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Digestive System > Gut and blood supply > Flashcards

Gut and blood supply Flashcards

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1
Q

Aortic branch
Vertebral Level of origin
Gut region supplied

A

Celiac trunk
T12
Forgut

Superior mesenteric Artery
L1
Midgut

Inferior mesenteric Artery
L3
Hindgut

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2
Q

Which two veins join to form the Portal vein?

A

superior mesenteric a splenic veins

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3
Q

the function of having a chain of ganglia from neck to coccyx?

A

to allow sympathetic nervous signals to travel up I down to reach more distant body regions

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4
Q

spinal levels of sympathetic nervous output from the spinal cord

A

T1-L2

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5
Q

Identify the 3 main branches of the Celiac trunk

A

common hepatic a .
left gastric a .
splenic a

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6
Q

Are the common hepatic a, left gastric a and splenic a pre-aortic or para-aortic

A

pre-aortic

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7
Q

What is the principle lymphatic vessel that drains the abdomen

A

thoracic duct

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8
Q

Identify the three main thoracic splanchnic nerves and their root values

A
  1. greater splanchnic
    Root Value: T5 - 9
  2. lesser splanchnic
    Root Value: T10-11
  3. least splanchnic
    Root Value: T12
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9
Q

What important difference distinguishes the Pelvic Splanchnic nerves from all other splanchnic nerves

A

they are the only splanchnic nerves that carry parasympathetic fibres , they do not originate from the sympathetic trunks , they originate directly fromthe anterior rami of S2-S4

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10
Q

Identify which parts of the gut the Vagus nerve and Pelvic Splanchnic nerves innervate

A

Vagus nerve: Foregut and midgut

Pelvic splanchnic: Hindgut

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11
Q

Name all the quandrants of the abdomen

A
  1. Epigastric – denotes the area of the abdomen in the midline around the position of the stomach
  2. Hypochondrium – denotes the area of the abdomen to the left and right of the epigastric region below the ribs and their associated cartilages
  3. Umbilical – denotes the area around the belly button
  4. Suprapubic – denotes the area of the abdomen in the midline superior to the pubic bones
  5. Inguinal – “Of the Groin”
  6. Flank – relating to the side of abdomen between the ribs and hip
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12
Q

Where do the following ligaments run to and from

Hepatogastric
Hepatoduodenal
Splenorenal
Gastrosplenic

A

“Hepatogastric Ligament” = a peritoneal ligament that runs between the Liver and the Stomach

“Hepatoduodenal Ligament” = a peritoneal ligament that runs between the Liver and the Duodenum

“Splenorenal Ligament” = a peritoneal ligament that runs between the Spleen and the Kidney

“Gastrosplenic Ligament” = a peritoneal ligament that runs between the Stomach and the Spleen (

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13
Q

Label the regions of the abdomen

A

Lecture Slide

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14
Q

Label the abdominal aorta

A

Lecture Slide

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15
Q

What spinal level is the celiac trunk, Superior mescentric artery (SMA), inferior mescentric artery (IMA)

A

Celiac trunk: T12
SMA L1
IMA L3

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16
Q

Label other arteries from main aorta in abodomen

A

Lecture Slide

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17
Q

Foregut:
What organs
- arterial
venous
nerve
lymphatic supply

A
  1. Component viscera
    * Distal Oesophagus
    * Stomach
    * Liver + Gall Bladder
    * Proximal 1⁄2 of Duodenum
    * Pancreas
  2. Neurovascular
    - Arterial = Branches of Coeliac Axis (Abd. Aorta @T12)
    - Venous drainage = Portal Vein
    - Nerve plexus = Coeliac Plexus (@T12)
  3. Lymphatics
    * Pre-Aortic nodes @T12 (coeliac nodes)
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18
Q

Foregut
-borders (inferior and superior)
- what ribs is fundus located at

A

Fundus: Ribs 5/6
Inferior: L1 (trans-pyloric plane)
Superior: Epigastric: (To left of the midline)

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19
Q

Foregut: Stomach layers

Study These Flashcards
A

3 muscle layers in the wall of the stomach

  • Outer = Longitudinal
  • Middle = Circular
  • Inner = Oblique
20
Q

Label the areas of the stomach

Study These Flashcards
A

Fundus, Body, plyorus and cardia

21
Q

Stomach
What are the SPECIFIC ARTERIAL branches of the CELIAC TRUNK (as this is foregut region) are supplying the..
- greater curvature
-lesser curvature
- fundus

Study These Flashcards
A

Lesser Curvature - 2 arteries anastamose
* Left Gastric (Coeliac Trunk)
*Right Gastric (Common Hepatic)

Greater Curvature- 2 arteries anastamose
* Left Gastro-omental (Splenic)
Right Gastro-omental (Gastroduodenal) ((Common Hepatic))

Fundus
* Short Gastric (Splenic)

* Structures on the right hand side of stomach supplied by common hepatic artery BUT Left hand side is SPLENIC ARTERY and then above is celiac artery* with the left gastric being the EXCEPTION

22
Q

Foregut/Midgut: Duodenum
-starts from?
-How many parts and where they are

Study These Flashcards
A

Origin: immediately following pyloric region of the stomach

(1st Part) (Trans-Pyloric Plane)

2nd Part Wraps around head of Pancreas (RHS of midline)

3rd Part crosses back over IVC & Aorta

4th part ascends to Duodenojejunal flexure (LHS
of midline)

23
Q

Foregut/midgut: Duodenum
- What parts are intraperitoneal and what is retroperitoneal

Study These Flashcards
A

1st Part = Intraperitoneal

2nd, 3rd & 4th = Retroperitoneal

24
Q

Foregut/Midgut: Duodenum
-arterial supply
-ANS nervous supply
-Venous drainage
-Lymphatic drainage

Study These Flashcards
A
  • Superior half = Superior Pancreaticoduodenal branches (From Gastroduodenal artery ‐ Coeliac origin)
  • Inferior half = Inferior Pancreaticoduodenal branches
  • (From Superior Mesenteric origin)

ANS Nervous Supply:
changesbetween
retroperitona
* Superior Half = Coeliac Plexus @T12
* Inferior Half = Superior Mesenteric Plexus @L1

Venous Drainage:
* Superior half = Direct to Portal Vein
* Inferior half = Superior Mesenteric vein (SMV)

Lymphatic Drainage:
Superior half = Pre‐aortic Coeliac nodes @T12
Inferior half = Pre‐aortic Sup. Mesenteric nodes @L1

25
Foregut/Midgut: Duodenum - What is ampulla of vater
Union of Common Bile Duct & Main Pancreatic Duct
26
Foregut/Midgut: Duodenum - what is major duodenal papilla? - role
* Enters through wall of Descending Duodenum (2nd Part) * Controls flow of Bile (from Liver) and Pancreatic Juice (from Pancreas) into the Duodenum via the Sphincter of Oddi
27
Midgut -organs -neurovascular -lymphatics
Component Viscera: * Distal Half of Duodenum * Jejunum * Ileum * Caecum & Appendix * Ascending Colon * 2/3 Transverse Colon Neurovascular: * Arterial = Branches of SMA (Abd. Aorta @L1) * Venous = SMV * Nerve plexus = Sup. Mesenteric Plexus (@L1) Lymphatics: * Pre-Aortic nodes @L1 (Superior Mesenteric Nodes)
28
where is midgut pain felt?
Umbilical region
29
Mid gut: Small intestine -role of small intestine - what are the two parts -how is it suspended in the body -Main difference between 2 regions of small intestine
Bulk of digestion occurring here in small intestine Divided into 2 parts: 1. Jejunum (proximally) top left * ~2/5th of small intestine length 2. Ileum (distally) bottom right * ~3/5th of small intestine length Suspended from body wall via a Mesentery * Fan‐shaped folds of peritoneum enclosing the gut tube * Allows ingress/egress of vessels, nerves and lymphatics Main identifying difference = arterial arcade patterning * Jejunum (A) = 1 or 2 arcades with long branches (vasa recta) * Ileum (B) = more arcades with many short branches (vasa recta)
30
Midgut: Small Intestine arterial supply ANS nervous supply Venous drainage Lymphatic drainage
Arterial Supply: (Branches of SMA @L1) * Jejunal arteries * Ileal arteries ANS Nervous Supply: * Superior Mesenteric Plexus @L1 Venous Drainage: * SMV Lymphatic Drainage: * Pre‐aortic Sup. Mesenteric nodes @L1
31
Label the regions of the large intestine (midgut/hindgut)
Lecture Slide
32
Midgut/Hindgut: Large Intestine - function -General features within
Function: * Absorb water and electrolytes * Store undigested material until expelled by the body Features: 1. Haustra – Sacculations of the wall 2. Teniae Coli – Longitudinal muscles collected into 3 bands (continuous with smooth muscle of small intestine) 3. Appendix
33
Midgut/Hindgut: Large Intestine Surface anatomy -in what quadrants are the following in... - large intestine -Caecum/Appendix -Hepatic Flexure -Splenic Flexure -Sigmoid Colon -rectum -transverse colon
- large intestine: Found in almost all regions except Umbilical -Caecum/Appendix: R Groin -Hepatic Flexure: R. Hypochondrium (Inferior to the Liver) -Splenic Flexure: L.Hypochondrium (anterior to the Liver) -Sigmoid Colon: L groin -rectum: Pubic region -transverse colon: Lower epigastric
34
Mid/hindgut arterial supply for each region of large intestine
From SMA @L1: * Caecum/Appendix = Caecal & Appendicular arteries, respectively (From Ileocolic a.) * Ascending Colon = Right Colic a. * Proximal 2/3 Trans. Colon = Middle Colic & Marginal a. From IMA @L3: * Distal 1/3 Trans. Colon = Marginal & Left Colic a * Descending Colon = Left Colic a. * Sigmoid Colon = Sigmoid a.
35
Label the Barium contrast radiographs
Lecture Slide
36
Compare the midgut and hindgut arterial supply ANS nervous supply Venous drainage Lymphatic drainage
Midgut arterial supply: * Branches of SMA @L1 ANS nervous supply * Superior Mesenteric Plexus @L1 Venous drainage SMV Lymphatic drainage * Pre‐aortic Sup. Mesenteric nodes @L1 Hindgut: arterial supply: * Branches of IMA @L3 ANS nervous supply * Inferior Mesenteric Plexus @L3 Venous drainage IMV Lymphatic drainage * Pre‐aortic Inf. Mesenteric nodes @L3
37
Hindgut: Rectum -purpose -divided into?
* Final storage depot Retroperitoneal: (Can divide into 3rds) * Sup. 1/3 = covered in visceral peritoneum Ant. & Lat. Surfaces * Mid. 1/3 = peritoneum on Ant. Surface only * Inf. 1/3 = Infraperitoneal
38
Hindgut: Rectum Arterial Venous ANS nervous Lymphatics
Arterial: * Superior Rectal branches of IMA (@L3) * (Middle Rectal branch of Internal Iliac) * Inferior Rectal branch of Internal Pudendal Venous Drainage = Arterial Supply (just back the other way) HOWEVER…: * Sup. Rectal v. – IMV – Portal Vein * Mid. & Inf. Rectal v. – Internal Iliac – Common Iliac – IVC (PORTAL SYSTEMIC ANASTAMOSIS!) ANS Nervous Supply: Proximal = Inf. Mesenteric Plexus @L3 Distal = Inferior/Superior Hypogastric Plexus Lymphatics: Proximal = To Pre‐aortic nodes @ L3 Distal = To Internal Iliac nodes
39
Draw the portal system diagram
Lecture Slide
40
Autonomic Supply of the Gut
PARASYMPATHETIC: * Vagus Nerve (CN X) * Pelvic Splanchnic nerves S2‐4 SYMPATHETIC: * Thoracic, Lumbar and Sacral Splanchnic nerves * From T5‐L2 sympathetic ganglia
41
Autonomic Supply of the Gut for each region (foregut, midgut, hindgut) plexus sympathetic parasympathetic
Foregut plexus: Celiac sympathetic: Greater splanchnic T5-9 parasympathetic: Vagus X Mid gut plexus: Superior mescenteric sympathetic: Lesser splanchnic T10-11 parasympathetic: vagus X Hindgut plexus: Inferior mescenteric sympathetic: Lumbral/sacral splanchnic L1-L2 parasympathetic: Pelvic splanchnic S2-S4
42
Referred pain
Pain is referred back to the origin spinal levels of the Sympathetic supply via afferent fibres and then via the dorsal root (along with somatic afferents). Unlike somatic peripheral nerves, there is no specific point of reference so pain is spread around the corresponding dermatone
43
Where is pain felt in each region, the nerves and the spinal region Foregut, midgut, hindgut
Foregut: ‐ T5 9 (Greater splanchnic) ‐ Pain to Epigastric region Midgut: ‐ T10 11 (Lesser splanchnic) ‐ Pain to Umbilical region Hindgut: ‐ L1/2 (Lumbar / Sacral splanchnic) ‐ Pain to Suprapubic region
44
Referred Pain: Appendicitis pain movement explained
1. Appendix becomes enflamed 2. Afferent sympathetic fibres refer back to T10 11 dermatomes 3. Broad diffuse pain experienced around the umbilical region 4. Appendix becomes so enflamed that it contacts and starts aggravating the parietal peritoneum of body wall – Somatic Sensory Supply! 5. Pain now felt as Acute & Localised to Lower Right Quadrant (R. Inguinal)
45
Where does the greater and lesser omentum come off
Greater omentum comes from greater curve of stomach Lesser omentum comes from lesser curve of stomach

Digestive System (31 decks)

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