Lymphatic Drainage Of Upper Limb

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Want to support the channel? Be a patron at: • / lymed Welcome to LY Med, where I go over everything you need to know for the USMLE STEP 1, with new videos every day. • Follow along with First Aid, or with my notes which can be found here: https://www.dropbox.com/sh/m55dzy5jju... • Welcome to our first video on gastroenterology! Before we can dive into the well-known path, physio and pharm of the, GIT, we must first understand the anatomy of the GIT! We start way back in the beginning, to the embryology and development of the tract. As an embryo, the GIT begins as a long continuous tube. The middle portion of the tube (midgut) herniates out, and then returns. By definition, this divides the tube into three portions. These are the : • Foregut: which is from the pharynx to the proximal duodenum. This also includes the liver, gallbladder, and pancreas. • Midgut: distal duodenum to left splenic flexure of the transverse colon. • Hindgut: rest of colon to the anal canal ABOVE the pectinate line. • That's how it is grossly, but how about the layers of gut. These are the mucosa, submucosa (which includes the submucosal nerve plexus), muscularis externa (myenteric nerve plexus), serosa. Whew, that was a lot of info. What vessels supply these portions of the gut. Well the foregut is supplied by the celiac trunk, the midgut by the SMA and the hindgut by the IMA. • We'll also go over some nerve innervations for completion sake. Next topic will be on the pectinate line. This is the line that divides the endodermal hindgut from the ectodermal outside skin. • Above the pectinate line is still your hindgut. It gets it's blood supply by the superior rectal artery. Lymph drainage is via the internal iliac lymph nodes. Pathologies here include adenocarcinoma and internal hemorrhoids. Below the pectinate line is your skin! The arterial supply here is via the inferior rectal artery. Lymph drainage is via the superficial inguinal nodes. Pathology here includes squamous cell carcinoma, external hemorrhoids and anal fissures. Quite a difference! • Our last topic will be on important gastrointestinal ligaments. These include: • Falciform ligament: contains the ligamentum teres hepatis (remnant of the fetal umbilical vein) • Hepatoduodenal ligament: contains the portal triad and important as this is the ligament that is clamped via the Pringle maneuver. • Gastrohepatic • Gastrocolic • Gastrosplenic • Splenorenal • Done!

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