Vasculature of Abdomen Flashcards
Where does the abdominal aorta start/end?
Starts at T12 / ends at L4 vertebra
What does the abdominal aorta bifurcate into?
Right and left common iliac arteries that supply the lower body
What are the branches of the abdominal aorta?
The abdominal aorta has:
- 3 single anterior visceral branches (coeliac, superior mesenteric artery, inferior mesenteric artery)
- 3 paired lateral visceral branches (suprarenal, renal, gonadal)
- 5 paired lateral abdominal wall branches (inferior phrenic and four lumbar)
- 3 terminal branches (two common iliac arteries and the median sacral artery)
- Inferior phrenic arteries (give rise to superior suprarenal)
- Coeliac artery
- Middle suprarenal arteries
- SMA
- Renal arteries (gives rise to inferior suprarenal)
- Gonadal arteries
- IMA
- Lumbar arteries (4 paired lumbar arteries arise at different points of the abdominal aorta)
- Terminal branches: 2x common iliac, median sacral artery
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Where do the inferior suprarenal arteries arise?
Branch of renal arteries
What do the inferior phrenic arteries supply?
The diaphragm
Where does the coeliac artery arise?
A large, unpaired visceral artery arising anteriorly at the level of T12 (at aortic hiatus of diaphragm). It is also known as the celiac trunk.
What does the coeliac artery supply?
Liver, stomach, abdominal oesophagus, spleen, the superior duodenum and the superior pancreas.
Where does the superior mesenteric artery arise?
A large, unpaired visceral artery arising anteriorly, just below the celiac artery. Arises at lower level of L1
What does the superior mesenteric artery supply?
The distal duodenum, jejuno-ileum, ascending colon and part of the transverse colon
Where do the middle suprarenal arteries arise from?
Small paired visceral arteries that arise either side posteriorly at the level of L1
What do the middle suprarenal arteries supply?
The adrenal glands
Where do the renal arteries arise from?
Paired visceral arteries that arise laterally at the level between L1 and L2
What do the renal arteries supply?
The kidneys
Where do the gonadal arteries arise from?
Paired visceral arteries that arise laterally at the level of L2
What is the male gonadal artery referred to as?
The testicular artery
What is the female gonadal artery referred to as?
The ovarian artery
Where does the inferior mesenteric artery arise from?
A large, unpaired visceral artery that arises anteriorly at the level of L3.
What does the inferior mesenteric artery supply?
The large intestine from the splenic flexure to the upper part of the rectum
Where does the median sacral artery arise from?
An unpaired parietal artery that arises posteriorly at the level of L4
What does the median sacral artery supply?
The coccyx, lumbar vertebrae and the sacrum
Where do the lumbar arteries arise from?
There are four pairs of parietal lumbar arteries that arise posterolaterally between the levels of L1 and L4
What do the lumbar arteries supply?
The abdominal wall and spinal cord
What does the coeliac trunk divide into?
3 major branches - left gastric, splenic and common hepatic arteries
Collectively, they are the major arterial supply to the stomach, spleen, liver, gall bladder, abdominal oesophagus, pancreas and duodenum
What direction do the left gastric, splenic and common hepatic arteries go?
Left gastric and splenic go to the left
Common hepatic goes to the right
Where does the left gastric artery ascend? What does it give rise to?
The left gastric artery is the smallest of the three branches. It ascends across the diaphragm giving rise to oesophageal branches, before continuing anteriorly along the lesser curvature of the stomach. Here, it anastomoses with the right gastric artery.
Where does the splenic artery go?
Arises from the coeliac trunk just inferior to the left gastric artery. It then travels left towards the spleen, running posterior to the stomach and along the superior margin of the pancreas
During the splenic artery’s course, where is it contained?
Within the splenorenal ligament
How does the splenic artery terminated?
Into 5 branches which supply segments of the spleen
In addition to supplying the spleen, what else does the splenic artery give rise to?
- Left gastroepiploic
- Short gastrics
- Pancreatic branches
What does the left gastroepiploic supply?
Supplies the greater curvature of the stomach
What does the left gastroepiploic anastomose with?
Anastomoses with the right gastroepiploic artery.
What do the short gastrics supply?
5-7 small branches supplying the fundus of the stomach.
What do the pancreatic branches supply?
Supply the body and tail of the pancreas
Describe the appearance of the splenic artery
The splenic artery has a tortuous appearance (similar to the facial branch of the external carotid artery) and thus is easily identifiable from other nearby vessels.
What does the common hepatic artery supply?
The sole arterial supply to the liver
What does the common hepatic artery divide into?
As it travels past the superior aspect of the duodenum, it divides into its two terminal branches:
- Proper hepatic
- Gastroduodenal arteries
Where does the proper hepatic artery ascend through?
The lesser omentum towards the liver
What does the proper hepatic artery give rise to?
- Right gastric
- Right and left hepatic
- Cystic
What does the right gastric supply?
supplies the pylorus and lesser curvature of the stomach.
What does the right and left hepatic supply?
divide inferior to the porta hepatis and supply their respective lobes of the liver.
What does the cystic supply?
branch of the right hepatic artery – supplies the gall bladder.
Where does the gastroduodenal artery descend?
Posterior to the superior portion of the duodenum
What are the branches of the gastroduodenal?
- Right gastroepiploic
2. Superior pancreaticoduodenal
What does the right gastroepiploic supply?
Supplies the greater curvature of the stomach. Found between the layers of the greater omentum, which it also supplies.
What does the superior pancreaticoduodenal supply?
Divides into an anterior and posterior branch, which supplies the head of the pancreas.
Which is the only organ to receive arterial supply from all 3 branches of the coeliac trunk? How is this achieved?
The stomach
This is achieved through a system of anastomoses along the greater (gastroepiploic arteries) and lesser (gastric arteries) curvatures.
What supplies the head of the pancreas?
The pancreaticoduodenal arcade is a network of arteries that surround and supply the head of the pancreas.
What are the 2 main arteries of the pancreaticoduodenal arcade?
Each has an anterior and posterior branch, that anastomose (e.g. anterior to anterior) forming a ring structure:
- Superior pancreaticoduodenal
- Inferior pancreaticoduodenal
What is the superior pancreaticoduodenal a branch of?
the gastroduodenal artery
What is the inferior pancreaticoduodenal a branch of?
Superior mesenteric artery (SMA)
The arrangement of the branches and the order from which they arise from the coeliac trunk can vary from person to person. What are common variations?
- The left gastric artery often arises proximal to the bifurcation of the splenic and common hepatic arteries. This is called a false tripod.
- The right gastric artery is occasionally seen as a branch of the common hepatic instead of the proper hepatic artery.
- The right gastric and right hepatic arteries may arise from the SMA.
- The left hepatic artery is sometimes seen as a branch of the left gastric artery.
- The inferior phrenic arteries may arise from the coeliac trunk instead of the abdominal aorta
What are the 3 terminal branches of the abdominal aorta?
2x common iliac, median sacral
How many pairs of lumbar arteries branch off the abdominal aorta? Where are they found?
4 pairs of lateral branches branch off at different points down the abdominal aorta
Is the coeliac, SMA and IMA paired or unpaired?
Single, unpaired
What branch does the inferior phrenic artery give off?
Superior suprarenal
Where does the superior suprarenal artery originate?
Branch of inferior phrenic artery
Where does the middle suprarenal artery originate?
Directly from aorta
Where does the inferior suprarenal artery originate?
Branch of renal artery
What branch does the renal artery give off?
Inferior suprarenal artery
