Abdomen - Anatomical Areas Flashcards
- Name the borders of Calot’s triangle
1. 2. List it’s contents
1.1.
Medial - Common Hepatic Duct
Inferior - Cystic duct
Superior - inferior surface liver
1.2. Right Hepatic artery Cystic artery Lymph Node of Lund Lymphatics
The lesser omentum is a double layer of visceral peritoneum attaching the lesser curvature of the stomach and the proximal duodenum to the liver.
Name the 2 ligaments found in the lesser omentum and it’s contents.
Hepatogastric ligament
Hepatoduodenal ligament
- contains portal triad
List the:
Foregut structures
Midgut structures
Hindgut structures
Foregut: oesophagus, stomach, duodenum (proximal to entrance of CBD), liver, pancreas, gallbladder
Midgut: duodenum (distal to CBD), jejunum, ileum, cecum, ascending colon and proximal 2/3 transverse colon
Hindgut: distal 1/3 transverse colon, descending, sigmoid, rectum and upper part anal canal
The gubernaculum is a fibrous cord of tissue which guides the decent of the gonads from the posterior abdominal to their anatomical position.
Name the remnants of this embryological structure in
- Males
- Females
- Small scrotal ligament - attaches testes to scrotum
1. 2. Ovarian and broad ligament
The processus vaginalis is an out-pocketing of peritoneum which normally degenerates.
Failure to do so results in:
Indirect inguinal hernia
Hydrocele
Undecended testis
Name the borders of the inguinal triangle (Hesselbach’s triangle)
Medial - lateral border of rectus abdominus
Lateral - inferior epigastric vessels
Inferior - inguinal ligament
Which type of epithelium lines the luminal surface of the oesophagus?
Non-keritanized stratified squamous
The oesophagus originates at which level?
C6 - cricoid cartilage
Terminates at T11 - cardiac oriface of the stomach
The anatomical structure of the oesophagus consists of adventitia (outer layer of connective tissue), muscle layer, submucosa and and mucosa.
Which type of muscles fibres make up the composition of the external muscle layer?
The external layer is longitudinal with an inner circular layer.
The external layer is divided into 3rds:
1st - voluntary striated
2nd - voluntary striated and smooth muscle
3rd - smooth muscle
The anatomical relations give rise to 4 physiological constrictions where foreign objects/food can become impacted - list them.
ABCD
Arch of aorta
Bronchus (left main stem)
Cricoid cartilage
Diaphragmatic hiatus
What is the arterial and venous supply of the oesophagus?
Vasculature is divided into thoracic and abdominal components
Thoracic:
Arterial: branches of thoracic aorta and inferior thyroid artery
Venous: azygous and inferior thyroid vein
Abdominal:
Arterial: left gastric and left inferior phrenic artery
Venous: left gastric vein (portal) and azygous (systemic)
Innervation of the oesophagus
Oesophageal plexus - combination of parasympathetic vagal trunks and sympathetic fibres from cervical and thoracic chains
These 2 fibres run in the vagal trunks
What is the lymphatic drainage of the oesophagus?
Upper: deep cervical
Middle: superior and posterior mediastinal
Lower: left gastric and celiac
The transpyloric plane is at which anatomical level?
L1
What are the anatomical relations of the stomach?
Superior: left dome of diaphragm
Anterior: diaphragm, greater omentum, left lobe liver, gallbladder, anterior abdominal wall
Posterior: lesser sac, pancreas, spleen, splenic artery, L kidney, L adrenal, transverse mesocolon
Name the arterial and venous supply of the stomach
Arterial
Lesser curvature:
R gastric artery - branch of common hepatic a.
L gastric artery - directly from coeliac trunk
Greater curvature:
R gastro-omental artery - terminal branch of R gastroduodenal - branch of common hepatic
L gastro-omental artery - branch of splenic artery - arises from coeliac trunk
Venous
R and L gastric veins - drain into portal vein
R short gastric, R and L gastro-omental drain into superior mesenteric
The oesophageal hiatus and lower oesophageal sphincter are at which anatomical levels?
Oesophageal hiatus - T10
Lower oesophageal sphincter - T11
Name the parts of the duodenum and it’s anatomical relations
D1 - Superior - L1
D2 - Descending - L1-3
D3 - Inferior - L3
D4 - Ascending - L3-2
Name the anatomical relations of D1-4
D1 - Superior
D2 - Descending
Anterior: transverse colon
Posterior: R kidney
Inferior: HOP
D3 - Inferior
Superior: pancreas
Anterior: SMA, SMV
Posterior: aorta and IVC
D4 - Ascending
List the characteristic features of the jejunum and ileum?
Jejunum:
Located in LUQ, thick intestinal wall, long vasa recta, less arcades (arterial loops), red in colour
Ileum:
Located in RLQ, thin walled, short vasa recta, more arcades, pink in colour
Name the vascular supply to the duodenum
Proximal to the major duodenal papilla:
Gastroduodenal artery - branch of common hepatic
The greater omentum consists of 4 layers of visceral peritoneum. Name it’s attachments
It attaches from the greater curvature of the stomach and proximal part of duodenum to transverse colon.
The lesser omentum is a double layer of visceral peritoneum. Name it’s attachments.
It attaches from the lesser curvature of the stomach and proximal duodenum to the liver
Name the distinguishing characteristics of the large intestines
Omental appendices (small fat filled pouches of peritoneum)
Teniae coli (mesocolic, free and omental coli) - 3 strips of muscle
Haustra
Wider in diameter
These features end at the rectosigmoid junction
Name the vascular supply of the
- Ascending
- Transverse
- Descending
- Sigmoid colon
Arterial
- Ascending: iliocolic, R colic artery (SMA)
- Transverse: R, Middle Colic (SMA) L colic (IMA)
- Descending: L colic
- Sigmoid: Sigmoid arteries (IMA)
Venous
- Ascending: ileocolic and R colic (SMA)
- Transverse: Middle Colic (SMA)
- Descending: L colic (IMA)
- Sigmoid: Sigmoid veins (IMA)
Innervation of the colon
Via their embryological origin:
Midgut structure: superior mesenteric plexus
Hindgut structures: inferior mesenteric plexus
Parasympathetic innervation: pelvic splanchnic nerves
Sympathetic innervation: lumbar splanchnic nerves
At what anatomical level is the pancreas?
Transpyloric plane L1
What are the anatomical relations of the pancreas?
Anterior: less sac, stomach and pylorus, transverse mesocolon (attaches anterior), D1, SMA anterior uncinate
Posterior: CBD, aorta, IVC (posterior to HOP), spleen, SMA (posterior to the neck)
Right: D2
The SMA and splenic vein unite behind which anatomical structure to form the hepatic portal vein?
Neck of pancreas
What is vascular supply of the pancreas?
Arterial:
Pancreatic branches of the splenic artery (celiac trunk)
HOP additionally supplied by:
Superior pancreaticoduodenal artery (branch of the gastroduodenal artery)
Inferior pancreaticoduodenal artery (branch of SMA)
Venous:
HOP: SMV into the portal vein
Pancreatic veins drain into splenic artery
What is vascular supply of the pancreas?
Arterial:
Pancreatic branches of the splenic artery (celiac trunk)
HOP additionally supplied by:
Superior pancreaticoduodenal artery (branch of the gastroduodenal artery)
Inferior pancreaticoduodenal artery (branch of SMA)
Venous:
HOP: SMV into the portal vein
Pancreatic veins drain into splenic artery
Name the attachments of the falciform ligament
Anterior surface liver to anterior abdominal wall
Name the attachments of the coronary ligaments
Superior surface of the liver to the inferior surface of the diaphragm
Anterior and posterior coronary ligaments demarcate the bare area
Name the attachments of the triangular ligaments
Left triangular ligament formed by the union of the anterior and posterior coronary ligaments attached the L lobe to the diaphragm
R triangular attaches R lobe to diaphragm
Name the potential space between the visceral surface of the love and the R kidney
Morison’s pouch
Name the fibrous layer covering the liver
Glisson’s capsule
Name the anatomical relations of the
- Caudate lobe
- Quadrate lobe
- Lies between the IVC and ligamentum venosum (remnant of ductus venosus)
- Lies between the gallbladder and ligamentum teres (remnant of fetal umbilical vein)
Structures contained within the portal triad
Hepatic artery Common hepatic duct Hepatic portal vein Lymphatic vessels Vagus nerve
Name the vasculature of the liver
Liver has unique dual supply
Hepatic artery proper 25% - supplies the non-parenchymal structures with arterial blood
Hepatic portal vein 75% - supplies the liver with partially deoxygenated blood carrying nutrients from small intestines - supplying parenchyma
Venous
Hepatic veins via IVC
The gastro splenic ligament connects the greater curvature of the stomach to the hilum of the spleen.
Which structures are contained within this ligament?
Short gastric arteries and veis
Left gastro-epiploic artery and vein
Name the structures which make up the walls of the inguinal canal?
Anterior wall - aponeurosis of external oblique - laterally IO
Posterior wall - transversalis fascia
Roof - transversalis fascia, IO, TA
Floor - Inguinal ligament - thickened medially by lacunar ligament
Describe the anatomical relations of the deep ring
Above the midpoint of the inguinal ligament
Lateral to the inferior epigastric vessels
Describe the anatomical relations to the superficial (external) inguinal ring?
Superior to the pubic tubercle
Formed by invagination of the EO
The cremasteric muscle is an extension of which muscle?
Internal Oblique
