Abdomen 1.3 Flashcards

1
Q

Where does the abdominal aorta enter the abdomen?

A

via the aortic hiatus (T12 vertebral level) in the diaphragm

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2
Q

When does the abdominal aorta divide into common iliac arteries?

A

anterior to L4 vertebra

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3
Q

Where does the abdominal aorta supply blood to?

A

abdominopelvic viscera and posterior abdominal wall

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4
Q

What are the 3 unpaired vessels supplying the GI tract?

A
  1. Celiac
  2. Superior mesenteric
  3. Inferior mesenteric
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5
Q

What are the paired branches to glandular structures?

A
  1. middle suprarenal
  2. left and right renal arteries
  3. left and right gonadal arteries
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6
Q

What are the parietal branches to the posterior abdominal wall?

A
  1. Inferior phrenic arteries
  2. 4 pairs of lumbar arteries
  3. a small median sacral artery (our “caudal” artery).
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7
Q

What is a common site for aortic aneurysms?

A
  • abdominal aorta inferior to the origin of the renal arteries and above the aortic bifurcation
  • Iliac arteries also usually involved
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8
Q

Where do the suprarenal gland receive their arterial blood supply from?

A
  • from inferior phrenic arteries
  • directly from middle suprarenal arteries arising from the aort
  • from inferior suprarenal arteries arising from the renal vessels
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9
Q

What type of organs are the suprarenal (adrenal) gland and the kidneys?

A

retroperiteneal

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10
Q

Which kidney is higher?

A

right kidney lies slightly lower than the left kidney, owing to the presence of the liver on the right side

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11
Q

What shape is the right adrenal gland?

A

usually is pyramidal in shape

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12
Q

What shape is the left adrenal gland?

A

usually semilunar in shape

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13
Q

Why are there lots of arteries and/or veins associated with the kidneys?

A

Because of the segmental development of the kidneys and their lobulated appearance

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14
Q

At what level does the inferior vena cava pierce the diaphragm?

A

T8 and enters right atrium of heart

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15
Q

What veins drain blood from the liver into the inferior vena cava just inferior to the diaphragm?

A

2 or 3 hepatic veins

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16
Q

What do principal tributaries of the inferior vena cava correspond to?

A

many of the arterial branches arising from the abdominal aorta

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17
Q

What are some of these tributaries?

A
  1. the common iliac veins
  2. pairs of lumbar veins
  3. gonadal (testicular or ovarian) veins
  4. renal veins
  5. azygos vein
  6. suprarenal veins
  7. inferior phrenic veins
  8. hepatic veins
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18
Q

What forms the portal venous system?

A

Veins draining the gastrointestinal tract, its accessory organs (gallbladder and pancreas) and the spleen

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19
Q

Which veins do not have valves?

A
  • Veins vary in number and arrangement and possess numerous connections with veins lying superficial or deep
  • and with veins of specialized systems such as the portal system draining the gastrointestinal tract
  • these veins do not have valves
  • blood flow may occur in either direction depending on the pressure gradient propelling the blood
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20
Q

How is the hepatic portal vein formed?

A

union of the splenic vein and superior mesenteric vein.

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21
Q

What are important portacaval anastomotic sites?

A
  1. sites around the esophagus
  2. the paraumbilical region
  3. the rectum,
  4. where portions of the gastrointestinal tract are in a retroperitoneal position.
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22
Q

How does blood still reach the heart if portal blood flow is decreased or prevented from flowing through the liver?

A

important portacaval anastomoses

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23
Q

What happens if the inferior vena cava is partially compressed or obstructed?

A

venous blood can flow via the portacaval anastomoses into the portal system of veins

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24
Q

What is the parietal and visceral peritoneum?

A

Parietal peritoneum lines the inner aspect of the abdominal walls and reflects onto the viscera as visceral peritoneum

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25
Q

What does the greater omentum do if a portion of the peritoneal cavity or its contents becomes inflamed?

A

the greater omentum can migrate to the site of inflammation and wall off the site by forming an adhesion, potentially protecting the remainder of the cavity (wall off infection site)

26
Q

What is the greater omentum a site for?

A

the metastatic spread of cancer from multiple primary sites

27
Q

Where is the lesser sac?

A

residing posterior to the stomach and anterior to the retroperitoneal pancreas

28
Q

How can you enter the lesser sac?

A

through the epiploic foramen of Winslow

29
Q

What lies anterior to the epiploic foramen?

A

hepatoduodenal ligament, which is a portion of the lesser omentum (the other part is the hepatogastric ligament)

30
Q

What is in the hepatoduodenal ligament?

A
  • the proper hepatic artery
  • the common bile duct
  • the portal vein
31
Q

What is secondary retroperitneal?

A
  • pancreas

- duodenum

32
Q

What could a perforated gastric ulcer in the posterior wall of the stomach lead to?

A

spill gastric contents into the lesser sac, and its acidic juices may erode into the pancreas

33
Q

What could cancer of the pancreas invade?

A

the duodenum, stomach, or spleen because of its close proximity to these structures

34
Q

Where is the omental bursa/lesser sac?

A

posterior to the stomach and anterior to the pancreas, which lies retroperitoneally.

35
Q

What is the rest of the abdominopelvic cavity referred to?

A

greater sac

36
Q

Where is the portal triad?

A

In the hepatoduodenal ligament (part of lesser omentum and other part is hepatogastric ligament)

37
Q

What are the aorta and IVC?

A

retroperitineal

38
Q

What is posterior to the portal triad?

A

access the inferior vena cava

39
Q

What could cancer/trauma of pancreas lead to?

A

implications of duodenum, stomach, spleen, left kidney and adrenal gland, and aorta and inferior vena cava

40
Q

How does bile leave the liver?

A

by the right and left hepatic ducts, draining into a common hepatic duct

41
Q

How does the common hepatic dict drain?

A

via the cystic duct into the gallbladder, which concentrates and stores bile

42
Q

How is the gallbladder stimulated to contract?

A

autonomic nerves and cholecystokinin

43
Q

What does gallbladder contracting lead to?

A

sending bile down the cystic duct

44
Q

How does bile flow?

A

through the common bile duct to the major duodenal papilla which empties into the descending duodenum

45
Q

What happens at this location to the common bile duct?

A

joins the main pancreatic duct to form the hepatopancreatic ampulla of Vater

46
Q

How common are gallstones?

A

occur in 10% to 20% of adults

47
Q

What are risk factors of gallstones?

A

increased age, obesity, and being female

48
Q

What are two different types of gallstones?

A
  • 80% of gallstones are cholesterol stones

- 20% are pigment (bilirubin calcium salts) stones

49
Q

What can gallstones lead to?

A
  1. block the flow of bile from the gallbladder to the duodenum
  2. cause inflammation (cholecystitis)
  3. or block the hepatopancreatic ampulla and impede exocrine secretion from the pancreas
50
Q

Where is the pain of acute cholecystitis felt?

A
  1. felt in the right upper abdominal quadrant
  2. radiating laterally just beneath the right breast
  3. to the back just below the inferior angle of the right scapula
51
Q

What does visceral peritoneum do on the liver?

A

reflects off the liver in the form of the falciform ligament and the coronary ligaments

52
Q

What do the falciform and coronary ligaments reflect off?

A

the right and left lobes of the liver and onto the underlying diaphragm

53
Q

What is the bare area of the liver?

A

marks the portion of the liver not covered by visceral peritoneum because it is in direct contact with the diaphragm

54
Q

What is the round ligament of the liver?

A

the obliterated left umbilical vein

55
Q

When is the round ligament of the liver visible?

A

in the free margin of the falciform ligament

56
Q

What does the round ligament join?

A

ligamentum venosum

57
Q

What is the ligamentum venosum?

A
  • fused ductus venosus from the fetus
  • before birth, this passageway allows umbilical blood coming from the placenta to bypass the liver and drain directly into the inferior vena cava and pass into the right atrium of the fetal heart
58
Q

What is the function of the liver?

A
  1. production and secretion of bile
  2. Storage of nutrients
  3. production of cellular fuels, plasma proteins and clotting factors;
  4. detoxification
  5. phagocytosis
59
Q

What is cirrhosis?

A

largely irreversible disease of the liver

60
Q

What are the causes of cirrhosis?

A
  1. alcoholic liver disease (60% to 70% of cases)
  2. viral hepatitis
  3. biliary diseases
  4. genetic hemochromatosis
  5. cryptogenic cirrhosis