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Anatomy > Abdomen wk 2 > Flashcards

Abdomen wk 2 Flashcards

1
Q

what is the deffinition and function of the eosophagus

A

muscular tube

designed for propulsion of food

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2
Q

position shape and size of oesophagus

A

25-30cm in an adult male

slightly less in female

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3
Q

parts of oesophagus and boundaries

A

cervical part:

  • lower border of cricoid cartilage (C6)
  • descends in front of C6 and C7 to thoracic inlet
  • first one-fifth

Thoracic part

  • T1 to T10
  • longest and continues within the abdomen through the oesophageal opening into the diaphragm

Abdominal part

  • shortes
  • 1/6 the total length
  • ends at cardiac orifice of the stomach
  • at level of T11
  • 2.5cm from median plane
  • behind 7th left costal cartilage
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4
Q

course and relations of the esophagus and vertebral bodies

A
  • median at its commencement opposite C6
  • deviates slightly to the left up to C7
  • returns to media plane at T5
  • inclines to left and forward at T7
  • enters abdomen sharply deiates to left at T10
  • joins stomach at T11
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5
Q

blood vessels and lymphatics of the esophagus of cervical part

A

-blood suppy by the inferior thyroid arteries and veins

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6
Q

bloods of the thoracic part of the eosophagus

A

thoracic part:
arteries:
-eosophageal branches from the descending thoracic aorta
-and bronchial arteries

vein:

  • azygos
  • hemiazygos
  • Accessory Hemiazygos
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7
Q

bloods of abdominal part of oesophagus

A

Arteries:
-Left gastric of coeliac trunk and left inferior phrenic

Veins

  • Azygos vein
  • :Left gastric vein
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8
Q

Oesophageal Lymph Nodes

A

Cervical part:
-Deep Cervical Nodes

Thoracic:
-Posterior Mediastinal Nodes

Abdomen:
-Left Gastric Nodes

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9
Q

Nerve supply of eosophagus

A

Cervical:
-Recurrent Laryngeal and Cervical Sympathetic Trunk by the plexus around inferior thyroid arteries from middle cervical ganglia.

Thoracic:

  • Vagal Trunk and Oesophageal Plexus above and below the root of the lung.
  • Sympathetic Trunk, Greater Splanchnic.

Abdominal:

  • Vagal Trunks anterior and posterior
  • Thoracic Sympathetic Trunk, Greater and Lesser Splanchnic, and plexus around Left Gastric and Inferior Phrenic Arteries.
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10
Q

Sites of Constriction of eosophagus

A

-At origin, 5cm from incisors.
- Narrowest point and partly due to inferior constrictor muscle
-Aortic Arch (22.5cm from incisors)
-Left Main Bronchus (27.5cm from incisor)
Oesophageal opening in Diaphragm (37-40cm from incisors)

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11
Q

Importance of Constrictions

A
  • Endoscopy

- Lodgement of foreign objects

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12
Q

Stomach Definition

A

-Most dilated part of GIT between Oesophagus and Small Intestine

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13
Q

Stomach Location

A

-Epigastric, Umbilical, and Left Hypochondriac Region. Depending on the contents and the surrounding viscera, can distend down to Hypogastric Region.

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14
Q

Shape of Stomach

A
  • J-shaped but modified by changes in contents (empty or full) and surrounding organs.
    • High and transverse in obese; short and elongated in asthenic, position of body and phase of respiration.
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15
Q

Size of Stomach

A
  • Mean capacity varies with age
    • 30ml at birth
    • 1000ml at puberty
    • 1500ml in adults
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16
Q

Name and briefly describe the parts of the Stomach

A
  • Cardia: Surrounds opening of oesophagus into stomach.
  • Fundus: Area above level of cardial orifice.
  • Body: Largest region.
  • Pyloric: Distal end of stomach, divided into Pyloric Antrum and Pyloric Canal.
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17
Q

Describe Lesser Curvature of Stomach

A
  • Cardia to pyloric orifice
  • Lesser omentum attached and contains left and right gastric arteries.
  • Incisura Angularis (Angular notch), used to demarcate body from pyloric antrum and canal.
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18
Q

Describe Greater Curvature of Stomach

A
  • 4-5 times longer.
  • Highest point of fundus and left 5th intercostal space, just below the pylorus (pyloric antrum and canal).
    • Covered by peritoneum and gives attachment to Gastrosplenic Ligament and Greater Omentum.
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19
Q

Surfaces of the Stomach

A

Anterior:

  • Diaphragm, upper part and left part is related to the spleen.
  • Right half to Quadrate lobe of Liver and anterior abdominal wall.

Posterior (Stomach Bed):

  • Diaphragm
  • Left Supra Renal Gland
  • Left Kidney
  • Splenic Artery
  • Pancreas
  • Left Coelic Flexure (Splenic Flexure)
  • Transverse Mesocolon inferiorly.

Superior:

-Left dome of the diaphragm.

20
Q

Relations of Stomach

A

Revise

21
Q

Interior Surface of Stomach

A
  • Gastric folds (Rugae)
    • Diminish with distension of the stomach.
  • Oesophageal openings and sphincter (physiological sphincter) at T11 vertebra.
  • Pyloric opening and sphincter (anatomical).
  • Pyloric opening at L1.
    • Indentified by Pre-Pyloric Vein of Mayo which runs vertically across its anterior surface.
22
Q

Arterial Supply of Stomach

A
  • Left Gastric Artery from Coeliac Trunk.
  • Right Gastric Artery from Hepatic Artery Proper.
  • Right Gastro-Omental Artery from Gastroduodenal Artery .of Common Hepatic Artery.
  • Left Gastro-Omental Artery from Splenic Artery.
  • Short Gastric Artery from Splenic Artery.
23
Q

Venous Drainage of Stomach

A
  • Short Gastric and Left Gastro-omental to Splenic Vein.
  • Right Gastro Epiploic (Epiploic = Omental) Vein to Superior Mesenteric Vein.
  • Left and Right Gastric, directly into Portal Vein.
24
Q

Nerve Supply of Stomach

A
  • Right (Posterior) and Left (Anterior) Vagal Trunks for Parasympathetic.
    - Secretomotor to glands .
    - Motor to muscles.
  • Sympathetic from Coeliac Plexus(T6 - T9 Segments of Spinal Cord) pass via Greater Splanchnic and then Gastric and Gastro-omental.
    - Vasomotor to blood vessels and pain fibres to muscles.
    - Motor to pylorus for sphinteric constrictions.
25
Q

Lymph Drainage of Stomach

A

Revise

26
Q

Description of Duodenum

A
  • Shortest and widest and most fixed part of small intestine.
  • Extends from pylorus to duodenal-jejunal flexure.
  • Length of 25cm
27
Q

Shape of Duodenum

A

-Horse-shoe shaped with convexity to right side and concavity enclosing head of pancreas.

28
Q

Location of Duodenum

A

-Epigastric and umbilical regions.

29
Q

Parts of Duodenum

A
  • Superior
  • Descending
  • Horizontal
  • Ascending
30
Q

Relations of Duodenum (Learn Table pg 21)

A

Superior Part:

  • Anterior and Superior: Quadrate lobe and Gall Bladder.
  • Posterior: Common Bile Duct, Portal Vein, and Gastroduodenal Artery.
  • Inferior: Head of Pancreas.

Descending Part:

  • Anterior (Superior - Inferior): Right Lobe of Liver, Transverse Colon and Root of Transverse Mesocolon and Jejunum.
  • Posterior: Right Kidney and structures at its Hilum , Inferior Vena Cava, and Psoas Major muscle.
  • Medial (Left): Head of Pancreas and Common Bile Duct.
  • Lateral (Right): Right Colic Flexure, Common Bile Duct (major and minor pancreatic ducts open into this part).

Horizontal:

  • Anterior: Superior Mesenteric Artery and Vein, and Intestine (Large Intestine).
  • Posterior: Right Ureter, Right Psoas Major muscle, Right Testicular/ Ovarian vessels, Inferior Vena Cava, Aorta, and Right Crus of Diaphragm.
  • Superior: Head of Pancreas.
  • Inferior: Coils of Jejunum.

Ascending:

  • Posterior: Left Psoas Muscle, Left Sympathetic Trunk, Left Renal, and Left Testicular Vessels, Inferior Mesenteric Vein.
  • Left Side: Left Kidney and Ureter.
  • Medial: Pancreas.
  • Superior: Body of Pancreas.

-

31
Q

Arterial Supply of Duodenum

A
  • Superior Pancreaticoduodenal Artery (Branch of Gastroduodenal Artery).
  • Inferior Pancreaticoduodenal artery (Branch of Superior Mesenteric Artery).
32
Q

Venous Drainage of Duodenum

A

-Pancreaticododenal Veins drain into Portal Vein.

33
Q

Recesses of Duodenum

A
  • Superior
  • Inferior
  • Paraduodenal
  • Retroduodenal
  • Duodenal-jejunal (mesocolic)
  • Mesentericoparietal (of Waldeyer)
34
Q

Flexure of Duodenum

A

Duodenojejunal Flexure:

  • Suspended by the suspensory ligament of the duodenum (of Treitz)
  • Around coeliac artery and right crus of diaphragm to flexure and ascending part.
35
Q

Applied anatomy of Duodenum

A
  • Oesophageal Ulcer
  • Posterior Gastric Ulcer or Cancer may erode pancreas and structures in stomach bed.
  • Referred pain to the back.
  • Peptic Ulcer (Ulcer in Pyloric Canal).
  • Ulceration into Splenic Artery leads to severe haemorrhage.
  • Duodenal Ulcer
36
Q

Definition and Function of the Liver

A

-Largest and heaviest gland.

Functions:

  • Secretes biles
  • Synthesises proteins
    • Metabolism of both nitrogenous and carbohydrates absorbed from intestine and carried to liver by the portal vein.
  • Destruction of red blood corpuscles and toxins.
37
Q

Position, Shape and Size of Liver

A

Location:

-Right Hypochondrium, Epigastrium, and may extend into Left Hypochondrium.

Size:

  • Relatively larger in foetus and new born (haemopoetic functions) than in adults.
    • Palpable below costal margin.

Weight:

  • 1.4-1.8 kg in males
  • 1.2-1.4 kg in females

Shape:

-Wedge-shaped or roughly triangular

Texture:

-Soft, solid, friable, easily lacerated and highly vascular.

Colour:

-Dark Reddish-Brown.

38
Q

Surfaces of Liver

A

Anterior

  • Diaphragm separates it from the 6-10 costal cartilages on the right; 7-8 costal cartilages on left.
  • Falciform ligament.

Superior:

  • Dome of diaphragm separates it from lung on right and heart on the left.
  • Bare area.
  • Inferior Vena Cava.

Posterior:

-Against Vertebral column; collectively the diaphragmatic surface.

39
Q

Lobes and features of Liver

A

Lobes:

  • Right
  • Left
  • Quadrate (Functionally part of Left lobe)
  • Caudate (Functionally part of Right + Left lobe)

Features:

  • Porta Hepatis and its contents
  • Gall Bladder
  • Inferior Vena Cava

Ligaments:

  • Falciform
  • Ligamentum Teres/Round Ligament (Remnant of umbilical vein)
  • Coronary
  • Right and Left Triangular
40
Q

Relations/Impressions of the Liver

A
  • Stomach
  • Pylorus
  • Duodenum
  • Colon
  • Hepatic Flexure
  • Right Kidney
  • Right Suprarenal Gland
  • Gall Bladder
  • Inferior Vena Cava
41
Q

Arterial Supply of Liver

A

-Dual blood supply:

  • Left and Right Hepatic Artery: Oxygenated Blood (20%)
  • Portal Vein: Nutrient rich blood from gut (80%)
42
Q

Venous Drainage of Liver

A

-Left and Right Hepatic veins: Carries deoxygenated blood

43
Q

Nerve supply of Liver

A
  • Hepatic Flexure from Coeliac Plexus accompanies the Hepatic arteries and its branches.
  • Both sympathetic and parasympathetic supply of liver.
44
Q

Lymphatic drainage of Liver

A
  • Major protein rich lymph producing organ.
  • Superficial vessels in the sub-serosa areolar tissue drain via hepatic, coeliac ad para-aortic group of lymph nodes to thoracic duct.
  • Deep vessels end in nodes around inferior vena cava.
45
Q

Applied anatomy of Liver

A
  • Great vascularity of liver cause considerable haemorrhaging in wounds of liver.
  • Liver is prone to perforation from fractures of surrounding ribs.
  • Liver is a good site of secondary carcinomas from any other body sites.

Anatomy (12 decks)

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