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ANAT-316 > Lecture 19 - Abdominal Veins and Visceral Innervation > Flashcards

Lecture 19 - Abdominal Veins and Visceral Innervation Flashcards

1
Q

What are the two systems of venous drainage?

A
  1. Portal system
  2. Caval system
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2
Q

What is the portal system?

A
  • Blood from some abdominal viscera drains into the portal vein
  • Filtered by the liver
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3
Q

What are the abdominal viscera that drains into the portal vein?

A
  1. Spleen
  2. Pancreas
  3. Gallbladder
  4. GIT
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4
Q

What neurovasculature connects the portal system to the inferior vena cava?

A

Via hepatic veins

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5
Q

Where do the hepatic veins drain into the IVC?

A

Below diaphragm before passing through the caval hiatus

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6
Q

What form the capillaries in the portal system?

A

Two veins

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7
Q

What is the caval system?

A

Blood from the rest of the lower body drains into the inferior vena cava

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8
Q

Where does the caval system pass?

A

Through the central tendon of the diaphragm at T8 (through caval hiatus)

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9
Q

How is blood carried back to the inferior vena cava?

A

Via paired veins

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10
Q

Where is the IVC located in relation to the midline?

A

To the right of the midline

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11
Q

What does the location of the IVC cause left veins to do?

A
  1. Left veins can be substantially longer
  2. Left veins drain into the renal vein
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12
Q

What left veins are substantially longer?

A

Renal vein

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13
Q

What left veins drain into the renal vein?

A
  1. Suprarenal vein
  2. Gonadal veins
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14
Q

What do the right veins drain into?

A

The inferior vena cava

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15
Q

What are the structures of the caval system?

A
  1. Inferior phrenic vein
  2. Hepatic veins
  3. Suprarenal vein
  4. Renal veins
  5. Gonadal veins
  6. Common iliac vein
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16
Q

What is left renal vein entrapment syndrome?

A
  • AKA nutcracker syndrome
  • Compression of the left renal vein
  • Passes between abdominal aorta and superior mesenteric artery
  • Leads to blockage of venous return
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17
Q

What is the consequence of nutcracker syndrome?

A
  • Problems with venous drainage from left kidney and left gonad
  • Symptoms: Referred pain, blood in urine, and varices
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18
Q

What 3 major vessels drain into the portal vein?

A
  1. Splenic vein
  2. Inferior mesenteric vein
  3. Superior mesenteric vein
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19
Q

Where does the splenic vein drain blood from?

A
  1. Spleen
  2. Foregut (large portion: esophagus, stomach, pancreas)
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20
Q

Where does the inferior mesenteric vein drain blood from?

A

Hindgut

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21
Q

Where does the inferior mesenteric vein drain?

A

Splenic vein

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22
Q

Where does the superior mesenteric vein drain blood from?

A

Midgut

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23
Q

The joining of which neurovasculature creates the portal vein?

A
  1. Splenic vein
  2. Inferior mesenteric artery
  3. Superior mesenteric vein
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24
Q

Where does blood enter in the portal system?

A
  1. Proper hepatic artery
  2. Portal vein
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25
Q

What does blood in the portal vein contain?

A

Venous blood contains nutrients and toxins

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26
Q

What does the proper hepatic artery supply?

A

Regular arterial blood supply to the liver

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27
Q

What is the function of the portal system?

A
  1. Blood filtration
  2. Nutrient metabolism
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28
Q

What is the portal triad?

A
  1. Portal vein
  2. Proper hepatic artery
  3. Bile duct
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29
Q

What are portosystemic anastomoses?

A
  • Occurs in individuals with elevated pressure in the portal vein
  • Blood that normally drains via the portal system enters systemic circulation
  • Occurs at these sites
30
Q

What can portosystemic anastomoses lead to?

A

Enlargement of veins in these regions (exp: varices/caput medusae)

31
Q

Where are the 3 portosystemic anastomoses?

A
  1. Gastroesophageal junction
  2. Anterior abdominal wall around umbilicus
  3. Anorectal junction
32
Q

What type of innervation does the lumbar plexus provide?

A

Somatic innervation

33
Q

What are the nerves of the lumbar plexus?

A
  1. Iliohypogastric
  2. Ilioinguinal
  3. Genitofemoral
  4. Lateral cutaneous nerve of the thigh
  5. Femoral
  6. Obturator
34
Q

What are the two types of viscera motor innervation?

A

Sympathetic and parasympahtetic

35
Q

What effects can sympathetic innervation have on the body?

A
  • Increase epinephrine release
  • Decrease urine production
  • Decrease GI motility
36
Q

What effects can parasympathetic innervation have on the body?

A
  • Relaxation of sphincters
  • Increase digestive enzyme production
  • Increase GI motility
  • Increase urine production
37
Q

What are prevertebral ganglia?

A

Where preganglionic sympathetic neurons of sympathetic splanchnics synapse

38
Q

What are the 4 prevertebral ganglia?

A
  1. Celiac ganglia
  2. Superior mesenteric ganglion
  3. Aorticorenal ganglion
  4. Inferior mesenteric ganglion
39
Q

What neurons synapse in the celiac ganglia?

A

Greater splanchnic nerve

40
Q

What neurons synapse in the superior mesenteric ganglion?

A
  1. Lesser splanchnic nerve
  2. Least splanchnic nerve
41
Q

What neurons synapse in the aorticorenal ganglion?

A

Lesser splanchnic nerve

42
Q

What neurons synapse in the inferior mesenteric ganglion?

A

Lumbar splanchnic nerve

43
Q

What are the 4 plexes of visceral sympathetic innervation?

A
  1. Celiac and renal plexes
  2. Superior mesenteric plexus
  3. Inferior mesenteric plexus
  4. Superior hypogastric plexus
44
Q

What makes up the celiac and renal plexes?

A

Thoracic splanchnic n. + vagal trunk branches

45
Q

Where does the celiac and renal plexes innervate?

A

Foregut and kidneys

46
Q

What makes up the superior mesenteric plexus?

A

Lesser and least splanchnic n. + vagal trunk branches

47
Q

Where does the superior mesenteric plexus innervate?

A

Midgut

48
Q

What makes up the inferior mesenteric plexus?

A

Lumbar splanchnic n. + vagal trunk branches

49
Q

Where does the inferior mesenteric plexus innervate?

A

Hindgut

50
Q

Where does superior hypogastric plexus innervate?

A

Pelvic viscera

51
Q

What passes through these plexes but do not synapse in prevertebral ganglia?

A

Parasympathetic neurons + visceral sensory neurons

52
Q

What do visceral plexes follow to reach their destinations?

A

Follow vessels/major arteries

53
Q

What is an example of the plexus following a major artery?

A

Superior mesenteric plexus:
Follows superior mesenteric artery + major branches to midgut

54
Q

Where does most of the parasympathetic innervation of the abdomen originate from?

A

Vagus nerve

55
Q

Where is parasympathetic innervation carried?

A
  • Through the diaphragm (along the esophagus)
  • Via anterior and posterior vagal trunks
56
Q

What does the parasympathetic innervation innervate?

A

Foregut and midgut

57
Q

Where does parasympathetic innervation of the hindgut and pelvis come from?

A

S2-S4 sacral outflow

58
Q

What does the parasympathetic innervation from S2-S4 arise as?

A

Pelvic splanchnic nerves

59
Q

Where do the pelvic splanchnic nerves run?

A
  • Enters inferior hypogastric plexus
  • Axons ascend toward inferior mesenteric region
60
Q

Where does visceral sensation from organs return?

A

To spinal cord

61
Q

How does visceral sensation return to the spinal cord?

A

Via plexes and splanchnic nerves

62
Q

What are spinal levels associated with?

A

Referred pain patterns to the corresponding dermatomes (ipsilaterally)

63
Q

What are the associated spinal levels for the liver?

A

T6-T9

64
Q

What are the associated spinal levels for the stomach?

A

T6-T9

65
Q

What are the associated spinal levels for the spleen?

A

T6-T8

66
Q

What are the associated spinal levels for the kidneys?

A

T10-L1

67
Q

What are the associated spinal levels for the small intestine ?

A

T8-T10

68
Q

What are the associated spinal levels for the ascending colon?

A

T10

69
Q

What are the associated spinal levels for the transverse colon?

A

T11

70
Q

What are the associated spinal levels for the descending colon?

A

T12-L3

71
Q

What are the associated spinal levels for the sigmoid colon?

A

S2

72
Q

What are the associated spinal levels for the rectum?

A

S4

ANAT-316 (25 decks)

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