01-27: Abdominal Viscera Flashcards
1
Q
What are the organs in the abdominal viscera?
A
- esophagus
- stomach
- small intestine
- large intestine
- rectum
- anus
- *Associated/Accessory organs:
- spleen
- pancreas
- liver
- gallbladder
2
Q
What are the portions of the large intestine?
A
- cecum (blind sac with appendix)
- ascending colon
- transverse colon
- descending colon
- sigmoid colon
3
Q
What are the portions of the small intestine?
A
- duodenum
- jejunum
- ileum
4
Q
Which organs make up the foregut?
A
- esophagus
- stomach
- duodenum
- liver
- gallbladder
- spleen
- pancreas
5
Q
Which organs make up the midgut?
A
- duodenum
- jejunum
- ileum
- cecum
- appendix
- ascending colin
- 2/3 of transverse colon
6
Q
Which organs make up the hindgut?
A
- 1/3 transverse colon
- descending colin
- sigmoid colin
- rectum
- anal canal
7
Q
What is the blood supply to the foregut?
A
celiac trunk
8
Q
What is the blood supply to the midgut?
A
superior mesenteric a
9
Q
What is the blood supply to the hindgut?
A
inferior mesenteric a
10
Q
At which vertebra does the esophagus pierce the diaphragm?
A
T10
11
Q
At the Esophageal Hiatus, where does the esophagus lie relative to the midline?
A
slightly left of the midline
12
Q
At the Cardiac Orifice, where does the esophagus lie relate to the midline?
A
turns sharply left to enter the stomach
13
Q
At which vertebra does the esophagus enter the stomach?
A
T11
14
Q
What is the width of the esophagus?
A
2.5cm
15
Q
Where is the esophageal sphincter?
A
not well defined
16
Q
What does failure of the esophageal sphincter to properly function lead to, clinically?
A
GERD
17
Q
What kind of hernia can be found at T10?
A
Esophageal Hiatal Hernia
18
Q
What are the openings in the diaphragm called?
A
hiatuses
19
Q
What structure passes through the diaphragm at T8?
A
IVC
20
Q
What structure passes through the diaphragm at T12?
A
Aorta
21
Q
What structure passes through the diaphragm at T10?
A
esophagus
22
Q
What is the condition when the esophageal hiatus of the diaphragm enlarges or weakens?
A
Sliding hiatal hernia
23
Q
What happens during a sliding hiatal hernia?
A
abdominal esophagus and parts of stomach hernia into the thorax
24
Q
Which parts of the stomach herniate into the thorax in a sliding hiatal hernia?
A
cardia
sometimes fundus
25
What is a defect in the diaphragm next to the esophageal hiatus?
paraesophageal hiatal hernia
26
What does a paraesophagel hiatal hernia permit to herniate?
Fundus of stomach
**NOT esophagus
27
What is a paraesophagel hiatal hernia caused by?
weakening somewhere other than the hiatus
28
Which regions is the stomach located in?
- Left Hypochondriac region
| - Epigastric region
29
Which vertebrae is the Left end of the stomach fixed at?
T10
| T10
30
Which vertebrae is the Right end of the stomach fixed at?
L1
| L2
31
Which plane does the stomach cross?
transpyloric plane
32
What are the main parts of the stomach?
- fundus
- cardiac orifice
- body
- pylorus
- pyloric antrum
- rugae
- pyloric sphincter
- pyloric orifice
33
What is the pyloric antrum?
entrance to the pylorus
34
What does the pyloric sphincter do?
mitigates food/digester material into the duodenum
35
What is the pyloric orifice?
entrance to the duodenum
36
The stomach has more layers of which type of muscle than the esophagus?
smooth muscle
37
What is the rugosae?
lost of folds that increase the surface area of the stomach
38
What are the 2 ligaments that connect to the stomach(?)?
- Hepatogastric ligament
| - Hepatoduodenal ligament
39
What 8 structures does the stomach have a relationship with POSTERIORLY?
- Diaphragm
- Spleen (posterior and lateral)
- Left suprarenal gland
- Upper Left kidney
- Pancreas
- Left colic flexure
- Left transverse colon
- Transverse mesoderm
40
What 4 structures does the stomach have a relationship with ANTERIORLY?
- Anterior abdominal wall
- Left costal margin
- Left diaphragm
- Left/Quadrate lobes of the liver
41
What 2 structures does the small intestine lie between?
- stomach
| - large intestine
42
What are the 3 subdivisions of the small intestine?
- duodenum
- jejunum
- ileum
43
Which subdivision of the small intestine is a "gateway for food"?
duodenum
44
How long is the duodenum?
10 inches (12 finger breadths)
45
At which vertebral bodies is the duodenum approximately located?
L1
L2
L3
L4
46
What structure is the starting point for the duodenum?
pylorus of the stomach
47
What structure is the ending point for the duodenum?
duodenual-jejunal junction
48
What are the 4 subdivisions of the duodenum?
1- superior part
2- descending part
3- horizontal part
4- ascending part
49
Is the duodenum primarily or secondarily retroperitoneal?
secondarily retroperitoneal
50
Which parts of the duodenum are the exception to being secondarily retroperitoneal?
- Some of 1st part (Superior part)
| - Some of 4th part (Ascending part)
51
The duodenum is covered by peritoneum except for in what area?
where the transverse mesocolon crosses the 2nd part (descending part)
52
Which part of the duodenum is surrounded by the Hepatoduodenal ligament?
1st part of duodenum (superior part)
**part of the lesser omentum
53
Where does the root of the mesentery begin?
at the duodeno-jejunal flexure
54
Where does the superior part of the duodenum start?
pyloric sphincter
55
How long is the superior part of the duodenum?
2 inches
56
Which ligament holds the superior part of the duodenum in place?
Hepatoduodenal ligament (attaches to the celiac trunk)
57
Which vessels are posterior and superior to the Superior Part of the Duodenum?
- Portal vein
- Hepatic a.
- Bile duct
58
What is the widened area of the Superior Part of the Duodenum?
duodenal bulb
59
What portion of the pancreas is inferior to the Superior Part of the Duodenum?
the head of the pancreas
60
How long is the Descending Part of the Duodenum?
3 inches
61
Are the portions of the Descending Part of the Duodenum primarily or secondarily retroperitoneal?
secondarily retroperitoneal
62
Which structures are anterior to the Descending Part of the Duodenum?
- Fundus of the gallbladder
- Right lobe of the liver
- Transverse colon
63
Which structures are posterior to the Descending Part of the Duodenum?
- Right kidney
| - Ureter
64
Which structure is medial to the Descending Part of the Duodenum?
Head of the pancreas
65
What 2 ducts enter into the Descending Part of the Duodenum at the Major Duodenal Papilla?
- Bile duct
| - Pancreatic duct
66
What 3 structures/vessels cross the anterior surface of the Horizontal Part of the Duodenum?
- Superior mesenteric a.
- Superior mesenteric v.
- Root of the mesentery
67
Where is the head of the pancreas relative to the Horizontal Part of the Duodenum?
SUPERIOR to the Horizontal Part of the Duodenum
68
Where is the jejunum relative to the Horizontal Part of the Duodenum?
ANTERIOR & INFERIOR to the Horizontal Part of the Duodenum
69
Is the Ascending Part of the Duodenum covered by peritoneum?
NO
70
What 2 structures are ANTERIOR to the Ascending Part of the Duodenum?
- Root of the mesentery
| - Jejunum
71
What vessel is POSTERIOR to the Ascending Part of the Duodenum?
Left margin of the aorta
72
The medial border of what muscle is POSTERIOR to the Ascending Part of the Duodenum?
psoas muscle
73
Which structure holds the Ascending Part of the Duodenum in place and anchors it to the Right Crus of the diaphragm?
Suspensory ligament of the duodenum
| Ligament of Treitz
74
What cavity does the jejunum and ileum occupy most of?
peritoneal cavity of the abdomen and pelvis
75
How long is the jejunum and ileum when uncoiled?
20 feet long
76
Where does the jejunum begin?
duodenal-jejunal junction
77
Where does the ileum end?
ilei-cecal valve
78
Which part of the small intestine is very mobile?
jejunum and ileum
79
What holds the jejunum and ileum to the posterior abdominal wall?
THE mesentery
80
What organ frames the jejunum and ileum?
Large intestine
81
What are the jejunum and ileum often called?
the "free" small intestine
82
How long is the jejunum?
8-10 feet long
83
How much of the free small intestine is made of the jejunum?
2/5
84
What is the anatomy and vasculature of the jejunum?
- SIMPLE vascular arcades
- LONG vasa recta
- MORE vascular
- GREATER diameter
- THICKER
- MORE plicae circularis
85
How long is the Ileum?
10-12 feet long
86
How much of the free small intestine is made of the Ileum?
3/5
87
What is the anatomy and vasculature of the Ileum?
- COMPOUND vascular arcades
- SHORTER vasa recta
- LESS vascular
- SMALLER diameter
- THINNER
- FEWER plicae circularis
88
How long is THE mesentery at the root?
15 cm long
89
On which side is THE mesentery more free?
left side
90
What 2 structures does THE mesentery attach to the POSTERIOR body wall?
- Jejunum
| - Ileum
91
What 7 structures does THE mesentery cross?
- L1 & L2
- 3rd part of duodenum (Horizontal)
- Aorta
- IVC
- Right ureter
- Right gonadal vessels
- Right psoas major
92
Where does THE mesentery end?
at the Right SI joint
93
At which vertebrae is the root of THE mesentery located?
L1
| L2
94
How many layers of peritoneum makes up THE mesentery?
2 layers of visceral peritoneum
95
What runs through the 2 layers of peritoneum of THE mesentery?
- nerves
- lymph nodes
- fat
- arteries
- veins
96
How long is the root of THE mesentery?
6-7 inches
97
How long is THE mesentery at it's intestinal border?
20 feet
98
What are the 8 regions of the Large intestine?
- Cecum & appendix
- Ascending colon
- Right colic flexure
- Transverse colon
- Left colic flexure
- Descending colon
- Sigmoid colon
- Rectum & Anal canal (in pelvis)
99
What are the functions of the large intestine?
- fecal formation
- fecal transport
- fecal evacuation
- water absorption
- mucus secretion
100
What are the 3 bands of longitudinal muscle on the outside of the colon?
Taenia coli
101
Where do the Taenia coli converge?
at the root of the appendix
102
What is produced by the Taenia Coli that slow the movement of feces?
haustra (sacculations)
103
What are the Epiploic Appendices?
tags of fat in the large intestine
104
Does the cecum have epiloic appendices?
NO
105
What is the blind pouch located inferior to to the ileal-cecal orifice?
cecum
106
What is the iliocolic valve?
2 folds in the cecum that are NOT a true sphincter
107
What is the ileal papilla?
a cone-like projection of the ileum into the cecum
108
Where is the opening for the appendix relative to the ileal papilla in the cecum?
INFERIOR to the ileal papilla
109
What is the appendix usually attached to?
posteromedial part of the cecum
110
Where is the appendix located?
at the junction of the 3 Taenia Coli
111
How long is the appendix?
9-10 cm
112
What supports the appendix?
mesoappendix
**Appendix has its own mesentery
113
What is at the end of the ascending colon?
Right colic flexure (hepatic flexure)
114
What is at the end of the transverse colon?
Left colic flexure (splenic flexure)
115
Which parts of the colon are secondarily retroperitoneal?
- ascending colon (except for the lowest part)
| - descending colon
116
Which parts of the colon are intraperitoneal?
- transverse colon (transverse mesocolon)
| - sigmoid colon (sigmoid mesocolon)
117
In which region does the spleen sit?
- left hypochondriac region
| - midaxillary line
118
What ribs does the spleen parallel?
9, 10, 11
119
What 2 structures does the spleen sit between?
stomach
| diaphragm
120
Is the spleen covered by peritoneum?
YES
121
What does the spleen develop in, and what does it develop from?
- Develops in the dorsal mesentery
| - Develops from mesoderm
122
What are the 2 ligaments associated with the spleen?
- Gastrosplenic ligament
| - Splenorenal ligament
123
Where is the spleen relative to the diaphragm?
POSTERIOR
124
Which structures are ANTERIOR to the spleen?
- stomach
- left colic flexure
- tail of the pancreas
125
What 2 structures lie INFERIOR to the spleen?
- Left kidney
| - Phrenicocolic ligament
126
What is the diaphragmatic surface of the spleen?
the smooth part of the spleen against the diaphragm
127
What is present on the visceral surface of the spleen?
- Hilum
- Colic impressions
- Gastric impressions
- Renal impressions
128
What are the 2 ligaments of the Hilum on the visceral surface of the spleen?
- Gastrosplenic ligament
| - Splenorenal ligament
129
What peritoneal type is the pancreas?
secondarily retroperitoneal
130
At which vertebrae is the pancreas located?
L1
| L2
131
What are the 4 parts of the pancreas?
- head
- body
- neck
- tail
132
What does the head of the pancreas have and where is it located?
- has Unicate process
| - in Duodenal curve
133
What is the body of the pancreas?
a triangular cross-section of the pancreas
134
Where is the neck of the pancreas located?
- constricted part
| - between the head and the body of the pancreas
135
Where is the tail of the pancreas located?
- in the Splenorenal ligament (some)
| - Anterior to the hilus of the spleen
136
Which vessels are POSTERIOR to the neck of the pancreas?
- superior mesenteric a.
| - superior mesenteric v.
137
Which vessels run Horizontally superior to or posterior to the body of the pancreas?
- splenic vein
| - splenic artery
138
Where are the IVC and aorta relative to the body of the pancreas?
POSTERIOR
139
Where is the stomach relative to the spleen?
ANTERIOR
140
Where is the duodenum relative to the head of the pancreas?
superior, right, and inferior to the head of the pancreas
141
Where does the transverse colon lie, relative to the pancreas?
ANTERIOR and INFERIOR to the pancreas
142
What does the main/major pancreatic duct join?
the bile duct
143
Where do the pancreatic and bile duct enter together?
The 2nd part of the duodenum through the hepatopancreatic ampulla
144
What does the pancreatic duct and the bile duct form together?
major duodenal papilla
145
Where does the accessory pancreatic duct enter the duodenum?
minor duodenal papilla
146
In what quadrant is most of the liver located?
RUQ
147
Which lobe of the liver is located in the LUQ?
the smaller left lobe
148
What produces bile? What stores bile?
Liver produces bile
| Gallbadder stores bile
149
What structure is a double layer of peritoneum that connects the liver to the anterior wall?
falciform ligament
150
What does the bare area of the liver include?
where the IVC is POSTERIOR to the liver and the hepatic veins drain into it
151
What veins drain into the bare area of the liver?
hepatic veins
152
What structures lie on the visceral surface of the liver?
- Ligamentum venosum
- Ligamentum teres hepatis
- Hepatic fossa for gallbladder
- Lobes of the liver (right, left, quadrate, caudate)
153
What did the ligamentum venosum used to shunt in infants?
between vena cava & portal vein
154
What does the portal hepatic transmit?
the portal triad
155
What makes up the portal triad?
- hepatic artery
- portal vein
- bile duct
156
What did the ligamentum teres hepatis used to be?
obliterated umbilical vein
157
What did the ligamentum venosum used to be?
ductus venosus
**connected the IVC and umbilicus vein
158
What 2 ligaments make up the lesser omentum?
- Hepatoduodenal ligament
| - Hepatogastric ligament
159
Where does the gallbladder lie?
in the hepatic fossa in RUQ
160
What 2 extra hepatic bile passages make up the common hepatic duct?
- cystic duct
| - bile duct
161
Which region is the gallbladder located on?
transpyloric line/region
162
At what costal cartilages does the gallbladder make contact with the abdominal wall at the midclavicular line?
costal cartilages 9 & 10
163
What are the 3 parts of the gallbladder?
- fundus
- head
- neck
164
What do the bile duct and the pancreatic duct enter through to get to the second part of the duodenum?
major duodenal papilla
