Blood And Nerve Supply To Abdominal Organs

Question 1

Three branches of the celiac trunk

Answer 1

Left gastric
Common hepatic
Splenic a

Question 2

Esophageal branch of the left gastric a anastomoses with what artery

Answer 2

Esophageal a of the thorax

Question 3

Left gastric a follows what gross anatomy of the stomach in what mesentery

Answer 3

Lesser curvature

Lesser omentum - hepatogastric ligament

Question 4

Branches of the splenic a (retroperitoneal to intraperitoneal)

Answer 4

To stomach
Posterior gastric a
Short gastric a
Left gastro-omental a

To spleen
Splenic branches

To pancreas
Pancreatic branches

Question 5

The splenic a travels in what ligament

Answer 5

Splenorenal ligament

Question 6

Short gastric a travel in what ligament

Answer 6

Gastrosplenic l

Question 7

Left gastro-omental a travels in what ligament

Answer 7

Gastrocolic l

Question 8

Branches of common hepatic a

Answer 8

Proper hepatic a (in hepatoduodenal ligament with portal vein and bile duct)
Right and left hepatic branches
(Cystic from right hepatic)
Gastroduodenal a (posterior to pylorus of stomach)

Question 9

Gastroduodenal gives rise to what arteries

Answer 9

Superior pancreaticoduodenal a

Right gastro-omental a

Question 10

right gastro-o mental a travels in what ligament

Answer 10

Gastrocolic l

Question 11

Cystic a typically comes off what a

Answer 11

Right hepatic a

Question 12

Hepatic a is typically anterior/posterior to portal vein

Answer 12

Anterior

Question 13

Blood supply to the liver has two sources, name them:

Answer 13

Hepatic portal vein - sustains parenchyma (75% of blood to liver)
Hepatic artery - sustains non-parenchyma structures like intrahepatic bile ducts (25%) - oxygenated

Question 14

Secondary branching of the liver gives rise to what division

Answer 14

Right and left liver

Question 15

Tertiary branching of the liver separates right and left liver into

Answer 15

7 segments

Question 16

Bile flow in the liver occurs in what direction

Answer 16

From hepatocytes into bile canaliculi, to interlobar biliary ducts, and then to the bile duct in the extrahepatic portal triad

Question 17

Blood flowing from the hepatic portal vein moves in what direction through the liver?

Answer 17

Towards the central vein

Question 18

Gallbladder is supplied by what a

Answer 18

Cystic a (typically from right hepatic)

Question 19

Cystic a can be found in what triangle

Answer 19

Cystohepatic triangle of Calot

Made up of cystic duct, common hepatic duct and visceral surface of liver

Question 20

Anastomoses of the stomach

Answer 20

Left gastric —> right gastric
Left and right gastro-o mental
Left gastric and right and left gastro-omental

Posterior gastric a and short gastric a wont anastomose

Question 21

Arteries supplying the stomach include (6)

Answer 21

Left and right gastric in lesser omentum
Left and right gastro-omental in gastrocolic ligament
Short gastric in gastrosplenic l
Posterior gastric a

Question 22

Blood supply to the pancreas

Answer 22

Pancreatic a from splenic a (supply tail,body, neck)
Anterior and posterior superior pancreaticoduodenal from gastroduodenal
Anterior and posterior inferior pancreaticoduodenal a from SMA

Question 23

The anastomoses of the anterior and posterior inferior and superior pancreaticoduodenal a represent an anastomoses of what important embryological division

Answer 23

Anastomoses of celiac trunk and SMA

Foregut + midgut

Question 24

Branches of the SMA (retroperitoneal —> intraperitoneal)

Answer 24

Anterior and posterior inferior pancreaticoduodenal  
Ileocolic 
Right colic 
Middle colic 
Jejunum 
Ileal a

Question 25

Vasa recta of the jejunum are long/short while the vasa recta of the ileum are long/short

Answer 25

Jejunum vasa recta are long | Ileum vasa recta are short

Question 26

Arcades in the jejunum are few/many. Arcades of the ileum are few/many

Answer 26

Arcades of jejunum are few | Arcades of the ileum are many

Question 27

Describe nutcracker syndrome

Answer 27

SMA compresses 3rd horizontal part of duodenum and the left renal vein Occurs with loss of mesenteric fat Blood and protein in urine Flank pain Nausea and vomiting (containing bile)

Question 28

Branches of the IMA

Answer 28

Left colic Sigmoid a Superior rectal

Question 29

Rectal a and their originations

Answer 29

Superior rectal from IMA Middle rectal from internal iliac Inferior rectal from internal pudendal

Question 30

Internal hemorrhoids contain veins fro what plexus

Answer 30

Internal venous plexus

Question 31

External hemorrhoids come from what venous system

Answer 31

External venous plexus

Question 32

IVC begins at what spinal level

Answer 32

L5. Right of midline - ascends though T8

Question 33

What v can bypass a blockage in the IVC

Answer 33

Ascending lumbar v - goes into azygous

Question 34

Portal vein drains what structures

Answer 34

Alimentary structures in the abdomen | Created by splenic v and superior mesenteric vein

Question 35

Portal-caval anastomoses (4) formed by a backup in the portal system (liver damage)

Answer 35

Esophageal (left gastric and azygos vv) Rectal (superior and middle/inferior rectal vv) Paraumbilical (paraumbilical/epigastric vv) Retroperitoneal (colic v and systemic retroperitoneal v)

Question 36

Portal v is found in what ligament

Answer 36

Hepatoduodenal ligament

Question 37

Esophageal varices are caused by portal-canal anastomoses in what v

Answer 37

Left gastric and azygous

Question 38

Hemorrhoids can be formed by a backup in the portal system, causing venous backup in the caval system in what anastomoses

Answer 38

Rectal | Superior rectal and middle or inferior rectal

Question 39

Paraumbilical venous anastomoses can be viewed when distension occurs causing what symptom

Answer 39

Caput medusae

Question 40

Sympathetic in the abdominal region

Answer 40

``` Greater splanchnic (T5-T9) Lesser splanchnic (T10, T11) Least splanchnic (T12) Lumbar splanchnic (L1-L3) ```

Question 41

Parasympathetic innervation of the abdomen

Answer 41

Vagus and pelvic splanchnic

Question 42

Vagus n supplies what structures

Answer 42

Foregut and midgut structures

Question 43

Pelvic splanchnic n supply what innervation (S/P) to what region of the gut

Answer 43

Parasympathetic to hindgut

Question 44

Sympathetic innervation of the gut induces what effect on digestion

Answer 44

Produces vasoconstriction in the gut and inhibits peristalsis

Question 45

Greater splanchnic typically supplies what sympathetic ganglia

Answer 45

Celiac

Question 46

Lesser splanchnic typically supplies which sympathetic ganglia

Answer 46

Aorticorenal ganglia

Question 47

Least and lumbar splachnics typically supply which sympathetic ganglaia

Answer 47

Superior and inferior mesenteric ganglia

Question 48

Celiac ganglia

Answer 48

Predominately greater splanchnic (sympathetic) Contains parasympathetics from vagus traveling through it (do not synapse here) Mixed plexus

Question 49

Superior mesenteric ganglion

Answer 49

Gets celiac plexus, lesser and least, some lumbar maybe Parasympathetics travel through as well Mixed ganglion

Question 50

Intermesetneric plexus

Answer 50

Supplies renal, gonads, ureters | Mixed (sympathetics and parasympathetics)

Question 51

Inferior mesenteric ganglion

Answer 51

Predominately gets input from lumbar splachnics Can get some from intermesenteric plexus Mixed

Question 52

Superior hypogastric plexus

Answer 52

Located at the bifurcation fo the aorta - only sympathetics (post-synaptic)

Question 53

Hypogastric n are P/S

Answer 53

Sympathetic - contribute to inferior hypogastric plexus

Question 54

Rectum is innervated by which splachnics

Answer 54

Above pectinate line Lumbar splachnics through inferior mesenteric plexus Parasympathetics through pelvic splachnics through inferior hypogastric plexus Below pectinate line Inferior part of anus - somatic innervation

Question 55

Pain below the pelvic pain line travel with what nerves

Answer 55

Parasympathetics

Question 56

Pelvic pain above the pelvic pain line travels with what n

Answer 56

Sympathetics