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Metabolism > The Blood supply to the gut > Flashcards

The Blood supply to the gut Flashcards

1
Q

What are the 3 unpaired arteries that supply the gut

A

Coeliac (T12)
superior mesenteric artery (L1)
inferior mesenteric artery (L3)

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2
Q

What supplies the foregut

A

coeliac trunk (T12)

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3
Q

what supplies the midgut

A

superior mesenteric artery (L1)

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4
Q

what supplies the handout

A

inferior mesenteric artery (L3)

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5
Q

What are the other paired abdominal artery

A
  • renal
  • gonadal
  • lumbar
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6
Q

where does the aortic bifurcation happen

A

Aortic bifurcation into common iliac happens at L4

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7
Q

what are the 3 arteries that the coeliac trunk split into

A
  • Left gastric
  • Splenic
  • Common hepatic
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8
Q

describe the left gastric artery

A
  • Left gastric artery course around the inferior curvature of the stomach, it also gives of oesophageal arteries as well
  • In terms of the stomach it supplies the lesser curvature of the stomach, it is joined by the right gastric artery
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9
Q

describe the splenic artery

A
  • Goes to the spleen
  • Easily identifiable as it is very torturous – blood pressure in this region is high
  • Course of the splenic artery goes through the stomach
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10
Q

what does the common hepatic do

A

gives a supply to the liver

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11
Q

what does the common hepatic split into

A

splits into the gastroduodenal

splits in the right gastric

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12
Q

describe what the gasproduodenal splits into

A
  • Gastroduodenal gives supraduodenal and superior pancreaticoduodenal
  • Gastroduodenal gives rise the right gastroepiploic this gives blood supply to the great curvature
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13
Q

what arises from the splenic artery

A

the left gastroepiploic comes from the splenic artery

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14
Q

what does the right gastric supply

A
  • The right gastric is the 2nd branch from the common hepatic, supplies lesser curvature and anatomises with the right gastric
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15
Q

what is the continuation of the common hepatic

A
  • Common hepatic carries on as the hepatic artery proper which goes to the liver
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16
Q

where do the gastric arteries lie

A

 Gastric arteries in the lesser omentum

17
Q

where do the gastroepiploic arteries lie

A
  • Gastroepiploic arteries in the greater omentum
18
Q

what does the superior mesenteric artery supply

A

• Supplies the distal duodenum (via inf pancreaticoduodenal a.), jejunum and the ileum (via jejunal & ileal arteries in the mesentery)
• Supplies the ascending and the transverse colon via the ileocolic, the right and the middle colic arteries
- supplies the midgut

19
Q

how do you tell the difference between the jejunum and ileum

A
  • As small intestine goes through the dimateter reduces inside
  • Can identify the two structures based on the blood supply to them
  • The jejunum has longer vasa recta than the ileum, jejunum has greater vascularity
  • In the jejunum there is smaller arterial arcades, as you move down into the ileum they separate out
  • These vessels are contained within the double layer of visceral peritoneum
20
Q

what are the branches of the superior mesenteric artery

A
  • Colic artery
  • right colic
  • ileocolic
  • appendicular
  • marginal arteries
  • jejunal and ill branches - these collectively are called the intestinal arteries
21
Q

describe what the branches of the superior mesenteric artery supply

A
  • Frist main branch is the middle colic artery – this supplies the upper right regions of the large intestine
  • The right colic – supplies to the ascending part of the large intestine
  • The ileocolic – this supplies the ileal where the large intestine and the small intestine meet
  • The appendix is supplied by the appendicular artery, it is suspended by the terminal part of the ileum
  • The superior mesenteric arteries will have the marginal artery these go around the margins
  • The jejunal and ileal branches – collectively these are called the intestinal arteries
22
Q

what are the inferior mesenteric arteries

A
  • Supplies left colic artery
  • Superior rectal artery
  • Sigmoid artery
  • Marginal artery – watershed overlap between SMA and IMA
23
Q

what is the blood supply to the liver

A
  • 75% of blood flow to liver from the hepatic portal system (liver also receives 25% from proper hepatic artery)
24
Q

what forms the hepatic portal system

A
  • Splenic and superior mesenteric veins meet posterior to head of pancreas to form portal vein
  • Inferior mesenteric veins drains to splenic
25
Q

what is another word for when the portal system and systemic system anatomises

A

portocaval

- portal is the portal part of the vein caval is the vena cava

26
Q

what forms the hepatic portal vein

A
  • The splenic vein
  • Inferior mesenteric vein
  • As left gastric vein and the right gastric vein
  • Superior mesenteric vein all form the hepatic portal vein
27
Q

how does the blood travel in the hepatic system

A
  • Hepatic aorta
  • To first capillary bed
  • To hepatic portal vein to 2nd capillary bed
  • Hepatic vein back to the heart
28
Q

what is used in emergencies

A
  • The portocaval anatomise are emergency route only

- Skips the liver and goes straight from the hepatic portal vein into the IVC and into the heart

29
Q

what are the places where the portal system anatomises

A

Oesophageal
rectal
paraumbilical

30
Q

where is the portal systemic oesophageal anatomise

A

portal: oesophageal and gastric, systemic; azygous and then it goes back into the IVC

31
Q

where is the portal systemic rectal anatomise

A

portal: superior rectal vein and systemic: mid and inferior rectal veins

32
Q

where is the portal systemic paraumbilical anatomise

A

portal: paraumbilical veins (fetus ductus venosus) bypasses the liver and goes into the IVC after birth this disappears, it turns into a ligament, if there is a blockage in the ligament in the portal system this ligament can open and give us collateral route, systemic: inferior epigastric veins

33
Q

what are the two vagal trunks

A
  • anterior

- posterior

34
Q

what is the anterior vagal trunk supplying (continuation of left vagus)

A

» gastric branches

» hepatic branch

35
Q

what does the posterior vagal trunk suppling (continuation of right vagus)

A

» gastric branches

» coeliac branch

36
Q

what is the other vagal supply

A

• S2-S4 parasympathetic supply – pelvic splanchnic nerves

37
Q

describe the sympathetic supply

A
  • Postganglionic fibers from the coeliac, superior mesenteric ganglion, or inferior mesenteric ganglion
  • Nerves originate in the spinal segment they synapse in the ganglion and send post ganglionic fibres to other structures
  • Nerves in the abdomen arise from T5 pass through the sympathetic ganglion and go down into the paraaortic ganglions
  • Have a celiac ganglion, SMG, IMG
  • Nerves that go through the spinal ganglion are called sphlanic nerves

Metabolism (26 decks)

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