Vasculature & abdominal autonomics

Anatomy Antr551 with Fitzsimmons at Michigan State University

About this deck

By: Gina Maki
Textbook:

Atlas of Human Anatomy: With Netteranatomy.com (Netter Basic Science)

Clinically Oriented Anatomy, Sixth Edition: Softcover North American Edition

Color Atlas of Anatomy: A Photographic Study of the Human Body (Point (Lippincott Williams & Wilkins))

Gray's Anatomy for Students: With STUDENT CONSULT Online Access
Created: 2011-08-07
Size: 30 flashcards
Views: 0

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atherosclerotic aorta

plaque build up in abd. aorta tends to occur at bifurcation , may result in claudication (pain while walking) or impotence

aneurysm

circumscribed dilation, often occurs at ab. aorta bifurcation

What is a portal system?

one capillary bed going to another without first going to heart

Where does lymph from preaortic nodes eventually drain to?

cisterna chyli and thoracic duct

What are signal lymph nodes?

enlarged lymph nodes in left supraclavicular or left cervical region suggesting cancer present in one or more FOREGUT derived structures

cancer of liver, stomach, or pancreas will often metastasize to pymph nodes in left supraclavicular or left cervical region

What GI structures are derived from the foregut?

distal esophagus, stomach, 1st and 2nd parts of duodenum, liver, biliary tract, gallbladder, pancreas, spleen

What is the primary arterial supply of the foregut?

branches of celiac trunk

What is the venous drainage of the foregut?

tributaries of splenic v
R/L gastric vv drain directly to hepatic portal v.

What GI structures are derived from the midgut?

2nd,3rd, and 4th parts of duodenum, jejunum, ileum, cecum, vermiform appendix, ascending colon, proximal transverse colon

what is the primary supply of the midgut?

branches of SMA

what is the main venous drainage of midgut?

tributaries of SMV

what GI structures are derived from hindgut?

distal transverse colon, descending colon, sigmoid colon, rectum, superior anal canal relative to pectinate line

what is the primary arterial supply of hindgut?

IMA branches

what is venous drainage of hindgut?

tributaries of IMV

parasympathetic overview

L vagus- anterior vagal trunk - foregut

R vagus- posterior vagal trunk - foregut and midgut

pelvic splanchnic- hindgut

sympathetic efferent overview

pregang. symp. arise from lateral gray horns of T5-L2

pass THROUGH symp. chain WITHOUT synapse
-form greater, lesser, least, and lumbar splanchnic nn. as they exit chain ganglia

splanchnic nn. usually terminate in prevertebral ganglia, synpase with post.gang. GVE

Where can you feel the initial pain from the gut structures

midline -d/t gut tube developing along midline

NO symp or parasymp from L3-S1, so no visceral pain refereed to this area

gut tube pain line (imaginary line to mid-sigmoid region)
-proximal to here- pain accompanies SYMPATHETIC pathways
-distal to here- pain accompanies PARASYMPATHETIC pathways

GVA's accompanying sympathetic GVE's

convey pain as chemical irritation or michanical distention

pass through abdominopelvic autonomic plexuses without synapse

enter dorsal horn T5-L2 -refer pain to these dermatomes

GVAs accompanying PARAsympathetic GVE's

convey hunger/nausea, distention w/ poor localization

sacral general visceral afferents of S2-S4 carry pain from bladder, prostate, urethra, cervix, and distal large intestine
--full bladder refer pain to distal penis (S3)

Overview of stomach

intraperitoneal
derived from Foregut
LUQ

esophagogastric junction

orad to here is inferior esophageal sphincter- physiological sphincter that constricts d/t tonic contraction of smooth mm.

if normal muscular tone impaired- stomach acis can seep into esophagus and cause pyrosis (heartburn)

sliding hiatal hernia

d/t weakening of R crus of diaphragm & phrenicoesophageal lig.

cardia and fundus into mediastinum

regurgitation of stomach contents and acid - pyrosis
-b.c diaphragm and lig. aren't tightening around orifice

paraesophageal hital hernia

fundus extends into mediastinum

no regurgitation - cardiac orifice and ligament intact
but strangulation and obstruction possible

Pylorus

rest on L1

defines transpyloric plane (midpt. b/t sternal notch and pubic symphysis)

attaches to liver via hepatoduodenal lig.

immobile

What is the stomach bed formed by?

left hemidiaphragm
left kidney and suprarenal gland
pancreas
transverse mesocolon
part of medial spleen

What is the arterial supply to the stomach? lesser curvature? greater curvature?

celiac trunk

lesser curvature:
L gastric (from celiac trunk), R gastric ( from common hepatic)

greater curvature:
R. gastro-omental a. (from gastroduodenal) L gastro-omental (from splenic) short gastric (from splenic)

Where does the lymph drainage
of the stomach go?

celiac nodes

what are the parasympathetic pathways of anterior and posterior stomach?

anterior- anterior and posterior vagal trunk

posterior- posterior vagal trunk

what are the sympathetic efferent pathways of the stomach?

preganglionic symp. GVEs originate from T6-T9

course in L&R greater splanchnic nn to celiac ganglia

postgang. symp. GVE run of vessels of celiac trunk

Where is the referred pain of the stomach?

epigastric / L hypochondriac regions / or interscapular region