Posterior Abdominal Wall, Kidneys, and Abdominal Vasculature

Vasculature and Related Structures: Alimentary Canal

• Anterior vagus nerve
  • esophageal artery; esophageal plexus
  • left gastric artery; ant. vagus courses to stomach following course of L. gastric A.
  • posterior vagus nerve; post. trunk follows celiac and superior mesen. A in corresponding plexus to the organs supplied by both arteries
  • left gastric vein
  • lesser omentum; contains L. gastric A., contains ant. vagus n.??
  • ligamentum venosum
  • esophageal hiatus; anterior vagus nerve and esophagus enters the abdominal cavity, esophageal a.v. ascend to esophagus, site of phrenoesophageal sphincter
  • cardiac sphincter; angle between gastroesophageal junction and fundus
• Esophageal artery
  • esophageal vein - portacaval shunt;
• Left gastric artery
  • esophageal artery; branches off L. gastric artery near gastroesophageal junction
• Short gastric arteries
  • gastroleino ligament; contains short gastrics to fundus of stomach
  • splenic artery; within lienorenal ligament, sup. to tail pancreas, short gastric br. of
  • tail of the pancreas;
  • leinorenal ligament
  • fundus of stomach; short gastrics
  • lesser sac superior recess; caudate lober is anterior border, diaphragm anterior and posterior borders (arched) as you continue left * epiploic foramen; anterior border is hepatoduodenal ligament, posterior broder is IVC, inferior border is 1st part duod, superior border caudate lobe
  • greater sac
  • greater omentum continuous with gastroleino and leinorenal ligaments
• Left gastroepiploic artery
  • leinorenal ligament; contained in
  • gastroleino ligament;
  • greater omentum
  • gastrocolic ligament; anast. with R. gastroepiploic in
• Right gastroepiploic artery
  • descending duodenum and cap; inferior to and left of cap
  • greater omentum
  • gastroduodenal artery; posterior to first part duod, gives off as its branch R. gastroepiploic A.
• Common hepatic artery
  • lesser omentum
  • hepatoduodenum ligament; contributes proper hep. a. as its branch in lig.
  • common bile duct; medial to (perpendicular sort of)
  • rt and lt hepatic arteries
  • cystic artery; br. of R. hepatic artery
• Gastroduodenal artery
  • duodenal cap; posterior to cap, within lesser omentum
  • right gastroepiploic; br. post to cap, within greater omentum
• Supraduodenal arteries
  • duodenal cap; superior surface
  • hepatoduodenal
• Retroduodenal arteries
  • head of pancreas; posterior to
• Superior anterior/posterior pancreaticoduodenal arteries
  • head of pancreas;
  • duodenal cap
  • retroperitoneal
  • superior mesenteric artery; just posterior to head of pancreas
• Proper hepatic artery
  • lesser omentum
• Right gastric artery
  • lesser curvature of the stomach
  • antrum
• Right hepatic artery
  • liver
  • cystic artery; br. of r. hepatic a.
• Left hepatic artery
  • porta hepatis
• Cystic artery
  • relationship to right hepatic artery
• Superior mesenteric artery
  • superior mesenteric syndrome alias "The Nutcacker"; anterior to aorta, left renal vein and 3rd part duodenum between arms of nutcracker
• Superior mesenteric vein
  • relationship to SMA
• Inferior anterior/posterior pancreaticoduodenal arteries
  • ligament of Trietz; suspends
  • head of pancreas
  • ascending duodenum
  • horizontal duodenum
• Intestinal artery
  • mesentery
  • autonomic plexus
• Intestinal arcade
  • simple vs complex
• Vasa recta
  • end arteries
  • windows
• Iliocolic artery
  • retroperitonial
  • hindgut
  • sympathetic autonomics
  • what about parasympathetic?
• Iliocecal artery (ascending)
• Appendicular artery
  • mesoappendix
  • iliocolic artery
• Right Colic artery
  • ascending colon
• Middle colic artery
  • anastomosis
  • transverse mesocolon
  • marginal artery
• Inferior mesenteric artery
  • lumbar splanchics
  • intermesenteric plexus
• Left colic artery
  • descending colon
  • parasympathetic innervation vs. sympathetic innervation
• Sigmoidal artery
  • sigmoidal mesocolon
• Superior rectal artery
  • upper 1/3 of rectum
  • presacral space
  • right and left hypogastric nerves

Vasculature of Posterior Abdominal Wall

• Inferior Phrenic Arteries
  • right and left crus of the diaphragm; superolateral or anterior to crus; diverge at crus
  • celiac trunk; superior to
  • aortic hiatus; courses through (cranially)
  • first branch??
  • superior suprenal arteries; gives of as its branch
  • central tendon; branch just under??
• Dorsal pancreatic artery; medial to great pancreatic artery, both from splenic A.
• Chief pancreatic artery
• Splenic artery
  • lesser sac; retroperitoneal in lesser sac
  • retroperitoneal; in lesser sac
  • body and tail and pancreas, superior to
  • leinorenal ligament; intraperitoneal through lig. to spleen (intraperitoneal)
  • gastroleino ligament
• Splenic vein
  • splenic artery; inferior to
  • pancreas; superior to
  • portal vein; drains to
  • inferior mesenteric vein; inf. mesenteric drains to splenic vein behind pancreas
  • superior mesenteric vein; splenic vein
• Middle suprarenal artery
  • suprarenal gland; supplies
  • celiac ganglion
  • superior mesenteric ganglion
  • aorta; branch from
  • celiac trunk;
  • superior mesenteric trunk
• Renal artery
  • gonadal arteries (branch aorta); arising just inferior to renal artery origin on aorta
  • inferior suprarenal arteries; br. from
  • L2-3
  • hilum of kidney (VAU)
• left renal vein
  • central vein
  • left gonadal vien; drains to left renal vein (not directly to IVC)
  • portacaval shunt
  • nutcracker; aneurysm in either SMA or aorta can trap/occlude L. renal vein
• right renal vein
  • IVC; drains to
  • central vein
• hilum of the kidney
  • mneumonic of VAU...isn't it different on the left and right sides?
  • renal vein
  • renal artery;
  • renal pelvis
  • ureter;
• Renal pyramids
  • renal papilla
• Major calyx
  • minor calyx
• Renal columns
  • renal cortex
• Renal medulla
• Kidney (know left and right differences)
  • vertebral projection left and right;
  • lumbocostotrigon
  • pneumothorax
  • 11th - 12th rib; left more cranial, superior border just brushes over superior border of 11th rib
  • posterior diaphragm
  • psoas major
  • quadratus lumborum
  • transverse mesocolon
  • decending duodenum
  • liver
• Lumbar arteries (4 pair)
  • vertebral bodies
  • sympathetic trunk; posterior to
  • IVC; posterior to
  • psoas major; posterior to
  • quadratus lumborum; inferior to
  • lumbar plexus (L2, L3, L4)
  • iliolumbar ligament
• Middle (median) sacral artery
  • L4
  • sacral promontory
  • left common iliac vein
  • left and right sympathetic trunks
  • superior hypogastric plexus
  • right and left hypogastric nerves
  • development: continuation of abdominal aorta
• Iliolumbar artery
  • posterior division internal iliac
  • ala of the sacram
  • lumbosacral trunk (part of L4 and all of L5)
  • 5th lumbar vertebra
  • obturator nerve
  • genitofemoral nerve
  • psoas major
  • anastomosis deep circumflex iliac artery

Autonomic Innervation of the Posterior Abdominal Wall

• Greater splanchnic nerve
  • crus of the diaphragm
  • suprarenal gland
  • preganglionic
    
  • celiac ganglion
  • aorta
  • celiac trunk
  • celiac plexus
  • aortic plexus
  • gonadal plexus
    
  • lesser and least splanchnic nerve
• Lesser splanchnic nerve
  • see greater splanchnic nerve
  • preganglionic
    
  • superior mesenteric ganglion
  • middle suprarenal artery
• Least splanchnic nerve
  • see greater and lesser splanchnic nn
  • preganglionic
    
  • superior border of renal vein at aorta
  • aorticorenal ganglion (maybe you see it maybe you don't)
  • renal plexus
  • aortic plexus
• Lumbar splanchnic nerves
  • lumbar sympathetic trunk
  • preganglionic
    
  • aortic plexus
  • inferior mesenteric ganglion (usually not see by the unassisted eye)
    
• Celiac plexus
  • celiac trunk
  • hepatic plexus
  • vagal branches (know they exist)
    
  • autonomic supply to the foregut
• Superior mesenteric plexus
  • autonomic supply to the midgut
• Inferior mesenteric plexus
  • sympathetic supply to the hindgut
• Extensions of pelvic plexus (inferior hypogastric plexus) ascending left pelvic brim
  • parasympathetic supply to the hindgut
    
  • derived from pelvic splanchnics
  • retroperitoneal along medial margin of descending colon
    
• Lumbar sympathetic trunk
  • anterior lateral vertebral bodies
  • medial arcuate ligament
    
  • lumbar arteries
  • lumbar splanchnics
  • white rami
  • grey rami
  • sacral promontary
    
• filler

Comments