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 bile Small arteries from: duct  cystic artery

 Posterior superior pancreaticoduodenal artery

Gallbladder  nerves from the celiac plexus  Cystic artery (right Hepatic  Cystic vein → right portal Cystic LNs →hepatic  SANS artery proper hepatic artery vein LNs →celiac lymph  PANS: vagus nerve common hepatic artery)  Small vessels run between nodes  {Hormonal stimulation: CCK}  Supply directly from the liver liver and gallbladder  Pancreatic arteries splenic artrey  tail, body, neck & upper half of Pancreatic LNs + splenic nerves from the celiac & superior head: foregut; superior Veins correspond to the Pancreas LNs mesenteric plexus pancreaticoduodenal arteries and drain into the →pancreaticosplenic  SANS: celiac & superior mesenteric (gastroduodenal artery splenic and superior LNs → superior ganglia hepatic artery) mesenteric vein before mesenteric LNs →celiac  PANS: vagus nerve  lower half of head & uncinate draining into the portal vein lymph nodes 11 process: midgut; inferior pancreaticoduodenal artery (superior mesenteric artrey) Spleen Splenic LNs nerves from the celiac plexus and splenic vein (formed by →Pancreatic LNs splenic artrey (divides into about six accompany the splenic artery tributaries in the hilum) joins →pancreaticosplenic branches in the hilum) celiac  SANS the superior mesenteric vein LNs →superior artery  PANS to form the portal vein mesenteric LNs →celiac lymph nodes nerves from the inferior hypogastric Sigmoid plexuses Sigmoid veins (→inferior Sigmoid LNs →inferior Colon  SANS: inferior mesenteric ganglia L1- Sigmoid arteries (inferior mesenteric vein →portal 14 mesenteric nodes (pre- L2 mesenteric artery) vein) aortic LNs)  PANS: pelvic splanchnic spinal nerves S2-S4 sheet PART INNERVATION BLOOD SUPPLY VENOUS DRAINAGE LYMPH DRAINAGE  superior rectal vein (→inferior mesenteric  superior rectal artery vein →portal vein) (inferior mesenteric artery)  middle rectal vein supplies mucous membrane Rectum nerves from the inferior hypogastric (→internal iliac vein  middle rectal artery (anterior  Upper part: inferior plexuses →IVC) division of the internal iliac mesenteric LNs.  SANS  Inferior rectal vein artery) supplies junction  Lower part: internal  PANS (→internal pudendal between the rectum and anal iliac LNs →common →internal iliac vein canal iliac LNs. {sensitive only to stretch}  inferior rectal artery (internal →IVC) {form a porto-systemic pudendal artery  internal iliac anastomosis: artery) hemorrhoidal/rectal venous plexus}  above the pectinate line(upper half): inferior hypogastric plexus and pelvic splanchnic nerves {sensitive only to  internal rectal venous stretch}  above the pectinate  above the pectinate line(upper plexus: superior rectal  below the pectinate line(lower half): line: internal iliac Anal Canal half): superior rectal artery vein somatic inferior rectal nerves nodes  below the pectinate line(lower  external rectal venous {sensitive to pain, temperature,  below the pectinate half): middle rectal artery plexus: touch} line: superficial (direct) & inferior rectal artery upper: superior rectal vein  external anal sphincter: inferior rectal inguinal nodes (indirect) internal iliac artery middle: middle rectal vein Nerve (pudendal nerve) and by a lower: inferior rectal vein branch from the 4th sacral nerve

Ascending aorta Abdominal aorta – T12 Common iliac arteries (right and left) ANTERIOR  Celiac trunk – L1 {foregut} {terminal branches of abdominal aorta}  Right coronary artrey o Left gastric artrey  Left coronary artrey o Splenic artrey  External iliac artrey ▪ Pancreatic artrey o Continue: femoral artrey > popliteal ▪ Short gastric artrey artrey > tibial artrey ▪ Left gastroepiploic artrey o Inferior epigastric artrey o Common hepatic artrey o Deep circumflex iliac artrey ▪ Right gastric artrey ▪ Gastroduodenal artrey  Internal iliac artrey • Right gastroepiploic artrey ANTERIOR • Superior pancreaticoduodenal artrey o obturator artery Aortic arch ▪ Right and Left hepatic arteries o inferior gluteal artery • Cystic artrey (from right branch) o umbilical artery

 Superior mesenteric artrey (SMA) – L2 {midgut} o Uterine artery♀ / deferential artrey♂  Left common carotid artrey o inferior pancreaticoduodenal artery o Vaginal artrey ♀ o Internal carotid artrey (ICA) o middle colic artery o inferior vesical artery o External carotid artrey (ECA) o right colic artery o middle rectal artery  Left subclavian artrey o jejunal and ileal arteries o internal pudendal artery  Right brachiocephalic artrey o ileocolic artery ▪ inferior rectal artrey o Right common carotid artrey ▪ superior branch POSTERIOR o Right subclavian artrey ▪ inferior branch o iliolumbar artrey • anterior cecal artrey o lateral sacral arteries • posterior cecal artrey o superior gluteal artrey o appendicular artrey  Inferior mesenteric artrey (IMA) – L3 {hindgut} o left colic artery o sigmoid arteries o superior rectal artery  Testicular/ovarian artrey POSTERIOR LATERAL  Median sacral artrey  Inferior phrenic artrey  4 Lumbar Arteries  Middle suprarenal artrey  Renal arteries *Only branches relevant/within the course are mentioned Rama Rayyan & Rama Abbady