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Clinical Morphology > Abdomen > Flashcards

Abdomen Flashcards

1
Q

3 muscles of abdominal wall

A

external oblique, internal oblique, transverse abdominus, rectus abdominus

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2
Q

innervation of abdominal wall

A

ventral rami of T7-L1

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3
Q

blood supply of abdominal wall

A

intercostal, musculophrenic, and superior/inferior epigastric vessels

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4
Q

aponeuroses

A

flat tendons

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5
Q

which muscles of the abdominal wall have aponeuroses

A

external/internal obliques and transverse abdominus

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6
Q

linea alba

A

central tendinous line where the aponeuroses interdigitate

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7
Q

what muscles of abdominal wall have linea alba

A

rectus abdominus - breaks up the muscle bellies

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8
Q

aponeuroses relationship to rectus abdominus muscle

A

wrap around it to form the anterior and posterior rectus sheaths (below umbilicus is anterior sheath only)

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9
Q

transversalis fascia

A

deep fascia of abdomen that sits posterior to rectus abominus muscle below umbilicus

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10
Q

3 flat muscles of abdominal wall and what are they a continuation of

A

internal/external obliques and transverse abdominus, continuation of the 3 intercostal muscle layers

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11
Q

tendinous intersections

A

transverse fibrous bands where rectus sheath attaches to rectus abdominus muscle

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12
Q

anterior rectus sheath

A

aponeurosis of external oblique and part of aponeurosis of internal oblique

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13
Q

posterior rectus sheath

A

aponeurosis of internal oblique and aponeurosis of transverse abdominus

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14
Q

arcuate line

A

where posterior rectus sheath ends

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15
Q

layers of abdominal wall (superficial to deep)

A

skin, superficial fascia (Camper’s fascia and Scarpa’s fascia), external oblique, internal oblique, transverse abominus, transversalis fascia, parietal peritoneum

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16
Q

direct inguinal hernia

A

protrudes through Hesselbach’s triangle

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17
Q

inguinal canal

A

oblique passageway through which the spermatic cord or round uterine ligament passes

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18
Q

indirect inguinal hernia

A

due to congenital defect in inguinal canal

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19
Q

direct inguinal hernias occur ____ to inferior epigastric arteries

A

medial

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20
Q

indirect inguinal hernias occur ________ to inferior epigastric arteries

A

lateral

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21
Q

which type of hernia occurs more often in women

A

femoral

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22
Q

location of femoral hernias

A

in medial-most compartment of femoral triangle, below inguinal ligament

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23
Q

inguinal ligament

A

free edge of aponeurosis of external oblique muscle

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24
Q

inguinal hernias occur ____ to inguinal ligament

A

superior

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25
Q

what normally occupies most medial compartment of femoral triangle

A

lymphatics

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26
Q

umbilicus lies at what vertebral level

A

T10

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27
Q

pain in epigastric region referred from

A

foregut

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28
Q

pain in umbilical region referred from

A

midgut

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29
Q

pain in pubic/hypogastric region referred from

A

hindgut

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30
Q

NVB of anterolateral abdominal wall travels between which muscles

A

transverse abdominis (deep), internal oblique (middle)

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31
Q

nerves of anterolateral abdominal wall have what origin

A

ventral rami of T7-L1

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32
Q

T7-T11 NVB

A

continuations of intercostal NVB

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33
Q

T12 nerve is called

A

subcostal nerve

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34
Q

L1 nerve branches are called

A

iliohypogastric, ilioinguinal

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35
Q

terminal branches of the internal thoracic artery

A

superior epigastric, musculophrenic arteries

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36
Q

branches of the external iliac artery

A

inferior epigastric, deep circumflex arteries

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37
Q

superior and inferior epigastric arteries location

A

run posterior to the rectus abdominis muscle within the posterior rectus sheath

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38
Q

planes of abdominal quadrants

A

midsaggital, transumbilical (T10)

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39
Q

McBurney’s point location

A

1/3 between anterior iliac spine and umbilicus

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40
Q

McBurney’s point significance

A

attachment point between appendix and cecum, pain is indicative of appendicitis

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41
Q

Planes of abdominal regions

A

midclavicular, subcostal, intertubercular

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42
Q

3 superior regions (R to L)

A

Right hypochondriac, epigastric, left hypochondriac

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43
Q

3 middle regions (R to L)

A

Right flank, umbilical, left flank

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44
Q

3 inferior regions (R to L)

A

R groin/inguinal, pubic/hypogastric, L groin/inguinal

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45
Q

peritoneum is composed of (histology)

A

simple squamous epithelium

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46
Q

visceral and parietal peritoneum are continuous at the

A

mesentery

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47
Q

the peritoneum is ____ in men and ____ in women

A

closed, open

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48
Q

what penetrates the peritoneum in women

A

the uterine tubes

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49
Q

what does the peritoneal cavity contain

A

serous peritoneal fluid

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50
Q

any organ that has a mesentery is

A

intraperitoneal

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51
Q

parietal peritoneum sensory innervation

A

T7-L1

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52
Q

lesser sac aka

A

omental bursa

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53
Q

location of lesser sac

A

posterior to the stomach and inferior to the liver

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54
Q

greater and lesser sac communicate through

A

epiploic foramen of Winslow

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55
Q

mesentery

A

double layer of peritoneum reflecting from the abdominal wall to enclose viscera

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56
Q

mesentery of small intestine aka

A

mesentery proper

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57
Q

mesentery of transverse colon aka

A

transverse mesocolon

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58
Q

mesentery of sigmoid colon aka

A

sigmoid mesocolon

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59
Q

omentum

A

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

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60
Q

greater omentum

A

passes from stomach to transverse colon

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61
Q

lesser omentum

A

passes from stomach to liver

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62
Q

greater omentum drapes over the

A

transverse colon

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63
Q

ligaments

A

parts of mesenteries between organs or between organ and body wall

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64
Q

lesser omentum forms the anterior wall of the

A

lesser sac

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65
Q

divisions of greater sac and what they are divided by

A

supracolic and infracolic compartments divided by transverse mesocolon

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66
Q

gutters of the infracolic compartment and their locations

A

right and left paracolic gutters to the left and right of ascending and descending colon

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67
Q

3 unpaired branches of abdominal aorta

A

celiac trunk, superior mesenteric artery, inferior mesenteric artery

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68
Q

celiac trunk supplies

A

foregut

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69
Q

SMA supplies

A

midgut

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70
Q

IMA supplies

A

hindgut

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71
Q

components of foregut

A

esophagus, stomach, first half of duodenum, liver, pancreas, gallbladder, spleen

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72
Q

components of midgut

A

second half of duodenum, jejunum, ileum, ascending colon, first 2/3 of transverse colon

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73
Q

components of hindgut

A

last 1/3 of transverse colon, descending colon, sigmoid colon, rectum

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74
Q

anastomosis at foregut-midgut junction

A

superior pancreaticoduodenal artery (celiac trunk) with inferior pancreaticoduodenal artery (SMA)

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75
Q

anastomosis at midgut-hindgut junction

A

middle colic artery (SMA) with left colic artery (IMA)

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76
Q

location of anastomosis at foregut-midgut junction

A

mid-duodenum

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77
Q

location of anastomosis at midgut-hindgut junction

A

splenic flexure

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78
Q

which anastomosis is most vulnerable to ischemia

A

midgut-hindgut junction

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79
Q

marginal artery

A

arterial arch formed by anastomoses of left, middle, and right colic arteries

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80
Q

why are the loops of small intestine vulnerable to ischemia?

A

intestinal branches of SMA do not anastomose with branches of celiac trunk or IMA

81
Q

rectal anastomosis

A

superior rectal artery (IMA) with middle and inferior rectal arteries (internal iliac artery)

82
Q

pre-aortic lymph nodes

A

celiac nodes, SMA nodes, IMA nodes

83
Q

path of lymph from viscera

A

travel along arterial paths to pre-aortic nodes, then to cisterna chyli to enter venous circulation

84
Q

cisterna chyli

A

dilated proximal end of thoracic duct

85
Q

enteric nervous system

A

intrinsic network of ganglia with connections to ANS that coordinates peristalsis and secretion

86
Q

sympathetic innervation to foregut

A

greater splanchnic nerves to celiac ganglion

87
Q

sympathetic innervation of midgut

A

greater and lesser splanchnic nerves to superior mesenteric ganglion

88
Q

sympathetic innervation of hindgut

A

lumbar and sacral splanchnic nerves to inferior mesenteric ganglion and hypogastric plexus/pelvic ganglia

89
Q

greater splanchnic nerves level

A

T5-T9

90
Q

lesser splanchnic nerves level

A

T10-T11

91
Q

lumbar and sacral splanchnic nerves level

A

L1-L2

92
Q

enteric ganglia and nerve plexuses

A

myenteric plexus and submucosal plexus within layers of intestinal wall

93
Q

origin of preganglionic sympathetic nerves for foregut

A

T5-T9

94
Q

sympathetic action in gut

A

decreased motility, contraction of sphincters, pathway for afferent fibers for visceral referred pain

95
Q

preganglionic sympathetic nerve fibers for foregut are the

A

greater splanchnic nerves

96
Q

postganglionic sympathetic nerve fibers fibers for foregut

A

celiac plexus via the celiac ganglia

97
Q

preganglionic parasympathetic nerve fibers for foregut

A

vagus

98
Q

parasympathetic action in gut

A

increased motility, relaxation of sphincters

99
Q

preganglionic sympathetic nerve fibers in midgut

A

greater and lesser splanchnic nerves

100
Q

postganglionic sympathetic nerve fibers in midgut

A

superior mesenteric plexus via the superior mesenteric ganglia

101
Q

preganglionic parasympathetic fibers in midgut

A

vagus

102
Q

route of referred pain in foregut

A

greater splanchnic nerves

103
Q

route of referred pain in midgut

A

lesser splanchnic nerves

104
Q

origion of preganglionic sympathetic neurons in hindgut

A

L1-L2

105
Q

preganglionic sympathetic neurons in hindgut

A

lumbar and sacral splanchnic nerves

106
Q

postganglionic sympathetic neurons in hindgut

A

inferior mesenteric plexus via the inferior mesenteric ganglia, hypogastric plexus via the pelvic ganglia

107
Q

route of referred pain for hindgut

A

lumbar and sacral splanchnic nerves

108
Q

preganglionic parasympathetic neurons in hindgut

A

pelvic splanchnic nerves

109
Q

origin of preganglionic parasympathetic neurons in hindgut

A

S2-S4

110
Q

2 main lobes of liver

A

right and left

111
Q

2 smaller lobes that are part of left lobe

A

caudate and quadrate

112
Q

portal vein

A

carries venous drainage from GI tract, accessory organs, and spleen to liver

113
Q

exocrine secretion of liver

A

bile

114
Q

what does the liver store

A

glycogen, fat, proteins, vitamins, iron

115
Q

what does the liver produce

A

fuels and plasma proteins, bile acids

116
Q

what does the liver metabolize

A

toxins

117
Q

what does the liver excrete

A

bilirubin

118
Q

blood supply to liver

A

proper hepatic artery

119
Q

proper hepatic artery is a branch of

A

common hepatic artery off the celiac trunk

120
Q

hepatoduodenal ligament carries

A

the portal triad

121
Q

components of portal triad

A

proper hepatic artery, portal vein, common bile duct

122
Q

what percentage of blood enters liver from proper hepatic artery

A

30%

123
Q

what percentage of blood enters liver from portal vein

A

70%

124
Q

path of blood out from liver

A

hepatic veins to IVC

125
Q

path of bile out of liver to gallbladder

A

left and right lobes drain to left and right hepatic ducts which combine to form common hepatic duct, then travels through cystic duct to gallbladder

126
Q

path of bile from gallbladder

A

leaves GB to enter cystic duct then goes to common bile duct, then to hepatopancreatic ampulla of Vater, then through major duodenal papilla to enter second part of duodenum

127
Q

hepatopancreatic ampulla is surround by

A

sphincter of Oddi

128
Q

function of gallbladder

A

stores and concentrates bile

129
Q

gallstones aka

A

cholelithiasis

130
Q

gallstones form from

A

bile, billirubin, and cholesterol

131
Q

most common place gallstones lodge

A

distal end of common bile duct

132
Q

common places gallstones lodge

A

hepatic and cystic ducts

133
Q

biliary colic

A

intense, spasmodic pain caused by gallstone lodged in cystic duct

134
Q

cholecystitis

A

inflammation of gallbladder caused by obstruction of cystic duct and buildup of bile within GB

135
Q

referred pain from cholecystitis

A

posterior thoracic wall and right shoulder

136
Q

pain of cholecystitis course

A

starts epigastric and becomes right hypochondriac

137
Q

choledocholithiasis

A

stones in common bile duct

138
Q

symptoms of choledocholithiasis

A

RUQ/epigastric pain, N/V, jaundice

139
Q

cause of jaundice

A

bilirubin is not excreted and instead seeps into bloodstream

140
Q

hepatopancreatic ampulla

A

where pancreatic duct joins bile duct

141
Q

how can pancreatitis result from gallstone

A

if the stone lodges in the major duodenal papilla, causing bile to back up into the pancreatic duct

142
Q

pancreas location

A

posterior wall of lesser sac

143
Q

parts of pancreas

A

head, neck, body, tail

144
Q

pancreas head location

A

c-shaped curve of duodenum

145
Q

path of pancreatic exocrine secretions (other than pancreatic duct)

A

accessory pancreatic duct to minor duodenal papilla to duodenum

146
Q

location of spleen

A

posterolateral to stomach

147
Q

spleen is connected to stomach via the

A

gastrosplenic ligament

148
Q

spleen is connect to left kidney via the

A

splenorenal ligament

149
Q

___contributes to the anterior roof of the inguinal canal

A

internal oblique

150
Q

covering of spermatic cord

A

cremasteric fascia and muscle

151
Q

where does the spermatic cord emerge from

A

behind lower part of internal oblique

152
Q

course of spermatic cord

A

passes inferior to transversus abdominis and carries a layer of transversalis fascia

153
Q

inguinal hernia definition

A

protrusion of abdominal contents (usually intestine covered by peritoneum and extraperitoneal fat) into some part of the inguinal canal

154
Q

indirect inguinal hernia

A

does not pass directly through abdominal wall

155
Q

indirect inguinal hernia course

A

herniating mass enters deep inguinal ring, transverses the inguinal canal, and emerges at the superficial ring

156
Q

coverings of herniating mass in indirect inguinal hernia

A

cremasteric fascia and muscle

157
Q

internal spermatic fascia

A

transversalis fascia

158
Q

direct inguinal hernia

A

pushes directly through posterior wall of inguinal canal medial to the inferior epigastric artery

159
Q

course of direct inguinal hernia

A

after emerging into inguinal canal, it traverses the medial end of the canal, and emerges at the superficial ring

160
Q

____can progress to the scrotum, but ____ usually do not

A

indirect inguinal hernias, direct inguinal hernias

161
Q

areas of weakness in the posterior aspect of anterior abdominal wall (inferior)

A

deep inguinal ring, femoral ring, Hesselbach’s triangle, supravesical fossa

162
Q

first veins to receive blood in portal system

A

portal tributaries

163
Q

capillaries in liver

A

liver sinusoids

164
Q

anastomoses between portal and systemic circulation are called

A

portosystemic anastomoses

165
Q

purpose of portosystemic anastomoses

A

to allow blood to return to the heart via the systemic circulation when a portal vein is occluded

166
Q

locations of 3 major portosystemic anastomoses

A

lower esophagus, rectum, umbilical region

167
Q

is the abdominal aorta intraperitoneal or retroperitoneal

A

retroperitoneal

168
Q

where does abdominal aorta start

A

T12 at the aortic hiatus

169
Q

paired branches of the abdominal aorta

A

middle adrenal, renal, gonadal, inferior phrenic, lumbar

170
Q

retroperitoneal organs

A

suprarenal glands, aorta/IVC, duodenum (last 2/3), pancreas, ureters, colon (ascending and descending), kidneys, esophagus, rectum

171
Q

terminal branches of abdominal aorta

A

common iliac arteries

172
Q

most common location of abdominal aortic aneurysm

A

IMA

173
Q

major causes of AAA

A

HTN, atherosclerosis

174
Q

symptom of ruptured AAA

A

sharp, tearing back pain

175
Q

systemic venous system aka

A

caval system

176
Q

common iliac vein is formed by

A

internal and external iliac veins

177
Q

where is common iliac vein formed

A

pelvic brim

178
Q

what drains into IVC

A

gonads, kidneys, posterior abdominal wall, liver, diaphragm

179
Q

IVC drains into right atrium just after receiving

A

hepatic veins

180
Q

3 major branches of celiac trunk

A

common hepatic, left gastric, splenic

181
Q

what does left gastric supply

A

lesser curvature

182
Q

major branch of left gastric

A

esophageal

183
Q

3 major branches of common hepatic artery

A

proper hepatic, right gastric, gastroduodenal

184
Q

what does right gastric artery supply

A

lesser curvature

185
Q

what does gastroduodenal artery supply

A

first part of duodenum

186
Q

2 major branches of gastroduodenal artery

A

right gastroepiploic, pancreaticoduodenal

187
Q

what does right gastroepiploic artery supply

A

greater curvature

188
Q

what are 2 major branches of the splenic artery

A

left gastroepiploic, short gastrics

189
Q

what does the left gastroepiploic artery supply

A

lesser curvature

190
Q

what do the short gastrics supply

A

fundus and top part of lesser curvature

191
Q

what anastomosis is responsible for caput madusae

A

paraumbilical and short epigastric veins

192
Q

what anastomosis is responsible for esophageal varices

A

left gastric and esophageal veins

193
Q

what anastomosis is responsible for hemorrhoids

A

superior and inferior rectal veins

194
Q

ampulla of vater aka

A

hepatopancreatic ampulla

195
Q

what structure can be compressed by SMA after rapid weight loss

A

third part of the duodenum

196
Q

2 ligaments that make up the lesser omentum

A

gastrohepatic, hepatoduodenal

197
Q

which ligament contains the portal triad

A

hepatoduodenal

198
Q

retroperitoneal anastomosis for portal system

A

retroperitoneal/lumbar veins, colic veins

Clinical Morphology (18 decks)

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