Part II. Anatomy of foregut derivatives pg 50-59 Flashcards
(238 cards)
1
Q
The esophagus is covered by ______ superior to thoracic diaphragm (esophageal plexus) and covered by (retroperitoneal) inferior to thoracic diaphragm?
NOTE: remember histology
A
- adventitia
- serosa
2
Q
Where are the 4 places where esophageal constriction is seen on fluoroscopy following a barium study?
A
- Upper Esophageal Sphincter where it is crossed by Cricopharyngeus M
- Where it is crossed by Aortic Arch
- Where it is crossed by L Main Bronchus
- Lower Esophageal Sphincter where it passes through thoracic diaphragm
3
Q
What is the clinical significance of the 4 esophageal constrictions?
A
- Foreign bodies tend to lodge here
- Swallowed corrosives do greatest damage here
- Carcinoma most frequently occurs here
- Damage resulting from endoscopic instruments most likely to occur here
4
Q
What is the point of passage for the esophagus through the diaphragm called?
A
Esophageal hiatus
5
Q
Where in the diaphragm does the esophagus pass through?
A
Right curs of thoracic diaphragm
6
Q
What attaches esophagus to thoracic diaphragm at hiatus?
A
Phrenicoesophageal ligaments
7
Q
What is the function of the Phrenicoesophageal ligaments?
A
- Permit independent movement during respiration and swallowing - Create a seal between thoracic and abdominal cavities
8
Q
Where is the esophagogastric junction located?
A
Left of midline at T11 (level with Xiphoid Process)
Note: esophageal hiatus is located just left of midline at T10
9
Q
The right border of the esophagogastric junction is continuous with what?
A
lesser curvature of stomach
10
Q
The left border of the esophagogastric junction is separated from fundus by what?
A
cardiac notch
11
Q
What structure of the esophagus prevents gastric reflux?
A
Cardiac sphincter
12
Q
What is the arterial supply to the esophagus?
A
- Esophageal Branch of L Gastric A (which branches from Celiac Trunk)
- L Inferior Phrenic A which branches from Abdominal Aorta
13
Q
What is the venous drainage of the esophagus superiorly?
A
drains to Azygos V via Esophageal Vs
14
Q
What is the venous drainage of the esophagus inferiorly?
A
drains to Hepatic Portal V via L Gastric V
15
Q
What are the primary nodes for the esophagus?
A
L gastric lymph nodes
16
Q
What are the secondary lymph nodes for the esophagus?
A
Celiac lymph nodes
17
Q
Lymph from the esophagus, ultimately drains where?
A
Thoracic duct
18
Q
Parasympathetic innervation to the esophagus is via ________.
A
Vagal trunks
19
Q
Presynaptic parasympathetic neurons from the vagal trunks, supplying the esophagus, synapse in which plexi?
A
myenteric and submucosal plexuses
20
Q
Sympathetic innervation to the esophagus is supplied by _________ from what spinal nerve roots?
A
Greater Splanchnic N (T5-T9)
21
Q
Presynaptic sympathetic neurons supplying the esophagus will synapse in what ganglion?
A
Celiac
22
Q
How do postsynaptic sympathetic neurons supplying the esophagus get from the celiac ganglion to the esophagus?
A
follow periarterial plexus
23
Q
Is the stomach intraperitoneal or retroperitoneal?
A
Intraperitoneal
24
Q
What abdominal quadrant is the stomach mostly located in?
A
Upper left abdominal quadrant
25
What is the function of the stomach?
- initiate digestion
- Blend food and digestive enzymes into chyme
- food reservoir (can hold up to 2-3 liters of food in an adult)
26
What are the internal ridges of the stomach called and what function do they have?
Rugae: increase surface area for digestion
27
Where is the cardia of the stomach located?
2cm left of midline at 6th costal cartilage (T11)
28
Where is the fundus of the stomach located?
under left dome of diaphragm superiorly to left 5th intercostal space
29
Where is the cardiac notch of the stomach located?
between esophagus and fundus
30
What is the pyloric antrum?
The structure in the pyloric part of the stomach that is a wide funnel-shaped extension of the body
31
What is the pyloric canal?
The narrower reaction in the pyloric part of the stomach that leads from the pyloric antrum to the sphincter
32
Where is the pyloric sphincter?
Where the stomach and duodenum meet
33
What is the function of the pyloric sphincter?
It is the thick circular muscle that regulates exit from stomach into duodenum
34
The concave border on right side of stomach
Lesser curvature
35
The convex border on left side of stomach
Greater curvature
36
What is the sharp indentation on the lesser curvature of the stomach at the junction of the body and the pyloric part of the stomach?
Angular Incisure
37
What is the primary arterial supply along lesser curvature of stomach?
L Gastric A branches directly from Celiac trunk
38
Very small artery that anastomoses with L Gastric A along lesser curvature?
R Gastric A usually branches from Proper Hepatic A
39
What arteries supply greater curvature of stomach in greater omentum
R Gastroepiploic A (gastro-omental) which and anastomoses with L Gastroepiploic A (gastro-omental) along greater curvature of stomach
40
Right gastroepiploic artery is a branch of _______ while left gastroepiploic artery is a branch of _______.
- Right Branches from Gastroduodenal A
| - Left Branches from Splenic A
41
What are the 4-5 very small arteries branching from splenic artery and supplying fundus of stomach?
Short gastric arteries
42
Venous drainage fo the stomach parallels the arteries supplying it and all eventually drain to where?
The liver
43
The left and right gastric veins drain into where?
Hepatic portal vein
44
Short Gastric V and L Gastroepiploic Vs drain to which vein before draining into hepatic portal vein?
Splenic vein
45
R Gastroepiploic V drains to which vein before draining to the hepatic portal vein?
Superior mesenteric vein
46
Primary lymphatic drainage on lesser curvature of the stomach is to _______.
Gastric nodes
47
Primary lymphatic drainage on greater curvature of the stomach is to _______.
Gastroepiploic nodes
48
Secondary lymphatic drainage for the stomach is to _______.
Celiac nodes
49
Lymphatic drainage of the stomach ultimately goes where?
To the thoracic duct
50
Parasympathetic innervation to the stomach is via _______.
Anterior/Posterior Vagal Trunks
51
Presynaptic parasympathetic neurons enter the abdomen via ______ and synapse on postsynaptic neurons in the __________ in the stomach.
- esophageal hiatus
| - myenteric/submucosa ganglia
52
What is the result of parasympathetic innervation to the stomach?
- Increase acid secretion
| - increase rate of emptying
53
Sympathetic innervation to the stomach is via ________ from what spinal nerve levels?
Greater splanchnic nerve (T6-T9)
54
Presynaptic sympathetic neurons that supply the stomach will synapse on postsynaptic neurons in the _______
Celiac ganglion
55
How do the axons of postsynaptic neurons get from the celiac ganglion to the stomach to innervate it?
They pass in tunica adventitia of arterial vessels to the stomach
56
Where does the duodenum begin and end?
It is C-shaped, begins at pylorus and ends at duodenojejunal junction (L2 level)
NOTE: it is the first, shortest, widest and most fixed region of small intestine (25cm)
57
Is the duodenum retroperitoneal or intraperitoneal?
Considered mostly retroperitoneal (the first 2cm are intraperitoneal)
58
What are the 4 parts of the duodenum?
- superior (1st) part
- Descending (2nd) part
- Inferior (3rd) part
- Ascending (4th) part
59
The superior part of the duodenum is covered anteriorly by ______ and posteriorly by ______.
- parietal peritoneum
| - adventitia
60
The superior part of the duodenum is attached to the liver by what structure?
Hepatoduodenal L (part of Lesser Omentum)
61
The superior part of the duodenum, where is ascends from the pylorus, is overlapped by what two structure?
Liver and gallbladder
62
The descending part of the duodenum curves around what structure?
Right side of head of pancreas
63
What structures are found in the descending part of the duodenum?
- Major duodenal papilla
| - minor duodenal papilla (although not always present)
64
What is the major duodenal papilla?
Internal opening of Common Bile Duct and Main Pancreatic Duct
65
What is the hepatopancreatic ampulla?
External union of common bile duct and main pancreatic duct
66
What is the Minor Duodenal Papilla?
Internal opening if Accessory Pancreatic Duct is present
67
The inferior part of the duodenum is where it begins to cross to the left. At what vertebral level does this happen?
L3
68
What vascular bundle passes anterior to the inferior part of the duodenum?
Superior Mesenteric AV
69
What structures are immediately superior to the inferior part of the duodenum?
Pancreatic head and Uncinate Process
70
The ascending part of the duodenum rise from and to what vertebral level?
from L3 vertebra to superior border of L2
71
What landmark denotes the end of the duodenum?
duodenojejunal junction at the point of acute angle
72
The ascending part fo the duodenum is supported by what?
suspensory muscle of duodenum (ligament of Trietz)
73
What happens to the acute angle of the duodenum when the suspensory muscle of duodenum (ligament of Trietz) contracts?
widens the angle of flexure facilitating movement through that part of the duodenum (not such a sharp angle)
74
What Artery Supplies duodenum proximal to Major Duodenal Papilla?
Superior Pancreaticoduodenal A from Gastroduodenal A
75
What Artery supplies the duodenum distal to Major Duodenal Papilla?
Inferior Pancreaticoduodenal A from Superior Mesenteric A (SMA)
76
What two arteries supplying the duodenum create an anastomosis between Celiac Trunk and SMA?
Superior and inferior pancreaticoduodenal arteries
77
What supplies blood from the distal esophagus to the major duodenal papilla (the embryonic foregut)?
Celiac trunk
78
What supplies blood from the major duodenal papilla to near the left colic flexure (embryonic midgut)?
Superior mesenteric artery
79
The venous drainage of the duodenum flows the arteries and drains to the __________.
Hepatic portal vein
80
Anteriorly, lymph from the duodenum drains to ______ and then ______.
- Pancreaticoduodenal lymph nodes
| - pyloric nodes
81
Posteriorly, lymph from the duodenum drains to _______.
Superior Mesenteric nodes
82
What are the Secondary nodes for the duodenum?
Celiac lymph nodes
83
Lymph from the duodenum ultimately drains where?
Lymphatic duct
84
Parasympathetic innervation to the duodenum is via ________.
Posterior Vagal Trunk
85
Sympathetic innervation to the duodenum is via ______ and ______, originating from what spinal nerve levels?
Greater and Lesser Splanchnic N (originating in T8-T10)
86
What is the largest gland in the body?
Liver
87
In what abdominal quadrant is the liver mostly located?
Upper right quadrant
88
What are the main functions of the liver?
- Carbohydrate metabolism and storage (glycogen)
- Plasma protein and lipoprotein synthesis and secretion
- Bile formation and secretion
- Drug and alcohol detoxification
89
What are the surfaces of the liver?
- Diaphragmatic surface - anterosuperior and convex aspect
| - visceral surface - posteroinferior and flat/concave aspect
90
What is the space that is the Anterosuperior extension of Greater Sac between liver and diaphragm?
Subphrenic recess
91
The subphrenic recess is separated into right and left by what structure?
Falciform ligament
92
What is the space that is the Inferior extension of Greater Sac between liver & R Kidney/Suprarenal gland?
Hepatorenal recess
93
The diaphragmatic surface of the liver is covered by _______ except posteriorly at the ________
- visceral peritoneum
| - bare area of the liver
94
At the bare area of the liver, the liver is in direct contact with what?
Thoracic diaphragm
95
The anterior and posterior peritoneal reflections from liver to thoracic diaphragm that outline bare area of liver are called what?
Coronary ligament
NOTE: forms a “crown” on top of the liver
96
The convergent of the anterior/posterior coronary ligament is called what?
Triangular ligament
Right side:
Left side: Falciform L and Lesser Omentum contributes
97
The visceral surface of the liver is covered by _______ except under ________ and at ________.
- visceral peritoneum
| - under Gallbladder : at porta hepatis
98
What is the Transverse fissure between caudate and quadrate lobes?
Porta hepatis
99
What is the significance of the porta hepatis?
It is the Entry/exit for Hepatic Portal V, Proper Hepatic A, Common Hepatic duct with the liver
100
The liver has 4 anatomical lobes. What are they?
- left lobe
- right lobe
- caudate lobe
- quadrate lobe
101
What anatomical lobe of the liver is left of Falciform L, Ligamentum Teres and Ligamentum Venosum
Left lobe
102
What anatomical lobe of the liver is right of IVC and Gall Bladder fossa?
Right lobe
103
What anatomical lobe of the liver is between Ligamentum Venosum and IVC?
Caudate lobe
104
What anatomical lobe of the liver is between Gall Bladder fossa and Ligamentum Teres
Quadrate lobe
105
What is the caudate process?
extension of Caudate lobe of the liver connecting it to right lobe
106
The liver has 2 functional lobes. What are they and what separates them?
Right and left separated by vertical line running through IVC and Gall Bladder fossa
107
Why are the functional lobes of the liver divided the way they are?
Because each has its own blood supply and venous/biliary drainage
108
Ligamentum teres (round ligament of the liver) is the remnant of what fetal structure?
Umbilical vein which Delivered oxygenated and nutrient rich blood from placenta to fetus
109
Ligamentum venous is the remnant of what fetal structure?
Ductus venosus which allowed placental blood to largely bypass liver by shunting directly to IVC
110
Where is the Ligamentum venosum located?
on visceral surface of the liver between caudate lobe and left lobe
111
Where is Ligamentum Teres located?
on free edge of Falciform L
112
Thick free edge of lesser omentum surrounding portal triad structures?
Hepatoduodenal ligament
113
Thin broad sheet of lesser omentum spanning from liver to lesser curvature of stomach?
Hepatogastric ligament
114
What supplies about 75% of blood coming to liver?
Hepatic portal vein
115
What kind of blood is delivered to the liver via the hepatic portal vein?
nutrient rich, bilirubin rich, poorly oxygenated blood
116
The hepatic portal vein is the confluence of what veins?
Superior Mesenteric V, Splenic V (Inferior Mesenteric V) Gastric vv.
117
What supplies about 25% of blood coming to liver?
Proper hepatic artery
118
What kind of blood is delivered to the liver via the proper hepatic artery?
highly oxygenated arterial blood
119
Proper hepatic artery branches from ________.
Common Hepatic A (which branches from Celiac Trunk)
120
What is the location of the proper hepatic artery in relation to the common bile duct and the hepatic portal vein?
left of Common Bile Duct and anterior to Hepatic Portal V
121
Where does the proper hepatic artery split into the right and left hepatic arteries?
Near the porta hepatis
122
Venous drainage in the liver confluences into hepatic veins which drain to _______ just inferior to the thoracic diaphragm.
Inferior vena cava
123
Liver vascular supply functionally compartmentalizes the liver into how many segments?
8
124
Branches of ______ and ______ supply each vascular segment of the liver. These do not anastomose with each other and are considered end vessels.
Hepatic portal vein : proper hepatic artery
125
Branches of Hepatic V return in what relation to the vascular segments of the liver?
between the vascular segments
126
The compartmentalization of the liver segments and their vasculature, allows for what, clinically?
Lobectomies after trauma or disease
127
The liver produces what percentage of the lymph that passes through the thoracic duct?
50%
128
The primary nodes for lymphatic drainage of the liver?
Hepatic lymph nodes
129
The secondary nodes for lymphatic drainage of the liver?
Celiac lymph nodes
130
Lymphatic drainage of the liver, gallbladder, spleen and pancreas drains to the thoracic duct via what structure?
Chyle cistern
131
The liver is the largest effect organ innervated via what plexus?
Celiac
132
Sympathetic innervation to the liver is via what nerve? From what spinal nerve levels?
Greater Splanchnic N (T6-T9)
133
Presynaptic sympathetic neurons will synapse on postganglionic sympathetic neurons in the ______ to supply the liver.
Celiac ganglion
134
What does sympathetic innervation to the liver stimulate?
vasoconstriction in hepatic arteries and hepatic portal V
NOTE: does not seem to affect bile formation
135
Parasympathetic innervation to the liver is via what? Where do the preganglionic parasympathetic fibers synapse?
- Vagal trunks
| - synapse in the liver
136
What does parasympathetic innervation to the liver stimulate?
Dilates bile duct luminal diameter
137
Visceral afferents (pain) from the liver (and gallbladder) pass in splanchnic nerves (mainly right greater splanchnic nerve) back to ______ cord levels which will refer pain where?
- T6-T9
| - Pain refers to area between ribs 6-9 on right side
138
What substance does the liver produce as part of its digestive function?
Bile
139
What is bile?
a yellow-green secretion that emulsifies fat
140
What is the function of the gallbladder
stores and concentrates bile until it is released to duodenum
141
What are the components of the biliary duct system from smallest to largest?
Bile canaliculi (in liver) -> bile ducts(in liver) -> right and left hepatic ducts (in liver) -> common hepatic duct (from liver at porta hepatis) -> cystic duct (from gallbladder) -> common bile duct (convergence of common hepatic and cystic ducts)
142
microscopic channels present between rows of hepatocytes
Bile canaliculli
143
microscopic components of intrahepatic portal triads
Bile Ducts
144
What forms as the convergence of intrahepatic bile ducts
Right and left hepatic ducts
145
convergence of R/L Hepatic Ducts at porta hepatis
Common Hepatic Duct
146
What transfers bile to/from gallbladder?
Cystic duct
147
the convergence of Common Hepatic and Cystic Ducts
Common Bile Duct
148
What is the path of the common bile duct?
Passes through Hepatoduodenal L and descends posterior to duodenum
149
The common hepatic bile duct joins with ________ to form _________ and open in the posterior duodenal wall at _______.
- Main Pancreatic Duct
- Hepatopancreatic Ampulla
- Major Duodenal Papilla
150
What is present at the distal end of the common bile duct to regulate the release of bile from the gallbladder?
Sphincter of common bile duct
151
Where is the gallbladder located?
In the gallbladder fossa on visceral surface of liver and sits on the superior part of the duodenum
152
The shallow fossa at the junction of the right and left functional lobes of the liver?
Gallbladder fossa
153
What is the bile storage capacity of the gallbladder?
50 mL
154
The wide blunt end of the gallbladder that projects from anterioinferior border of the liver?
Fundus
155
The fundus of the gallbladder contacts the anterior body wall just below the tip of what costal cartilage?
Right 9th
156
The part of the gallbladder that is adjacent to visceral surface of the liver, transverse colon and duodenum
Body
157
The narrow, tapered region of the gallbladder near the porta hepatis?
Neck
158
What is the spiral valve?
The mucosa in the cystic duct that spirals to form a valve that is responsive to constriction of sphincter at distal end of common bile duct
159
What supplies blood to the gallbladder?
Cystic artery (descending aorta -> celiac trunk -> proper hepatic artery -> right hepatic artery -> cystic artery)
160
Venous drainage of the gallbladder is through cystic veins which either drain to ______ or _______.
Right hepatic vein : directly to the liver
161
The primary nodes for lympathic drainage of the gallbladder?
Cystic and hepatic lymph nodes
162
The secondary nodes for lympathic drainage of the gallbladder?
Celiac lymph nodes
163
Lymphatic drainage of the gallbladder drains to the thoracic duct via what structure?
Chyle cistern
164
The gallbladder is innervated via what plexus?
Celiac
165
Parasympathetic innervation to the gallbladder is via what?
Vagal trunks
166
Parasympathetic innervation of the gallbladder stimulates what?
Contraction of gallbladder and relaxation of sphincters at ampulla
167
The hormone produced by the duodenum in response to a fatty meal that stimulates contraction of gallbladder and relaxation of sphincters at ampulla
cholecystokinin (CCK)
168
Sympathetic innervation to the gallbladder is via what nerve? What spinal nerve levels contribute to innervation?
Greater Splanchnic N (T6-T9)
169
Sympathetic innervation of the gallbladder stimulates what?
Relaxation of gallbladder and contraction of sphincters at ampulla
170
The largest lymphatic organ in the body
The spleen
171
Is the spleen intraperitoneal or retroperitoneal?
Intraperitoneal
172
What abdominal quadrant is the spleen in?
Upper left
173
What rib level is the spleen located at?
9-11
174
The spleen is surround entirely by ________ except at the ________.
- Visceral peritoneum
| - hilum
175
What structures surround the spleen and where in relation to it?
- Stomach is anterior
- thoracic diaphragm is posterior
- L kidney and pancreas are medial
- L colic flexure is inferior
176
The rounded convex surface of the spleen is adjacent to what structure?
Thoracic diaphragm
177
Describe the anterior superior borders of the spleen?
Sharper and notched
178
Describe the posterior and inferior border of the spleen?
Rounded and smooth
179
What is the primary function of the spleen?
Filter blood (both physically and immunologically)
180
Is the spleen a vital organ?
No
181
How does the spleen respond to dynamic blood flow?
Expands and contracts somewhat dynamically
182
What structure spans from the spleen to the greater curvature of the stomach?
Gastrosplenic ligament
183
What arteries are located in the gastrosplenic ligament?
Short Gastric A and L Gastroepiploic A
184
What structure spans from spleen to posterior wall near L kidney?
Splenorenal ligament
185
What vascular bundle is located in the splenorenal ligament?
Splenic AV
186
What is the arterial supply to the spleen?
Splenic artery (largest branch of celiac trunk)
187
The splenic artery is a tortuous artery that passes along the superior border of the ________.
Pancreas
188
The splenic artery, which is in the splenorenal ligament, splits into about 5 branches near what landmark?
Splenic hilum
189
The convergence of several venous tributaries at the splenic hilum?
Splenic vein
190
The splenic vein is joined by ________ and then passes posteriorly to the ________.
- Inferior mesenteric vein
| - pancreas
191
After the plenum vein and the inferior mesenteric vein join, they are subsequently joined by ________ to form the hepatic portal vein.
Superior mesenteric vein
192
What are the primary nodes fro lymphatic drainage of the spleen?
Pancreaticosplenic lymph nodes
193
What are the secondary node for lymphatic drainage of the spleen?
Celiac or superior mesenteric lymph nodes
194
The spleen is innervated by what plexus?
Celiac plexus
195
Sympathetic innervation of the spleen is via what? Which vertebral levels contribute to it?
Greater Splanchnic N (T6-T8)
196
Preganglionic sympathetic neurons supplying the spleen will synapse on postganglionic sympathetic neurons where?
Celiac ganglion
197
Sympathetic innervation of the spleen stimulates what?
Vasomotor and stimulate splenic contraction
198
Parasympathetic innervation to the spleen stimulates what?
HAHA...trick question!!
| There is no apparent parasympathetic innervation to the spleen
199
Is the pancreas intraperitoneal or retroperitoneal?
Retroperitoneal
200
The pancreas is located posterior to the stomach at what vertebral level?
L1-L2
201
What organ is to the right of the pancreas? To the left?
duodenum on right and spleen on left
202
The pancreas has both endocrine and exocrine functions. What is it;s exocrine function?
digestive enzyme secretion and delivery to duodenum
203
The pancreas has both endocrine and exocrine functions. What is it’s endocrine function?
insulin/glucagon secretion and delivery to blood
204
What part of the pancreas is surrounded by the C-shaped duodenum?
The head of the pancreas
205
The head of the pancreas is located to the right of what artery?
Superior mesenteric artery
206
What part of the pancreas is located anterior to IVC, R Renal AV and L Renal V?
The head of the pancreas
207
The inferomedial extension of pancreatic head posterior to superior mesenteric artery?
Uncinate process
208
What structure courses through the posterosuperior portion of the head of the pancreas?
Common bile duct
209
The short segment of the pancreas that is located anterior to the superior mesenteric artery and vein.
Neck of the pancreas
210
Where in relation to the pancreas, do the Superior Mesenteric V and Splenic V merge to form Hepatic Portal V?
posterior to neck of the pancreas
211
What is the elongated left side of the pancreas that is located to the left of the superior mesenteric artery?
Body of the pancreas
212
The body of the pancreas is located transversely anterior to what arterial structure and at what vertebral level?
Abdominal Aorta and L2
213
The body of the pancreas is covered anteriorly by ________, posteriorly by _________.
- parietal peritoneum
| - adventitia
214
What part of the pancreas is located anterior to L Kidney and close to hilum of spleen?
Tail of the pancreas
215
How does the main pancreatic duct course through the pancreas?
From tail to head
216
The main pancreatic duct merges with the common bile duct to form what?
Hepatopancreatic Ampulla
217
What are present at the distal ends of the common bile duct, main pancreatic duct and hepatopancreatic ampulla?
Sphincters to regulate flow of bile & pancreatic juice into duodenum (and duodenal reflux)
218
The accessory pancreatic duct usually communicates with the major pancreatic duct, but when it does not, which is larger?
The accessory pancreatic duct which means that it carries more of the pancreatic juice in this scenario
219
What is the arterial supply to the tail of the pancreas?
Pancreatic arteries which are up to 10 small branches along length of Splenic A
220
What is the arterial supply to the superior aspect of the head of the pancreas?
Anterior/Posterior Superior Pancreaticoduodenal As which branch from Gastroduodenal A (indirectly from Celiac Trunk)
221
What is the arterial supply to the inferior aspect of the head of the pancreas?
Anterior/Posterior Inferior Pancreaticoduodenal As which branch from Superior Mesenteric A
222
Venous drainage of the pancreas is via ________.
Pancreatic veins
223
The pancreatic veins drain primarily to _____ and less so to _______ but ultimately , venous flows to ______.
- Splenic vein
- superior mesenteric vein
- hepatic portal vein
224
The primary nodes for lymphatic drainage of the pancreas are what?
Pancreaticosplenic nodes alone the splenic artery
225
Secondary nodes for lymphatic drainage of the pancreas are what?
Celiac, superior mesenteric and hepatic nodes
226
Sympathetic innervation to the pancreas is via what nerves? What spinal cord levels contribute?
Greater & Lesser Splanchnic N (T6-T10)
227
Preganglionic sympathetic neurons that supply the pancreas will synapse in one of two ganglia. What are they?
Celiac and Superior Mesenteric ganglia
228
What is the action of sympathetic innervation to the pancreas?
vasoconstriction and inhibition of pancreatic secretions
229
Pancreatic pain refers to what cord segments and their corresponding dermatomes?
(T6-10)
NOTE: Pain may also refer to the back between T10 and L2 vertebrae
230
Parasympathetic innervation to the pancreas is via what?
Vagal trunks and Celiac and Superior Mesenteric plexuses
231
What is the action of parasympathetic stimulation to the pancreas?
Increased pancreatic secretions
NOTE: pancreatic secretions are primarily stimulated by hormones
232
What are the three main branches of the celiac trunk?
- left gastric artery, left side of lesser curvature of the stomach
- splenic artery, spleen
- common hepatic artery
233
The left gastric artery is a branch off of the celiac trunk. It has one branch. What is it and what does it innervate?
Esophageal branch, inferior esophagus
234
The splenic artery has three branches. What are they and what do they supply?
- Pancreatic arteries, pancreas
- Short Gastric Artery, fundus of stomach
- L Gastroepiploic Artery, left side of greater curvature of stomach
235
The common hepatic artery has two branches. What are they and what do they supply?
- Proper Hepatic A, liver
| - Gastroduodenal A, stomach, duodenum, pancreas
236
The proper hepatic artery has 3 branches. What are they and what do they supply?
- R Gastric A, right side of lesser curvature of stomach
- R Hepatic A, right functional lobe of liver
- L Hepatic A, left functional lobe of liver
237
What is the branch off of the right hepatic artery and what does it supply?
Cystic A - gallbladder
238
The gastroscope also artery has 2 branches. What are they and what do they supply?
- Superior Pancreaticoduodenal A, pancreas and duodenum
| - R Gastroepiploic A, right side of greater curvature of stomach
