Abdominal Cavity Flashcards
Right Upper Quadrant contains:
rt lobe of liver, gallbladder, pylorus, the first three parts of the duodenum, head of the pancreas, rt. suprarenal gland, rt. kidney, rt. colic flexure, superior part of ascending colon, rt. half of transverse colon
Left Upper Quadrant contains:
left lobe of liver, spleen, most of stomach, jejunum and proximal ileum, body and tail of pancreas, left suprarenal gland, left kidney, left colic flexure, superior part of descending colon, left half of transverse colon
Right lower quandrant contains:
cecum, appendix, most of ileum, inferior part of ascending colon, right ovary, right uterine tube, right ureter, right spermatic cord
Left lower quadrant contains:
Sigmoid colon, inferior part of descending colon, left ovary, left uterine tube, left ureter, left spermatic cord
Clinical importance of the inguinal canal
potential weakness in the abdominal wall, and thus a common site of herniation
What is the purpose of the inguinal canal?
serves as a pathway by which structures can pass form the abdominal wall to the external genitalia.
Anterior wall of the inguinal canal:
aponeurosis of the external oblique, reinforced by the internal oblique muscle laterally
Posterior wall of inguinal canal
transversalis fascia
Roof of inguinal canal
transversalis fascia, internal oblique, and transversus abdominis
Floor of inguinal canal
inguinal ligament (a ‘rolled’ portion of the external oblique aponeurosis)
Superolateral border of inguinal triangle
inferior epigastric vessels
Medial border of inguinal triangle
rectus abdominis m., lateral border
Inferior border of inguinal triangle
inguinal ligament
Abdominal cavity
the major part of the abdominopelvic cavity, bounded by the thoracic diaphragm and the pelvic inlet. It includes both the peritoneal cavity and the retroperitoneal space.
The abdominal cavity is bounded by the:
the diaphragm and the pelvic inlet
Pelvic Inlet
anteriorly: symphysis pubis
posteriorly: promontory of sacrum, ala of sacrum
laterally: ileopectineal (arcuate) lines
Peritoneum
serous membrane that investts viscera
-comprised of parietal and visceral peritoneum
Peritoneal Cavity
the part of the abdomen surrounded by periotneum. It is a potential space between the parietal and visceral layers of peritoneum.
Retroperitoneal space
the area behind (posterior to) the peritoneum.
Mesenteries
result from the invagination of intraperiotneal organs into the sac. Connect viscera to the posterior abdominal wall and are very important in that they conduct blood vessels and nerves.
What is the importance of the mesenteries?
conduct blood vessels and nerves
The mesentery of the colon is usually called the:
mesocolon
Greater omentum
attaches to the stomach, drops far down into the abdominal cavity, and comes back up to attach to the transverse colon.
Lesser omentum
connects the stomach to the liver, and its membranous portion is called the hepatograstric ligament
The lesser sac communicates with the greater sac via the
epiploic foramen of Winslow
Intraperitoneal consists of:
- stomach
- part 1 of duodenum
- jejunum, ileum
- cecum, appendix
- transverse colon
- sigmoid colon
- liver, gallbladder
- tail of pancreas
- spleen
Retroperitoneal consists of:
- parts 2,3,4 duodenum
- ascending, descending colon
- rectum
- head, neck, body of pancreas
- kidneys, ureters
- suprarenal gland
- abdominal aorta
- inferior vena cava
Rule of thumb: If it has a mesentery or mesogastrium component it is the:
intraperitoneal
The _____ is a portion of the digestive system connecting the mouth to the stomach, allowing the passage of food for digestion
esophagus
The esophagus descends in the posterior ______ through the ____ _____ of the diaphragm and terminating at the stomach.
mediastinum; esophageal hiatus
The ____ ____ _____ protects the reflux of gastric contents into the esophagus.
lower esophageal sphincter
Gastroesophageal Reflux Disease (GERD)
the retrograde movement of gastric contents across the LES into the esophagus
Hiatal hernia
involves herniation of the esophagus, stomach, or other structures through the esophageal hiatus of the diaphragm
Functions of the stomach:
- receives boluses from the esophagus
- stores and chemically digests boluses into chyme
- absorbs aspirin and alcohol
- secretes chyme into the duodenum
A heavily built hypersthenic individual with a short thorax and long abdomen is likely to have a stomach that is placed _____
high
In people with slender asthenic physique, the stomach is likely to be:
low and vertical
Small intestine comprises the:
- duodenum
- jejunum
- ileum
Duodenum
first part of the small intestine; the widest and shortest part. C-shaped, lies in the upper abdomen near the midline
Jejunum
mostly in the left upper quadrant, comprising about 40% of the total length
Ileum
lies mostly in the right lower quadrant, providing the remaining 60%
Duodenum is divisible into four parts:
- superior
- descending
- inferior
- ascending
Duodenum receives:
- chyme from the stomach-highly acidic
2. secretions from the pancreas and liver/gallbladder
Duodenal ulcers
65% of duodenal ulcers occur in the posterior wall of the superior part of the duodenum within 3 cm of the pylorus
Where do duodenal ulcers typically occur?
posterior wall of the superior part of the duodenum within 3 cm of the pylorus
Occasionally, an ulcer perforates the duodenal wall, permitting the content to enter peritoneal cavity causing:
peritonitis
The large intestine; the longitudinal muscle forms 3 ____ ___, instead of being continuous all the way around.
teniae coli
In the large intestine, the tenia coli are actually shorter than the colon, so viscera forms ____ ____ (bulges)
haustra coli
The surface of the colon has fat-filled tabs, called:
omental appendages
The pancreas is an important endocrine and exocrine gland of the ______
foregut
The endocrine portions of the pancreas
Pancreatic islets
-regulate blood glucose, and secrete into capillaries
The exocrine portions of the pancreas
acinar, and secrete into ducts coalescing into a pancreatic duct, and sometimes an accessory pancreatic duct
4 parts of the pancreas
head-surrounded by duodenum
neck-posterior to pyloris
body- posterior to stomach
tail- anterior to left kidney, oriented towards spleen
The endocrine portions of the pancreas are:
pancreatic islets
The exocrine portions of the pancreas are:
acinar
The ____ pancreatic duct runs the length of the pancreas from tail to head, and terminates in the lumen of the descending duodenum.
main
The main pancreatic duct joins with the common bile duct to form the:
hepatopancreatic ampulla
Both pancreatic ducts and the common bile duct are transmitted through the ____ of the pancreas
head
Fresh bile is produced by the
liver
fresh bile from the liver drains via the:
right and left hepatic ducts
The right and left hepatic ducts join to become the
common hepatic duct
Bile enters the gallbladder via the _______
cystic duct
The common hepatic duct joins the cystic duct to form the
common bile duct
Function of the gallbladder
store and concentrate bile
Cholelithiasis
gallbladder stones (bile concentration leads to stone formation)
cholecystectomy
surgical removal of the gallbladder
Triangle of calot is formed by:
- cystic duct laterally
- the liver superiorly
- common hepatic duct medially
*important in finding cystic artery
In laparoscopic cholecystectomy, ____ artery is stapled before removing gallbladder.
cystic
The ductus venosus allows the umbilical and portal venous blood flows to bypass the
liver microcirculation
The liver receives all blood from the digestive system before it enters the:
Inferior vena cava
Functions of the liver:
- metabolism
- neutralization of waste
- vitamin storage
- mineral storage
- drug inactivation
- phagocytosis and antigen presentation
- synthesis of plasma proteins
- removal of circulating hormones
- removal of antibodies
- synthesis and secretion of bile
The hepatic portal vein which transports blood from:
capillaries of the GI tract
Jaundice results from high levels of ______ in the blood.
bilirubin
How would a tumor in the head of the pancreas relate to jaundice?
-tumors in the head of the pancreas often obstruct the common bile duct, resulting in blockade of the normal bile recycling circuit. This blockade prevents excretion of bilirubin. The accumulation of bilirubin in various tissues, including the skin, causes jaundice.
The portal vein receives drainage from the:
gallbladder, spleen, pancreas, stomach, and small and large intestines
Kidneys, adrenal glands, gonads and diaphragm drain into the
IVC- caval system
The ____ vein forms from the confluence of the superior and the splenic veins.
portal
Portacaval anastomoses
areas where vessels of the portal venous and systemic venous systems communicate
Portal side consists of:
- superior rectal vein
- esophageal veins
- paraumbilical veins
Systemic side consists of:
- middle and inferior rectal veins (to IVC)
- esophageal veins (to azygous vv- SVC)
- subcutaneous veins of anterior abdominal wall (to IVC)
Portocaval anastomoses allow blood to drain through one system (typically caval) if there is ____________ in the other (typically portal)
obstruction/diminished flow/increased pressure
With portal _______, the increased flow of blood through caval veins can lead to dilations called varices.
hypertension
with portal dilation, the increased flow of blood through caval veins can lead to dilations called:
varices
Esophageal varices
submucosal veins in the esophagus bcome dilated
Suggest possible surgical treatments for lowering the blood pressure in the portal system
surgically creating a shunt between the high pressure portal system and the low pressure systemic veins: portocaval anastomosis or splenorenal anastomosis.
What is the cause of ascites and splenomegaly?
The increased pressure in the splenic vein causes engorgement and subsequent enlargement of the spleen.
Pancreatic carcinomas frequently metastasize to the liver, resulting in significant hepatomegaly. Why is the liver a common target for metastasis?
Blood-borne metastases from a pancreatic tumor would enter the portal vein via either the splenic or superior mesenteric vein. All blood in the portal system filters through the liver before entering the inferior vena cava. The liver’s microscopic structure makes it a likely resting place for wandering tumor cells.
