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ANA > Abdomen 3 > Flashcards

Abdomen 3 Flashcards

1
Q

the small and large intestine are supplied by what

A

the superior and inferior mesenteric aa.

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2
Q

the superior mesenteric a. supplies what region

A

mid duodenum through to the mid-transverse colon

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3
Q

the superior mesenteric arises at what vertebral level

A

L1

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4
Q

the superior mesenteric a. emerges from behind what organ?

A

from behind the head of the pancreas at the uncinate process and horizontal (3rd part) of the duodenum

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5
Q

The superior mesenteric a. extends down where

A

extends in the root of the mesentery toward the terminal portion of the ileum

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6
Q

first branch of the superior mesenteric a.

A

inferior pancreatico-duodenal a.

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7
Q

what does the inferior pancreatic-duodenal a. anastomose with

A

the superior pancreatic-duodenal a. off the common hepatic branch of the celiac trunk

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8
Q

Off to the left side of the superior mesenteric artery arise what branches

A

jejunal and ileal branches (intestinal arteries)

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9
Q

what is the second major branch of the superior mesentaric a. and what does it supply

A

middle colic a. that supplies the midtransverse colon

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10
Q

what is the 3rd branch off the superior mesenteric a.

A

right colic a. that passes towards the ascending colon

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11
Q

what is the 4th branch off the superior mesenteric a.

A

ileocolic a. that extends toward the cecum

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12
Q

which artery ends up anastomosing with the terminal portion of the superior mesenteric?

A

ileocolic a., together they form an anastomotic loop

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13
Q

the anastomotic loop of the superior mesenteric terminal branch and the ileocolic a. gives off what

A

anterior and posterior cecal aa.

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14
Q

the posterior cecal aa. gives rise to what artery?

A

appendicular a.

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15
Q

the inferior mesenteric a. supplies what region

A

the hind gut, remainder of the transverse colon

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16
Q

what is the first branch off the inferior mesenteric a. and what does it supply

A

left colic a. that goes up to anastomose with the marginal artery to supply the last part of the transverse colon

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17
Q

what branches off the left colic artery?

A

the descending branch that supplies the descending colon

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18
Q

what arteries branch of the inferior mesenteric to supply the sigmoid colon?

A

sigmoid arteries

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19
Q

what is the final branch of the inferior mesenteric a. and what does it supply

A

superior rectal a. that supplies the upper rectal area

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20
Q

what arteries supply the remainder of the rectum

A

middle and inferior rectal arteries

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21
Q

where do the middle rectal arteries arise from

A

internal iliac artery

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22
Q

where do inferior rectal arteries arise from

A

internal pudendal arteries

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23
Q

what two arteries contribute to the formation of the marginal artery

A

sigmoid and left colic aa.

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24
Q

blood from the stomach and intestines is carried to where

A

to the liver via the hepatic portal system

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25
Q

after being filtered by the liver, the venous blood is then dumped into the ____ by the ____

A

inferior vena cava by the hepatic vein

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26
Q

what forms the hepatic portal vein

A

formed by the union of the superior mesenteric vein with the splenic vein

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27
Q

the splenic vein accept what vein

A

the inferior mesenteric vein

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28
Q

what is the chair of the venous drainage of the intestine

A

chair back: hepatic portal vein
seat: splenic v.
back chair leg: superior mesenteric v.
front chair leg: inferior mesenteric v.

the seat and the back chair left fuse to form the hepatic portal vein

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29
Q

what are portocaval anastomoses

A

a type of anastomosis that occurs between the veins of the portal circulation and those of the systemic circulation

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30
Q

why do we have portocaval anastomoses

A

utilized when return of blood through the liver becomes obstructed and that increases hydrostatic pressure in the venous portal system

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31
Q

how are the alternate pathways for the hepatic portal system found

A

found at sites where the venous drainage is shared by both hepatic portal and systemic venous systems

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32
Q

first portocaval anastomosis

A

lower end of the esophagus- where esophogeal veins drain via the left gastric vein to the portal vein or the azygous v. in the thorax (esophageal varices)

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33
Q

second portocaval anastomosis

A

at the anal canal- where rectal vv. drain via the inferior mesenteric v. to the portal vein or to the internal ilaic vv. via the middle and inferior rectal vv.

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34
Q

distended anal veins are called what

A

hemorrhoids; portal obstruction is a rare cause for these

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35
Q

3rd portocaval anastomosis

A

at the umbilicus, where the region may be drained by small veins traveling in the falciform ligament to the portal vein or by systemic veins draining the anterior abdominal wall

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36
Q

the pattern of distended veins radiating form the umbilicus is called

A

caput medusae

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37
Q

fourth portocaval anastomosis

A

at the retroperitoneal of the intestine- where veins in the wall of the intestine may drain via portal tributaries or to veins of the adjacent abdominal wall (areas of the duodenum, ascending colon/descending colon)

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38
Q

reminder to look at diagram on pg 203 for portal caval anastomoses

A

…

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39
Q

what are the 3 main types of of branches of the abdominal aorta

A
  • parietal
  • paired visceral
  • unpaired visceral
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40
Q

what branches are in the unpaired visceral group of the aortic branches

A
  • celiac trunk
  • superior mesenteric a.
  • inferior mesenteric a.
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41
Q

study abdominal aorta diagram on pg 204 (no associated text to explain)

A

…

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42
Q

where are abdominal prevertebral autonomic plexuses located

A

on the anterior surface of the abdominal aorta, around the branches of vessels originating there

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43
Q

celiac plexus is found surrounding what

A

celiac trunk

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44
Q

there is a ___ ___ on either side of celiac trunk

A

celiac ganglion

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45
Q

what brings pre-ganglionic sympathetic innervation into the celiac plexus

A

greater splanchnic n.

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46
Q

what brings pre-ganglionic parasympathetic innervation into the celiac plexus

A

anterior and posterior vagus nn.

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47
Q

only the sympathetic preganglionic fibers that have not already synapsed where will synapse in the prevertebral ganglia

A

in the paravertebral ganglia of the sympathetic trunk

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48
Q

do parasympathetic vagal fibers synapse in the prevertebral ganglia?

A

no, they pass through it and then synapse in the wall of the organs they innervate

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49
Q

what are the main subsidiary plexuses that extend out along the various vessels in and around the celiac trunk

A

hepatic, gastric, splenic, suprarenal, renal, gonadal

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50
Q

where is the superior mesenteric plexus found

A

at the base of the superior mesenteric a.

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51
Q

the superior mesenteric plexus also receives sympathetic and parasympathetic innervation from where

A

sympathetic from sympathetic trunk via greater splanchnic n. and parasympathetic via anterior/posterior vagus nn.

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52
Q

where is the intermesenteric plexus

A

lies between the two mesenteric plexuses

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53
Q

where does the intermesenteric plexus receive its innervation from

A

receives sympathetic input via the lumbar splanchnic n.

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54
Q

the inferior mesenteric plexus receives its parasympathetic input from where

A

from the pelvic parasympathetic outflow via the pelvic splanchnic nn.

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55
Q

where does the pelvic parasympathetic outflow come from

A

S2, S3, S4

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56
Q

where do you have white rami communicans vs grey

A

white only T1-L2, grey C1-Co4

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57
Q

What two plexuses are found continuing down into the pelvis

A

superior and inferior hypogastric plexuses

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58
Q

which nerves carry afferent (sensory) fibers back to the CNS

A

pelvic splanchnic and sympathetic nerves

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59
Q

The sensory fibers coming from the abdomen synapse where and do what

A

do NOT synapse in the various autonomic ganglia, synapse in CNS and are responsible for sensation of pain from abdominal viscera

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60
Q

the kidneys are part of the posterior abdominal wall and are considered

A

retroperitoneal

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61
Q

at birth the kidneys exhibit what

A

fetal lobulation which is normally lost at age 5-6

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62
Q

kidneys location

A

on the posterior abdominal wall in the paravertebral gutter around the level of the upper 3 lumbar vertebra

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63
Q

Which kidney is higher

A

the left, with its upper pole overlapping the diaphragm

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64
Q

what is the renal sinus

A

space around the renal pelvis

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65
Q

Each kidney is covered by a what

A

fibrous capsule

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66
Q

cortex of kidney

A

lies immediately under the capsule and extends inward as renal columns between the renal pyramids

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67
Q

renal pyramids

A

comprise the medulla

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68
Q

renal papilla

A

the apex of each pyramid

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69
Q

the renal papilla is surround by a funnel shaped ____

A

minor calyx

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70
Q

Minor calyces are branches of larger ___

A

major calyces

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71
Q

Major calyces are branches of ___

A

the renal pelvis

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72
Q

The renal pelvis narrows into ___

A

ureter

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73
Q

what is a ureter

A

a muscular tube traversing the posterior abdominal wall into the pelvis and penetrating the walls of the urinary bladder

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74
Q

what lies on top of the kidneys

A

adrenal glands or suprarenal glands

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75
Q

the stomach has an association with which kidney

A

left kidney

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76
Q

the liver has an association with which kidney

A

right kidney

77
Q

the duodenum has an association with which kidney

A

right kidney

78
Q

the colon has an association with which kidney

A

both kidneys

79
Q

the small intestine has an association with which kidney

A

both kidneys

80
Q

the pancreas has an association with which kidney

A

left kidney

81
Q

the spleen has an association with which kidney

A

left kidney

82
Q

each kidney and surparenal gland is surround by what

A

perirenal fat which is in turn enclosed by anterior and posterior layers of renal fascia

83
Q

the perirenal fat and renal fascia fuse where

A

fuse above and lateral to the kidney but remain as separate layers around the ureter, blending with the adjacent retro-peritoneal tissue

84
Q

renal arteries carry about ___% of cardiac output

A

20%

85
Q

about 90% of the 20% CO delivered to kidneys is specifically delivered to

A

the cortex for filtration

86
Q

at the ___ of the kidney, the renal artery dives into ____ to supply ___

A

hilus of the kidney, the renal artery dives into a number of branches to supply the five segments of each kidney

87
Q

five segments of the kidney

A

apical, upper, middle, lower, posterior

88
Q

the lower lobes may also receive arterial branches directly from the ___

A

aorta

89
Q

each of the segmental arteries going to the kidney can be considered an ____

A

end artery

90
Q

if the renal arteries are ligated, what happens

A

the development of an obvious ischemic area within the kidney parenchyma

91
Q

each segmental artery of the kidney divides into what

A

a number of interlobar arteries

92
Q

interlobar arteries ascend where

A

ascend in the renal columns to the corticomedullary junction

93
Q

the interlobar arteries branch into what

A

arcuate arteries that run parallel to this interface

94
Q

what arteries arise from the arcuate arteries

A

interlobular arteries that ascend into the overlying cortex

95
Q

Interlobular arteries provide ____ ____ that supply each glomerulus

A

afferent arterioles

96
Q

what is a glomerulus

A

filtration capillary of the kidney

97
Q

What are the 3 points of constriction of the ureter where a kidney stone may be lodged

A
  • narrowing of the renal pelvis to the ureter
  • where ureter crosses the common iliac artery bifurcation before bending down into pelvis
  • penetration of bladder wall
98
Q

ureters are retroperitoneal and cross ____ to the bifurcation of the ___ ____ ___ into the external and internal iliac aa.

A

anterior; common iliac artery

99
Q

blood supply of the ureters

A

derived segmentally from the renal and vesical aa.

100
Q

what are the suprarenal glands

A

essential endocrine glands capping the apical lobe of each kidney and are separated from it by peritoneal fat

101
Q

the left suprarenal gland has what shape

A

semilunar

102
Q

the right suprarenal gland has what shape

A

pyramidal

103
Q

blood supply of the of the suprarenal glands

A

branches from the inferior phrenic, renal aa., and the aorta for endocrine function

104
Q

the left suprarenal gland drains to the ___ ___

A

renal vein

105
Q

the right suprarenal gland drains to the ____

A

inferior vena cava

106
Q

what kind of fibers penetrate the suprarenal glands and synapse in the medulla

A

pre-ganglionic sympathetic fibers

-NO synapsing at paravertebral or prevertebral ganglion

107
Q

what do the sympathetic fibers do in the suprarenal glands

A

stimulate release of epinephrine and norepinephrine; allows us to respond to scary situations very quickly

108
Q

muscles of the posterior abdominal wall

A

psoas major, iliacus, quadratus lumborum

109
Q

location of psoas major

A

in the paravertebral gutter adjacent to the lumbar vertebral bodies

110
Q

the psoas major passes under the ___ ___ with the ___ muscle to a common tendinous attachment on the _____

A

inguinal ligament; iliacus; lesser trochanter of the femur

111
Q

psoas major innervation

A

ventral rami of L1, L2, L3

112
Q

iliacus muscle location

A

arises from internal aspect of the ala of the iliac bone

113
Q

the illiacus muscle and psoas major are covered by what

A

illiac fascia

114
Q

iliacus muscle innervation

A

innervated by the femoral nerve

115
Q

the combined iliopsoas muscle has what action

A

powerful flexor of the hip

116
Q

what is the psoas minor

A

a muscle that may occur on the anterior surface of the major

117
Q

where does the psoas minor distally attach

A

the pectineal line

118
Q

quadratus lumborum location

A

flat muscle immediately lateral to the upper part of psoas

119
Q

quadratus lumborum attachment

A

extends from R12 and the tips of the lumbar transverse processes to the iliolumbar ligament

120
Q

where is the iliolumbar ligament located

A

between L5 and the iliac crest

121
Q

action of the quadratus lumborum

A

stabilizes R12 in inspiration as well as laterally flexing the trunk

122
Q

innervation of quadratus lumborum

A

ventral rami of T12, L1, L2, L3

123
Q

a thickening of the fascia over the surface of the psoas major forms ___

A

the medial arcuate ligament of the diaphragm

124
Q

thickening of fascia over the quadratus lumborum forms the

A

lateral arcuate ligament of the diaphragm

125
Q

the majority of the muscle fibers of the diaphragm arise from the inner aspect of the thoracic outlet and arise to insert into a

A

central tendon (central tendon of the diaphragm)

126
Q

muscular part of the diaphragm arises from what sources

A
  • sternal part
  • costal part
  • lumbar part
  • fibrous arches
  • crura
127
Q

sternal part

A

two slips from the deep surface of the xiphoid process

-descends to the central tendon

128
Q

the sternal part has a small gap on each lateral aspect called

A

the sternocostal triangle

129
Q

the sternocostal triangle transmits what through it

A

superior episgastric a. and lymphatics

130
Q

potential site for diaphragmatic hernia

A

sternocostal triangle

131
Q

costal part

A

inner aspect of lower 6 ribs and costal cartilages

-form left and right domes of the diaphragm

132
Q

the costal parts insert into what

A

into the anterolateral aspects of the central tendon

133
Q

what are lumbocostal triangles

A

they may exist between the costal muscular and the lateral arcuate ligament; have a relationship with the posterosuperior aspects of the kidneys and are separated from them only by pleura

134
Q

lumbar part

A

vertebral part; from the lateral, medial, and median arcuate ligaments and as crura from the upper lumbar vertebrae

135
Q

fibrous arches

A

medial arcuate ligament and lateral arcuate ligament

136
Q

medial arcuate ligament

A

a thickening of the fascia over the upper psoas major spanning the body of L1 to its transverse process

137
Q

lateral arcuate ligament

A

a thickening of the fascia over the upper quadratus lumborum spanning the transverse process of
L1 to R12

138
Q

muscles fibers from both the medial and lateral arcuate ligaments extend up where

A

to the central tendon of the diaphragm

139
Q

crura

A

arise from the lumbar vertebrae in the form of two muscular crura that ascend to the central tendon

140
Q

right crus location

A

from L1 to L3/L4

141
Q

left crus location

A

arises from L1-L2 only

142
Q

the crura unite in front of the ___ in a fibrous arch, the ____. the crura uniting forms the ____

A

aorta; median arcuate ligament; aortic hiatus of the diaphragm

143
Q

the right crus splits to do what

A

surround the esophagus in a sling-like loop

144
Q

the left crus goes to the left of the ____, but may assist in formation of the ____ ____

A

esophagus; esophageal hiatus

145
Q

openings of the diaphragm

A
  • aortic
  • esophageal
  • caval
146
Q

aortic hiatus

A

anterior to T12, between crura and transmits the aorta, thoracic duct and azygous vein and greater splanchnic nerve

147
Q

esophageal hiatus

A

art level of T10 and transmits the esophagus and right and left vagus nn.

148
Q

caval hiatus

A

at level of T8 and transmits the inferior vena cava as well as the right phrenic nerve and lymphatics from the liver

149
Q

splanchnic nerves pierce the ____

A

crura

150
Q

sympathetic trunk passes where

A

against the vertebral bodies posterior to the medial arcuate ligament

151
Q

the left phrenic n. pierces the

A

diaphragm to the left of the pericardial sac

152
Q

the ventral rami of T1-T12 represent segmental nerves and innervate what

A

each ventral ramus remaining separate and is responsible for innervating an individual dermatome

153
Q

the ventral ramus of T12 remains separate and is referred to as the ____ nerve

A

subcostal nerve

154
Q

the ventral rami of L1-4 give rise to the

A

lumbar plexus

155
Q

what is the lumbar plexus

A

a branching array of ventral rami that eventually anastomose to nerves responsible for an action

156
Q

general action of the lumbar plexus innervation

A

innervation of the extensor and adductor compartments of the thigh

157
Q

part of the ventral rami of L4 and L5 contribute to the ____ plexus that also supplies the _____

A

sacral plexus; lower limbs

158
Q

location of the subcostal nerve

A

appears beneath the lateral arcuate ligment and crosses the quadratus lumborum below R12

159
Q

subcostal nerve supplies __

A

lower part of rectus abdominis, the anterolateral abdominal muscles and the strip of overlying skin

160
Q

the ___ and ___ nerves are dervied from L1 spinal nerve

A

iliohypogastric and ilioinguinal

161
Q

innervation of the iliohypogastric nerve

A

supplies skin over the upper lateral surface of the thigh and lower abdomen above the pubis

162
Q

the ilioinguinal nerves passes forward with the ___ ___

A

spermatic cord

163
Q

ilioinguinal nerve supplies what

A

the skin of the external genitalia and adjacent region of the thigh

164
Q

the lateral femoral cutaneous nerve arises from what

A

L2 and L3 spinal nerves combined

165
Q

lateral femoral cutaenous nerve location

A

emerges from the lateral border of the psoas and passes into the thigh beneath the lateral end of the inguinal ligmant where it may become entrapped and cause pain

166
Q

the lateral femoral cutaneous nerve supplies what

A

the skin on the lateral aspect of the thigh (said that wearing a tight pair of jeans may irritate this nerve)

167
Q

largest nerve of the lumbar plexus

A

femoral nerve

168
Q

femoral nerve is formed from what

A

L2, L3, L4 spinal nerves

169
Q

femoral nerve location

A

lies in the groove between the psoas and iliacus, passes under the inguinal ligament

170
Q

femoral nerve supplies what

A

muscles of the anterior compartment of the thigh as well as the overlying skin

171
Q

genitofemoral nerve comes from where

A

L1 and L2 spinal nerves

172
Q

location of the genitofemoral nerve and its division

A

on the surface of the psoas major and it divides into a genital and femoral branch

173
Q

genital branch of the genitofemoral n. supplies what

A

supplies skin of external genitalia and cremaster m. in male

174
Q

femoral branch of genitofemoral n. supplies what

A

a small patch of skin just below the inguinal ligament

175
Q

obturator nerve root values

A

L2, L3, L4

176
Q

obturator nerve location

A

appears at the medial border of the psoas and passes through the pelvis before exiting into the thigh

177
Q

obturator nerve supplies what

A

motor innervation to the medial (adductor) compartment of the thigh and overlying skin

178
Q

what is the lumbosacral trunk

A

a portion of L4 that joins with L5 to form a stout trunk that enters the pelvis to join in the formation of the sacral plexus

179
Q

important landmark for the identification of lumbar plexus nerves

A

psoas major

180
Q

organ located exclusively in the right hypochondriac region

A

liver

181
Q

organ located exclusively in the epigastric region

A

stomach

182
Q

organ located exclusively in the left hypochondriac region

A

spleen

183
Q

organ located exclusively in the right lateral region

A

ascending colon

184
Q

organ located exclusively in the umbilical region

A

small intestine

185
Q

organ location exclusively in the left lateral region

A

descending colon

186
Q

organ located exclusively in the right inguinal region

A

appendix

187
Q

organ located exclusively in the hypogastric region

A

bladder

188
Q

organ located exclusively in the left inguinal region

A

sigmoid colon

ANA (17 decks)

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