Blood and Nerve Supply to Abdominal Organs Flashcards Preview

GI Midterm > Blood and Nerve Supply to Abdominal Organs > Flashcards

Flashcards in Blood and Nerve Supply to Abdominal Organs Deck (34):
1

abdominal aorta

begins at T12
retroperitoneal
terminates at L4

2

relationships of the abdominal aorta

IVC lies to the right of aorta
L renal v. crosses anterior to the aorta
anterior longitudinal lig. and vertebral bodies are posterior
thoracic duct and cisterna chyli is to the right
duodenum, pancreas, and root of mesentery all cross anterior surface of the aorta

3

abdominal aortic aneurysm AAA

ballon like dialation of the abdominal aorta
usually arises below the renal a and above the aortic bifurcation
primarily due to atherosclerosis
presents as pulsatile abdominal mass that grows with time
aorta should be no larger than 3 cm on palpation
major complication is rupture

4

Foregut

Nerve plexus - celiac
Artery - celiac
PNS - vagus
Vertebral Level - T2-L1
SNS - T5-T9, greater splanchnic n.
Structures - stomach 1st and 2nd part of duodenum, liver, gallbladder, pancreas, spleen

5

Midgut

Nerve plexus - SM
Artery - SMA
PNS - vagus
Vertebral Level - L1
SNS - T10- T11, lesser splanchnic n.
Structures - 3rd and 4th part of duodenum to proximal 2/3 of transverse colon

6

Hindgut

Nerve plexus - IM
Artery - IMA
PNS - Pelvic splanchnic
Vertebral Level - L3
SNS - T12- L2, least splanchnic n.
Structures - distal 1/3 of transverse colon to upper portion of rectum

7

Celiac Trunk

branches at T12-L1
3 branches - L gastric, splenic, common hepatic
base of a surrounded by celiac plexus and ganglion

8

Left gastric a

gives off esophageal branches
follow lesser curvature of stomach
anastomoses w/ R gastric a along the lesser curvature

9

Splenic a

runs posterior to stomach, superior to the pancreas
very tortuous
within splenorenal ligament
ends as several splenic a
branches - short gastric a, L gastro-omental a, panceatic branches

10

Common hepatic a

Proper hepatic
Gastroduodenal a.

11

Proper hepatic a

R gastric a
ends as R and L hepatic a
cystic a is usually a branch

12

Gastro-duodenal a

may give off supraduodenal a
runs posterior to duodenum
bifurcates into R gastro-omental a and superior pancreaticoduodenal a

13

Relationship of portal triad

proper hepatic a - left
portal vein - posterior
bile duct - right
surrounded by hepatoduodenal ligament

14

cholecystectomy

dissection is through hepatoduodenal ligament to reach the cystic a which must be ligated before removing the gall bladder

15

Calot's triangle

medially - common hepatic duct
laterally - cystic duct
superiorly- edge of liver
cystic a crosses the middle of the triangle
calot's node - main route of lyphatic drainage of gallbladder

16

Superior Mesenteric a

1 cm inferior to celiac trunk
emerges from aorta posterior to the neck of the panceas

17

Blood supply to the pancreas and duodenum

pancreas receives branches from both the celiac and superior mesenteric arteries
celiac - superior pancreaticoduodenal
SMA
anastomosing arcades b/w SMA and gastroduodenal

18

Superior Mesenteric a

supplies branches to the free small intestine and part of large intestine
emerges from the aorta posterior to the neck of the pancreas, to the left of the SMV, enters THE mesentery and runs b/w its layers to reach the ileum and jejunum

19

SMA branches to small intestine

inferior pancreatico-duodenal a
jejunal arteries
ileal arteries

20

SMA branches to large intestine

ileocolic a
R colic a
Middle colic a

21

Ileocolic a

posterior cecal branch
anterior cecal branch
ileal branch
appendicular branch
ascending colic branch

22

R colic a

ascending colon
R colic flecure

23

middle colic a

supplices R colic flecure and transverse colon

24

IMA

supplies derivaties of hindgut
branches - left colic a, sigmoid a, superior rectal a, margial a

25

Superior rectal a and v

drain to IMV

26

Middle rectal a and v

drain to internal iliac v

27

inferior rectal a and v

drain to internal pudendal v

28

Sympathetic innervation

preganglionic fibers arise at T5-L1
travel in respective splanchnic n
synapse in prevertebral sympathetic ganglia
postganglionic fibers travel from ganglia to abdominal organs

29

Parasympathetic innervations

preganglionic fibers travel through celiac plexus but do not synapse, synapse in n plexi of enteric (intrinsic) nervous system contained in gut wall
supplied by vagus and pelvic n
vagus innervates the foregut and midgut
pelvic n arise at S2-S4 innervate hindgut

30

Enteric nervous system

composed of a series of ganglionic nerve plexi contained within the gut wall
two principal components
Myenteric (Auerbach's) plexus
Submucosal (Meissner's) plexus

31

Myenteric (Auerbach's) plexus

between outer longitudinal and inner circular muscle layers
motility

32

Submucosal (Meissner's) plexus

secretions blood flow absorption

33

Hirschsprung Disease

failure of neural crest cells to migrate during intestinal development
no myenteric plexus (need to take some muscularis mucosa)
neural crest cells become the enteric ganglion cells
no PNS so the gut cannot relax causing constriction and megacolon of the proximal colon segments
most cases occur in the rectosigmoid junction
down syndrome babies have higher risk

34

chagas disease

megacolon
T. cruzi destroys autonomic nervous system mainly myenteric plexus