Abdominal Cavity Flashcards by Myka Masters

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

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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

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Right lower quandrant contains:

cecum, appendix, most of ileum, inferior part of ascending colon, right ovary, right uterine tube, right ureter, right spermatic cord

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Left lower quadrant contains:

Sigmoid colon, inferior part of descending colon, left ovary, left uterine tube, left ureter, left spermatic cord

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Clinical importance of the inguinal canal

potential weakness in the abdominal wall, and thus a common site of herniation

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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.

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Anterior wall of the inguinal canal:

aponeurosis of the external oblique, reinforced by the internal oblique muscle laterally

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Posterior wall of inguinal canal

transversalis fascia

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Roof of inguinal canal

transversalis fascia, internal oblique, and transversus abdominis

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Floor of inguinal canal

inguinal ligament (a ‘rolled’ portion of the external oblique aponeurosis)

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Superolateral border of inguinal triangle

inferior epigastric vessels

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Medial border of inguinal triangle

rectus abdominis m., lateral border

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Inferior border of inguinal triangle

inguinal ligament

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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.

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The abdominal cavity is bounded by the:

the diaphragm and the pelvic inlet

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Pelvic Inlet

anteriorly: symphysis pubis
posteriorly: promontory of sacrum, ala of sacrum
laterally: ileopectineal (arcuate) lines

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Peritoneum

serous membrane that investts viscera

-comprised of parietal and visceral peritoneum

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Peritoneal Cavity

the part of the abdomen surrounded by periotneum. It is a potential space between the parietal and visceral layers of peritoneum.

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Retroperitoneal space

the area behind (posterior to) the peritoneum.

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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.

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What is the importance of the mesenteries?

conduct blood vessels and nerves

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The mesentery of the colon is usually called the:

mesocolon

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Greater omentum

attaches to the stomach, drops far down into the abdominal cavity, and comes back up to attach to the transverse colon.

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Lesser omentum

connects the stomach to the liver, and its membranous portion is called the hepatograstric ligament

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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:

1. 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.