Anastomosis of Portocavalis

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1.

Anastomosis of Portocavalis
- The anastomosis of portal system and the systemic system the vessel doesnt go
through the liver but it goes around it
- It is important because if there is cirrhosis in the liver there is another pathway for
the blood to flow from the portal sytem to the heart. Atleast there is blood flow
going to the heart.

Clinical terms:

a) caput medusae due to the dilated vessel that flows from the paraumbilical vein and into the
superficial epigastric vein. = UMBILICAL

b) Hemmorhoids due to the the swollen vein that flows from the superior rectal vein into the medial
and inferior rectal vein. RECTUM

c) Varices oesophagus when left gastric vein flows to the azygous vein = ESOPHAGEAL

due to cirrhosis and portal system hypertension

2. Fascia superficialis
I) Cutaneus Nerves
a) N. Cutaneus anterior from n. Intercostalis (t7-t11) n. Subcostalis (t12) n.
Illiohypogastricus (L1)
b) N. Cutaneus lateralis n. Intercostalis (t10-t11) INNERVASI M .OBLIQUUS EXTERNUS

II) Vascularisasi
a) A. Cutanea anterior
b) A. Cutanea lateralis
c) A. Inguinalis superficialis

III) Aliran Limfatik


a) Di atas Umbilical alir ke nnll. Axillaris anterior
b) Di bawah umbilical alir ke nnll. Inguinalis superficialis

3. Pharynx
I) Musculus Pharynx
m. constrictor pharyngeus superior media inferior

II) Innervasi
a) R. Pharyngeus N. Vagus = MOTORIK
b) R. Pharyngeus N. Glossopharyngeal = SENSORIK
c) R. Pharyngeus ggl. Sympathis cervical superior = VASOMOTORIK

4. Oesophagus
Innervasi
I) Parasimpatis
a) ½ bagian atas N. Laryngeus recurrens
b) ½ bagian bawah plexus oesophagei bentuk oleh kedua N X bersifat sensoris
motorik dan secretomotorik
II) Simpatis
a) ½ bagian atas ggl. Cervicalis medius
b) ½ bagianbawah ggl thoracalis vasomotor

Vaskularisasi

a) 1/3 a. Thyroidea inferior


b) 1/3 tengah r. Oesophagei a. Thoracalis
c) A. Gastrica sinistra

III) Klinis
Varices oesophagei karena cirrhosis hepar
Achalasia

5. Gaster
Vaskularisasi
I) A. Gastrica sinistra
II) A. Gastrica dextra
III) A. Gastroepiploica dextra
IV) A. Gastroepiploica sinistra
V) A. Gastrica breves

Innervasi

I) Para simpatis
a) N. Vagus
b) N. Gastricus anterior (fundus dan corpus)
c) N. Pylorieus ( antrum)
d) N. Gastricus posterior (posterior fundus)

II) Simpatis
a) T6-T10 chorda spinalis m. Spchinter pylori sensasi sakit ke gaster

Aliran Limfa
I) Area gastrica superior = nnll. Coeliacus
II) Area gastrica inferior = nod. Gastricus – nod piloricus – nod coeliacus
III) Area pancreaticolienallis = nodulus coeliacus

6. Intestinum tenue
I) Duodenum
a) Pars descendens (intraperitoneal)
Papilla duodeni minor : ductus pancreaticus accessorius
Papilla duodeni major: ductus pancreaticus andductus wirsungi, ada sphingter
odi

b) Pars superior
c) Pars transversa
d) Pars ascendens = lig. Treitz

Vaskularisasi
I) A. Pancreaticoduodenalis superior inferior

7. Pankreas (retroperitoneal)

Vaskularisasi
I) A. Pancreaticoduodenalis superior inferior (Caput)
II) A. Lienalis, a. Pancreatica magna (corpus)

Aliran limfa
Nodus pancreaticolienalis, coeliacus

Innervasi
I) Parasimpatis
N. Vagus : sekresi pancreas cairan enzim

II) Simpatis
N. Splanchnicus : vasomotor

8. Hepar

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