Abdomen 2

Question 1

What are the accessory organs of the GIT located in the abdomen?

Answer 1

Liver, gallbladder, pancreas

Question 2

What is the liver located just beneath?

Answer 2

The diaphragm (internally), the right nipple (externally)

Question 3

Where does the gall bladder hang?

Answer 3

Below the anterior border of the liver

Question 4

Where does the falciform ligament run to and from?

Answer 4

Highest part of liver to pronounced notch on anterior border of the liver (hepatic notch)

Question 5

What are the anterior/posterior borders of the falciform ligament attached to?

Answer 5

Anterior: abdominal wall
Posterior: Runs free down to umbilicus

Question 6

What is the ligamentum teres and where is it found?

Answer 6

Free (posterior) border of falciform ligament, cord-like structure; remnant of umbilical vein

Question 7

What does the ligamentum teres run through?

Answer 7

Hepatic notch

Question 8

What structures divide the anterior surface of the liver into right and left lobes?

Answer 8

Line of attachment of falciform ligament and hepatic notch

Question 9

What relevant ligaments are superior to the liver?

Answer 9

Coronary and left/right triangular

Question 10

Where does the lesser omentum pass to and from?

Answer 10

Posterior surface of the liver (porta hepatis specifically) to the lesser curve of the stomach all the way up to the diaphragm

Question 11

What are the anterior and posterior surfaces of the liver properly known as?

Answer 11

Diaphragmatic and visceral respectively

Question 12

What is the porta hepatis and where is it located?

Answer 12

-Where the portal vein and hepatic artery enter the liver and the hepatic ducts leave it (remember that the liver has a dual blood supply). Also where the lesser omentum passes from
- Located superior to the gallbladder at the posterior/visceral surface of the liver

Question 13

Describe the vertical groove of the liver

Answer 13

Visceral surface of liver, divides it into right/left (4 lobes in total), ends at hepatic notch, lower part formed by ligamentum teres, upper part formed by ligamentum venosum

Question 14

What are the 4 lobes of the visceral aspect of the liver?

Answer 14

Left of vertical groove: Left lobe
Right of vertical groove: Right lobe, quadrate lobe, caudate lobe (caudate is superior to quadrate)

Question 15

What function do the lobes of the liver have?

Answer 15

No functional significance, just for distinguishing different parts of the liver

Question 16

What is the purpose of the hilum of the liver and where is it located?

Answer 16

Visceral surface of the liver, the site at which the hepatic portal vein, proper hepatic artery and the common hepatic duct enter/leave the liver

Question 17

What happens when the pancreatic duct joins with the bile duct?

Answer 17

They form a common duct called the hepatopancreatic duct which drains into the duodenum via the major duodenal papilla

Question 18

Where are different parts of the pancreas located?

Answer 18

Tail: intraperitoneal, the rest: retroperitoneal

Question 19

What does the arterial supply to the abdominal organs come from?

Answer 19

Abdominal aorta

Question 20

What are the three major branches of the abdominal aorta which supply the GIT and the additional organs of the abdominal cavity?

Answer 20

Coeliac trunk, superior mesenteric, inferior mesenteric (relevant embryologically to foregut, midgut, hindgut blood supply)

Question 21

What three groups can the branches of the abdominal aorta be divided into? Describe where they arise from and what they supply.

Answer 21

Unpaired visceral, paired visceral and parietal branches.

• The unpaired visceral arise from the anterior aspect of the aorta and supply organs of the GIT and the accessory organs.
• The paired visceral arise laterally from the aorta and supply adrenal glands, kidneys and gonads.
• The parietal branches arise posterolaterally and mainly supply the posterior abdominal wall musculoskeletal structures.

Question 22

Where does the abdominal aorta end and what does it bifurcate into?

Answer 22

The abdominal aorta descends in the abdominal cavity until the level of the umbilicus at around L4, where it bifurcates into the right and left common iliac arteries which supply the pelvis and lower limb.

Question 23

What are the two venous drainage pathways of the abdominal organs and what do they drain?

Answer 23

• The portal venous system which directs blood to the liver via the hepatic portal vein
• The systemic venous system which directs blood straight back to the heart via the IVC.

The blood drained from all of the abdominal organs enters into the portal venous circulation except for the kidneys and adrenal glands (and gonads, but these aren’t abdominal although they originated in the abdomen during embryological development)

Question 24

Why is the venous drainage of the abdominal organs clinically relevant?

Answer 24

There are a number of sites of anastomoses where veins from the portal venous system anastomose with those of the systemic venous system. This means that if there is a problem with the portal venous drainage, blood from the portal venous system can be diverted into the systemic venous system- this can cause oesophageal varices, varicose veins of the anterior abdominal wall and haemorrhoids in the rectum.

Question 25

What does the lymphatic drainage of the abdominal contents follow the same path as?

Answer 25

The arterial supply

If you know whether a structure is foregut, midgut or hindgut derived, then you can easily work out which group of pre-aortic lymph nodes they will drain into

Question 26

Where is the portal vein formed and what vessels is it formed from?

Answer 26

Behind the neck of the pancreas, formed from superior mesenteric vein, inferior mesenteric veins and the splenic vein, all of which are inferior to the portal vein

Question 27

How many hepatic veins are there and where are they located?

Answer 27

Three, superior surface of the liver, must remove the inferior vena cava to see them in a dissection

Question 28

What is similar about the blood supply/drainage of the kidneys, adrenal glands and gonads?

Answer 28

Blood supply: Paired visceral branches of the abdominal aorta
Blood drainage: Systemic venous system (back into IVC)