Transcript 27-Arterial supply of mid & hindgut

Dr. Ahmed Fathalla Ibrahim
SUPERIOR MESENTERIC
ARTERY
SUPERIOR MESENTERIC
ARTERY
SUPERIOR MESENTERIC
ARTERY
SUPERIOR MESENTERIC
ARTERY
SUPERIOR MESENTERIC
ARTERY
ILEOCOLIC ARTERY
SUPERIOR MESENTERIC
ARTERY
SUPPLY:
• It is the artery of midgut
• It supplies:
1. Duodenum: 2nd part (below biliary
orifice), 3rd & 4th parts
2. Jejunum & ileum
3. Cecum & appendix
4. Ascending colon
5. Right 2/3 of transverse colon
SUPERIOR MESENTERIC
ARTERY
ORIGIN:
• It arises as a single branch from the
front of abdominal aorta
• It lies at the level of lower border of L1
• Its origin lies behind body of pancreas
SUPERIOR MESENTERIC
ARTERY
COURSE:
• It descends describing a curve with a
concavity towards the right
• It runs through the root of mesentery
of small intestine
TERMINATION:
•
It ends by anastomosing with the ileal
branches of ileocolic artery (its own
branch)
SUPERIOR MESENTERIC
ARTERY
RELATIONS:
• The artery descends anterior to (crosses) the
following structures:
1. Left renal vein
2. Uncinate process of pancreas
3. Third part of duodenum
4. Abdominal aorta
5. Inferior vena cava
6. Right psoas major muscle (+ right ureter)
• On its right side (lateral to it): superior
mesenteric vein
BRANCHES OF SUPERIOR
MESENTERIC ARTERY
Inferior pancreaticoduodenal artery:
• Runs (as a single or double branches)
in the groove between head of
pancreas & duodenum
• Supplies head of pancreas &
duodenum
• Ends by anastomosing with superior
pancreaticoduodenal artery
BRANCHES OF SUPERIOR
MESENTERIC ARTERY
Jejunal & ileal branches:
• They are 12 to 15 in number
• They arise from the left side of artery
• They run between the 2 layers of mesentery
of small intestine
• Each artery divides into 2 branches which
anastomose with adjacent branches forming
arcades. Branches of arcades unite to form
2nd, 3rd & 4th series of arcades. Terminal
arcades gives straight end arteries supplying
jejunum & ileum
• Fewer arcades supply jejunum compared to
ileum
BRANCHES OF SUPERIOR
MESENTERIC ARTERY
Ileocolic artery:
•
Arise from the right side of artery
•
Descends downward & to the right (anterior to
right psoas major muscle)
•
Divides into:
1. Superior branch: supplies lower part of ascending
colon & anastomoses with descending branch of
right colic
2. Inferior branch: divides into the following arteries:
•
Anterior & posterior cecal
•
Appendicular (may arise from posterior cecal)
•
Ileal branches: supply distal part of ileum &
anastomose with termination of superior
mesenteric artery
BRANCHES OF SUPERIOR
MESENTERIC ARTERY
Right colic artery:
• Arise from the right side of artery
• Divides into:
1. Ascending branch: anastomoses with
right branch of middle colic artery
2. Descending branch: anastomoses
with superior branch of ileocolic
artery
• Supplies ascending colon & right
colic flexure
BRANCHES OF SUPERIOR
MESENTERIC ARTERY
Middle colic artery:
• Arise from the right side of artery
• Divides into:
1. Right branch: anastomoses with
ascending branch of right colic artery
2. Left branch: anastomoses with
ascending branch of left colic artery
• Supplies right 2/3 of transverse colon
INFERIOR MESENTERIC
ARTERY
SUPPLY:
• It is the artery of hindgut
• It supplies:
1.Left 1/3 of transverse colon
2.Descending colon
3.Sigmoid colon
4.Rectum
5.Upper (endodermal) part of anal canal
INFERIOR MESENTERIC
ARTERY
INFERIOR MESENTERIC
ARTERY
ORIGIN:
• It arises as a single branch from the
front of abdominal aorta
• It lies at the level of L3
• Its origin lies behind 3rd part of
duodenum
INFERIOR MESENTERIC
ARTERY
COURSE & RELATIONS:
• The artery descends to the left side of
abdominal aorta
• It lies anterior to left psoas major
muscle & left common iliac artery
• On its left side (lateral to it): inferior
mesenteric vein
• Continues in the pelvis as superior
rectal artery
BRANCHES OF INFERIOR
MESENTERIC ARTERY
Left colic artery:
• Divides into:
1. Ascending branch: anastomoses with
left branch of middle colic artery
2. Descending branch: anastomoses
with sigmoid arteries
• Supplies: left 1/3 of transverse colon,
left colic flexure & descending colon
BRANCHES OF INFERIOR
MESENTERIC ARTERY
Sigmoid arteries:
•
•
1.
2.
•
They are 2 or 3 branches
They anastomose with:
Descending branch of left colic artery
Superior rectal artery
They supply: sigmoid colon
MARGINAL ARTERY
MARGINAL ARTERY
• It is formed by the anastomosis
between the colic branches of superior
& inferior mesenteric arteries
• It begins by anastomosis between ileal
branches of ileocolic & termination of
superior mesenteric artery
• It ends by anastomosis between
sigmoid branches of inferior
mesenteric with superior rectal artery
• From the marginal artery, straight end
arteries (vasa recta) supply the large
intestine