Abdominal Aorta Flashcards Preview

Anatomy (TOPNOTCH SUPPLEMENT) > Abdominal Aorta > Flashcards

Flashcards in Abdominal Aorta Deck (15):
0

T12, supplies the foregut (i.e. Intraabdominal esophagus, stomach, upper part of duodenum, liver, GB, & pancreas)

Branches:
- left gastric artery
- splenic artery
- common hepatic artery

Celiac trunk

1

L1, supplies the midgut (i.e. lower part of duodenum, jejunum, ileum, cecum, appendix, ascending colon & proximal 2/3 of transverse colon)

Superior mesenteric artery (SMA)

2

Kidneys

Renal artery

3

Testes or ovaries

Gonadal artery

4

L3, supplies the hindgut (i.e. distal 1/3 of transverse colon to upper portion of rectum)

Inferior mesenteric artery (IMA)

5

As terminal branches

Common iliac artery

6

Usually below L1 (below renal artery & SMA), elderly men

MC site of ruptured AAA: left posterolateral wall (retroperitoneal)

IMA usually lies in the middle of an AAA

SSX: sudden onset severe, central abdominal pain, radiate to the back, pulsatile tender abdominal mass, hypotension if ruptured

Surgical complications: ischemic colitis (ligation of IMA), spinal cord ischemia (ligation of great redicular artery or artery of Adamkiewicz)

Abdominal aortic aneurysm (AAA)

7

MC cause: embolism within SMA

Severe abdominal pain, out of proportion to P.E. findings

Patient profile: elderly, +heart disease, taking digoxin (splanchnic vasoconstrictor)

Acute mesenteric ischemia

8

MC: bifurcation of abdominal aorta

May result to claudication (i.e. leg pains when walking) & impotence (lack of blood in internal iliac artery)

Gradual occlusion

9

Union of R & L common iliac vein at level L5

Drains all blood from below diaphragm to the R atrium

IVC below kidneys may be ligated (50% mortality)

L gonadal vein --> L renal vein

R gonadal vein --> IVC
- R sided hydronephrosis in a woman may indicate thrombosis of R ovarian vein --> ureter constrict because the R ovarian vein crosses the ureter to drain into IVC
- L sided testicular varicocele may indicate occlusion of L testicular vein or L renal vein by malignant renal tumor

If IVC is blocked by a retroperitoneal tumor or large thrombus, 2 routes of collateral venous return are followed:
1. Azygous vein ➡️ R atrium
2. Lumbar vein ➡️ external & internal vertebral venous plexus ➡️ cranial dural sinuses ➡️ internal jugular vein ➡️ R atrium

Inferior vena cava

10

Hepatic portal system

Portal vein
- formed posterior to the neck of pancreas
- Union of splenic vein & SMV

Inferior mesenteric vein
- ends by joining splenic vein

11

Portal-IVC anastomosis

Site of anastomosis
ESOPHAGUS

Clinical sign
ESOPHAGEAL VARICES

Veins involved (PortalCaval)
L GASTRIC VEIN ESOPHAGEAL VEIN

12

Portal-IVC anastomosis

Site of anastomosis
UMBILICUS

Clinical sign
CAPUT MEDUSA


Veins involved (PortalCaval)
PARAUMBILICAL VEIN SUPERFICIAL & INFERIOR EPIGASTRIC VEIN

13

Portal-IVC anastomosis

Site of anastomosis
RECTUM

Clinical sign
HEMORRHOIDS

Veins involved (PortalCaval)
SUPERIOR RECTAL VEIN MIDDLE & INFERIOR RECTAL VEIN

14

Portal-IVC anastomosis

Site of anastomosis
RETROPERITONEAL ORGANS

Clinical sign
NOT CLINICALLY RELEVANT

Veins involved (PortalCaval)
TRIBUTARIES OF SMV & IMV VEINS OF POSTERIOR ABDOMINAL WALL