Trunk: neurovascular and lymph Flashcards

1
Q

where does abdominal aorta start:

A
  • below diaphragm

- T12 aortic hiatus

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2
Q

bifurcation of aorta and into

A

L4

- common iliacs

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3
Q

common iliacs supply:

A
  • lower limb via external iliac

- pelvis, perineum via internal

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4
Q

ascending aorta: branches

A
  • R and L coronary aa
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5
Q

ascending aorta: R coronary aa

A
  • R marginal

- post interventricular

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6
Q

ascending aorta: L coronary aa

A
  • ant interventricular

- circumflex

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7
Q

ascending aorta: supplies

A
  • R side heart
  • R ventricle
  • L ventricle
  • ant RV LV septum L atrium
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8
Q

arch of aorta: branches

A
  • R brachiocephalic trunk
  • L common carotid
  • L subclavian aa
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9
Q

arch of aorta: brachiocephalic trunk

A
  • R common carotid

- R subclavian aa

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10
Q

arch of aorta: L subclavian aa

A
  • with R subclavian aa
  • internal thoracic aa -> 6 paired ant intercostal aa
  • vertebral aa
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11
Q

arch of aorta: internal thoracic aa become:

A

superior epigastric aa and musculophrenic

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12
Q

arch of aorta: supplies

A
  • head and neck
  • upper limb
  • ant thoracic wall
  • cervical vertebrae and fuse to form basilar aa in brain
  • sup abdominal wall
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13
Q

thoracic aorta: name 7 branches

A
  • pericardial
  • bronchial
  • oesophageal
  • mediastinal
  • intercostal
  • subcostal
  • superior phrenic
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14
Q

ant intercostal aa: branches

A
  • lateral branches of int thoracic aa (branches of subclavian aa)
  • internal thoracic aa
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15
Q

ant intercostal aa: lateral branches of internal thoracic aa features

A
  • first 6 intercostal spaces

- anastomoses w post ICA

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16
Q

ant intercostal aa: internal thoracic aa branches

A
  • superior epigastric aa

- musculophrenic aa (gives ant intercostal aa for lower 6 ICS)

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17
Q

abdominal aorta: branches

A
  • celiac plexus
  • renal aa
  • superior mesenteric
  • inferior mesenteric
  • gonadal
  • common iliac aa
  • median sacral
  • lumbar
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18
Q

abdominal aorta: paired/ unpaired- name ant midline branches

A
  • celiac trunk T12
  • sup mesenteric L1
  • inf mesenteric L3

unpaired

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19
Q

abdominal aorta: paired/ unpaired- lateral visceral

A
  • suprarenal L1
  • renal L1
  • gonadal L2

paired

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20
Q

abdominal aorta: paired/ unpaired- lateral parietal

A
  • inf phrenic
  • 5 lumbar L1-4
    paired
  • median sacral L4 (unpaired)
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21
Q

abdominal aorta: paired/ unpaired- R and L common iliac

A
  • L4
  • internal iliac -> internal pudendal
  • external iliac -> inf epigastric
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22
Q

abdominal aorta: paired/ unpaired- at inguinal lig

A

ext iliac -> femoral aa

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23
Q

celiac trunk: branches

A
  • L gastric
  • hepatic
  • splenic
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24
Q

celiac trunk: L gastric

A
  • supply abdominal oesophagus and stomach

- runs lesser curvatures -> anastomose w R gastric aa

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25
celiac trunk: common hepatic
- forward to porta hepatis -> L and R hepatic before entering liver
26
celiac trunk: common hepatic branches
- R gastric - gastroduodenal - R gastro-omental (epiploic) - superior pancreaticoduodenal
27
celiac trunk: splenic
- horizontal to post border of pancreas
28
celiac trunk: splenic branches
- pancreatic aa - short gastric - L gastro-omental (epiploic)
29
superior mesenteric artery: features
- supplies small intestine (exc sup part of duodenum) - cecum, ascending colon, half transverse colon - crosses uncinate process of pancrease
30
superior mesenteric artery: branches
- inferior pancreaticoduodenal - jejunal and ileal branches - middle colic - iliocolic - R colic
31
inferior mesenteric artery: features
- supplies L half of transverse colon, descending colon, iliac and sigmoid, greater part of rectum
32
inferior mesenteric artery: branches
- L colic - sigmoid - superior rectal aa
33
pelvic arteries: pathway branches
abdominal aorta - R/L common iliac - (R) ext/ int iliac - (int) post/ ant trunk
34
pelvic arteries: ext iliac branches
- deep circumflex | - inf epigastric
35
pelvic arteries: post trunk branches
- iliolumbar - lateral sacral aa - superior gluteal
36
pelvic arteries: ant trunk
- sup/inf vesical - middle rectal - vaginal - obturator - uterine - int pudendal - inf gluteal
37
azygos vein: structures related
- hemiazygos v | - accessory hemiazygos v
38
lymphatic: lymph node collections divided into
- parietal | - visceral
39
lymphatic: parietal lymph nodes lie
- behind peritoneum (abdominal cavity), close association w large blood vessels
40
lymphatic: name parietal lymph nodes
- ext/ int iliac - common iliac - epigastric and circumflex - lumbar - sacral - lateral aortic, preaortic, retroaortic
41
lymphatic: visceral lymph nodes lie
- closer to visceral vessels | - related to celiac trunk, SMA and IFA
42
lymphatic: what drains lateral aortic lymph nodes and deep lymph nodes of abdomen
2x lumbar trunk
43
lymphatic: what drains stomach, liver, pancreas and spleen
intestinal trunk
44
lymphatic: both lumbar and intestinal trunks drain into
cysterna chyli (dilation at diaphragmatic end of thoracic duct)
45
innervation: autonomic system innervates
- thoracic - abdominal - pelvic viscera
46
innervation: autonomic system made up of
- parasympathetic - sympathetic divisions - enteric nervous system
47
innervation: somatic supply to
- musculofascial wall | - peritoneum from spinal nerves
48
spinal nerves: how many pairs
- 31 pairs
49
spinal nerves: name pairs
- 8 cervical - 12 thoracic - 5 lumbar - 5 sacral - 1 coccygeal
50
spinal nerves: name plexuses
- cervical - brachial - lumbar - sacral
51
intercostal nerves carry:
- somatic motor fibres for muscles - somatic sensory to skin, parietal pleura, parietal peritoneum - post ganglionic sympathetic fibres
52
innervation: anterolateral abdominal wall and pass btw
- ant rami of T7-12 - ant rami of L1 -> iliohypogastric, ilioinguinal btw internal oblique and transversus abdominis
53
innervation: sympathetic in thorax
- cardiac - pulmonary - esophageal plexuses
54
innervation: sympathetic in abdomen
- celiac - sup mesenteric - inf mesenteric
55
innervation: sympathetic in pelvis
- hypogastric plexuses
56
innervation: name parasympathetic
- vagus | - pelvic splanchnic nn
57
innervation: parasympathetic vagus supplies
- thoracic and abdominal organs -> 2/3 of transverse colon
58
innervation: parasympathetic pelvic splanchnic nerves supply
- S2-4 | - rest of colon, pelvic, perineum
59
enteric nervous system: features
- from autonomic nervous system | - walls of digestive organs
60
enteric nervous system: enteric neuron
- neurons cell body in ganglion within wall of digestive tract, biliary system or pancreas
61
enteric nervous system: names main parts
- myenteric plexus - submucosal plexus - intrinsic primary afferent neuron
62
enteric nervous system: myenteric plexus
- plexus of ganglia nerve fibre bundles - btw longitudinal/ circular muscle layers - forms continuous network from upper esophagus - internal anal sphincter
63
enteric nervous system: submucosal plexus
- small ganglia within submucosal layer - btw ext musculature and mucosa of small/ large intestines - continuous network from duodenum - internal anal sphincter
64
enteric nervous system: intrinsic primary afferent neuron
- neurons of ENS that detect states of digestive organs - chemical entities within lumen of intestine - tension in gut wall - first neurons of intrinsic neural reflex circuits of intestine
65
referred pain: theory
- nociceptors from several locations converge on single ascending tract in spinal cord - brain associates activation of pathway w pain in skin eg. kidney vs skin
66
Hirschsprungs disease: symptoms in newborns/ infants
- difficulty w bowel movements - infrequent but explosive stools - jaundice - poor feeding - poor weight gain - vomiting
67
Hirschsprungs disease: symptoms in older children
- constipation which gets worse gradually - fecal impaction - malnutrition - slow growth - swollen belly
68
Hirschsprungs disease: features
- congenital absence of ganglion cells in myenteric plexus of colon - from rectum to variable distance proximally - failure of peristalsis beyond transition zone - colon proximal to transition zone dilated