Abdominal Flashcards
Function of Liver (4)
- bile production & secretion
- detoxification
- blood clotting mechanism
- storage
Where does bare area of liver contact and what distinguish it from the rest of the liver?
- contact diaphragm
2. not covered by peritoneum
Name the four lobes of the liver and it’s anatomical position.
- R & L lobes
- quadrate lobe
- caudate lobe
- quadrate & caudate lobes are anatomically on R but functionally belong to left
The liver is divided by what structures (3)?
- falciform ligament separate R & L
2. gallbladder & porta hepatis separate quadrate & caudate
Describe the Hepatic Portal System.
- the portal vein
- hepatic veins
- product of digestion in blood from GI–>portal vein–>liver
- liver–>hepatic veins–>IVC
Shape, Position, Function of Gallbladder
Shape:
1. pear shaped sac
2. contains fundus, body, neck (cystic duct)
Position
1. inferior surface of liver
Function
1. receives, stores, concentrate, expel bile
2. bile emulsifies fat (small particle for digestion)
Route of bile produced from liver to duodenum.
make in liver–>stored gallbladder–>excrete cystic duct–>bile duct–>duodenum
What is the name of sphincter that control bile flow into duodenum?
Sphincter of Oddi at the hepatopancreatic ampulla of Vater
Description, Location, Function of Pancreas
Description 1.head, body, tail Location 1.posterior to stomach 2. between duodenum on right 3. spleen on left Function 1. produce digestive enzyme that empties into duodenum through pancreatic duct 2.secrete insulin & glucagon directly into blood
Structure of hepatopancreatic ampulla of Vater and its function.
structure:
- funnel shaped form by the joining of pancreatic ducts and bile duct
- expel bile & pancreatic enzymes into duodenum
Location & Functions of Spleen.
Location: 1.against diaphragm 2.between 9-11 rib on left side Function 1.filter blood 2. store red corpuscles 3. produce lymphocytes & antibodies
Describe the location of splenic artery.
- posterior to omental bursa
- anterior to left kidney
- along superior border of pancreas
Position, Description, Function of Kidneys
Position 1.retroperitoneal 2. behind 11th-12th ribs Description 1. R: lower due to liver; 12th rib 2. L: 11th-12th rib Function 1. remove excess water & salt from blood 2. return nutrients to blood
Kidney internal anatomy & pathway of urine
anatomy
1. nephrons located in renal pyramids
Pathway
urine–>minor calyx–>major calyx–>renal pelvis–>urinary bladder–>urethra
Function of ureter and what causes ureteric colic?
Position
1. retroperitoneal
Function
1. passage of urine from renal pelvis to urinary bladder
Ureteric colic
1. ureteric calculus (stone) distention rapidly
What thoracoabdominal nerve innervate the somatic abdominal wall?
Subcostal nerve at what point?
Iliohypogastric nerve?
Ilioinguina nerve?
- T7-T11
- T12
- L1
- L1
Autonomic innervation of abd organs 1.sympathetic:
- T5-T9 (4)
- T9-T12 (5)
- T12-L2 (2)
- vasoconstriction, inhibit peristalsis
- SPED: esophagus, stomach, duodenum, pancreas
- AJ KIT: ascending colon, jejunum, kidney, ileum, transverse colon
- Dr: descending colon, rectum
Autonomic innervation of abd organs 1.parasympathetic
- vagus nerve
- pelvic splanchnic nn. (S2-4)
- vasodilation, increase persistalsis and secretions
- GI tract proximal to left colic flexure
- descending colon, rectum
Referred pain origin and pathway
- Pain from organ–>afferent nerves–>spinal cord.
- impulse from skin–>to same spinal segment
- Pain from organ=somatic
- organ is innervated segmentally, so is abdominal wall. Brain mistake pain in organ for pain in abd wall.
- appendicitis pain around umbilicus (T10) then localized to McBurney’s point
- Innervation of kidney & ureter “loin to groin”
2. Innervation of diaphragm
- T11-L2
2. phrenic nerve C3-C5; irritation to diaphragm refers to shoulder area (C3-C5)
Arteries of posterior abdomen types
- Unpaired visceral
- Paired visceral
- Unpaired parietal
- Paired parietal
- SIC: superior mesenteric artery, inferior mesenteric artery, celiac trunk
- SR: suprarenal (/superior/middle), right & left renal arteries, testicular/ovarian arteries
- mediian sacral
- segmental: phrenic (inferior), lumbar, spinal arteries (subcostal).
Celiac trunk branch to (3) arteries and it supplies what (5)?
- splenic artery, common hepatic artery, left gastric artery.
- SLEDS: liver, spleen, stomach, duodenum, esophagus
Three arteries from superior mesenteric artery
- jejunal a. to jejunum
- ileal a. to ileum
- colic a. to 2/3 proximal colon
-
What are the three arteries that make up the colic arteries?
- Ileocolic a- branch to cecum end of colon
- R colic a- right ascending colon
- Middle colic a-superior branch off the above around duodeum
What two arteries anastomose to form arterial arcades?
jejunal arteries and ileal arteries- cover mesentary.
Inferior mesenteric artery run through what structure and what is the name of the artery there?
- distal 1/3 of colon (L colic a. & sigmoid a)
2. Rectum (superior rectal a.)
- Name the four major veins.
2. All venous blood from where drains into where in the abdomen.
- PISS: portal vein, inferior mesenteric v., superior mesenteric v., splenic v.
- all venous blood from GI tract drains into portal vein to be filtered by the liver
The three diaphragmatic apertures and the structure associated.
- caval opening-inferior vena cava (btw T8-9)
- esophageal hiatus-esophagus (T10)
- aortic hiatus-aorta; does not pierce diaphragm but passes posterior to diaphragm at T12
Muscles of posterior abdominal wall (3 paired muscles)
- psoas major
- Iliacus
- Quadratus lumborum
OIAN of Psoas major
O-transverse processes, intervertebral disc, and bodies of T12-L5
I- lesser trochanter of femur
A-flexes thigh and trunk
N-L1-L3
OIAN of Iliacus
O-superior 2/3 of iliac fossa
I-lesser trochanter
A-flexes trunk
N-femoral nerve
OIAN of Quadratus Lumborum
O-Iliolumbar ligament, iliac crest, transverse process of L5
I-12th rib and tips of lumbar transverse processes (L1-4)
A-flexes trunk laterally and fixes 12th rib
N-T12-L4
Abdominal cavity contain (3)?
when supine what is the landmark?
- digestive organs
- spleen
- kidneys
- superiorly to 5th anterior intercostal space
Name the 3 flat muscles and 1 strap muscle of the abdominal wall
- EAO-external abdominal oblique
- IAO-internal abdominal oblique
- TA- transverse abdominus
- rectus abdominis
What form the inguinal ligament?
The lower edge (inferior margin) of aponeurosis of external oblique
- Anatomical location of inguinal ligament.
2. superficial inguinal
- anterior superior iliac spine to pubic tubercle
2. triangular opening at medial end is superficial inguinal ring, the exit of the spermatic cord in males.
OINA of rectus abdominus
O-anterior pubis
I-costal cartilages of ribs 5-7th, xiphoid process of sternum
N-intercostal nerves
A-flexes lumbar spine, depresses ribs, stabalizes pelvis (while walking), active during expiration, maintenance of abd tone
- Location of transversalis fascia
- where does it lines
- what is it consists of
- lies deep to transversus abdominus muscle
- forms internal lining of entire abdominal wall, external to peritoneum
- diaphragmatic fascia, iliac fascia, psoas fascia, pelvic fascia
Functions of abdominal wall muscles
- support anterlateral abd wall
- protect abd viscera
- compresses abd contents/increase abd pressure (inspiration, vomit, bear down)
- move trunk and maintain posture
- guards inguinal canal
Inguinal canal:
- position in relation to inguinal ligament
- Deep ring
- superficial ring
- medial wall
- function
- lies parallel and superior to inguinal ligament
- entrance to inguinal canal, form in transversalis fascia
- exit from inguinal canal, form in external oblique aponeurosis
- conjoint tendon (merging of IO and TA)
- transmit spermatic cord in male; round ligament of uterus in XX; Ilioinguinal nerve
Contents of spermatic cord
- ductus deferens
- artery of ductus deferens
- testicular artery
- pampiniform plexus of veins
- cremasteric artery
- sympathetic nerve fibers
- genital branch of genitofemoral nerve
- lymphatic vessels
List three coverings of spermatic cord and the fascia associated.
- Internal spermatic fascia (transversalis fascia)
- cremasteric fascia (internal oblique)
- external spermatic fascia (external oblique aponeurosis)
Intraperitoneal organs (9) enclose by layer of peritoneum
- liver
- gallbladder
- stomach
- small intestine (except duodenum)
- transverse colon
- sigmoid colon
- cecum and appendix
- spleen
- superior part of uterus
Retro/subperitoneal organs (11) where the only one surface is covered by peritoneum
- duodenum
- abdominal aorta
- inferior vena cava
- inferior part of uterus
- kidneys
- ureters
- bladder
- ascending colon
- descending colon
- rectum
- pancreas
- what defines peritoneal cavity
- what it contains
- xx & xy
- divides into what? and what separates these?
- role of omental bursa
- potential space between parietal and visceral peritoneum
- contains peritoneal fluid that lubricates surface of peritoneum and facilitate free movement of viscera
- completely closed in XY; communicates with exterior through openings in uterine tubes (fallopian) in females.
- greater sac and lesser sac (omental bursa lies posterior to lesser omentum and stomach). Omental foramen (epiploic foramen) opening between the two sac
- allow free movement of stomach; has superior recess and inferior recess.
- What is omentum
- lesser omentum
- greater omentum
- double layer peritoneum (mesentery) extends from stomach to adjacent organs
- joins lesser curvature of stomach and proximal part of duodenum to liver
- attached from greater curvature of stomach to transverse colon; overlying transverse colon and small intestine
Greater omentum has considerable mobility and can surround inflamed organ and wall off infection
- Peritoneal cavity divide into (2)?
- What is the opening between the two call?
- Function of omental bursa and its parts?
- greater sac (main part of peritoneal cavity)
lesser sac (omental bursa) posterior to lesser omentum and stomach - omental foramen (epiploic foramen)
- allows free movement of stomach with superior recess and inferior recess
What does the wall of greater omentum when fused obliterate?
2. How many layers of peritoneum in greater omentum?
- inferior recess
2. 4 layers
- what is mesentery?
2. which organs does it surround?
- double layer of visceral peritoneum connecting peritoneal organs with abdominal wall.
- small intestine (except duodenum)
liver
stomach
transverse colon
sigmoid colon
appendix
spleen.
What does peritoneal ligaments made of?
where doe sit connect?
what does it lack?
- double layer of peritoneum (not mesentery/omenta)
- connects an organ with another organ or abdominal wall
- lacks connective tissue like mesentery, may contain blood vessels
What four organs make up the GI tract?
esophagus
stomach
small intestine
large intestine
- Esophagus begin from which vertebrae?
- Where does it pass through and terminate? and location
- When full, where does the esophagus constrict?
- C6; muscular tube extending from pharynx to stomach, pass food through
- pass through diaphragm at T10 esophageal hiatus. terminate at esophagogastric junction enter cardial orifice at T11 and 7th left costal cartilage.
Located in posterior mediastinum, posterior to trachea, right anterior to descending thoracic aorta, vagus nerve (esophageal nerve) - neck, aortic arch, left primary bronchus, diaphragm.
3.
- stomach location
- function
- different parts
- superior, left and center
- enzymatic digestion where food is broken down by muscular walls, increase surface area of food, convert food into liquid mixture (chyme). Low pH activates enzymes, gastric enzymes break down proteins into amino acids
- cardia (next to esophagogastric junction)
fundus, body (lesser/greater curvature), pyloric (antrum, canal, sphincter, orifice)
- location of small intestine
- function
- Three division
- extend from pylorus of stomach to ileocecal junction with large intestine
- complete digestion (fat broken, absorb products, water, electrolytes, minerals)
- Duodenum, jejunum, ileum
- characteristic and location of duodenum
2. 4 regions
- shortest and widest part of small intestine
from pyloric opening to duodenojejunal junction, C-shaped, surrounds head of pancreas - superior, descending, horizontal, ascending,
Jejunum and Ileum description
- duodenojejunal junction to ileocecal junction.
6-7 meters long, 2/5 jejunum, 3/5 ileum
- junction connecting large intestine
- function
- divisions
- ileocecal junction to anus, 1.5 meters long
- convert liquid contents of ileum into semisolid feces by absorbing fluid and electrolytes
- cecum, appendix, colon, rectum, anus
Description of cecum, location, etc
- blind pouch of large intestine
- lies in right iliac fossa
- usually surrounded by intraperitoneal peritoneum
Description of appendix
- vermiform appendix
- narrow, hollow, and muscular tube
- suspended from terminal ileum by mesoappendix
- most often it is behind the cecum (retrocecal)
- For parts of colon
2. what is teniae coli
- ascending, transverse, descending, sigmoid
2. teniae coli is (longitudinal bands of smooth muscle) pull colon to form haustra (pouches)
Rectum
- rectosigmoid junction located at S3
- S-shaped
- supports and retains fecal mass before it is expelled during defecation
anal canal location
muscles and function
- terminal part of large intestine inferior to pelvic diaphragm
- internal anal sphincter muscles (involuntary, smooth muscle)
- external anal sphincter muscles (voluntary, skeletal muscle)
