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Anatomy > Abdomen 2 > Flashcards

Abdomen 2 Flashcards

1
Q

Peritoneum

A

Single continuous layer of squamous epithelium called mesothelium

Part which wraps around viscera is visceral peritoneum

Other parts are parietal peritoneum

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2
Q

Mesentery

A

Fold in peritoneum that allow communication of intraperitoneal organs with abdo wall

Nerves and vessels pass through

Entire gut has dorsal mesentery

Foregut has ventral mesentery

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3
Q

Secondary retroperitoneal organs

A

In contact with wall

Lose mesentery

2-4th part of duodenum
Pancreas (tail is intraperitoneal)
Ascending and descending colon

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4
Q

Primary retroperitoneal organs

A

Develop posterior to peritoneal cavity so never have mesentery

Kidneys and ureters 
Suprarenal glands 
Aorta and IVC
Lumbar plexus, sympathetic trunk 
Oesophagus 
Rectum
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5
Q

What forms in foregut dorsal mesentery

A

Premature spleen

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6
Q

What forms in ventral mesentery

A

Premature liver

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7
Q

Ventral ligaments

A

Liver splits ventral foregut mesentery into:
Falciform ligament
Lesser omentum

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8
Q

Dorsal ligaments

A

Spleen splits dorsal foregut mesentery into:
Gastrosplenic ligament
Splenorenal ligament

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9
Q

Omental bursa

A

Pocket of peritoneal cavity

Lesser sac behind stomach and liver
Rest become greater sac

Only connected by Omental foremen under lesser omentum

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10
Q

Lesser omentum

A

Made up of two ligaments:
Hepatogastric
Hepatoduodenal

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11
Q

Portal triad

A

Near inferior end of lesser omentum

Common bile duct
Portal vein
Hepatic artery

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12
Q

Liver lobes

A

Divided by Falciform ligament into two

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13
Q

Liver ligaments

A

Attaches to diaphragm or posterior abdominal wall via triangular ligaments

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14
Q

Liver structure

A

Hepatocytes arranged into lobules

Central vein drain into each lobule to hepatic vein

Portal triad seen at periphery of each lobule

Portal circulation

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15
Q

Gallbladder

A

Fundus, body, neck
Cystic duct and spiral valves
Hepatic duct and common bile duct

Hepatopancreatic ampulla of Vater
Pancreatic duct

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16
Q

Gallstones

A

Fever, jaundice, RUQ pain

Cholelithiasis - uncomplicated
Choledocholithiasis - gallstone in CBD - progress to ascending cholangitis (Charcot’s triad)

May radiate to right shoulder of phrenic nerve irritated

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17
Q

Lower oesophageal sphincter

A

Diaphragm contributes to formation

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18
Q

Hiatus hernia

A

Sliding and rolling

Part of stomach protrude through oesophageal hiatus

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19
Q

Stomach

A

Fundus
Body
Pyloric antrum
Pyloric canal - muscular sphincter at end to prevent food entering duodenum

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20
Q

Duodenum

A

First part - common for ulcers

Second part - major duodenal papilla - entrance of common bile duct

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21
Q

Small intestine

A

Duodenum - jejunum proximal 2/5 - ileum distal distal 3/5

Villi and valvulae conniventes

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22
Q

Large intestine

A

Begin at ileocaecal valve
End at rectum

Ascending, transverse (from right to left colic flexure) , descending, sigmoid

Taeniae coli, haustra, appendices

23
Q

Abdominal aorta branches

A 
Coeliac trunk 
Superior mesenteric artery 
Renal artery 
Gonadal artery 
Inferior mesenteric artery 
Common iliac artery

Can smoking really give intestinal cancer

24
Q

Blood supply for regions of gut

A

3 unpaired arteries
Connect to intraperitoneal viscera by dorsal mesenteric

Foregut - coeliac trunk - liver, pancreas, spleen
Midgut - SMA - intestines and colon
Hindgut - IMA - colon and rectum

25
Q

Stomach arteries

A

Coeliac trunk:
Common hepatic, left gastric and splenic

Right gastric and gastroduodenal (from common hepatic) 
Left gastric (branch of splenic)
26
Q

Liver and gallbladder arteries

A

Right and left hepatic arteries (from proper hepatic - common hepatic)
Cystic artery

27
Q

Colon arteries

A

Caecum - ileocolic SMA
Ascending - right colic SMA
Transverse and right colic flexure - middle colic SMA
Left colic flexure - anastomosis of middle and left colic SMA and IMA
Descending - left colic IMA
Sigmoid - sigmoid IMA
Rectum - rectal IMA

28
Q

SMA branches

A 
Jejunal
Ileal 
Ileocolic
Right colic 
Middle colic
29
Q

IMA branches

A

Left colic
Sigmoid
Superior rectal

30
Q

Jejunum vs Ileum

A

Jejunum has larger diameter, less prominent arterial arcades, longer vasa recta

31
Q

Venous drainage of gut

A

Into portal system

Posterior to first part of duodenum the portal vein forms

Foregut - portal and splenic
Midgut - SMV
Hindgut - IMV which empties into splenic vein

32
Q

Portosystemic anastomosis

A

Oesophageal and left gastric vein - oesophageal varices

Superior and inferior rectal veins - haemorrhoids

Para umbilical and epigastric vein - caput Medusa

33
Q

Lymphatics

A

Follow arterial supply

Coeliac, SM and IM

All drain into cisterna Chyli (elongated lymphatic sac in front of L1 and 2) - thoracic duct commences here

34
Q

Referred Pain

A

Retroperitoneal organ pain – presents as back pain

Appendicitis – when irritating visceral peritoneum - presents as umbilical pain.

When irritating parietal peritoneum (i.e. appendix has become more inflamed) - presents as RLQ pain

Irritation of diaphragm – presents as shoulder tip pain

Visceral peritoneal organ pain referred to skin supplied by same nerve segment

35
Q

Parasympathetic nerve supply of the stomach

A

Anterior and posterior vagal trunks and their branches, which enter the abdomen through the esophageal hiatus.

36
Q

anterior vagal trunk

A

Mainly from the left vagus nerve (CN X).

It runs toward the lesser curvature of the stomach, where it gives off hepatic and duodenal branches, which leave the stomach in the hepatoduodenal ligament.

The rest of the anterior vagal trunk continues along the lesser curvature, giving rise to anterior gastric branches.

37
Q

posterior vagal trunk

A

Mainly from the right vagus nerve, passes toward the lesser curvature of the stomach.

Supplies branches to the anterior and posterior surfaces of the stomach.

It gives off a celiac branch, which passes to the celiac plexus, and then continues along the lesser curvature, giving rise to posterior gastric branches.

38
Q

sympathetic nerve supply of the stomach

A

From the T6 through T9 segments of the spinal cord, passes to the celiac plexus through the greater splanchnic nerve and is distributed through the plexuses around the gastric and gastro-omental arteries.

39
Q

Anatomical variations in the position of the appendix

A

Retrocaecal

40
Q

Gastric lymphatics

A

Lymph from the superior two thirds of the stomach drains to the gastric lymph nodes; lymph from the fundus and superior part of the body of the stomach drain to the pancreaticosplenic lymph nodes.

Lymph from the right two thirds of the inferior third of the stomach drains to the pyloric lymph nodes.

Lymph from the left one third of the greater curvature drains to the pancreaticoduodenal lymph nodes.

41
Q

Arteries of duodenum

A

The celiac trunk, via the gastroduodenal artery and its branch, the superior pancreaticoduodenal artery, supplies the duodenum proximal to the entry of the bile duct into the descending part of the duodenum.

The superior mesenteric artery, through its branch, the inferior pancreaticoduodenal artery, supplies the duodenum distal to the entry of the bile duct.

42
Q

Lymphatics of duodenum

A

The anterior lymphatic vessels drain into the pancreaticoduodenal lymph nodes, and into the pyloric lymph nodes.

The posterior lymphatic vessels drain into the superior mesenteric lymph nodes. Efferent lymphatic vessels from the duodenal lymph nodes drain into the celiac lymph nodes.

43
Q

Lymphatics of jejunum and ileum

A

Mesenteric lymph nodes: scattered among the arterial arcades.

Efferent lymphatic vessels from the mesenteric lymph nodes drain to the superior mesenteric lymph nodes.

Lymphatic vessels from the terminal ileum follow the ileal branch of the ileocolic artery to the ileocolic lymph nodes.

44
Q

Nerve supply of jejunum and ileum

A

The sympathetic fibers in the nerves to the jejunum and ileum originate in the T8–T10 segments of the spinal cord and reach the superior mesenteric nerve plexus through the sympathetic trunks and thoracic abdominopelvic (greater, lesser, and least) splanchnic nerves.

45
Q

Nerve supply of caecum and appendix

A

Superior mesenteric plexus

The sympathetic nerve fibers originate in the lower thoracic part of the spinal cord, and the parasympathetic nerve fibers derive from the vagus nerves. Afferent nerve fibers from the appendix accompany the sympathetic nerves to the T10 segment of the spinal cord

46
Q

Lymphatic drainage of the cecum and appendix

A

Lymph nodes in the meso-appendix and to the ileocolic lymph nodes that lie along the ileocolic artery.

Efferent lymphatic vessels pass to the superior mesenteric lymph nodes.

47
Q

lymphatic drainage of colon

A

Ascending - Epicolic and paracolic lymph nodes, to the superior mesenteric lymph nodes

Transverse - middle colic lymph nodes, which in turn drain to the superior mesenteric lymph nodes

Descending and sigmoid - Epicolic and paracolic nodes and then through the intermediate colic lymph nodes. Lymph from these nodes passes to the inferior mesenteric lymph nodes.

48
Q

Lymphatics of liver

A

Superficial lymphatics in the subperitoneal fibrous capsule of the liver, which forms its outer surface, and as deep lymphatics in the connective tissue.

Most lymph is formed in the perisinusoidal spaces and drains to the deep lymphatics in the surrounding intralobular portal triads.

49
Q

Nerves of liver

A

From the hepatic plexus, the largest derivative of the celiac plexus.

This plexus consists of sympathetic fibers from the celiac plexus and parasympathetic fibers from the anterior and posterior vagal trunks.

50
Q

Veins of bile duct

A

Enter the liver directly. The posterior superior pancreaticoduodenal vein drains the distal part of the bile duct and empties into the hepatic portal vein or one of its tributaries.

51
Q

Lymphs of bile duct

A

Cystic lymph nodes near the neck of the gallbladder, the lymph node of the omental foramen, and the hepatic lymph nodes. Efferent lymphatic vessels from the bile duct pass to the celiac lymph nodes.

52
Q

Lymphs of gallbladder

A

Hepatic lymph nodes, often through cystic lymph nodes located near the neck of the gallbladder. Efferent lymphatic vessels from these nodes pass to the celiac lymph nodes.

53
Q

Nerves of gallbladder and cystic duct

A

Cystic artery from the celiac (nerve) plexus and the vagus nerve (parasympathetic). The right phrenic nerve (somatic afferent fibers) may carry pain caused by gallbladder inflammation.

Anatomy (8 decks)

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