Author: Shahab Shahid MBBS•Reviewer: Jerome GoffinLast reviewed: September 23, 2021Reading time: 8 minutes

The gastrointestinal tract is made up of a variety of hollow guts that extend from the mouth all the means down come the rectum. The GI tract enables united state to process, digest and gain nutrient from the food us eat. Its miscellaneous parts are committed to absorb specific nutrients and also vitamins together as vitamin B12 i m sorry is absorbed in the terminal ileum.

You are watching: What does the superior mesenteric artery supply

The bowel, which part of the GI tract, establishes in three separate sections; namely the foregut, midgut and hindgut. Separate nerves, arteries, and veins supply these various sections.

This write-up will explain the remarkable mesenteric artery (which supplies the midgut), consisting of its branches, and clinical relevance.


Contents
Branches
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Anatomy



There are three major parts the make up the cradle tract. These room the foregut, midgut and hindgut. The foregut extends indigenous the mouth to the major duodenal papilla (where the ampulla that Vater empties into the duodenum). The midgut extends from this suggest to the proximal two thirds that the way along the transverse colon. The hindgut runs from this suggest to the dentate line of the anal canal. The blood supply to the rectum occurs from the superior, middle and also inferior rectal arteries.



The exceptional mesenteric artery arises from the ab aorta in ~ the level of the very first lumbar vertebral body L1, approximately a centimeter below the coeliac trunk. That arises over the renal arteries (that arise in ~ vertebral level L1-L2). The exceptional mesenteric artery gives the midgut, while the worse mesenteric artery provides the hindgut. Each of this arteries offer rise to further major branches that suppl

y areas of the cradle tract. The exceptional mesenteric arterys initial course is forwards and downwards, and it travel posterior to the neck that the pancreas and the splenic vein. The superior mesenteric artery is usually uncovered running come the left side of the remarkable mesenteric vein (which drains the same region as the artery supplies).

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Superior mesenteric artery (ventral view)

Similarly, the forgiveness inputs come the foregut, midgut and also hindgut arise native the thoracic and also lumbar splanchnic nerves, i.e. T5-T9, T9-T12 and also L1-L2 respectively. The parasympathetic innervation to the foregut and midgut is gave by the vagus nerve (cranial nerve 10) when the pelvic splanchnic nerves carry out parasympathetic innervation to the hindgut.

Branches


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Inferior pancreaticoduodenal artery- This is the an initial branch the the premium mesenteric artery, emerging from its best side, and supplies the head of the pancreas and the inferior and also ascending areas of the duodenum. This artery gives off two further branches i.e. Anterior and also posterior branches. Both branches run in between the c shaped interior curvature the the duodenum, and the head the the pancreas. Lock anastomose with the remarkable pancreaticoduodenal artery that is the terminal branch the the gastroduodenal artery.

Middle colic artery- This is the second branch arising from the best side the the remarkable mesenteric artery and supplies the proximal two thirds the the transverse colon. The branches turn off just listed below the pancreas, and also travels upwards within the mesentery that the transverse colon. That left and right branches anastomose with assorted arteries i.e. The left one anastomoses v the left colic artery (a branch the the worse mesenteric artery), and the best anastomoses with the ideal colic artery.

Right colic artery- This artery runs straight to the right, and also supplies the ascending colon. In stimulate to reach this component of the bowel, it passes anteriorly to the gonadal vessels and the psoas major (as well together the ureter, i m sorry lies retroperitoneally, this vessels operation within the greater omentum, i m sorry is a quadruple class of peritoneum). It divides to kind an ascending and descending branch. The previous anastomoses through the middle colic artery and the latter anastomoses v the ileocolic artery.

Ileocolic artery- This artery provides the caecum, appendix and ileum. In stimulate to with the ascending colon, it overcome downward and also to the right. It has additional branches including the anterior and also posterior cecal arteries (which supply their respective parts of the caecum), the ileal branch of the ileocolic, which provides the junction in between the ileum and also the caecum, and the appendicular artery which provides the appendix. The appendicular artery is an finish artery, and hence the postposition is delicate to ischaemic necrosis if this artery is blocked. The colic branch operation superiorly and also supplies the ascending colon.

Jejunal and also Ileal branches- these arteries branch off from the left next of the premium mesenteric artery to it is provided the jejunum and also ileum. They form arterial arcades (a network that arteries that lies near the bowel and supplies it). The arcades because that the jejunum space longer and also less associated (i.e. Under anastomoses). The arcades that the ileum are much shorter and are an ext connected (i.e. More anastomoses). This mirrors the role of the various parts the the bowel. The arterial arcades don"t supply straight the small intestine. They give off the so-called straight arteries (arteriae recta) the are longer than the arcades and they lastly supply the small intestine.

Marginal artery the Drummond- The terminal branches the the exceptional mesenteric artery (middle colic, ideal colic and ileocolic arteries) and also inferior mesenteric artery (left colic and also sigmoid arteries) anastomose to kind the marginal artery, that runs follow me the inner border that the colon. Teacher David Drummond described the artery first. In surgical terms, during bowel surgery when the major arteries might be clamped turn off to reduce blood loss, the marginal artery is adequate to perfuse the colon.

Mnemonic

There is a rapid little method to remember all superior mesenteric artery branches to the large intestine. Simply keep in mind "MRI", i m sorry stands for:

Middle colic a.Right colic a.Ileocolic a.

Clinical points

Nutcracker syndrome- This outcomes from one elevated left renal vein pressure due to the compression that the renal vein in between the premium mesenteric artery and the abdominal aorta. Symptoms incorporate blood in the urine, ache in the abdomen (usually in the flank). Varicoceles may likewise result, as the left gonadal vein drains into the left renal vein, and also hence i do not care backlogged, causing venous engorgement.

Mesenteric ischaemia- Chronic mesenteric ischaemia can result from atherosclerosis of the mesenteric arteries. Acute mesenteric ischaemia generally results from an embolus the becomes lodged in any type of of the branches of the mesenteric arteries. Risk components include atrial fibrillation, chronic renal failure and heart failure. Treatment has surgical revascularization, yet radiological interventions space being developed.

Superior mesenteric artery syndrome- This is a rare condition that occurs when the duodenum is trapped between the abdominal aorta and the exceptional mesenteric artery, leading to compression or complete obstruction. The patient will existing with bloating after ~ meals, nausea and vomiting and also a emotion of ab fullness. Treatment includes diet change to law the underlying reason (which is regularly rapid load loss, or previous abdominal surgery), and also surgery.


Sources

References:

Frank H.Netter MD: Atlas of human being Anatomy, fifth Edition, Elsevier Saunders.Chummy S.Sinnatamby: Last’s Anatomy regional and Applied, 12th Edition, Churchill Livingstone Elsevier.Richard L. Drake, A. Wayne Vogl, Adam. W.M. Mitchell: Gray’s Anatomy for Students, 2nd Edition, Churchill Livingstone Elsevier.Atlas and also textbook of human being Anatomy. J.P McMurrich, D.J.Sobotta.

Illustrators:

Superior mesenteric artery (ventral view) - Irina Münstermann

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