Lecture 9: Blood and Nerve Supply Flashcards
(67 cards)
What vertebral level does aorta enter the abdomen and where does it divide?
- Enters via aortic hiatus of diaphragm at T12
- Ends at L4 by dividing into right and left common iliacs

What are the unpaired visceral branches of the aorta, their spinal levels, and which embryologic region does each branch supply?
- Celiac (T12) - foregut
- Superior mesenteric (L1) - midgut
- Inferior mesenteric (L3) - hindgut

What are the paired visceral branches of the aorta and spinal levels?
- Suprarenal (L1)
- Renal (L1/L2)
- Gonadal (L2)
What are the paired parietal branches off the aorta and vertebral levels?
- Inferior phrenic (T12)
- Subcostal (T12)
- Lumbar (L1-L4)
What are the foregut derivatives, major artery supply, innervation, and referred pain region?
Organs: Esophagus, stomach, liver and pancreas, biliary apparatus, and proximal duodenum
Innervation: Greater splanchnic (T5-T9)
Artery: Celiac
Referred pain: Epigastrium

What are the midgut derivatives, major artery supply, innervation, and referred pain region?
Organs: Small intestine, cecum and appendix, ascending colon, right 1/2 of transverse colon
Innervation: thoracic splanchnic (T8-12)
Artery: Superior mesenteric
Referred pain: Umbilical region

What are the hindgut derivatives, major artery supply, innervation, and referred pain region?
Organs: Left 1/2 transverse colon, descending colon, sigmoid colon, rectum, superior anal canal
Innervation: Lumbar splanchnics (L1-L2)
Artery: Inferior mesenteric artery
Referred pain: Hypogastrium

What are the 3 branches off the celiac trunk?
1) Left gastric a
2) Splenic a
3) Common hepatic a
What is the blood supply to the liver off the celiac trunk?
Common Hepatic artery –> Proper hepatic artery branches into R. and L. Hepatic arteries. The cystic artery will usually branch off the right hepatic artery.

What are 2 vascular variations of the hepatic arteries?
1) Accessory or replaced right hepatic artery coming from SMA
2) Accessory or replaced left hepatic artery coming from left gastric a

What are the relationships of the right hepatic artery to the portal vein?
- Commonly right hepatic artery is anterior to portal vein
- Sometimes, rarely, can be posterior to portal vein

Explain the dual blood supply to the liver and what each supplies?
1) Hepatic portal vein (75-80%) - sustains liver parenchyma
2) Hepatic artery (20-25%) - sustains non-parenchymal structures (intrahepatic bile ducts)
What is the cystohepatic triangle (of Calot) made up of; significance?
- Cystic duct, common hepatic duct, and visceral surface of liver
- Where the Cystic artery is often found

What arteries anastomose at the lesser curvature of the stomach?
Left and right gastric arteries
What arteries anastamose at the greater curvature of the stomach?
Right and left gastro-omental arteries
What are the anastomses of the stomach formed by the left gastric artery?
Left gastric –> Right gastro-omental
Left gastric –> Left gastro-omental
Left gastric –> Right Gastric
Which artery supplying the stomach can be compromised with a posterior rupture from a peptice ulcer?
Gastroduodenal a.

What branches does the gastroduodenal artey give off to supply what part of pancreas and duodenum?
- Anterior and posterior superior pancreaticoduodenal arteries
- Supplies head of pancreas and 1st/2nd part of duodenum
What branches does the SMA give off to supply what part of pancreas and duodenum?
- Anterior and posterior inferior pancreaticoduodenal arteries.
- Supplies 3rd and 4th part of the duodenum
What arteries do the major blood supply for the tail, body, and neck of the pancreas and where do they arise from?
1) Dorsal pancreatic artery
2) Greater pancreatic artery
*Arise from the Splenic a.
What marks the transition from foregut to midgut?
The anastomosis between anterior and posterior superior pancreaticoduodenals w/ the anterior and posterior inferior pancreaticoduodenals.

Describe what the SMA does as it enters the middle of the colon, what vertebral level, what are its branches?
- Starts retroperitoneal, but then descends into the mesentery, supplies midgut at level of L1.
- Branches into:
- Jejunal as.
- Ileal as.
- Middle Colic - transverse colon
- Right Colic - superior part of ascending colon
- Ileocolic - lower part of ascending colon
- Appendicular - appendix

We will need to distinguish the Jejunal arteries from the Ileal arteies, what are the key features that will help us differentiate between the two?
Jejunum = long vasa recta w/ few arcades
Ileum = short vasa recta w/ many arcades

What are two of the common variation in the SMA colic arteries?
1) Absent middle colic replaced by large branch from left colic
2) Absent right colic artery










