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27. The portal vein. The portal-systemic anastomoses. The lymphatic dranaige
of the abdominal and pelvic organs. The histology of the suprarenal gland.
Development of the 2 external features of the fetus. External features of a
matured newborn. Twin pregnancy. Fetal membranes in twins.
Posted in Abdomen by Sahaja on December 27, 2008

27. The portal vein. The portal-systemic anastomoses. The lymphatic dranaige of the abdominal and pelvic organs.
The histology of the suprarenal gland. Development of the 2 external features of the fetus. External features of a
matured newborn. Twin pregnancy. Fetal membranes in twins.

Anatomy: The portal vein. The portal-systemic anastomoses. The lymphatic dranaige of the abdominal and pelvic
organs.

Portal Venous System

system of vessels in which blood collected from structures of the primitive gut – all unpaired visceral organs.
Ex/
Stomach, Spleen, Liver, Intestines, Pancreas, GB

From those organs –> portal v –> liver sinusoids –> IVC (after filtration)

Portal v - formed by union of splenic v & sup mesenteric v, just post to border b/w head and neck of pancreas
Inf mesenteric v joins either one or jxn b/ w the two
located in Porta Hepatis b/w hepatic a proper, common bile duct
w/in hepatoduodenal ligament

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Carries into Liver:

hormones - Insulin, Glucagon, Somatostatin from pancreas

RBC degradation products (ex/ bilirubin)
Absorbed food + other materials (not lipids) – amino acids, H20, salts, sugars etc
antibodies secreted by spleen products

Veins that drain into portal v

1. Sup mesenteric v -
w/ a @ R side of mesenteric root,
rec veins that correspond to art of sup mesenteric a
Inf pancreaticoduodenal v, L colic v, middle colic v
2. Splenic v – union of branches from around spleen
Short gastric v, splenic br, pancreatic br, L gastroepiploic v
3. Inf mesenteric v – union of sup rectal v, sigmoid v, L colic v
4. L gastric v
5. Paraumbilical v – in falciform lig, usually closed
but dilate in portal hypertension
connect L branches of portal v w/ sub cutaneous v in umbilical region
(br of sup/inf epigastric, thoracoepigatric + sup epigastric v)

Portal Systemic Anastomosis

B/w portal system & either SVC/IVC
very important, since need to fxn during liver insufficiency,
to transport blood from portal –> systemic circulation directly
CLINICAL NOTE: Portal Hypertension – Inc BP in portal v system, caused by pregnancy, cirrhosis of liver –> blood will
flow to lower pressure areas –> veins that are anastomosed w/ veins that will flow into vena cava instead

1. Esophageal Anastomosis

formed b/w L gastric (to portal v) of stomach + esophageal v (azygos system)

In case of portal hypertension, these veins can enlarge or erupt –> bleeding
esophageal v located w/in walls of esophagus,
if they enlarge – will protrude more into lumen of esophagus

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if erupt can cause bleeding into lumen of esophagus = verices

2. Rectal Anastomosis

b/w sup rectal v (inf mesenteric v) + mid rectal v (int iliac v) = hemorroidal v
In case of portal hypertension, veins of int hemorrhoidal plexus enlarge & cause internal hemorrhoids

3. Paraumbilical Anastomosis

located around umbilicus

b/w sup/inf epigastric & paraumbilical v
Inflow limb is recanalized umbilical v (in round lig of liver)
Outflow limb is towards the superficial + deep abdominal anastomosis systems
Special v located around umbilicus
running radial towards it, establish the connection b/w inflow – outflow part = paraumbilical v
In portal hypertension, paraumbilical v. enlarges, elevate from ant ab wall, causing classical symptom = Caput
medusae

4. Retroperitoneal anastomosis

loc @ retropertineum, least important connection

formed b/w v of abdominal v & v of duod/colon = veins of Retzius
these veins could be cut if enlarges - bleeding in retroperitoneal space

The lymphatic drainage of the abdominal and pelvic organs.

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Histology:The histology of the suprarenal gland.

Embryology: Development of the 2 external features of the fetus. External features of a matured newborn. Twin
pregnancy. Fetal membranes in twins.

9th week –> birth = fetal period

growth in length = 3/4/5th months –>
CRL = crown-rump length
CHL = crown-heel length

Month 4 (see figure)

External Features: At four months fetal skin is transparent enough for underlying blood vessels to be seen clearly. Fingernails
are well established and toenails begin to form. Nostrils by this time are almost formed and eyes move from the lateral sides
of the head to the ventral side. Soft and thin hairs, called lunugo hairs, begin to grow on the scalp

Month 5

External Features: At five months, sebaceous glands accumulated at the surface of the skin begin to deposit verniz caseosa,
which serves as a protective coating for the epidermis. The lanugo hairs that began formation during the fourth month now
cover most of the entire body. Eyelids and eyebrows develop and abdomen begins to fill out.

Month 6

External Features: By the sixth month and the end of the second trimester, fetal skin is now red and wrinkled and lanugo
hairs have darkened.

Month 7

External Features: At seven months, the fetus continues the development of hair and the scalp hairs grow beyond the length
of the thin lanugo hairs that developed during the second trimester. Eyelashes are well developed and eyelids begin to open.

Month 8

External Features: By the eighth month, the skin is pink and smooth, the eyes are capable of reacting to light and the
fingernails have grown long enough to reach the tip of the fingers.

Month 9

External Features: Toenails grow up to the tip of the toes and fingernails grow beyond the fingertips. The skin is fully
covered in vernix caseosa (which serves to protect the epidermis) and most of the lanugo hairs are shed. By this time, the
placenta weighs about 500grams and the umbilical cord becomes central in the abdomen.

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About This Site:

This site was made for the Anatomy, Histology, Embryology class in 2nd yr, 1st semester at the University of Debrecen. All
theoretical topics are listed as described on the website of the Anatomy department.

We combined Practical class notes, Moore, Board Review Series textbooks of Gross Anatomy and Embryology, Langman’s,
DiFiore’s, as well as the Lab manual for Histology at Semmelweiss. We believe it to be all inclusive of the material you will
need for your test. We made them for ourselves, but since people asked for them, and emailing them seemed next to
impossible, we decided to post them here.

On the left are the newest topics we’ve added.

To see all the topics we’ve done so far, scroll down and click on the Category you would like to see: Head & ;eck,
Thorax, Abdomen, & Pelvis.

Added a search box in the sidebar, so you can search for the item you want.

But the best way to find the topic that you want?

Scroll down and click on the “Link to Topics” Page. There is the list of all topics. If a link to your topic of choice
exists, we’ve started/finished it, else we’re working on it. There! That’s easier, isn’t it?

We’ve added pictures, links, and animations where we have found them.

Hope this helps you, and GOOD LUCK!

(P.s. If you find mistakes, or want to add info, or find something we missed, please comment below the post in question, and
we will fix or add it. )

We are adding more info by the day, so check back in with us!

Created by Sahaja Parsa and Anne H.

contact: sahaja.parsa[at]gmail.com

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