Vasculature of the Abdomen Flashcards
What is the Abdominal aorta a continuation of
Thoracic descending aorta
Where does the Abdominal aorta begin
aortic haitus of diaphragm T12 Vertebra
Is the Abdominal aorta intraperitoneal or retroperitoneal
retroperitoneal
What does the abdominal aorta divide into at its end and where
Common iliac arteries at L4
What are the 3 large anterior unpaired branches of the abdominal aorta, and what do they supply
Celiac Trunk
Superior Mesenteric artery
Inferior Mesenteric artery
Supplies Gastrointestinal tract
What are 6 branches of the abdominal aorta to the abdominal wall and paired abdominal glands? Which are unpaired?
Inferior phrenic Lumbar Middle Suprarenal Renal (give off inferior suprarenal) Gonadal Median Sacral
Median Sacral unpaired
Where do the inferior phrenic arteries arise and what do they provide?
pair arises immediately above origin of celiac trunk
provides diaphragm
also superior suprarenal arteries
Where do the Lumbar arteries arise and what do they provide? And how many are there?
4 pairs of arteries
Arise at levels of L1-L4
Posterior branches supply:
Spinal cord
Cauda equina
Spinal Meninges
Where do the Middle Suprarenal arteries arise?
Pair arises at L1
Where do the Renal arteries arise and what do they provide?
Arise at L1
Supply the kidneys
also provide inferior suprarenal arteries
Where do the gonadal arteries arise?
Just below renal arteries at L2
Where do the Median Sacral arteries arise?
Unpaired and small
is caudal continuation of aorta
What was the artery of the embryoic foregut
Celiac trunk
How long is the celiac trunk
1-2 cm
What 7 things does the celiac trunk provide for
Stomach adjacent esophagus proximal duodenum liver gall bladder pancreas spleen
Where does the celiac trunk arise
Just below aortic hiatus at T12
What are generally the 3 branches of the celiac trunk
Left Gastric
Common Hepatic
Splenic
What arteries may frequently be given off the celiac trunk (excluding 3 general)
dorsal pancreatic artery
inferior phrenic arteries
What is the smallest branch of the celiac trunk and which direction off of the celiac trunk does it run?
Left gastric
To the left off celiac trunk
What does the left gastric supply
Lesser curvature of stomach and the esophagus
What is the path of the left gastric and what does it anstamose with
goes left and courses between layers of lesser omentum to eventually anastamose with right gastric
What artery off the Celiac trunk runs to the right posterior to the duodenum?
Common hepatic
Once it passes behind the duodenum what does the common hepatic split into
ascending: proper hepatic artery
Descending: gastroduodenal artery
what does the proper hepatic enter and what does it give off there
Enters Hepatoduodenal ligament of lesser omentum
gives off right gastric
What does the proper hepatic terminate as
left and right hepatic arteries
Where does the gastroduodenal artery pass between and what does it give off while there
superior (1st) part of duodeum and pancreas
Gives off the duodenal branches
What does the gastroduodenal artery temrinate as
superior pancreaticoduodenal
Right gastro-omental (gastroepiploic)
What is the largest celiac branch
Splenic
What is the path of the splenic artery and what does it supply along that path?
Follows superior border of the pancreas then enters splenorenal ligament Supplies: Pancreas Spleen Greater curvature of the stomach
What does 3 things does the splenic artery give off after it enters the splenorenal ligament
Short gastric branches
splenic branches
Left gastro-omental (gastroepiploic)
What does the Left gastro-omental artery anastamose with and where
Right gastro-omental
In Greater omentum
What does the superior Mesenteric artery supply
Derivatives of the midgut
mainly most of the small intestine (exept proximal duodenum) and large intestine up to left colic flexure
Where Does the superior mesenteric artery arise
Posterior to the body of the pancreas at L1
What is the path of the Superior Mesenteric once it arises
Descends over:
left renal vein
uncinate process of pancreas
horizontal (3rd) part of duodenum)
Then
Enters: the root of the mesentery of the the small intestine
Then: Follows oblique course towards the right ilac fossa
What 3 things does the Superior Mesenteric descend over
left renal vein
uncinate process of pancreas
horizontal (3rd) part of duodenum)
What are the 5 branches of the superior mesenteric
Inferior pacreaticoduodenal Intestinal Right Colic (often branch of ileocolic or middle or absent) Ileocolic Middle Colic
Which direction does the Inferior pacreaticoduodenal pass and what does it divide into
Passes to the right
Divides into anterior and posterior branches
What do the anterior and posterior branches of the Inferior pacreaticoduodenal help to form and with what?
pacreaticoduodenal arcades
With branches of the Superior pacreaticoduodenal artery from celiac trunk
What are the intestinal arteries divided into and how many are there
Jejunal and ileal arteries
15-18
Where do the ileal and jejunal intestinal arteries pass
to the left, between layers of mesentery
What do the ileal and jejunal intestinal arteries do in the mesentery
Form a series of arterial arcades
How many layers of arches are formed at the upper jejunal and ileal region
one or two at upper jejunal
3 to 5 at ileal
What arte the small straight vessls that arise from the last arch in a series and what do they supply
Vasa recta
supply intestine
What is the lowermost branch of the Superior mesenteric and what does it supply
Ileocolic
Ileum
cecum
appendix
What artery supplies the asceding colon
Right colic
What is the right colic a branch of
often ileocolic or middle colic
but may be absent altogether
What artery supplies the transverse colon and were does it enter
Middle colic
transverse mesocolon
What does the inferior mesenteric artery supply
Descending and sigmoid colons
proximal rectum
(derivatives of hindgut)
Where does the inferior mesenteric arise and pass (relative to aorta)
Just below the 3rd part of the duodenum at level of L3
passes downward and to left of the aorta
What are the 3 branches of the inferior mesenteric
Left colic
Sigmoid
Superior Rectal
What artery supplies the descending colon
Left Colic
How many sigmoid arteries are there and what do they suply
2 to 4
supply sigmoid colon
What supplies the proximal rectum
superior rectal
Where does the superior rectal artery arise
it is a continuation of inferior mesenteric as it crosses the left common iliac vessels
What do branches of the sueprior rectal anastomose with
Terminal branches of middle and inferior recal arteries of internal iliac system
What is the name for the series of anastomoses between adjacent branches of inferior mesenteric, adjacent branches of superior mesenteric, and adjacent branches of the two systems?
Marginal artery
What are the anastomoses within the continuous arch known as the marginal artery
anastomoses between adjacent branches of inferior mesenteric
anastomoses between adjacent branches of superior mesenteric
anastomoses between adjacent branches of the two systems
What is the largest vein in the body
Inferior Vena Cava
What union forms the inferior vena cava and at what vertebral level
Union of common iliac veins
At level of L5
Is the inferior vena cava intraperitoneal or retroperitoneal
retroperitoneal
What is the position of the Inferior vena cava relative to the aorta
ascends the abdominal cavity to the right of the aorta
Where does the inferior vena cava pierce the diaphragm
Vena caval foramen at t8
What do tributaries of the inferior vena cava generally correspond to and what is the exception to that
Arterial branches of the aorta
The veins that empty into hepatic portal vein
What are the 7 Tribuaries associated with the Inferior vena cava
Lumbar Common Iliac Hepatic Renal Right Gonadal Right Suprarenal Right Inferior phrenic
What forms the common iliac vein
Union of external and internal iliac veins
How many pairs of lumbar veins are there and how many does the Inferior vena cava recieve
4 pairs
variable number
Where do the renal veins lie in relation to the renal arteries
anterior
What is the size comparison of the left and right renal veins and why is it so
Left longer than right
due to embryology of inferior vena cava
Where does the left renal vein pass between and what does it recieve
passes between superior mesenteric artery and aorta
recieves
left gonadal
left suprarenal
Which gondal vein is shorter and where do each drain
Right is shorter
Left drains to left renal
Right drains to inferior vena cava
Which suprarenal vein is shorter and where do each drain
Right is shorter
Left drains to left renal
Right drains to inferior vena cava
Where do the left and right inferior phrenic nerves drain into
left inferior phrenic: left suprarenal (which drains into left renal)
Right drains into inferior vena cava
Where do the hepatic veins drain
inferior vena cava just as it passes through diaphragm
Where does the hepatic portal vein receive blood ffrom
All venous blood from GI tract (minus lower portion of anal canal), pancreas and spleen
Where is the hepatic portal vein formed and by what
formed behind pancreas
by union of splenic vein (inferior to artery)
and Superior mesenteric vein (right of artery)
Inferior Mesenteric empties into one of those veins
After it has been formed what veins does the portal vein recieve and what doe it enter once it recieves them
Gastric veins
Enters hepatoduodenal ligament
What is anterior to the portal vein in the hepatoduodenal ligament
proper hepatic artery and common bile duct
where does the portal vein divide into left and right portal viens
Porta hepatis
What is unique about the portal vein and its tributaries
No functionally competent valves
What other venous system does the portal system communicate with
Caval (systemic) venous system
What woud happen if there was an obstruction of portal circulation
Anastomoses with caval venous system would still allow blood from gi to reach the heart
What does abstructed bloodflow to the portal vein cause
portal hypertension
What does portal hypertesnion cause
veins in portal vaval anastomotic areas to dilate and become varicose
What are the3 Major portal-caval anastomoses
Esophageal
Rectal
Paraumbilical
What makes up the esophageal portal-caval anastomoses
esophageal tributaries of left gastric vein with esophageal veins of aszygos
What makes up the Rectal portal-caval anastomoses
Superior rectal veins with middle and inferior rectal veins
What makes up the Paraumbilical portal-caval anastomoses
Paraumbilical veins in falciform ligament w/ superficial veins in the anterolateral abdominal wall
What makes up the Splenic portal-caval anastomoses
tributaries of splenic and colic veins with left renal vein
