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JKC Anatomy- Spring '24 > Abdomen 1+2- Exam 4 > Flashcards

Abdomen 1+2- Exam 4 Flashcards

1
Q

The outer subcutaneous fat fascia of the abdominal wall

A

camper’s fascia

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1
Q

the thicker underside fascia is called _____.

A

Scarpa’s fascia

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2
Q

Which fascia layer is capable of holding a suture?

A

Scarpa’s fascia

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3
Q

a ____ is a broad flat tendon

A

aponeurosis

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4
Q

The ______ seals off the abdomen from the thigh. What layer is it part of?

A

inguinal ligamen

part of the external abdominal oblique aponeurosis

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5
Q

the ____ separates the rectus abdominis muscles. The site of multiple muscle insertions

A

linea alba

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6
Q

The _____ divides the external abdominal oblique muscles from the linea alba

A

linea semilunaris- more lateral

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7
Q

When you are turning your torso to the right, what muscles are contracting?

A

Left external obliques

Right internal obliques

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8
Q

The rectus abdominis muscles attaches from the ___ to ____

A

ribcage to the pubic bones

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9
Q

The umbilicus is at what level?
The inginual/groin is at what level?

A

T10

L1

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10
Q

What three arteries in the abdomen extend off the internal thoracic artery?

A

Superior epigastric artery

Musculophrenic artery

Pericardiacophrenic

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11
Q

What artery supplies the rectus abdominis muscle?

A

Superior epigastric artery

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12
Q

What artery supplies the lateral side of the abdominal body wall?

A

musculophrenic artery

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13
Q

What artery supplies the rectus sheath?

A

Inferior epigastric artery

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14
Q

What three arteries extend off the external iliac artery?

A

Inferior epigastric
Superficial epigastric
superficial circumflex iliac

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15
Q

Posteriorly, the abdominal wall muscles get their blood from _____

A

lumbar segmental arteries

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16
Q

For lymph above the umbilicus, where does it drain?

A

drains towards the axillary and parasternal nodes

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17
Q

For lymph below the umbilicus, where does it drain?

A

towards superficial inguinal nodes

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18
Q

What is the innermost layer of the abdominal wall? What does it secrete?

A

Parietal peritoneum

serous fluid

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19
Q

Describe the rectus sheath above the arcuate line

A

1.5 layers in front (External abdominal and half of internal abdominal) and 1.5 layers behind (the other half of internal abdominal and transversus abdominis muscle) the rectus abdominis muscle

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20
Q

Describe the rectus sheath below the arcuate line

A

All three layers are in front of the rectus abdominus

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21
Q

What are the borders of the lumbar triangle. Why is it important?

A

external abdominal oblique
latissimus dorsi
iliac crest

site of frequent hernias

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22
Q

Where does the psoas major attach?

A

proximal: lumbar transverse processes and bodies of T12- S1 vertebrae

Distal: lesser trochanter

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23
Q

What is the innervation and major function of the psoas major?

A

Anterior rami of L2-4

flexion of the thigh at the hip

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24
Q

What are the attachments of the iliacus muscle?

A

proximal: iliac fossa and lateral sacrum

distal: lesser trochanter

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25
Q

What is the innervation and major function of the iliacus?

A

anterior rami of L2-4

flexion of the thigh at the hip

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26
Q

What causes extreme psoas tenderness and may minic appendicitis and femoral hernia?

A

psoas abscesses

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27
Q

What causes psoas abscesses?

A

tubercular infection of the vertebral bodies that spread to the psoas fascia

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28
Q

Attachments of the quadratus lumborum muscle?

A

P: lumbar transverse processes and 12th rib
D: iliac crest

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29
Q

What is the innervation and major function of the quadratus lumborum?

A

anterior rami of T12-L4

fixation of 12th rib during inspiration, lateral flexion of the spinal column

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30
Q

What is the nerve that runs below the 12th rib?

A

SUBcostal nerve- T12

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31
Q

The lateral cutaneous nerve of the thigh does what levels?

A

L2-3

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32
Q

The ____ nerve runs on the lateral side of the psoas major. What levels?

A

femoral nerve

L2 L3 L4

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33
Q

What are the paired arteries?

A

inferior phrenic
renal
gonadal
lumbar segmental
right and left common iliac

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34
Q

What are the unpaired arteries?

A

celiac trunk
superior mesenteric
inferior mesenteric

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35
Q

The _____ covers the quadrattus lumborum muscles

A

lateral arcuate ligaments

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36
Q

The ____ covers the psoas major muscles

A

medial arcuate ligament

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37
Q

the _____ covers the aorta

A

median arcuate ligament

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38
Q

At what level does the crura and median arcuate ligaments form the ______.

A

T12

form the aortic hiatus

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39
Q

The _______ travels through the diaphragm at the ____ level during expiration. It lies primarily in the fibers of the right crus and is usually compressed by the muscle.

A

esophageal hiatus

T10

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40
Q

The _____ travels through the diaphragm’s central tendon at the ___ level during expiration

A

caval opening

T8

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41
Q

The ____ nerve is the sole motor nerve to the diaphragm

A

phrenic

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42
Q

What level does the phrenic nerve arise from?

A

C3, 4, 5

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43
Q

What is hemidiaphragm most commonly caused by?

A

damage to the right or left phrenic nerves

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44
Q

______ branches superiorly and runs with phrenic nerve. What nerves does it branch off of?

A

Pericardiacophrenic artery

Internal thoracic artery

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45
Q

_____ terminal branch of internal thoracic, arising at the same time as the superior epigastric artery.

A

Musculophrenic artery

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46
Q

What two arteries supply the diaphragm that extend off the internal thoracic

A

Pericardiacophrenic

Musculophrenic

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47
Q

What two arteries of the abdomen come off the aorta itself?

A

Superior phrenic

inferior phrenic

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48
Q

The aorta itself gives off the
________ just before it enters the abdomen

A

superior phrenic artery

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49
Q

The aorta itself gives off the
________ immediately after entering the thorax

A

inferior phrenic artery

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50
Q

The _____ also contribute some blood to the lateral diaphragm

A

intercostal arteries

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51
Q

The superficial inguinal ring has a ____ and _____

A

lateral and medial crus

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52
Q

Why is the lateral and medial crus of the superficial inguinal ring important surgically?

A

good spot for hernias

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53
Q

indirect inguinal hernias are hernias at what spot?

A

inguinal ring

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54
Q

**the testicular artery/vein and ductus deferens pass through _____.

A

deep inguinal ring

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55
Q

**the deep inguinal ring is _____ to the inferior epigastric artery. What type of hernia exits here?

A

lateral

indirect

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56
Q

A direct inguinal hernia is ____ to the inferior epigastric artery/vein. Most common in (men/women)?

A

medial

women

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57
Q

_____ hernia pushed out in the gap next to external iliac vein/artery going into the thigh. More common in men/women?

A

femoral hernia

women

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58
Q

A direct inguinal hernia is ____ to the inferior epigastric artery/vein

A

medial

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59
Q

___ and ____ hernias are much more common in women

A

femoral and direct

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60
Q

_____ hernias are much more common in men

A

indirect

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61
Q

What is a hernia sac?

A

When the intestine pushes part of the peritoneum ahead of it as it falls out of the abdominal cavity

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62
Q

What kind of hernia exits at the yellow circle?

A

indirect hernia

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63
Q

What kind of hernia exits at the green circle?

A

direct hernia

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64
Q

What kind of hernia exits at the light blue circle?

A

femoral hernia

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65
Q

The ____ muscle is on top of the testicular cord allowing them to rise and fall with temperature changes. What muscle did it used to be a part of?

A

cremaster

internal abdominal oblique

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66
Q

____ hernias follow the same path as the spermatacord, can fill the scrotum

A

indirect hernias

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67
Q

What are the 3 components of Hesselbach’s triangle?

A

Rectus abdominus
pubic bone
inferior epigastric vessels

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68
Q

What is this illustrating?

A

lumbar hernia

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69
Q

The adult teeth include: __ incisors, ___ canine, ___ premolars, and ___ molars

A

2 incisors
1 canine
2 premolars
3 molars (3rd is the “wisdom” tooth)

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70
Q

Layer of teeth: _____ outer layer of crown

A

Enamel

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71
Q

Layer of teeth: ____ lines the alveolar bone (tooth sockets)

A

cementum

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72
Q

layer of teeth: _____ found deep to the enamel and cementum, makes up the bulk of the tooth

A

dentin

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73
Q

_______ ligament allows the teeth to have a little wiggle and be able to shift with braces

A

peridontal

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74
Q

______ sharp extensions that cover most of the tongue, no taste buds.

A

Papillae filiform

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75
Q

_____ little pale dots on surface of tongue, have taste buds.

A

Fungiform papillae

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76
Q

_____ large circular papillae near the posterior 1/3rd of tongue, have taste buds & secretory glands

A

Circumvalate papillae

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77
Q

______ longitudinal folds on that lateral aspect of the tongue, have taste buds and secretory glands.

A

Foliate papillae

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78
Q

______ taste bud sensory cells contact the outside environment through a small pore

A

tastent

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79
Q

What are the two functions of the mucosa?

A

Extract nutrients from food
Protect the body from pathogens

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80
Q

What are the three layers in the mucosa?

A

epithelium
lamina propria
muscularis mucosae

81
Q

_____ is a loose connective tissue that anchors the gut tube to nearby structures

A

Adventitia

82
Q

_____ is a thin layer of connective tissue covered by simple squamous epithelium.

A

Serosa

83
Q

_____ keeps the bowel mobile and prevents irritation that could lead to adhesions

A

Serosa

84
Q

____ keeps the esophagus closed

A

upper esophageal sphincter

85
Q

What kind of cells are present in the mucosa of the esophagus?

A

nonkeratinized stratified squamous epithelium

86
Q

What is the first 1/3 of the esophagus composed of?
2nd 1/3rd?
last 1/3rd?

A

Inner circular layer
Outer longitudinal layer
skeletal -> smooth muscle

87
Q

at the _______ there is a stark shift between stratified squamous epithelium of the esophagus and the simple columnar (but highly folded) epithelium of the stomach.

A

Gastroesophageal junction

88
Q

Prolonged GERD can lead to metaplasia of the esophagus which is called _____ where the mucosa of the esophagus takes on the appearance and function of the cardiac region of the stomach.

A

Barrett’s esophagus

89
Q

What organ is found in the upper right quadrant?

A

liver

90
Q

What is first thing you see when you remove the skin from the abdomine?

A

greater omentum

91
Q

What are the 4 regions of the stomach?

A

Cardia
Fundus
Body
Pyloris

92
Q

What regions of the stomach are responsible for secreting mucous?

A

Cardia and Pyloris

93
Q

What parts of the stomach are responsible for digestion?

A

Fundus
Body

94
Q

Folds in the stomach wall are called _____. What is their job?

A

rugae

facilitate the stomach’s expansion

95
Q

The stomach’s external wall consists of a protective layer called the _____ over three layers of smooth muscle.

A

tunica serosa

96
Q

What direction is the outer layer of stomach muscle?

A

Longitudinal

97
Q

The lesser curvature of the stomach is on what side?

A

Superior right side

98
Q

The greater curvature of the stomach is on what side?

A

left inferior side

99
Q

Cells in the stomach’s epithelium produce _____ to assist digestion of food

A

hydrochloric acid

100
Q

The epithelium of the cardiac and pyloric regions consists almost entirely of ______ surrounding gastric pits.

A

mucus-producing cells

101
Q

____ produce HCl to lower the pH of the stomach. They also release ____.

A

Parietal cells

intrinsic factor

102
Q

what does intrinsic factor help with?

A

absorption of vit B12

103
Q

_____ release precursors of digestive enzymes pepsin, rennin, and lipase

A

Chief cells

104
Q

Excessive HCl secretion caused by an over production of ____

A

gastrin

105
Q

infection with _____, a bacteria that can survive in the stomach’s acidic environment and destroys the epithelial lining

A

helicobacter pylorii

106
Q

the ____ is 2/5th of the length of the small intestine and located in the Upper Left quad

A

jejunum

107
Q

The ____ is 3/5th of the length of the small intestine and is located in the Lower Right quadrant

A

Ileum

108
Q

____ are folds into the lumen of the small intestine

A

Plicae circularis

109
Q

what are lacteal?

A

microscopic Villi, folds of mucosa with a lymphatic duct in the core

110
Q

very very tiny ____ are seen on the surface of the actual absorptive cells

A

microvilli

111
Q

During celiac and other autoimmune gut diseases, inflammation damages the ____, and the SA for absorption ____

A

villi

decreases

112
Q

Mucous and bicarbonate secretions from ______ in the submucosa raise the pH to protect the remaining digestive tract and activate pancreatic enzymes

A

duodenal glands (Brunner glands)

113
Q

The duodenum has 4 parts, name them.

A

superior
descending
inferior
ascending

114
Q

What part of the duodenum receives gastric content?

A

superior

115
Q

What part of the duodenum receives common bile duct from the liver and pancreas?

A

descending

116
Q

What part of the duodenum is anchored by suspensory muscle/ligament and becomes the jejunum after?

A

Ascending

117
Q

The suspensory muscle / ligament of the duodenum ______ is an extension of the right diaphragmatic crura and is an important surgical landmark. Where the duodenum becomes the jejunum

A

ligament of Trietz

118
Q

**What quadrant is the jejunum located?

A

Upper Left

119
Q

**What quadrant is the ileum located in?

A

Lower Right

120
Q

_____ are where bacteria in the gut are located that aid in healthy digestion

A

Peyer’s patch in the ileum

121
Q

In the jejunum, there are ____ arcades and _____ vasa recta

A

fewer arcades

long vasa recta

122
Q

In the ileum, there are ____ arcades and _____ vasa recta

A

many arcades

short vasa recta

123
Q

In the jejunum, what is different about their submucosa?

A

no special structures

124
Q

____ and ____ generally travel through intestinal veins and are then transported to the liver

A

Proteins and carbohydrates

125
Q

Fatty molecules tend to get absorbed by _____, which transport them through the lymphatic ducts, bypassing ____. Where do they end up?

A

lacteals

the liver

LEFT subclavian vein

126
Q

How is the ileum different from the jejunum?

A

contains large lymph nodules in the lamina propria

127
Q

_____ and are a major component of our immune maintenance over the normaflora of the gut and response to infection. Where are they found?

A

Peyer patches

in the ileum

128
Q

You need ___ and ____ in order to properly digest Vit B12

A

Stomach and ileum

129
Q

Vitamin B12 deficiency can lead to ______

A

pernicious anemia

130
Q

At the terminal end of the ileum is a thickening (not a true sphincter) of the muscularis externa that prevents release of the food bolus into the large intestine unless relaxed. What is this called?

A

Ileocecal valve

131
Q

What is an intussusception?

A

ileum pushes itself into the cecum and turns itself inside out

“de-gloving”

132
Q

What quadrant is the appendix located?

A

Lower RIGHT

133
Q

The _____ is suspended by a mesentery but the ____ and _____ are not

A

ileum

cecum

ascending colon

134
Q

Does the appendix have a mesentery?

A

yes, tiny mesentery that carries the blood supply

135
Q

What is the McBurney’s point? What does it indicate?

A

half way between the umbilicus and the ASIS

appendicitis

136
Q

What quadrant is the cecum located?

A

Lower right

137
Q

What quadrant is the ascending colon located in?

A

Upper Right

138
Q

Where does the ascending colon become the transverse colon?

A

at the right colic (hepatic) flexture

139
Q

What quadrant is the transverse colon in? Does it have a mesentry?

A

upper left

Yes

140
Q

Where does the transverse colon become the descending colon?

A

at the left colic (splenic) fixture

141
Q

The descending colon is in what quadrant?

A

Lower left quadrant

142
Q

Does the sigmoid colon have a mesentry?

A

yes

143
Q

The sigmoid colon loses its mesentry as it becomes the ____ within the pelvis

A

rectum

144
Q

Large intestine is distinctive in appearance due to the ___ and _____

A

wide lumen and 3 tenia coli

145
Q

What is this? What are the pink dots?

A

Large intestine

tenia coli

146
Q

What organ? What is the arrow pointing at?

A

Large intestine

Haustra

147
Q

What are the yellow fatty things?

A

Omental appendages

148
Q

The internal anal sphincter is ___ muscle

A

smooth

149
Q

the external anal sphincter is ___ muscle

A

skeletal

150
Q

What kind of cells make up the rectum?

A

simple columnar, mostly goblet

151
Q

What kind of cells make up the anus?

A

stratified squamous epithelium

152
Q

Name some functions of the liver

A

-generates albumin
-stores and distributes glucose and vitamins
-detoxifies substances by making them soluble for excretion by the kidneys.
-creates clotting factors.
-creates and secretes bile.
-iron metabolism is intimately involved with the liver

153
Q

The liver and the stomach are closely connected by ____

A

the lesser omentum

154
Q

What is the portal triad?

A

portal vein, hepatic artery, and bile ducts

155
Q

If the liver was bleeding profusely where you would put your fingers?

A

around the hepatoduodenal ligament to close off the blood supply

156
Q

** What organs make up the foregut?

A

esophagus
stomach
liver
gallbladder
bile ducts
pancreas
proximal duodenum

157
Q

**What organs make up the midgut?

A

distal duodenum
jejunum
ileum
cecum
appendix
ascending colon
transverse colon

158
Q

**What organs make up the hindgut?

A

descending colon
sigmoid colon
rectum

159
Q

** What organs have a visible mesentery?

A

stomach
liver
spleen
1st and 4th portion of duodenu

160
Q

**What organs are considered intraperitoneal?

A

jejunum
ileum
appendix
transverse colon
sigmoid colon

161
Q

**What is intestinal atresia? What other feature does it present with?

A

blockage in the small intestine distal to the common bile duct insertion

presents with bilious emesis

162
Q

**What are the major events in midgut development?

A
  1. Rotation
  2. Elongation
163
Q

The ___ duct extends off the ileum and normally disappears during development, but if a blind pouch remains it is know as a _____

A

ileal (Meckel’s diverticulum)

164
Q

The ____ and _____ will become the bladder and urethra

A

urogenital sinus

allantois

165
Q

The portal triangle is found within what ligament?

A

the hepatoduodenal ligament

165
Q
A
166
Q

The _____ connects the stomach and liver

A

lesser omentum

167
Q

Between hepatocytes are _____, through which blood flows.

A

hepatic sinusoids

168
Q

Hepatocytes are stabilized by ______. What type of collagen are they?

A

reticular fibers

type III collagen

169
Q

Which are smaller type I or type III collagen?

A

type III are smaller than type I and do NOT impede blood flow

170
Q

The portal triangle contains what three structures?

A

portal vein
hepatic artery
bile duct

171
Q

______ deoxygenated blood from the gut tube and associated organs to the liver

A

Portal vein

172
Q

______ carries oxygenated blood from the aorta to the live

A

hepatic artery

173
Q

_____ carries bile from the liver

A

bile duct

174
Q

Blood from both the hepatic arteries and portal veins empty into the _____ and drain to a ______.

A

hepatic sinusoids and drain to a central vein

175
Q

Central veins fuse to become _____, which eventually drain into the inferior vena cava.

A

2-3 hepatic veins

176
Q

Cirrhosis of the liver leads to ___ cells releasing ____ to replace the reticular fibers. This leads to hepatocytes forming _____ instead of cords which causes blood to back up.

A

Ito (NOT hepatocytes)

type I collagen

clumps

177
Q

What is hemochromatosis? What is an obvious sign?

A

a build up of too much iron and it damages the liver and other organs

“rusty” skin pigmenting

178
Q

Hepatocytes produce ____ but keep it rigidly separated from the sinusoidal capillaries. Bile enters specialized ____ that are sandwiched on either side by neighboring hepatocytes

A

bile

canaliculi

179
Q

Bile drains to larger ducts alongside the _____ and ______ before entering the duodenum at the _______.

A

hepatic artery

portal vein

hepatopancreatic ampulla.

180
Q

True/False: Bile production can slow down or accelerate but never stops

A

True

181
Q

Where is excess bile stored and concentrated?

A

gall bladder

182
Q

What happens when bile gets into the blood?

A

jaundice

183
Q

How does the gall bladder remove the water in the bile?

A

through tiny microvilli in the gall bladder’s lining

184
Q

How does the gall bladder know when to release bile?

A

Fat in the duodenum stimulates release of hormones that cause the gall bladder to contract and release bile into the duodenum

185
Q

What are Rokitansky-Aschoff Sinuses?

A

A frequent feature of gallbladder specimens is a sinus from the lumen extending into and past the muscularis externa

These act as reservoirs for bacteria, predisposing to chronic infections and bile stone formation

186
Q

What are cholelithiasis?

A

Gall stones

187
Q

The pancreas manufactures digestive _____ that are excreted into the major and minor pancreatic ducts and released into the ________.

A

proenzymes

descending portion of the duodenum

188
Q

How do the pro-enzymes of the pancreas become active?

A

when the pH drops (usually in the stomach because of the low pH in the stomach)

189
Q

Clusters of endocrine cells, the _______ secrete hormones that regulate metabolism directly into the blood stream.

A

pancreatic islets (of Langerhans)

190
Q

The pancreatic islets (of Langerhans) are readily visible on H&E stain and contain cells that synthesize ______ that are released into the extensive blood supply that floods the organ.

A

endocrine hormones

191
Q

What are the big three pancreatic hormones?

A

insulin
glucagon
somatostatin

192
Q

What is the main cause of pancreatitis? Usually caused by ?

A

when proenzymes become activated and begin to digest itself

gall stone obstructing the hepatopancreatic ampulla

193
Q

What quadrant is the spleen located in?

A

Upper left

194
Q

If ribs 8-11 are lacerated, what organ is it most likely to hit?

A

the spleen

195
Q

What organs are the spleen in contact with?

A

stomach
transverse colon
left kidney
diaphragm

196
Q

Where do vessels of the spleen enter/exit?

A

hilum

197
Q

What is the function of the spleen?

A

-filters blood
-forms lymphoid cells
-eliminates or deactivates blood-borne antigens
-destroys aged platelets and erythrocytes
-participates in fetal hematopoiesis

198
Q

Within the spleen, where does the red blood cell turnover?

A

red pulp

199
Q

Within the spleen, where do you find clusters of immune lymphocytes?

A

white pulp

JKC Anatomy- Spring '24 (14 decks)

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