Abdomen Flashcards
What is within the left upper quadrant
Left upper quadrant
Left lobe of liver, spleen, stomach, jejunum and proximal ileum, body and tail of pancreas, left kidney, left suprarenal (adrenal) gland, left colic (splenic) flexure, left half of transverse colon, and superior part of descending colon.
Right lower quadrant
right lower quadrant
Cecum, appendix, most of the ileum, inferior part of the ascending colon, right ovary, right uterine tube, right ureter, right spermatic cord, uterus (if enlarged), urinary bladder (if distended).
left lower quadrant
Left lower quadrant
Sigmoid colon, inferior part of descending colon, left ovary, left uterine tube, left ureter, left spermatic cord, uterus (if enlarged), urinary bladder (if distended).
right upper quadrant - what is within it
right upper quadrant
Right lobe of liver, gallbladder, pylorus of stomach, duodenum (parts 1-3), head of pancreas, right suprarenal (adrenal) gland, right kidney, right colic (hepatic) flexure, superior part of ascending colon, right half of transverse colon.
From superficial to deep list the layers of the antero-lateral wall of the abdomen
- skin
- superficial fatty layer of subcutaneous tissue (Camper fascia)
- deep membranous layer of subcutaneous tissue (Scarpa fascia)
- superficial investing fascia
- external oblique muscle
- intermediate investing fascia
- internal oblique muscle
- deep investing fascia
- transversus abdominis muscle
- endoabdominal (transversalis) fascia
- extraperitoneal fat
- parietal peritoneum.
What is the orientation of muscle fibers in the external oblique,
oriented at an angle from superior lateral to inferior medial
what is orientation of muscle fibers in internal oblique
oriented at an angle from inferior medial to superior lateral
** I think this should say inferior lateral to superior medial to make an A… external oblique should make a V
what is orientation of muscle fibers in transversus abdominus
horizontally from medial to lateral and lateral to medial
what is the orientation of muscle fibers in the rectus abdominis
vertical superior to inferior or inferior to superior
what area or region extends between the ASIS and pubic tubercle
why is this area/region anatomically and clinically relevant
inguinal region
this is the region where structures exit and enter the abdominal cavity (ex: femoral artery)
also important as it relates to hernias
what defines the anterior boundary, posterior boundary, roof and floor of the inguinal canal for the lateral 3rd?
Posterior: transversalis fascia
anterior: internal oblique and lateral crus of aponeursis of external oblique
roof: transversalis fascia
floor: iliopubic tract
what defines the anterior boundary, posterior boundary, roof and floor of the inguinal canal for the middle 3rd?
posterior: transversalis fascia
anterior: aponeurosis of external oblique muscle
roof: musculo-aponeurotic arches of internal oblique muscle and transversus abdominus muscle
floor: inguinal ligament
what defines the anterior boundary, posterior boundary, roof and floor of the inguinal canal for the medial 3rd
posterior—inguinal falx (conjoint tendon) and reflected inguinal ligament;
anterior—aponeurosis of external oblique muscle and fascia;
roof—medial crus of aponeurosis of external oblique;
floor—lacunar ligament.
what is the gubernaculum
Fibrous connective tissue tract connecting the gonad to the anteriolateral abdominal wall.
what is the processus vaginalis
a diverticulum of the peritoneum that enters to the developing scrotum through the inguinal canal
what are the adult derivatives of the female gubernaculum
round ligament of the uterus
from what muscle is the cremaster muscle derived
internal oblique muscle
what is the function of the cremaster muscle
reflexively elevate the testes when contracted in cold temps to maintain the optimum temperature for sperm produciton
what is dartos muscle
smooth muscle of the fat free subcutaneous tissue of the scrotum that produced contraction of the skin of the scrotum in response to cold
aka science direct says contraction of skin = wrinkles skin causing decreased SA = decreased heat loss
whereas the cremaster muscle is voluntary and elevates in response to stimulus like cold temp
What are the constituents of the spermatic cord
- ductus deferent (vas deferens)
- testicular artery
- artery of ductus deferens
- cremasteric artery
- pampiniform venous plexus
- sympathetic nerve fibers
- genital branch of the genitofemeral nerve
- lymphatic vessels
- vestige of processus vaginalis (remnants of the processus vaginalis)
what is the ductus deferens
a muscular tube approximately 45 cm long that conveys sperms from the epididymis to the ejaculatory duct.
what does the testicular artery supply
arising from the aorta and supplying the testis and epididymis.
where does the artery of ductus deferens arise
arising from the inferior vesical artery
where does the cremasteric artery arise from
from inferior epigastric artery
what is the pampiniform venous plexus
a network formed by up to 12 veins that converge superiorly as right or left testicular veins.
where are sympathetic nerve fibers found in the spermatic cord
on arteries and the ductus deferens.
what does the genital branch of the genitofemoral nerve supply
supplies the cremaster muscle
what doe the lymphatic vessels of the spermaticord do
draining the testis and closely associated structures and passing to the lumbar lymph nodes.
where is the vestige of processus vaginalis found
may be seen as a fibrous thread in the anterior part of the spermatic cord extending between the abdominal peritoneum and the tunica vaginalis;
it may not be detectable.”
- What is the relative length of the digestive tube to the body in the developing embryo?
They are the same length
- Why, from a functional point of view, does the digestive tube undergo “exuberant growth?”
To increase absorptive surface area for nutrient absorption.
- From what embryonic germ layer (endoderm, mesoderm, or ectoderm) is the peritoneum derived?
mesoderm
What peritoneal layer invests the outer surface of many abdominal organs?
visceral
What does it mean to describe an organ as secondarily retroperitoneal?
These organs begin as being invested by peritoneum but then move out of the peritoneal membrane to become retroperitoneal . Examples include the ascending and descending colon.
another way of explaining:
Secondarily retroperitoneal, meaning the structures initially were suspended in mesentery and later migrated behind the peritoneum during development. the duodenum,
What organs or specific parts of organs are retroperitoneal?
SADPUKER
Suprarenal gland
Aorta and vena cava
second and third parts of Duodenum
Pancreas
Ureters
ascending and descending Colon.
Kidneys
abdominal portion of Esophagus
S = Suprarenal (adrenal) glands A = Aorta/Inferior Vena Cava D = Duodenum (second and third segments) P = Pancreas U = Ureters C = Colon (ascending and descending only) K = Kidneys E = Esophagus R = Rectum
_______ is a double layer of peritoneum that occurs as a result of the invagination of the peritoneum by an organ and constitutes a continuity of the visceral and parietal peritoneum. It provides a means for neurovascular communications between the organ and the body wall. This typically anchors the intraperitoneal organ to the posterior body wall.
mesentery
list the three compartments of the periotenum
- Omental bursa (lesser sac),
- supracolic compartment of greater sac
- and infracolic compartment of greater sac
________ is a double-layered extension or fold of peritoneum that passes from the stomach and proximal part of the duodenum to adjacent organs in the abdominal cavity
an omentum
________ is a prominent, four-layered peritoneal fold that hangs down like an apron from the greater curvature of the stomach and the proximal part of the duodenum. After descending, it folds back and attaches to the anterior surface of the transverse colon and its mesentery.
greater omentum
_________ is a much smaller, double-layered peritoneal fold that connects the lesser curvature of the stomach and the proximal part of the duodenum to the liver. It also connects the stomach to a triad of structures that run between the duodenum and liver in the free edge of the lesser omentum.
lesser omentum
_______ consists of a double layer of peritoneum that connects an organ with another organ or to the abdominal wall.
a peritoneal ligament
- The liver is connected to the anterior abdominal wall by the_______ ligament.
_falciform__
The liver is connected to the stomach by the __________ ligament, the membranous portion of the lesser omentum.
_hepatogastric__
The liver is connected to the duodenum by the _________ ligament, the thickened free edge of the lesser omentum, which conducts the portal triad: portal vein, hepatic artery, and bile duct.
__hepatoduodenal_
What divides the supracolic compartment from the infracolic compartment?
transverse mesocolon
What major organs are located in the supracolic compartment
stomach
liver
spleen
What major organs or pairs of organs are located in the infracolic compartment?
small intestine
ascending colon
descending colon
What provides communication between the supracolic and infracolic compartments?
omental foramen
What three structures are found within the hepatoduodenal ligament?
collectively these structures make up the ______________ triad
- hepatic portal vein
- hepatic artery
- bile duct
portal triad
What landmarks would one use to form the plane that separates the abdominal and pelvic cavities?
promontory and ala of sacrum and linea terminalis, which includes the arcuate line of inner surface of ilium and pecten pubis and pubic crest.
What type of epithelial tissue lines the peritoneum and what is the specific name given to this epithelium?
simple squamous epithelium called mesothelium
What is peristalsis?
rhythmic contraction of the smooth muscle in the muscularis of the digestive organs consisting of alternate contraction of circular and longitudinal muscle layers.
Perstalsis propels stuff in the lumen of the digestive organ forward in the digestive tract.
what constitutes the GI tract
from what three embryonic structures is the GI tract derived
esophagus, stomach, small intestine and large intestine.
derived from the
- foregut
- midgut
- hindgut
What main arteries supply the foregut, midgut, and hindgut?
Foregut: celiac trunk
midgut: superior mesenteric artery
hindgut: inferior mesenteric artery
what defines a portal system
two capillary beds connected by a vein called a portal vein.
what are the three constrictions of the esophagus
- cervical constriction (upper esophageal sphincter)
- thoracic (broncho-aortic) constriction
- diaphragmatic constriction
What can be described as:
at its beginning at the pharyngo-esophageal junction, approximately 15 cm from the incisor teeth; formed by the cricopharyngeus muscle .
cervical constriction (upper esophageal sphincter)
What can be described as
a compound constriction where it is first crossed by the arch of the aorta, 22.5 cm from the incisor teeth, and then where it is crossed by the left main bronchus, 27.5 cm from the incisor teeth; the former is seen in anteroposterior views, the latter in lateral views.
thoracic (broncho-aortic) constriction
What can be described as
where it passes through the esophageal hiatus of the diaphragm, approximately 40 cm from the incisor teeth
diaphragmatic constriction
what are the four main functional layers of the digestive tube
from superficial to deep these are:
- serosa
- muscularis
- submucosa
- mucosa
What types of muscle is associated with the first 3rd, middle 3rd, and last 3rd of the esophagus (arranged superior to inferior).
1st 1/3 is skeletal muscle.
2nd 1/3 is mixed skeletal and smooth muscle
3rd 1/3 is smooth muscle
What type of epithelium lines the lumen of the esophagus?
non-keratinized stratified squamous epithelium
What is barret’s esophagus
replacement of non-keratinized stratified squamous epithelium with simple columnar epithelium—typically resulting from gastroesophageal reflux of HCl-rich chyme
What opening in the diaphragm does the esophagus pass through?
esophageal hiatus
What is chyme
A mixture of ingested food stuff (from bolus that enters the stomach) with secretions of the digestive tract.
What part of the stomach:
the part surrounding the cardial orifice , the superior opening or inlet of the stomach.
cardia
what part of the stomach:
the dilated superior part of the stomach that is related to the left dome of the diaphragm, limited inferiorly by the plane of the cardial orifice
fundus
What part of the stomach:
the area between the esophagus and the fundus
cardial notch
What part of the stomach
The major part of the stomach between the fundus and the pyloric antrum
body
What part of the stomach
the widest part of the funnel shaped outflow region of the stomach
pyloric antrum
What part of the stomach
the narrowest part of the funnel shaped outflow region of the stomach
pyloric canal
the distal sphincter region of pyloric antrum/pyloric canal
pyloric sphincter
the concave right border of the stomach
lesser curvature
the convex left border of the stomach
greater curvature
what is the internal wrinkles of the stomach mucosa
rugae
What are the three branching arteries of the celiac trunk
- common hepatic artery
- splenic artery
- left gastric artery
from what main artery does the right gastric artery arise
hepatic artery
from what main artery does the gastroduodenal artery arise
hepatic artery
from what main arteries doe the superior pancreaticoduodenal artery and inferior pancreaticoduodenal artery arise
superior pancreaticoduodenal artery—gastroduodenal artery
inferior pancreaticoduodenal artery—superior mesenteric artery
From what main artery do the posterior gastric and short gastric arteries arise
splenic artery which is off the celiac trunk
to what main vein does the right gastric vein carry blood
hepatic portal vein
to what main vein does the left gastric vein carry blood
splenic vein
what cells of the stomach mucosa secrete HCl?
what other substance, required for adequate absorption of Vit B12 in the small intestine is secreted by these cells
parietal
intrinsic factor
what cells of the stomach secrete pepsinogen
chief cells
what cells of the stomach secrete gastrin
G cells or enterendocrine cells
what are the layers of the smooth muscle of the stomach muscularis from superficial to deep
longitudinal layer
circular layer
oblique layer
what are the divisons of the duodenum
- superior
- descending
- horizontal
- ascending
what division of the duodenum received secretions via hepatopancreatic ampulla
descending part
What arteries supply the duodenum proximal and distal to the bile duct?
proximal—celiac trunk;
distal—superior mesenteric artery
What main segment of the small intestine has Brunner’s glands?
What is the function of these glands?
duodenum
produces a bicarbonate-rich (alkaline) solution to neutralize the acidic chyme arriving from the stomach.
What are the plicae circularis and their function?
Which segment of the small intestine is characterized by large, densely packed plicae circularis?
Increases surface area for nutrient absorption but also slow the movement of chyme to increase the time for nutrient absorption.
jejunum
another way of describing:
the numerous permanent crescentic folds of mucous membrane found in the small intestine
What is the function of villi in the small intestine?
What type of epithelial cells line the lumen of the small intestine?
increases surface area for nutrient absorption
simple columnar epithelium
What artery and what vein serve the jejunum and ileum?
superior mesenteric artery and superior mesenteric vein
What is the name of the lymphatic vessel associated with the villi and what is the function of this vessel?
lacteal;
absorption of dietary lipids as chylomicrons
- What parts of the large intestine fit the following descriptions:
a. small, fatty projections
b. three distinct longitudinal bands of smooth muscle
c. “sacculations” wall of the colon
d. the first part of the large intestine; a blind intestinal pouch
e. contains lymphoid tissue; arises from the posteromedial aspect of d.
a. omental appendices
b. tenia coli
c. haustra
d. cecum
e. appendix
From what main artery is the right colic artery and middle colic artery derived?
What part of the colon is supplied by the right colic artery and what part of the colon is supplied by the middle colic artery?
superior mesenteric artery
Right colic—ascending colon; middle colic—transverse colic
From what main artery is the left colic artery derived?
What parts of the colon are supplied by the left colic artery?
inferior mesenteric artery
descending colon
Contrast the function of the spleen prenatally and postnatally.
Prenatally the spleen is important for hemopoiesis.
In the adult the spleen macrophages play a role in processing old, worn out RBCs (red pulp) and adaptive immune responses (white pulp).
What artery and vein supply the spleen?
splenic artery and splenic vein
What are functional differences between red pulp and white pulp in the spleen (Wheater’s Functional Histology)?
In the adult the spleen macrophages play a role in processing old, worn out RBCs (red pulp) and adaptive immune responses (white pulp).
What are the four main parts of the pancreas?
What part is associated with the uncinated process of the pancreas?
tail, body, neck, head
head
Why is the pancreas referred to as a mixed gland?
What is the main difference between endocrine and exocrine glands?
The pancreas consists of both endocrine and exocrine gland tissue
Exocrine glands have a duct whereas endocrine glands do not.
What is the region defined by the union of main pancreatic duct and bile duct?
What sphincter is associated with the termination of the bile duct?
What sphincter is associated with the hepatopancreatic ampulla?
hepatopancreatic ampulla
sphincter of bile duct
sphincter of Oddi or hepatopancreatic sphincter
Parts of the liver
the smooth dome shaped region that is related to the concavity of the inferior surface of the diaphragm.
diaphragmatic surface
parts of the liver
area of a that is not covered by visceral peritoneum.
bare area of liver
parts of the liver
Continuous groove formed anteriorly by the fossa for the gallbladder and posteriorly by the groove of the vena cava.
right sagittal fissure
parts of the liver
continuous groove formed anteriorly by the fissure for the round ligament and posteriorly by the fissure for the ligamentum venousum.
umbilical or left sagittal fissure
part of the liver
remnant of the umbilical vein
round ligament
part of the liver
consists of bile duct, hepatic artery, and hepatic portal vein
Portal triad
Blood in the hepatic portal vein travels to the liver sinusoids that eventually carry blood to the ______ vein.
central vein
Hepatocytes secrete bile into the bile_______ formed between them.
__canaliculi_
The union of the _______ duct and common _______ duct forms the bile duct.
cystic duct and the
hepatic duct
What organ removes excess salt, water, and wastes of protein metabolism?
Kidney
What is the concaved medial margin of each kidney?
hilum
What is the space within the kidney just past the hilum?
sinus (typically full of adipose)
What is the flattened, funnel-shaped expansion of the ureter?
renal pelvis
What renal pyramid structure is associated with the minor calyx?
renal papilla
What muscular tube carries urine from the kidney to the urinary bladder?
ureter
What artery and vein serve the kidney?
What is the main artery that serves the renal artery?
What is the main vein that receives blood from the renal veins?
renal artery and renal vein
aorta
inferior vena cava
What are the three zonas of the adrenal cortex?
- zona glomerulosa
- zona fasciculata
- zona reticularis
What is the central region of the adrenal gland called?
adrenal medulla
