Blood Supply to the Digestive Tract - Escobar

Question 1

hepatorenal recess

Answer 1

if person lies on supine position, this is where fluid will be collected

Question 2

anatomical lobation

Answer 2

Right, left, quadrate, caudal. Caudal is top middle, quadrate is bot middle.

Quadrate and caudal is part of left.

Quadrate: 3/ anterior
Caudal: 4/posterior

Question 3

extrahepatic biliary system:

Answer 3

Right and left hepatic ducts -> common hepatic duct

when common hepatic duct joins with cystic duct -> common bile duct

Common bile duct joins with pancreatic duct and goes into 2nd part duodenum.

Question 4

After common bile duct…

Answer 4

Common bile duct joins with pancreatic duct at hepatopancreatic ampulla. Drains into 2nd part of duodenum at Major duodenal papilla

Question 5

Where is the celiac trunk

Answer 5

Lower T12, upper L1

Question 6

What supplies the foregut, midgut, hindgut

Answer 6

Foregut: Celiac trunk
Midgut: Superior mesenteric artery
Hindgut: Inferior mesenteric artery

Question 7

Foregut consists of:

Answer 7

Everything from esophagus to duodenum, at level of major duodenal papilla (remember its at 2nd part of duodenum, the descending part)

Esophagus, stomach, proximal duodenum, liver, gallbladder, pancreas, spleen

Question 8

Midgut consists of:

Answer 8

from distal portion of duodenum to last 1/3 of transverse colon

Distal duodenum, jejunum, ileum, cecum, appendix, ascending colon, proximal 2/3 of transverse colon.

Question 9

Hindgut consists of:

Answer 9

From distal 1/3 of transverse colon to anal canal

Distal 1/3 transverse colon, descending colon, sigmoid colon, rectum.

Question 10

Left gastric artery *

Answer 10

Hepatogastric ligament, part of lesser omentum

Question 11

Splenic artery consists of:

Answer 11

Short gastric
Left gastroomental (left gastroepiploic artery)

Question 12

Common hepatic artery branches into:

Answer 12

Gastroduodenal artery (goes down and behind duodenum)
- Right gastroomental artery
- Superior pancreaticoduodenal
Proper hepatic artery (continues right to liver)
- Right gastric
- Right and Left Hepatic
-Right hepatic goes to cystic artery

Question 13

Left renal vein goes inbetween what:

Answer 13

Aorta and superior mesenteric artery

Question 14

Superior Mesenteric Artery branches out to what:

Right side

Answer 14

Middle Colic: Transverse colon
Right colic: Ascending colon
Ileo colic: Cecum, parts of terminal ileum, appendix

Question 15

Superior Mesenteric Artery branches out to what:

Left side

Answer 15

Intestinal branch, supplies jejunal and ileum

Question 16

Inferior Mesenteric Artery branches into what:

Answer 16

Left Colic: Descending colon. Anastamoses with left branch of middle colic from superior mesentery

Sigmoid arteries: Sigmoid colon / descending colon

Superior Rectal: Proximal rectum

Question 17

Marginal Artery:

Answer 17

provides continuous blood supply in event of reduced blood flow.

Question 18

Rectal arteries:

short

Answer 18

Superior rectal artery from inferior mesenteric artery

Middle rectal

Internal pudendal

Inferior rectal

Question 19

What 2 veins make up the hepatic portal vein?

Answer 19

Superior mesenteric vein
Splenic Vein

Question 20

Alternate routes to bypass blood drainage through portal system

complication of portal hypertension

Answer 20

Esophageal varices

area of rectum

area around umbilicus

these routes allow blood to go to systemic circulation and back to heart , not through portal vein.

Question 21

3 veinous drainage of anterior abdominal wall:

Answer 21

upper

umbilical

below

Question 22

Caput medusae

Answer 22

Parallel to round ligament from umbilical are Paraumbilical veins anastamoses with thoracoepigastric vein to bypass liver.

Question 23

Parasympathetic innervation of GI tract

Answer 23

Via Vagal nerves (vagus nerve), Cranial nerve 10.
In charge of foregut / midgut

Pelvic splanchnic, from S2,3,4 - supplies hindgut

Question 24

Sympathetic innervation of GI Tract

Answer 24

Greater splanchnic: T5-T9. synapse on Celiac ganglia. Post ganglionic follow all branches of celiac artery supplying foregut.

Lesser splanchnic T10-T11: synapse on superior mesenteric ganglion. Supplies midgut
Least splanchnic T12: same^^^.

Lumbar Splanchnic L1-L3: synapse to inferior mesenteric ganglion. suppleis hindgut.

Question 25

Pain stimuli

Answer 25

Foregut / midgut: from sympathetics

Hindgut: from parasympathetics

Question 26

Dermatomes

Answer 26

pains from organs referred to dermatomes, not to brain.

Question 27

Pectinate line:

Answer 27

superior rectal artery supplies rectum up to pectinate line.

middle / inferior rectal arteries supply blood below pectinate line.