Abdomen - Abdominal Viscera (2)

Question 1

Which of the intestines are supplied by the superior mesenteric artery?

Answer 1

Jejunum, Ileum, Ascending colon, and most of the Transverse colon. These are all parts of the GIT that are derived from the midgut.

Question 2

Which of the intestines are supplied by the inferior mesenteric artery?

Answer 2

Some of the Transverse colon (splenic flexure), Descending colon, Sigmoid colon, Rectum. These are all parts of the GIT that are derived from the hindgut.

Question 3

Which lobe of the liver is the largest?

Answer 3

The right lobe.

Question 4

How big is the gallbladder?

Answer 4

7-10cm long.

Question 5

What is the transpyloric plane? Through which structures does it pass?

Answer 5

This plane runs through the L1 vertebra.
It is approximately midway between the xyphisternum and the umbilicus.
It crosses through:
- pylorus
- head, neck, body of pancreas
- the hilum of the left kidney
- the superior pole of the right kidney
- the gall bladder
- abdominal aorta (SMA)
- tips of 9th costal cartilages
- splenic vein

Question 6

What is the course of the ureters?

Answer 6

The ureters descend from the hilum of each kidney, traversing each tip of the lumbar vertebral transverse processes, passing over the pelvic brim at the bifurcation of the common ileac arteries, before entering the urinary bladder. The ureters cross over psoas major (anteriorly). The gonadal vessels cross over the ureters (anteriorly).

Question 7

Name all the singular branches of the abdominal aorta.

Answer 7

Coeliac trunk (at T12)
Superior mesenteric
Inferior mesenteric

Question 8

Name all the paired branches of the abdominal aorta.

Answer 8

R and L Superior Adrenal 
R and L Inferior Adrenal 
R and L Renal (at L1)
R and L Gonadal
R and L Subcostal
R and L Lumbar (x4 pairs)
R and L Inferior Phrenic (at T12)

Question 9

What is the spinal level of the Coeliac trunk?

Answer 9

T12

Question 10

What are the branches of the Coeliac trunk, and which viscera do they supply?

Answer 10

BRANCHES: Left gastric, Common hepatic, Splenic.

VISCERAL SUPPLY: Liver, Stomach, Spleen, Oesophagus, Superior part of Duodenum, Pancreas.

Question 11

Describe the relations of the right kidney.

Answer 11

Spinal level is L1.
Retroperitoneal.
Sits behind the 2nd part of the duodenum.
Transpyloric plane transects its hilum.
Sits inferior to adrenal gland.
Medial to the kidney are the vertebral bodies and psoas.
Anteromedially is the IVC.

Question 12

Name the four major parts of the stomach.

Answer 12

Cardia, Fundus, Body, Pyloric Antrum.

Question 13

Describe the relations of the stomach.

Answer 13

The stomach is covered in peritoneum. The greater omentum hangs inferiorly from the greater curvature. The lesser omentum connects to the lesser curvature.
Spinal level: The fundus lies posterior the left 6th costal cartilage.
Posteriorly: Pancreas.
Anteriorly: Diaphragm, left lobe of liver, anterior abdominal wall.
Posterolaterally: Spleen.

Question 14

What is the blood supply to the greater curvature of the stomach?

Answer 14

Gastro-omental (aka Gastro-epiploic) artery (coming from the Coeliac trunk)

Question 15

What is the blood supply to the lesser curvature of the stomach?

Answer 15

Left gastric and Right gastric arteries.

Question 16

Describe the relations of the spleen.

Answer 16

Spleen lies between ribs 9-11 (usually not palpable).
Sits just on top of the transpyloric plane.
Anteromedially is the stomach.
Posteromedially is the left kidney.
Medially is the tail of the pancreas.

Question 17

What is the size of the spleen?

Answer 17

The size of your fist. Approx 1x3x5 inches, or 7x12 cm.

Question 18

Which parts of the colon have a mesentry?

Answer 18

Appendix, Transverse colon, Sigmoid.

Question 19

Name the four parts of the pancreas.

Answer 19

Head, Neck, Body, Tail

Question 20

Describe the blood supply to the different parts of the pancreas.

Answer 20

The pancreas is supplied by branches of the Coeliac trunk.
The Splenic artery provides most of the branches to the tail, body, neck and head.
The Pancreatico-duodenal artery (a branch of the common hepatic) supplies the head.

Question 21

At what spinal level does the abdominal aorta divide into right and left common iliac arteries?

Answer 21

L4 (PSIS, like when you do a lumbar puncture).

Question 22

Which part of the duodenum lies anterior to the abdominal aorta?

Answer 22

3rd part.

Question 23

Which part of the duodenum lies at the hilum of the right kidney?

Answer 23

2nd part.