Small Group Session II

(to view with answers)

Visceral Blood Supply

Answer the following questions upon completion of your dissection of the vascular
supply to the gut.

I. Arterial Supply:

A. Indicate in the space provided whether the named artery is "free" or "retroperitoneal".

1. Splenic artery __________________________________________________________
2. Inferior pancreatico-duodenal artery ________________________________________
3. Middle colic artery ______________________________________________________
4. Right colic artery _______________________________________________________
5. Sigmoid arcade ________________________________________________________
6. Ovarian/Testicular artery _________________________________________________

B. What are the major differences between the vascular patterns of the proximal jejunum
compared to the more distal ileum?
________________________________________________________________________
________________________________________________________________________
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C. What is the functional significance of the arterial arcades, especially in the jejunum?
________________________________________________________________________
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D. What is the functional significance of the arterial vasa recti?
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
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E. In severe cases of "abdominal angina", the superior mesenteric artery commonly exhibits
atherosclerosis or narrowing of the vessels. Under these conditions, how may blood still fill the
branches to the small intestine? ________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
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II. Portal Venous System:

A. What are the major differences in the vascular pattern between the portal system of veins
and the arterial supply to the small and large intestine?
________________________________________________________________________
_________________________________________________________________________
_________________________________________________________________________
_________________________________________________________________________

KIDNEYS AND POSTERIOR WALL

A. On your cadaver, what structures overlie the hilum of the right kidney?
_________________________________________________________________________
_________________________________________________________________________

B. On your cadaver, what muscle groups lie posterior to the left kidney?
_________________________________________________________________________
_________________________________________________________________________

C. Based on your knowledge of the relative position of the kidney, describe a surgical
procedure to remove the left kidney via a retro-peritoneal approach. Include the direction of
the skin incision, the muscles transected and the compartments exposed. Be specific as to
the vertebral level, and the consequences of the surgical approach; i.e. denervation and
subsequent nerve loss (sensory and motor); and important blood vessels ligated. Include
possible injury to adjacent organs.

Surgical approach:______________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
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Vertebral level(s):______________________________________________________________
_____________________________________________________________________________
Skin incision:__________________________________________________________________
_____________________________________________________________________________
Muscles transected:_____________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
Nerves transected:______________________________________________________________
_____________________________________________________________________________
Sensory/motor nerve loss: _______________________________________________________
_____________________________________________________________________________
Arterial vessels ligated:__________________________________________________________
_____________________________________________________________________________
Important anastomoses required to maintain proper blood supply:________________________
_____________________________________________________________________________
_____________________________________________________________________________
Venous vessels ligated: _________________________________________________________
_____________________________________________________________________________
Important alternate venous drainage after venous ligation ______________________________
_____________________________________________________________________________
Compartments entered (in order of sequence):________________________________________
_____________________________________________________________________________
Other organs/structures cut and or removed during this procedure: ______________________
_____________________________________________________________________________
_____________________________________________________________________________
Adjacent organs that may be injured: _______________________________________________
_____________________________________________________________________________
_____________________________________________________________________________

D. Name each of the arteries that supply the male ureters and the extent of their distribution.

1) ___________________________________________________________________________
2) ___________________________________________________________________________
3) ___________________________________________________________________________
4) ___________________________________________________________________________

Which of the above branches is replaced in the female, and what is its contribution?
_____________________________________________________________________________
_____________________________________________________________________________

E. Describe the contents of each of the following compartments that surround the bladder
and indicate its clinical importance.

(1) Retropubic space: ___________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
(2) Utero-vesicle space: _________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
(3) Recto-vesicle space: _________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
(4) Pre-vesicle space: ___________________________________________________________
_____________________________________________________________________________
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(5) Utero-rectal space: __________________________________________________________
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