Untitled Document (4) PDF - Arterial Supply

TABLE 5.3. Principal Arteries of Anterolateral Abdominal Wall Nerve Origin Course Distribution Musculophrenic Internal thoracic artery Descends along costal margin Abdominal wall of hypochondriac region, anterolateral, diaphragm Descends in rectus sheath deep to rectus abdominis Superior re...

TABLE 5.3. Principal Arteries of Anterolateral Abdominal Wall Nerve Origin Course Distribution Musculophrenic Internal thoracic artery Descends along costal margin Abdominal wall of hypochondriac region, anterolateral, diaphragm Descends in rectus sheath deep to rectus abdominis Superior rectus abdominis and superior part of anterolateral abdominal wall Abdominal aorta Arteries continue beyond ribs to descend in abdominal wall between internal oblique and transversus abdominis Abdominal wall, lateral region External iliac artery Runs superiorly and enters rectus sheath; runs deep to rectus abdominis Inferior rectus abdominis and medial part of anterolateral abdominal wall Runs on deep aspect of anterior abdominal wall, parallel to inguinal ligament Iliacus muscle and inferior part of anterolateral abdominal wall Runs in superficial fascia along inguinal ligament Superficial abdominal wall of inguinal region and adjacent anterior thigh Superior epigastric 10th and 11th posterior intercostal Subcostal Inferior epigastric Deep circumflex iliac Superficial circumflex iliac Femoral artery Superficial epigastric Runs in superficial fascia toward umbilicus Subcutaneous tissue and skin over pubic and inferior umbilical region Arterial Supply to Esophagus, Stomach, Duodenum, Liver, Gallbladder, Pancreas, and Spleen Arterya Origin Course Distribution Celiac trunk Abdominal aorta (T12) just distal to aortic hiatus of diaphragm After short antero-inferior course, bifurcates into splenic and common hepatic arteries Esophagus, stomach, duodenum (proximal to bile duct), liver and biliary apparatus, and pancreas Left gastric Celiac trunk Ascends retroperitoneally to esophageal hiatus, giving rise to an esophageal branch; then descending along lesser curvature to anastomose with right gastric artery Distal portion of esophagus and left portion of lesser curvature of stomach Runs retroperitoneally along superior border of pancreas, then passes between layers of splenorenal ligament to hilum of spleen Body of pancreas, spleen, and greater curvature of stomach; posterior gastric branch supplies posterior wall Splenic and fundus of stomach Left gastro-omental (gastro-epiploic) Splenic artery in hilum of spleen Short gastric (4 or 5 branches) Passes between layers of gastrosplenic ligament to greater curvature of stomach Left portion of greater curvature of stomach Pass between layers of gastrosplenic ligament to fundus of stomach Fundus of stomach Hepaticb Celiac trunk Passes retroperitoneally to reach hepatoduodenal ligament and passes between its layers to porta hepatis; divides into right and left hepatic arteries Liver, gallbladder, stomach, pancreas, duodenum, and respective lobes of liver Cystic Right hepatic artery Arises within hepatoduodenal ligament Gallbladder and cystic duct Right gastricc Hepatic artery Runs along lesser curvature of stomach Right portion of lesser curvature of stomach Descends retroperitoneally posterior to gastroduodenal junction Stomach, pancreas, first part of duodenum, and distal part of bile duct Gastroduodenal Right gastro-omental (gastro-epiploic)c Gastroduodenal artery Anterior and posterior superior pancreaticoduodenal Anterior and posterior inferior pancreaticoduodenal Superior mesenteric artery Passes between layers of greater omentum to greater curvature of stomach Right portion of greater curvature of stomach Descend on head of pancreas Proximal portion of duodenum and head of pancreas Ascend on head of pancreas Distal portion of duodenum and head of pancreas Arterial Supply to Intestines Artery Origin Course Distribution Superior mesenteric Abdominal aorta (L1) Runs in root of mesentery to ileocecal junction Part of gastrointestinal tract derived from midgut Intestinal (n = 15–18) Superior mesenteric artery Passes between two layers of mesentery Jejunum and ileum Middle colic Ascends retroperitoneally and passes between layers of transverse mesocolon Transverse colon Right colic Passes retroperitoneally to reach ascending colon Ascending colon Ileocolic Terminal branch of superior mesenteric artery Runs along root of mesentery and divides into ileal and colic branches Ileum, cecum, and ascending colon Appendicular Ileocolic artery Passes between layers of meso-appendix Appendix Inferior mesenteric Abdominal aorta (L3) Descends retroperitoneally to left of abdominal aorta Descending colon Left colic Inferior mesenteric artery Passes retroperitoneally toward left to descending colon Sigmoid (n = 3 or 4 branches) Passes retroperitoneally toward left to sigmoid colon Descending and sigmoid colon Superior rectal Terminal branch of inferior mesenteric artery Descends retroperitoneally to rectum Proximal part of rectum Middle rectal Internal iliac artery Passes retroperitoneally to rectum Midpart of rectum Inferior rectal Internal pudendal artery Crosses ischio-anal fossa to reach rectum Distal part of rectum and anal canal Autonomic Innervation of Abdominal Viscera (Splanchnic Nerves) Splanchnic Nerves Autonomi System c Fiber Typea Origin Destination A. Cardiopulmonary (cervical and upper thoracic) Postsynap Sympathetic tic Cervical and Thoracic cavity upper (viscera superior to thoracic level of diaphragm) sympathetic trunk B. Abdominopelvic Presynapt ic Lower thoracic and abdominope lvic sympathetic trunk: Abdominopelvic cavity (prevertebral ganglia serving viscera and suprarenal glands inferior to level of diaphragm) Thoracic sympathetic trunk: Abdominal prevertebral ganglia: 1. Lower thoracic a. b. Greater c. d. Lesser a. a. b. Celiac b. T5–T e. f. Least ganglia 9 or c. T10 d. Aorticorenal level ganglia c. e. d. T10– f. and T11 level e. f. T12 level 2. Lumbar Abdominal sympathetic trunk Other abdominal prevertebral ganglia (superior and inferior mesenteric, and of intermesenteric/hyp ogastric plexuses) 3. Sacral C. Pelvic Pelvic (sacral) sympathetic trunk Parasympath Anterior etic rami of S2–S4 spinal nerves Pelvic prevertebral ganglia Intrinsic ganglia of descending and sigmoid colon, rectum, and pelvic viscera