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Clinical anatomy > Abdomen IV > Flashcards

Abdomen IV Flashcards

1
Q

How do the intestines develop?

A
  • herniate out during development and enter back inside the abdominal wall
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2
Q

What is omphalocele and why does it occur?

A
  • Gut contents protruding from the umbilical ring
  • Malrotation of midgut
  • Failure of rectus abdominis to develop correctly
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3
Q

What are the two primary intestinal loops?

A
  • cranial limb
  • caudal limb
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4
Q

What 3 things does the cranial limb contain?

A
  • distal duodenum
  • jejunum
  • ileum
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5
Q

What 5 things does the caudal limb of the intestinal loop contain?

A
  • distal ileum
  • cecum
  • appendix
  • ascending colon
  • distal 2/3 of transverse colon
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6
Q

What is the function of the vitelline duct?

A
  • connects growing fetus to yolk sac
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7
Q

What is Meckel’s diverticulum?

A
  • outpouching of the ileum
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8
Q

Where does the midgut extend from and to?

A
  • extends from the major duodenal papilla, in the duodenum, to a point two-thirds distally along the transverse colon
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9
Q

What is the midgut supplied by?

A
  • superior mesenteric artery
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10
Q

How long is the jejunum and the ileum?

A
  • The jejunum is approximately 2.5 m in length and the ilium is approximately 3 m
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11
Q

Where does the ileum terminate?

A
  • ileocecal junction
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12
Q

Where is the ileocecal junction located?

A
  • right iliac fossa
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13
Q

What are plicae circulares?

A
  • inner folding in the lining of the mucosa of the jejunum and ileum
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14
Q

Where does the jejunum begin?

A
  • at the duodenal jejunal flexure which is when the fourth part of the duodenum bends upwards
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15
Q

What is the duodenaljejunal junction held up by?

A
  • Ligament of Treitz
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16
Q

Where are the ileum and jejunum located quadrant wise?

A
  • ileum is in the right lower quadrant and the jejunum is in the left lower quadrant
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17
Q

What is contained within the mesentery?

A
  • superior mesenteric artery
  • superior mesenteric vein
  • lymph nodes
  • fat
  • autonomic nerves
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18
Q

What are the anatomical landmarks for the root of the mesentery?

A
  • duodenal-jejunal flexure to sacro-iliac joint
  • oblique course from the duodenojejunal flexure to the ileocecal junction
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19
Q

Are the jejunum and ileum retro or intraperitoneal?

A
  • intraperitoneal
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20
Q

What are the jejunum and ileum suspended by?

A

*

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21
Q

What does the superior mesenteric vein join with?

A
  • joins the splenic vein to form the portal vein to process all the nutrients in the liver
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22
Q

How long is the root of the mesentery?

A
  • 15cm long
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23
Q

Fill in this table

A
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24
Q

What are the vessels in the mesentery called?

A
  • arterial arcades and vasa recta
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25
Q

What does occlusion of the vasa recta by an embolus cause?

A
  • ischemia of the part of the intestine concerned.
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26
Q

What happens if there is severe ischemia as a result of an embolus in the vasa recta?

A
  • necrosis of the involved segment and paralytic ileus (obstruction of the intestine) occurs
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27
Q

What disease is the small bowel commonly involved in?

A
  • Inflammatory bowel disease
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28
Q

How does IBD differ from ulcerative colitis?

A
  • Ulcerative colitis is limited to the colon while
  • Crohn’s disease can occur anywhere between the mouth and the anus
  • Ulcerative colitis only affects the inner most lining of the colon
  • Crohn’s disease can occur in all the layers of the bowel walls
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29
Q

Where does the large intestine extend from and to?

A
  • from ileocecal junction to anus
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30
Q

What is lateral to the ascending and descending colon?

A
  • paracolic gutters
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31
Q

What are the 5 functions of the large intestine?

A
  • water and salt absorption
  • temporary storage of feces
  • little or no digestive function
  • secretion of mucus
  • extensive action of microorganisms
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32
Q

Where does the cecum lie?

A

*

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33
Q

What is the first part of the large intestine?

A
  • caecum
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34
Q

What is the function of the ileocecal valve?

A
  • prevents reflux of colonic contents into the terminal ileum
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35
Q

Name the parts of the intestine after the cecum?

A
  • ascending colon which bends and is called the hepatic flexure,
  • then it becomes the transverse colon which bends again and is called the splenic flexure
  • becomes the descending colon
  • becomes the sigmoid colon
  • then the rectum and anal canal
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36
Q

Label this image

A
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37
Q

What are omental appendices?

A
  • pockets of peritoneum filled with fat
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38
Q

What are haustra?

A
  • muscles of the large intestine forms three longitudinal bands and as they contract they have a sacculated appearance called haustra
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39
Q

Label this image

A
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40
Q

What is the boundary of the midgut to hindgut?

A
  • superior mesenteric artery to inferior mesenteric artery
  • vagus nerve to pelvic splanchnic nerve (S2-S4)
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41
Q

Where does the ileum enter the cecum?

A
  • ileocecal junction
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42
Q

What is the relationship of the opening of the appendix to the ileocaecal opening?

A
  • appendix
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43
Q

What kind of a structure is the appendix and what is it suspended from the posterior abdominal wall by?

A
  • intraperitoneal and suspended from the posterior abdominal wall by the mesoappendix
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44
Q

What artery supplies the appendix and which artery does this arise from?

A
  • appendicular artery
  • branch of ileocolic artery
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45
Q

What is the arterial supply of the caecum and where does this arise from?

A
  • ileocolic artery
  • branch of the superior mesenteric artery
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46
Q

Label this image

A
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47
Q

What is appendicitis?

A
  • inflammation of the appendix stretching the visceral peritoneum
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48
Q

) Why is pain from appendicitis felt, initially, in the umbilical region, but later in the right iliac region?

A
  • pain is referred to peri umbilical region T10
  • later pain in right lower quadrant : irritant of parietal peritoneum lining posterior abdominal wall
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49
Q

Where is the McBurney’s point?

A
  • lateral 1/3 of line from ASIS to umbilicus
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50
Q

What are the two borders of the ascending colon?

A
  • Ileocolic junction to hepatic flexure
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51
Q

What kind of organ is the ascending colon now and during development (intra/retroperitoneal)?

A
  • Secondary retroperitoneal
  • It was once intraperitoneal during embryological development but it migrates so only the anterior surface is covered in parietal peritoneum
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52
Q

What is lateral to the ascending colon?

A
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53
Q

What is the blood supply to the ascending colon?

A
  • supplied by the superior mesenteric artery via the ileocolic and right colic arteries
54
Q

Where does the transverse colon end and begin?

A
  • begins at the hepatic (right colic) flexure
  • terminates at the splenic (left colic) flexure.
55
Q

When does the midgut become the hindgut?

A
  • at a point two-thirds distally along the transverse colon
56
Q

What is the change in blood supply from midgut to hindgut?

A
  • proximal ⅔ of the transverse colon will be supplied by the superior mesenteric artery
  • The distal ⅓ and the rest will be supplied by the inferior mesenteric artery
57
Q

Is the transverse colon intra or retroperitoneal?

A
  • intraperitoneal
58
Q

What is the innervation of the proximal 2/3 of the transverse mesocolon and what happens at the red dotted line?

A
  • proximal ⅔ – parasympathetic innervation is through the vagus nerve (10)
  • At the red dotted line the vagus stops and the pelvic splanchnic nerve take over innervation of the hindgut
59
Q

Where do the pelvic splanchnic nerves arise?

A
  • S2- S4
60
Q

How is the transverse colon suspended from the posterior abdominal wall and at what level?

A
  • by the transverse mesocolon at the level of L1
61
Q

What does the transverse mesocolon divide the abdominal cavity into?

A
  • supracolic
  • infracolic compartments
62
Q

How can surgical access to the lesser sac be gained?

A
  • via the supra colic portion of the transverse mesocolon
63
Q

What mesentery is fused with the transverse colon?

A
  • greater omentum
64
Q

Label this image

A
65
Q

What is the anterior layer of the transverse mesocolon attached to?

A
  • posterior layer of greater omentum
66
Q

Where does the arterial supply to the midgut arise from?

A
  • superior mesenteric artery
67
Q

Where is the superior mesenteric artery from?

A
  • unpaired branch of abdominal aorta
68
Q

From where does the middle colic artery arise?

A
  • superior mesenteric artery
69
Q

Label this image

A
70
Q

At what vertebral level does the superior mesenteric artery arise from the abdominal aorta?

A
  • L1
71
Q

What is superior mesenteric artery thrombosis?

A
  • differential diagnosis for acute severe abdominal pain
72
Q

Does the superior mesenteric artery run to the left or the right of the superior mesenteric vein?

A
  • left
73
Q

What vessel does the SMV unite with to form the hepatic portal vein?

A
  • splenic vein
74
Q

What does the superior mesenteric vein drain into?

A
  • hepatic portal vein
75
Q

Where does the lymphatic drainage of the midgut go?

A
  • they follow the branches of the superior mesenteric artery.
  • The nodes eventually drain into the intestinal lymphatic trunk and the cisterna chyli.
76
Q

What is the cisterna chyli?

A
  • cisterna chyli is the dilated origin of the thoracic duct
  • receives the right and left lumbar lymphatic trunks and the intestinal lymphatic trunk
77
Q

What do the autonomic nerves of the midgut modulate?

A
  • activity of the submucosal and myenteric nerve plexus within the walls of the intestine
78
Q

What nerves carry a) sympathetic and b) parasympathetic fibres to the midgut?

A
  • Parasympathetic innervation of the midgut is from the superior mesenteric plexus
  • sympathetic innervation is from the lesser splanchnic nerve.
79
Q

What is the marginal artery of drummond and what is its function?

A
  • anastomoses between the superior and inferior mesenteric artery
  • It serves as a collateral supply to prevent ischemia
80
Q

Label this image

A
81
Q

Is the descending colon intra or retroperitoneal?

A
  • descending colon is retroperitoneal
82
Q

What is lateral to the descending colon?

A
  • left paracolic gutter
83
Q

Where does the hindgut extend from and to?

A
  • from a point two-thirds along the transverse colon to the upper half of the anal canal
84
Q

What are taeniae coli?

A
  • three longitudinal bands of muscle which run from the caecum to the rectum
85
Q

What are appendices epiploicae?

A
  • tags of peritoneum filled with fat
86
Q

Is the sigmoid colon intra or retroperitoneal and what is it suspended by?

A
  • suspended from the posterior abdominal wall by a double fold of peritoneum known as the sigmoid mesocolon
87
Q

At what level does the sigmoid colon become the rectum?

A
  • S3
88
Q

What is diverticulosis?

A
  • outpouching of the colonic mucosa and submucosa through weaknesses of muscle and layers in the colon
89
Q

What is diverticulitis?

A
  • infections and inflammation of diverticulum
90
Q

What are the indentations in the rectum formed by?

A
  • formed by thickenings in the folds of the mucosa in the lining of the rectum
91
Q

What are the thickenings in the rectum that form indentations?

A
  • transverse rectal folds
92
Q

When does the rectum become the anal canal?

A
  • as it travels through the pelvic floor/ pelvic diaphragm
93
Q

Where is the rectosigmoid junction located?

A
  • S3
94
Q

Why is the 80 degree angle of the anorectal flexure important?

A
  • continence
95
Q

What is the ampulla of the rectum?

A
  • the distal portion of the rectum which dilates in the presence of faeces and is important for continence
96
Q

What muscle is the pelvic floor made from?

A
97
Q

Label this

A
98
Q

Label this

A
99
Q

What does the pectinate line represent?

A
  • termination of the hindgut, and thus a change in peritoneal coverings, epithelial lining, blood supply, venous drainage, lymphatic drainage and innervation.
100
Q

What does the internal anal sphincter control?

A
  • superior 2/3 of anal canal
101
Q

What does the external anal sphincter control?

A
  • inferior third of anal canal
102
Q

What types of muscle are the internal and external anal sphincters?

A
  • internal : extension of circular
  • external : skeletal
103
Q

What kind of control does the internal anal sphincter have?

A
  • involuntary : tonically contracted
104
Q

What kind of control does the external anal sphincter have?

A
  • voluntary
105
Q

What does the pectinate line separate?

A
  • upper 2/3 and lower 1/3 of anal canal
106
Q

What does the pectinate line demarcate the transition between?

A
  • transition between columnar epithelium to stratified squamous epithelium
107
Q

What is the innervation of the internal anal sphincter?

A
  • pelvic splanchnic nerves
  • relaxes muscle
108
Q

What is the innervation of the external anal sphincter?

A
  • inferior rectal branch of pudendal nerve
109
Q

Fill in this table

A
110
Q

What is an internal hemorrhoid caused by?

A
  • Prolapses of rectal mucosa containing dilated veins of the internal rectal venous plexus.
  • They often fall into anal canal and are compressed by anal sphincters
111
Q

What is an external hemorrhoid caused by?

A
  • Blood clots from external rectal venous plexus that are covered in skin
112
Q

What is the blood supply of the hindgut?

A
  • inferior mesenteric artery
113
Q

Where does the inferior mesenteric artery arise from?

A
  • the aorta
  • L3
114
Q

What are the 4 branches of the inferior mesenteric artery?

A
  • Left colic artery
  • Sigmoidal arteries
  • Superior rectal artery
  • Marginal artery
115
Q

Label this image

A
116
Q

From what artery does the superior rectal artery arise?

A
  • branch of inferior mesenteric artery
117
Q

Where does the middle rectal artery arise from?

A
  • branch of internal iliac artery
118
Q

Where does the inferior rectal artery arise from?

A
  • branch of internal pudendal artery
119
Q

What do the middle and inferior rectal arteries supply?

A
  • anal canal NOT the rectum
120
Q

What do the superior rectal veins drain into?

A
  • inferior mesenteric vein (portal system
121
Q

What do middle rectal veins drain into?

A
  • internal iliac vein (systemic system)
122
Q

What do the inferior rectal veins drain into?

A
  • inferior pudendal (systemic system)
123
Q

What is the hepatosystemic anastomoses?

A
  • occurs between the superior and middle and inferior rectal veins
  • in the anal canal
124
Q

How does the lymphatic system of the hindgut work?

A
  • The lymphatic system hindgut follows the branches of the inferior mesenteric artery
  • The nodes eventually drain into the intestinal lymphatic trunk and the cisterna chyli
125
Q

Where are the pre-aortic lymph nodes?

A
  • pre aortic nodes lie on the main blood vessels : celiac, superior mesenteric and inferior mesenteric nodes
126
Q

What do the preaortic lymph nodes drain into?

A
  • intestinal trunk which drain into the cisterna chyli
127
Q

Where do the parasympathetic fibers to the hindgut travel?

A
  • through the pelvic splanchnic nerves (S2 –S4). These also carry visceral afferent (sensory) fibres
128
Q

Where do the sympathetic nerves to the hindgut travel?

A
  • hindgut travel through the lumbar splanchnic nerves (L1 – L2).
129
Q

Why is pain from the gallbladder referred to shoulder?

A
  • can irritate diagphragm
  • diaphragm innervated by C3,C4,C5
130
Q

Label this diagram

A
131
Q

Label this diagram

A

Clinical anatomy (10 decks)

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