Lecture 13

Question 1

There is some overlap between arterial supply of some regions of the gut. An example is the head and uncinate process of the pancreas. It is supplied by?

Answer 1

Coeliac trunk (superior pancreaticoduodenal arteries)
Sup. mesenteric artery (inferior pancreaticoduodenal arteries)

Question 2

What supplies, drains and drains lymph of the foregut?

Answer 2

coeliac trunk, splenic vein, coeliac nodes

Question 3

What supplies, drains and drains lymph of the midgut?

Answer 3

superior mesenteric artery, superior mesenteric vein, superior mesenteric nodes

Question 4

What supplies, drains and drains lymph of the hindgut?

Answer 4

inferior mesenteric artery, inferior mesenteric vein, inferior mesenteric nodes

Question 5

What consists the foregut

Answer 5

stomach, liver, gall bladder, pancreas, spleen, first and half of the second part of duodenum

Question 6

What consists the midgut

Answer 6

distal duodenum (from half of second part onwards), rest of small intestine, large intestine to 2/3 of transverse colon

Question 7

What consists the hindgut

Answer 7

from last 1/3 of transverse colon to anus

Note: rectum and anus mostly supplied by branches of internal iliac but still considered hindgut

Question 8

What is sympathetic and parasympathetic innervation of foregut?

Answer 8

Coeliac ganglion (supplied by greater thoracic splanchnic nerves)
Vagus

Question 9

What is sympathetic and parasympathetic innervation of midgut?

Answer 9

Superior mesenteric ganglion (supplied by lesser thoracic splanchnic nerves)
Vagus

Question 10

What is sympathetic and parasympathetic innervation of hindgut?

Answer 10

Inferior mesenteric ganglion (supplied by least thoracic splanchnic nerves)
Pelvic splanchnics (from the sacral splanchnics

Question 11

Are splanchnic nerves mostly sympathetic or parasympathetic?

Answer 11

Sympathetic (most) or para (pelvic)

Question 12

What does sympathetic/parasympathetic innervation do to gut motility?

Answer 12

Sympathetic - reduces motility and is vasoconstrictive

Parasympathetic - increases motility and secretion

Question 13

What is arterial supply of the stomach (divided by greater and lesser curvatures and superior/inferior)?

Answer 13

The lesser curvature - right gastric artery inferiorly and the left gastric artery superiorly.
The greater curvature - right gastroepiploic artery inferiorly and the left gastroepiploic artery superiorly

Question 14

What do the L and R gastroepiploic arteries branch off?

Answer 14

L - splenic artery

R - gastroduodenal artery

Question 15

What does the gastroduodenal artery branch off?

Answer 15

common hepatic artery

Question 16

What does the common hepatic artery turn into?

Answer 16

hepatic artery proper

Question 17

Where does the marginal artery extend from?

Answer 17

iliocolic branches of the superior mesenteric artery to sigmoid branches of the inferior mesenteric artery

Question 18

How do the three major veins draining the gut form the portal vein?

Answer 18

Inferior mesenteric vein joins splenic vein behind pancreas body
Superior mesenteric vein joins splenic vein behind pancreas head
Portal vein formed by joining of splenic and superior mesenteric veins

Question 19

What is the arterial supply of the rectum and anus?

Answer 19

Superior rectal (branch of inferior mesenteric)
Middle rectal (branch of internal iliac)
Inferior rectal (branch of internal iliac)
Middle sacral artery (arises at bifurcation of aorta in the common iliac arteries)

Question 20

What are the venous structures that drain blood from the rectum and anus?

Answer 20

rectal venous plexus

Question 21

What are the two types of rectal venous plexus?

Answer 21

internal (drain within wall)

external (drain outside muscle)

Question 22

What are the subdivisions of the internal and external venous plexus and what do they drain into?

Answer 22

internal - inferior mesenteric vein
upper external - inferior mesenteric
middle external - internal iliac vein
lower external - internal pudendal

Question 23

Where does rectum and anal lymph drain to?

Answer 23

all to preaortic and iliac nodes except for lower anal canal, which drains to superficial inguinal nodes

Question 24

What is the type of innervation of the rectum and anus?

Answer 24

autonomic except in lower anal canal where it is somatic

Question 25

Where does rectum and anus get its sympathetic and para innervation from?

Answer 25

sympathetic - lumbar sympathetic trunk | para - pelvic splanchnics

Question 26

What modality of somatosensation does sensory innervation of rectum and anus involve (in relation to pectinate line)?

Answer 26

stretch above pectinate line and pain/temp below

Question 27

What is arterial supply of the pancreas?

Answer 27

Mostly splenic artery but head and uncinate process also supplied by pancreaticoduodenal arteries

Question 28

Draw flow of blood from coeliac trunk to pancreticoduodenal to superior mesenteric

Answer 28

Pg 157

Question 29

What is venous drainage of the pancreas?

Answer 29

Mostly splenic vein but head and uncinate process also drained by pancreaticoduodenal veins

Question 30

What is lymph drainage of the pancreas?

Answer 30

coeliac nodes

Question 31

What is sympathetic and para innervation of the pancreas? Which bvs do they travel along?

Answer 31

Sympathetic - (greater) thoracic splanchnics Para - vagal Fibres travel as a plexus on the splenic and pancreaticoduodenal arteries

Question 32

Hepatic artery and portal vein enter the liver and travel together in structures called?

Answer 32

Portal triads (contain proper hepatic artery, hepatic portal vein, one or two small bile ductules of cuboidal epithelium, lymphatic vessels branch of the vagus nerve)

Question 33

Where does lymph pass through in the liver? Where does it drain into?

Answer 33

Pass through pores in walls of sinusoids (capillaries) to the Space of Disse (between sinusoids and hepatocytes). Drains into thoracic duct

Question 34

What is arterial supply of gall bladder?

Answer 34

cystic artery

Question 35

What is venous drainage of gall bladder? Where does its vein drain into?

Answer 35

cystic vein, which drains into right branch of portal vein