Vessels and nerves of the hindgut (Dave's notes) Flashcards
What is the blood supply of the hindgut and at what level does this arise?
The IMA, which arises at L#/the level of the umbilicus
What are the boundaries of the IMA supply?
The splenic flexure to the anal canal
Describe the course of the IMA
The IMA runs obliquely down in the left infracolic compartment to the pelvic brim. It crosses the pelvic brim at the bifurcation of the left common iliac vessels over the SI joint, then converges with the ureter
What significant structures does the IMA cross?
Lies on the aorta, crosses the left psoas, ST (sympathetic trunk?), common iliac artery and hypogastric nerve
What are the terminal branches of the IMA?
The superior rectal artery
At what level does the IMA become the superior rectal artery?
At the pelvic brim
Does the IMA cross the left ureter?
No but all of its branches do
What is the course of the left colic artery?
The left colic artery passes up to the splenic flexure dividing into ascending and descending branches. The ascending branch crosses the left psoas, gonadal vessels, ureter, GF nerve and QL. The ascending branch divides into upper and lower branches, each of which divides into ascending and descending.
The sigmoid arteries are …….. to …….. branches forming ……………. ………..
three to four branches forming anastomotic loops
Describe the venous drainage of the hindgut
The superior rectal vein runs up in the root of the sigmoid mesocolon (to the left of the artery) and becomes the IMV. The IMV receives tributaries identical to the arterial branches but runs some distance to the left of the artery.
What occurs to the IMV at the DJ flexure?
The IMV arches right raising a ridge and creating the paraduodenal recess.
What is the course of the IMV from the point of the ridge it forms at the DJ flexure?
The IMV passes along the lower border of the pancreas in front of ?the left renal vein to enter into the splenic vein (but may enter into the SMV).
