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Anatomy yr 1 > ABDOMEN II > Flashcards

ABDOMEN II Flashcards

1
Q

What does the term ‘intraperitoneal’ mean?

A

Within or administered through the peritoneum- a thin, transparent membrane that lines the wall of the abdominal cavity

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2
Q

What does the term ‘retroperitoneal’ mean?

A

The space behind the peritoneum, with no specific delineating structures

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3
Q

What’s the peritoneal cavity?

A

The space between the parietal and visceral peritoneum

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4
Q

What’s contained within the peritoneal cavity?

A

A thin film of peritoneal fluid, which consists of water, electrolytes, leukocytes and antibodies

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5
Q

What are the 2 compartments of the greater sac, and what divides it into them?

A

The greater sac is divided into the supra colic and infra colic compartments by the transverse colon

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6
Q

What is the lesser omentum?

A

A double fold of peritoneum that attaches the liver to the lesser curvature of the stomach (hypogastric ligament) and to the first part of the duodenum (hepatoduodenal ligament). It is derived from the embryonic ventral mesogastrium

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7
Q

What’s the free edge of the lesser omentum between?

A

The porta hepatis and the duodenum

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8
Q

What does the free edge of the lesser omentum contain?

A

The hepatoduodenal ligament carries the portal triad- proper hepatic artery, the portal vein and the common bile duct. There are also lymph glands, lymph vessels and nerves, forming the hepatic hilum

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9
Q

What would result in clamping the lesser omentum during surgery?

A

A large atraumatic haemostat is used to clamp the hepatoduodenal ligament (Pringle’s manoeuvre), interrupting blood flow through the hepatic artery and the portal vein and thus helping to control bleeding from the liver

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10
Q

What is found posterior to the lesser omentum and through the epiploic foramen?

A

The lesser sac (omental bursa)

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11
Q

What are the borders of the epiploic foramen?

A

Roof- caudate process of the liver
Floor- First part of the duodenum
Posterior border- Inferior vena cava
Anterior border- Hepatoduodenal ligament in the free edge of the lesser omentum

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12
Q

Where does the greater omentum attach?

A

To the greater curvature of the stomach and the transverse colon

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13
Q

Why’s the greater omentum known as the abdominal policeman?

A

For its role in fighting intraabdominal infection

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14
Q

What’s the transverse mesocolon?

A

The mesentery associated with the transverse colon, which attaches it to the posterior abdominal wall

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15
Q

What does the transverse mesocolon divide the peritoneal cavity into?

A

Supracolic and infracolic compartments

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16
Q

What’s the mesentery?

A

A fan-shaped organ, filled with fat, which attaches the jejunum and ilium to the posterior abdominal wall. It contains the superior mesenteric artery and vein and their branches

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17
Q

Where is the root of the mesentery?

A

On the posterior abdominal wall

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18
Q

What’s the sigmoid mesocolon?

A

The mesentery associated with the sigmoid colon, the root of which forms an inverted ‘V’

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19
Q

What is the falciform ligament?

A

A double fold of peritoneum that attaches the liver to the anterior abdominal wall. It’s continuous with the visceral peritoneum surrounding the liver, and subsequently the lesser omentum.

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20
Q

What’s the falciform ligament derived from?

A

Its derived from the embryonic ventral mesogastrium

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21
Q

What does the free edge of the falciform ligament contain?

A

The ligamentum teres- a remnant of the umbilical vein

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22
Q

What are peritoneal recesses?

A

Regions where the peritoneum is reflected away from the posterior abdominal wall to form a pouch or recess

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23
Q

What’s the clinical importance of the left and right paracolic gutters?

A

The paracolic gutters provide pathways for the flow of ascitic fluid and the spread of intraperitoneal infections. Similarly, the paracolic gutters provide pathways for the spread of tumour cells that have sloughed from the ulcerated surface of a tumour and entered the peritoneal cavity

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24
Q

What’s the subphrenic space?

A

A space between the upper surface of the right lobe of the liver and below the diaphragm

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25
Q

What’s the hepatorenal pouch (of Morrison)?

A

A space between the liver and the right kidney

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26
Q

What is the rectovesical pouch?

A

A space between therectum and bladder of males

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27
Q

What is the uterovesical pouch?

A

The space between the uterus and bladder in females

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28
Q

What’s the rectouterine pouch (of Douglas)?

A

A space between the uterus and bladder in females

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29
Q

Where does the foregut extend from?

A

From the oral cavity to the major duodenal papilla of the duodenum

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30
Q

What does the foregut include?

A

The distal end of the oesophagus, the stomach and a portion of the duodenum. It also includes the lower respiratory tract, liver, gallbladder, pancreas and spleen

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31
Q

At what opening does the oesophagus pierce the diaphragm?

A

The oesophageal hiatus

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32
Q

At what point does the oesophagus enter the stomach?

A

The cardiac orifice

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33
Q

What is a hiatal hernia?

A

A protrusion of part of the stomach into the mediastinum through the oesophageal hiatus of the diaphragm

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34
Q

What are the 2 main types of hiatal hernia?

A

Sliding hiatal hernia and paraoesophageal (ROLLING) hiatal hernia

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35
Q

What’s a sliding hiatal hernia?

A

Where the abdominal part of the oesophagus, the cardia, and parts of the fundus slide superiorly through the oesophageal hiatus into the thorax, especially when the person lies down or bends over. Regurgitation of stomach contents into the oesophagus is possible

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36
Q

What is a paraoesophageal hiatal hernia?

A

The cardia remains in its normal position, but a pouch of peritoneum, often containing part of the fundus, extends through the oesophageal hiatus anterior to the oesophagus. In these cases, no regurgitation usually occurs because the cardiac orifice is in its normal position

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37
Q

In what region of the abdomen is the stomach found?

A

The left hypogastric and epigastric regions

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38
Q

What is the fundus normally filled with?

A

Air

39
Q

What is the cardia?

A

The region where food enters the stomach from the oesophagus, which is guarded by the lower oesophageal sphincter

40
Q

What’s the name of the longitudinal ridges on the internal surfaces of the body of the stomach?

A

Rugae

41
Q

What’s the purpose of the rugae in the body of the stomach?

A

To allow the stomach to stretch to accommodate for large amounts of food, and to help grip and move food during digestion

42
Q

What are the 3 parts of the pylorum?

A

The pyloric antrum, the pyloric canal and the pyloric sphincter

43
Q

What does the pylorus control?

A

The emptying of chyme into the duodenum

44
Q

What does the lesser curvature of the stomach give attachment to?

A

The lesser omentum

45
Q

What does the greater curvature give attachment to?

A

The greater omentum

46
Q

What is the cardiac notch?

A

The angle between the oesophagus and the fundus of the stomach

47
Q

What is the incisor angularis?

A

A small notch on the lesser curvature of the stomach, near the pyloric end, which marks where the body ends and pylorus begins

48
Q

Is the duodenum intraperitoneal or retroperitoneal?

A

The first part is intraperitoneal, while the rest is retroperitoneal

49
Q

What is the duodenal cap?

A

The very first part (2cm) of the duodenum which is slightly dilated

50
Q

What is the first part of the duodenum?

A

D1 is the superior part of the duodenum, which begins as a continuation of the duodenal end of the pylorus and ends at the superior duodenal flexure

51
Q

What is the second part of the duodenum?

A

This starts at the superior duodenal flexure, passes inferiorly to the lower border of L3, then turns medially into the inferior duodenal flexure

52
Q

What’s another name for the major duodenal papilla?

A

The ampulla of Vater

53
Q

What enters the descending duodenum through the major duodenal papilla?

A

The pancreatic duct and the common bile duct

54
Q

What’s the minor duodenal papilla the entrance for?

A

The accessory pancreatic duct

55
Q

Where does the junction between the embryological foregut and midgut lie?

A

Just inferior to the major duodenal papilla

56
Q

What is the 3rd part of the duodenum?

A

D3 starts at the inferior duodenal flexure, passes transversely left to cross the vertebral column

57
Q

What vessels run superior to the third part of the duodenum?

A

The superior mesenteric artery and vein

58
Q

What is the 4th part of the duodenum?

A

D4, the ascending part, passes superiorly, either anterior to, or to the left of, the aorta, until it reaches the inferior border of the pancreas. Then it curves anteriorly and terminates at the duodenojejunal flexure to become the duodenum

59
Q

What surrounds the duodenojejunal flexure?

A

The ligament of Treitz- a peritoneal fold containing muscle fibres

60
Q

What’s the arterial supply to the duodenal cap?

A

The right gastric and right epiploic arteries

61
Q

What’s the arterial supply to D1, bar the duodenal cap, and the proximal half of D2?

A

The superior pancreaticoduodenal artery (a branch of the gastroduodenal artery)

62
Q

What’s the arterial supply to between mid-D2 and the ligament of Treitz?

A

The inferior pancreaticduodenal artery (a branch of the SMA)

63
Q

Where do most (95%) inflammatory erosions of the duodenal wall (duodenal ulcers) occur?

A

In the posterior wall of the superior part of the duodenum

64
Q

From what trunk does vascular supply to the stomach arise?

A

The coeliac trunk

65
Q

Why does vascular supply to the stomach arise from the coeliac trunk?

A

The stomach is developed from the embryological foregut

66
Q

What thoracic vertebral level is the coeliac trunk?

A

T12

67
Q

What are the 3 arteries from the coeliac trunk?

A

The common hepatic artery, the left gastric artery and the splenic artery

68
Q

Where does the proper hepatic artery bifurcate and what into?

A

The proper hepatic artery bifurcates into the left and right hepatic arteries at or before the porta hepatis

69
Q

What triangle does the right hepatic artery pass into?

A

The right hepatic artery passes superiorly and turns right, crossing behind the common hepatic duct to enter Calot’s triangle

70
Q

What segments of the liver does the left hepatic artery supply?

A

Segments I, II and III

71
Q

What does the left hepatic artery usually give off?

A

A middle hepatic artery branch that runs towards the right side of the umbilical fissure

72
Q

What branch does the right hepatic artery give off in Calot’s triangle?

A

The cystic artery

73
Q

What is the cystic artery the main blood supply to?

A

The gall bladder

74
Q

What is the right gastric artery?

A

A non-hepatic branch of (usually) the proper hepatic artery, that supplies the pylorus and lesser curvature of the stomach. Can be a branch of the common hepatic artery or even the SMA in some cases

75
Q

Where does the common hepatic artery become the proper hepatic artery?

A

After it gives off the gastroduodenal artery

76
Q

What does the gastroduodenal artery supply?

A

The pylorus, proximal duodenum, and the head of the pancreas

77
Q

What is the gastroduodenal artery one of the major sources of, and why?

A

It’s one of the most important sources of upper gastrointestinal bleeding due to its proximity to the anterior wall of the proximal duodenum

78
Q

What does the gastroduodenal artery give off behind the first part of the duodenum?

A

The supra duodenal artery

79
Q

What does the gastroduodenal artery bifurcate into?

A

The right gastroepiploic artery and the superior pancreaticduodenal artery

80
Q

Where does the left gastroepiploic artery arise from?

A

The splenic artery

81
Q

What are the branches of the splenic artery?

A

The left gastroepiploic artery, the short gastric arteries and the pancreatic branches, which include the dorsal pancreatic artery, the transverse pancreatic artery and the greater pancreatic artery

82
Q

What do the pancreatic branches of the splenic artery supply?

A

The neck, body and tail of the pancreas

83
Q

What do the short gastric arteries supply?

A

The cardiac and fundal regions of the stomach

84
Q

Where do the short gastric arteries arise?

A

Before the splenic artery reaches the splenic hilum

85
Q

What ligament do the short gastric arteries run in?

A

The gastrosplenic ligament

86
Q

What forms the splenic vein?

A

The splenic tributaries emerging at the splenic hilum in the splenorenal ligament at the tip of the tail of the pancreas

87
Q

Where does the splenic vein run?

A

In the splenorenal ligament close to the splenic artery

88
Q

Where does the splenic form the portal vein?

A

Behind the neck of the pancreas where it confluences with the superior mesenteric artery

89
Q

What’s the lymphatic drainage of the stomach?

A

Gastric nodes along the lesser curvature and gastroepiploic nodes along the greater curvature

90
Q

What’s the lymphatic drainage from the superior portion of the duodenum?

A

Gastroduodenal nodes

91
Q

What supplies the stomachs sympathetic innervation?

A

The greater splanchnic nerves (T5-T9)

92
Q

What supplies the stomachs parasympathetic innervation?

A

The left and right vagus nerves (anterior and posterior vagal trunks)

93
Q

What are the medial, inferior and superior borders of Calot’s triangle?

A

The medial border is the common hepatic duct.
The inferior border is the cystic duct.
The superior border is the inferior anterior border of the liver

94
Q

Why is Calot’s triangle important to laparoscopic cholecystectomy?

A

In the procedure, the surgeon carefully dissects the triangle and identifies its contents and borders. This allows the surgeon to take any anatomical variation into account and permits safe ligation and division of the cystic duct and cystic artery

Anatomy yr 1 (20 decks)

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