Nerves, Vessels, and Lymphatics of the Abdomen Flashcards
Where does the abdominal aorta begin and end.
Begins in the midline at T12/L1 and ends anterior to L4 by dividing into right and left common iliac arteries.
How many branches does the abdominal aorta have as it descends into the abdominal cavity?
- Anterior, lateral, posterior
How many anterior branches down the abdominal aorta have, and what do they supply?
3 anterior, unpaired branches (1) coming off the front of the aorta supply the unpaired viscera of the GIT (all of the derivatives of the primitive GIT
How many lateral branches down the abdominal aorta have, and what do they supply?
3 lateral pairs of branches (2) coming off the side of the aorta and they supply the paired viscera (kidneys, adrenals and gonads (testes in male and ovaries in female)). Note that the ureter derives its supply from adjacent structures as it descends, not directly from the abdominal aorta.
What do the posterior branches of the abdominal cavity supply?
Series of paired, posterior branches- all of which supply the walls of the abdominal cavity (including the diaphragm). Will supply the diaphragm first before tracking around to the posterior abdominal wall.
What is the faciform ligament and what part of the primitive gut tube is it?
Ventral mesentery is only in the proximal part of the primitive gut tube, this becomes the falciform ligament.
What are the 3 components of the primitive gut tube?
foregut, midgut and hindgut.
What are the 3 branches coming off the primitive aorta and what component of the primitive gut tube do they supply?
The Celiac trunk is the artery of the foregut.
The Superior mesenteric artery supplies the midgut.
Inferior mesenteric artery supplies the hindgut.
What structures make up the foregut?
includes everything from the abdominal oesophagus to the major duodenal papilla- the abdominal oesophagus, the stomach and the proximal duodenum down to 1⁄2 way along the second part, but also the liver, gall bladder, pancreas and spleen (which the foregut also gives rise to.)
What structures make up the midgut?
The midgut, is continuing on from the major duodenal papilla from the distal part of the duodenum, the jejenum and ileum, caecum and ascending colon, and most of the transverse colon.
- NOTE: There is no sharp line of demarcation between the midgut and hindgut, but it is just short of the splenic flexure- so includes the ascending and most of the transverse colon.
What structures make up the hindgut?
The hindgut is the point just short of the splenic flexure in the transverse colon, then descending colon, sigmoid colon, rectum and anal canal.
What are the 3 branches of the celiac trunk?
- Splenic artery
- Left gastric artery
- Common hepatic artery
What is the passage of the splenic artery?
Heads directly to the left. Has a tortuous course, characterized by lots of curves and even loops along the superior border of the pancreas (retroperitoneal structure). Occasionally tucked in behind the top of the pancreas. Heading, along with the tail of the pancreas, to the hilum of the spleen. It is the main arterial supply to the spleen, but also to the pancreas, as indicated by its position.
What does the splenic artery give rise to?
Also gives a series of short branches to the fundus of the stomach, called the SHORT GASTRIC ARTERIES and has a branch which turns along the proximal greater curvature, called the LEFT GASTROEPIPLOIC ARTERY.
What is the passage of the left gastric artery?
Heads up and to the left, giving oesophageal branches to the abdominal oesophagus before turning and running along the lesser curvature to give the left gastric artery to contribute to the anastomosis (along with right gastric artery) of the lesser curvature of the stomach.
What is the passage way for the common hepatic artery?
It turns right and then divides. Must not only supply the liver, but also the gall bladder, the distal part of the stomach, and the first part of the duodenum. Since it is ‘common’ hepatic artery, going to do more than hepatic artery proper would do.
What are the branches of the common hepatic artery? Explain their passage as you discuss their names.
Heads towards the liver to the site of the free edge of the lesser omentum, where it divides into the PROPER HEPATIC ARTERY which will ascend in the free edge of the lesser omentum to the porta hepatis, where it will divide into RIGHT AND LEFT HEPATIC ARTERIES to supply the right and left lobes of the liver. There are usually two extra branches of the proper hepatic artery- the CYSTIC ARTERY comes off the right hepatic artery to the gall bladder (but may come off left hepatic artery or hepatic artery). Proper hepatic artery also gives off the RIGHT GASTRIC ARTERY, which most commonly turns and runs along the lesser curvature to anastomose with the left gastric artery. Other terminal branch of the common hepatic artery is the GASTRODUODENAL ARTERY which has left to supply the greater curvature of the stomach and the proximal part of the duodenum and associated head of the pancreas. Tracking behind the first part of the duodenum, the gastroduodenal artery will then give rise to the RIGHT GASTROEPIPLOIC ARTERY which will run along the greater curvature and anastomose with the left gastroepiploic from the splenic artery. Also the SUPERIOR PANCREATIOCDUODENAL ARTERY- which passes behind to supply the first part of the duodenum (superior) and the head of the pancreas.
Where does the superior mesenteric artery arise and travel too?
Arises 1 cm below the celiac trunk, at L1. Travels along the route of the mesentery on the diagonal line through which it attaches to the posterior abdominal wall.
What are the branches of the superior mesenteric artery?
Gives off an INFERIOR PANCREATICODUODENAL ARTERY irst to supply the last part of the duodenum (from the duodenal papilla onwards) and pancreas. As it goes along the posterior abdominal wall, sends all of the branches of the small intestine to the left and all of the branches of the large intestine to the right.
=All of the jejunal and ileal branches come off the left and enter the double fold of peritoneum in that diagonal line along the posterior abdominal wall and head up to the coils of the jejenum and ileum.
=Colic branches coming off the right hand side to the components of the large intestine that are derived from the midgut. ILEOCOLIC ARTERY supplies the first part of the large intestine (cecum, appendix, and the first part of the ascending colon) and then the RIGHT COLIC ARTERY.
Where does the inferior mesenteric artery arise from and travel to?
Arises at the inferior border of the third part of the duodenum, below the third or horizontal part of the dudoneum corresponding to L3.
What branches does the inferior mesentertic artery give off?
Gives off a series of COLIC branches to the components of the large intestinal tract and then changes its name and becomes the SUPERFICIAL RECTAL ARTERY, coming from the rectum from above and entering the pelvis.
What is the venous drainage of all the structures derived from the primitive gut tube? i. e those supplied by the unpaired branches of the abdominal aorta
Drain through the portal system of veins, which unite to form a single portal vein posterior to the neck of the pancreas at L2.
What is the portal vein formed by?
Portal vein is formed by the superior mesenteric and the splenic vein, which the inferior mesenteric vein joins.
How does the portal vein travel?
Portal vein ascends behind the first part of the duodenum, then in the free edge of the lesser omentum (as part of the portal triad with hepatic artery and bile duct system) and then enters the liver at the porta hepatis.
=Enters the liver, where it spills its blood containing digestive products and nutrients into the hepatic sinusoids for processing, it then enters the hepatic veins.
