GA 5

Question 1

Celiac Trunk

Answer 1

T12/Upper L1

-supplies foregut + spleen

Question 2

SMA

Answer 2

Lower L1

-supplies midgut

Question 3

IMA

Answer 3

L3

-supplies hindgut

Question 4

Aortic Hiatus

Answer 4

T12

Question 5

Aorta splits to R/L Common Iliacs

Answer 5

L4

Question 6

Unpaired Visceral Arteries

Answer 6

Celiac - T12
IMA - L3
SMA - L1

Question 7

Paired Visceral Arteries

Answer 7

Suprarenal - L1
Renal - L1/2
Gonadal (testicular/ovarian) - L2

Question 8

Paired Parietal Arteries

Answer 8

Inferior phrenic - T12
Subcostal - T12
Lumbar - L1-4

Question 9

What is the parasympathetic innervation of the foregut? midgut? hindgut?

Answer 9

1. Vagus
2. Vagus
3. Pelvic Splanchnic

Question 10

What is the sympathetic innervation of the foregut? midgut? hindgut?

Answer 10

1. Thoracic splanchnic T5-9
2. Thoracic splanchnic T8-12
3. Lumbar splanchnic L1-2

Question 11

How does the right hepatic artery typically relate to the portal vein? what is a common variation?

Answer 11

91% - anterior

9% - posterior

Question 12

An accessory or replaced right hepatic artery may originate from where? left hepatic artery?

Answer 12

a. SMA

b. left gastric artery

Question 13

What supplies the liver with blood?

Answer 13

75% - hepatic portal vein (supplies parenchyma)

25% - hepatic artery (supplies non-parenchyma)

Question 14

What supplies the gall bladder?

Answer 14

cystic artery

Question 15

What are four variations of the cystic artery?

Answer 15

6. 2% - cystic off of left hepatic artery
7. 1% - cystic off of right hepatic artery + anterior to common hepatic duct
8. 1% - cystic off of proper hepatic + anterior to common hepatic duct
9. 6% -cystic off of gastroduodenal artery

Question 16

What does the ileo colic artery supply? appendix?

Answer 16

• ileocecal junction

- appendicular artery (comes from IC artery)

Question 17

What does the middle colic artery supply?

Answer 17

transverse colon

Question 18

What does the right coli artery supply?

Answer 18

ascending colon

Question 19

What does the left colic artery supply?

Answer 19

descending colon

Question 20

What are some common variations of the SMA?

Answer 20

• common trunk for right and middle colic arteries
• common trunk for right and ileocolic arteries
• absent middle colic replaced by a large branch from left colic
• absent right colic artery

Question 21

Nutcracker Syndrome

Answer 21

• left renal vein (possible the 3rd part of the D) can become entrapped between the SMA and aorta an
• hematuria, proteinuria, nausea, bilious vomit, left flank pain, left scrotal pain, varicocele

Question 22

What arteries contribute to the marginal artery?

Answer 22

middle, right, left, and ileo colic arteries

Question 23

What three arteries supply the rectum? where do they come from?

Answer 23

superior rectal artery - IMA
middle rectal artery - internal iliacs
inferior recta artery - internal pudendal

Question 24

Hemorrhoid Pain: Internal vs. External

Answer 24

Internal are NOT painful because they are under autonomic control, while external are painful because they are under somatic control

Question 25

What causes internal hemorrhoids? external?

Answer 25

1. prolapse of the rectal mucosa that contains the normally dilated veins of the internal venous plexus 2. thromboses or blood clots in veins of the external venous plexus

Question 26

When does the IVC enter the abdomen?

Answer 26

at T8 through the canal opening

Question 27

What are the four portal canal anastomoses? what comprises them?

Answer 27

esophageal - left gastric/azygous rectal - superior rectal/middle or inf recta paraumbilical - paraumbilical/epigastric retroperitoneal - colic veins/systemic retroperitoneal veins

Question 28

Esophageal varices

Answer 28

due to portal hypertension | -if they rupture, it can be life threatening

Question 29

What causes portal hypertension?

Answer 29

scarring and fibrosis from cirrhosis obstruct the hepatic portal vein in the liver, and pressure rises in the vein

Question 30

Caput Medusae

Answer 30

due to portal obstruction, veins of the anterior abdominal wall that anastomose with the paraumbilical veins become varicose