Vessels Flashcards Preview

Question 1

1

What is the name of the first part of the aorta?

What are the branches of arcus aortae?

Answer

aorta ascendens

arcus aortae:

truncus brachiocephalicus
- a. subclavia dextra
- a. carotis communis dextra
a. carotis communis sinistra
a. subclavia sinistra

in 10%: either as 4th branch/arcus aorticus: a. thyroidea ima → thyroid gland

Question 2

2

List the branches of the abdominal aorta in craniocaudal direction.

Where do they end (only paired branches)?

Answer

parietal branches

a. phrenica inferior (2) → diaphragm
aa. lumbales (8) → a. intercostales

visceral branches

truncus coeliacus below hiatus aorticus
a. mesenterica superior below pancreas
a. suprarenalis media (2) → adrenal glands
a. renalis (2) at L2 → a. suprarenalis inf.
a. testicularis/ovarica (2) → spermatic cord/ovaries
a. mesenterica inferior above bifurcatio aortae

end branches

a. sacralis mediana on sacrum → (5) a. lumbalis
a. iliaca communis at L4 → a. iliaca int./ext.

Question 3

3

List the branches of truncus coeliacus.

What does it supply?

Answer

⇒ supplies upper abdominal organs

a. gastrica sin. → anastomosis with a. gastrica dex. in curvatura minor
a. hepatica communis
a. splenica

Question 4

4

List the branches of a. hepatica communis

→ 2nd generation

Answer

a. hepatica propria → liver
- a. cystica → gall bladder
- a. gastrica dex. → anastomosis with a. gastrica sin. in curvatura minor
a. gastroduodenalis
- a. gastroomentalis dex. → anastomosis with a. gastroomentalis sin. in curvatura major
- a. pancreaticoduodenalis sup. ant./post. → LESSER RIOLAN anastomosis with inf. ant./post.

Question 5

5

List the branches of a. splenica.

Answer

rr. pancreatici + a. pancreatica dorsalis → corpus/tail of pancreas
a. gastroomentalis sin. → anastomosis with a. gastroomentalis dex. in curvatura major
aa. gastrici breves → cardia/fundus of stomach
rr. splenici → spleen

Question 6

6

List the branches of a. mesenterica superior.

What does it supply?

Answer

⇒ supplies distal duodenum, entire small intestine, large intestine until 2/3 of colon transversum

a. pancreaticoduodenalis inf.
- ant./post. → LESSER RIOLAN anastomosis with a. pancreaticoduodenalis sup. ant./post.
4-5 aa. jejunales + 12 aa. ileales → jejunum, ileum
a. colica media → GREATER RIOLAN anastomosis with a. colica sin.
a. colica dextra → colon ascendens
a. ileocolica

Question 7

7

List the branches of a. ileocolica.

Answer

r. colicus → colon ascendens
r. ilealis → ileum
a. appendicularis → appendix vermiformis
a. caecalis ant./post. → cecum

Question 8

8

List the branches of a. mesenterica inferior.

What does it supply?

Answer

⇒ supplies left colon

a. colica sin. → GREATER RIOLAN anastomosis with a. colica media → colon descendens
aa. sigmoideae → SUDECK anastomosis with a. rectalis sup. → colon sigmoideum
a. rectalis sup. → cf. aa. sigmoidea → upper part of rectum, corpus cavernosum recti

Question 9

9

Where are important arterial anastomoses in the abdominal cavity?

Answer

LESSER RIOLAN anastomosis: truncus coeliacus + a. mesenterica sup. via aa. pancreaticoduodenales
GREATER RIOLAN anastomosis: a. mesenterica sup./inf. via a. colica med./sin.
SUDECK anastomosis: anastomosis btw a. rectalis sup. + a. sigmoidea

Question 10

10

#1 - 5/6

Answer

1) pars abdominalis aortae

2) r. oesophagealis

3) truncus coeliacus

4) a. gastrica sin.

5+6) aa. gastricae breves

Question 11

11

#7 - 11

Answer

7) a. splenica

8) a. gastroomentalis sin.

9) a. pancreatica magna

10) a. caudae pancreatis

11) a. gastroomentalis dex.

Question 12

12

#12 - 16

Answer

12) a. splenica

13) a. gastrica dextra

14) a. hepatica communis

15) a. hepatica propria

16) a. cystica

Question 13

13

#17 - 21

Answer

17) a. gastroduodenalis

18) a. pancreatica dorsalis

19) a. supraduodenalis

20) a. pancreaticoduodenalis sup. post.

21) a. pancreaticoduodenalis sup. ant.

Question 14

14

#22 - 26/27

Answer

22) a. mesenterica sup.

23) a. pancreaticoduodenalis inf.

24) a. mesenterica inf.

25) a. colica sin.

26+27) aa. sigmoideae

Question 15

15

#28 - 32/33

Answer

28) a. rectalis inf.

29) a. rectalis sup.

30) a. colica med.

31) a. colica dex.

32+33) aa. jejunales

Question 16

16

#34 - 37

#35/36 is the same

Answer

34) a. ileocolica

35+36) aa. ileales

37) a. appendicularis

Question 17

17

List the tributaries of v. portae.

Where do they originate from?

Answer

⇒ receives blood from unpaired abdominal organs

v. cystica (from gall bladder)
vv. paraumbilicales (accompany lig. teres hepatis from abd. wall)
v. gastrica dex./sin. (from stomach)
v. pylorica (from pylorus)
v. pancreaticoduodenalis sup. post. (from head of pancreas)
v. splenica (from spleen, parts of pancreas/stomach)
v. mesenterica superior (from duodenum, small intestine, parts of colon/stomach)
v. mesenterica inferior (from colon/rectum)

Question 18

18

List the tributaries of v. splenica.

Answer

vv. gastricae breves (from fundus/upper part of curvatura major)
v. gastroomentalis sin.
v. gastrica posterior (not always)
vv. pancreaticae (esp. from tail of pancreas)

Question 19

19

List the tributaries of v. mesenterica superior.

Answer

v. gastroomentalis dex. + vv. pancreaticoduodenales
vv. pancreaticae (from head + corpus of pancreas)
vv. jejunales, ileales
v. ileocolica
v. colica dextra
v. colica media

Question 20

20

List the tributaries of v. mesenterica inferior.

Answer

v. colica sin.
v. sigmoidea
v. rectalis sup. (anastomosis with v. rectalis med./inf.)

Question 21

21

List the portocaval anastomoses.

Answer

btw esophagus/cardia
around navel
at rectum
retroperitoneal

Question 22

22

Which vessels from the portocaval anastomosis btw esophagus and cardia?

Which vv. belong to the portal, which to the caval system?

Why is it clinically relevant?

Answer

vv. gastricae (portal) + vv. esophageales (caval) → v. azygos/v. hemiazygos → v. cava superior

⇒ can cause esophageal varices

Question 23

23

Which vessels from the portocaval anastomosis around the navel?

Why is it clinically relevant?

Answer

vv. paraumbilicales → v. epigastrica sup./inf. → v. thoracoepigastrica/v. epigastrica superficialis → v. cava superior

⇒ can cause caput medusae syndrome

Question 24

24

Which vessels form the portocaval anastomosis at the rectum?

Which vv. belong to the portal, which to the caval system?

Why is it clinically relevant?

Answer

v. rectalis sup. (portal) + v. rectalis med./inf. (caval) → v. iliaca int. → v. cava inferior

⇒ can cause hemorrhages

Question 25

25

Give an example for a retroperitoneal portocaval anastomosis.

Answer

ex: v. mesenterica inf. + v. testicularis/ovarica → v. cava inf.

Question 26

26

#1 - 5/6

What is the clinical importance of 5/6?

Answer

1) v. azygos

2) v. hemiazygos

3) v. portae hepatis

4) v. hepatica

5+6) plexus venosus submucosus → site for esophageal varices

Question 27

27

#7/8 - 12

Answer

7+8) vv. oesophageae

9) v. phrenica inf.

10) v. gastrica inf.

11) v. splenica

12) v. renalis sin.

Question 28

28

#13 - 17

Answer

13) v. testicularis/ovarica

14) v. mesenterica inf.

15) v. mesenterica sup.

16) v. colica sup.

17) v. sigmoidea

Question 29

29

#18 - 22

What is the clinical importance of 20?

Answer

18) v. cava inf.

19) v. rectalis sup.

20) v. paraumbilicalis → site for caput medusae syndrome

21) v. epigastrica superificalis

22) v. iliaca communis

Question 30

30

#23 - 25/26

What is the clinical importance of 25/26?

Answer

23) v. epigastrica inf.

24) v. iliaca int.

25+26) vv. rectales inf. → site of hemorrhages

Question 31

31

List the parietal branches of a. iliaca interna.

What do they supply?

Answer

5 parietal branches ⇒ supply mm. of hip, pelvic diaphragm, external genitals, proximal adductors

a. iliolumbalis cf. own flashcard
aa. sacrales laterales
- rr. spinales → sacral canal, anastomose w/ a. sacralis mediana
a. obturatoria w/ n. obturatorius through canalis obturatorius cf. own flashcard
a. glutea superior through foramen piriforme → glutes
a. glutea inferior through foramen infrapiriforme → m. gluteus maximus

Question 32

32

List the branches of a. ileolumbalis

Answer

r. iliacus → m. iliacus, anastomoses w/ a. circumflexa ilium profunda
r. lumbalis → m. psoas + m. quadratus lumborum, anastomoses w/ a. lumbalis r. spinalis

Question 33

33

List the branches of a. obturatoria

Answer

r. pubicus → anastomoses w/ a. epigastrica inf.
r. anterior → symphysis + adductors, anastomoses w/ a. circumflexa femoris medialis
r. posterior → glutes + tuber ischiadicum
r. acetabularis → through incisura acetabula into lig. capitis femoris + head of femur

Question 34

34

List the visceral branches of a. iliaca interna.

What do they supply?

Answer

6 visceral branches ⇒ supply the pelvic organs

a. umbilicalis
a. vesicalis inferior → fundus of urinary bladder, prostate gland + seminal vesicles/ vagina
a. uterina
a. vaginalis
a. rectalis media → branches at ampulla recti
a. pudenda interna through foramen infrapiriforme + ischiadicum minus to side of fossa ischioanalis into canalis pudendalis (= ALCOCK canal)

Question 35

35

List the branches of a. umbilicalis

Answer

distal part obliterates to lig. umbilicale mediale
proximal:
- aa. vesicales superiores → apex of urinary bladder
- a. ductus deferentis

Question 36

36

List the branches of a. uterina

Answer

rr. vaginales
r. ovaricus anastomoses w/ a. ovarica (from aorta)
r. tubarius
rr. helicini → uterus

Question 37

37

List the branches of a. pudenda interna.

Answer

a. rectalis inferior → anus, anastomoses w/ a. rectalis media
a. perinealis
- rr. scrotales/labiales posteriores
a. bulbi penis/vestibuli → bulbus of corpus spongiosum penis
a. profunda penis/clitoridis → corpora cavernosa
a. dorsalis penis/clitoridis → penis clitoris

Question 38

38

What is a corona mortis?

Answer

corona mortis (= crown of death) exists if anastomosis btw a. obturatoria + a. epigastrica inf. originates entirely from a. epigastrica inf. / a. iliaca ext.

⇒ used to lead to fatal bleedings in surgeries of inguinal hernias

Question 39

39

Where should intramuscular injections in the m. gluteus medius be done?

Answer

upper lateral quadrant to avoid accidental intravascular injection

Question 40

40

Which venous plexuses are formed by v. iliaca int.?

Clinical relevance?

Answer

plexus in lesser pelvis
plexus venosus rectalis: connection to v. portae (cf. hemorrhages)
plexus venosus vesicalis: on fundus of urinary bladder, in connection w/ plexus venosus rectalis + prostaticus/uterinus + vaginalis
plexus venosus uterinus + vaginalis surround uterus + vagina
plexus venosus prostaticus: incorporates v. dorsalis profunda penis, anastomoses to venous vertebral plexuses
⇒ often metastases in vertebral column in case of prostate carcinomas

Question 41

41

List the branches of a. iliaca externa.

Answer

medial to m. iliopsoas under lig. inguinale to lacuna vasorum

a. epigastrica inf.: anastomoses w/ a. epigastrica sup.
a. circumflexa ilium profunda: anastomoses w/ r. iliacus of a. iliolumbalis

Question 42

42

List the branches of a. epigastrica inf.

Answer

r. pubicus: branch to symphysis, anastomoses w/ r. pubicus of a. obturatoria
a. cremasterica: through canalis inguinals → m. cremaster + coats of testes
a. lig. teretis uteri: (only in females) together w/ lig. teres uteri through canalis inguinalis

Question 43

43

List the branches of a. thoracica interna.

It is covered by which structures?

Answer

covered by fascia endothoracica + m. transversus thoracicus

rr. mediastinales: → sup. + ant. inf. mediastinum
rr. thymici
rr. bronchiales, rr. tracheales
a. pericardiophrenica: together w/ n. phrenicus btw pericardium + pleura → diaphragm
rr. perforantes → chest musc.
rr. intercostales ant. of intercostal spaces 1-6: anastomose w/ aa. intercostales post.

at level of 6^th, 7^th rib branch into:

a. musculophrenica → intercostal space 7-10 + diaphragm
a. epigastrica sup.: through trig. sternocostale to diaphragm, anastomoses w/ a. epigastrica inf. (collateral circulation to aorta)

Question 44

44

List the tributaries of v. cava inf.

Answer

vv. hepaticae (dex., intermed., sin., often truncus hepaticus sin.)
v. renalis sin. + dex.
BUT: v. renalis sin. receives the next 3
v. suprarenalis dex.
v. testicularis/ovarica dex.
v. phrenica inf. dex.
v. sacralis mediana
vv. iliacae communes

Question 45

45

Which vessels form the v. cava sup.

Answer

collects blood from head, neck, arms, thorax + lumbal region

forms from vv. brachiocephalicae

Question 46

46

Which veins form v. brachiocephalica?

How is the structure called?

Answer

v. subclavia
v. jugularis int./

⇒ angulus venosus

Question 47

47

Which vessels drain into v. brachiocephalica?

Answer

v. thyroidea inf.
v. vertebralis
vv. throcicae int.
+ v. intercostalis suprema
+ vv. from thymus, pericardium, bronchi, trachea, esophagus, intercostal spaces

Question 48

48

Which vessels form v. jugularis ext.?

Which vessel drains into it?

Where does it drain into?

Answer

on m. sternocleidomastoideus

formed by:

v. occipitalis
v. auricularis post.

receives:

v. jugularis ant. (from region around hyoid bone)

→ v. subclavia/v. jugularis int.

Question 49

49

Which vessels drain into v. jugularis int.?

Answer

v. opthalmica sup.
v. facialis
plexus pterygoideus
vv. pharyngeales
v. lingualis
v. thyroidea sup./med.
v. sternocleidomastoidea

Question 50

50

Where does a. carotis branch into a. carotis ext. + int.?

What is important abt that spot?

Answer

in trigonum caroticum

here baroreceptors innervated by n. glossopharyngeus

Question 51

51

List all branches of a. carotis ext.

Mnemonic?

Answer

Some Anatomists Like Freaking Out Poor Medical Students

S: superior thyroid a. → thyroid
A: ascending pharyngeal a. → pharynx, dura mater
L: lingual a. → tongue
F: facial a. → tuba, lips, ext. nose
O: occipital a. → dura mater
P: posterior auricular a. → n. facialis
M: maxillary a. → own card
S: superficial temporal a. → parotid, ear, eyes

Question 52

52

Since a. maxillaris has A LOT of branches: how can it be subdivided?

Answer

pars mandibularis (5)
pars pterygoidea (4)
pars pterygopalatina (5)

Question 53

53

Which regions are supplied by pars mandibularis of a. maxillaris?

Answer

mandible, middle ear, lower jaw, dura mater

a. auricularis prof. → mandible
a. tympanica ant. → middle ear
a. alveolaris inf. → teeth + gingiva
a. meningea med. → dura mater

Question 54

54

Which regions are supplied by pars pterygoidea of a. maxillaris?

Answer

mm. of mastication, cheeks

a. masseterica
aa. temporales ant./post.
rr. pterygoidei
a. buccalis

Question 55

55

Which regions are supplied by pars pterygopalatina of a. maxillaris?

Answer

teeth of upper jaw, palate, nasal cavity

a. alveolaris sup. post.
a. infraorbitalis
a. palatina descendens
a. canalis pterygoidei
a. sphenopalatina

Question 56

56

Where does a. subclavia originate from?

Answer

left: arcus aorticus
right: truncus brachiocephalicus

Question 57

57

What are the branches of a. subclavia?

Answer

a. vertebralis → parts of brain
a. thoracica int.
truncus thyrocervicalis
truncus costocervicalis

Question 58

58

List the branches of truncus thyrocervicalis.

Answer

a. thyroidea inf.
a. cervicalis asc.
a. transversa colli
r. prof.
r. sup.
a. suprascapularis

Question 59

59

Which branches are given off by truncus costocervicalis?

Answer

a. intercostalis suprema
a. cervicalis profunda

Question 60

60

Where do v. azygos and hemiazygos drain into?

Which structure is often also formed?

Answer

v. hemiazygos → v. azygos → v. brachiocephalica sin.

often: v. hemiazygos accessoria formed by v. intercostales (can drain into either of theim)

Question 61

61

Which vessels drain into v. azygos, hemiazygos resp.?

Also list 2nd generation.

Answer

vv. mediastinales (vv. oesophageales, bronchiales, pericardiacae)
vv. intercostales post. + r. dorsalis esp.
- r. spinalis (spinal cord)
- plexus venosus vertebrales ext. (covering vertebrae)

Vessels Flashcards Preview

Anatomy II > Vessels > Flashcards

What is the name of the first part of the aorta? What are the branches of arcus aortae?

aorta ascendens arcus aortae: truncus brachiocephalicus a. subclavia dextra a. carotis communis dextra a. carotis communis sinistra a. subclavia sinistra ​in 10%: either as 4th branch/arcus aorticus: a. thyroidea ima → thyroid gland

List the branches of the abdominal aorta in craniocaudal direction. Where do they end (only paired branches)?

List the branches of truncus coeliacus. What does it supply?

⇒ supplies upper abdominal organs a. gastrica sin. → anastomosis with a. gastrica dex. in curvatura minor a. hepatica communis a. splenica

List the branches of a. hepatica communis → 2nd generation

List the branches of a. splenica.

​​rr. pancreatici + a. pancreatica dorsalis → corpus/tail of pancreas a. gastroomentalis sin. → anastomosis with a. gastroomentalis dex. in curvatura major aa. gastrici breves → cardia/fundus of stomach rr. splenici → spleen

List the branches of a. mesenterica superior. What does it supply?

List the branches of a. ileocolica.

r. colicus → colon ascendens r. ilealis → ileum a. appendicularis → appendix vermiformis a. caecalis ant./post. → cecum

List the branches of a. mesenterica inferior. What does it supply?

⇒ supplies left colon a. colica sin. → GREATER RIOLAN anastomosis with a. colica media → colon descendens aa. sigmoideae → SUDECK anastomosis with a. rectalis sup. → colon sigmoideum a. rectalis sup. → cf. aa. sigmoidea → upper part of rectum, corpus cavernosum recti

Where are important arterial anastomoses in the abdominal cavity?

LESSER RIOLAN anastomosis: truncus coeliacus + a. mesenterica sup. via aa. pancreaticoduodenales GREATER RIOLAN anastomosis: a. mesenterica sup./inf. via a. colica med./sin. SUDECK anastomosis: anastomosis btw a. rectalis sup. + a. sigmoidea

#1 - 5/6

1) pars abdominalis aortae 2) r. oesophagealis 3) truncus coeliacus 4) a. gastrica sin. 5+6) aa. gastricae breves

#7 - 11

7) a. splenica 8) a. gastroomentalis sin. 9) a. pancreatica magna 10) a. caudae pancreatis 11) a. gastroomentalis dex.

#12 - 16

12) a. splenica 13) a. gastrica dextra 14) a. hepatica communis 15) a. hepatica propria 16) a. cystica

#17 - 21

17) a. gastroduodenalis 18) a. pancreatica dorsalis 19) a. supraduodenalis 20) a. pancreaticoduodenalis sup. post. 21) a. pancreaticoduodenalis sup. ant.

#22 - 26/27

22) a. mesenterica sup. 23) a. pancreaticoduodenalis inf. 24) a. mesenterica inf. 25) a. colica sin. 26+27) aa. sigmoideae

#28 - 32/33

28) a. rectalis inf. 29) a. rectalis sup. 30) a. colica med. 31) a. colica dex. 32+33) aa. jejunales

#34 - 37 #35/36 is the same

34) a. ileocolica 35+36) aa. ileales 37) a. appendicularis

List the tributaries of v. portae. Where do they originate from?

List the tributaries of v. splenica.

vv. gastricae breves (from fundus/upper part of curvatura major) v. gastroomentalis sin. v. gastrica posterior (not always) vv. pancreaticae (esp. from tail of pancreas)

List the tributaries of v. mesenterica superior.

v. gastroomentalis dex. + vv. pancreaticoduodenales vv. pancreaticae (from head + corpus of pancreas) vv. jejunales, ileales v. ileocolica v. colica dextra v. colica media

List the tributaries of v. mesenterica inferior.

v. colica sin. v. sigmoidea v. rectalis sup. (anastomosis with v. rectalis med./inf.)

List the portocaval anastomoses.

btw esophagus/cardia around navel at rectum retroperitoneal

Which vessels from the portocaval anastomosis btw esophagus and cardia? Which vv. belong to the portal, which to the caval system? Why is it clinically relevant?

vv. gastricae (portal) + vv. esophageales (caval) → v. azygos/v. hemiazygos → v. cava superior ⇒ can cause esophageal varices

Which vessels from the portocaval anastomosis around the navel? Why is it clinically relevant?

vv. paraumbilicales → v. epigastrica sup./inf. → v. thoracoepigastrica/v. epigastrica superficialis → v. cava superior ⇒ can cause caput medusae syndrome

Which vessels form the portocaval anastomosis at the rectum? Which vv. belong to the portal, which to the caval system? Why is it clinically relevant?

v. rectalis sup. (portal) + v. rectalis med./inf. (caval) → v. iliaca int. → v. cava inferior ⇒ can cause hemorrhages

Give an example for a retroperitoneal portocaval anastomosis.

ex: v. mesenterica inf. + v. testicularis/ovarica → v. cava inf.

#1 - 5/6 What is the clinical importance of 5/6?

1) v. azygos 2) v. hemiazygos 3) v. portae hepatis 4) v. hepatica 5+6) plexus venosus submucosus → site for esophageal varices

#7/8 - 12

7+8) vv. oesophageae 9) v. phrenica inf. 10) v. gastrica inf. 11) v. splenica 12) v. renalis sin.

#13 - 17

13) v. testicularis/ovarica 14) v. mesenterica inf. 15) v. mesenterica sup. 16) v. colica sup. 17) v. sigmoidea

#18 - 22 What is the clinical importance of 20?

18) v. cava inf. 19) v. rectalis sup. 20) v. paraumbilicalis → site for caput medusae syndrome 21) v. epigastrica superificalis 22) v. iliaca communis

#23 - 25/26 What is the clinical importance of 25/26?

23) v. epigastrica inf. 24) v. iliaca int. 25+26) vv. rectales inf. → site of hemorrhages

List the parietal branches of a. iliaca interna. What do they supply?

List the branches of a. ileolumbalis

r. iliacus → m. iliacus, anastomoses w/ a. circumflexa ilium profunda r. lumbalis → m. psoas + m. quadratus lumborum, anastomoses w/ a. lumbalis r. spinalis

List the branches of a. obturatoria

r. pubicus → anastomoses w/ a. epigastrica inf. r. anterior → symphysis + adductors, anastomoses w/ a. circumflexa femoris medialis r. posterior → glutes + tuber ischiadicum r. acetabularis → through incisura acetabula into lig. capitis femoris + head of femur

List the visceral branches of a. iliaca interna. What do they supply?

List the branches of a. umbilicalis

distal part obliterates to lig. umbilicale mediale proximal: aa. vesicales superiores → apex of urinary bladder a. ductus deferentis

List the branches of a. uterina

rr. vaginales r. ovaricus anastomoses w/ a. ovarica (from aorta) r. tubarius rr. helicini → uterus

List the branches of a. pudenda interna.

a. rectalis inferior → anus, anastomoses w/ a. rectalis media a. perinealis rr. scrotales/labiales posteriores a. bulbi penis/vestibuli → bulbus of corpus spongiosum penis a. profunda penis/clitoridis → corpora cavernosa a. dorsalis penis/clitoridis → penis clitoris

What is a corona mortis?

corona mortis (= crown of death) exists if anastomosis btw a. obturatoria + a. epigastrica inf. originates entirely from a. epigastrica inf. / a. iliaca ext. ⇒ used to lead to fatal bleedings in surgeries of inguinal hernias

Where should intramuscular injections in the m. gluteus medius be done?

upper lateral quadrant to avoid accidental intravascular injection

Which venous plexuses are formed by v. iliaca int.? Clinical relevance?

List the branches of a. iliaca externa.

medial to m. iliopsoas under lig. inguinale to lacuna vasorum a. epigastrica inf.: anastomoses w/ a. epigastrica sup. a. circumflexa ilium profunda: anastomoses w/ r. iliacus of a. iliolumbalis

List the branches of a. epigastrica inf.

r. pubicus: branch to symphysis, anastomoses w/ r. pubicus of a. obturatoria a. cremasterica: through canalis inguinals → m. cremaster + coats of testes a. lig. teretis uteri: (only in females) together w/ lig. teres uteri through canalis inguinalis

List the branches of a. thoracica interna. It is covered by which structures?

What is the name of the first part of the aorta?

What are the branches of arcus aortae?

aorta ascendens

arcus aortae:

truncus brachiocephalicus

a. subclavia dextra

a. carotis communis dextra

a. carotis communis sinistra

a. subclavia sinistra

in 10%: either as 4th branch/arcus aorticus: a. thyroidea ima → thyroid gland

List the branches of the abdominal aorta in craniocaudal direction.

Where do they end (only paired branches)?

List the branches of truncus coeliacus.

What does it supply?

⇒ supplies upper abdominal organs

a. gastrica sin. → anastomosis with a. gastrica dex. in curvatura minor

a. hepatica communis

a. splenica

List the branches of a. hepatica communis

→ 2nd generation

rr. pancreatici + a. pancreatica dorsalis → corpus/tail of pancreas

a. gastroomentalis sin. → anastomosis with a. gastroomentalis dex. in curvatura major

aa. gastrici breves → cardia/fundus of stomach

rr. splenici → spleen

List the branches of a. mesenterica superior.

What does it supply?

r. colicus → colon ascendens

r. ilealis → ileum

a. appendicularis → appendix vermiformis

a. caecalis ant./post. → cecum

List the branches of a. mesenterica inferior.

What does it supply?

⇒ supplies left colon

a. colica sin. → GREATER RIOLAN anastomosis with a. colica media → colon descendens

aa. sigmoideae → SUDECK anastomosis with a. rectalis sup. → colon sigmoideum

a. rectalis sup. → cf. aa. sigmoidea → upper part of rectum, corpus cavernosum recti

LESSER RIOLAN anastomosis: truncus coeliacus + a. mesenterica sup. via aa. pancreaticoduodenales

GREATER RIOLAN anastomosis: a. mesenterica sup./inf. via a. colica med./sin.

SUDECK anastomosis: anastomosis btw a. rectalis sup. + a. sigmoidea

1) pars abdominalis aortae

2) r. oesophagealis

3) truncus coeliacus

4) a. gastrica sin.

5+6) aa. gastricae breves

7) a. splenica

8) a. gastroomentalis sin.

9) a. pancreatica magna

10) a. caudae pancreatis

11) a. gastroomentalis dex.

12) a. splenica

13) a. gastrica dextra

14) a. hepatica communis

15) a. hepatica propria

16) a. cystica

17) a. gastroduodenalis

18) a. pancreatica dorsalis

19) a. supraduodenalis

20) a. pancreaticoduodenalis sup. post.

21) a. pancreaticoduodenalis sup. ant.

22) a. mesenterica sup.

23) a. pancreaticoduodenalis inf.

24) a. mesenterica inf.

25) a. colica sin.

26+27) aa. sigmoideae

28) a. rectalis inf.

29) a. rectalis sup.

30) a. colica med.

31) a. colica dex.

32+33) aa. jejunales

#34 - 37

#35/36 is the same

34) a. ileocolica

35+36) aa. ileales

37) a. appendicularis

List the tributaries of v. portae.

Where do they originate from?

vv. gastricae breves (from fundus/upper part of curvatura major)

v. gastroomentalis sin.

v. gastrica posterior (not always)

vv. pancreaticae (esp. from tail of pancreas)

v. gastroomentalis dex. + vv. pancreaticoduodenales

vv. pancreaticae (from head + corpus of pancreas)

vv. jejunales, ileales

v. ileocolica

v. colica dextra

v. colica media

v. colica sin.

v. sigmoidea

v. rectalis sup. (anastomosis with v. rectalis med./inf.)

btw esophagus/cardia

around navel

at rectum

retroperitoneal

Which vessels from the portocaval anastomosis btw esophagus and cardia?

Which vv. belong to the portal, which to the caval system?

Why is it clinically relevant?

vv. gastricae (portal) + vv. esophageales (caval) → v. azygos/v. hemiazygos → v. cava superior

⇒ can cause esophageal varices

Which vessels from the portocaval anastomosis around the navel?

Why is it clinically relevant?

vv. paraumbilicales → v. epigastrica sup./inf. → v. thoracoepigastrica/v. epigastrica superficialis → v. cava superior

⇒ can cause caput medusae syndrome

Which vessels form the portocaval anastomosis at the rectum?

Which vv. belong to the portal, which to the caval system?

Why is it clinically relevant?

v. rectalis sup. (portal) + v. rectalis med./inf. (caval) → v. iliaca int. → v. cava inferior

⇒ can cause hemorrhages

#1 - 5/6

What is the clinical importance of 5/6?

1) v. azygos

2) v. hemiazygos

3) v. portae hepatis

4) v. hepatica

5+6) plexus venosus submucosus → site for esophageal varices

7+8) vv. oesophageae

9) v. phrenica inf.

10) v. gastrica inf.

11) v. splenica

12) v. renalis sin.

13) v. testicularis/ovarica

14) v. mesenterica inf.

15) v. mesenterica sup.

16) v. colica sup.

17) v. sigmoidea

#18 - 22

What is the clinical importance of 20?

18) v. cava inf.

19) v. rectalis sup.

20) v. paraumbilicalis → site for caput medusae syndrome

21) v. epigastrica superificalis

22) v. iliaca communis

#23 - 25/26

What is the clinical importance of 25/26?

23) v. epigastrica inf.

24) v. iliaca int.

25+26) vv. rectales inf. → site of hemorrhages

List the parietal branches of a. iliaca interna.

What do they supply?

r. iliacus → m. iliacus, anastomoses w/ a. circumflexa ilium profunda

r. lumbalis → m. psoas + m. quadratus lumborum, anastomoses w/ a. lumbalis r. spinalis

r. pubicus → anastomoses w/ a. epigastrica inf.

r. anterior → symphysis + adductors, anastomoses w/ a. circumflexa femoris medialis

r. posterior → glutes + tuber ischiadicum

r. acetabularis → through incisura acetabula into lig. capitis femoris + head of femur

List the visceral branches of a. iliaca interna.

What do they supply?

distal part obliterates to lig. umbilicale mediale

proximal:

aa. vesicales superiores → apex of urinary bladder

a. ductus deferentis

rr. vaginales

r. ovaricus anastomoses w/ a. ovarica (from aorta)

r. tubarius

rr. helicini → uterus

a. rectalis inferior → anus, anastomoses w/ a. rectalis media

a. perinealis

rr. scrotales/labiales posteriores

a. bulbi penis/vestibuli → bulbus of corpus spongiosum penis

a. profunda penis/clitoridis → corpora cavernosa

a. dorsalis penis/clitoridis → penis clitoris

corona mortis (= crown of death) exists if anastomosis btw a. obturatoria + a. epigastrica inf. originates entirely from a. epigastrica inf. / a. iliaca ext.

⇒ used to lead to fatal bleedings in surgeries of inguinal hernias

Which venous plexuses are formed by v. iliaca int.?

Clinical relevance?

medial to m. iliopsoas under lig. inguinale to lacuna vasorum

a. epigastrica inf.: anastomoses w/ a. epigastrica sup.

a. circumflexa ilium profunda: anastomoses w/ r. iliacus of a. iliolumbalis

r. pubicus: branch to symphysis, anastomoses w/ r. pubicus of a. obturatoria

a. cremasterica: through canalis inguinals → m. cremaster + coats of testes

a. lig. teretis uteri: (only in females) together w/ lig. teres uteri through canalis inguinalis

List the branches of a. thoracica interna.

It is covered by which structures?

vv. hepaticae (dex., intermed., sin., often truncus hepaticus sin.)

v. renalis sin. + dex.
BUT: v. renalis sin. receives the next 3

v. suprarenalis dex.

v. testicularis/ovarica dex.

v. phrenica inf. dex.

v. sacralis mediana

vv. iliacae communes

collects blood from head, neck, arms, thorax + lumbal region

forms from vv. brachiocephalicae

Which veins form v. brachiocephalica?

How is the structure called?

v. subclavia

v. jugularis int./

⇒ angulus venosus

v. thyroidea inf.

v. vertebralis

vv. throcicae int.

+ v. intercostalis suprema

+ vv. from thymus, pericardium, bronchi, trachea, esophagus, intercostal spaces

Which vessels form v. jugularis ext.?

Which vessel drains into it?

Where does it drain into?

on m. sternocleidomastoideus

formed by:

v. occipitalis

v. auricularis post.

receives:

v. jugularis ant. (from region around hyoid bone)

→ v. subclavia/v. jugularis int.

v. opthalmica sup.

v. facialis

plexus pterygoideus

vv. pharyngeales

v. lingualis

v. thyroidea sup./med.

v. sternocleidomastoidea

Where does a. carotis branch into a. carotis ext. + int.?

What is important abt that spot?

in trigonum caroticum

here baroreceptors innervated by n. glossopharyngeus

List all branches of a. carotis ext.

Mnemonic?

pars mandibularis (5)

pars pterygoidea (4)

pars pterygopalatina (5)

mandible, middle ear, lower jaw, dura mater

a. auricularis prof. → mandible

a. tympanica ant. → middle ear

a. alveolaris inf. → teeth + gingiva

a. meningea med. → dura mater

mm. of mastication, cheeks

a. masseterica

aa. temporales ant./post.

rr. pterygoidei

a. buccalis

teeth of upper jaw, palate, nasal cavity

a. alveolaris sup. post.

a. infraorbitalis

a. palatina descendens

a. canalis pterygoidei

a. sphenopalatina

left: arcus aorticus

right: truncus brachiocephalicus

a. vertebralis → parts of brain

a. thoracica int.

truncus thyrocervicalis

truncus costocervicalis

a. thyroidea inf.

a. cervicalis asc.

a. transversa colli

r. prof.

r. sup.

a. suprascapularis

a. intercostalis suprema

a. cervicalis profunda

Where do v. azygos and hemiazygos drain into?

Which structure is often also formed?

v. hemiazygos → v. azygos → v. brachiocephalica sin.

often: v. hemiazygos accessoria formed by v. intercostales (can drain into either of theim)

Which vessels drain into v. azygos, hemiazygos resp.?

Also list 2nd generation.

vv. mediastinales (vv. oesophageales, bronchiales, pericardiacae)

vv. intercostales post. + r. dorsalis esp.

r. spinalis (spinal cord)

plexus venosus vertebrales ext. (covering vertebrae)