Transcript Abdominal Cavity III

Abdominal Cavity III
Arteries
• Visceral branches of descending / abdominal
aorta (continuation of thoracic aorta)
• Celiac artery / trunk - at level of T12 - to foregut
– Left gastric: to lesser curvature of stomach
• anastomoses with right gastric (branch of proper/common
hepatic artery)
– Splenic artery
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pancreatic branches
splenic branches (several)
Left gastroepiploic
short gastric a
Arteries
• (common) hepatic
– Right gastric
– gastroduodenal - further divides into
• Right gastroepiploic
• superior pancreaticoduodenal a - to pancreas &
head of pancreas and duodenum
– Right, Left hepatic (terminal branches) - to R,
L lobes of liver
Superior mesenteric artery
• to midgut, exits abdominal aorta at level L1 enters mesentery to viscera
– inferior pancreaticoduodenal - to duodenum & head of
pancreas
– middle colic artery - R, L branches - to transverse
colon
– right colic artery - ascending, descending branches to ascending colon
– ileocolic artery - branches to supply ileum, cecum &
appendix
– intestinal arteies - exit all along course of sup
mesenteric through mesentery to jejunum, ileum
Renal artery
• Large arteries
Suprarenal Glands
• superior - usually from inferior phrenic
artery
• middle - usually from lateral aorta at level
of superior mesenteric
• inferior - usually from renal a
(see atlas 247)
Inferior mesenteric
• left colic artery - ascending, descending
branches - to descending colon
• sigmoid branches - to sigmoid colon
• superior rectal a = termination of inferior
mesenteric - curves down into pelvis minor
Parietal branches of descending aorta
• phrenic artery - at base of diaphragm - usually
give off superior suprarenals
• gonadal artery: either ovarian or testicular - at
T12 or L1,
• lumbar artery(4 pairs) to posterior wall structures
• Middle sacral artery : single /unpaired vessel at
bifurcation of aorta in front of L5 vertebral body
• Abdominal aorta divides at ~ L4 vertebral level
to L, R common iliac artery
– common iliacs then divide in front of lumbosacral joint
into internal, external iliac artery
Portal vein
• Portal System - Venous drainage of
gastrointestinal tract, spleen, pancreas,
gallbladder - all delivered to liver
• Portal vein is formed by junction of splenic vein
& superior mesenteric vein - posterior to
pancreas
– splenic vein
• small splenic vein
• short gastric vein
• left gastroepiploic vein
– superior mesenteric vein - tributaries parallel
branches of sup. mesenteric artery
– inferior mesenteric vein - usually joins splenic or sup.
mesenteric before entering portal vein
Portal hypertension
• Portal hypertension is the build-up of
pressure in the portal vein
Inferior vana cava
• drains post abdominal wall (& non-GI related
structures)
• formed by junction of R, L common iliac veins
from legs
• middle sacral vein enters L common iliac
• lies to R of vertebral bodies
• contacts diaphragm posteriorly & liver anteriorly
receives:
– L renal vein
• L suprarenal vein
• L gonadal (testicular or ovarian)
Inferior vana cava
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R renal v
R suprarenal
R gonadal
inferior phrenics (R, L)
hepatic veins (vary in #)
lumbar vein (also vary in #, some enter
ascending lumbars, drain into azygos,
hemiazygos)
Nerve supply
• ANS - supplies visceral organs: contain SNS &
PNS fibers & general visceral sensory branch
• aortic plexus: SNS & PNS network surrounds
entire aorta, perivascular plexuses at each
subdivision follow corresponding blood vessels
to organs
• PNS - vagal trunks (anterior - mostly from L
vagus; & post - mostly from R vagus)
- inferior mesenteric viscera - from S2-S4
• SNS - greater, lesser splanchnic nerves (from T5
- S4 spinal nerves & ganglia)
Nerve supply
• Celiac plexus: celiac ganglia & nerve fibers
around celiac artery, subdivisions are
continuations of celiac
• superior mesenteric plexus: ganglia & nerve
fibers around a; follow vessels to organs
• hepatic plexus: ganglia & nerve fibers around
artery; follow vessels to organs
• renal plexus: ganglia & nerve fibers around a;
follow vessels to organs
• inferior mesenteric plexus: ganglia & nerve
fibers around a; follow vessels to organs