10/19 Abdomen III

Question 1

contents of foregut

Answer 1

abdominal esophagus
1st part duodenum
liver
gallbladder
spleen
pancrease
stomach

Question 2

location/protection of stomach

Answer 2

ULQ

lower thoracic wall protects

Question 3

where does the pyloris cross the midline

Answer 3

L1 disc/transpyloric plane

Question 4

location of cardia and fundus of stomach

Answer 4

adj to diaphragm, deep to left costal margin

Question 5

parts and characteristics of pylorus

Answer 5

thickened smooth muscle

gastro-duodenal jxn marked by pyloric sphincter around pyloric canal at the L1 disc level. antrum leads into canal

Question 6

location/protection of spleen

Answer 6

ULQ, posterior/left of stomach

Question 7

two surfaces of spleen

Answer 7

lateral/diaphragmatic

visceral/medial: contains hilum
gastric surface
renal surface (L kidney, attached via splenorenal ligament (greater omentum))
colic surface (L colic/splenic feature, transition btween transverse and descending colon)

Question 8

what ligament contains the tail of pancreas and distal splenic vessels

Answer 8

splenorenal ligament

Question 9

how does the spleen attach to the stomach

Answer 9

gastrosplenic ligament (greater omentum)

Question 10

location of the liver

Answer 10

URQ, deep to R costal margin

Question 11

2 surfaces of the liver

Answer 11

diaphragmatic: smooth, sup/ant, falciform ligament, ligamentum teres
visceral: post/inf, attaches to lesser omentum, contains porta hepatis, ligamentum venosum

Question 12

bare area of the liver

Answer 12

posterior right surface

Question 13

division of 4 lobes of liver, visceral surface

Answer 13

“H”
lig venosum (caudate lobe) fossa for IVC
(left lobe) portal hepatis (right lobe)
lig teres (quadrate lobe) fossa for gallbadder

Question 14

contents and location of portal triad

Answer 14

hepatoduodenal ligament (lesser omentum)

comon bile duct
portal vein
proper hepatic a

Question 15

major duodenal papilla

Answer 15

divides foregut and midgut

where bile and pancreatic secretions enter 2nd part of duodenum

Question 16

location of pancreas

Answer 16

post abdominal wall, btwn duodenum (R) and spleen (L)

Question 17

4 segments of pancreas

Answer 17

retroperitoneal: head, neck, body
intraperitoneal: tail (in splenorenal ligament)

Question 18

main pancreatic duct

Answer 18

deep to body and neck of pancreas, dumps into common bile duct, then major duodenal papilla (2nd pt duodenum)
occasionally, pts have an accessory duct just superior

Question 19

problem: liver’s bare area

Answer 19

lymphatic vessels pass btwn lungs and liver w/o encountering a boundary of peritoneum and can facilitate the spread of cancer and infection

Question 20

problem: gall stones

Answer 20

can occur in several parts of billary tree

Question 21

problem: stomach ulcer

Answer 21

if erodes posterior stomach wall, endangers splenic a, threatens blood supply to fundus (only supply), and greater curvature (not as bad, anastomoses of gastroepiplotic aa)

Question 22

problem: duodenal ulcer

Answer 22

if in 1st part, endangers gastroduodenal a (blood supply to pylorus, 1st part of duodenum, and head of pancreas)

Question 23

3 branches of celiac trunk

Answer 23

left gastric a
splenic a
common hepatic a

Question 24

3 anastomoses of celiac trunk

Answer 24

L gastric a (directly off CT) + R gastric a (from common hepatic a/ proper hepatic a)

L gastroepiplotic a (from splenic a) + R gastroepiplotic a (from gastroduodenal a/proper hepatic a)

sup. pancreaticoduodenal aa (from gastroduodenal a/proper hepatic + inf pancreaticoduodenal aa (from superior mesenteric a