Hepatic artery Anomalies

Q)  Most common anomaly of hepatic artery noted during liver resection is
a. Accessory right hepatic artery originating from superior mesenteric artery
b. Replaced right hepatic artery originating from superior mesenteric artery
c. Accessory left hepatic artery originating left gastric artery

d. Replaced left hepatic artery originating from left gastric artery

Right gastro epiploic vein

Q) Right gastroepiploic vein drains into
A. Splenic vein
B. Left gastric vein
C. Portal vein
D. Superior mesenteric vein


ANswer is free

D SMV

Veins of SMV
Right gastro epiploic vein

The right gastroepiploic vein is a significant blood vessel located in the abdomen. It runs parallel to the right gastroepiploic artery and is an essential part of the venous drainage system of the stomach. Originating from the greater curvature of the stomach, this vein receives blood from various branches, including the short gastric veins. As it continues its course, it eventually joins with the superior mesenteric vein, contributing to the portal venous system. Understanding the anatomy and function of the right gastroepiploic vein is crucial for medical professionals in diagnosing and treating related conditions, ensuring proper circulation and overall digestive health.

lymphatics of colon

Q ) Which of the following group of lymph nodes  lymphatics of the colon first drain to?

a) Paracolic

b) Epicolic

c) Nodes along SMA/IMA

d) Para aortic


Ans ) b

Lymphatics first drain to epicolic group along the bowel wall

Then it goes to  paracolic group along the marginal artery

Intermediate group along the named vessels SMA/IMA

Finally to para aortic 

Colon and upper 2/5 of rectum --- Para aortic

Lower 1/5 of rectum and anal canal - Superficial inguinal lymph nodes

Ref Sabiston-1317

Blood supply of CBD

Q) Supraduodenal  CBD is supplied by all except (AIIMS NOV 18)
a Cystic art
b RHA
c LHA
d Anterosuperior pancreaticoduodenal artery

 

Ans c

The blood supply to the right and left hepatic ducts and upper portion of the CHD is from the CA and the right and left hepatic arteries.

The supraduodenal bile duct is supplied by arterial branches from the right hepatic, cystic, posterior superior pancreaticoduodenal, and retroduodenal arteries.

arteries to the supraduodenal bile duct run parallel to the duct at the 3 and 9 o’clock positions.

Approximately 60% of the blood supply to the supraduodenal bile duct originates
inferiorly from the pancreaticoduodenal and retroduodenal arteries

whereas 38% of the blood supply originates superiorly from the right hepatic artery and CD artery

Shackelford-1253

Bible of GI Surgery for AIIMS. Get your own Kindle Edition 

 

Esophagus Length

Q) Length of Esophagus is 

 A. 20 cm
B. 25 cm
C. 30-35cm
D. 40cm

Length of esophagus is important in various resection surgeries as well as endoscopy


Answer

 b 25 cm

The length of esophagus  is anatomically defined as the distance between the cricoid cartilage and the gastric orifice. It ranges in adults from 22 to 28 cm (24 ± 5 SD),  last 3 to 6 cm of which are located in the abdomen.

The shortest distance between the cricoid cartilage and the celiac axis is the orthotopic route in the posterior mediastinum, being 30 cm. The retrosternal (32 cm) and the subcutaneous route (34 cm) proved to be longer

Deviations to the left 

Esophagus through out its length deviates to the left in superior mediastinum and lower posterior mediastinum.

Constrictions of esophagus

Cervical narrowest at c5/6

Thoracic T4-5

Abdominal

 

Ref Shackelford page 10

Blood supply duodenum

Q) Supraduodenal artery of Wilkie is a branch of

a) GDA

b) Rt gastroepiploic

c) Rt gastric

d) Sup Pancreaticoduodenal

Ans For Premium 

Discuss blood supply of 1st part of duodenum, and course of all arteries mentioned in choices.