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BLOOD - Fluids in general:

In document Anatomic Sciences Nuggets (Page 43-68)

o Extracellular fluid (Na-142; K-4) vs intracellular (Na-10 K-140) o Fluid: 50-60% of body weight

 Intracellular fluid (w/in cells) = 35-40% of body weight

 Extracellular fluid (outside the cells) = 15-20% of body weight

• Blood plasma = 4-5% of body weight

• Interstitial fluid = 11-15% of boby weight

o Transcellular fluids: 1-2 Liters; CSF, intraocular, synovial, pericardial, pleural, peritoneal

o Tissue (interstitial) fluid contains a small % of plasma proteins of low MW that pass through the capillary walls as a consequence of hydrostatic pressure of blood. This fluid bathes the cells

- Blood

o 8% of total body weight o Volume = 4-6 liters o Temp = 38°C o pH = 7.35-7.45 - Blood composition

o 55% plasma:

 91% water

 7 % protein

• Albumins – 55%

• Globulins – 38%

• Fibrinogen – 7%

 2% other solutes

• Metabolic end products, food materials, respiratory gases, hormones, ions o 45% formed elements:

 1) Erythrocytes – 4.3-5.8 million/mm3

• Proerythroblast → erythroblast → normoblast → reticulocyte → erythrocyte

• Biconcave, enucleated discs – 7-8µm in diameter o Contain heme (an endogenous pigment) o Biconcave shape increases surface area 20-30%

o High surface area : volume ratio

• No MB-bound organelles

• Energy source is glucose

o 90% from anaerobic metabolism – degraded to lactate o 10% from HMP shunt

• Function = O2 & CO2 transport

o Oxyhemoglobin = hemoglobin molecule + O2

o Carbaminohemoglobin = hemoglobin + CO2 (~70% of CO2 is transported as bicarbonate ions)

 Remember Carboxyhemoglobin is CO

RBC MB contains chloride-bicarbonate antiport – allows transport of CO2 to lungs for elimination

• Hematocrit = proportion of erythrocytes in a blood sample o 46%, for males, 40% for females

• Formed via erythropoiesis – stimulated by erythropoietin produced in kidney

o In erythropoiesis, the cytoplasmic acidophilia increases (Duh, they become more red – ) o In erythropoiesis, cells trend toward:

 A progressively smaller size

 A progressive loss of organelles

 A progressive increase in cytoplasmic Hemoglobin concentration

• Average life span = 120 days

o Normoblast is a developmental stage of the erythrocyte (not monocyte, lymphocyte, or eosinophil)

• Shrink and crenate in hypertonic solution

Become ghost cells in hypotonic solution

• Erythrocytosis = polycythemia = ↑ # of RBCs

• Anisocytosis = varying sizes

• Poikilocytosis = varying shapes

 2) Platelets – 250-400k/mm3

• Cytoplasmic fragments of cells that promote clotting (as part of hemostasis) o Thrombopoietin stimulates megakaryocytes to give rise to platelets

• Minute, irregularly shaped, disk-like cytoplasmic bodies found in blood plasma

• No nucleus, DNA or hemoglobin

Life span is 5-9 days – removed in spleen & liver

• Stop blood loss by forming a platelet plug

• Contain secretory vesicles (granules), which release ADP & others chemicals when platelets adhere to collagen o Induces changes that make platelet surface sticky

o Additional platelets adhere to original platelets to form plug

• Thromboxane A directly promotes platelet Aggregation o Where PGI “inhibits Platelet grouping”

 3) Leukocytes – 5-10k/mm3

Neutrophils – 60-70% [of leukocytes] in a differential blood count o More recent #s say 40-75%

o Lobed nucleus, fine granules

o Large, spherical azuriphilic 1° granules (lysosomes)

 Contain hydrolytic enzymes, lysosyme, myeloperoxidase, & lactoferrin o Function = phagocytosis (they love to ingest bacteria)

o Nucleus becomes more hyperchromatic during the development in the red bone marrow o Neutrophils w/ > 5 lobes are called “hypersegmented”

• Lymphocytes – 20-30% (agranulocytes) o Round nucleus, little cytoplasm

o Function = produce Ab, destroy specific target cells o T cells:

 Differentiate in the thymus

 Account for 70-80% of circulating lymphocytes

 Produces cell-mediated immunity

 Interact w/ specific antigen, become sensitized & differentiate into several types of daughter cells:

• Helper T cell (CD4)—helps activate other T lymphocytes

• Cytotoxic T cell (CD8)—combines w/ Ag on surface of foreign cell causing lysis & cytokine release

• Suppressor T cell—suppresses activation of immune system – maintains hemostasis & tolerance to self

Memory T cell—remains inactive until 2nd exposure to same Ag – then reproduce to mount a faster reaction

o Aka ‘delayed hypersensitivity T cell’

o B cells:

 Differentiate in bone marrow

 20-30% of circulating lymphocytes

 Antibody immunity

 Once activated by/sensitized to Ag→daughter cells that either make Ab/s or become memory cells

 Memory B cells→plasma cells (after 2nd exposure to Ag)

 Can function as an APC via MHC Class II o Plasma cells:

 Differentiated from B-cells

 Found mainly in bone marrow and CT; and sometimes blood

 Off-center nucleus & clock-face chromatin distribution

 Short 5-10 day life

 Specific immunity

Aid in the immunologic defense of the body (NOT mast cells, neutrophils, giant cells)

Plasma cells (NOT T-cells or B-cells) produce most of the body’s Ab/s

Contain large amount of rough ER & well-developed Golgi apparatus (Same with Mucous secreting Goblets)

 Are found in the inner medullary center of lymph nodes (aka Medullary Cords)

• Monocytes – 2-6% (agranulocytes)

o Kidney-shaped nucleus (Crescent Moon shaped) o Differentiates into macrophages in tissues

o Function = phagocytosis

• Eosinophils – 1-4%

o Lobed nucleus, red or yellow granules

o Function = may phagocytize Ab-Ag complexes

o Contain histiminase, acid phosphatase, and aurosulfurnimase

• Basophils – 0-1%

o Obscured nucleus, purple granules

o Function = release histamine, heparin, serotonin, & SRS-A (slow reacting substance of anaphylaxis) o Similar to mast cells w/ coarse cytoplasmic granules

 Granules contain heparin (anticoagulant), histamine (vasodilator) and bradykinin, serotonin, & SRS-A (slow reacting substance of anaphylaxis)

 Heparin can prevent blood coagulation & can speed the removal of fat particles from blood after a fatty meal

 Occur in most loose CT, especially along the path of BVs

o NOTE: serum = blood plasma w/o fibrinogen - Bone marrow:

o Produces WBCs, RBCs & platelets by hematopoiesis o Red marrow:

 Cavities of cranial bone, vertebrae, ribs, sternum, & ends of long bones

 Prior to birth, other areas produce blood elements: liver, spleen, lymph nodes

 Hemacytoblasts (pluripotent stem cells):

• So, the principal site of granulocytic hemopoiesis in the adult human is red bone marrow

o Yellow marrow:

 Found only in cancellous (spongy) tissue of certain bones:

• Flat skull bones, ribs, sternum, vertebrae, portions of ossa coxae & proximal epiphyses of humerus & femur

 Minor location of fat storage ARTERIES

 Blood vessel walls:

 Tunica intima

 Innermost layer

 Consists of simple squamous epithelium (endothelium) and a thin CT basement MB

 ONLY layer present in all vessels

 In atherscletotic pt, this is the layer involved in the hypertrophy

 Tunica Media

 Middle Layer

 Usually very thick in arteries (smooth muscle w/ some elastic fibers). In Lg arteries, elastic fibers are most prominent. In small arteries, smooth muscle is most prominent in this layer.

 What keeps blood flowing during diastole  energy stored in elastic fibers of arteries

 Tunica Externa (Adventitia)

 Outer layer of CT w/ elastic & collagenous fibers

 The tunica adventitia of the medium sized artery has mostly what?  collagen and elastin

 In larger vessels, infiltrated w/ tiny BVs called vasa vasorum (vessels of the vessels) that nourish external tissues of BV wall

 Arteries

 Highest BP found here

Greatest drop/change/gradient in BP is from the arteries to the arterioles

 There are more elastic membranes in a large artery than there are in a medium-sized artery

 Arterioles

 Very small diameter (<0.5mm)

 Small lumen, thick tunica media almost entirely of smooth muscle, little elastic tissue

 Has the greatest

proportion

of smooth muscle thickness when compared to the size of the lumen

Other choices: large arteries (don’t get clowned), capillaries, veins

 Smooth muscle (fibers, with single, centrally-placed nuclei) dilation/constriction is caused by neurochemical stimuli & has profound impact on peripheral resistance

 Can empty in toSinusoids in certain tissues (liver, spleen, pituitary, adrenal, carotid body, pancreas, parathyroid – not in kidneys, they just have a portal system

 Sinusoids are wider & more irregular than capillaries

 Walls consist of phagocytic cells, from part of reticuloendothelial system—deals w/ phagocytosis & Ab formation

 Capillaries

 Exchange occurs here

 Endothelium only (no tunica media or adventitia)

 Which is seen continuously throughout Circulatory system?  ENDOTHELIUM

 Constant lumen & complete endothelial lining (unlike sinusoids)

 NO elastic fibers

 One RBC at a time

 Velocity of blood is slowest here

 Aorta:

 Tunica media is composed primarily of elastic fibers (distinguishing factor between aorta & arteries)

 Has four parts:

 1) Ascending aorta:

• Beginning portion, R & L coronary arteries branch from it (to supply heart muscle)

• Syphilis aneurysm occurs here

 2) Arch of Aorta:

• Gives rise to 3 Branches that supply all of the blood to the head, neck, and upper limbs:

♦ Brachiocephalic

 Extremely short

 1st branch of aorta

 At the neck it divides into the Right Common Carotid and right Subclavian artery

 ***Only 1 Brachiocephalic artery, BUT 2 Brachiocephalic veins – Don’t get clowned.

♦ Left common carotid

 Along w/ right common carotid, supplies head and neck

 SEE BELOW

♦ Left Subclavian

 Along w/ right subclavian, supplies upper limbs

 SEE BELOW

 3) Thoracic portion:

From T4→T12 (lies in the posterior mediastinum)

• All of the arterial branches from this part are small – See pps. 70, 116 of Essential Clinical Anatomy 2nd Ed. (ECA)

♦ Posterior Intercostals

 Supply intercostal, serratus anterior, and pectoral muscles

 Anastomoses w/ Internal Thoracic (Subclavian) when it gives off the Anterior Cutaneous artery

 At the mid-axillary line, give rise to Lateral Cutaneous artery

♦ Subcostals

 Supply the thorax & the diaphragm

♦ Pericardial braches

♦ Mediastinal branches

♦ Esophageal branches

♦ Bronchial branches

♦ Superior Phrenic (at the level of the diaphragm)

 4) Abdominal portion: (SEE BELOW)

Most common location for an atherosclerotic-induced aneurysm

From T12→L4

♦ Branches to:

 (Unpaired)

 Celiac Trunk

 Superior Mesenteric

 Inferior Mesenteric

 NOTE: Spleen, stomach, pancreas & appendix are supplied by the 3 unpaired aortic branches (not adrenals)

 (Paired)

 Suprarenal – NOT From unpaired

 Renal

• If the renal artery is occluded, you are likely to get 2ndary HTN

 Gonadal

 Lumbar

♦ Terminates w/ branching of:

 Right Common Iliac arteries

 Left Common Iliac arteries

 Small Middle Sacral artery

• Supply abdomen, pelvic region & lower limbs

 Common Carotid: (FROM ABOVE)

 Supplies head & neck

Branches into ICA & ECA at superior border of thyroid cartilage

 Another Q: Branches at the level of C4 or the Hyoid bone

 Carotid Sinus

 Spindle-shaped dilation located at junction of ICA & ECA

 Has baroreceptors for pressure – when stimulated causes vasodilation, ↓ HR, & ↓ BP

Innervated by carotid sinus branch of CN IX (only 1 because it’s just a sinus, not a whole body)

Carotid sinus syndrome: temporary loss of consciousness accompanying convulsive seizures

♦ Due to intensity of carotid sinus reflex when pressure builds in one or both carotid sinuses

 Carotid body:

 Lies posterior to the bifurcation of the Common Carotid

 Innervated by CN IX & CN X (2 because it’s a whole body)

 Sensitive to ↑ CO2 & ↓ O2 tension in blood

 Carotid Sheath:

 In it runs:

• Common Carotid

• Internal Jugular Vein

• Vagus Nerve

NOT ansa cervicalis

NOT phrenic nerve

 Branches of Common Carotid (2)

 Internal Carotid: (3 Branches)

 Inside the cranial cavity

 Branches to:

• Ophthalmic:

♦ Supplies orbit & eye through optic foramen w/ optic nerve

♦ Branches to:

 Anterior ethmoidal—Supplies the nasal cavity

 Dorsal Nasal—Anastomoses w/ Angular branch (Facial)

• Anterior Cerebral:

♦ Great cerebral circle of Willis

♦ Supplies:

 Medial surfaces of hemispheres –entire medial surface except a little bit from posterior cerebral artery. These arteries wrap around the top and get the superior and frontal pole surfaces as well

 Anterior & superior portions of frontal & parietal lobes

 Anterior portions of basal ganglia, internal capsule, corpus callosum

• Middle Cerebral:

♦ Great cerebral circle of Willis. The artery most often occluded in stroke.

♦ Largest branch of ICA

 Branches include Lenticulostriate Arteries

 These are “Arteries of Stroke” (not the middle meningeal).

 Thin-walled, frequently rupture to cause cerebral hemorrhage

 Supply internal capsule, caudate, putamen. – (is this why ppl often have ataxia with stroke??)

♦ Supplies:

 Lateral surface of the cerebral hemisphere – primary motor and sensory areas of face, throat, hand and arm + areas of speech in dominant hemisphere.  Droop in face.

 Posterior limb of the internal capsule & part of the basal ganglia

NOTE: Circle of Willis: (aka ‘cerebral arterial circle’)

♦ Rupture of a vessel in the circle of Willis→ causes subarachnoid hemorrhage

♦ The Basilar artery emits into 2 posterior cerebral arteries (Basilar artery is formed by both vertebrals joining)

 Then posterior cerebral arteries emit posterior communicating artery

 Then posterior communicating artery joins middle cerebral artery

• Then middle cerebral artery emits anterior cerebral artery (Mid. cerebral is term. branch of int. carotid)

♦ Finally anterior cerebral arteries joined by anterior communicating artery

♦ From Front to Back

 Ant. Communicating→Ant. Cerebral→Middle Cerebral→Post. Communicating→Post. Cerebral→Basilar

♦ Anterior Communicating:

 Most common circle of Willis aneurysm – may cause visual field defects

♦ Posterior Communicating:

 Common area of aneurysm – causes CN III palsy

♦ The basilar & anterior communicating arteries are the unpaired vessels of the Circle of Willis

♦ Forms an important means of collateral circulation in case of obstruction

 If the internal carotid is blocked, blood will still get to the brain via the vertebral arteries/Basilar

NOTE: Stroke warning signs

♦ Sudden weakness; paralysis; numbness of the face, arm, & leg on one/both sides of body

♦ Loss of speech or difficulty speaking or understanding speech

♦ Dimness or loss of vision, particularly in only one eye

♦ Unexplained dizziness, unsteadiness, & sudden falls

♦ Sudden severe headache & loss of consciousness

 SIDENOTE: Branches of the Vertebral Artery (these have nothing to do w/ the carotid arteries)

• Meningeal branches

• Anterior & posterior spinal

• Posterior inferior cerebellar (see diagram)

• Medullary branches

Basilar artery:

♦ Formed by the union of the two vertebral arteries

♦ Gives several insignificant (to Boards studying) branches

♦ Significant branches: Posterior cerebral arteries

 Supplies:

 Occipital pole

 Inferomedial temporal lobes

 Subthalamic nucleus

 External Carotid: (8 Branches)

 From the level of the superior border of the thyroid cartilage (bifurcation of common carotid) to the neck of the Mn into the parotid

 Supplies the muscles of the neck, face, thyroid gland, salivary glands, scalp, tongue, jaws, and teeth

 Branches from Inferior to Superior – SALFO PMS – (Some Angry Lady Figured Out PMS)

• Superior thyroid

• Ascending Pharyngeal

• Lingual

• Facial

• Occipital

• Posterior auricular

• Maxillary

• Superficial Temporal

 Terminal Branches

• Maxillary and Superficial Temporal  the most superior branch

 ANTERIOR BRANCHES: (4)

• Superior Thyroid:

♦ Supplies thyroid gland

♦ Originates just below the level of the hyoid bone’s greater cornu

♦ Branches to:

 The SCM

 Superior laryngeal artery

 Pierces thyrohyoid MB w/ the internal laryngeal nerve (aka internal branch of superior laryngeal n.)

 CAREFUL (the artery is the superior thyroid, but then turns into superior laryngeal, whereas the nerve is internal branch of superior laryngeal, then internal and external branches)

• Lingual:

♦ Supplies tongue & floor of the mouth and tip of the tongue

 Tongue also receives blood from Tonsillar branch (Facial) and Ascending Pharyngeal

 Lingual artery does not follow the lingual nerve

 Lingual artery does NOT pass between the medial pterygoid & the ramus of the Mn

♦ Branches at the level of the tip of the greater horn of the hyoid bone in the carotid triangle

♦ Passes Medial (deep) to the hyoglossus muscle and Superior to the Mylohyoid (Deep from the neck aspect)to enter the oral cavity

 So NOT between Hyoglossus and Mylohyoid

 It passes between the Hyoglossus and the Genioglossus

♦ Branches to:

 Suprahyoid

 Dorsal Lingual

 Sublingual

 Deep Lingual

 The terminal branch that supplies the anterior 1/3 of the tongue (tip)

 Ascends between the genioglossus and the inferior longitudinal muscles

 If you pierce the tip of the tongue with a bur, you most likely hit the Deep Lingual Artery

• Facial:

♦ Supplies face, tonsils, palate, labial glands, muscles of lips, ala and dorsum of the nose, muscles of facial expression, and submandibular gland

♦ Branches to: (8)

 Cervical: (4)

 a) Tonsillar—to tonsils & some supply to the tongue

 b) Ascending Pharyngeal—to pharyngeal wall & some supply to the tongue?????

 c) Glandular—to submandibular gland

 d) Submental—to area below chin

 Facial portion: (4)

 a) Inferior labial—to the lower lip

 b) Superior labial—to the upper lip and vestibule of the nose

 c) Lateral nasal—to outer side of lateral nose (lateral wall)

 c) Angular—medial side of eye

• Terminal branch of facial artery

Anastomoses w/ the dorsal nasal branch of ophthalmic

• Maxillary artery: (picture)

♦ Supplies ALL teeth, muscles of mastication, hard/soft palate, and most of nasal cavity (NOT skin of forehead) – ethmoidal from ophthalmic gets some of the nasal cavity.

♦ Branches from ECA at the posterior border of the Mn ramus

♦ Terminal branch of ECA to region of infratemporal fossa and nasal cavity

♦ Lateral pterygoid muscle divides maxillary artery into 3 parts:

 1) Mandibular portion before muscle (DAM-AI)

• Gives rise to branches supplying the tympanic cavity and membrane, dura, and mandibular teeth

 Deep Auricular—to external auditory meatus

 Anterior Tympanic—to eardrum

 Middle Meningeal—to cranial cavity (damage to this artery results in epidural hematoma/hemorrhage)

 Accessory Meningeal—to cranial cavity

 Inferior Alveolar—to chin & Mn teeth (runs along w/ vein & nerve and lingual nerve in the

pterygomandibular space—between the pterygoid muscle and the ramus of Mn (lingual artery does not)

• 3rd Branch of Mx artery???Other Answer was Middle Meningeal. ECA 2nd Ed says its middle meningeal

♦ IN Netters, they both come off at the same level!!! I hate this test

 2) Pterygoid portion passing over/under muscle (ADPMB – A Dr. Pepper Makes Bubbles

• Gives rise to branches that supply the muscles of mastication

 Anterior Temporal - ECA 2nd ed. Doesn’t list this one in its breakdown.

 Deep Temporal arteries

 Pterygoid—medial and lateral

 Masseteric

 Buccal

 3) Pterygopalatine portion crossing muscle (SAD PIP SA(D))

• Gives rise to branches that supply the max teeth, portions of the face, orbit, palate, and nasal cavity

 Sphenopalatine

• Terminal branch of maxillary artery

Enters the nasal cavity through the sphenopalatine foramen along w/ the nasopalatine branch of the maxillary nerve

Principal artery to the nasal cavity, conchae, meatus, and paranasal sinuses

• Damage results in epistaxis (nosebleed)

Nasopalatine (Comes off the Sphenopalatine- which came through the Sphenopalatine Formamen with the Nasopalatine Nerve)

♦ Comes through incisive foramen

♦ Supplies anterior hard palate

♦ Anastomoses w/ Greater Palatine artery of the Descending Palatine

 Artery of the pterygoid canal

 Descending palatine—greater and lesser palatine

• Branches to:

• Greater Palatine Artery—passes to the palate through the greater palatine foramen

♦ Supplies mucosa of hard palate posterior to maxillary canine

♦ A laceration of the palatal mucosa in the area of Mx M1 is most likely to damage the G. P. artery

♦ Anastomoses w/ nasopalatine artery

• Lesser Palatine Artery—Supplies soft palate & tonsils after emerging from the lesser palatine foramen

 Pharyngeal

 Infraorbital—canine and incisor, Part of the 3rd Part of the Maxillary Artery

• Careful, the Infraorbital NERVE comes out from V2, but this is the artery

 Posterior Superior Alveolar (Dental)—maxillary molars and premolar

• PSA is a direct branch off of Mx artery

 Anterior and Middle Superior Alveolar??? – Maxillary anteriors

 POSTERIOR BRANCHES (4):

• Ascending Pharyngeal

♦ Supplies the pharyngeal constrictor muscles

♦ Supplies the tongue

• Occipital

♦ Pharynx and suboccipital triangle

♦ SCM

♦ Hooks CN XII – Landmark for finding XII

• Posterior Auricular

♦ Back of scalp

• Superficial Temporal – does supply the temporalis muscle (along w/ the maxillary artery)

 Supplies the TMJ

♦ Transverse Facial – does NOT supply the temporalis (it branches off too early) – it runs superficial to zygomatic arch.

 Subclavian (FROM ABOVE)

 Divided in 3 parts by the scalene muscles – PICTURE – I couldn’t find a good one

 1st Part – Medial o the scalene m.

 Vertebral (foramen magnum)

• FIRST BRANCH

• **If internal carotid becomes blocked, blood still reaches the brain via the vertebral arteries

Branches from vertebral artery found in section on circle of Willis

 ThyroCERVical Trunk (3)

• Suprascapular

• Transverse cervical

• Inferior thyroid

 Internal Thoracic: (mammary)

• Descends directly behind the 1st 6 costal cartilages, just lateral to the sternum

• Branches to:

♦ Upper Anterior Intercostals—which anastomose w/ the Posterior Intercostals (Thoracic Aorta)

 This network provides muscular branches to the intercostal, serratus anterior, and pectoral muscles

♦ Musculophrenic—Supplies the diaphragm and lower intercostal spaces anteriorly

♦ Superior Epigastric—Enters the rectus sheath and supplies rectus muscles are far as the umbilicus

 ***NOTE: The inferior epigastric artery (External Iliac) anastomes w/ the Superior Epigastric in the rectus sheath in the area of umbilicus

 2nd Part – Behind the scalene m.

 Costocervical (2):

• Supreme intercostal (High Intercostal)

• Deep cervical

 3rd Part – Lateral to the scalene m.

 Dorsal Scapular:

• Supplies the back

 Axillary Artery

 Continuation of the Subclavian

 Begins at the 1st rib and ends at the margin of the teres major m., then turns into the Brachial artery (runs with Median Nerve), then turns into the Radial and Ulnar arteries at the Cubital fossa

 Brachial Artery

Supplies the Posterior Compartment of the arm

 Thoracodorsal

• Supplies the latissimus dorsi m.

 Divided into 3 Sections by the tendon of the pectoralis minor m.

 1st Part (MEDIAL)

• Supreme Thoracic artery

 2nd Part (DEEP)

• Thoraco-acromial artery

• Lateral thoracic artery

 3rd Part (LATERAL)

• Subscapular artery

• Posterior circumflex humeral artery

• Anterior circumflex humeral artery

 Abdominal portion of descending aorta: (FROM ABOVE)

 From T12→L4

 Branches to:

 (UNPAIRED)  CSI

• 1) Celiac Trunk

♦ Hepatic (Common) – the common hepatic artery is a branch of the celiac artery

 Liver, upper pancreas, duodenum, and gallbladder

 Branches to:

 Right Hepatic—to right lobe of liver

 Cystic—to gall bladder

 Left Hepatic

Right Gastric—lesser curvature of the stomach (ALL “Gastrics” go to lesser curvature)

• Gatroduodenal—pancreas and duodenum

 ***[SEE Hepatic Circulation BELOW]

♦ Left Gastric—lesser curvature of the stomach and inferior part of the esophagus

♦ Splenic – spleen, stomach, and omentum

 Branches to:

 Left Gastroepiploic—to greater curvature of the stomach (Epiploic appedanges of Greater omenum)

 Short Gastric—to ??lesser?? curvature of the stomach

• **Stomach supplied by: R & L Gastric, Gastroepiploic & Short Gastric artery

• 2) Superior Mesenteric—small intestine (duodenum and jejunum), pancreas, cecum, ascending and transverse colons

♦ Supplies the GI tract from the middle of the 2nd part of the duodenum to the distal 1/3 of the transverse colon

♦ Supplies the right colic flexure

♦ Supplies the right colic flexure

In document Anatomic Sciences Nuggets (Page 43-68)

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