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Let’s continue our USMLE Review with Anatomy from the Gold Standard USMLE Step 1 Audio Review program.
Play USMLE Audio MP3 03 08 Anatomy Stomach 4 Below
Begin 03 08 Anatomy Stomach 4 Transcription
Let’s look at the arteries in this region.
What main trunk from the abdominal aorta supplies the stomach, the spleen, the liver, the gallbladder, part of the duodenum and part of the pancreas?
- The celiac trunk.
And at what level does the celiac trunk come off the abdominal aorta?
- At the lower border of the twelfth thoracic vertebrae.
The celiac trunk then divides into three main branches, what are they from left to right?
- The left gastric artery, the splenic artery and the common hepatic artery.
Now at this point where are we in relation to the peritoneum?
- We are still retroperitoneal.
Now the left gastric artery branch from the celiac trunk runs more or less left and superior towards the stomach before it reaches the stomach it gives off a branch which runs superiorly, what is this branch?
- The esophageal branch of the left gastric artery.
And what does this supply?
- The lower third of the esophagus, it continues on up through the diaphragm.
Now, the left gastric artery continues on after giving off the esophageal branch and reaches the stomach running down primarily one part of the stomach, what is that?
- The lesser curvature of the stomach.
And what is its relation to the peritoneum at this point?
- At this point it is intraperitoneal.
As the left gastric artery runs down the lesser curvature of the stomach it is of course giving off branches, it primarily serves what two parts of the stomach?
- The cardia region and the body of the stomach.
As the left gastric artery runs down the lesser curvature of the stomach and reaches the antrum of the pylorus, it anastomoses with the end of another artery coming the opposite direction, what is the other artery?
- The right gastric artery.
The intraperitoneal portion of the right gastric artery is following what part of the stomach?
- The superior portion of the pylorus.
The right gastric artery is coming from the right from one of the main branches of the celiac trunk, what branch is it coming from?
- The common hepatic branch from the celiac trunk.
Ok so the left gastric artery is the first branch to come off the celiac trunk on the left, what is the next branch to come off the celiac trunk?
- The splenic artery.
And how does it run and lie in reference to the stomach and peritoneum?
- It runs retroperitoneally, transversely to the left, behind the stomach over to the spleen.
Before it reaches the spleen however, it gives off two branches which supply more of the stomach, what are these two branches?
- The short gastric branches and the left gastroepiploic.
The short gastric branches from the splenic artery supply what part of the stomach?
- Primarily the left side of the fundus of the stomach.
And the left gastroepiploic which comes off the splenic artery at about the same place, follows what part of the stomach?
- It follows the greater curvature of the stomach on down.
And what is its relation to the peritoneum?
- The left gastroepiploic artery is intraperitoneal and is following the attachment of the greater omentum or the gastrocolic ligament at that point to the greater curvature of the stomach. The splenic artery then continues on of course to give splenic branches to the spleen.
Now let’s go back, what artery again supplied the top part of the pylorus?
- The right gastric artery.
And it came from the right from what main branch of the celiac trunk?
- The common hepatic branch of the celiac trunk.
Now this common hepatic branch gives off three arteries one of which is before the right gastric artery, what are these three in order from left to right?
- The gastroduodenal, the right gastric and the hepatic.
The gastroduodenal artery from the common hepatic, it’s the first branch off the common hepatic, then splits into two more arteries, what are the two arteries it splits into?
- The right gastroepiploic and the superior pancreaticoduodenal arteries.
Now the right gastroepiploic artery from the gastroduodenal artery, which is the first branch from the common hepatic, the right gastroepiploic artery supplies what part of the stomach?
- The bottom part of the pylorus.
And at the end of the right gastroepiploic artery as it travels from right to left, what artery does it anastomose with?
The left gastroepiploic which came from?
- The splenic artery.
Now the gastroduodenal branch of the common hepatic splits into two superior pancreaticoduodenal arteries, what are they?
- The posterior branch and the anterior branch.
We’ll cover those in more detail later. And what was the third branch of the common hepatic after the gastroduodenal and the right gastric?
- It was the hepatic branch.
The hepatic branch of the common hepatic then branches twice more, what are they?
- The left branch of the hepatic and the right branch of the hepatic.
And the right branch of the hepatic has one more important branching, what is that?
- The cystic artery.
We’ll cover these in more detail later also.
****END OF TRANSCRIPTION****
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