the associated vertebrae are responsible for the postganglionic supply if the foregut?

Answer 8

T6-9

Question 9

What are the regions of the associated vertebrae are responsible for the postganglionic supply if the midgut?

Answer 9

T8-12

Question 10

What are the regions of the associated vertebrae are responsible for the postganglionic supply if the hindgut?

Answer 10

T12-L2

Question 11

Visceral afferents pass to the same spinal cord segment involved in Sympathetics innervation up to ___ ______ ___BUT beyond that they run with parasympathetics

Answer 11

Visceral afferents pass to the same spinal cord segment involved in sympathetic innervation up to mid sigmoid colon BUT beyond that they run with parasympathetics

Question 12

Any point distal to the mid point of the sigmoid colon will refer to

Answer 12

cutaneous distribution of S2-4

Question 13

Afferent fibres carryingpainfrom a lll unpaired abdo viscera prox. to mid-sigmoid will refer pain to…

Answer 13

midline of anterior abdominal wall T6-L2

Question 14

Afferent fibres carrying pain from mid-sigmoid down will refer pain to ..

Answer 14

perineal region (s2-4)

Question 15

Lymph drainage is to lymph nodes assocviated with

Answer 15

the abdo aorta - in front

Question 16

what are the lymph nodes in front of the aorta called?

what do they drain

Answer 16

pre-aortic nodes

assoc w the 3 unapired branches

Drain the unpaired derivatives of GIT

Question 17

where are para-aortic nodes

Answer 17

sitting alongside the aorta - with the paired branches

Question 18

The lymph of pre-arotic nodes drains where?

Answer 18

upwards via the intestinal lymph trunk and then into the thoracic duct

Question 19

True or false

para-aortic nodes drain the gonads

Answer 19

true

cancer of the testes or ovaries will drain here

Question 20

True or false

para-aortic nodes drain
the walls of the abdo cavity including the diaphragm

Answer 20

True

drains all paired branches on the side and back of the aorta

Question 21

True or False

para-aortic nodes drain
The pelvis and lower limb

Answer 21

true

Question 22

Cisterna chyli collects lymph from where?.

Answer 22

EVERYTHING belwo the diaphragm - goes through as thoracic duct

Question 23

The right and left lumbar truck, going into the cisterna chyii receive lymph from where?

Answer 23

para-aortic lymph nodes - paired viscera

Question 24

There are a series of paired branches off the back of the aorta in the abdomen, what do they supply?

Answer 24

Diaphragm

posterior abdominal wall

Question 25

The ventral mesentery becomes the ...

Answer 25

falciform ligament

Question 26

What are the boundaries of the foregut?

Answer 26

the abdominal oesophagus to the major duodenal papillae (including liver, gallbladder, pancreas and spleen)

Question 27

What are the boundaries of the midgut?

Answer 27

major duodenal papillae to the point just short of the splenic flexure (no specific line)

Question 28

What are the boundaries of the hindgut?

Answer 28

the point just short of the splenic flexure to the anal canal

Question 29

The coeliac trunk is visible where?

Answer 29

just above the pancreas - T12

Question 30

What are the 3 branches of celiac trunk

Answer 30

up to the left - Left gastric a. to the left directly - splenic artery (tortuous course) To the right - common hepatic artery

Question 31

What are the branches of the splenic

Answer 31

short gastrics and left gastroepiploic a.

Question 32

Left gastric a. runs along where? (what is the other branch it gives off before hand though)

Answer 32

lesser curvature of the stomach. Gives off Esophageal branch before

Question 33

common hepatic artery initially heads to the ... What does it do?

Answer 33

site of the free edge of the lesser omentum 1st branch - proper hepatic artery then ascends to the liver, before dividing into left and right hepatic artery (RHA includes branch = cystic artery) 2nd branch - gastroduodenal artery - gives off right gastric a and right gastroepiploic a. Also gives of supraduodenal branch

Question 34

The SMA arises how far below the celiac a?

Answer 34

1 cm (L1) - travels along the route of the mesentery

Question 35

The colic branches come off what side of the SMA?

Answer 35

Right side

Question 36

What vertebral level is the IMA?

Answer 36

L3

Question 37

Once the IMA gives off its branches to the colon it becomes the ..

Answer 37

Superior rectal artery

Question 38

the IMV joins which other vein?

Answer 38

Splenic vein

Question 39

the splenic vein the meets the SMV to form the portal vein behind the ___at vertebral level __

Answer 39

the splenic vein the meets the SMV to form the portal vein behind the pancreas at L2

Question 40

All the structures of the primitive gut tube have venous drainage through...

Answer 40

portal vein

Question 41

Where are the points of Portosystemic Anastomoses? (which are enlarged in portal hypertension)

Answer 41

1. Middle part of the esophagus is systemic, lower part drains to the portal vein - results in visibility dilated esophageal mucosal veins (which can rupture = can cough up blood) 2. Anal canal - lowest end is my middle and inferior rectal veins into the IVC (get dilated anal veins) 3. Superficial veins on the anterior abdominal wall 4. Retroperitoneal viscera 5. bare area of the liver

Question 42

The left gonadal arteries/veins come off the ...

Answer 42

left renal artery and vein

Question 43

true or False the hepatic portal system has valves

Answer 43

False - it doesn't that's how backwards flow can cause portal hypertension