00:01
So now let's spend some time looking
at the celiac trunk in some detail.
00:06
So here we can see
we have the celiac trunk.
00:08
it's coming off the
abdominal aorta,
And we can see it comes
off at a roundabout,
the 12th thoracic vertebral level.
00:16
Just as the aorta was passed
through the aortic hiatus.
00:20
It gives off three
important branches.
00:23
We can see the left gastric artery,
we can see the splenic artery
and we can see the
common hepatic artery.
00:31
The left gastric artery
is going to supply
the lesser curvature of the stomach
and also it's going to pass up to
the cardiac esophageal junction
between the esophagus
and the stomach.
00:43
And here we can see the left
gastric passing up towards that area
and giving off some of
esophageal branches.
00:49
These are going to anastomose
with other esophageal branches
coming from the
thoracic aorta directly.
00:56
As the esophagus passes
down in front of the aorta,
it is receiving esophagus or
branches along its journey.
01:03
Here we can then see
the left gastric artery
passing along the lesser curvature
where it's then going to meet
with the right gastric artery.
01:11
And if you remember the
right gastric artery
is coming from the
gastroduodenal artery.
01:16
Let's now have a look
at the splenic artery.
01:19
The splenic artery
is running along the
superior and posterior
aspect of the pancreas
heading towards the
hilum of the spleen.
01:26
And here we can see as it
runs towards the spleen
within the splenorenal ligament
is running some splenic branches.
01:35
These branches are
entering into the spleen.
01:38
Along the journey,
along the superior and posterior
aspect of the pancreas,
it gives rise to some
pancreatic branches
that supply the body and
the tail of the pancreas.
01:49
It also supplies superiorly
some short gastric arteries
that go on to supply the
upper part of the body
and the fundus of the stomach.
01:58
It also gives rise to a branch
that supplies parts of
the greater curvature
and this is the left
gastro-omental artery.
02:06
Anastomosing with
the left gastro-omental artery,
we will also have the
right gastro-omental artery
and hopefully you
remember that that comes
from the gastroduodenal artery
and this forms that anastomosis
around the greater curvature.
02:21
Coming from the left and the
right gastro-omental arteries
are some anterior and
posterior branches.
02:27
These are going to supply
the anterior and posterior
surfaces of the stomach.
02:32
Descending inferiorly,
we also have some omental branches
and these paths into
the greater momentum.
02:37
As you remember from
the peritoneum lecture,
the greater omentum hangs from
the stomach and the transverse colon
and these are omental branches go
and supply that greater momentum.
02:48
Now let's turn our attention
to the common hepatic artery.
02:52
The common hepatic artery here gives
rise to a really important branch
that we've heard of a
couple of times before.
02:58
The gastro duodenal artery.
03:00
Once is giving off this
gastroduodenal branch
it then carries on towards the
liver as the hepatic artery proper.
03:07
The hepatic artery proper
is then going to divide
into the left and the
right hepatic arteries.
03:13
And these go on to supply
the left and right functional
lobes, respectively.
03:18
As the hepatic artery
causes towards the liver,
it will also give rise
to the cystic artery
and the cystic artery
supplies the gallbladder.
03:26
Coming off, sometimes
the gastric duodenal artery.
03:29
But in this diagram here,
we can see it coming off
the hepatic artery proper
is the right gastric artery.
03:36
And remember,
the right gastric artery
will anastomosed
with the left gastric artery
around that lesser curvature.
03:43
Now, let's concentrate on
the gastroduodenal artery.
03:46
You can see it gives rise
to the supraduodenal artery
that supplies the superior
aspect of the duodenum.
03:52
And then it gives
rise to the posterior
superior pancreaticoduodenal
artery.
03:58
So here we have the superior
pancreaticoduodenal artery,
but it's giving rise to a
branch that heads posteriorly
hence we call it the posterior
superior pancreatic duodenal artery.
04:10
We'll also remember that it gives
rise to the right gastro-omental
with anastomoses with
the left gastro-omental
supplying the greater
curvature of the stomach.
04:19
As we have a posterior superior
pancreaticoduodenal artery,
it carries on and gives
rise to an anterior version.
04:26
So these superior
pancreaticoduodenal arteries
are coming ultimately
from the celiac trunk,
and they're supplying the more
superior aspect of this region,
both the pancreas and the duodenum
around the head of the pancreas,
and the duodenum.
04:42
As the gastroduodenal
artery passes down
is giving rise to branches both
anteriorly and posteriorly.
04:49
Hence, we use the anatomical
terminology to locate them.
04:52
As we continue moving inferiorly,
we actually find we have inferior
pancreaticoduodenal arteries,
and these come from the
superior mesenteric artery.
05:02
This is the anterior version.
05:04
And we also find we have
a posterior version.
05:07
And these are important.
05:09
They're coming from the
superior mesenteric artery,
which means they're starting
to supply the midgut.
05:15
And here we have the
anastomosis between these
inferior and superior
pancreatic duodenal arteries
via their anterior
and posterior pairs.
05:26
So you can see that the celiac trunk
is a really complicated blood vessel
but gives rise to
three primary branches.
05:33
The left gastric,
the splenic and the common hepatic.
05:37
The left gastric will then go on
to supply some of the esophagus
giving some esophageal branches.
05:44
The common hepatic
has lots of branches.
05:47
It gives rise to the
gastroduodenal artery.
05:49
It gives rise to the
hepatic artery proper.
05:52
The hepatic artery proper will
then on its way to the liver
give rise to the cystic.
05:57
The hepatic artery proper,
once it's given rise to the cystic
may well give rise
to the right gastric
before it then goes on to give rise
to right and left hepatic arteries.
06:08
The right gastric it's
important to note here
runs along the lesser
curvature of the stomach
to anastomose with the left gastric.
06:17
The gastroduodenal artery
gives rise to the superior
pancreaticoduodenal artery.
06:23
And as we've seen, this has both
anterior and posterior branches.
06:28
The gastricduodenal artery also
gives right gastro-omental artery
with the splenic artery giving rise
to the left gastro-omental artery.
06:38
And these two paired arteries
supply the greater curvature
of the stomach.
06:43
So we can see in this
diagram how the celiac trunk
can actually supply both the lesser
and the greater curvature
of the stomach
by two complex anastomoses.
06:55
The left gastric and
the right gastric
supplying the lesser curvature
and the left and right
gastro-omental arteries
supplying the greater curvature.
07:04
It may be helpful
to actually go away,
and try and draw
this diagram yourself
and then come and check
for the main branches.
07:11
We can also just for completeness,
see coming off the splenic artery
we have some short gastric
arteries that supply the fundus
and the superior aspects
of the body of the stomach.