Anatomy IV Nerves, Vessels

Question 1

Name the 3 arteries that supply the following:
Foregut
Midgut
Hindgut

Answer 1

Celiac Trunk
Superior mesenteric artery
inferior mesenteric artery

Question 2

3 vascular planes that the abdominal aorta supply they are?

Answer 2

Anterior: gastro
Lateral: paired: kidneys, gonads, adrenals
Posterior: diaphragm, post abdo wall

Question 3

Celiac trunk supplies from what till what?

Answer 3

abdo esophagus –> main duodenal papilla

Question 4

What organs do the Celiac trunk supply? 5 things:

Answer 4

stomach
liver
gall bladder
pancreas
spleen

Question 5

What organs do the superior mesenteric trunk supply?

Answer 5

after duodenal papilla, jejunum, ileum, appendix, cecum, ascending and most of transverse colon

Question 6

superior mesenteric trunk supplies from what till what?

Answer 6

after duodenal papilla to just short of splenic flexure

Question 7

What organs do the inferior mesenteric trunk supply?

Answer 7

descending colon
sigmoid
rectum
top of anal canal

Question 8

Celiac trunk breaks into how many branches and at what level?

Answer 8

T12

immediately into 3 branches

Question 9

What are the 3 branches that the celiac trunk breaks into?

Answer 9

Splenic: (left)
Left gastric
Common hepatic (Right)

Question 10

Splenic is straight or loopy? runs along?

Answer 10

loopy,

runs along superior border of pancreas

Question 11

What does the splenic artery supply? 4 things

Answer 11

spleen
pancreas
some to top of greater curvature
anastamoses and gives off left gastric epiploic artery

Question 12

What does the left gastric artery supply?

Answer 12

abdominal esophageal
cardio esophageal junction
supplies along lesser curvature of stomach

Question 13

Which direction does the hepatic artery turn right after celiac trunk? what does it divide into?

Answer 13

turns right
proper hepatic artery
gastroduodenal artery

Question 14

proper hepatic artery runs how? supplies what? divides?

Answer 14

runs on the free edge of lesser omentum as part of portal triad
supplies Liver
divides into left and right hepatic artery

Question 15

What artery supplies the gall bladder?

Answer 15

the cystic artery coming off the right hepatic artery can be variable

Question 16

Gastroduodenal artery comes from what?

Answer 16

common hepatic artery

Question 17

Gastroduodenal artery runs behind or in front of duodunum?

Answer 17

BEHIND

Question 18

proximal duodenum is common site for what?

Answer 18

peptic ulcer

if it bad enough, it can erode into the Gastroduodenal artery then you just vomit blood

Question 19

Gastroduodenal artery supplies what?

Answer 19

proximal duodenum
head of pancreas
last part of greater curvatures

Question 20

How does Gastroduodenal artery supply the proximal duodenum
head of pancreas?
last part of greater curvatures?

Answer 20

superior pancreo-duodenal artery

right superior right epiploic artery

Question 21

Where and what level does the superior mesenteric artery arise?

Answer 21

1cm below celiac trunk at L1

Question 22

superior mesenteric artery travels along what?

Answer 22

root of mesentery

Question 23

superior mesenteric artery: every branch to left is to what? right?

Answer 23

left: jejunum and ileum
right: colon

Question 24

superior mesenteric artery before is supplies the jejunum and ilum, has to supply what? via what?

Answer 24

last part of duodenum via inferior pancreaduodenal artery

Question 25

How do you know you're looking at jejunum?

Answer 25

long vasa recta | few arcades

Question 26

How do you know you're looking at ileum?

Answer 26

short vasa recta | multiple arcades

Question 27

Are there vasa recta, arcades in the marginal artery?

Answer 27

Nope

Question 28

colic arteries contribute to one channel called the?

Answer 28

marginal artery

Question 29

How does marginal artery run?

Answer 29

parallel to colon

Question 30

from the superior mesenteric artery, there are 3 branches that go right to support the colon, they are?

Answer 30

ileocolic right colic: ascending colon middle colic: transverse colon

Question 31

inferior mesenteric artery comes off aortic artery near what part of duodenum? near what vertebra?

Answer 31

horizontal part of duodenum | opposite L3

Question 32

inferior mesenteric artery heads which direction?

Answer 32

left and downwards

Question 33

inferior mesenteric artery gives off 2 colic branches they are?

Answer 33

left colic: descending colon | sigmoid colic

Question 34

inferior mesenteric artery changes name into what as is passes into pelvis?

Answer 34

superior rectal artery

Question 35

What organs drain through portal system? 4 things

Answer 35

``` tubular gastrointestinal tract pancreas gall bladder spleen NOT THE LIVER ```

Question 36

``` Veins from tubular gastrointestinal tract pancreas gall bladder spleen unite to form what? ```

Answer 36

hepatic portal vein

Question 37

hepatic portal vein forms where? what vertebral level?

Answer 37

behind neck of pancreas at L2

Question 38

hepatic portal vein made up of

Answer 38

Inferior mesenteric vein meets the splenic vein which meeting superior mesenteric vein

Question 39

where does hepatic portal vein travel after all the smaller veins join up?

Answer 39

behind the duodenum, ascends free edge of lesser omentum as part of triad, behind the proper hepatic artery

Question 40

what happens to blood after hepatic portal vein enters the liver?

Answer 40

into sinusoids to process products of digestion

Question 41

blood in sinusoids to hepatic veins then where?

Answer 41

To the IVC

Question 42

What drains into the systemic caval system?

Answer 42

sides and back of abdo aorta: adrenals, kidneys, gonads, abdo walls and diaphragm

Question 43

sides and back of abdo aorta: adrenals, kidneys, gonads, abdo walls and diaphragm drains into what?

Answer 43

IVC via Caval system

Question 44

valves in the portal system? high or low pressure?

Answer 44

Valveless. low pressure.

Question 45

What happens in liver fibrosis/cirrhosis?

Answer 45

portal hypertension

Question 46

How does the body compensate with portal hypertension?

Answer 46

it uses anastamoses between portal and systemic and those enlarge

Question 47

Name the portal/systemic veins anastamoses. what happens with portal hypertension?

Answer 47

1. lower esophagus near cardiac orifice (left gastric veins anastamos with azygous vein) 2. superior rectal veins (haemorrhoids) 3. anterior abdo wall (dilated veins near umbilicus) 4. retroperitoneal viscus against post abdo 5. bare area of liver

Question 48

What happens to lower esophagus near cardiac orifice veins in portal hypertension?

Answer 48

They dilated and risk of tearing them if swallow something big/sharp, they vomit (BUCKET OF BLOOD)

Question 49

abdo viscera innervated by autonomic or somatic nervous system?

Answer 49

autonomic

Question 50

Preganglionic sympathetic fibres derived from what to innervated abdo?

Answer 50

T6-L2

Question 51

Sympathetic ganglion clusteres around what arteries?

Answer 51

unpaired branches of aorta | renal arteries

Question 52

Where is parasympathetic innervation? foregut midgut pelvic splanchnics

Answer 52

foregut/midgut = vagus | pelvic splanchnics/hindgut = S2-4

Question 53

Post ganglionic fibres in abdo pass with blood vessels: what levels for foregut midgut hind gut?

Answer 53

foregut: T6-9 midgut: T8-12 hind gut: T12-L2

Question 54

afferent fibres carrying pain from unpaired abdo viscera prox to mid-sigmoid refers where?

Answer 54

midline of abdowall T6-L2 dermatomes

Question 55

afferent fibres carryin pain from mid sigmoid down refers to?

Answer 55

perianal region, S2-4

Question 56

preaortic lymph nodes drain ant. abdo aorta, organized around unpaired branches, which organs? 5 things

Answer 56

``` GI tract liver gall bladder spleen pancreas ```

Question 57

paraaortic lymph nodes receive from?

Answer 57

``` post abdo wall kidneys adrenals gonads pelvis lower limb ```

Question 58

intestinal lymph trunks created from which lymph nodes?

Answer 58

preaortic lymph nodes

Question 59

right and left lumbar lymph trunks created from which nodes?

Answer 59

paraaortic nodes

Question 60

intestinal, right and left lumbar lymph trunks coalesce into what?

Answer 60

cisterna chyli just under the diaphragm

Question 61

placement of cisterna chyli ?

Answer 61

aortic hiatus between crura

Question 62

thoracic duct pathway?

Answer 62

with aorta through hiatus at level of T12, traverses thorax, posterior to esophagus heading across to left and emptying into junction of left internal jugular vein and left subclavian vein