12.3-12.5

Question 1

The oseophagus descends behind the ___, in the midline and pierces the diaphragm at T___

Answer 1

Trachea, pierces diaphragm at T10.

Question 2

The oesophageal hiatus is in the right ___ of the diaphragm, and the left ___ forms a sling around it.

Answer 2

Crus, crus!

Question 3

There are two types of herniations of stomach through diaphragm: ___ ___ hernia and ___ ___ hernia

Answer 3

Sliding oesophageal (95%)!
Paraoesophageal hiatal (5%).

Question 4

The ___ in the stomach increase in prominence as you get close to the ___ sphincter.,

Answer 4

Rugae

Pyloric

Question 5

The anastomosis of vessels along the lesser curvature =

Answer 5

Gastric vessels.

Question 6

The anastomosis of vessels along the greater curvature =

Answer 6

Gastroepiploic vessels.

Question 7

The duodenum is divided into 4 parts of lengths:

Answer 7

2 inch, 3 inch, 4 inch and 1 inch.

Question 8

The first inch of the duodenum is ___peritoneal

Answer 8

Intra!

Question 9

The mesentery for the transverse colon comes off the ___ ___ wall, and across the ___ part of the duodenum

Answer 9

Posterior abdominal wall

Across second part of duodenum

Question 10

The major duodenal papilla is ___ inches down the second part of duodenum

Answer 10

1.5 inches

I.e. halfway down second part

Question 11

There is a minor duodenal papilla ___ inch above the major duodenal papilla

Answer 11

1

Question 12

The third part of the duodenum crosses from right ___ (muscle), in front of ___ and ___ (vessels) and to left ___ (muscle)

Answer 12

Right psoas, IVC and aorta, to left psoas.

Question 13

The third part of duodenum crosses the lumbar vertebral column at the level of L___

Answer 13

3

Question 14

3 key features cross the front of the third part of duodenum:

Answer 14

Superior mesenteric artery AND vein, and mesentery for small intestine.

Question 15

The neurovascular structures for jejunum and ileum are conducted by the ___ from the ___ ___ wall.

Answer 15

Mesentery from posterior abdominal wall

Question 16

Proximal loops of vessels in mesentery are called ___ ___

Answer 16

Vascular arcades

Question 17

The long/vertically orientated vessels to mucosal tube are called ___ ___

Answer 17

Vasa recta

Question 18

There is more absorption in ___ c.f. ___, so there are more mucosal folds and thicker walls in ___

Answer 18

Jejunum c.f. ileum.

More mucosal folds and thicker walls in jejunum!

Question 19

In the mesentery of jejunum there is ___ fat!

Answer 19

LESS

So can see vessels in jejunum more clearly c.f. in ileum.

Question 20

Difference in arrangement of vessels in jejunum c.f. ileum?

Answer 20

Jejunum - fewer arcades, long vasa recta.

Ileum - lots of arcades and short vasa recta.

Question 21

In SI, the inner and outer muscles coats are ___

Answer 21

Continuous

Question 22

In LI the inner muscle coat is a ring and outer longitudinal muscle coat forms ___ ___

Answer 22

Teniae coli - three discrete longitudinal muscle bands.

Question 23

Arrangement of appendix:

Answer 23

In 65% - retrocecal

In 20% - hangs into pelvis.

Question 24

Features of rectum:

Answer 24

Midline position, and teniae spread out and unite to form a single continuous outer muscle coat.

Question 25

In the porta hepatis, the portal vein is at the ___, and the hepatic artery and bile duct are at the ___ (and what sides too?)

Answer 25

Portal vein back.
Hepatic artery and bile duct at front.
Hepatic artery is on left, and bile duct is on right.

Question 26

There are two other lobes in the middle of the H of the liver called:

Answer 26

Caudate (top) and quadrate (bottom).

Question 27

There is a free ___ to the lesser omentum because the duodenum becomes ___

Answer 27

Free edge

Retroperitoneal

Question 28

The portal triad enter/exits the porta hepatis via the free edge of the ___ omentum

Answer 28

Lesser

Question 29

Venous drainage of the liver is NOT out of the ___ (where other structures are), but drain directly into ___

Answer 29

Hilum

But into IVC direct

Question 30

The common hepatic duct and bile duct runs behind:

Answer 30

First part of duodenum, tucked into groove between second aprt of duodenum and pancreatic head, to midpoint of second part of duodenum (1.5 inches down on posteromedial wall).

Question 31

The gall bladder lies over the ___ part of the duodenum

Answer 31

First

Question 32

Neck of pancreas over:

Body of pancreas above:

Answer 32

Over top of superior mesenteric vessels.

Above DJF.

Question 33

The main duct of pancreas drains almost all of pancreas except:

Answer 33

Lower part of head and uncinate process.

Question 34

There is an accessory ____ duct that drains the distal part of head of pancreas and uncinate process.

Answer 34

Accessory pancreatic duct

Question 35

Aorta and IVC are ___peritoneal

Answer 35

Retro

Question 36

There is a ___ nerve supply to parietal peritoneum and a ___ nerve supply to visceral peritoneum

Answer 36

Somatic

Visceral

Question 37

The deepest abdominal structures are paired: ___, ___ and ___

Answer 37

Adrenals, kidneys and ureters

Question 38

Kidneys are on ___ (muscle) and ureters are on ___ (muscle)

Answer 38

Quadratus lumborum

Psoas, parallel to tips of LUMBAR TRANSVERSE PROCESSES (important radiologically)!

Question 39

All unpaired structures are derived from the ___ ___ tube

Answer 39

Primitive gut tube

Question 40

Secondarily retroperitoneal structures (i.e. start intraperitoneal and become retro) include:

Answer 40

Duodenum and pancreas with bile duct, and ascending and descending colon.

Question 41

The peritoneal cavity is divided into ___ and ___ sac

Answer 41

Lesser and greater

Question 42

The space of peritoneal cavity enclosed behind stomach acts as a ___ and is called the ___ ___ or ___ ___

Answer 42

Bursa
Lesser sac
Omental bursa

Question 43

The lesser sac communicates with the greater sac at ONE point only:

Answer 43

Epiploic of omental foramen )of Winslow)

Question 44

There is an oblique line of attachment of the mesentery from:

Answer 44

DJ flexure, across third part of duodenum, aorta/IVC, right psoas, to ileocecal junction.

Question 45

The liver is ___peritoneal

Answer 45

Intra!

Question 46

Greater omentum is full of ___

Answer 46

Fat - fatty apron

Question 47

There are basically _ layers of greater omentum because it folds back up behind itself

Answer 47

4

Question 48

Spleen is ___peritoneal

Answer 48

Intra

Question 49

Path of greater omentum:

Answer 49

Comes down from greater curvature of stomach, down to suprapubic region and folds back and up behind itself, then passes over small intestine and transverse colon, and attaches to posterior abdominal wall (same place as transverse mesocolon!).

Question 50

The greater omentum higher up off the greater curvature splits and surrounds the spleen to form the ___-___ ligament.

Answer 50

Gastro-splenic