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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 • • • • 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 • • • • • • 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