Blood supply of abdomen

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abdomen blood supply

Transcript of Blood supply of abdomen

  • 1. Muhammad Ramzan Ul Rehman 1

2. Muhammad Ramzan Ul Rehman 2 3. The abdominal aorta begins at the aortichiatus of the diaphragm, anterior to thelower border of vertebra TXII.It descends through the abdomen, anteriorto the vertebral bodies, and by the time itends at the level of vertebra LIV it is slightlyto the left of midline.The terminal branches of the abdominalaorta are the two common iliac arteries.Muhammad Ramzan Ul Rehman 3 4. The abdominal aorta has anterior,lateral, and posterior branches as itpasses through the abdominal cavity.The three anterior branches supply thegastrointestinal viscera:the celiac trunkthe superior mesenteric andthe inferior mesentericarteries.Muhammad Ramzan Ul Rehman 4 5. Muhammad Ramzan Ul Rehman 5 6. Muhammad Ramzan Ul Rehman 6 7. A. foregut,B. midgut, andC. hindgut regions. The boundaries of these regions are directlyrelated to the areas of distribution of the threeanterior branches of the abdominal aorta.Muhammad Ramzan Ul Rehman 7 8. Divisions of thegastrointestinaltract intoforegut, midgut,and hindgut,summarizing theprimary arterialsupply to eachsegment.Muhammad Ramzan Ul Rehman 8 9. The foregut begins with the abdominalesophagus and ends just inferior to themajor duodenal papilla, midway along thedescending part of the duodenum.It includes the abdominal esophagus,stomach, duodenum (superior to themajor papilla), liver, pancreas, andgallbladder.The spleen also develops in relation tothe foregut region. The foregut issupplied by the celiac trunk.Muhammad Ramzan Ul Rehman 9 10. Divisions of thegastrointestinaltract intoforegut, midgut,and hindgut,summarizing theprimary arterialsupply to eachsegment.Muhammad Ramzan Ul Rehman 10 11. The midgut begins just inferior to the majorduodenal papilla, in the descending part of theduodenum, and ends at the junction betweenthe proximal two-thirds and distal one-third ofthe transverse colon.It includes the duodenum (inferior to themajor duodenal papilla), jejunum, ileum,cecum, appendix, ascending colon, and theright two-thirds of the transverse colon.The midgut is supplied by the superiormesenteric artery.Muhammad Ramzan Ul Rehman 11 12. Divisions of thegastrointestinaltract intoforegut, midgut,and hindgut,summarizing theprimary arterialsupply to eachsegment.Muhammad Ramzan Ul Rehman 12 13. The hindgut begins just before the left colicflexure (the junction between the proximaltwo-thirds and distal one-third of thetransverse colon) and ends midway throughthe anal canal.It includes the left one-third of the transversecolon, descending colon, sigmoid colon,rectum, and upper part of the anal canal.The hindgut is supplied by the inferiormesenteric arteryMuhammad Ramzan Ul Rehman 13 14. Divisions of thegastrointestinaltract intoforegut, midgut,and hindgut,summarizing theprimary arterialsupply to eachsegment.Muhammad Ramzan Ul Rehman 14 15. The celiac trunk is the anterior branch of theabdominal aorta supplying the foregut.It arises from the abdominal aortaimmediately below the aortic hiatus of thediaphragm, anterior to the upper part ofvertebra LI.It immediately divides into the:A. left gastric,B. splenic, andC. common hepatic arteries.Muhammad Ramzan Ul Rehman 15 16. Muhammad Ramzan Ul Rehman 16 17. Muhammad Ramzan Ul Rehman 17 18. Muhammad Ramzan Ul Rehman 18 19. Muhammad Ramzan Ul Rehman 19 20. Muhammad Ramzan Ul Rehman 20 21. The left gastric artery is the smallest branch ofthe celiac trunk.It ascends to the cardioesophageal junction andsends esophageal branches upward to theabdominal part of the esophagus.Some of these branches continue through theesophageal hiatus of the diaphragm andanastomose with esophageal branches from thethoracic aorta.The left gastric artery itself turns to the right anddescends along the lesser curvature of thestomach in the lesser omentum.It supplies both surfaces of the stomach in thisarea and anastomoses with the right gastric artery.Muhammad Ramzan Ul Rehman 21 22. Muhammad Ramzan Ul Rehman 22 23. Muhammad Ramzan Ul Rehman 23 24. The splenic artery, the largest branch of the celiac trunk,takes a tortuous course to the left along the superior borderof the pancreas.It travels in the splenorenal ligament and divides intonumerous branches, which enter the hilum of the spleen.As the splenic artery passes along the superior border of thepancreas, it gives off numerous small branches to supply theneck, body, and tail of the pancreas.Muhammad Ramzan Ul Rehman 24 25. Approaching the spleen, the splenic artery givesoff short gastric arteries, which pass throughthe gastrosplenic ligament to supply the fundusof the stomach.It also gives off the left gastro-omental artery,which runs to the right along the greatercurvature of the stomach, and anastomoses withthe right gastro-omental artery.Muhammad Ramzan Ul Rehman 25 26. Muhammad Ramzan Ul Rehman 26 27. Muhammad Ramzan Ul Rehman 27 28. The common hepatic artery is a medium-sizedbranch of the celiac trunk that runs tothe right and divides into its two terminalbranches, the hepatic artery proper and thegastroduodenal artery.The hepatic artery proper ascends towardsthe liver in the free edge of the lesseromentum.It runs to the left of the bile duct and anteriorto the portal vein, and divides into the rightand left hepatic arteries near the portahepatis.Muhammad Ramzan Ul Rehman 28 29. Muhammad Ramzan Ul Rehman 29 30. Muhammad Ramzan Ul Rehman 30 31. Muhammad Ramzan Ul Rehman 31 32. As the right hepatic artery nears the liver, itgives off the cystic artery to the gallbladder.The gastroduodenal artery may give off thesupraduodenal artery before descendingposterior to the superior part of theduodenum.Reaching the lower border of the superiorpart of the duodenum, the gastroduodenalartery divides into its terminal branches, theright gastro-omental artery and the superiorpancreaticoduodenal arteryMuhammad Ramzan Ul Rehman 32 33. Muhammad Ramzan Ul Rehman 33 34. Muhammad Ramzan Ul Rehman 34 35. Muhammad Ramzan Ul Rehman 35 36. passes to the left, along the greater curvature ofthe stomach, eventually anastomosing with theleft gastro-omental artery from the splenic artery.The right gastro-omental artery sends branches toboth surfaces of the stomach and additionalbranches descend into the greater omentum.The superior pancreaticoduodenal artery dividesinto anterior and posterior branches as it descendsand supplies the head of the pancreas and theduodenum.These vessels eventually anastomose with anteriorand posterior branches of the inferiorpancreaticoduodenal artery.Muhammad Ramzan Ul Rehman 36 37. Muhammad Ramzan Ul Rehman 37 38. The superior mesenteric artery is the anteriorbranch of the abdominal aorta supplying themidgut.It arises from the abdominal aortaimmediately below the celiac artery,anteriorto the lower part of vertebra LI.Muhammad Ramzan Ul Rehman 38 39. is crossed anteriorly by the splenic vein and theneck of pancreas. Posterior to the artery are theleft renal vein, the uncinate process of thepancreas, and the inferior part of theduodenum.After giving off its first branch (the inferiorpancreaticoduodenal artery) the superiormesenteric artery gives off jejunal and ilealarteries on its left.Muhammad Ramzan Ul Rehman 39 40. Muhammad Ramzan Ul Rehman 40 41. Branching from the right side of themain trunk of the superior mesentericartery are three vessels-A. the middle colic,B. right colic, andC. ileocolic arteries-which supply theterminal ileum, cecum, ascendingcolon, and two-thirds of thetransverse colon.Muhammad Ramzan Ul Rehman 41 42. Muhammad Ramzan Ul Rehman 42 43. Muhammad Ramzan Ul Rehman 43 44. Muhammad Ramzan Ul Rehman 44 45. Muhammad Ramzan Ul Rehman 45 46. The inferior pancreaticoduodenal artery is thefirst branch of the superior mesenteric artery.It divides immediately into anterior andposterior branches, which ascend on thecorresponding sides of the head of thepancreas.Superiorly, these arteries anastomose withanterior and posterior superiorpancreaticoduodenal arteries.This arterial network supplies the head anduncinate process of the pancreas and theduodenumMuhammad Ramzan Ul Rehman 46 47. Muhammad Ramzan Ul Rehman 47 48. Muhammad Ramzan Ul Rehman 48 49. Distal to the inferior pancreaticoduodenal artery,the superior mesenteric artery gives offnumerous branches.Arising on the left is a large number of jejunaland ileal arteries supplying the jejunum and mostof the ileum.These branches leave the main trunk of theartery, pass between two layers of themesentery, and form anastomosing arches orarcades as they pass outward to supply the smallintestine.The number of arterial arcades increases distallyalong the gut.Muhammad Ramzan Ul Rehman 49 50. Muhammad Ramzan Ul Rehman 50 51. Muhammad Ramzan Ul Rehman 51 52. There may be single and then double arcades inthe area of the jejunum, with a continuedincrease in the number of arcades moving intoand through the area of the ileum.Extending from the terminal arcade are vasarecta (straight arteries), which provide the finaldirect vascular supply to the walls of the smallintestine.The vasa recta supplying the jejunum are usuallylong and close together, forming narrow windowsvisible in the mesentery.The vasa recta supplying the ileum are generallyshort and far apart, forming low broad windows.Muhammad Ramzan Ul Rehman 52 53. Muhammad Ramzan Ul Rehman 53 54. The middle colic artery is the first of the three branchesfrom the right side of the main trunk of the superiormesenteric artery.Arising as the superior mesenteric artery emerges frombeneath the pancreas, the middle colic artery enters thetransverse mesocolon and divides into right and leftbranches.The right branch anastomoses with the right colic arterywhile the left branch anastomoses with the left colic artery,which is a branch of the inferior mesenteric artery.Muhammad Ramzan Ul Rehman 54 55.