5b. Abdomen HAL - Worksheet Flashcards
the kidneys are located where in relation to peritoneum
retroperitoneum
what are the kidneys encased in in terms of fat
peri and pararenal fat pads
where are the kidneys located in relation to psoas major muscle and what other muscle is near it
located anterior to the psoas maj and quadratus lumborum muscles
what is noticeable about the perirenal fat pads around the kidney and their relation to each other and the IVC and Abdominal aorta
they are continuous across the midline
what might you expect to see in a case of trauma where one kidney has ruptured since the perirenal fat pads are continuous along the midline
blood in the retroperitoneum contained within the boundaries of the renal fascia, potentially crossing the midline
the hila of the kidney lie on what plane
L1 trans-pyloric plane
what key structures enter and exit the kidney at the hilum
renal artery enters, renal vein and renal pelvis exit
why is it difficult to attain a complete view of the renal vessels in the coronal plane
the aorta and IVC are relatively more anterior than the renal hila
why is it difficult to attain a complete view of the renal vessels in the axial plane
the renal vessels may descend slightly to the kidneys relative to their origin
left kidney is located higher than the right so not on same horizontal plane
which kidney is typically positioned more inferior, why?
right due to position and size of liver
what are the 3 main places that a kidney stone is likely to get stuck
pelvis ureteric junction (where ureters leave the renal pelvis)
pelvic brim/bifurcation of common iliac artery
vesico-ureteric junction (where ureters enter bladder)
which muscles do the ureters descend upon as they course from kidney to bladder
psoas major
the ureters are roughly in line with what parts of the lumbar spine
transverse processes (specifically the tips)
the psoas muscles fills what on either side of the transverse processes
paravertebral gutter on either side
what aspect of the bladder do the ureters enter at
posterior aspect
is the small bowel intra/retroperitoneal
intra
what parts of the large colon are intraperitoneal and which parts are retroperitoneal
ascending and descending are retroperitoneal
transverse and sigmoid colon are intraperitoneal
the large intestine starts around what region of the abdomen
right groin
in what region of the abdomen does the ileum transition into the caecum
right groin
what region of the abdomen is the appendix
right groin
what region of the abdomen is the ascending colon
right flank
what region of the abdomen is the hepatic flexure
right hypochondrium
what region of the abdomen is the transverse colon
epigastric
what region of the abdomen is the splenic flexure
left hypochondrium
what region of the abdomen is the descending colon
left flank
what region of the abdomen is the sigmoid colon
left groin
what region of the abdomen is the rectum
pubic
where do you expect to find the ascending and descending colon
located relatively posteriorly within the abdominal cavity behind the peritoneum
what is the alrge intestine filled with during life that helps to identify it on CT/MR
gas
and faeces but gas is more identifiable as a density
where is the small intestine jejunum to ileum situated in the abdomenn
situated relatively anterior and centrally within the abdomen and inferior to the transverse colon
what is the GI tract composed of
stomach and duodenum
how would you describe the location of the stomach in the abdomen
anterior and left in epigastric region
where do you expect to see bowel gas within the stomach on a cross sectional image
top of the screen within structure anterior of patient as gas has risen to top
CT and MR typically taken laying supine
the duodenum is what shaped
C or G shaped
what direction does the duodenum travel in
traverses to right (superior portion), descends and then traverses to the left (inferior portion) and then ascends before becoming the jejunum
what does the inferior portion of the duodenum pass over (which vessel)
aorta
in which plane do you expect to see the full length of the descending/ascending duodenum
coronal and/or sagittal
in which plane do you expect to see the full length of the superior/inferior duodenum
axial and maybe coronal
in the axial slice, what organ do you expect to see immediately to the left of the descending duodenum
head of pancreas
the liver is located under what
right dome of diaphragm
the anatomic system of dividing the liver into lobes produces what 2 lobes
right and left lobes
what divides the liver into the right and left anatomic lobes
falciform ligament
how many physiological lobes of the liver are there
8
what divides the physiological lobes of the liver
venous architecture divides it into 4 columns
what venous structure divides the physiological lobes of the liver into 4 columns
via 3 main hepatic veins
what are the 3 hepatic veins
left, central and right
what divides the left and right physiological lobes in cantlies line
central hepatic vein
what vessel divides the liver into a superior and inferior half
2 main branches of the portal vein
the caudate lobe is what segment and what does it drain into
segment 1
drains into the IVC
the segment 4 gets split into what parts and where are they located in relation to which vessels
part A and B either side of left portal vein branch
the gall bladder is located where in relation to the liver
pinned to and hangs from the postero-inferior surface of the liver
what way does the gall bladder slope
slopes to the anterior
what can be used to estimate cantlies line
gall bladder and IVC
what is the difference between imaging and diagrams depicting the gall bladder and IVC relation
gall bladder is located anteriorly and to the right of the IVC but diagrams depict them as line antero-posteriorly
the gall bladder drains into what structure
bile duct
what 3 structures form the portal triad
hepatic artery and portal vein plus bile duct
where is the portal vein in relation to the IVC
anterior
what bit of the large bowel can you see inferior to the right lobe
hepatic flexure
what other major solid organ is also closely attributed to the right lobe
right kidney
what is the clinical significance of the livers relationship with the right kidney
hepatorenal pouch of Morrison is the most dependent part of the abdomen when supine and therefore is where the blood/fluids will collect and can be seen on imaging
what is the difference between the IVC and the aorta that can help you differentiate them on the images
aorta is always more circular in axial cross section due to thick elastic muscular walls
IVC is often more ellipsoid nd flattened due to weaker walls and lower blood pressure
the spleen is on what side of the abdomen
left side
the 3 impressions on the visceral/internal surface of the spleen correlate to what 3 organs
stomach = ant and right of spleen
kidney = post and inf of spleen
splenic flexure = ant and inf of spleen
what is the difference between the splenic artery and splenic vein in terms of structure
how does this relate to visualising them in images
splenic artery is very tortuous and is unlikely to get all in single slice
splenic vein is straight and therefore more likely see more
what organ does the splenic vein course behind
pancreas
what are the 5 sections of the pancreas
head, neck, body, tail and uncinate process
what is a key anatomical relation to the uncinate of the pancreas to other organs around it in terms of location
posterior to the SMA and SMV
what is a key anatomical relation to the head of the pancreas to other organs around it in terms of location
left of descending duodenum
what is a key anatomical relation to the neck of the pancreas to other organs around it in terms of location
anterior to SMA and portal vein origin
what is a key anatomical relation to the body of the pancreas to other organs around it in terms of location
anterior to splenic vein
what is a key anatomical relation to the tail of the pancreas to other organs around it in terms of location
sits in hilum of the spleen
can you see all parts of the pancreas in one level and one plane in imaging
no head, neck and body and some tail in one horizontal plane but to see the uncinate process, need to drop one level
what do you notice about the head of the pancreas in comparison to other divisions
head has more vertical dimension than other components (eg sits on 2 levels while others site more on one)
coronal and sagittal therefore would show it entirety
which important vein is formed behind the neck of the pancreas
portal vein
what are the transpyloric plane structures
renal hila
pylorus of stomach
gall bladder fundus
SMA origin of aorta
