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Abdominal Cavity Flashcards

1
Q

What is the alimentary/GI Tract ?

A

Digestive tube that extends from mouth to anus. (W/in the abdominal cavity).

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2
Q

What is included in the ACCESSORY DIGESTIVE ORGANS?

A

teeth, tongue, salivary glands, liver, gallbladder, pancreas.

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3
Q

What are the embryological division of the GI Tract?

A

Foregut, Midgut, Hindgut

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4
Q

What is the order of Digestion?
(REMEMBER - ALL THESE STEPS CAN GO ON AT THE SAME TIME)

A

Ingestion
- Food goes in mouth
Propulsion
- mvmnt. of food through GI Tract (swallowing and peristalsis)
Mechanical Digestion
- chewing, churning of the food (break it down)
- includes segmentation of intestine
Chemical digestion
- breakdown of carbs, lipids, proteins
Absorption
- absorption of digested end products into blood or lymphatic capillaries
Defecation
- taking a dookie

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5
Q

What is peristalsis?
What part of “the digestive process” is peristalsis including in?
What’s the point of peristalsis?

A

Alternate waves of contraction and relaxation of ADJACENT SEGMENTS muscles in the GI Tract organ walls
Peristalsis is part of propulsion.

Squeeze food from one organ to another. Some mixing of food.

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6
Q

What is Segmentation?
What part of “the digestive process” is segmentation including in?

A

Parallel waves of constriction of NONADJACENT SEGMENTS of the intestines.
Segmentation is part of mechanical digestion.

Mixes food with digestive juices
Moves food over the intestinal wall –> Increases efficiency of nutrient absorption

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7
Q

What are the 2 layers of the peritoneum?

A

Parietal Peritoneum
Visceral Peritoneum

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8
Q

What is unique about the parietal peritoneum? (HINT: Sensitivity)

A

Parietal peritoneum is sensitive to extreme temp, pain, pressure.

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9
Q

What is unique about the visceral peritoneum? (HINT: Sensitivity)

A

Visceral peritoneum is insensitive to touch, heat, cold, and LACERATIONS.

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10
Q

Describe the peritoneal cavity.
Are there any organs within peritoneal cavity?
Is there fluid in the Peritoneal cavity?

A

POTENTIAL SPACE between parietal and visceral peritoneum. –> NO ORGANS

Peritoneal fluid is in the peritoneal cavity

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11
Q

Describe the peritoneal ligament.

A

DOUBLE LAYER OF PERITONEUM. –> connects one organ to another OR one organ to abdominal wall.
Neuro-vasculature runs through the peritoneal ligament, omentum, or mesentary.

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12
Q

What are the 2 classes that GI organs can be classified into?

A

Intraperitoneal organs
Retroperitoneal organs

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13
Q

What organs are included in the Intraperitoneal organs?
Are the intraperitoneal organs covered with visceral peritoneum?
Are intraperitoneal organs moving?

A

Liver, spleen, stomach, 1st part of duodenum, jejunum, ileum, cecum, vermiform appendix, transverse colon, sigmoid colon

Intraperitoneal organs are ALMOST COMPLETELY COVERED w/ visceral peritoneum.

YES THEY ARE MOVING

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14
Q

What organs are included in the Retroperitoneal organs? (POSTERIOR to peritoneal cavity)
Are the Retroperitoneal organs covered with peritoneum?
Are retroperitoneal organs moving?

A

Abdominal esophagus, Pancreas, 2-4th parts of duodenum, ascending colon, descending colon, rectum, kidneys, suprarenal glands, bladder, aorta, IVC AND SVC, kinda reproductive structures

Partially covered with parietal peritoneum.

STUCK IN SPACE (NOT MOVING). (located in POSTERIOR ABDONIMAL WALL)

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15
Q

What is the falciform ligament?
What comes off of it?
What does it divide

A

Extends from liver to upper anterior abdominal wall.
Encloses round ligament of liver (ligamentum teres).
Divides SUBPHRENIC RECESS (space between anterior part of liver and diaphragm) into right and left sides.
Ex: Peritoneal Ligament

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16
Q

What is the round ligament (ligamentum teres) ?

A

Remnant of umbilical vein.
Comes off of the falciform ligament.
Ex: Peritoneal Ligament

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17
Q

Where is the BARE AREA?
What ligament demarcates (sets it’s boundary) it?
What are the lateral most extensions of the ligaments called?

A

Bare area is an area on the liver against the diaphragm.
Coronary ligaments demarcate the bare area
Right Triangular Ligament, Left Triangular Ligament
NO PERITONEUM in bare area

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18
Q

What is the space inferior to the liver but anterior to the right kidney?

A

Hepatorenal recess (Morrison Pouch)

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19
Q

What is an OMENTUM?
What are the 2 kinds?

A

An omentum is double-layered extension of peritoneum.
Greater and Lesser omentum.

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20
Q

What does the Lesser omentum connect?
What 2 ligaments is divided into?

A

Connects the lesser curvature of the stomach and 1st part of duodenum (superior portion) to the liver.
Divided into hepatogastric ligament and the hepatoduodenal ligament.

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21
Q

Where is the Portal triad found?
What is found within the portal triad? (3 components)

A

Portal triad is found within the hepatoduodenal ligament.
Hepatic PROPER artery, portal vein, and Common bile duct are found within portal triad. (Portal vein is found underneath the other two.

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22
Q

What does the greater omentum connect.
What parts make up the greater omentum? (3)
What is the function of the greater omentum?

A

Extends down as apron from greater curvature of stomach and comes back to meet transverse colon.

3 Parts making up the greater omentum
- Gastrocolic ligament (Connects stomach to colon)
- Gastrosplenic ligament (connects spleen to stomach at the greater curvature)
- Gastrophrenic ligament (Connects stomach to diaphragm)

Greater omentum senses inflammation and delivers leukocytes to the site.

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23
Q

What ligament connects the spleen to the stomach?
What ligament connects the spleen to the left kidney?

A

Spleen is connected to stomach by gastrosplenic ligament. (@ greater curvature of stomach)
Spleen is connected to left kidney via splenorenal ligament.

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24
Q

What vessels course through the gastrosplenic ligament?

A

Short gastric vessel
LEFT gastro-omental vessel

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25
What artery and vein course through the splenorenal ligament?
Splenic artery Splenic vein
26
What is a mesentery
Mesentery is simply 2 layers of peritoneum
27
What is "THE MESENTERY" ?
mesentery of the small intestine (begins at root of the mesentery)
28
What is the mesentery of the transverse colon called? (top of stomach area)
Transverse mesocolon
29
What is the mesentery of sigmoid colon called? (Towards the bottom left)
Sigmoid mesocolon
30
What is the mesentery of the appendix called? (Towards bottom right)
Mesoappendix
31
What sacs is the peritoneal cavity divided into?
Greater sac and Lesser sac
32
What is the greater sac? What are the 2 compartments of the greater sac? What divides the greater sac into 2 compartments?
Large space between anterior abdominal wall and the internal organs. Supracolic compartment and infracolic compartment Transverse mesocolon divides the greater sac
33
What is the lesser sac? How do you get into the lesser sac?
Smaller space between posterior stomach and the anterior pancreas. Pass through omental foreman (foramen of winslow). --> This is one way for surgeons to get access to the pancreas.
34
What divides the infracolic compartment? (Remember this is 1/2 of the compartments of the greater sac) What are the 2 divisions?
Root of THE MESENTERY (mesentery of small intestine) divides the infracolic compartment into 1. Right infracolic space 2. Left infracolic space
35
How does the supracolic and infracolic compartments communicate with each other? (Part of greater sac)
They communicate through the parocolic gutters (Left and Right)
36
What is included in the foregut? What develops in association with foregut? But not derived from foregut.
Esophagus, stomach, 1st and 2nd part of the duodenum, liver, gallbladder, and pancreas. Spleen develops in association with the foregut. spleen is NOT derived from the foregut
37
How does the foregut and spleen receive arterial blood?
Celiac trunk and its branches.
38
What innervates the foregut?
Greater Splanchnic Nerves (T5-T9 sympathetics) Anterior Vagal Trunk nerves (CN 10 parasympathetics)
39
What are the 3 regions of the esophagus? Where does vertebral level does it start and extend to?
Cervical esophagus Thoracic esophagus Abdominal esophagus Extends from vertebral lvl C6 --> T11 Top 1/3rd --> striated muscle Mid 1/3rd --> skeletal and smooth muscle Bottom 1/3rd --> smooth muscle
40
What are the 3 areas of esophageal constrictions?
Upper constriction (C6) - due to Cricopharyngeal muscle (where pharynx and esophagus meet) Middle Constriction (T4/T5) - at level of carina Lower constriction (T10) - at level of diaphragm
41
What is Zenker's diverticulum? (Hint - diverticulum means abnormal sac) What's the treatment?
Diverticulum (abnormal sac) of the pharynx just above/superior to the cricopharyngeus muscle Leads to abnormal sac that can trap food or liquids. Barium Swallow Eval Endoscopic Fix
42
What is Barrett's Esophagus? Where does it normally occur? Why can it be dangerous?
Cells lining esophagus change abnormally Stratified squamous epithelium --> simple columnar epithelium Correlation between Barret's esophagus and esophageal adenocarcinoma.
43
Where does the distal/abdominal esophagus emerge from the esophageal hiatus? Esophageal hiatus --> opening in diaphragm where esophagus passes from the thoracic to abdominal cavity. What 2 trunks pass through the esophageal hiatus along w/ esophagus?(Hint: Vagus nerve CN 10)
T10 Anterior and posterior VAGAL trunks course through esophageal hiatus and the esophagus
44
What is the Z-line (esophagogastric junction)? What level do we see this line?
Z-lines mark the ends of the esophagus at T11. This is where we see the division of the stratified squamous epithelial cells and the simple columnar cells of the stomach. (Esophageal mucosa --> gastric mucosa) Right above this line is the inferior esophageal sphincter.
45
What is a hiatal hernia? (Hiatal Hernias are examples of diaphragmatic hernias) What are the 2 kinds of hiatal hernias?
Hiatal hernias are protrusions of part of the stomach go through the esophageal hiatus. 2 kinds of hiatal hernia - paraesophageal hernia - sliding hernia
46
What is a paraesophageal hernia? (10% of all hernias)
Stomach fundus (upper part) passing superiorly into thoracic cavity
47
What is a sliding hernia? (90% of all hernias)
Abdominal portion of esophagus and cardia and fundus of stomach slide superiorly through the esophageal hiatus. Can causes some regurgitation of stomach content into esophagus.
48
What is Gastroesophageal reflux disease (GERD)?
Abnormal relaxation of the LES (relaxes too much) --> stomach contents passing back up through the esophagus
49
What is the MOST DILATED REGION OF THE GI TRACT?
Stomach
50
What are the 4 regions of the stomach?
CARDIAC FUNGUS BODY PYLORIC REGION
51
What are the 2 curvatures of the stomach?
Lesser curvature Greater Curvature
52
What are the 2 notches of the stomach?
Cardiac notch (Near the fundus and cardiac regions) Angular Notch (near where the body ends and the pyloric region begins)
53
What are the 3 parts of the pyloric region?
Pyloric antrum (closest to body) Pyloric canal Pyloric sphincter
54
Where does the stomach begin and where does it end?
Begins at T11 Ends at pyloric valve (L1)
55
Vagus nerve (parasympathetics) innervate all of the GI tract (except hindgut) and the STOMACH of course. If they are not functioning, what can happen? What operation will fix it?
If vagus nerves and their trunks (anterior and posterior vagal trunks) aren't functioning --> parietal cells won't secrete HCL and therefore stomach can't do its job correctly. VAGATOMY will be performed. --> targets anterior or posterior vagal trunks as they are start descending onto stomach surface The more distal the branch that is severed, the less affect it will have on the foregut and midgut function.
56
What procedure will reduce the amount of food a person can consume? (intended for them fluffy boys haha)
GASTRIC BYPASS SURGERY (Roux-en-Y procedure) - Surgeon staples the stomach to form a small (useable) and large (unused) pouch - Small stomach pouch is then attached to jejunum - Remainder of
57
What is another procedure that can be used to reduce the size of the stomach and limit the amount of food a fluffy person can consume?
LAP-BAND PROCEDURE - wrap an inflatable silicone device around the upper part of the stomach - fill band with saline --> reduces the size of stomach
58
What are the 4 stomach variations?
Hypertonic Orthotonic Hypotonic Atonic
59
What is on the internal stomach? What is its function? What forms it?
Gastric folds (RUGAE) Functions to increase surface in the stomach. GASTRIC MUCOSA form gastric folds (rugae)
60
What forms temporarily during swallowing? (Hint: it's between the gastric folds along the lesser curvature?
Gastric canal (furrow)
61
The pyloric sphincter links what two organs? What it do tho?
Stomach and duodenum (of small intestine) Controls rate of chyme going into the duodenum of small intestine
62
What causes pyloric sphincter CONSTRICTION?
SYMPATHETICS
63
What causes pyloric sphincter DILATION?
PARASYMPATHETICS
64
What is the stomach mucosa cells covered with? What do they open into?
Stomach mucosa cells are covered with GASTRIC PITS. They open into GASTRIC GLANDS.
65
What 2 regions of the stomach primarily have MUCOSAL CELLS?
CARDIAC REGION OF STOMACH (NEAR ESOPHAGUS) PYLORIC REGION (NEAR DUODENUM OF SMALL INTESTINE)
66
What 3 types of secretory cells do the gastric glands of the FUNDUS and BODY HAVE?
Mucous neck cells Parietal cells Chief Cells
67
What are 2 secretory cell types in the stomach?
Enteroendocrine cells (Mostly found in pyloric region of stomach) Undifferentiated stem cells
68
Function of mucous neck cell?
secretes MUCOUS
69
Function of parietal cells?
Secrete HCL and gastric intrinsic factor Absorbs that vitamin B12 --> manufacture RBCs (needed to form RBCs)
70
Function of Chief Cells?
Secrete PEPSINOGEN (when activated (pepsin) --> breaks proteins down
71
Function of Enteroendocrine Cells? Where are they found mostly?
release GASTRIN (tells parietal cells to make HCL) Found mostly in PYLORIC REGION
72
Function of undifferentiated Stem Cells?
Replace epithelial lining (every 3-7 days)
73
What are 4 portions of the duodenum?
Superior Portion (1st part of duodenum) Descending Portion (2nd part) Horizontal Portion (3rd part) Ascending Portion(4th part)
74
What 2 portions of the duodenum make up the FOREGUT OF THE DUODENUM?
Superior (1st) and descending (2nd) portion
75
What level is the SUPERIOR (1ST) PORTION OF DUODENUM at? What's another name for it? What suspends it? (HINT --> makes it intraperitoneal
L1 DUODENAL CAP or AMPULLA HEPATODUODENAL LIGAMENT suspends superior portion of duodenum.
76
What level is the descending (2nd) portion of the duodenum at? What drains into the descending portion of the duodenum?
L2-L3 Bile duct and Main Pancreatic Duct via HEPATOPANCREATIC AMPULLA (of vater)
77
Are there descending, horizontal, and ascending portions (2nd-4th) of the duodenum part of the intra or retroperitoneal cavity?
RETROPERITONEAL (bcuz they're posterior to parietal peritoneum)
78
What bacteria is associated with open lesions or ulcers involving the stomach or duodenum? What does it cause?
H.pylori Gastric acid production is HIGH even if meal isn't consumed or digested.
79
What does high acidity to do the stomach? (ex: from open lesions or ulcers - gastric acid)
HIGHER THAN NORMAL ACIDITY overwhelms bicarbonate --> stomach and duodenum mucosal cells are vulnerable (oh no) H.pylori then erodes mucosal lining --> any acid or digestive enzymes secreted can now go an erode the stomach
80
What can the POSTERIOR GASTRIC ULCERS erode? Where they mostly located at?
They can erode the splenic artery Superior border of pancreas (is where splenic artery is found eroded).
81
What can DUODENAL ULCERS erode? Where they mostly located at?
They are mostly located at SUPERIOR DUODENUM (Duodenal Cap) They can erode GASTRODUODENAL ARTERY. --> lead to hemorrhaging
82
What are the 4 lobes of the LIVER?
Right Lobe Left lobe Caudate Lobe Quadrate lobe (closest to gallbladder)
83
What passes through the PORTA HEPATIS on the liver?
Portal vein Hepatic arteries (w/ their autonomics) Hepatic ducts
84
What is included in the "LEFT LIVER" ?
Left lobe, caudate lobe, and MOST of quadrate lobe (HEPATIC SEGMENTS 1-4)
85
What is included in the "RIGHT LIVER" ?
Right lobe and rest of quadrate lobe (HEPATIC SEGMENTS 5-8)
86
What sends poorly oxygenated blood, but high-nutrient blood to the liver?
Portal vein
87
What send well-oxygenated blood to the liver?
Hepatic Artery
88
What do the HEPATIC SEGMENTS contain? (segments of the liver)
Each hepatic segment contains tributary of portal vein, branch of hepatic artery and hepatic duct, and lymphatic drainage
89
What veins drain the hepatic segments? What do these veins drain into?
Right hepatic vein Left hepatic vein Intermediate hepatic vein These 3 veins drain into the IVC.
90
What level does the liver extend from ? (Start and end)
Liver goes from T7 - L2/L3
91
What is LIVER CIRRHOSIS? What can cause it? What can it lead to? (HINT: decreasing blood flow of a major vein)
Liver cirrhosis is when the liver doesn't function properly. Can be caused by alcohol abuse, chronic HEP B and C, fatty liver. Can cause portal hypertension (increased portal vein hypertension) --> increased blood flow RESISTANCE --> esophageal varices and splenomegaly (enlarged spleen)
92
Removing the right or left lobe of the liver is called? (hepatic lobe) Removing a segment of the liver is called?
Lobectomy Segmentectomy
93
Where is bile produced? Where is bile stored?
Bile is produced in the liver. Bile is stored in the gallbladder.
94
What are the 3 regions of the gallbladder?
Fundus (just past liver) Body (where bile is stored) Neck (continuous with cystic duct)
95
Where level is the BODY of the gallbladder found?
L1
96
When the cystic duct meets the common hepatic duct (formed by right and left hepatic ducts), what is it called?
COMMON BILE DUCT = cystic duct + common hepatic duct
97
The procedure to remove the gallbladder is called? When do we do it?
Cholecystectomy (usually done LAPROSCOPICALLY) We do it for cholecystitis, biliary colic (spastic pain from cystic duct), gallbladder cancer.
98
Inflammation of the gallbladder is called? Gallstones located in the gallbladder are called? Gallstones located in the cystic or bile ducts are called?
Cholecystitis Cholelithiasis Choledocholithiasis
99
What cells secrete the stored bile?
Hepatocytes (aka liver cells)
100
What order does bile pass through? (biliary system) Remember that what we see in lab is just the major duodenal papilla!!
Hepatocytes --> bile canaliculi --> interlobular bile duct --> left and right hepatic duct --> common hepatic duct --> common bile duct --> hepatopancreatic ampulla of vater (wrapped by sphincter of oddi) --> major duodenal papilla --> descending duodenum
101
What are the 5 regions of the pancrease?
Uncinate process Head Neck Body Tail
102
What level do you find the pancreas at?
L1/L2
103
Where does the MAIN PANCREATIC DUCT begin in the pancreas? What other duct does it meet with?
Begins in the tail. Main pancreatic duct merges with the common bile duct --> Forms the hepatopancreatic ampulla (of vater)
104
What is inflammation of the pancreas called?
Pancreatitis
105
What is the most common cause of ACUTE PANCREATITIS?
presence of gallstones in the hepatopancreatic ampulla
106
What is the most common cause of CHRONIC PANCREATITIS?
heavy alcohol use (alcoholism)
107
Why is PANCREATIC CANCER hella sad? What is the most common form of pancreatic cancer?
Bcuz it's usually found late-stage. Pancreatic adenocarcinoma. - affects exocrine portion of pancreas
108
What level is the SPLEEN found at? (start and end at) Between what ribs is the spleen found?
T10-L1 Spleen is found between the LEFT 9th-11th ribs.
109
What area of the spleen is NOT surrounded by peritoneum? What artery and vein courses through this area?
The HILUM of spleen. Splenic artery and Splenic Vein
110
Enlargement of the spleen is called? What's the treatment for enlarged spleen?
Splenomegaly (If spleen extends past L1 --> you got a SPLENOMEGALY Splenectomy
111
What is peritonitis? What can cause peritonitis?
Peritonitis is inflammation of the peritoneum. Bacterial contamination occurring after a trauma or open incision can cause fecal matter to enter the peritoneal cavity.
112
What is excess fluid in the peritoneal cavity called?
Ascites
113
What provides a pathway for ascites (ascitic fluid) to pass through? (spread infection)
Paracolic gutters
114
Where does the lymph of the abdominal region drain from and into?
Abdominal lymph goes through the left gastric lymph node and into the celiac lymph node.

GI ANAT (7 decks)

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