Vascular: Abdominal Vasculature
Abdominal Arterial Supply
Splanchnic Supply
- High Variation in Flow
- Shock/Hypovolemia: 10% of Cardiac Output
- Fasting: 25% of Cardiac Output
- After a Large Meal: 35% of Cardiac Output
- 70-80% of Flow Supplies the Mucosa/Submucosa
Abdominal Aorta Branches
- Inferior Phrenic
- Superior Suprarenal
- Celiac Trunk
- Left Gastric
- Common Hepatic
- Splenic
- Middle Suprarenal
- Superior Mesenteric (SMA)
- Renals
- Inferior Suprarenal
- *Right Renal Artery Passes Posterior to IVC
- Gonadals
- Inferior Mesenteric (IMA)
- First-Fourth Lumbars
- Common Iliacs
Branches of the Abdominal Aorta
Suprarenal Arteries
Celiac Trunk Branches
- Left Gastric
- Esophageal Branch
- Common Hepatic
- Right Gastric
- Gastroduodenal (GDA)
- Supraduodenal
- Right Gastroepiploic
- Superior Pancreaticoduodenal
- Anterior Branch
- Posterior Branch
- Proper Hepatic
- Left Hepatic
- Right Hepatic
- Cystic
- Splenic
- Pancreatic Branches
- Short Gastrics
- Left Gastroepiploic
Celiac Artery 1
Celiac Artery (Behind Stomach) 1
Mesenteric Branches
- Superior Mesenteric (SMA)
- Inferior Pancreaticoduodenal
- Anterior Branch
- Posterior Branch
- Middle Colic
- Intestinal Branches
- Right Colic
- Marginal Artery
- Ileocolic
- Inferior Pancreaticoduodenal
- Inferior Mesenteric (IMA)
- Left Colic
- Sigmoid Branches
- Superior Rectal
- Connections:
- Marginal Artery of Drummond – Along Margin of Colon
- Arc (Arch) of Riolan (Meandering Mesenteric Artery) – Direct Connection of SMA & IMA
- Arc (Arch) of Barkow – Anastomosis of the Right & Left Gastroepiploic Arteries
- Has Multiple Ascending Branches That Supply the Transverse Colon
- Arc (Arch) of Buhler – Anastomosis Directly Between the Celiac Artery & SMA
- Travels Posterior to the Pancreas, Directly Anterior to the Aorta
- Present in 1-4% of Individuals
SMA Branches 1
IMA Branches 1
Common Iliac Artery (CIA) Branches
- Internal Iliac Artery (IIA)
- Posterior Division
- Iliolumbar Artery
- Lateral Sacral Artery
- Superior Gluteal Artery
- Anterior Division
- Obturator Artery
- Inferior Gluteal Artery
- Umbilical Artery
- Uterine Artery
- Vaginal Artery
- Middle Rectal Artery
- Internal Pudendal Artery
- Inferior Rectal Artery
- Perineal Artery
- Posterior Scrotal/Labial Artery
- Artery of the Bulb of the Penis/Vestibule
- Dorsal Artery of the Penis/Clitoris
- Deep Artery of the Penis/Clitoris
- Posterior Division
- External Iliac Artery (EIA)
- Inferior Epigastrics
- Anastomose to Superior Epigastrics
- Deep Circumflex Iliac Artery
- Common Femoral Artery (Terminal Branch After Passing Inguinal Ligament)
- Inferior Epigastrics
Iliac Artery Branches 1
Watershed Areas
- Region that Receives Dual Blood Supply
- Ischemia Effects
- Protected from Arterial Blockage (Atherosclerosis/Embolus) – Blood from Second Supply
- Vulnerable from Systemic Hypoperfusion – Supplied by Most Distal Branches
- Sites
- Griffith’s Point: Splenic Flexure (SMA/IMA)
- Sudeck’s Point: Rectosigmoid Junction (SRA/MRA/IRA)
- Right Colon – Poorly Developed Marginal Artery in 50% of Patients
- Less Common
- Also Found in Brain
Abdominal Venous Drainage
Portal Drainage
- Inferior Mesenteric Vein (IMV) Enters Splenic Vein
- Splenic Vein & Superior Mesenteric Vein (SMV) Combine to Form Portal Vein
- Portal Vein Branches into Left & Right Portal Veins into the Liver
- Coronary Veins (From Left Gastric Vein)
- Shunt from Portal Vein to Lower Esophagus & Azygous System
- Cause of Esophageal Varices
Inferior Vena Cava (IVC) Drainage
- Inferior Phrenic Veins
- Hepatic Veins
- Segment I – Drains Directly into IVC
- Left Hepatic Vein
- Middle Hepatic Vein – Drains into Left Hepatic Vein
- Right Hepatic Vein
- Right Suprarenal Vein – Drains into the IVC
- Renal Veins
- Left Suprarenal Vein – Drains into the Left Renal Vein
- Left Gonadal Vein – Drains into the Left Renal Vein
- *Left Renal Vein Passes Anterior to Aorta, Posterior to SMA
- Right Gonadal Vein – Drains into the IVC
- Lumbar Veins (#1-4)
- Common Iliacs
Portal Drainage 1
IVC Drainage 1
References
- Gray H. Anatomy of the Human Body (1918). Public Domain.