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sheet PART INNERVATION BLOOD SUPPLY VENOUS DRAINAGE LYMPH DRAINAGE Roof: greater palatine & nasopalatine Mouth nerves (maxillary N.) Floor: lingual nerve (mandibular N.) Taste {ant 1/3}: chorda tympani nerve (facial nerve) Cheeks: buccal nerve (mandibular N.) Buccinator muscle: Buccal Nerve 1 (facial Nerve) Orbicularis oris muscle: facial nerve Tip: Submental LNs Tongue lingual artery (ECA) sides of ant 2/3: Ant 1/3: Lingual nerve (sensory) & tonsillar branch of facial artery lingual veins correspond to submandibular & chorda tympani (Taste) (ECA) the arteries and drain into IJV deep cervical LNs Post 2/3: glossopharyngeal N. (both) ascending pharyngeal artery post 1/3: Deep (ECA) cervical LNs greater palatine vein greater palatine artrey Palate Hard Palate: greater palatine and (→maxillary V.) (maxillary A.) nasopalatine nerves ascending palatine vein Deep cervical lymph ascending palatine artrey Soft Palate: lesser palatine and (→facial V.) nodes (facial A.) glossopharyngeal nerves ascending pharyngeal ascending pharyngeal artery vein PANS (secreto-motor) & Sensory: 2 Parotid gland Auriculotemporal nerve {Inferior salivary Nucleus → tympanic branch of glossopharyngeal N.→ Lesser petrosal nerve parasympathetic preganglionic fibres → otic ganglia → auriculotemporal nerve parasympathetic postganglionic fibres} sheet PART INNERVATION BLOOD SUPPLY VENOUS DRAINAGE LYMPH DRAINAGE PANS (secreto-motor): facial nerve Submandibular Sensory: lingual nerve gland {Superior salivary Nucleus → Chorda tympani branch from facial nerve parasympathetic preganglionic fibres + Sublingual lingual nerve → submandibular ganglia gland → parasympathetic postganglionic fibres directly to gland} Pharynx Directly: deep cervical LNs Nasal pharynx: maxillary nerve Ascending pharyngeal artrey Indirectly: Oral pharynx: glossopharyngeal nerve tonsillar branch of facial artery Veins correspond to the retropharyngeal or Laryngeal pharynx: internal laryngeal branches of maxillary & lingual arteries and drain into IJV paratracheal nodes nerve (Vagus Nerve) arteries into deep cervical nodes Palatine Join external palatine vein, Tonsils upper deep cervical Branch from maxillary nerve tonsillar branch of the facial artery pharyngeal or the facial vein lymph nodes (→IJV) upper 1/3: deep cervical nodes upper 1/3: inferior thyroid SANS: sympathetic trunk upper 1/3: inferior thyroid middle 1/3: superior Esophagus artery PANS: Vagus Nerve veins & posterior middle 1/3: descending thoracic lower part of its thoracic course middle 1/3: azygos veins mediastinal nodes aorta branches surrounded by the esophageal nerve lower 1/3: left gastric vein lower 1/3: nodes lower 1/3: left gastric artery plexus (→Portal V.) along the left gastric Self- branches study blood vessels and sheet celiac nodes SANS: motor fibres, celiac ganglion T6-T9 Pyloric Superior pyloric PANS: inhibitory fibres, vagus Nerve sphincter (Suprapyloric) & inferior Anterior nerve of Latarjet (anterior pyloric (Subpyloric) vagal trunk) lymph nodes Posterior nerve of Latarjet (posterior vagal trunk) sheet PART INNERVATION BLOOD SUPPLY VENOUS DRAINAGE LYMPH DRAINAGE upper right: Left gastric artery {Veins correspond to the (celiac artrey) arteries} lower right: Right gastric artery left & right gastric veins Nerves from the celiac plexus (hepatic artrey) right & left gastric stomach (→directly to portal vein) SANS: {carries pain sensation} Fundus: short gastric artrey LNs short gastric & left PANS: (splenic artrey) right & left gastroepiploic vein posterior surface: posterior gastric upper greater curvature: left gastroepiploic (→splenic vein) nerve right vagus nerve gastroepiploic artery (splenic nodes right gastroepiploic vein anterior surface: anterior gastric artrey) short gastric nodes. (→superior mesenteric nerve left vagus nerve lower greater curvature: right All drain into celiac LNs vein) gastroepiploic artery superior mesenteric + splenic (gastroduodenal artrey vein →portal vein hepatic artery) Superior Epigastric artery Above umbilicus: Lateral Thoracoabdominal nerve: Lower 6 (Internal Thoracic A. Above the th Thoracic Vein (→Axillary thoracic nerves & 12 subcostal Subclavian A.) umbilicus: Ant. Anterior Vein) & Superior nerve Inferior Epigastric artery Axillary lymph abdominal Epigastric Vein (→Internal Dermatomes: (nerves to the skin of (external iliac A.) nodes wall Thoracic Vein) abdomen, Anterior lateral cutaneous lower 6 Intercostal arteries Above the iliac nerve terminal branches of Below umbilicus: Inferior 4 4 Lumbar arteries (abdominal crest: Post. Axillary Thoracoabdominal nerve) Epigastric Vein aorta) supply abdominal lymph nodes T7: above umbilicus, below xiphoid process (→External Iliac Vein) muscles Below the umbilicus T10: surrounding umbilicus Paraumbilical Veins: Deep circumflex artery & iliac crest: L1: below umbilicus, above symphysis pubis Ligamentum teres (external iliac artery) supplies Superficial Inguinal LI nerve: Iliohypogastric & Ilioinguinal {remnant of the umbilical abdomen in the anterior lymph nodes nerves vein} (→Portal Vein) superior iliac spine region Testes Pampiniform plexus Vasomotor/sensory sympathetic fibres Testicular Lymph Testicular Artrey (abdominal →Testicular V → Right side 5 around Testicular Artery ( renal or Vessels →lumbar para- aorta-L2) into IVC and Left side into left aortic sympathetic plexus) aortic Lymph nodes-L1 Renal Vein sheet PART INNERVATION BLOOD SUPPLY VENOUS DRAINAGE LYMPH DRAINAGE Scrotum same sympathetic fibres to testes scrotum+skin: inguinal ilioinguinal nerve-L1 lymph nodes in the genital branch of genitofemoral nerve femoral triangle also supplies cremasteric muscle Drainage upward: Upper half {1st + ½ of 2nd part}: Upper half {1st + ½ of 2nd pancreaticoduodenal foregut; superior part}: superior nodes Duodenum pancreaticoduodenal artery pancreaticoduodenal vein →gastroduodenal nerves from the celiac plexus & Superior (gastroduodenal artery (→portal vein) nodes →celiac mesenteric plexus 7 celiac trunk ) Lower half {½ of 2nd +3rd + nodes SANS Lower half {½ of 2nd +3rd + 4th 4th part}: inferior Drainage PANS: vagus Nerve part}: midgut; inferior pancreaticoduodenal vein downward: pancreaticoduodenal artery (→superior mesenteric pancreaticoduodenal (superior mesenteric artery) vein) nodes →superior mesenteric nodes Jejunum Midgut; vasa recta series of arcades jejunal arteries nerves from the Superior mesenteric superior mesenteric artery Midgut; intermediate superior mesenteric vein (join plexus mesenteric nodes the splenic vein to form the Ileum SANS: T6-9 Midgut; vasa recta series of →superior mesenteric portal vein) PANS: vagus Nerve arcades ilial arteries nodes superior mesenteric artery 8 end of ilium: ileocolic artery (superior mesenteric artery) nerves from the superior mesenteric Cecum plexus SANS: greater splanchnic nerve (T6-9) anterior and posterior cecal anterior and posterior cecal mesenteric nodes synapses in celiac ganglia & lesser arteries (ileocolic artery veins (→superior mesenteric →superior mesenteric splanchnic nerve synapses in superior Superior mesenteric artrey) vein) nodes mesenteric ganglia PANS: vagus nerve sheet PART INNERVATION BLOOD SUPPLY VENOUS DRAINAGE LYMPH DRAINAGE Appendix nerves from Superior Mesenteric plexus SANS(vasomotor): accompanied by one or two nodes in the Appendicular artery (posterior afferent pain sensation nerve fibres and Appendicular vein mesoappendix cecal artery ilio-cecal artery enter the spinal cord at the T10 level (→posterior cecal vein) →superior mesenteric superior mesenteric artery) PANS: vagus neve nodes skin over umbilicus: T10 dermatome Ascending right colic artrey (superior nerves from Superior Mesenteric plexus Colon mesenteric artrey) Veins correspond to the SANS: superior mesenteric ganglia colic nodes →superior beginning of the ascending arteries and drain into T6-T9 mesenteric nodes colon: ileocolic artery superior mesenteric vein PANS: vagus nerve (superior mesenteric artery) 9 Proximal(medial) 2/3: midgut; Proximal 2/3: sup mesenteric plexus Proximal 2/3: colic middle colic artery ( superior Transverse SANS: superior mesenteric ganglia T6-T9 Veins correspond to the nodes →superior mesenteric artery) Colon PANS: vagus N. arteries and drain into mesenteric nodes Distal(lateral) 1/3: hindgut; left Distal 1/3: inf mesenteric plexus superior & inferior Distal 1/3: colic colic artery superior & inferior SANS: inferior mesenteric ganglia L1-L2 mesenteric veins nodes →inferior branches ( inferior PANS: sacral spinal nerves S2-S4 mesenteric nodes mesenteric artery) Descending nerves from the inferior mesenteric left colic {mainly} (inferior Colon plexus mesenteric artery) Veins correspond to the colic nodes & inferior SANS: inferior mesenteric ganglia L1- end of descending colon: arteries and drain into mesenteric nodes L2 sigmoid branches (inferior inferior mesenteric veins PANS: sacral spinal nerves S2-S4 mesenteric artery) 1/3 – 1/2 of total body lymph hepatic LNs in porta Liver nerves from the celiac plexus (hepatic Hepatic portal vein (formed by hepatis →celiac plexus) superior mesenteric & splenic nodes central vein →hepatic veins 10 SANS vein union) {75-80%, nutrients} few lymph vessels →I.V.C pass from the bare PANS: large hepatic branch Hepatic artery (celiac trunk) area through the anterior vagus trunk {20-25%, oxygen} diaphragm to posterior mediastinal LNs →right thoracic duct sheet PART INNERVATION BLOOD SUPPLY VENOUS DRAINAGE LYMPH DRAINAGE Common
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