Abdomen Flashcards

1
Q

Describe the greater sac.

A

It accounts for most of the space of the peritoneal, extending from the diaphragm to the pelvic floor.

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2
Q

Describe the lesser sac (omental bursa).

A

It is posterior to the lesser omentum stomach, liver and inside the greater momentum.

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3
Q

How do the greater and lesser sacs communicate with each other?

A

Omental Foramen (AKA the epiploic foramen or foramen of Winslow’s)

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4
Q

What is the difference between males and females in regard to the peritoneal cavity?

A

Males have a completely closed cavity whereas females have an opening of the fallopian tube into the peritoneal cavity.

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5
Q

What are the peritoneal folds around the stomach called?

A

Omentum

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6
Q

What are the peritoneal folds around the small intestine called?

A

Mesentery

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7
Q

What are the peritoneal folds around the large intestine called?

A

Meso-colon

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8
Q

What is the fate of the ventral mesentery?

A

The formation of the liver divides it into lesser omentum and falciform ligament.

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9
Q

What organs are completely covered by visceral peritoneum and are freely mobile?

A
Stomach 
1st Part of Duodenum
Jejunum
Ileum
Appendix 
Transverse Colon
Sigmoid Colon
Liver
Spleen
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10
Q

Describe the nerve supply of the parietal peritoneum.

A

Somatic nerves of the overlying muscles and skin.

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11
Q

Describe the nerve supply of the visceral peritoneum.

A

Autonomic nerves with the underlying viscera. It receives sympathetic innervation.

It does not have somatic innervation so it is insensitive to pain.

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12
Q

What is the blood supply of the foregut?

A

Celiac Trunk at T12

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13
Q

What is the blood supply of the midgut?

A

Superior Mesenteric Artery at L1

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14
Q

What is the blood supply of the hind gut?

A

Inferior Mesenteric Artery at L3

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15
Q

What are the celiac trunk, superior mesenteric artery and inferior mesenteric artery all branches off of?

A

They are all branches of the abdominal aorta and arise from the anterior surface of the abdominal aorta. The branches all anastomose with each other.

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16
Q

What are branches of the celiac trunk?

A

Splenic Artery
Left Gastric Artery
Common Hepatic Artery

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17
Q

What are the branches of the superior mesenteric artery?

A

Ileocolic Artery
Right Colic Artery
Middle Colic Artery
Inferior Pancreaticoduodenal

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18
Q

What are the branches of the inferior mesenteric artery?

A

Left Colic Artery
Sigmoid Branches
Superior Rectal Artery

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19
Q

What is the blood supply of the stomach?

A

Celiac Trunk

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20
Q

Describe the location of the greater omentum.

A

It hangs down from the greater curvature of stomach, covering the transverse colon and other abdominal viscera

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21
Q

What is the stomach bed?

A

It is a group of structures related posteriorly to the stomach, with 4 to the left and 4 transverse.

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22
Q

What are the left structures in the stomach bed?

A

Left kidney
Left suprarenal
Left colic flexure
Left crus of diaphragm

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23
Q

What embryonic structure is the lesser omentum a derivative of?

A

Ventral Mesentery

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24
Q

What embryonic structure is the lesser omentum a derivative of?

A

Ventral Mesentery

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25
Q

Describe the location of the lesser omentum .

A

It extends from the porta hepatis of liver to the lesser curvature of stomach and the 1st part of duodenum.

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26
Q

What ligaments does the lesser omentum consist of?

A

Hepatogastric Ligament

Hepatoduodenal Ligament

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27
Q

What ligaments does the lesser omentum consist of?

A

Hepatogastric Ligament

Hepatoduodenal Ligament

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28
Q

What embryonic structure is the greater omentum a derivative of?

A

Dorsal Mesentary

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29
Q

Describe the location of the greater omentum.

A

It hangs down from the greater curvature of stomach, covering the transverse colon and other abdominal viscera

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30
Q

What ligaments does the greater omentum consist of?

A

Gastrosplenic Ligament
Gastrophrenic Ligament
Gastrocolic Ligament
Lienorenal (splenorenal) Ligament

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31
Q

What is known as the policeman of the abdomen?

A

Greater Omentum for its role in fighting intra-abdominal infection.

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32
Q

What is the largest gland in the human body?

A

Liver

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33
Q

What are the branches of the common hepatic artery?

A

Hepatic Artery Proper
Right Gastric Artery
Gastroduodenal Artery

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34
Q

What is the blood supply of the liver and what are the branches of this vessel?

A

The liver is supplied by the hepatic artery proper, which branches into the left and right hepatic arteries. The right hepatic artery further branches into the cystic artery.

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35
Q

What is the blood supply of the gall bladder?

A

Cystic Artery - a branch of the right hepatic artery

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36
Q

What are the 5 peritoneal ligaments of the liver?

A
Coronary Ligament
Falciform Ligament - remnant of the ventral mesentery
Right Triangular Ligament
Left Triangular Ligament
Round Ligament (Ligamentum Teres)

->Lesser Omentum - attaches liver to the stomach

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37
Q

What are the 5 surfaces of the liver?

A
Right
Anterior
Posterior
Superior
Inferior
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38
Q

What are the 5 fissures of the liver?

A

Fissure for Ligamentum Venosum
Fissure for Ligamentum Teres (round ligament)
Fossa of Gallbladder
Fissure for Inferior Vena Cava
Porta Hepatis (lies transversely between the quadrate and caudate lobes)

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39
Q

How are the structures in the porta hepatis arranged?

A

Vein - Portal Vein
Artery - Hepatic Artery
Duct - Hepatic Duct

VAD

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40
Q

What is the difference between the anatomical division of the liver and the functional division?

A

Anatomical - divides the liver based on the falciform ligament and the right lobe contains the caudate and quadrate

Functional - divides the liver based on the fossa of the gall bladder and the left lobe contains the caudate and the quadrate

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41
Q

What are the 4 lobes of the liver?

A

Right
Left
Caudate
Quadrate

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42
Q

What is the blood supply of the quadrate and the caudate?

A

They are supplied by the left hepatic artery and the left branch of the portal vein

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43
Q

Describe how the blood supply of the liver is met.

A

75% through the portal vein

25% through the hepatic artery

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44
Q

What is the Sphincter of Oddi?

A

It is a layer of circular muscle surrounding the lower end of bile duct, pancreatic duct and ampulla, controlling the flow of bile and pancreatic secretions.

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45
Q

What is the venous drainage of the liver?

A

The hepatic veins drain into the inferior vena cava.

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46
Q

Describe the biliary system from the hepatic ducts to the Ampulla of Vater.

A

The left and right hepatic ducts merge to form the common hepatic duct.

The common hepatic duct gives off a branch to the gall bladder, which is the cystic duct.

It continues downwards and becomes the common bile duct, where the main pancreatic duct merges.

They lead into the Ampulla of Vater, which opens on the major duodenal papillae at the 2nd part of the duodenum.

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47
Q

What are the 3 parts of the gall bladder?

A

Fundus
Body
Neck

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48
Q

What is the site of maximum tenderness in the case of in case of acute gall bladder inflammation?

A

Fundus

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49
Q

Where does the body of the gall bladder lie?

A

It lies in the gall bladder fossa on the inferior surface of the liver

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50
Q

What is a common site of gall bladder stones?

A

The neck of the gallbladder in a sac called Hartmann’s Pouch.

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51
Q

What level of the abdominal aorta does the celiac trunk branch out from?

A

T12

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52
Q

Where does the left gastric artery go?

A

It goes upwards from the celiac trunk and enters the lesser omentum and it eventually anastomoses with the right gastric artery.

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53
Q

Where does the splenic artery go?

A

It goes to the left on tortuous path and runs on the superior border of the pancreas. It ends in the lienorenal ligament and gives the spleen 5-6 branches.

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54
Q

What are the branches of the splenic artery?

A

Short Gastric Arteries
Left Gastroepiploic Artery (Gastromental Artery)
-Both run in the gastrosplenic ligament

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55
Q

What branches does the gastroduodenal artery give off?

A

Superior Pancreaticoduodenal

Right Gastroepiploic

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56
Q

What branches does the common hepatic artery first give off?

A

Gastroduodenal

  • Superior Pancreaticoduodenal
  • Right Gastroepiploic
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57
Q

What are the branches of the hepatic artery proper?

A

Right and Left Hepatic Arteries

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58
Q

What is a branch of the right hepatic artery?

A

Cystic Artery

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59
Q

Where is the spleen located?

A

It is wedged between the stomach and left kidney connected to them

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60
Q

What connects the spleen to the stomach?

A

Gastrosplenic Ligament

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61
Q

What connects the spleen to the left kidney?

A

Lienorenal Ligament

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62
Q

What are the two surfaces of the spleen?

A

Diaphragmatic

Visceral

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63
Q

Describe the diaphragmatic surface of the spleen.

A

Related to the diaphragm which separates it from left lung & 9th, 10th & 11th ribs.

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64
Q

Describe the visceral surface of the spleen.

A

Contains the hilum which transmits splenic vessels & gives attachment to gastrosplenic and lienorenal ligaments.

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65
Q

What is the blood supply of the spleen?

A

It is supplied by the celiac trunk through the splenic artery

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66
Q

Describe the path of the splenic vein.

A

The splenic vein receives the inferior mesenteric vein and unites with the superior mesenteric vein and gives the portal vein.

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67
Q

What are the unpaired branches of the aorta in the abdomen?

A

Celiac Trunk
Superior Mesentery Artery
Inferior Mesentery Artery

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68
Q

What is the longest part of the gastrointestinal tract?

A

Small Intestine

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69
Q

What are the components of the small intestine?

A

Duodenum
Jejunum
Ileum

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70
Q

Where do the duodenum and pancreas lie?

A

They lie at lie at the junction between foregut and midgut.

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71
Q

What is the first part of the small intestine and is C-shaped? What are other characteristics of it?

A

Duodenum. It is the shortest, widest and most fixed part of the small intestine.

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72
Q

What is the the first part of the duodenum and the peritoneum component of it?

A

It is the duodenal cap and it lies anterolateral to L1 and is an intraperitoneal component.

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73
Q

What is the most common site for duodenal ulcers?

A

1st Part of the Duodenum

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74
Q

Where does the second part of the duodenum lie?

A

It lies right to L2-L3

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75
Q

What does the second part of the duodenum receive?

A

It receives the major duodenal papilla, which is the opening of the bile duct and the main pancreatic duct. It also receives the minor duodenal papilla, which is the opening of the accessory pancreatic duct.

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76
Q

Where does the third part of the duodenum lie and what crosses it?

A

It lies at the level of L3 and it is crossed by the superior mesenteric artery and vein

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77
Q

Where does the fourth part of the duodenum lie?

A

It ascends to the left from L3 to L2 and ends at the duodenojejunal flexure

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78
Q

What tethers the duodenojejunal flexure?

A

Ligament of Treitz (Suspensory Ligament of the Duodenum)

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79
Q

What are the two main functions of the pancreas?

A

Exocrine - digestive enzymes

Endocrine - insulin and glycogen

80
Q

Where does the pancreas lie in respect to the peritoneal?

A

It is a retroperitoneal organ except for its tail, which lies in the lienorenal (splenorenal) ligament

81
Q

What are the 4 parts of the pancreas?

A

Head
Neck
Body
Tail

82
Q

Describe the location of the head of the pancreas.

A

It lies within the C-shaped concavity of the duodenum and has the uncinate process.

83
Q

Describe the location of the neck of the pancreas.

A

It lies anterior to the beginning of the portal vein where the splenic vein & SMV join to form the portal vein.

84
Q

Describe the location of the body of the pancreas.

A

It forms the major portion of the stomach bed

85
Q

Describe the location of the tail of the pancreas.

A

Ends in the splenorenal ligament at the hilum of the spleen

86
Q

What passes anterior to the uncinate process?

A

Superior mesentery artery and vein

87
Q

What are the two ducts of the pancreas and their drainage?

A

Main Pancreatic Duct (Duct of Wirsung) - it drains the tail, body, neck and upper part of the head and joins the bile duct to form the ampulla of vater

Accessory Pancreatic Duct (Duct of Santorini) - it drains the uncinate process and lower part of the head and opens at the minor papilla

88
Q

Describe the start and end of the jejunum and ileum.

A

They begin at the duodenojejunal flexure and ends at the ileocecal junction, the union of the terminal ileum and the cecum.

89
Q

Describe the location of the jejunum and ileum in regards to the peritoneum.

A

They are completely intraperitoneal

90
Q

What are the borders of the mesentery?

A

Attached Border (Root) - around 6 inches long and crosses the 3rd part of the duodenum, the aorta, inferior vena cava, right ureter and the right psoas major

Free Border - 6 meters long and encloses loops of the jejunum and the ileum

91
Q

What is the blood supply of the jejunum and ileum?

A

Superior Mesenteric Artery

92
Q

What are some of the main features of the jejunum?

A

Has a thick and heavy wall with greater vasculature than the ileum and is a deeper red color. It also has less fat in the mesentery.

93
Q

What are some main features of the ileum?

A

Has a thin and light wall with less vasculature and is a paler pink color. It also has more fat in the mesentery.

94
Q

What are the parts of the large intestine?

A
Cecum and Appendix
Ascending Colon
Transverse Colon
Descending Colon
Sigmoid Colon
Rectum
Anal Canal
95
Q

Describe the large intestine in relation to the peritoneum.

A

The large intestine is all retroperitoneal except for the:

  • Appendix
  • Transverse Colon
  • Sigmoid Colon
  • Cecum
96
Q

What is the blood supply of the large intestine?

A

Superior Mesenteric Artery

Inferior Mesenteric Artery

97
Q

What are the retroperitoneal organs?

A
Suprarenal Glands
Aorta
Duodenum (2nd and 3rd)
Pancreas
Ureter
Colon (Ascending and Descending)
Kidney
Esophagus
Rectum

SAD PUCKER

98
Q

What are the appendices epiploicae of the large intestine?

A

They are small pouches filled with fat that are absent in the cecum, appendix and rectum

CAR

99
Q

What are the teniae coli of the large intestine?

A

Three narrow bands of the outer longitudinal muscular coat that begin at the base of appendix and end at sigmoid colon

100
Q

What are the sacculations (haustra) of the large intestine?

A

They are bulges in between the teniae coli

101
Q

What guards the ileal opening into the cecum?

A

Ileocecal Valve

102
Q

What is the appendix and where is it located?

A

It is a blind-ending tube, rich in lymphoid tissue, suspended by mesoappendix. The 3 teniae coli meet at the base of the appendix, but its location is variable. Retrocecal location is most common though.

103
Q

What is acute appendicitis?

A

It is an acute inflammation of the appendix due to viral or bacterial infection and can lead to thrombosis of the appendicular artery and perforation of the appendix

104
Q

What is McBurney’s point?

A

It is the point of maximum tenderness in acute appendicitis.

105
Q

Where is pain from appendicitis relayed?

A

In the umbilicus with T10

106
Q

What is Meckel’s Diverticulum and what can be caused as a result of it?

A

It is a bulge in the small intestine and inflammation can lead to symptoms similar to appendicitis.

107
Q

What is the parasympathetic innervation of the foregut and the midgut?

A

Vagus Nerves

108
Q

What is the parasympathetic innervation of the hind gut?

A

Pelvic Splanchnic Nerves

109
Q

What is the sympathetic innervation of the foregut and the midgut?

A

Greater Splanchnic Nerves (T5-9)
Lesser Splanchnic Nerves (T10-11)
Least Splanchnic Nerves (T12)

110
Q

What is the sympathetic innervation of the hind gut?

A

Lumbar Splanchnic Nerves

111
Q

What are the boundaries of the foregut?

A

Stomach to the 2nd part of the duodenum

112
Q

What are the boundaries of the midgut?

A

3rd part of the duodenum to the first 2/3 of the transverse colon

113
Q

What are the boundaries of the hind gut?

A

Last 1/3 of the transverse colon to the rectum

114
Q

Describe the path of the superior mesentery artery.

A

It goes from the abdominal aorta at the level of L1 down to the right iliac fossa. It runs through the uncinate process and enters the mesentery and ends by anastomoses with the ileal branch of ileocolic artery

115
Q

SMA Branch: Inferior Pancreaticoduodenal

What does it supply?

A

1/2 of the duodenum and the pancreas

116
Q

SMA Branch: Ileocolic

What does it supply?

A

Cecum and appendix

117
Q

SMA Branch: Right Colic

What does it supply?

A

Ascending Colon

118
Q

SMA Branch: Middle Colic

What does it supply?

A

Right 2/3 of transverse colon

119
Q

What are the branches of the ileocolic artery?

A

Anterior cecal artery
Posterior cecal artery
Appendicular artery
Ileal Artery - anastomoses with the SMA

120
Q

Describe the path of the inferior mesentery artery.

A

Starts from the abdominal aorta at the level of L3 and it runs downwards to the left iliac fossa. It runs behind the 3rd part of the duodenum and ends crossing the left common iliac artery and becomes the superior rectal artery

121
Q

All of the branches of the SMA are to the right EXCEPT…

A

Jejunal and Ileal branches. They are to the left.

122
Q

IMA Branch: Left Colic

What does it supply?

A

Left 1/3 of the transverse colon and the upper descending colon

123
Q

IMA Branch: Sigmoid Branches

What does it supply?

A

Lower descending colon and the sigmoid colon

124
Q

IMA Branch: Superior Rectal

What does it supply?

A

Sigmoid colon and the rectum

125
Q

What is the Marginal Artery of Drummond?

A

It is an arterial arcade along the colon that has branches that interconnect the middle, right and left colic

126
Q

Describe what feeds into the portal vein.

A

It is a part of the hepatic venous system and blood from the intestinal capillary bed goes to the portal vein and then it goes to the liver sinusoids (a 2nd capillary bed) and then ending up in the inferior vena cava

127
Q

What does the portal vein start as and how does it end?

A

It starts as the union of the SMV and the splenic veins and ends as an artery

128
Q

Where does the portal vein drain blood from?

A

It drains blood from the GIT tract, pancreas, spleen and gallbladder liver and feeds it to the hepatic veins and is dumped to the inferior vena cava

129
Q

What is the position of the portal vein?

A

It always runs posterior, with it being arranged as portal Vein, hepatic Artery and hepatic Duct, posterior to anterior.

VAD

130
Q

What are the tributaries of the portal vein?

A

SMV
Splenic Vein (receives the IMV as well)
Right and Left Gastric Veins
Paraumbilical Veins

131
Q

What are the most important sites of the portosystemic anastamosis?

A
  1. The left gastric vein and the esophageal vein of the Azygos system (Inferior Esophagus)
  2. The superior rectal vein and the middle and inferior rectal veins (Inferior Rectum)
  3. The paraumbilical veins and radicles of the superficial epigastric veins (Umbilical Area)
132
Q

What can liver cirrhosis cause?

A

Liver fibrosis, which can lead to portal hypertension.

133
Q

What are some of the effects of portal hypertension?

A

Esophageal varices -> Hematemesis (vomiting blood)

Rectal varices -> bleeding rectum (Hemorrhoids)

Caput medusae -> varicose veins radiating from the umbilicus (Medusa’s head)

134
Q

What are the muscles of the posterior abdominal wall?

A

Psoas Major
Psoas Minor
Quadratus Lumborum
Iiacus

135
Q

What are the bones of the posterior abdominal wall?

A

Iliac Bone
Lumbar Vertebrae
Last 2 ribs

136
Q

What are the layers of the posterior abdominal wall?

A
Bony Layer
Muscles
Fascia
Visceral Layer
Parietal Peritoneal Layer
137
Q

Where does the psoas major insert?

A

Inserts on the lumbar vertebrae

138
Q

What is formed in the psoas major?

A

Lumbar Plexus

139
Q

What is in the visceral layer of the posterior abdominal wall?

A
Kidneys
Ureters
Suprarenalglands
Abdominal Aorta
IVC
140
Q

Iliacus Innervation

A

Femoral Nerve

141
Q

Psoas Major Innervation

A

Ventral Rami of First Four Lumbar Nerves

142
Q

Psoas Minor Innervation

A

Ventral Rami of First Lumbar Nerve

143
Q

Quadratus Lumborum Innervation

A

Ventral Rami of T12 and First Four Lumbar Nerves

144
Q

What are the 3 openings in the diaphragm and their locations?

A

T8 - Inferior Vena Cava
T10 - Esophagus
T12 - Aorta

145
Q

Which copula of the diaphragm is higher?

A

The right is higher than the left due to the liver

146
Q

What is the insertion of the diaphragm?

A

Central Tendon

147
Q

Describe the origin of the diaphragm.

A

Xiphoid Process at the sternum
6 Lower Costal Cartilages at the ribs
2 Crura and 5 Ligaments at the lumbar vertebrae

148
Q

What is the right crus?

A

It is larger, longer and stronger than the left and arises from bodies of upper 3 lumbar vertebrae. Some fibers run up to form the esophageal hiatus by encircling esophagus and others run down to form the suspensory ligament of duodenum.

149
Q

What is the left crus?

A

It arises from the upper 2 lumbar.

150
Q

What is the median arcuate ligament?

A

Connects the left and right crura and forms the aortic hiatus

151
Q

What are the medial arcuate ligaments?

A

Tendinous arch across the upper part of psoas major

152
Q

What are the lateral arcuate ligaments?

A

Tendinous arch across the quadratus lumborum

153
Q

What does the caval hiatus transduct?

A

Inferior Vena Cava

Right Phrenic Nerve (in some cases)

154
Q

What does the esophageal hiatus transduct?

A

Esophagus

Anterior and Posterior Vagus Trunks

155
Q

What does the aortic hiatus transduct?

A

Aorta
Thoracic Duct
Azygos Vein
Greater Splanchnic Nerve (sometimes)

156
Q

What is the nerve branch of T12 called?

A

Subcostal Nerve

157
Q

What are the nerve branches of L1?

A

Iliohypogastric Nerve

Ilioinguinal Nerve

158
Q

What nerves run in front of the quadratus lumborum?

A

Subcostal Nerve
Iliohypogastric Nerve
Ilioinguinal Nerve

159
Q

Where does the subcostal nerve run?

A

It pierces the transverse abdominal and and runs between it and the internal oblique

160
Q

Where do the iliohypogastric nerve and

ilioinguinal nerve run?

A

They pierce the transverse abdominal and internal oblique and run between the external and internal oblique

161
Q

What nerve is the is the only one that accompanies the spermatic cord (or round ligament of uterus), continues through inguinal canal and emerges through the superficial inguinal ring?

A

Ilioinguinal Nerve

162
Q

What nerve is comprised of L1 and L2?

A

Genitofemoral Nerve

163
Q

Where does the genitofemoral nerve run?

A

It emerges on the front of the psoas muscle and descends on its anterior surface

164
Q

What are the branches of the genitofemoral nerve?

A

Genital - enters the inguinal canal through the deep inguinal ring to reach spermatic cord and supply cremaster muscle

Femoral - supplies the skin of the femoral triangle

165
Q

What nerves receive L2, 3 and 4?

A

Femoral Nerve

Obturator Nerve

166
Q

Where does the femoral nerve run?

A

It emerges from the lateral border of the psoas major and descends in the groove between the psoas and the iliacus

167
Q

Where does the obturator nerve run?

A

It descends along the medial border of the psoas muscle and enters the thigh through the obturator foramen

168
Q

What nerve receives L2 and L3?

A

Lateral Femoral Cutaneous Nerve

169
Q

Where does the lateral femoral cutaneous nerve run?

A

It emerges from the lateral side of the psoas muscle and runs in front of iliacus

170
Q

What nerve is described as white, round and glistening?

A

Obturator Nerve

171
Q

Where do the kidneys lie?

A

They are retroperitoneal and they lie around the level of T12 to L3

172
Q

Describe the asymmetry of the kidneys.

A

The right kidney lies a little lower than the left because of the large size of the right lobe of the liver. So the right kidney is related to rib 12 posteriorly, whereas the left kidney is related to ribs 11 and 12

173
Q

What is the arrangement of structures in the hilum of the kidney?

A

Anterior to Posterior:

Renal Vein
Renal Artery
Pelvis of Ureter

VAP (Vein, Artery, Pelvis)

174
Q

What is the outer layer of the kidney called?

A

Cortex - forms the outer part of the kidney and also projects into the medullary region between the renal pyramids as renal
columns

175
Q

What is the inner layer of the kidney called?

A

Medulla - forms the inner part of the kidney and consists of 8 to 12 renal pyramids. Each pyramid has a base toward the cortex and an apex called renal papilla which opens into the minor calyx

176
Q

What are the minor calyces?

A

They receive urine from the the collecting tubules and empty into two or three major calyces, which in turn empty into the renal pelvis of the ureter.

177
Q

What is the blood supply of the kidney?

A

The renal arteries arise from the side of the abdominal aorta, opposite the upper border of L2.

178
Q

What is the difference in the right and left renal arteries?

A

The right renal artery is longer than the left and passes posterior to IVC

179
Q

What are the branches of the renal artery?

A

It gives the inferior suprarenal artery and also enters the hilum and divides into 5 segmental arteries

180
Q

Where do the left and right renal veins open to?

A

Inferior Vena Cava

181
Q

What is the difference in the left and right renal veins?

A

Left renal vein is longer than the right renal vein and it passes anterior to the aorta
below the origin of the SMA

182
Q

What 3 veins does the left renal vein receive?

A

Left suprarenal vein
Left gonadal (testicular or ovarian) vein
Inferior hemiazygos vein (sometimes)

183
Q

What is the ureter?

A

It is a retroperitoneal muscular tube that begins with the renal pelvis, extending from the kidney to the urinary bladder.

184
Q

What are the common sites for obstruction by kidney stones?

A
  1. Uretero-pelvic junction - where it joins the renal pelvis.
  2. Pelvic inlet - where it crosses the pelvic brim over the distal end of the common iliac artery.
    3. Ureterovesicular junction - where it enters the wall of the urinary bladder. This is the narrowest point of the whole ureter.
185
Q

What is the abdominal aorta and where does it divide?

A

It is the continuation of the thoracic aorta and it divides at the level of L4 into the left and right common iliac arteries

186
Q

What are the unpaired visceral branches of the abdominal aorta?

A

Celiac - T12
SMA - L1
IMA - L3

187
Q

What are the paired visceral branches of the abdominal aorta?

A

Suprarenal - L1
Renal - L1
Gonadal - L2

188
Q

What are the paired parietal branches of the abdominal aorta?

A

Subcostal - T12
Inferior Phrenic - T12
Lumbar - L1-4

189
Q

What artery arises from the back of the aorta just above the bifurcation and descends in front of sacrum to supply the rectum and anal canal, giving the 5th pair of lumbar arteries?

A

Median Sacral Artery

190
Q

What are the terminal branches of the abdominal aorta?

A

Common Iliac Arteries

191
Q

Describe the structure of the IVC.

A

It is formed on the right side of L5 by the union of the two common iliac veins, below the bifurcation of the aorta. It is longer than the abdominal aorta and ascends along the right side of the aorta.

192
Q

What forms the IVC?

A

It is formed by the union of external and internal iliac veins.

193
Q

What are some of the tributaries of the IVC?

A
  1. Receives the right gonadal & right suprarenal veins. On the left side, these veins usually drain into left renal vein.
  2. Receives the hepatic veins.
  3. Receives the right and left renal veins.
  4. Receives 3rd and 4th lumbar veins and inferior phrenic veins
  5. Receives the right gonadal & right suprarenal veins. On the left side, these veins usually drain into left renal vein.
194
Q

What is the cisterna chyli?

A

It is the lower dilated lymphatic sac at the end of the thoracic duct and lies just to the right and posterior to the aorta.

195
Q

Where does the cisterna chyli drain?

A

It narrows superiorly and gives the thoracic duct which pass the aortic opening of the diaphragm to reach the thorax and drains at the junction between the left subclavian & internal jugular vein

196
Q

What nerve is lateral to the psoas major between the psoas and iliacus?

A

Femoral Nerve

197
Q

What nerve is medial to the psoas major and goes to the to the adductor compartment of the thigh?

A

Obturator Nerve