Worksheet 4 - The hindgut and vessels, liver, gall bladder and biliary tree Flashcards
which artery supplies the hindgut?
IMA
5 areas which the IMA supplies?
Left 1/3 of transverse colon descending colon sigmoid colon rectum upper anal canal
level of IMA
L3
3 branches of IMA
LSS
left colic
sigmoidal
superior rectal artery
what does the marginal artery supply?
colon
structure inside of colon?
rugae
function of rugae
increase SA
at what level does the sigmoid colon continues to be the rectum? what is the name of this junction
S3 - rectosigmoidal
how many valves on the left + right interior rectum?
L= 2 R = 1
3 arteries supplies the rectum (from superior to inferior)
superior, middle and inferior rectal artery
which rectal artery is posterior?
superior rectal
origination of all of the rectal arteries
- superior rectal = IMA
- Middle rectal = inf. vescial - internal ilac
- Inferior rectal = internal pudenal = internal iliac
what is the main venous drainage of the gut?
hepatic portal vein
Most of the veins in the foregut are parallel to the arterial supply, except from which 2 arteries?
coelic + gastroduodenal
what do all of the midgut veins drain into?
splenic vein
where does the SMV become the hepatic portal vein
posterior to the neck of the pancreas, where the splenic vein enters
where is the IMV located in relation to the IMA?
to the left
venous drainage of thoracic oesophagus -2?
azygos vein + inferior thyroid vein
venous drainage of abdominal oesphagus ?
Portal; left gastric vein
Systemic; azygos vein
Portosystemic anastomoses of L gastric V?
Oesophagus V
Portosystemic anastomoses of superior rectal vein?
middlle + inf rectal V
Portosystemic anastomoses of paraumbilical V?
epigastric V
clinical significance of Portosystemic anastomoses
can cause portal hypertension
where do lymph nodes lie?
anterior to aorta, around coelic trunk, SMA, IMA
even though the major arterial supply to the rectum is the superior rectal artery, where does the lymphatic drainage occur?
middle rectal artery to internal ilac lymph nodes
a collective name for the coelic, SM, IM lymph nodes?
pre-aortic
what does the coeliac group of lymph nodes drain into?
cisterna chyli
which lymphatic channel originates from the cisterna chyli?
thoracic duct
where does the thoracic duct drain into?
junction between L internal jugular V + L subclavian V
what are Peyer’s patches?
small masses of lymphatic tissue in the ileum
what type of nerves innervate the gut?
sympathetic + parasympathetic
between which layer of the gut wall are instrinsic (myenteric) nerve plexuses found?
longitudinal + circular layers of muscularis
what do most of the autonomic fibres to the gut travel through?
coeliac plexus
where do the parasympathetic fibres to the hindgut travel through?
inferior hypogastric plexus
which parasympathetic nerves innervate the coeliac plexus?
r+l bagus nerve
which sympathetic nerves innervate the coeliac plexus?
splanchnic nerves
initial pain of foregut
epigastric region T5-T9
intiial pain of midgut
umbilical region T9-T10
initial pain of hindgut
pubic region on abdomen + thighs L1-2
what separates the left and right liver lobes anatomically?
falciform ligament
lobes of posterior right lobe
caudate + quadrate
which ligament is found at the free edge of the falciform ligament
round ligament of liver
what is the round ligament of the liver a remnant of
umbilical vein
where does the pancreatic duct span from
bile duct to pancreas
what is the name of the area which indicates the union of the pancreatic duct and the common bile duct?
hepatopancreatic ampulla of Vater
where is the sphincter of oddi?
betweent the commmon bile duct + duodenum
what is the cystohepatic triangle of Calot?
a triangle formed by the cystic duct, common hepatic duct and the cystic artery
venous drainage of gall bladder
cystic vein - hepatic portal vein
what parts of the rectum does the superior rectal artery supply?
superior + middle
