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GI Anatomy > Abdomen > Flashcards

Abdomen Flashcards

1
Q

Three muscles that are a continuation of the 3 intercostal muscle layers of the thorax.

A

External oblique, internal oblique, transverse abdominus

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2
Q

What lies within the rectus sheath?

A

rectus abdominus

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3
Q

What composes the rectus sheath?

A

the aponeuroses of the flat muscles

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4
Q

What is the linea alba?

A

Where the aponeuroses from each side interdigitate in the midline between the paired rectus muscles

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5
Q

Tendinous intersections

A

transverse fibrous bands where the rectus sheath attaches to the rectus abdominus muscle. “Six pack”

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6
Q

Arcuate line

A

where the posterior rectus sheath ends. Below it the rectus abdominus rests on the transversalis fascia

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7
Q

Anterior rectus sheath

A

Formed by the aponeurosis of the external oblique and part of the aponeurosis of internal oblique

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8
Q

Posterior rectus sheath

A

formed by the rest of the aponeurosis of the internal oblique and the aponeurosis of the transverse abdominus

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9
Q

The internal oblique aponeurosis contributes to which rectus sheath?

A

Anterior and Posterior

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10
Q

What is important about the inferior one third of the posterior rectus sheath?

A

It is absent because all three aponeuroses go anterior to the rectus abdominus muscle

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11
Q

Nerves and vessels of the abdominal wall travel between which layers?

A

the deep and middle or the transverse abdominus and internal oblique.

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12
Q

What nerves innervate the abdominal wall?

A

anterior or ventral rami of spinal nerves T7-L1

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13
Q

Nerves that are continuations of the intercostal nerves (accompanies by continuations of intercostal arteries and veins)

A

T7-T11 and accompanying vessels

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14
Q

Subcostal nerve

A

T12

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15
Q

L1 splits into?

A

iliohypogastric and ilioinguinal nerves

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16
Q

Terminal branches of the internal thoracic artery

A

Superior epigastric and musculophrenic arteries

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17
Q

Branches of the external iliac artery

A

Inferior epigastric and deep circumflex

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18
Q

What is the peritoneum

A

Simple squamous (serous) epithelium lining the abdominal cavity reflecting onto viscera

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19
Q

Parietal peritoneum

A

lines the internal surface of the abdominal wall

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20
Q

Visceral peritoneum

A

invests or covers the viscera

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21
Q

Mesentery

A

where the visceral and parietal peritoneum are continuous. provides a bath for blood vessels, nerves, lymphatics to reach abdominal organs

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22
Q

Peritoneal cavity

A

potential space between the parietal and visceral peritoneum that contains only serous peritoneal fluid, which allows organs to move without friction. Closed in men. In women, uterine tubes open into peritoneal cavity (possibility for infection)

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23
Q

Intraperitoneal

A

Organs covered on all sides by the peritoneum

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24
Q

Retroperitoneal

A

organs covered on one surface by peritoneum

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25
Q

Any organ that has a mesentery is? (retro or intraperitoneal)

A

Intraperitoneal

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26
Q

What innervates the parietal peritoneum?

A

Shares innervation with abdominal wall, T7-L1. Sharp, somatic pain localized a long a dermatome

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27
Q

Visceral peritoneum

A

Shares sensory innervation with viscera, diffuse, dull, referred pain.

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28
Q

Pain from foregut organs refers to

A

epigastric region

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29
Q

Pain from midgut organs refers to

A

umbilical region

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30
Q

Pain from hindgut organs refers to

A

Pubic or hypogastric region

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31
Q

Greater sac

A

Most of the peritoneal cavity

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32
Q

Lesser sac

A

(aka omental bursa), a small compartment located posterior to the stomach and inferior to the liver

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33
Q

Mesentery of the small intestine

A

mesentrery proper

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34
Q

mesentery of the transverse colon

A

transverse mesocolon

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35
Q

mesentery of the sigmoid colon

A

sigmoid mesocolon

36
Q

What are mesenteries of the stomach called? (generally) And what is their function?

A

omenta, they attach the stomach to other organs

37
Q

Omentum definition

A

a broad layer of the peritoneum passing from the stomach to another organ

38
Q

What is the Greater omentum?

A

passes from the stomach to the transverse colon, then drapes over it to form an apron in the greater sac

39
Q

What is the lesser omentum and what wall does if form?

A

passes from stomach to liver. forms the anterior wall of the lesser sac along with the stomach

40
Q

Where is the epiploic foramen?

A

posterior to the free edge of the lesser omentum

41
Q

What are ligaments?

A

mesenteries between organs, or organ and body wall.

42
Q

What is the purpose of peritoneal spaces/gutters?

A

Allows passage of infectious fluids between different compartments of the abdomen and pelvis.

43
Q

Which direction does peritoneal fluid usually flow? What causes it to flow the opposite way?

A

Fluid usually flows upwards. If there is excess fluid(ascites), fluid flows downward. Ascites flow can be limited by the presence of mesenteries and ligaments

44
Q

The transverse mesocolon divides what?

A

It divides the greater sac into the supracolic and infracolic compartments, partially limiting fluid flow between the compartments, except laterally.

45
Q

What restricts flow to the left?

A

Phrenicocolic ligament

46
Q

Paracolic gutters are in which compartment?

A

In the infracolic compartment, where fluid flows to the right and left of the colon

47
Q

GI tract divided into three regions based on?

A

embryological origin and blood supply

48
Q

Celiac trunk, superior mesenteric artery, and inferior mesenteric artery are all branches of what?

A

abdominal aorta

49
Q

Foregut blood supply

A

Celiac trunk

50
Q

Midgut blood supply

A

superior mesenteric artery

51
Q

Hindgut blood supply

A

Inferior mesenteric artery

52
Q

What makes up the foregut?

A
  • esophagus
  • stomach
  • first half of the duodenum
  • small intestine
  • liver
  • pancreas
  • spleen
  • gallbladder
53
Q

What makes up the midgut?

A

second half of the duodenum

  • jejunum
  • ileum (these three are small intestine)
  • ascending colon
  • first 2/3 of the transverse colon
54
Q

What makes up the hindgut?

A
  • the last 1/3 of the transverse colon
  • descending colon
  • sigmoid colon
  • rectum
55
Q

What is collectively the small intestine?

A

Duodenum, jejunum, ileum

56
Q

What is the large intestine?

A

From ascending colon to rectum

57
Q

What anastomoses at the foregut-midgut junction?

A

Superior pancreaticoduodenal artery, a branch of the celiac trunk anastomoses with the inferior pancreaticoduodenal artery, a branch of the SMA.

58
Q

What anastomoses at the midgut hindgut junction? What’s special about it?

A

The middle colic artery from the SMA anastomoses with the left colic artery from the IMA. This watershed area is vulnerable to ischemia if anastomosis is not robust!

59
Q

What forms the marginal artery?

A

anastomoses between the left, middle, right colic aa

60
Q

Why are the loops of small intestine susceptible to ischemia?

A

Because the intestinal branches of the SMA do not anastamose with the branches of the celiac trunk or IMA

61
Q

What nodes are found in the foregut?

A

celiac nodes

62
Q

What nodes are found in the midgut?

A

SMA nodes

63
Q

What nodes are found in the hindgut?

A

IMA nodea

64
Q

Where does lymph flow?

A

from pre-aortic nodes to cisterna chyli, to eventually enter venous circulation

65
Q

Liver Lobes

A

Right and left. Left further divided into caudate and quadrate.

66
Q

Liver functions

A
  • stores energy sources and iron(glycogen, fat, protein, vitamins)
  • produces fuels and plasma proteins
  • metabolizes toxins
  • modifies hormones
  • produces bile acids
  • excretes substances (bilirubin) in bile
67
Q

What supplies the liver with oxygenated blood?

A

Proper hepatic artery, a branch of the common hepatic from the celiac trunk

68
Q

What does the proper hepatic artery run withIN

A

THE Hepatoduodenal ligament, along with the portal vein and common bile duct anterior to the epiploic foramen

69
Q

How does blood enter and leave the liver?

A

enters thru proper hepatic artery (30%), portal vein (70%) and leaves via the hepatic veins which drain into IVC before it enters right atrium

70
Q

Biliary system path

A
  • drains right and left lobes of liver
  • leaves via right and left hepatic ducts
  • enters common hepatic duct
  • enters cystic duct and stored and concentrated in gallbladder
  • once stimulated, bile leaves the gallbladder, enters cystic duct and passes down the common bile duct
  • enters hepatopancreatic ampulla (of Vater) which is surrounded by smooth muscle sphincter of Oddi
  • Bile empties into the second part of the duodenum at the major duodenal papilla
71
Q

What’s the pancreas and where is it?

A

an exocrine and endocrine organ that lies posterior to the stomach in the posterior wall of the lesser sac. It is retroperitoneal except for the distal tail, which contacts the spleen.

72
Q

What drains pancreatic secretions?

A

The main pancreatic duct (which joins the common bile duct and hepatopancreatic ampulla) and the accessory pancreatic duct, emptying into the duodenum at the minor duodenal papilla

73
Q

What is the spleen and where is it?

A

It’s a large lymph node that lies in the LUQ (hypochondrium) posterolateral to the stomach and protected by the ribs.

74
Q

What is the spleen connected to?

A

the gastroplenic ligament connects it to the stomach and the splenorenal ligament connects it to the left kidney

75
Q

What is the hepatic portal system generally?

A
  • carries blood from abdominal viscera to the liver
  • arterial blood flows into a capillary system in the GI viscera then into veins (portal tributaries) and then more capillaries (liver sinusoids) then collected by veins that return blood to heart.
  • There are no valves in this system!
76
Q

What are Portosystemic anastomoses?

A
  • they make up for lack of valves in the portal system

- they allow blood to return to the heart via systemic circulation when a major vein of portal system is occluded.

77
Q

Where are the portosystemic anastomoses?

A
  • lower esophagus
  • rectum
  • umbilical region
  • retroperitoneal anastomosis (not clinically significant.
78
Q

What happens when portal blood flow is restricted?

A

It backflows into systemic circulation, resulting in engorged veins resulting in esophageal varices, hemorrhoids, and cutaneous engorged veins around the umbilicus called a caput medusae

79
Q

Consequences of Cirrhosis of liver?

A

disrupts portal blood flow, leading to portal hypertension and engorgement of the portosystemic anastomoses. Major cause alcoholic liver disease

80
Q

Is the abdominal aorta and IVC intra or retroperitoneal?

A

Retroperitoneal

81
Q

Abdominal aorta is a continuation of \?

A

the thoracic aorta. it begins at T12 when it passes thru aortic hiatus of diaphragm. Gives off 3 paired visceral branches and several paired branches

82
Q

What is a AAA?

A

A localized abnormal dilation of the aorta that occurs when structure of the aortic wall is compromised (usually at IMA).

83
Q

Causes and symptoms of AAA?

A
  • HTN and atherosclerosis
  • symptoms can include abdominal and back pain and nausea and early satiety
  • 75% are asymptomatic, often discovered as an abdominal mass by palpation
  • sharp tearing back pain accompanies a rupture of an AAA
84
Q

What is the IVC

A
  • part of the systemic or caval system of veins that drain blood from body wall
  • receives drainage from the gonads, kidney, posterior abdominal wall, liver, diaphragm
  • IVC drains into right atrium of heart
85
Q

What forms the common iliac vein?

A

-the internal and external iliac veins

86
Q

What forms the IVC?

A

-two common iliac veins

GI Anatomy (1 decks)

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