Abdominal Cavity Flashcards
common bile duct
formed by
cystic duct from gall bladder
hepatic duct from liver
parts of stomach
superior= fundus
cardiac portion (to the R of fundus portion, small)
body
inferior= pylorus
lesser curvature = medial
greater curvature = lateral
Left to right
Superior duodenum
Horizontal duodenum
Ascending duodenum (first part of sm intestine)
Left to Right
Pancreas
Head > body > tail
Deep to stomach
greater omentum
aka fatty apron
derived from dorsal mesentary (even tho it’s ventral)
smobile parts of large intestine
transverse
sigmoid ( > rectum > anus)
rest of large intestine attached to body wall
flow thru large intestine
structurally
ascending colon
right/hepatic colic flexure
transverse
left/splenic colic flexure
descending colon
sigmoid colon
small intestine
structures
duodenum
jejunum
ileum
meeting of ileum and ascending colon
caecum
pouch like
vermiform appendix comes off
large intestine
structure
taenia coli= muscular band thru middle
haustra= bubbles/pouches separated by semilunar compartments
epiploic appendices = fat pouches hang off
intraperitoneal organs
mesenteric relations
stomach, first and last duodenum, gall bladder, transverse colon, jejunum, ileum, sigmoid colon, appendix
only attched to body wall via dorsal mesentary move freely
secondarily retroperitoneal organs
mesenteric relations
ascending and descending colon, pancreas, middle duodenum
started mobile then got stuck behind body wall
pussy cat dolls
primary retroperitoneal organs
aorta, kidneys
thoracic esophagus, rectum, anal canal
started and stayed behind body wall
at the beginning and end of digestive tract
everything b/t started free
gut divisions
foregut
midgut
hindgut
foregut
esophagus > 1st part duodenum
aka initial digestion
blood from celiac trunk
midgut
duodenum > 2/3 transverse colon
aka most of intestines
blood from superior mesenteric artery
hindgut
last 1/3 transverse colon > anus
end of digestion
blood from inferior mesenteric artery
branches of celiac trunk
foregut
to the R: common hepatic (liver)
to the L: L. gastric (lesser curve) and splenic (spleen)
branches of common hepatic
foregut
gastrodeuodenal (behind stomach and duo) > superior pancreaticoduodenal (pan and duo) and R. gastro-omental (greater curver)
R gastric (lesser curve)
proper hepatic > R and L hepatic
R hepatic > cystic
branches from splenic artery
L. gastro-omental (greater curve)
foregut anastomoses
R and L gastrics in lesser curve
R and L gastro-omental in greater
branches of superior mesenteric
midgut
to the L: lots of intestinal arteries
to the R: inferior pancreaticodeodenal, R colic (lg intestine), marginal (more lateral), middle colic, ileocolic (down to junction)
vasa rectae: straight vessels, off of marginal and intestinal
arcades: loops off of intestinal
marginal very important for collateral circulation
branches of inferior mesenteric
hindgut
L colic
sigmoid
superior rectal
L colic joines with marginal
rectum/anal circulation
inferior, middle rectal arteries from internal iliac artery
for collateral circulation
general portal vein flow
portal = 2 capillary beds
1. gut (cap 1)
2. liver (cap 2)
3. heart
hepatic portal vein flow
splenic + inferior mesenteric + superior mesenteric >
hepatic portal vein >
hepatic vein >
inferior vena cava >
heart
rectum/anal venous flow
inferior rectal
middle rectal
internal iliac
common iliac (internal + external)
inferior vena cava
alcohol thru rectum not detoxed by liver
hepatic portal tributaries
esophageal
paraumbilical
rectal
retroperitoneal
if backed up = portal hypertension
esophageal varices
build up of venous blood
look like beads
can burst and drown people
rectum hemorrhoids
internal or external to anus
only external from portal hypertension
same thing as varices just called different
caput medusae
build up in umbilical region
looks like snakes under skin
foregut innervations
sympathetics
T5-9
sympathetic chain > greater splanchnic nerve > synapse in celiac ganglia > target organs via branches of celiac trunk
visceral afferent also sympathetic (pressure, chemoreceptor)
foregut innervations
parasympathetic
vagus C10
celiac plexus > celiac trunk follow > synapse in ganglia in gut plexus > short post synaptic fibers > target organ
midgut innervations
sympathetic
T10-T12
sympathetic trunk > lesser splanchnic (10-11) or least splanchnic (12) > synapse @ superior mesenteric ganglion > branches of SMA > organs
midgut innervations
parasympathetic
vagus
SM plexus > SMA branches > synapse @ ganglia in gut plexus > short post syn fibers > target organ
same as foregut
hindgut innervations
sympathetics
L1-2
sympathetic trunk > lumbar splanchnic nerves > synapse @ inferior mesenteric ganglion > IMA branches> target organ
hindgut innervation
parasympathetic
S2-4
pelvic splanchnic nerves > IMA branches > synapse @ ganglia in gut plexus > short post synaptic fibers > target organs
spaces in abdominal cavity
greater sac (taken up by liver)
lesser sac (behind liver and stomach)
epiploic foramen (opening to lesser)
basically all potential spaces since things take up space
lesser omentum
remnant of ventral mesentary
contains 2 ligaments:
1. hepatogastric (liver > stomach)
2. hepatoduodenal (liver > duo)
splenic ligaments
from dorsal mesentary
lienorenal (spleen > body wall)
gastrosplenic (stomach > spleen)
dorsal mesointestine
aka frilly skirt
from dorsal mesentary
connect small intestine > body wall
dorsal mesentary of large intestines
transverse mesocolon
sigmoid mesocolon
dorsal mesocolon (most of attachment for secondary retroperitoneal organs)
liver
structure
right and left lobes split by falciform ligament
ligamentum teres inside falciform
coronary ligament on crown/top
bare area @ superior-posterior portion
bare area target for infections to reach gut cavity
falciform ligament
remnant of ventral mesentary
connects liver to ventral body wall
esophagus
muscular organ to move food
has circlular and longitudinal muscles to squeeze and push down
stomach
functions
- reservoir for food
- digestive process, main
aka mechanically churn food/liquid/saliva
very acidic HCl
secretions digest proteins
propel chyme into duodenum
stomach
structure
circular and longitudinal muscle layers
gastric folds inside to inc surface area when full
superior > inferior:
cardiac zone (closest to esophagus)
gastric and fundic zones
pyloric zone (closest to duodenum)
hiatal hernias
sliding: less severe, just monitor if will slide down into stomach
paraesophageal: stuck above diaphragm in lung cavity, needs surgery
function of small intestine
- mix food w/ dig enzymes and secretions
acid neutralized in duodenum, fats digested, carbs digested with pancreatic amylase - absorbs nutrients/electrolytes/water
iron @ duodenum, vitamin B12 in ileum - moves digesta to colon
small intestine
structure
ampulla of duodenum w/ Brunner’s glands for acid neutralization
circular folds/valves of kerckring to inc SA
papillas- minor (pancreas only) and major (bile and pancreas secretions)
jejunum
small intestine
reddish from inc blood flow
thicker walls
less fat that does NOT lay on intestines
-plicae circulares/valves of kerckring to inc SA are larger and more freq
arcades (loopy) and vasa rectae longer
ileum
small intestine
pinkish
thinner walls
more fat that lays on intestines
plicae circulares sparser
many arcades and shorter vasa rectae
has lymphoid nodules
large intestine
function
absorb water and electrolytes
produces bacterial digestion (vitamin K) and biotin (hair production)
moves/stores/evac stool
appendix
appendicitis
can variate (if too high mistaken for gall bladder issue) or situs inversus
rectum
where feces stored before evac
muscles: internal anal spincter (involuntary)
external anal sphincter (3 parts) voluntary
pectinate line: where endo/ectoderm fuse
ectoderm (below line) has nociception but not endoderm (above line) so might not feel problems
liver
main functions
protein synthesis
bile production/secretion
carb metabolism/storage
detoxification
is highly regenerative
liver
lobes
left lobe
right lobe
caudate lobe (next to IVC)
quadrate lobe (b/t gall bladder and falciform lig)
bare area (no visceral mesentary)
porta hepatis
contents
hepatic portal vein + proper hepatic artery + common bile duct
portal triad
gall bladder
function
bile storage/concenration/release
doesn’t synthesize anything
bile flow
gall bladder
cystic duct
common bile duct
sphincter of oddi (gets clogged w/ stones)
major duodenal papilla
deuodenum
gall stones
treat by removing gall bladder
location matters: if in cystic duct bile still from liver, if in common bile duct then block all bile flow
pancreas
function
- synthesize/secrete enzymes for breakdown organic parts of food
juice (proteases, lipases, nucleases, amylase) - pancreatic juices delivered to duodenum
- endocrine function produces/regulates via blood stream
insulin, glucagon
pancreatic ducts
main pancreatic duct (body and tail)
accessory pancreatic duct (head)
drain to sphincter of oddi w/ common bile
spleen
functions
- produce mature WBCs in response to antigens
- secrete antibodies
- destroy senescent RBC
- recycle chemicals from destroyed RBC
- reservoir and deploy undifferentiated monocytes
no digestive function, from mesoderm instead of endoderm
kidney
function
- remove excess water, salts, blood wastes (nitrogenous)
- return nutrients to blood
- secrete hormones to regulate BP and production of RBCs
kidney
position
spans T12 to L3
R kidney is lower than L bc of liver
kidney fat
pararenal: outside, behind parietal peritoneum
perirenal: w/i renal fascia
fibrous renal capsule deep to perirenal fat
contents of kidney hilum
- renal arteries, can have many
-inferior suprarenal branch off - renal vein
- renal pelvis > ureter
kidney lobes
structure
cortex on outside
medulla /pyramids connecting to
renal papilla
minor calicies from each lobe drain to major calices drain to renal pelvis
kidney innervation
sympathetics T10-L1
some sources say no parasympathetics
suprarenal/adrenal gland
outer cortex = corticosteroids, androgens
inner adrenal medulla = fight or flight, norepinephrine and epinephrine
suprarenal gland
blood supply
superior suprarenal from inferior phrenic
middle suprarenal from aorta
inferior suprarenal from renal artery
diaphragm openings
- caval for IVC
- esophagus and vagal trunks
- aorta and thoracic duct
I 8 (ate) 10 eggs at 12 (noon)
diaphragm
other muscles
central tendon from septum transversum
right crus- wraps around esophagus
left crus- attaches to central tendon
diaphragm innervation
motor: phrenic C3,4,5
sensory: phrenic, intercostal T5-11, subcostal T12
diaphragm
ligaments
lateral arcuate= over quadratus lumborum
medial arcuate= arches over psoas major and minor
median arcuate = arch over aorta
posterior wall muscles
- psoas major
- psoas minor
- quadratus lumborum
- iliacus
psoas major
L1-3
attaches to lesser trochanter of femur
thigh flexion, side flexion
psoas minor
L1
attaches to pubic bone
side flexion
some people don’t have
quadratus lumborum
T12 + L1-4
attaches to iliac crest
back extension aka back bend
iliacus
L2-4
attaches to lesser trochanter femur like psoas major
thigh flexion
stabilize hips in motion
posterior wall innervations
long list
- iliohypogastric L1 (umbilical>ilium)
- iliolinguinal L1 (scrotum/labia)
- genitofemoral L1-2 (cremaster)
-pierces psoas major - lateral femoral cutaneous L2-3 (skin of lateral thigh)
-runs over iliacus - femoral L2-4 (quads/anterior skin thigh)
-lateral/under psoas major, iliacus - lumbosacral trunk L4-5 (no direct innervations, joins with sacral to form sciatic)
- obturator L2-4 (thigh ADductors)
-medial to psoas major
subcostal
innervations
T12
ext. oblique, skin anterolateral abdom wall
iliohypogastric
L1
abdom muscles and overlying skin
iliolinguinal
L1
skin of inguinal and pubic regions
genitofemoral
L1-2
skin below inguinal ligament and cremaster
lateral femoral cutaneous
L2-3
anterolateral skin of thigh
femoral
L2-4
iliacus, hip flexors, knee extensors, skin of ant leg
obturator
L2-4
thigh adductors, skin of medial thigh
lumbosacral trunk
L4-5
becomes part of sciatic nerve
aortic aneurysm
common @ split of common iliac arteries bc cholesterol sticks = pressure build up in aorta
lumbar arteries
off aorta
4 pairs
same as intercostal basically
gonadal artery
off aorta
can be testicular or ovarian
