At what vertebral level does the aorta bifurcate into the common iliac arteries?
What plexus do the pelvic splanchnic nerves travel through?
The inferior hypogastric plexus.
What are the paired visceral arteries that branch from the aorta, and at what vertebral levels do they branch?
What do we see clinically if retrograde portal vein blood uses the left gastric artery to return to systemic circulation?
What are the borders of the cystohepatic triangle (triangle of Calot)?
The common hepatic duct (medial).
The cystic duct (lateral).
Inferior border of the liver (superior).
At what point does pain travel with the parasympathetics?
Below the pelvic pain line, where the visceral afferents travel with the pelvic splanchnic nerve.
By definition, what separates internal and external hemorrhoids?
The pectinate line.
How does the vagus nerve enter the abdominal cavity?
It follows the esophagus as the anterior and posterior vagal trunks, and enters through the esophageal hiatus of the diaphragm.
Where are the esophageal varices located, histologically speaking?
In the submucosa of the esophagus.
What is the primary function of sympathetic innervation to the abdomen?
Vasoconstriction and inhibition of peristalsis.
What are the 2 less common configurations for the 3 veins that make up the portal vein?
1. The inferior mesenteric vein attaches to the superior mesenteric vein. The superior mesenteric vein and the splenic vein come together to form the portal vein.
2. The inferior mesenteric vein, superior mesenteric vein, and splenic vein, all come together to form the portal vein.
What is innervated by the pelvic splanchnic nerves?
The colon and rectum from the splenic flexure to the pectinate line.
What do we see clinically if retrograde circulation from the portal vein opens the umbilical vein to return to systemic circulation?
What is the basic path for an abdominal sympathetic nerve from the spinal cord to organ?
Starts at the intermediolateral cell column, passes out the ventral horn and the anterior ramus, goes through the white ramus, and then through the paravertebral ganglia without synapsing. They then continue as the abdominopelvic splanchnic nerves (still presynaptic) and synapse at the prevertebral sympathetic ganglia. They then follow the periarterial plexuses to their target organ.
What structure serves as an anastomosis between the arteries of the midgut and hindgut?
The marginal artery of Drummond.
What is of the name for the opening of the diaphragm through which the inferior vena cava passes?
At what vertebral level is it located?
The caval opening of the diaphragm.
What are the unpaired visceral arteries that branch from the aorta, and at what vertebral levels do they branch?
Superior mesenteric (L1).
Inferior mesenteric (L3).
What are the 4 sympathetic splanchnic nerves innovating the abdomen, and at what vertebral levels do they exit?
Greater splanchnic: T5-T9.
Lesser splanchnic: T10-T11.
Least splanchnic: T12.
Lumbar splanchnic: L1-L2
Where do the right lumbar veins converge and drain?
Into the azygos vein.
Where is a "replaced" right hepatic artery likely to originate?
Superior Mesenteric Artery
What is the significance of the cystohepatic triangle?
In the majority of the population, it is the location of the cystic artery.
Why might the liver still contain a great deal of moving blood, even if the hepatic artery is occluded?
Because 70% of the blood to the liver comes from the portal vein.
What sympathetic ganglia also carry fibers from the vagus nerve?
Some inferior mesenteric.
What arteries supply the marginal artery of Drummond?
Ileocolic, right colic, middle colic, left colic.
What are the 2 possible routes for the venous return of blood in the rectal venous plexus?
Either through the superior rectal vein and the portal system,
or the middle/inferior rectal veins and the caval (systemic) return system.
What structures are supplied by the short gastric arteries?
The fundus of the stomach.
The superior pole of the spleen.
Is the hypogastric nerve sympathetic or parasympathetic?
The hypogastric nerve is exclusively sympathetic.
What 2 structures can become compressed by the superior mesenteric artery?
What is the name of this syndrome?
Left renal vein, possibly the 3rd part of the duodenum.
Renal vein entrapment syndrome – or "Nutcracker syndrome."
What are the paired parietal branches of the aorta, and at what vertebral levels do they branch?
Inferior phrenic (T12).
In general, which ganglia correspond to the greater, lesser, and least splanchnic, and lumbar nerves?
Greater splanchnic – celiac ganglia.
Lesser and least splanchnic – superior mesenteric ganglia.
Lumbar splanchnic – inferior mesenteric ganglion