2017 Anatomy - Peritoneum, Esophagus, Stomach, Small Intestine, Spleen

Question 1

Which mesentary gives rise to the Greater and which gives rise to the Lesser Omentum?

Answer 1

Dorsal = greater

Ventral = lesser

Question 2

What are the two ligaments of the lesser omentum and where do they run from/to?

Answer 2

Hepatogastic: Stomach - Liver (Medial)

Hepatoduodenal: Duodenum -Liver (Lateral)

Question 3

Through what opening do the Greater and Lesser Sacs (Omental Bursa) communicate?

Answer 3

Epiploic Foramen

Question 4

Which vessels run through the Hepatoduodenal ligament?

Answer 4

Hepatic Artery

Hepatic Portal Vein

Bile Duct

Question 5

At what level (aprox.) does the esophagus pierce the diaphagm?

Answer 5

T10

Question 6

Which nerve makes up the Anterior Vagal Trunk (plexus) and which makes up the Posterior?

Answer 6

Left = Anterior

Right = Posterior

Question 7

What is the name of the opening of the stomach into which the esophagus opens, what is the name of the feature which makes the change in epithelium type here?

Answer 7

Cardial Orfice

Z-line

Question 8

What is a disease of the esophagus caused by increase portal hypertension?

Answer 8

Esophageal varices

Question 9

What are the 4 major regions of the stomach?

Answer 9

Cardia

Fundus

Body

Pyloric

Question 10

What are the 4 features of the stomach?

Answer 10

Greater Curvature

Lesser Curvature

Cardial Notch

Angular Incisure

Question 11

What 7 organs are a part of the “bed of the stomach”?

Answer 11

Diaphragm (left dome)

Spleen

Left Kidney

Suprarenal Galnd

Pancreas

Trasverse Mesocolon

Colon

Question 12

What are the ligaments/attachments of the stomach?

Answer 12

Gastrospleic ligament: from greater omentum, connects greater curve to hilum of spleen

Gastrophrenic ligament: from greater omentum, connects greater curve to inferior surface of diaphragm

Gastrocolic ligament: greater omentum, connects greater curve to transverse colon

Hepatogastic ligament: lesser omentum, lesser curve to liver

Question 13

What are the 4 groups of lymph nodes of the stomach and where do they ultimately drain (nodes and duct)?

Answer 13

Gastric Lymph Nodes - cardia and superior stomach

Pancreaticosplenic - posterior stomach along the Splenic Artery

Gastro-Omental - inferior portion of greater curve

Pyloric - around pyloric canal

All drain to Celiac Lymph Nodes and into the Thoracic Duct

Question 14

Understand the basic arterial supply of the stomach?

Answer 14

Question 15

From where does the:

left gastric artery

right gastric artery

right gastro-omental artery

left gastro-omental artery

posterior gastric artery

arise?

Answer 15

Celiac Trunk

Hepatic Artery Proper

Gastroduodenal Artery

Splenic Artery

Splenic Artery

Question 16

What are the 3 segments of the small intestine?

Answer 16

Duodenum

Jejunum

Ilium

Question 17

What is the first portion of the duodenum and some important features?

Answer 17

Superior portion

located right of L1 body

passes anteior to bile duct, gastroduodenal artery, portal vein, and IVC

clincally called the duodenal cap and site of duodenal ulcers

Question 18

What is the second portion of the duodenum and some important features?

Answer 18

Descending portion

extends down right side of L1-L3

contains the Major Duodenal Papilla, entrance of bile duct and pancreatic ducts.

also contains Minor Duodenal Papilla, entrance of accessory pancreatic duct

Question 19

What is the importance of the Major Duodenal Papilla embroylocigally and vascularly?

Answer 19

Marks the fusion of the foregut with the midgut

Proximal to MDP = perfused by Celiac Trunk

Distal to MDP = perfused by Mesenteric Artery (Superior or Inferior)

Question 20

What is the third portion of the duodenum and some important features?

Answer 20

Inferior portion

longest section, runs horizontally across at L3

it crosses the IVC and is crossed by the Superior Mesenteric Artery

Question 21

What is the fourth portion of the duodenum and some important features?

What is the name of the ligament at the end of the duodenum, supporting it?

Answer 21

Ascending Part

passes upward to the left of abdominal aorta

ends at L2 level with duodenojejunal flexure

Suspensory Muscle (ligament) of duodenum (aka Ligament of Treitz)

Question 22

Know the vascular supply of the duodenum

Answer 22

Question 23

Which has a thicker wall, Jejunum or Ilium?

Answer 23

Jejunum

Question 24

Compare the Plicae Circularis of the Jejunum and Ilium?

Answer 24

Larger and more pronounced in Jejunum.

Question 25

How do the Jejunum and Ilium get their arterial supply? Describe the differences in Vasa Recta of the two segments.

Answer 25

via Jejunal/Ilial Arteries which are branches of the Superior Mesenteric Artery

Jejunum has fewer but longer Vasa Recta

Ilium has more/longer Arterial Arcades

Question 26

What is a histological feature unique to the Ilium?

Answer 26

Peyer’s Patches

Question 27

Where is the spleen and what organs/features surround it?

Answer 27

Left hypochondriac

anterior - stomach

posterior/lateral - ribs 9-11

medial - left kidney

inferior - left colic flexure

superior - diaphragm

Question 28

What vessels and ligaments attach to the hilum of the spleen?

Answer 28

the Splenic Artery and Vein

Splenorenal ligament - spleen to kidney

Gastrosplenic Ligament - spleen to stomach