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BS VI Quiz I > 1. Anatomy Pt. I > Flashcards

1. Anatomy Pt. I Flashcards

1
Q

After passing through the esophageal hiatus of the diaphragm, the abdominal ESOPHAGUS discharges its contents into the ____

The stomach empties into the ____, comprising DUODENUM, JEJUNUM and ILEUM.

The ileum is continuous with the ____, the proximal part of the LARGE INTESTINE or COLON.

Distal to the cecum we find, in sequence, the ____, TRANSVERSE, DESCENDING and ____ parts of the colon.

Finally, the ____ and ANAL CANAL are found in the true pelvis.

A 
stomach
small intestine
cecum
ascending
sigmoid
rectum
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2
Q

GI viscera occupy both the ____ and the ____ cavities of the trunk

A

abdominal

pelvic

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3
Q

It is important to note that diaphragmatic contraction, pelvic floor contraction and contraction of the muscles in aponeuroses of the antero-lateral abdominal wall will have a profound effect on the pressures within the cavity.

The pressures will change with certain activities such as: • ____
• ____
• ____

A

respiration
defecation
urination

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4
Q

The ____ muscles and their ____ form a strong but flexible abdominal wall, restraining the viscera and regulating changes in intra-abdominal pressure

Violating the integrity of the abdominal wall may lead to formation of ____

A

anterolateral abdominal
aponeuroses
hernias

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5
Q

Here are examples of hernias:
• Epigastric hernia – Just under the ____ of the sternum we see
abdominal-pelvic contents escaping
• Umbilical hernia – in region of the ____

These are hernia locations in the abdominal-pelvic cavity, we will discuss diaphragm hernia locations in a bit

A

xiphoid process

umbilicus

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6
Q

The walls, roof and floor of the abdominopelvic cavity are lined with a serous membrane - ____ – derived from ____

A

parietal peritoneum

somatic mesoderm

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7
Q

While most gut derivatives are ____, invested by a thin layer of ____, derived from ____, and suspended by a mesentery…

…others have lost their suspensory mesentery and assumed a
____ position

A

peritonealized
visceral peritoneum
splanchnic mesoderm
(secondarily) retroperitoneal position

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8
Q

The potential space between the parietal and visceral layers of peritoneum is called the ____

A

peritoneal cavity

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9
Q

With the muscles of the abdominal wall and their aponeuroses reflected, note the…

FALCIFORM LIGAMENT
Derived from the
____
of the embryonic foregut

In the free edge, the
ROUND LIGAMENT OF THE LIVER
the obliterated
____

GREATER OMENTUM
Derived from the
____
of the embryonic foregut

A

ventral mesentery
umbilical vein
dorsal mesentery

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10
Q

So what is a mesentery anyway?

It is a double layer of ____

A

visceral periotneum

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11
Q

The____ of the peritonealized (intraperitoneal) viscera of the developed human suspend the organs and transmit the following structures between the GI tract and the posterior abdominal wall

  • Arterial supply from branches of the ____
  • Venous drainage to the ____
  • ____ nerves
  • ____
A 
dorsal mesenteries
abdominal aorta
hepatic portal system
autonomic
lymphatics
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12
Q

Much of the GI tract remains attached to the posterior abdominal wall via
____

But…during development, some viscera lose their suspensory mesenteries and become ____ to the posterior abdominal wall

Such viscera are covered by peritoneum only on their ____ and lateral aspects

These are referred to as ____ VISCERA

A

dorsal mesentery
fixed
anterior
secondarily retroperioneal

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13
Q

____ frequently persist for these (retroperitoneal) organs

A

mesenteric stubs

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14
Q

The secondarily retroperitoneal viscera include:

  • ____
  • ____
  • ____
  • ____
A

distal 3/4 duodenum
ascending colon
descending colon
rectum

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15
Q

Derivatives of the ____ that suspended the embryonic gut are associated in the adult with FOREGUT derivatives only

A

ventral mesentery

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16
Q

As the liver expands dramatically into the ____ of the foregut during development, these elements of the ____ will be examined more closely in the next module

A

ventral mesentery

lesser omentum

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17
Q

The dorsal mesenteries are conduits for three arteries arising from the anterior aspect of the ____

A

abdominal aorta

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18
Q

These vessels, arising as ____ in the embryo, will supply organs derived from the endoderm of the three abdominal divisions of the embryonic gut

A

vitelline arteries

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19
Q

The origins of these vessels are consistent in relation to the vertebral column

  • ____
  • – L1 transpyloric plane —
  • ____
  • – L3 subcostal plane —
  • ____
A

celiac
superior mesenteric
inferior mesenteric

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20
Q

Recall that ____ and ____ are continuous with each other in the axial plane of the inferior border
of the ____, at the ____ vertebral level

A

hypopharynx
esophagus
cricoid cartilage
C6

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21
Q

The thoracic ESOPHAGUS courses the length of both the ____

The esophagus passes through the esophageal hiatus of the ____ at the ____ level along with:
• ____
• ____

A 
superior and posterior mediastinum
diaphragm
T10
anterior and posterior vagal trunks
esophageal blood vessels
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22
Q 
Esophageal arteries (4-5)
arise from the \_\_\_\_

Esophageal veins participate in an ____ between the ____ circulations

A

descending (thoracic) aorta
anastomosis
portal and caval (systemic)

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23
Q

The esophageal plexus is formed with contributions from:

  • ____ nerves
  • Direct visceral branches from ____ ganglia

Inferiorly, the vagus nerves reconstitute as ____

A

left and right vagal

upper thoracic sympathetic

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24
Q

The esophagus is vulnerable to inflammation and carcinogenesis at three points of constriction

1 – ____
2 – ____
3 – ____

A

cervical constriction
broncho-aortic constriction
draphragmatic constriction

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25
Q

Esophageal diverticulum

Some 70% of these are
____
occurring at the junction of the pharynx and the ____

____ diverticulum

____ (parahiatal) diverticulum

A

hypopharyngeal diverticulum
esophagus
parabronchial
epiphrenic

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26
Q

Retention of food and secretions within the lesion’s pouch leads to:

  • ____
  • ____
  • ____
  • ____
A

halitosis
regurgitation
aspiration
dysphagia

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27
Q

Foregut derivatives

Distal____, stomach, liver, gall bladder, ____, proximal duodenum

Receive blood supply from the ____ and its branches

Receive preganglionic sympathetic innervation from ____

Receive preganglionic parasympathetic innervation from the ____

A 
esophagus
pancreas
celiac artery
thoracic splanchnic nerves
vagus nerves
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28
Q

A physiological ____ is found at the gastroesophageal junction

____– incomplete IES relaxation

____ Junction of esophageal and gastric mucosae

GERD – excessive relaxation of IES leading to ____ and ____

A

inferior esophageal sphincter

achalasia

Z-line
esophagitis
barrett’s esophagus

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29
Q

An acute angle between the ____ and the ____ of the stomach - the ANGLE OF HIS - also functions as a ____, limiting potential reflux of gastric contents

A

esophagus
cardia
valve

30
Q
  • CARDIA
  • FUNDUS
  • BODY
  • PYLORUS
  • lesser and greater curvatures

hese curvatures are formed by the rotations of the ____

A

embryonic foregut

31
Q

This 1st rotation explains the ____

The AP rotation also explains the size and relations of the ____derived from the ____

A

vagal trunks
greater omentum
dorsal mesogastrium

32
Q

Note that the GREATER OMENTUM features ____ layers of peritoneum and fuses with the ____

A

four

transverse mesocolon

33
Q

The stomach consists of ____ muscular layers which churn food, liquid and saliva into ____

A

three

chyme

34
Q
  • PYLORIC SPHINCTER
  • PYLORIC CANAL
  • gastric folds (rugae)

Peptic ulcer disease (PUD) – lesions extending thru either the ____ or ____ mucosa

A

gastric

duodenal

35
Q

An essential component of surgical management of peptic ulcer disease, ____ was once commonly performed to treat and prevent PUD - NO LONGER

A

vagotomy

36
Q

DIAPHRAGMATIC HERNIAS result from loss of muscle tonus and widening of the ____

PARAESOPHAGEAL HIATAL HERNIA usually involves the ____

SLIDING HIATAL HERNIA a ____-shaped protrusion usually involving the ____

A

esophageal hiatus
fundus
bell
cardia

37
Q

Lesser omentum

A remnant of ____ mesentery connecting the ____ to the lesser curvature of the ____ and the ____

A

ventral
liver
stomach
first part of the duodenum

38
Q

The LESSER OMENTUM is comprised of two distinct portions

  • ____ ligament
  • ____ ligament contains the ____
A

hepatogastric
hepatoduodenal
hepatic triad

39
Q

Hepatic (portal) triad

  • ____
  • ____
  • ____
A

proper hepatic artery
common bile duct
hepatic portal vein

40
Q

Vascular and biliary elements pass through a ____ fissure in the visceral surface of the liver known as the ____

Proper Hepatic Artery a
branch of the ____ (is a direct branch of ____)

A

transverse
porta hepatis
common hepatic artery
celiac artery

41
Q

Main branches of the CELIAC TRUNK:

  • ____
  • ____
  • ____
A

left gastric
common hepatic
splenic

42
Q

Proper hepatic
Esophageal
Left & right gastrics

____ is ligated in cholecystectomy (gallbladder removal)

____ may bleed profusely as a result of peptic ulcer disease

LOOK AT THIS SLIDE BROTHER

A

cystic

gastroduodenal

43
Q

Branches of ____ and

____ anastomose around pancreas and duodenum

A

celiac

superior mesenteric

44
Q 
The
HEPATIC
PORTAL VEIN
drains the abdominal gut from the
\_\_\_\_ to the
\_\_\_\_...
As well as the
• \_\_\_\_
• \_\_\_\_
• \_\_\_\_
A 
distal esophagus
superior rectum
spleen
pancreas
gallbladder
45
Q

The HEPATIC PORTAL VEIN is normally formed deep to the neck of the ____ by the confluence of two veins (____ and ____)

A

pancrease
splenic
superior mesenteric

46
Q

The Common bile duct and the anatomy of the biliary tree will be presented in the next module

A

YAY

47
Q

The free edge of the ____ also forms the anterior wall of the ____, providing access to the ____, a large recess of the ____ created by the rotations of the stomach during development

A

hepatoduodenal ligament
epiploic foramen (of Winslow)
lesser sac
peritoneal cavity

48
Q

The LESSER SAC is also known as the ____

A

omental bursa

49
Q

The OMENTAL BURSA permits the stomach to move freely against the posterior abdominal wall during ____

____ HERNIAS
ARE POSSIBLE

A

peristalsis

internal

50
Q

The spleen is a fully ____ organ

The spleen arises as a condensation of ____ in the dorsal mesentery
of the ____ rather than from ____

A

peritonealized
mesenchyme
embryonic foregut
gut endoderm

51
Q

The long axis of the spleen is aligned with the ____ rib, the lowest of the ____ ribs, on the left side

Protected by the rib cage, the organ is NOT normally ____ on physical exam

A

10th
false
palpable

52
Q 
With the stomach
removed and its
dorsal mesentery
opened, the splenic
artery and vein are
seen passing through
the \_\_\_\_ of the organ
as it lies in the \_\_\_\_ of the abdominal cavity
A

hilum

left upper quadrant

53
Q

Why is the
splenic artery, a physiologic end-artery, so tortuous?

There are TWO answers

The spleen may store more than ____ fluid ounces of blood

This location of the spleen immediately deep to fragile ribs, coupled with the organ’s vascularity and its living consistency, predisposes the organ to relatively easy rupture by ____

A

8

external trauma

54
Q

The duodenum has four parts

  1. ____ (continuous with the pylorus)
  2. ____ (a 2nd vertical or descending portion)
  3. ____ (crosses midline from right left)
  4. ____ (points up)
A

superior
descending
transverse
ascending

55
Q

The pancreas lies on the posterior abdominal wall, posterior to the ____ between the ____ on the right and the ____ on the left

A

stomach
duodenum
spleen

56
Q

The duodenum wraps around the ____

The “C” shape of the duodenum embraces the pancreatic head

Duodenum terminates at the ____

A

pancreatic head

duodenojejunal junction

57
Q

Both bile and pancreatic juice drain into the
second (the ____) part of the the ____

COMMON BILE DUCT

The the ____ Marks the boundary between foregut and midgut derivatives

A

descending
duodenum
major duodenal papilla

58
Q

Midgut derivatives

Distal duodenum, jejunum, ileum, cecum, ascending colon, proximal 2/3 transverse colon
0 Receive blood supply from the ____ and its branches
Receive preganglionic sympathetic innervation from ____ nerves
Receive preganglionic parasympathetic innvervation from the ____

A

superior mesenteric artery
thoracic splanchnic
vagal trunks

59
Q

Elevating the
GREATER OMENTUM, TRANSVERSE COLON and TRANSVERSE MESOCOLON reveals the
____
and
____… Which have much in common in terms of both ____ and peritoneal ____

A

jejunum
ileum
structure
relationships

60
Q 
JEJUNUM
\_\_\_\_ quadrant 
\_\_\_\_
Many \_\_\_\_ folds 
More \_\_\_\_
ILEUM
\_\_\_\_ quadrant 
\_\_\_\_
\_\_\_\_ such folds
Less \_\_\_\_
A

upper left
wider
circular
vascular

lower right
narrower
few
vascular

61
Q

As you look into the ileum, which has a smoother luminal wall, we might find little concentrations of tissue called ____ patches, and Peyer’s patches are examples of ____. Prominent in the ____and present but not in equal abundance and not presenting as obviously in the jejunum.

A

peyer’s
gut associated lymphatic tissue (GALT)
ileum

62
Q

In the
____ quadrant…
The ____ prevents reflux of bacteria-laden cecal contents into the small intestine
ILEO- CECAL JUNCTION

A

right lower

ileo-cecal valve

63
Q

The relatively small human cecum, lying in the ____ quadrant, is the first part of the ____.

A

right lower

large intestine

64
Q

Diagnostic features of the colon

  • ____ (3)
  • ____
  • ____

FYI - these end at the rectum

A

teniae coli
epiploic appendages
haustra

65
Q

The ____ is open to the cecum inferior to the ileo-cecal valve

The appendix has evolved independently ____ times in mammalian evolution…so is it really a useless vestigial structure?

The appendix is suspended from the cecum by it own ____

A

vermiform appendix
32
mesentery

66
Q

Appendicitis may be caused by ____ of lymphatic follicles or by obstruction by a ____

Thrombosis of the ____ and rupture of the appendix producing ____ are concerns

A

hyperplasia
fecolith
appendicular artery
peritonitis

67
Q

Ascending colon

- hepatic (right colic) flexure

A

ya

68
Q

Everything we have seen from the major duodenal papilla to the point 2/3 of the way along the transverse colon is midgut and is supplied by the ____ and drained by the ____. The superior mesenteric artery arising from the abdominal aorta and the superior mesenteric vein ultimately draining into the portal system, so into the hepatic portal vein.

A

superior mesenteric artery

superior mesenteric vein

69
Q

SMA

  • ____(jejunal and ileal)
  • ____ (anatomotic loop)
  • ____
  • ____
A

intestinal
arcade
vasa recta
inferior pacreaticoduodenal

70
Q

The ____ generally supply alternating sides of the intestine

A

vasa recta

BS VI Quiz I (4 decks)

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