Midterm Two Flashcards
What are the branches of the celiac trunk?
- left gastric
- splenic artery
- common hepatic artery
Draw the branches of the celiac trunk.
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Where does the esophagus enter the diaphragm and at which vertebral level?
- esophageal hiatus of diaphragm at T-10 level
What type of muscle is found in the first, middle and last thirds of the esophagus?
- top (first) third
- voluntary striated muscle
- middle third
- voluntary striated muscle
- smooth muscle
- bottom (last) third
- smooth muscle
Which lymphatic trunks and nodes does the thoracic part of the esophagus drain into?
- lymph from top of esophagus (neck)
- drains into jugular trunk
- lymph from middle part of esophagus (near lungs)
- drains into bronchomediastinal trunks
- lymph from lower part of esophagus
- drains into superior diaphragmatic lymph nodes
Which lymph nodes does the abdominal part of the esophagus drain into?
- abominal lymph nodes
- celiac lymph nodes
On a diagram, label the esophageal arteries, the esophageal branch of the left inferior phrenic artery, the esophageal branch of the left gastric artery and the left gastric artery
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On a diagram of the stomach, label the following: cardiac notch, cardia, fundus, body, pyloric canal, pyloric antrum, lesser curvature, greater curvature, gastric canal, gastric folds, cardiac orfice, Z-line
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What forms the physiological inferior esophageal sphincter?
- diaphragmatic musculature surrounding hiatus
What does the Z-line demarcate?
- transition line from esophageal to gastric mucosa
What are the two parts of the pyloris? Which part is wide and which part is narrow?
- antrum (chamber) = wide
- canal = narrow
Along which curvature is the angular incisure found?
lesser curvature
The angular incisure is the junction between which structures?
- body
- pylorus
When an where does the gastric canal form?
- during swallowing only temporarily
- forms between the longitudinal gastric curves along the lesser curvature
On a diagram of the stomach, label the following: celiac trunk, left and right gastric arteries, left and right gastro-omental arteries.
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Which arteries supply the lesser curvature and which supply the greater curvature?
- lesser curvature
- right gastric artery
- greater curvature
- left and right gastro-omental artery
What are the parts of the small intestine?
- duodenum
- jejunum
- ileum
On diagrams of the small intestine, label the following: celiac trunk, gastroduodenal artery, superior mesenteric artery, inferior mesenteric artery, arterial arcades, vasa recta straight arteries.
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On diagrams of the small intestine, label the following: splenic vein, hepatic portal vein, pancreaticoduodenal vein, superior mesenteric vein.
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What is the arterial supply of the proximal part of the duodenum? What is the arterial supply of the distal part of the duodenum?
- proximal
- branches of celiac trunk
- distal
- branches of superior mesenteric artery
Which lymph nodes drain the duodenum?
- pyloric lymph nodes
- superior mesenteric lymphnodes
What is the sympathetic nerve supply of the duodenum?
- superior mesenteric plexus
- celiac plexus
What is the parasympathetic supply of the stomach?
- anterior and posterior vagal trunks
What is the sympathetic supply of the stomach including splanchnic nerve and plexus?
- T5-T9 segments
- greater splanchnic nerve
- celiac plexus
The mixed sympathetic and parasympathetic supply is around the parietal plexus. Which arteries are involved in this periarterial plexus around the stomach?
- gastric arteries
- gastromomental arteries
Identify on a diagram the jejunum and ileum.
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Which artery provides the blood supply to the jejunum? Explain in terms of arterial arcades and vasa recta and straight arteries.
- jejunum and ilium get blood supply from superior mesenteric artery
- arterial arcades - loops
- vasa recta come off the arterial arcades
- straight arteries branch off vasa recta
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Describe the relationship of the superior mesenteric vein, splenic vein, and hepatic portal vein.
- hepatic portal system
What is the sympathetic nervous system supply of the jejunum and ileum including the splanchnic nerves, galnglia and plexuses.
- greater and lesser splancnic nerves which innervate the celiac and superior mesenteric ganglia
What is the parasympathetic nerve supply of the jejunum and ileum? Where do the postsynaptic parasympathetic neurons synapse?
- posterior vagal trunk
- presynaptic parasympathetic fibers synapse with postsynaptic parasympathetic fibers in the myenteric and submucus plexuses in the intestinal wall
Which plexus does the greater splanchnic nerve converge on?
celiac
What is the cystic artery a branch of?
right hepatic artery
Which 2 veins does the thoracic esophagus drain into?
- esophageal vein
- azygous vein
Which 2 veins does the abdominal esophagus drian into?
- left gastric vein drains into portal venous system
Which vessels supply the duodenum?
- gastroduodenal artery
- superior pancreaticoduodenal artery
- inferior pancreaticoduodenal artery
Which lymph nodes drain the duodenum?
- pyloric and superior mesenteric
The ileocolic artery is a direct branch from which artery?
superior mesenteric artery
What is the cystic artery a branch of?
right hepatic artery
What main artery does the appendicular artery come from?
ileocolical
Identify the superior and inferior pancreaticoduodenal veins.
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What is the arterial supply to the cecum?
ileocolic artery which is a terminal branch of the superior mesenteric artery
What is the arterial supply to the appendix?
appendicular artery which is a branch of the ileocolic artery
The ileoceolic artery is a branch of which artery?
- terminal branch of the superior mesenteric artery
The appendicular artery is a branch of which artery?
- ileocolic artery
What is the arterial supply of the ascending colon?
- ileocolic artery
- right colic artery
What is the parasympathetic supply of the cecum?
vagal trunks
The ileocolic and right colic arteries are branches of which artery?
superior mesenteric artery
Describe the venous drainage of the colon and right colic flexure.
- ileocolic and right colic veins
- which drain into the superior mesenteric vein
Which flexures are at the end of the transverse colon?
- right colic flexure
- left colic flexure
What is the blood supply of the transverse colon?
- middle colic artery
- right colic arteries via anastemoses
- left colic artery
What is the venous drainage of the transverse colon?
- superior mesenteric vein
True or false: some nerves from the inferior mesenteric plexus may follow anastomoses from the left colic artery in the transverse colon.
true
What is the parasympathetic nervous system supply of the ascending colon and right colic flexure?
vagal trunks
For the sympathetic nervous system supply of the transverse colon, list the plexuses and the blood vessels involved.
- superior mesenteric plexus
- will follow right and middle colic arteries
- inferior mesenteric plexus
- will follow left colic artery
What is the parasympathetic nerve supply for the transverse colon?
vagal trunks
What is the blood supply of the descending and sigmoid colon?
- left colic artery and sigmoid artery
- which are both branches of inferior mesenteric artery
- marginal artery
What is the venous drainage of the descending and sigmoid colon?
- inferior meseneteric vein
- which drains into the splenic vein
- which drains into the hepatic portal vein
- which drains into the splenic vein
What is the sympathetic nervous system supply of the descending and sigmoid colon?
- inferior mesenteric ganglion
- pariarterial plexuses on inferior mesenteric artery and its branches
What is the parasympathetic nervous system supply of the descending and sigmoid colon?
- pelvic splanchnic nerves which merge on the inferior hypogastric plexus
Label this diagram.
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What are the 4 features to know of the large colon?
- teniae coli
- thickened bands of longitudinal muscle
- haustra
- pouches
- omental appendices
- small fatty appendices
- caliber
- large diameter of the colon
Label this diagram.
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Label this diagram.
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On a diagram, label the following: celiac artery, splenic artery, gastroduodenal artery, anterior and posterior pancreaticoduodenal arteries, superior mesenteric artery.
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On a diagram, label the following: splenic vein, inferior mesenteric vein, hepatic portal vein, superior mesenteric vein.
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On a diagram, label the following: vagus nerve, greater splanchnic nerve, lesser splanchnic nerve, celiac ganglion, celiac trunk, superior mesenteric ganglion, superior mesenteric artery.
- greater splanchnic nerve is close to the artery
- lesser splanchnic nerve is further from the artery
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On a diagram of the pancreas and duodenum, label the following: uncinate process, head of pancreas, neck of pancreas, body of pancreas, tail of pancreas, bile duct, accesory pancreatic duct, minor duodenal papilla, major duodenal papilla, main pancreatic duct.
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What is the minor duodenal papilla an opening for?
accessory pancreatic duct
What is the major duodenal papilla an opening for?
- ampula
On a diagram of the duodenum and its ducts, label the following: sphincter of the bile duct, spincter of the pancreatic duct, hepatopancreatic ampulla, major duodenal papilla.
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On a diagram of the liver, label the following: falciform ligament, bare area, portal triad, quadrate lobe, right lobe, left lobe, caudate lobe, left and right sagittal fissures, portal vein and porta hepatis
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On a diagram of the liver, label the following: falciform ligament, bare area, portal triad, quadrate lobe, right lobe, left lobe, caudate lobe, left and right sagittal fissures, portal vein and porta hepatis
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Which ligament anchors the liver to the anterior abdominal wall?
falciform ligament
Which ligament separates the right lobe from the left lobe?
falciform ligament
Which structures are seen in the left sagittal fissure? Which one is seen anteriorly and which one is seen posteriorly?
- round ligament
- anterior
- ligamentum venosum
- posterior
What is the round ligament of the liver a remnant of?
umbilical vein which carried oxygen from the placenta to fetus
What is the ligamentum venosum a remnant of?
fetal ductus venosus which shunted blood from the umbilical vein
The liver segments are served by which branches of arteries and veins?
- each segment will get a tertiary branch of a hepatic artery, hepatic portal vein, and a hepatic duct
- each segment is supplied by a tertiary branch of the right or left hepatic artery and hepatic portal vein
- between the segments are where the right and left hepatic vein and middle hepatic vein are found
The left gastroepiploic (gastro-omentum) artery is a branch of which artery?
splenic artery
The right gastroepiploic (gastro-omentum) artery is a branch of which artery?
gastroduodenal artery
Which arteries provide arterial supply to the esophagus?
arterial supply from the esophageal branches of the left gastric artery (branch of the celiac trunk) and left inferior phrenic artery
Which veins drain the stomach?
- right and left gastric vein
- right and left gastroepiploic vein
Which veins drain the duodenum?
- superior and inferior pancreaticoduodenal veins
What is the sympathetic supply of the esophagus including splanchnic nerve and plexus?
- thoracic sympathetic trunk to the greater splanchnic nerve
- celiac plexus
The mixed sympathetic and parasympathetic supply is around the periarterial plexus. Which arteries are involve in this periarterial plexus around the esophagus?
periarterial plexuses around the left gastric and left inferior phrenic artery
What is the sympathetic suply of the stomach including splanchnic nerve and plexus?
- T5-T9 –> greater splanchnic n. –> celiac plexus
Which artery provides blood supply to the jejunum. Explain in terms of arterial arcades and vasa recta and straight arteries.
- superior mesenteric artery –> arterial arcades –> vasa recta –> straight arteries –> jejunum
Which vein drains the jejunum and ileum?
- superior mesenteric vein –> arterial arcades –> vasa recta –> straight veins
Describe the lacteals and indicate what they absorb.
- lacteals = lymph vessels in the villi
- that absorb fat soluble vitamins and fats
The mixed parasympathetic and sympathetic supply is to which blood vessels (pariarterial plexuses) of the jejunum and ileum?
- superior mesenteric artery
- arterial arcades
- vasa recta
- straight arteries
Describe the venous drainage of the cecum and appendix.
- ileocolic and appendicular vein
What is the sympathetic supply of the cecum including spinal levels, splanchnic nerve, and plexus?
- superior mesenteric plexus
- T10, T11, T12 –> lesser splanchnic nerve –> superior mesenteric ganglion
The mixed sympathetic and parasympathetic supply of the cecum is found in the periarterial plexuses surrounding which arteries?
- ileocolic artery
- superior mesenteric artery
What is the parasympathetic supply of the duodenum?
vagus trunk
What is the sympathetic suply of the colon and right colic flexure including spinal levels, splanchnic nerve and plexus.
- superior mesenteric plexus
- T10, T11, T12 –> lesser splanchnic nerve –> superior mesenteric ganglion
The middle colic artery is a branch of which artery?
superior mesenteric artery
What is the arterial supply of the liver?
- right and left hepatic arteries
- proper hepatic artery that goes into portal triad
On a diagram, label the right hepatic vein, left hepatic vein, middle hepatic vein and inferior vena cava.
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Which structures are found in the portal triad?
- hepatic portal vein
- hepatic artery
- bile duct
What is the sympathetic nervous system supply of the liver?
- comes from celiac plexus whihc innervates the hepatic plexus and accompanies branches of the hepatic artery and hepatic portal vein
What is the parasympathetic supply of the liver?
- anterior posterior vagal trunks which innervates the hepatic plexus and accompanies branches of the hepatic artery and the hepatic portal vein
Which plexus serves the liver and recieves both parasympathetic and sympathetic supply?
hepatic plexus
On a diagram, label the following: anterior vagal trunk, posterior vagal trunk, celiac ganglion and plexus and hepatic plexus.
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What is the arterial supply of the gall bladder?
cystic artery
Which artery does the cystic artery come from?
right hepatic artery
What is the venous drainage of the gall bladder?
cystic veins
What is the parasympathetic supply of the gall bladder?
vagal trunks
The mixed supply of the transverse colon is found in the periarterial plexuses surrounding which arteries?
- middle colic artery
- right colic arteries via anastemoses
- left colic artery
The left colic and sigmoid arteries are branches of which artery?
inferior mesenteric artery
Which artery provides collateral circulation and is an anatomical variant?
marginal artery
The marginal artery is an anastomosis of which artery?
- ileocolic
- left colic
- right colic
- middle colic
- sigmoid artery
The mixed supply of the descending and sigmoid colons are found in the periarterial plexuses surrounding which arteries?
- left colic artery and sigmoid artery
- which are both branches of inferior mesenteric artery
- marginal artery
What are the parts of the large intestine?
- ascending colon
- transverse colon
- descending colon
- sigmoid colon
- appendix
- cecum
- rectum
- anal canal
What are the features of the large intestine?
- teniae coli
- thickened bands of longitudinal muscle
- haustra
- pouches
- omental appendices
- small fatty appendices
- caliber
- large diameter of the colon
On a diagram, label the following: appendicular artery, ileocolic artery, right colic artery, middle colic artery, ileocecal valve and ileal orfice, orfice of the appendix, appendicular artery, ileocolic artery, tenia coli.
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On a diagram, label the following: celiac gangion, superior mesenteric ganglion, lumbar splanchnic nerves, inferior mesenteric ganglion and plexus
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On a diagram, label the following: ileocolic artery, right colic artery and lymph nodes, middle colic artery, left colic artery, inferior mesenteric artery.
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On a diagram, label the following: cecum, appendix, ascending colon, transverse colon, descending colon, sigmoid colon, right colic flexure and left colic flexure.
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Through which ligaments does the spleen connet to the stomah and kidney?
splenorenal ligament
How does the spleen connect to the posterior wall of the greater curvature of the stomach?
gastrosplenic ligament
On a diagram, label the following: gastrosplenic ligament, splenorenal ligament, hilum.
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Describe the blood supply of the spleen.
- splenic artery
- branch of the celiac artery or celiac trunk
Describe the venous drainage of the spleen.
- splenic vein
- joined by the inferior mesenteric vein
- splenic veins unite with superior mesenteric vein to form the hepatic portal vein
What is the sympathetic nervous supply of the spleen including the plexus and splanchnic nerve?
- celiac plexus
- distributed along the splenich artery
- vasomotor- causes vasoconstriction at the spleen
- distributed along the splenich artery
What is the parasympathetic nerve supply of the spleen?
vagal trunks
Which arteries supply the pancreas and which arteries are they branches of?
- tail of pancreas
- splenich artery gives rise to pancreatic artery
- head of pancreas
- supplied by gastroduodenal artery
- 2 brances
- anterior superior pancreaticoduodenal artery
- posterior superior pancreaticoduodenal artery
- 2 brances
- supplied by superior mesenteric artery
- 2 branches
- anterior inferior pancreaticoduodenal artery
- posterior inferior pancreaticoduodenal artery
- 2 branches
- supplied by gastroduodenal artery
What is the venous drainage of the pancreas?
- pancreatic veins drain into the splenic vein
- most
- superior mesenteric vein
What is the sympathetic nerve supply of the pancreas including splanchnic nerve and plexus?
- two plexuses
- T5-T9 –> greater splanchnic nerve –> celiac ganglion –> pancreas
- T10-T12 –> lesser splanchnic nerve –> superior mesenteric ganglion –> pancreas
What is the parasympathetic nervous system supply of the pancreas?
vagal trunks
What is the sympathetic nerve supply of the gallbladder including splanchnic nerve and plexus?
- T5-T9 –> greater splanchnic nerve –> celiac ganglion –> gall bladder
On a diagram, label the following: right hepatic duct, left hepatic duct, common hepatic duct, cystic duct, bile duct.
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Which artery supplies the tail of the pancreas?
greater pancreatic artery which is a branch of the splenic artery
Head of the pancreas is supplied by which two arteries?
- gastroduodenal artery
- superior mesenteric artery
Which plexuses are involved in the sympathetic innervation of the pancreas and include the splanchnic nerves.
- celiac plexus
- greater splanchnic nerve
- superior mesenteric plexus
- lesser splanchnic nerve
Which duct opens at the minor duodenal papilla?
acessory pancreatic duct
Which structure does the main pancreatic duct merge with?
bile duct
Which structure lies in the left sagittal fissure anteriorly?
round ligament
Which structure lies in the posterior part of the left sagittal fissure?
ligamentum venosum
Which struture is the fetal umbilical vein?
round ligament
What encloses the portal triad?
lesser omentum
Which parts of the liver are not covered in peritoneum?
- bare area
- bed of galbladder
- porta hepatis
What connects the liver with the anterior abdominal wall?
falciform ligament
How many hepatic segments are there?
8
What is the sympathetic nervous system supply of the liver?
- celiac plexus
- hepatic plexus
Which duct does the cystic duct join to form the common bile duct?
common hepatic duct
WHich lobes do the R and L sagittal fissures in the porta hepatis separate?
caudate and quadrate lobes
True or false: there is a middle hepatic vein
true
True or false: the hepatic veins join the inferior vena cava
true
True or false: hepatic segments are suplied by tertiary branches; right and left hepatic veins.
true
Which ligament separates the right lobe from the left lobe of the liver?
falciform ligament
What is the parasympathetic supply of the esophagus?
vagal trunks
The lymph nodes of the liver drain into which structure?
cisterna chyli
Which part of the spleen does not contain peritoneum?
hilum
The left gastric artery is a branch of this artery.
celiac trunk
The right gastric artery is a branch of this artery
common hepatic artery
The left gastric artery is a branch of this artery.
celiac trunk
The right gastric artery is a branch of this artery.
common hepatic artery
The common hepatic artery is a branch of this artery.
celiac trunk
The splenic artery is a branch of this artery.
celiac trunk
The left gastro-omental (gastroepiploic) artery is a branch of this artery.
splenic artery
The right gastro-omental (gastroepiploic) artery is a branch of this artery.
gastroduodenal
The gastroduodenal artery is a branch of this artery
common hepatic trunk (artery)
The superior pancreaticoduodenal artery is a branch of this artery.
gastroduodenal artery
The proper hepatic artery is a branch of this artery
common hepatic artery
The cystic artery is a branch of this artery
right hepatic artery
The vertebral lvel where the esophagus enters the esophageal hiatus of the diaphragm.
T10
Lymph in the abdominal part of the esophagus drains here.
celiac (abdominal) lymph nodes
The transition line from esophageal to gastric mucosa.
Z-line
The pyloric antrum meets the pyloric canal here
angular incisure
This forms in the stomach during swallowing
gastric canal
The first branch of the abdominal aorta
inferior phrenic arteries
The second branch of the abdominal aorta
celiac trunk
The third branch of the abdominal aorta
superior mesenteric artery
The superior pancreaticoduodenal artery is a branch of this artery
gastroduodenal
The inferior pancreaticoduodenal artery is a branch of this artery
superior mesenteric artery
This connects the liver to the anterior wall
falciform ligament
The remnant of the fetal ductus venosum
ligamentum venosus
This is found anteriorly in the left sagittal fissure of the liver.
round ligament
This is found posteriorly in the elft saggital fissure of the liver.
ligamentum venosum
What is found between the right and left lobes of the liver?
falciform ligament
List the branches of the superior mesenteric artery.
- middle colic artery
- right colic artery
- ileocolic artery
- inferior pancreaticoduodenal artery
List the branches of the inferior mesenteric artery.
- left colic
- superior sigmoid
- sigmoid
- superior rectal
What three structures make up the portal triad.
- portal vein
- hepatic artery
- bile duct
Features of the large intestine.
- haustra
- omental appendices
- caliber
- teniae coli
What are the lobes of the liver that can be seen on the posterior-inferior view.
- caudate lobe
- quadrate lobe
- left lobe
- right lobe
List the organs supplied by the celiac plexus.
- galbladder
- liver
- pancreas
- stomach
- esophagus
- spleen
- adrenal glands
- small intestine
List the structures see on the posterior inferior aspect of the liver.
- inferior vena cava
- ligamentum venosum
- round ligament
- portal triad
- protein vein
- hepatic artery
- bile duct
- gallbladder
- caudate process