Lecture 16 - Nerves and Vessels of Abdomen Flashcards
Abdo viscera are innervated by the
ANS
The preganglionic, sympathetic fibres are derived from __-___
T6-L2 - they are pre ganglionic, the ganglion is assocaited with the main branches of the abdo aorta
The sympathetic ganglion cluster around …
unpaired branches of aorta and renal arteries
where is parasympathetic innervation from for foregut and midgut
vagus
where is parasympathetic innervation from for hindgut
pelvic splanchnics
The postganglionic symp. fibres run with ..
the vessels dervides from the abdo aorta
wbere are the pelvic splanchnics derived from?
sacral plexus
What are the regions of the associated vertebrae are responsible for the postganglionic supply if the foregut?
T6-9
What are the regions of the associated vertebrae are responsible for the postganglionic supply if the midgut?
T8-12
What are the regions of the associated vertebrae are responsible for the postganglionic supply if the hindgut?
T12-L2
Visceral afferents pass to the same spinal cord segment involved in Sympathetics innervation up to ___ ______ ___BUT beyond that they run with parasympathetics
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
Any point distal to the mid point of the sigmoid colon will refer to
cutaneous distribution of S2-4
Afferent fibres carryingpainfrom a lll unpaired abdo viscera prox. to mid-sigmoid will refer pain to…
midline of anterior abdominal wall T6-L2
Afferent fibres carrying pain from mid-sigmoid down will refer pain to ..
perineal region (s2-4)
Lymph drainage is to lymph nodes assocviated with
the abdo aorta - in front
what are the lymph nodes in front of the aorta called?
what do they drain
pre-aortic nodes
assoc w the 3 unapired branches
Drain the unpaired derivatives of GIT
where are para-aortic nodes
sitting alongside the aorta - with the paired branches
The lymph of pre-arotic nodes drains where?
upwards via the intestinal lymph trunk and then into the thoracic duct
True or false
para-aortic nodes drain the gonads
true
cancer of the testes or ovaries will drain here
True or false
para-aortic nodes drain
the walls of the abdo cavity including the diaphragm
True
drains all paired branches on the side and back of the aorta
True or False
para-aortic nodes drain
The pelvis and lower limb
true
Cisterna chyli collects lymph from where?.
EVERYTHING belwo the diaphragm - goes through as thoracic duct
The right and left lumbar truck, going into the cisterna chyii receive lymph from where?
para-aortic lymph nodes - paired viscera
There are a series of paired branches off the back of the aorta in the abdomen, what do they supply?
Diaphragm
posterior abdominal wall
The ventral mesentery becomes the …
falciform ligament
What are the boundaries of the foregut?
the abdominal oesophagus to the major duodenal papillae (including liver, gallbladder, pancreas and spleen)
What are the boundaries of the midgut?
major duodenal papillae to the point just short of the splenic flexure (no specific line)
What are the boundaries of the hindgut?
the point just short of the splenic flexure to the anal canal
The coeliac trunk is visible where?
just above the pancreas - T12
What are the 3 branches of celiac trunk
up to the left - Left gastric a.
to the left directly - splenic artery (tortuous course)
To the right - common hepatic artery
What are the branches of the splenic
short gastrics and left gastroepiploic a.
Left gastric a. runs along where? (what is the other branch it gives off before hand though)
lesser curvature of the stomach. Gives off Esophageal branch before
common hepatic artery initially heads to the …
What does it do?
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
The SMA arises how far below the celiac a?
1 cm (L1) - travels along the route of the mesentery
The colic branches come off what side of the SMA?
Right side
What vertebral level is the IMA?
L3
Once the IMA gives off its branches to the colon it becomes the ..
Superior rectal artery
the IMV joins which other vein?
Splenic vein
the splenic vein the meets the SMV to form the portal vein behind the ___at vertebral level __
the splenic vein the meets the SMV to form the portal vein behind the pancreas at L2
All the structures of the primitive gut tube have venous drainage through…
portal vein
Where are the points of Portosystemic Anastomoses? (which are enlarged in portal hypertension)
- 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)
- Anal canal - lowest end is my middle and inferior rectal veins into the IVC (get dilated anal veins)
- Superficial veins on the anterior abdominal wall
- Retroperitoneal viscera
- bare area of the liver
The left gonadal arteries/veins come off the …
left renal artery and vein
true or False
the hepatic portal system has valves
False - it doesn’t
that’s how backwards flow can cause portal hypertension
