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Blood supply abdomen
Blood supply to the abdomen
| Question | Answer |
|---|---|
| Describe the origin of the arteries of the abdomen | Three pairs of vitelline arteries fuse at the midline during during embryonic development, forming three unpaired midline arteries arising from the aorta |
| * What artery trunk supplies the foregut? What structures does it supply? | The celiac trunk: distal 1/3 of esophagus, stomach, 1st and 2nd parts of duodenum, liver and gallbladder, pancreas, spleen |
| * What artery trunk supplies the midgut? What structures does it supply? | Superior mesenteric artery: 3rd + 4th parts of the duodenum, jejunum and ilium, cecum and appendix, ascending colon, proximal 2/3 of transverse colon |
| * What artery trunk supplies the hindgut? What structures does it supply? | Inferior mesenteric artery: distal 1/3 of transverse colon, descending colon, sigmoid colon, rectum, superior 1/2 of the anal canal |
| * * What is the marginal artery of drummond? What arteries contribute to this plexus? | Complex anastomoses of branches of the superior and inferior mesenteric arteries which frames the entire large intestine; includes connections between ileocolic, right colic, middle colic, left colic, sigmoidal, and superior rectal arteries |
| Where does the celiac trunk branch off (vertebral landmark)? | T12 |
| What structure surrounds it? | The celiac plexus |
| What three branches does it give off? | Left gastric, splenic, and common hepatic |
| * * Describe the path and structures supplied by the left gastric artery, as well as any branches | ascends retropperitoneally to the gastroesophageal junction level; gives off esophageal branches and descends along the lesser curvature of stomach (within less omentum); anastomoses with right gastric artery; can give off accessory hepatic artery |
| * Describe the path and structures supplied by the splenic artery, as well as any branches | Runs retroperitoneally along upper border of pancreas; reaches spleen within lienorenal ligament; gives off pancreatic branches, short gastric arteries; left gastro-omental artery; splenic branches |
| * * What supplies the fundus of the stomach? | short gastric arteries from the splenic artery of the celiac trunk |
| * * Describe the path of the left gastro-omental (gastroepiploic artery) | Runs along greater curvature of stomach within gastrocolic ligament; anastomoses with right gastro-omental artery |
| Describe the path of the common hepatic artery | Descends retroperitoneally to the right until it lies above the first segment of the duodenum and divides into two branches: 1) hepatic artery proper and 2) gastroduodenal |
| * What are the branches and areas supplied by the hepatic artery proper? | Right hepatic artery (right lobe of liver), left hepatic artery (left lobe of liver); cystic artery*; right gastric artery (usually branch of right hepatic artery) |
| Where does the hepatic artery travel through (i.e. what ligament does it pass through)? What structure does it run with as it enters the liver? | Enters the hepatoduodenal ligament and ascends immediately to the left of the common bile duct |
| * Where does the cystic artery come from? | Usually a branch of the right hepatic artery; may arise from hepatic proper, rght, or left hepatic, or gastroduodenal; may pass in front or in back of common bile + cystic ducts; may be accessory cystic arteries |
| Where does the right gastric artery come from? | May arise from common hepatic artery, hepatic artery proper, or right hepatic artery |
| Where does the gastroduodenal artery pass through? | Passes behind first segment of duodenum and divides into two principal branches |
| What are the branches of the gastroduodenal artery? | Right gastro-omental (gastroepiploic) and te superior pancreaticoduodenal artery |
| * * Describe the path of the right gastro-omental branch | Right gastro-omental (gastroepiploic): anastomoses w/ left gastro-omental artery along greater curv. of stomach within gastroilic ligament; |
| * * Describe the path of the superior pancreaticoduodenal artery | usually anterior and posterior superior pancreaticoduodenal arteries; runs between second segment of duodenum and head of the pancreas and anastomoses with inferior pancreaticodudoneal artery |
| * Where are the aneastomoses of hind and mid gut? | Make a chart |
| * * * Summary: What (5) vessels supply the stomach? | left gastric artery: lesser curvature of stomach + distal 1/3 esophagus; right gastric artery: lesser curv of stomach; short gastric arteries: fundus of stomach; right gastro-omental: greater curv. of stomach; left gastro-omental: greater curv of stomach |
| * Summary: What (3) arteries supply the pancreas? | Pancreatic branches from splenic artery; superior pancreaticoduodenal artery; inferior pancreaticoduodenal artery |
| * Summary: what artery supplies the spleen? | Splenic artery |
| * What (2) arteries supply 30% of the liver? What vein drains most of the blood of the liver? | Right and left hepatic arteries; portal vein |
| * What artery supplies the gallbladder? | Cystic artery |
| * What (2) arteries supply the duodenum? | The superior and inferior pancreaticoduodenal artery |
| Where does the superior mesenteric artery originate from? | From the abdominal aorta at the level of L1 |
| Where is it located with respect to the pancrease and the duodenum? | Runs downward and to the right behind the neck of the pancreas but in front of the third segment of the duodenum |
| What are the (5) major branches of the superior mesenteric artery? | Inferior pancreaticoduodenal artery, jejunal and ileal branches, ileocolic artery, right colic artery, middle colic artery |
| * * The ________ anastomoses with the superior pancreaticoduodenal artery to supply the pancreas and duodenum | inferior pancreaticoduodenal artery |
| * On which side do the jujunal and the ileal branches come out of the superior mesenteric artery? | Left side |
| The jejunal and the ileal branches divide into two and unite with the adjacent divisions of the other branches to form a series of ___ | arcades in the mesenteries |
| Arcades are more developed along the _____ than along the ______ | ilium; jejunum |
| The arcades give rise to the _____ | Straight arteries (arteria recta) |
| * Where does the ileocolic artery arise from? What branches are given off from this artery? | From the right side of the superior mesenteric artery; passes in the mesentery directly towards the cecum |
| * What structure does the right colic artery supply? | The ascending colon |
| * What structure does the middle colic artery supply? | The proximal 2/3 of the transverse colon |
| * Where does the inferior mesenteric artery arise from? Vertebral level? | 3-4 cm proximal to the bifurcation of the aorta at the level of L3 |
| * What are the three branches given off by the inferior mesenteric artery? | Left colic artery, sigmoidal arteries, superior rectal artery |
| * what structures does the left colic artery supply? | The distal 1/3 of the transverse colon and the upper part of the descending colon |
| * What do the sigmoidal arteries supply? | The lower part of the descending colon and the sigmoid colon |
| * * The superior rectal artery is a direct continuation of the ________. It anastomoses with the ______ and _______ ______ arteries | inferior mesenteric artery; middle and inferior rectal |
| * What structures does the superior rectal artery supply? | rectum and the proximal 1/2 of the anal canal |
| Unlike the abdominal digestive system and associated digestive glands, the _________ organs and structures are supplied by ________ arteries. This is the case for the entire ____ system, the _____ glands, and the _______. | retroperitoneal; paired; urogenital system; suprarenal glands; posterior abdominal wall |
| The _____ retroperitoneal portions of the digestive system are supplied by unpaired arteries | secondary retroperitoneal |
| Secondary retropertioneal structures are those that begin embryonic development as _________ structures and later lose their mesenteries when they fuse with the parietal peritoneum of the posterior abdominal wall | intraperitoneal |
| What are the secondary retroperitoneal structures | distal 3/4 of the duodenum, pancreas, ascending colon, descending colon, rectum |
| In the abdomen, the primary retroperitoneal structures are all supplie by the paired arteries which are direct branches of the ______. In the pelvis, the paired arteries are direct branches of the ________. | abdominal aorta; internal iliac arteries |
| All of these primary retroperitoneal structures are drained by the branches of the _______. | Inferior vena cava |
| * * What three arteries supply the suprarenal glands? Where do they branch from? | The superior suprarenals (branch from right and left inferior phrenic arteries), the middle suprarenal (branch of abdominal aorta), the inferior suprarenal (branch of left and right renal arteries) |
| How are the suprarenal glands drained? | Usually by single vein: right suprarenal vein drains directly into inferior vena cava; left suprarenal vein drains into left renal vein which then drains into IVC |
| Where do the gonads get their arteries? Where does this artery orginiate? What about the corresponding veins | From the abdominal aorta; orginiates below the origin of the renal arteries; the viens follow the same pater as the suprarenal glands |
| * What accounts for the difference in drainage on the right and left side ? | Due to differences in embryonic development on the two sides of the body |
| * What is the hepatic portal system? | System of veins interposed between two capillary networks; the intestinal and splenic venous blood does not return directly to heart, but passes through the liver (hepatic sinusoids) |
| * what (7) compose the hepatic portal system? | portal vein, superior and inferior mesenteric veins, splenic vein, right and left gastric veins, cystic vein, paraumilical vein |
| Where does the portal vein form (i.e. behind what organ)? What two veins join to form it? | Behind the neck of the pancreas; union of the the superior mesenteric and splenic veins |
| * What are the structures of the portal triad? | The common bile duct, hepatic artery proper, and the portal vein; located behind the first segment of the duodenum. The artery enteres the free margin of the hepatodudodenal ligament |
| * Describe the path of the portal vein | Ascends in the hepatoduodenal ligament in front of the epiploic foramen of Winslow and then enters the porta hepatis of the liver; in the liver, vein branches into many veins that eventually open into hepatic sinusoids |
| Where is the blood recollected? | The hepatic veins which drein into inferior vena cava on the posterior surface of the liver |
| Which vessels drain directly into the portal vein? | The right and left gastric veins, the cystic veins, and the paraumbilical veins; drains directly into portal vein before entering porta hepatis |
| The splenic vein forms at the _______ and runs along the upper border of the _____ with the ______ artery. It usually receives the ______ ______ vein. | hilus of the spleen, pancreas, splenic, inferior mesenteric |
| Under normal conditions, the portal venous blood traverses the liver and drains into the ________ by way of the ______. | IVC; hepatic veins |
| * What causes portal hypertension? | In the case of fibrosus (caused by loss/injury to parenchymal cells-->scarring-->chirrosis), increasd resistance to blood flow results in build up of pressure-->portal hypertension |
| * * Alternate routes of blood flow back to the heart exist which connect the portal and systemic venous system and are known as the _________. These routes are possible because there are no valves in any of the tributaries of the _____. | portal-systemic anastomoses; hepatic portal system |
| * Where are the four major communications between the portal and systemic venous system? | (4) : At the lower end of the esophagus, on the anterior abdominal wall, in the anal canal, and the posterior abdominal wall. |
| * Describe the communication between the portal and systemic venous systems at the lower end of the esophagus; when they become dilated, what is seen? | esophageal branches of the LEFT GASTRIC VEIN (portal) and the esophageal branches of the AZYGOUS VEINS (systemic); esophageal varices |
| * Describe the communication between the portal and systemic venous systems at the anterior abdominal wall; when they become dilated, what is seen? | PARAUMBILICAL VEINS (portal) and the SUPERFICIAL VEINS OF THE ANTERIOR ABDOMINAL WALL (systemic); Caput medusae |
| * Describe the communication between the portal and systemic venous systems at anal canal; when they become dilated, what is seen? | SUPERIOR RECTAL VEINS (portal) and MIDDLE AND INFERIOR RECTAL VEINS (systematic); hemorrhoids (though they are also often caused by something else) |
| * Describe the communication between the portal and systemic venous systems at posterior abdominal wall. | TRIBUTARIES OF THE SECONDARY RETROPERITONEAL ORGANS (portal) and TRIBUTARIES OF THE PRIMARY RETROPERITONEAL ORGANS (systemic) |
| * * What comprises the cardia of the stomach? | Anastomoses of the coronary vein of the stomach with the esophageal veins |
| * What veins do the paraumbilical veins join with? Along what ligament do they do this? | Along the ligamentum teres; with the veins of the abdominal wall |
| * What veins comprise the hemorrhoidal plexus? | superior rectal veins fro inferior mesenteric with middle and inferior rectal veins from the internal iliac |
| * * What veins does the splenic vein anastomose with? | The retroperitoneal veins (suprarenal and the inferior phrenic) |
Created by:
karkis77
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