blood supply of abdomen

where does the celiac trunk branch off the abdominal aorta?

T12 (last rib)

superior rectal artery anastomoses with?

middle and inferior rectal arteries

how many arteries supply the gonads? -are they symmetric?

one set of paired arteries from the abdominal aorta below the origin of the renal arteries -no

celiac trunk gives right to

1. common hepatic (to the right) 2. splenic (posterior) 3. and left gastric (anterior)

what are the secondary retroperitoneal structures?

1. distal 3/4 of the duodenum 2. pancreas 3. ascending colon 4. descending colon 5. rectum

splenic vein 1. forms where? 2. runs along what organ with which other vessel? 3. usually receives which other vein

1. forms at the hilus of the spleen 2. splenic artery 3. usually receives the inferior mesenteric vein

lesser omentum

A sheet of connective tissue which attaches to the lesser curvature of the stomach

suprarenal glands 1. also known as? 2. retro or intra?

1. adrenal gland (endocrine glands secreting hormones adrenaline and steroids) 2. primary retroperitoneal

right gastroepiploic artery 1. also known as 2. anastomoses with? 3. where does this anastomose take place? 4. within which ligament does this take place?

1. also known as the right gastro-omental artery 2. anastomoses with the left gasto-omental artery 3. along the greater curvature of the stomach 4. within the gastrocolic ligament (ligament of the greater omentum)

why are the portal-systemic anastomoses routes possible?

because there are no valves in any of the tributaries of the hepatic portal system and they form anastomoses with branches fo the systemic venous circulation

ileocolic artery gives rise to

colic, ileal, cecal and appendicular branches

three pairs of ___________ ___________ arteries (blood supply to the yolk sac) fuse at the midline during closure of the lateral body folds. what is the result?

embryonic vitelline arteries; this results in the formation fo 3 unpaired midline arteries arising from abdominal aorta

superior rectal artery 1. this is the direct continuation of what vessel?

inferior mesenteric artery

superior suprarenals are branches of the

inferior phrenic (diaphragm) artery

it is relatively common for the left gastric artery to give rise to?

left accessory hepatic artery

the left suprarenal vein drains into the

left renal vein which then drains into the IVC

in the __________, paired arteries are direct branches of the ?

pelvis, internal iliac arteries

following injury and death of liver parenchymal cells (hepatocytes) caused by infection, toxins, alcohol, poisons, etc., excessive scarring may result through proliferation of connective tissue. resulting fibrosis exhibits a variety of patterns and is known as cirrhosis of the liver --> resistance to blood flow thru liver --> portal hypertension. how is this combatted?

portal-systemic anastomoses: alternate routes of blood flow back to the heart exist which connect the portal and systemic venous systems and are known as the portal-systemic anastomoses.

inferior suprarenal is a branch of the

renal artery

celiac trunk lies ___________ behind peritoneum and is surround by what nerve bundle? what does this nerve bundle convey?

retroperitoneally, celiac plexus- conveys abdominal pain

cystic artery is usually a branch of what artery -may arise from which other vessels? -may pass where in relation to the common bile and cystic ducts

right hepatic artery (which is branch of hepatic artery proper which is branch of common hepatic artery of celiac trunk) -hepatic proper, right or left hepatic, or the gastroduodenal -may pass in front or in back of the common bile and cystic ducts -there may be accessory cystic arteries

inferior pancreaticoduodenal artery 1. anastomoses with the ____?_______ to supply what two structures?

superior pacreaticoduodenal artery to supply the pancreas and duodenum

right gastric artery supplies what?

supplies descending

cystic artery supplies what?

supplies the gallbladder

superior rectal artery supplies the ____________ and proximal 1/2 of __________?

supplies the rectum and proximal 1/2 of the anal canal

superior pancreaticoduodenal artery 1. runs between the second segment of the duodenum and the head of the pancreas 2. anastomoses with the?

(note: there are usually anterior and posterior superior pancreaticoduodenal arteries) 1. second segment of the duodenum and the head of the pancreas 2. anastomoses with the inferior pancreaticduodenal artery from the superior mesentery artery

rectum (portal systemic anastomoses) -where? -what branches anastomose? -dilation of channels?

-anal canal -superior rectal veins (portal) and middle + inferior rectal veins (systemic) -dilation of channels -- hemorrhoids (hemorrhoids often have causes other than portal hypertension)

within the lesser omentum, what does the left gastric artery anastomose with? what is the right gastric artery a branch of?

-anastomose with right gastric artery -common hepatic

umbilicus (portal systemic anastomoses) -where? -what branches anastomose? -dilation of channels?

-anterior abdominal wall -paraumbilical veins (portal) and superficial epigastric veins of the anterior abdominal wall (systemic) -dilation of channels -- Caput medusae (Medusa's head) of umbicular veins

left gastric artery arises from? ascends ___________ to the level of which junction? gives off what branches? then descends where?

-arises from the celiac trunk -ascends retroperitoneally to the level fo the gastroesophageal junction -gives off esophageal branches -along lesser curvature of the stomach within the lesser omentum

the portal vein is formed where? by the union of which 2 veins? describe the path of this vein

-behind the neck fo the pancreas -union of superior mesenteric and splenic veins -ascends behind the first segment of the duodenum and enters the free margin of the hepatoduodenal ligament lying behind and between the common bile duct and the hepatic artery proper (these three structures are known as the portal triad) -it ascends in the hepatoduodenal ligament in front of the epiploic foramen of winslow and then enters the porta hepatis of the liver

-how does blood get from the liver to the heart?

-blood is recollected into the hepatic veins which drain into the inferior vena cava on the posterior surface of the liver

what happens to the portal vein within the liver?

-branches into many generations of vessels which eventually open into the hepatic sinusoids

marginal artery of Drummond

-formed by complex anastomoses of branches of the superior and inferior mesenteric arteries which frames the entire large intestine -the anastomoses includes connections between the ileocolic, right colic, middle colic, left colic, sigmoidal and superior rectal arteries (6)

the intestinal and splenic venous blood does not return directly to the ________ but rather passes through specialized capillary networks in the _______ ( _________ sinusoids) why?

-heart; liver; hepatic -this path enables the liver to eliminate consumed toxins from the blood before it reaches the heart

subcardinal-supracardinal anastomoses

-in embryo, the inferior phrenic veins, suprarenal veins, and gonadal veins drain into these anastomoses -on the right, portions of these embryonic vessels of the cardinal system form the IVC (therefore, the right inferior phrenic, right suprarenal and right gonadal veins all drain directly into the IVC) -on the left, homologous portions of the embryonic cardinal vein system gives rise to the left renal vein (therefore the left inferior phrenic, left suprarenal and left gonadal veins drain into the left renal vein)

cardia of the stomach (portal systemic anastomoses) -where is this? -what branches anastomose? -dilation of channels?

-lower end of the esophagus -esophageal branches of the left gastric vein (portal) esophageal branches of the azygous veins (systemic) --> which then drain into the IVC -dilation of channels -- esophageal varices

splenorenal ligament

-one of the 4 ligaments of the greater omentum -where the splenic artery reaches the spleen

why is there a different in drainage (veins) on the right and left side of the body with respect to gonads and suprarenal glands?

-result of difference in embryonic development -in the embryo, there is a complicated system of anastomosing venous channels forming what are called paired subcardinal supracardinal anastomoses.

blood from which veins drain directly into the portal vein just before it enters the porta hepatis?

-right and left gastric veins -cystic veins -paraumbilical veins

what are the 2 principle branches of the gastroduodenal artery

-right gastro-omental (gastroepiploic) artery -superior pancreaticduodenal artery

under conditions of portal hypertension, what happens to the portal system anastomoses branches?

-these anastomoses become greatly dilated and act as major venous channels

posterior abdominal wall (portal systemic anastomoses) -which branches anastomose? -dilation of these channels causes what?

-tributaries of secondary retroperitoneal organs (portal) -tributaries of primary retroperitoneal organs (systemic) aka veins draining colon and veins draining posterior abdominal wall -dilation causes ascites is a condition in which fluid collects in spaces within your abdomen

each suprarenal gland is usually drained by how many veins?

1

sigmoidal arteries 1. how many are there usually? 2. supply what two parts?

1. 3 or 4 2. supplies the lower part of the descending colon and the sigmoid colon

jejunal and ileal branches 1. arise from which side of the SMA? 2. each divides into #? and unites with adjacent divisions of other branches to form a series of ________ in the mesenteries 3. the series of ^ are more developed along the _________ (posterior) than the________ (anterior) 4. the ^^ give rise to what type of arteries? (alt names?)

1. arise from the left side 2. 2, arcades 3. ileum; jejunum 4. straight arteries (arteria recta)

what are the 4 major communications between the portal and systemic venous systems

1. cardia of the stomach 2. umbilicus 3. anal canal 4. posterior abdominal wall

common hepatic artery 1. arises from? 2. descends retro or intra to the right until it lies above what structure? 3. at ^ that point, it divides into what branches?

1. celiac trunk 2. retro, above the first segment of the duodenum 3. hepatic artery proper (anterior), gastroduodenal (posterior)

short gastric arteries 1. arise from what? 2. supply what? (be specific in area too!) 3. reaching ^ organ where

1. from splenic artery which is from the celiac trunk 2. supply the fundus of the stomach 3. reaching it in gastrosplenic ligament

hepatic artery proper 1. enters what ligament and then ascends immediately to the left of the 2. _________ ________ ________ 3. gives rise to what branches

1. hepatoduodenal ligament 2. common bile duct 3. right hepatic artery, left hepatic artery, cystic artery, right gastric artery

what are the important branches of the SMA?

1. inferior pancreaticoduodenal artery 2. jejunal and ileal branches (12-15 branches) 3. ileocolic artery (most posterior) 4. right colic artery 5. middle colic artery

what are the branches of the inferior mesenteric artery? what do they all supply?

1. left colic artery 2. sigmoidal arteries 3. superior rectal artery -all supply the hindgut

left colic artery 1. is the most _________ (anterior or posterior) 2. supplies what 2 parts?

1. most anterior 2. supplies the distal 1/3 of the transverse colon and the upper part of the descending colon

what are the 4 important branches given off by the splenic artery

1. pancreatic branches 2. short gastric arteries 3. left gastro-omental artery 4. splenic branches

the hepatic portal system consists of which vessels (6)

1. portal vein 2. superior and inferior mesenteric veins (small and large intestine) 3. splenic vein (spleen) 4. right and left gastric veins (stomach) 5. cystic vein (gallbladder) 6. paraumbilical veins (small veins next to falciform ligament)

gastroduodenal artery 1. anterior or posterior? 2. arise from? 3. passes behind the ? 4. what happens after #3?

1. posterior 2. arise from the hepatic artery proper 3. behind the first segment of the duodenum 4. branches off into 2 arteries

ileocolic artery (most _______ coming off SMA) 1. arises from which side of the SMA 2. passes into the mesentery directly towards the ________

1. posterior 2. cecum (connection between small and large intestine

superior mesenteric artery (SMA) 1. originates retro or intraperitoneally? 2. originates from what vessel? 3. at what level does it originate?

1. retro 2. abdominal aorta 3. at the level of the L1 (one vertebrate down from the celiac trunk)

inferior mesenteric artery arises 1. retro or intraperitoneally, 2. 3-4 cm above what?

1. retro 2. the bifurcation fo the aorta at the level of L3

left gastro-omental or gastroepiploic artery 1. runs along what organ and part, within which ligament? 2. anatomoses with what artery?

1. runs along the greater curvature of the stomach 2. right gastroepiploic artery

SMA's position relative to pancreas and duodenum?

1. runs downward and to the right behind the neck of the pancreas 2. but in front of the third segment of the duodenum

arteries associated with suprarenal glands

1. superior suprarenal 2. middle suprarenal 3. inferior suprarenal

splenic artery 1. supplies what? 2. is a branch of what? 3. runs retro or intra peritoneal? along the upper border of the pancreas 4. where does it reach the spleen

1. supplies the spleen 2. branch of the celiac trunk 3. retro 4. reaches the spleen within the splenorenal ligament

primary retroperitoneal organs such as A, B, C are supplied by _________ __________ unlike the abdominal digestive system and associated digestive glands

1. suprarenal glands 2. entire urogenital system (kidney, urinary bladder, gonads and anal canal) 3. posterior abdominal wall and structures -PAIRED ARTERIES

Gonadal Veins (Right and Left)

Bilateral veins that empty either the testes or ovaries. -the right gonadal vein courses parallel to the IVC and empties into the IVC; -the left gonadal vein courses parallel and lateral to the IVC and empties into the left renal vein.

spleen is supplied by fore, mid or hindgut? what artery?

FORE -splenic artery

stomach: fore, mid or hindgut? supplies by what arteries

FORE 1. left gastric artery 2. right gastric artery 3. short gastric arteries 4. right gastro-omental artery 5. left gastro-omental artery

pancreas is supplied by for, mid or hindgut? supplied by what arteries?

FORE 1. pancreatic branches from the splenic artery 2. superior pancreaticoduodenal artery 3. inferior pancreaticoduodenal artery

liver is supplied by fore, mid, or hindgut? what arteries? what are the percentage breakdowns

FORE 1. right and left hepatic arteries (30%) 2. portal vein (70% of the blood)

duodenum is supplied by fore, mid, or hindgut? what arteries?

FORE 1. superior pancreaticoduodenal artery 2. inferior pancreaticoduodenal artery

the right suprarenal vein drains directly into

IVC

all of the primary retroperitoneal structures (abdominal and pelvic) are drained by branches of the ?

IVC; not true for secondary retroperitoneal portions

hepatic artery proper is anterior or posterior?

anterior

what are secondary retroperitoneal structures supplied (blood wise) by?

UNPAIRED ARTERIES

Definition of a portal system

a system of veins interposed between 2 capillary networks

in the ___________, primary retroperitoneal are all supplies by paired arteries which are direct branches of the ?

abdomen, abdominal aorta

middle suprarenal is a branch of the

abdominal aorta

three unpaired midline arteries arising from which blood vessel supply respectively the derivatives of the embryonic foregut, midgut and hindgut?

abdominal aorta

the testes and ovaries receive their respective blood supplies directly by way of branches of ?

the abdominal aorta -structures which begin development in one location and subsequently migrate to a different location carry their blood supply, nerve supply and lymphatic drainage with them