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PHA 500 > 7. Abdominal Contents I > Flashcards

7. Abdominal Contents I Flashcards

1
Q

Abdominopelvic Cavity

A

Abdominal + pelvic

Continuous

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2
Q

Peritoneum

A

Serous membrane lining walls and organs

2 continuous parts:
Parietal + Visceral

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3
Q

Parietal Peritoneum

A

Lines internal aspect of abdominopelvic cavity

Somatic sensory innervation

  • supplied by nerves of ab wall
  • pain, temp, touch
  • acute localized pain
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4
Q

Visceral Peritoneum

A

Invests organs

Visceral sensory innervation
-stretch, ischemia

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5
Q

Peritoneal Cavity

A

Potential space between parietal and visceral peritoneum

Contains thin layer of fluid
WHAT DOES THIS MEAN

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6
Q

Ascites

A

Excess fluid in peritoneal cavity (between visceral and parietal layers)

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7
Q

Peritoneal Cavity (M/F)

A

Males: closed

Females: open

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8
Q

Retroperitoneal Space

A

Between parietal peritoneum and muscles of posterior ab wall

Contains:

  • fat
  • vessels
  • some organs
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9
Q

Primary Retroperitoneal Organs

A

Deep to parietal peritoneum in retroperitoneal space

WHICH ONES?

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10
Q

Ontogeny of Gut Tube

A

Developing organs become invested in visceral peritoneum

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11
Q

Intraperitoneal Organs

A

Completely covered by visceral peritoneum

Mobile

Ex: stomach

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12
Q

Secondarily Retroperitoneal Organs

A

Pressed against posterior body wall in early development - mesentery fuses to ab wall

Loss of mobility

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13
Q

Mesenteries

A

Two layers of peritoneum suspending organs

Pathway for blood vessels and nerves to get to and from ab organs

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14
Q

Lesser Omentum

A

Connect stomach and duodenum to liver

Extends from lesser curvature of stomach/proximal duodenum to liver

Composed of 2 peritoneal ligaments (hepatogastric and hepatoduodenal ligaments)

Contains portal triad

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15
Q

Greater Omentum

A

Connect stomach to large intestine

Extends from greater curvature of stomach/proximal duodenum to transverse colon

LARGE

Forms adhesions to wall off inflamed organs (protects adjacent viscera)

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16
Q

Greater Sac

A

Potential space

Larger sac

Extends from diaphragm to pelvic region

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17
Q

Lesser Sac

A

Omental bursa

Smaller sac

Posterior to stomach and lesser omentum

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18
Q

Omental (Epiploic) Foramen

A

Opening deep to hepatoduodenal ligament

Allows for communication between greater and lesser sacs

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19
Q

Embryonic Gut Tube

A

Foregut
Midgut
Hindgut

Common bloody supply, venous and lymphatic drainage, innervation

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20
Q

Foregut (derivatives)

A 
Esophagus
Stomach
Proximal duodenum
Liver
Gallbladder
Pancreas
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21
Q

Foregut (blood supply, venous drainage, lymphatics)

A

Blood supply: celiac trunk

Venous grainage: gastric veins, splenic vein

Lymphatics: celiac lymph nodes

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22
Q

Spleen

A

Not foregut/digestive organ

Lymphatic organ

LUQ
Deep to ribs 9-11

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23
Q

Esophagus

A

Abdominal portion: intraperitoneal

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24
Q

Esophagus (hiatal hernias)

A

Part of esophagus or other part of gut pushes up through hiatus

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25
Q

Stomach

A

Intraperitoneal

LUQ

Transpyloric plane

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26
Q

Stomach (curvatures)

A

Look and Label Image

Lesser: superior concave margin

Greater: inferior convex margin

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27
Q

Stomach: Cardia

A

Narrow proximal region

Where esophagus enters stomach

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28
Q

Stomach: Fundus

A

Dome of stomach

Inferior to L dome of diaphragm

Gas bubble on xray

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29
Q

Stomach: Body

A

Largest part of stomach

Between fundus and pyloric antrum

30
Q

Stomach: Pyloric Portion

A

Pyloric antrum

Pyloric canal

31
Q

Stomach: Pyloric Sphincter

A

Circular smooth muscle

Regulates flow of food from stomach to duodenum

32
Q

Stomach: Rugae

A

Internal folds of gastric mucosa

Adaption to allow stomach to expand

33
Q

Duodenum

A

RUQ

4 Parts:

  • 1st and 2nd: foregut
  • 3rd and 4th: midgut

First part of small intestine

C shaped

34
Q

Superior (1st Part) of Duodenum

A

Intraperitoneal

Lies on transpyloric plane (L1)

35
Q

Descending (2nd Part) of Duodenum

A

Secondarily retroperitoneal (helps anchor stomach to small intestine)

Parallel to IVC

Curves around head of pancreas

36
Q

Pancreas

A

Secondarily retroperitoneal

RUQ

Posterior to stomach
Between duodenum and spleen
Anterior to IVC

Head+Body+Tail

Tail in contact with spleen

37
Q

Liver

A

Intraperitoneal

Covered w/ visceral peritoneum (except at bare area)

Mostly RUQ, partially LUQ

Deep to ribs 7-11

38
Q

Liver: Falciform Ligament

A

Attaches liver to anterior ab wall

39
Q

Liver: Hepatoduodenal Ligament of Lesser Omentum

A

Contains portal triad

40
Q

Portal Triad

A

Portal vein
Proper hepatic artery
Bile duct

41
Q

Lobes of Liver

A

R lobe
L lobe
Caudate lobe
Quadrate lobe

42
Q

Segments of Liver

A

8 segments

Each segment:

  • L or R hepatic artery
  • portal vein
  • L or R hepatic duct

hepatic veins are intersegmental

43
Q

Bile Duct

A

Smooth muscle sphincter

Sphincter forces bile into cystic duct and gall bladder

L and R hepatic ducts drain into common hepatic duct –> joins cystic duct –> forms bile duct

44
Q

Gallbladder

A

Bile storage

Intraperitoneal

RUQ

45
Q

Major Duodenal Papilla

A

Pancreatic duct and Bile duct converge to form the hepatopancreatic ampulla

Opens to duodenum via major duodenal papilla

46
Q

Splenomegaly

A

Enlargement of spleen

Cause: Sickle cells clog spleen

47
Q

Spleen: Hilum

A

Where vessels and nerves enter and exit

Medial surface of spleen

48
Q

Abdominal Aorta

A

Extends from aortic hiatus to bifurcation into L and R common iliac arteries (T12-L4)

49
Q

Paired Branches

A

Supply primarily retroperitoneal organs (eg: kidneys, gonads)

50
Q

Unpaired Branches

A

Supply ab organs

Foregut: celiac trunk (T12)

Midgut: superior mesenteric artery (SMA) (L1)

Hindgut: inferior mesenteric artery (IMA) (L3)

51
Q

Celiac Trunk Branches

A

Supply abdominal foregut derivatives and spleen

Branches

  • L gastric artery
  • splenic artery
  • common hepatic artery
52
Q

Left Gastric Artery

A

Courses along lesser curvature
In lesser omentum

Branch:
-Esophageal (supplies ab esophagus)

53
Q

Splenic Artery

A

Tortuous course
Goes off to pancreas

Branches:

  • Short gastric arteries (go to fundus
  • L gastro omental artery (aka: gastro epiploic artery)(courses along greater curvature, in greater omentum)
54
Q

Common Hepatic Artery: Proper Hepatic Artery

A

Courses in hepatoduodenal ligament

Branches
-R gastric artery (anastomoses w/ L gastric artery)(courses along lesser curvature, in lesser omentum)

-R and L hepatic arteries (supply liver)

55
Q

Celiac Trunk Branches

A

Look and Label Image

56
Q

Cystic Artery

A

Usually arises from R hepatic artery

Goes to gallbladder

57
Q

Common Hepatic Artery: Gastroduodenal Artery

A

Branch:
-R gastro omental artery (R gastro epoploic artery) (courses along R R side of greater curvature, in greater omentum)(anastomoses w/ L gastro omental artery)

-Anterior and posterior superior pancreaticoduodenal Arteries (supply duodenum and pancreas )

58
Q

Pancreaticoduodenal Arteries

A

Anterior and Posterior Superior Pancreaticoduodenal arteries (branch off gastroduodenal artery)

Anastomose

Anterior and Posterior Inferior Pancreaticoduodenal arteries (branch off SMA)

59
Q

Caval (Systemic) System (venous system 1)

A

Parallel paired aortic branches

Drain contents of the retroperitoneal space

Drain into IVC

60
Q

Portal System (venous system 2)

A

O poor/nutrient rich blood from ab organs –> portal vein –> liver (detoxifies/processes blood) –> hepatic veins –> IVC

61
Q

Portal System

A

3 main tributaries:

  • splenic vein (foregut)
  • superior mesenteric vein (midgut)
  • inferior mesenteric vein (hindgut)

All 3 converge on portal vein

Capillaries on either end

62
Q

Minor Duodenal Papilla

A

Accessory pancreatic duct enters dudodenum at minor duodenal papilla

63
Q

Portal Caval Anastomoses

A

Vessels in portal system do not have valves - blood can flow in either direction

Locations:

  • umbilicus
  • distal esophagus
  • colon
  • rectum/anus
64
Q

Portal Caval Anastomoses: Esophageal Varices

A

Around the distal esophagus, esophageal veins drain into either the azygos system (caval) or left gastric vein (portal); dilated esophageal varices can rupture, resulting in potentially fatal bleeding

65
Q

Portal Vein Tributaries

A 
Cystic veins
R and L gastric veins
Splenic vein
-Short gastric
-L gastro omental vein
Superior mesenteric vein
-R gastro omental vein
-anterior and posterior superior pancreaticoduodenal vein
66
Q

Fetal Circulation in the Abdomen

A

O rich blood enters fetus via umbilical vein
-Adult remnant: round ligament of liver (ligamentum teres) located in inferior margin of falciform ligament

O rich blood bypasses liver via ductus venosus
-Adult remnant: ligamentum venosum

O poor blood leaves fetus via umbilical arteries
-Adult remnants: medial umbilical ligaments

67
Q

Foregut Lymphatics

A

Lymph - celiac lymph nodes - chyle cistern - thoracic duct

68
Q

Foregut Innervation: Parasymathetic

A

Stimulates peristalsis, secretion

Vagus nerve

Preganglionic cell bodies: brain
Preganglionic cell fiber: vagus nerve
Postganglionic cell body: wall of foregut organs
Postganglionic fiber: wall of foregut organs

69
Q

Foregut Innervation: Sympathetic

A

Inhibits peristalsis, constricts GI blood vessels

Preganglionic cell bodies: lateral horn of thoracic spinal cord

Preganglionic fibers: ventral root - spinal nerve - ventral ramus - white ramus communicans - sympathetic trunk - greater thoracic splanchnic nerve (T5 -T9)

Postganglionic cell bodies: celiac ganglion (prevertebral ganglion)

Postganglionic fiber: follow arterial branches to target organs

70
Q

Referred Pain

A

Foregut visceral pain is typically referred to area at and inferior to costal margin

PHA 500 (11 decks)

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