Blood supply to midgut and hindgut (+ a bit of liver) Flashcards

1
Q

Blood supply to midgut

A

Superior mesenteric artery

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2
Q

Blood supply to hindgut

A

Inferior mesenteric artery

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3
Q

Where do both these vessels originate?

A

Abdominal aorta

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4
Q

What level does superior mesenteric artery branch off?

A

L1

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5
Q

What level does inferior mesenteric artery branch off?

A

Around L3

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6
Q

Branches of superior mesenteric artery

A

Ileocolic artery –> caecum

Right colic artery –> ascending colon

Middle colic artery –> first 2/3 transverse colon

Branches to ileum and jejunum

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7
Q

Branches of inferior mesenteric artery

A

Left colic artery –> descending colon

Sigmoidal artery –> sigmoid colon

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8
Q

Change of name of inferior mesenteric

A

As it passes into pelvis it is renamed superior rectal artery - supplying superior rectum

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9
Q

What is formed by the anastomoses of all the arteries supplying the mid and hindgut?

A

Marginal artery - surrounds inner large bowel like a margin

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10
Q

Where do the inferior and superior mesenteric artery anastomose?

A

Left colic artery anastomoses with middle colic artery at splenic flexure

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11
Q

Watershed area in mid/hindgut

A

From margin of midgut to hindgut at transverse colon onwards there is area with worst blood supply - ischaemia can occur if BP drops

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12
Q

Look on notability at the diagram you drew ella it will make sense

A

Plz look

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13
Q

Venous drainage of midgut

A

Superior mesenteric vein

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14
Q

Venous drainage of hindgut

A

Inferior mesenteric vein

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15
Q

Rectum drainage

A

Upper 1/3 superior rectal vein
Middle and lower 1/3 –> systemic venous system (middle rectal vein and inferior rectal veins —> internal iliacs)

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16
Q

LI vs SI

A

LI - shorter and wider
LI - crypts but NO villi

17
Q

How is water reabsorbed in LI?

A

Facilitated by ENaC channels
Induced by aldosterone
Very tight junctions - allows gradient to form and less ions to leak out

18
Q

Epithelia in large intestine

A

Columnar

19
Q

Retroperitoneal parts of LI

A

Ascending and descending = retroperitoneal

Transverse = not and has its own mesentery (like sigmoid colon does)

20
Q

Ligaments of the liver

A

Falciform ligament
Coronary ligament (anterior and posterior folds)
R and L triangular ligament
Lesser omentum

21
Q

Falciform ligament function

A

Connects the anterior liver to the anterior abdominal wall
Sickle shaped
Remenant of ligamentum teres (umbilical vein) which was ventral mesentery

22
Q

Coronary folds (anterior and posterior) function

A

Attaches superior liver to inferior diaphragm
Borders mark the bare surface of the liver

23
Q

Triangular ligaments left and right formed from

A

Anterior and posterior coronary folds come together each side at left and right lobe to form these

24
Q

What do the triangular ligaments connect to?

A

Right - connects right lobe to diaphragm

Left - connects left lobe to diaphragm

25
Q

Lesser omentum - what does it connect

A

Connects liver to lesser curve of the stomach and 1st part of duodenum

26
Q

How else is the liver secured?

A

Hepatic veins connect to inferior vena cava

27
Q

3 hepatic recesses

A

Subphrenic recess
Subhepatic recess
Morisons recess

28
Q

Subphrenic recess - what is it?

A

Between diaphragm and anterior/superior parts of the liver

Seperated into R and L by falciform ligament

29
Q

Subhepatic space - what is it

A

Part of supracolic compartment - space between transverse colon and inferior liver

30
Q

Morisons pouch - what is it?

A

Potential space between the visceral surface of the liver and the R kidney

Deepest part of peritoneal cavity when supine (lay on back), pathology fluids (blood or ascites) can accumulate here in bedridden pts