Lecture 16 - Nerves and Vessels of Abdomen Flashcards

1
Q

Abdo viscera are innervated by the

A

ANS

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2
Q

The preganglionic, sympathetic fibres are derived from __-___

A

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

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3
Q

The sympathetic ganglion cluster around …

A

unpaired branches of aorta and renal arteries

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4
Q

where is parasympathetic innervation from for foregut and midgut

A

vagus

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5
Q

where is parasympathetic innervation from for hindgut

A

pelvic splanchnics

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6
Q

The postganglionic symp. fibres run with ..

A

the vessels dervides from the abdo aorta

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7
Q

wbere are the pelvic splanchnics derived from?

A

sacral plexus

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8
Q

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

A

T6-9

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9
Q

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

A

T8-12

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10
Q

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

A

T12-L2

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11
Q

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

A

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

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12
Q

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

A

cutaneous distribution of S2-4

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13
Q

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

A

midline of anterior abdominal wall T6-L2

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14
Q

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

A

perineal region (s2-4)

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15
Q

Lymph drainage is to lymph nodes assocviated with

A

the abdo aorta - in front

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16
Q

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

what do they drain

A

pre-aortic nodes

assoc w the 3 unapired branches

Drain the unpaired derivatives of GIT

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17
Q

where are para-aortic nodes

A

sitting alongside the aorta - with the paired branches

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18
Q

The lymph of pre-arotic nodes drains where?

A

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

19
Q

True or false

para-aortic nodes drain the gonads

A

true

cancer of the testes or ovaries will drain here

20
Q

True or false

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

A

True

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

21
Q

True or False

para-aortic nodes drain
The pelvis and lower limb

A

true

22
Q

Cisterna chyli collects lymph from where?.

A

EVERYTHING belwo the diaphragm - goes through as thoracic duct

23
Q

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

A

para-aortic lymph nodes - paired viscera

24
Q

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

A

Diaphragm

posterior abdominal wall

25
Q

The ventral mesentery becomes the …

A

falciform ligament

26
Q

What are the boundaries of the foregut?

A

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

27
Q

What are the boundaries of the midgut?

A

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

28
Q

What are the boundaries of the hindgut?

A

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

29
Q

The coeliac trunk is visible where?

A

just above the pancreas - T12

30
Q

What are the 3 branches of celiac trunk

A

up to the left - Left gastric a.

to the left directly - splenic artery (tortuous course)

To the right - common hepatic artery

31
Q

What are the branches of the splenic

A

short gastrics and left gastroepiploic a.

32
Q

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

A

lesser curvature of the stomach. Gives off Esophageal branch before

33
Q

common hepatic artery initially heads to the …

What does it do?

A

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

34
Q

The SMA arises how far below the celiac a?

A

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

35
Q

The colic branches come off what side of the SMA?

A

Right side

36
Q

What vertebral level is the IMA?

A

L3

37
Q

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

A

Superior rectal artery

38
Q

the IMV joins which other vein?

A

Splenic vein

39
Q

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

A

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

40
Q

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

A

portal vein

41
Q

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

A
  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
42
Q

The left gonadal arteries/veins come off the …

A

left renal artery and vein

43
Q

true or False

the hepatic portal system has valves

A

False - it doesn’t

that’s how backwards flow can cause portal hypertension