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Blood supply abdomen

Blood supply to the abdomen

Describe the origin of the arteries of the abdomen Three pairs of vitelline arteries fuse at the midline during during embryonic development, forming three unpaired midline arteries arising from the aorta
* What artery trunk supplies the foregut? What structures does it supply? The celiac trunk: distal 1/3 of esophagus, stomach, 1st and 2nd parts of duodenum, liver and gallbladder, pancreas, spleen
* What artery trunk supplies the midgut? What structures does it supply? Superior mesenteric artery: 3rd + 4th parts of the duodenum, jejunum and ilium, cecum and appendix, ascending colon, proximal 2/3 of transverse colon
* What artery trunk supplies the hindgut? What structures does it supply? Inferior mesenteric artery: distal 1/3 of transverse colon, descending colon, sigmoid colon, rectum, superior 1/2 of the anal canal
* * What is the marginal artery of drummond? What arteries contribute to this plexus? Complex anastomoses of branches of the superior and inferior mesenteric arteries which frames the entire large intestine; includes connections between ileocolic, right colic, middle colic, left colic, sigmoidal, and superior rectal arteries
Where does the celiac trunk branch off (vertebral landmark)? T12
What structure surrounds it? The celiac plexus
What three branches does it give off? Left gastric, splenic, and common hepatic
* * Describe the path and structures supplied by the left gastric artery, as well as any branches ascends retropperitoneally to the gastroesophageal junction level; gives off esophageal branches and descends along the lesser curvature of stomach (within less omentum); anastomoses with right gastric artery; can give off accessory hepatic artery
* Describe the path and structures supplied by the splenic artery, as well as any branches Runs retroperitoneally along upper border of pancreas; reaches spleen within lienorenal ligament; gives off pancreatic branches, short gastric arteries; left gastro-omental artery; splenic branches
* * What supplies the fundus of the stomach? short gastric arteries from the splenic artery of the celiac trunk
* * Describe the path of the left gastro-omental (gastroepiploic artery) Runs along greater curvature of stomach within gastrocolic ligament; anastomoses with right gastro-omental artery
Describe the path of the common hepatic artery Descends retroperitoneally to the right until it lies above the first segment of the duodenum and divides into two branches: 1) hepatic artery proper and 2) gastroduodenal
* What are the branches and areas supplied by the hepatic artery proper? Right hepatic artery (right lobe of liver), left hepatic artery (left lobe of liver); cystic artery*; right gastric artery (usually branch of right hepatic artery)
Where does the hepatic artery travel through (i.e. what ligament does it pass through)? What structure does it run with as it enters the liver? Enters the hepatoduodenal ligament and ascends immediately to the left of the common bile duct
* Where does the cystic artery come from? Usually a branch of the right hepatic artery; may arise from hepatic proper, rght, or left hepatic, or gastroduodenal; may pass in front or in back of common bile + cystic ducts; may be accessory cystic arteries
Where does the right gastric artery come from? May arise from common hepatic artery, hepatic artery proper, or right hepatic artery
Where does the gastroduodenal artery pass through? Passes behind first segment of duodenum and divides into two principal branches
What are the branches of the gastroduodenal artery? Right gastro-omental (gastroepiploic) and te superior pancreaticoduodenal artery
* * Describe the path of the right gastro-omental branch Right gastro-omental (gastroepiploic): anastomoses w/ left gastro-omental artery along greater curv. of stomach within gastroilic ligament;
* * Describe the path of the superior pancreaticoduodenal artery usually anterior and posterior superior pancreaticoduodenal arteries; runs between second segment of duodenum and head of the pancreas and anastomoses with inferior pancreaticodudoneal artery
* Where are the aneastomoses of hind and mid gut? Make a chart
* * * Summary: What (5) vessels supply the stomach? left gastric artery: lesser curvature of stomach + distal 1/3 esophagus; right gastric artery: lesser curv of stomach; short gastric arteries: fundus of stomach; right gastro-omental: greater curv. of stomach; left gastro-omental: greater curv of stomach
* Summary: What (3) arteries supply the pancreas? Pancreatic branches from splenic artery; superior pancreaticoduodenal artery; inferior pancreaticoduodenal artery
* Summary: what artery supplies the spleen? Splenic artery
* What (2) arteries supply 30% of the liver? What vein drains most of the blood of the liver? Right and left hepatic arteries; portal vein
* What artery supplies the gallbladder? Cystic artery
* What (2) arteries supply the duodenum? The superior and inferior pancreaticoduodenal artery
Where does the superior mesenteric artery originate from? From the abdominal aorta at the level of L1
Where is it located with respect to the pancrease and the duodenum? Runs downward and to the right behind the neck of the pancreas but in front of the third segment of the duodenum
What are the (5) major branches of the superior mesenteric artery? Inferior pancreaticoduodenal artery, jejunal and ileal branches, ileocolic artery, right colic artery, middle colic artery
* * The ________ anastomoses with the superior pancreaticoduodenal artery to supply the pancreas and duodenum inferior pancreaticoduodenal artery
* On which side do the jujunal and the ileal branches come out of the superior mesenteric artery? Left side
The jejunal and the ileal branches divide into two and unite with the adjacent divisions of the other branches to form a series of ___ arcades in the mesenteries
Arcades are more developed along the _____ than along the ______ ilium; jejunum
The arcades give rise to the _____ Straight arteries (arteria recta)
* Where does the ileocolic artery arise from? What branches are given off from this artery? From the right side of the superior mesenteric artery; passes in the mesentery directly towards the cecum
* What structure does the right colic artery supply? The ascending colon
* What structure does the middle colic artery supply? The proximal 2/3 of the transverse colon
* Where does the inferior mesenteric artery arise from? Vertebral level? 3-4 cm proximal to the bifurcation of the aorta at the level of L3
* What are the three branches given off by the inferior mesenteric artery? Left colic artery, sigmoidal arteries, superior rectal artery
* what structures does the left colic artery supply? The distal 1/3 of the transverse colon and the upper part of the descending colon
* What do the sigmoidal arteries supply? The lower part of the descending colon and the sigmoid colon
* * The superior rectal artery is a direct continuation of the ________. It anastomoses with the ______ and _______ ______ arteries inferior mesenteric artery; middle and inferior rectal
* What structures does the superior rectal artery supply? rectum and the proximal 1/2 of the anal canal
Unlike the abdominal digestive system and associated digestive glands, the _________ organs and structures are supplied by ________ arteries. This is the case for the entire ____ system, the _____ glands, and the _______. retroperitoneal; paired; urogenital system; suprarenal glands; posterior abdominal wall
The _____ retroperitoneal portions of the digestive system are supplied by unpaired arteries secondary retroperitoneal
Secondary retropertioneal structures are those that begin embryonic development as _________ structures and later lose their mesenteries when they fuse with the parietal peritoneum of the posterior abdominal wall intraperitoneal
What are the secondary retroperitoneal structures distal 3/4 of the duodenum, pancreas, ascending colon, descending colon, rectum
In the abdomen, the primary retroperitoneal structures are all supplie by the paired arteries which are direct branches of the ______. In the pelvis, the paired arteries are direct branches of the ________. abdominal aorta; internal iliac arteries
All of these primary retroperitoneal structures are drained by the branches of the _______. Inferior vena cava
* * What three arteries supply the suprarenal glands? Where do they branch from? The superior suprarenals (branch from right and left inferior phrenic arteries), the middle suprarenal (branch of abdominal aorta), the inferior suprarenal (branch of left and right renal arteries)
How are the suprarenal glands drained? Usually by single vein: right suprarenal vein drains directly into inferior vena cava; left suprarenal vein drains into left renal vein which then drains into IVC
Where do the gonads get their arteries? Where does this artery orginiate? What about the corresponding veins From the abdominal aorta; orginiates below the origin of the renal arteries; the viens follow the same pater as the suprarenal glands
* What accounts for the difference in drainage on the right and left side ? Due to differences in embryonic development on the two sides of the body
* What is the hepatic portal system? System of veins interposed between two capillary networks; the intestinal and splenic venous blood does not return directly to heart, but passes through the liver (hepatic sinusoids)
* what (7) compose the hepatic portal system? portal vein, superior and inferior mesenteric veins, splenic vein, right and left gastric veins, cystic vein, paraumilical vein
Where does the portal vein form (i.e. behind what organ)? What two veins join to form it? Behind the neck of the pancreas; union of the the superior mesenteric and splenic veins
* What are the structures of the portal triad? The common bile duct, hepatic artery proper, and the portal vein; located behind the first segment of the duodenum. The artery enteres the free margin of the hepatodudodenal ligament
* Describe the path of the portal vein Ascends in the hepatoduodenal ligament in front of the epiploic foramen of Winslow and then enters the porta hepatis of the liver; in the liver, vein branches into many veins that eventually open into hepatic sinusoids
Where is the blood recollected? The hepatic veins which drein into inferior vena cava on the posterior surface of the liver
Which vessels drain directly into the portal vein? The right and left gastric veins, the cystic veins, and the paraumbilical veins; drains directly into portal vein before entering porta hepatis
The splenic vein forms at the _______ and runs along the upper border of the _____ with the ______ artery. It usually receives the ______ ______ vein. hilus of the spleen, pancreas, splenic, inferior mesenteric
Under normal conditions, the portal venous blood traverses the liver and drains into the ________ by way of the ______. IVC; hepatic veins
* What causes portal hypertension? In the case of fibrosus (caused by loss/injury to parenchymal cells-->scarring-->chirrosis), increasd resistance to blood flow results in build up of pressure-->portal hypertension
* * Alternate routes of blood flow back to the heart exist which connect the portal and systemic venous system and are known as the _________. These routes are possible because there are no valves in any of the tributaries of the _____. portal-systemic anastomoses; hepatic portal system
* Where are the four major communications between the portal and systemic venous system? (4) : At the lower end of the esophagus, on the anterior abdominal wall, in the anal canal, and the posterior abdominal wall.
* Describe the communication between the portal and systemic venous systems at the lower end of the esophagus; when they become dilated, what is seen? esophageal branches of the LEFT GASTRIC VEIN (portal) and the esophageal branches of the AZYGOUS VEINS (systemic); esophageal varices
* Describe the communication between the portal and systemic venous systems at the anterior abdominal wall; when they become dilated, what is seen? PARAUMBILICAL VEINS (portal) and the SUPERFICIAL VEINS OF THE ANTERIOR ABDOMINAL WALL (systemic); Caput medusae
* Describe the communication between the portal and systemic venous systems at anal canal; when they become dilated, what is seen? SUPERIOR RECTAL VEINS (portal) and MIDDLE AND INFERIOR RECTAL VEINS (systematic); hemorrhoids (though they are also often caused by something else)
* Describe the communication between the portal and systemic venous systems at posterior abdominal wall. TRIBUTARIES OF THE SECONDARY RETROPERITONEAL ORGANS (portal) and TRIBUTARIES OF THE PRIMARY RETROPERITONEAL ORGANS (systemic)
* * What comprises the cardia of the stomach? Anastomoses of the coronary vein of the stomach with the esophageal veins
* What veins do the paraumbilical veins join with? Along what ligament do they do this? Along the ligamentum teres; with the veins of the abdominal wall
* What veins comprise the hemorrhoidal plexus? superior rectal veins fro inferior mesenteric with middle and inferior rectal veins from the internal iliac
* * What veins does the splenic vein anastomose with? The retroperitoneal veins (suprarenal and the inferior phrenic)
Created by: karkis77



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