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DPT Anatomy > Abdominal contents > Flashcards

Abdominal contents Flashcards

1
Q

what makes up the anterior abdominal contents?

A

digestive tract and related organs (foregut, midgut, hindgut)

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2
Q

what makes up the posterior abdominal contents?

A

kidneys, suprarenal glands, neurovascular system

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3
Q

what makes up the foregut and what is its blood supply?

A

abdominal esophagus, stomach, liver, 1/2 duodenum, pancreas, spleen

celiac artery/trunk

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4
Q

what makes up the midgut and what is its blood supply?

A

1/2 duodenum, jejunum, ileum, proximal 1/2 colon

superior mesenteric artery

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5
Q

what makes up the hindgut and what is its blood supply?

A

distal 1/2 colon

inferior mesenteric artery

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6
Q

what happens to the foregut in the 3rd month of development?

A

rotates 90 degrees clockwise

  • left vagus plexus rotates anterior
  • right vagus plexus rotates posterior
  • formation of lesser peritoneal sac happens
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7
Q

what happens to the midgut as it starts to rotate and elongate?

A

turns around the superior mesenteric artery 270 degrees counterclockwise

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8
Q

what happens if the midgut doesn’t rotate all the way?

A 
abnormal alignment of the contents
at only 180 degrees:
- appendix under liver
- pain around McBurney's point
- splanchnic nerves mixed
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9
Q

does the hindgut have rotation?

A

no & elongates slowly

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10
Q

what makes up the abdominal cavity?

A

all contents inn the abdominal wall/diaphragm and pelvic inlet

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11
Q

what makes up the peritoneal cavity?

A

contents in peritoneum

  • visceral peritoneum
  • parietal peritoneum
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12
Q

what is the folding of the visceral peritoneum?

A

greater and lesser omentum (ligament)

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13
Q

where is the greater omentum?

A

from the greater curvature of stomach to transverse colon

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14
Q

where is the lesser omentum?

A

from lesser curvature of stomach to liver

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15
Q

what is the folding of the parietal peritoneum made of?

A

mesentery, mesocolon, falciform ligament

  • attaches organs to abdominal wall
  • provide neurovascular bundle
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16
Q

what are the intraperitoneal organs referring to?

A

structures within the peritoneum / covered by visceral peritoneum

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17
Q

what organs are intraperitoneal organs? Are they fixed or mobile?

A

esophagus, stomach, jejunum, ileum, caecum, appendix, transverse colon, sigmoid colon, spleen

organs are mobile

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18
Q

what organs are primary retroperitoneal organs? are they fixed or mobile?

A

distal rectum, kidneys, ureters, adrenal glands, IVC & AA, testes before descending to scrotum in males

organs are fixed

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19
Q

what organs are secondary retroperitoneal? are they fixed or mobile?
what makes them secondary organs?

A

they are spun out of the visceral peritoneum

  • 3/4 duodenum
  • pancreas (tail in hilum of spleen)
  • ascending colon
  • descending colon
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20
Q

where is the greater peritoneal sac located?

A

with intraperitoneal organs

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21
Q

where is the lesser peritoneal sac located?

A

recess bounded by greater and lesser omentum

empty

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22
Q

what is the omental foramen?

A 
connecting the greater sac and lesser sac
hepatoduodenal ligament is located here
- made of:
1. hepatic artery proper
2. hepatic portal vein
3. common bile duct
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23
Q

why is the squamocolumnar junction significant?

A

transition from squamous (ectoderm) to columnar (endoderm)

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24
Q

what causes GERD (heart burn)?

A

malfunction of the squamocolumnar junction

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25
Q

what is a partial splenectomy?

A

reserves partial functions and supports the stomach

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26
Q

what are the functions of the stomach?

A

digestion
limited absorption (meds, alcohol, nicotine)
intrinsic factor for B12 absorption - makes more red blood cells
- lipid and fat soluble vitamins are absorbed here too

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27
Q

what is anemia common in vegetarians?

A

they have limited vitamin B12 from their food which limits the amount of red blood cells created

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28
Q

what 2 additional lobes are found on the posterior side of the liver?

A

caudate and quadrate (medial to IVA and gallbladder)

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29
Q

what are the 4 ligaments of the liver that divide it into right and left lobes?

A

falciform ligament
coronary/left triangular ligaments
ligament teres
ligamentum venosum

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30
Q

what are the functions of the liver?

A

nutrient storage
detoxification (filter out nutrients)
secret bile –> drain to gallbladder

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31
Q

what is the difference between the portal vein and the hepatic vein?

A

portal vein drains into the liver
- nutrient enriched and deoxygenated

hepatic vein drains into IVC

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32
Q

what are the two blood vessels that flow into the liver? lungs?

A 
liver:
portal vein (deoxygenated) - acts like artery
hepatic artery (oxygenated)
lungs:
pulmonary artery (deoxygenated)
bronchial artery (oxygenated)
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33
Q

what is the venous drain out of the liver? lungs?

A 
liver:
hepatic vein (deoxygenated)
lungs:
pulmonary vein (oxygenated) - oxygenated like artery
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34
Q

what does the gallbladder store?

A
  • concentration of bile from common hepatic duct
  • leaves organic components only
  • digestion and absorption of lipids/lip-soluble vitamins
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35
Q

how does a gallstone form and what may need to happen if symptoms show?

A

deposits of bile (highly organic components)

cholecystectomy may happen - removal of gallbladder

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36
Q

what is the blood supply for the gallbladder?

A

cystic artery from right hepatic artery

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37
Q

what is the innervation of the gallbladder?

A

visceral motor

30-80% is innervated by the phrenic nerve - pain around shoulder and back

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38
Q

what are the functions of the pancreas?

A

endocrine: insulin and glucagon (secreted by beta and alpha cells)
exocrine: digestive enzymes

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39
Q

what is unique about the blood supply of the pancreas?

A

endocrine glands have complicated blood supply

multiple anastomoses

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40
Q

how is the spleen derived?

A

mesoderm derived

develops with endoderm-derived stomach into peritoneal organ

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41
Q

what is Kehr’s sign?

A

referred left shoulder pain - ruptured spleen
thin and easily lacerated
bleeding

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42
Q

what is the red pulp for in the spleen?

A

hematopoietic - regenerating red blood cells

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43
Q

what is the white pulp for in the spleen?

A

immunity
- follicles
- germinal centers
reproduction of WBCs

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44
Q

what are the functions of the spleen?

A

center of immune response
surveillance (24/7)
mesenteric lymph nodes come from the spleen

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45
Q

what is the importance of the lacteal duct?

A

it absorbs fat

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46
Q

what 2 parts of the duodenum are part of the foregut?

A

1 - superior
- from pyloric canal/pyloric sphincter
2 - descending
- major and minor duodenal papilla for bile and digestive enzymes

47
Q

what 2 parts of the duodenum are part of the midgut?

A

3 - horizontal

4 - ascending (duodenojejunal junction/flexure)

48
Q

what is the ligament of treitz and where is it located?

A
  • piece of diaphragm muscle from esophageal hiatus, R crus

- suspending 3/4 duodenum and duodenojejunal flexure

49
Q

what is the starting blood supply for the duodenum and where does it drain into?

A

blood supply: gastroduodenal branch from common hepatic artery
drains into: superior mesenteric vein

50
Q

at what level is the superior mesenteric artery?

A

L1

51
Q

at what level is the inferior mesenteric artery?

A

L3

52
Q

which artery is embedded in the jejunum and ileum?

A

superior mesenteric artery

53
Q

which artery is embedded in the transverse colon?

A

middle colic artery

54
Q

which arteries are embedded in the sigmoid colon?

A

sigmoid and superior rectal arteries

55
Q

which artery is embedded in the appendix?

A

appendicular artery

56
Q

why can it be difficult to perform an appendectomy sometimes?

A

appendix can swim around the mesoappendix

in 180 degrees rotation during development it may not situate to the correct spot

57
Q

how are the intraperitneal organs attached to the abdominal wall? fixed or highly mobile?

A

mesentery proper

highly mobile

58
Q

how long is the midgut: jejunum and ileum?

A

5-10 m

59
Q

what is the difference between the jejunum and ileum?

A

jejunum: less layers of arcades and longer vasa recta. mainly absorbs nutrients
ileum: less circular folds

60
Q

where does the midgut stretch from?

A

ileocecal junction to 2/3 transverse colon

61
Q

where does the hindgut extend from?

A

distal 1/3 transverse colon to anus

62
Q

what is the total length of the colon?

A

2 meters

63
Q

what is tenia coli?

A

3 separate longitudinal ribbons of smooth muscle on the outside of the colon

64
Q

what is haustra?

A

segmentation of the wall

semilunar folds inside

65
Q

what is the function of the colon?

A
  • limited absorption: water, salt
  • symbiosis
  • dehydrate digested food residues to stool
66
Q

what does constipation do to the colon?

A

compress obturator nerve and induce right inner, mid thigh numbness/tingling

67
Q

which kidney is higher and why?

A

left kidney is higher.

right kidney is lower due to the liver

68
Q

what kind of capsule does the kidneys have?

A

thick capsule/outer layer

69
Q

what is in the hilum of the kidney?

A

renal artery
renal vein
renal pelvis

70
Q

what are the functions of the kidneys?

A

urine production
electrolyte and water balance
regulate blood pressure: renin-angiotensin system
hematopoiesis: cytokine erythropoietin (EPO)

71
Q

at what level is the renal artery?

A

L2

72
Q

what is an abdominal aorta aneurysm?

A

ballooning of the abdominal aorta

73
Q

what is nutcracker syndrome?

A

left renal vein runs between superior mesenteric artery and aorta.
L renal vein impinged is nutcracker syndrome

74
Q

where is the sympathetics in the kidney?

A

blood vessel smooth muscles

75
Q

where is the parasympathetics for the kidneys?

A

ureter - parasympathetic for peristalsis of urine drainage into urinary bladder

76
Q

where does the adrenal glands sit?

A

over the kidneys - no connections

77
Q

what does the adrenal glands do?

A 
regulate metabolism
blood pressure
immune response
stress response
sexual hormones
78
Q

where does the right adrenal gland drain into?

A

IVC directly

79
Q

where does the left adrenal gland drain into?

A

renal vein

80
Q

what important structures are at the T12 level?

A 
aortic hiatus (median arcuate ligament)
celiac trunk: foregut
81
Q

what important structure is at L1, transpyloric plane?

A

superior mesenteric artery: midgut

82
Q

what important structure is at L3?

A

inferior mesenteric artery: hindgut

83
Q

what important structure is at L2?

A

renal artery but can be higher too

84
Q

what is the primary retroperitoneal and descends to the pelvis/scrotum?

A

gonadal artery

85
Q

what important structure is at the division of L4?

A

common iliac artery

86
Q

what important structures merge at L5?

A

inferior vena cava formed by common iliac veins

87
Q

what veins drain directly to the inferior vena cava? Why?

A

right adrenal gland vein
right gonadal vein (left through renal vein, right directly into ivc)

IVC is on the right so many right veins drain into it

88
Q

what are the celiac and mesenteric veins?

A

midline vessels

89
Q

what percentage drains into left subclavian vein? Right?

A

75%

25%

90
Q

what artery is the anastomosis of the foregut and midgut?

A

superior and inferior pancreaticoduodenal artery

91
Q

what is the anastomosis between the midgut and hindgut?

A

middle and left colic artery

92
Q

what is the anastomosis between the hindgut and pelvis?

A

superior rectal and middle/inferior rectal (internal iliac artery)

93
Q

what is the importance of anastomosis in the abdominal aorta?

A

bypass of atherosclerosis (buildup of fats in arteries)

94
Q

what is the water shed zone?

A

region that receives dual blood supply - such as splenic flexure and large intestine
- less blood supply at splenic flexure = bowel resection

95
Q

where does the digestive tract drain back to?

A

portal vein –> goes to liver portal system

right gastric, splenic vein, superior mesenteric, inferior mesenteric

96
Q

what are the functions of portal system?

A

storage of nutrients

detoxication

97
Q

what happens to drainage during portal hypertension?

A

back flow of blood through anastomosis

98
Q

what is the blood flow when esophageal varices are present?

A

gastric/splenic vein to esophageal veins

99
Q

what is the blood flow during hemorrhoids?

A

rectal veins to internal iliac veins

100
Q

what are the veins in caput medusa?

A

paraumbilical veins

- if IVC is impaired, drainage goes directly to subclavian veins

101
Q

what is the sympathetic innervation of the foregut?

A

greater splanchnic nerve T5-T9

102
Q

what is the sympathetic innervation of the hindgut?

A

lumbar splanchnic nerve L1-L2

103
Q

what is the parasympathetic innervation of the foregut?

A

vagus nerve (cranial nerve 10)

104
Q

what is the parasympathetic innervation of the midgut?

A

vagus nerve (cranial nerve 10) to 2/3 transverse colon

105
Q

what is the parasympathetic innervation of the hindgut?

A

pelvic splanchnic nerve S2-S4

106
Q

what are the monitoring stimuli for the visceral sensory system?

A

stretch, temperature, chemicals, irritation

** all are free nerve endings, not myelinated, diffuse ascending pathways

107
Q

what are the reactions to stimuli as part of the visceral sensory system?

A

hunger, fullness, pain, nausea, etc

108
Q

what is the phrenic nerve a shuttle for?

A

mediastinal pleura
fibrous pericardial capsule
gallbladder nociception

109
Q

what is the autonomous nervous system made up of?

A

plexus of enteric neurons

“2nd brain”

110
Q

what happens when the enteric nervous system and central nervous system (visceral motor) work together?

A

inhibition of sympathetic visceral motor
activation by parasympathetic visceral motor
connection by symbiotic bacteria: depression

111
Q

what is referral pain?

A

pain commonly perceived as somatic

112
Q

is the visceral membrane innervated?

A

no, no nociception

113
Q

what is the most common referral pain in physical therapy?

A
  1. kidney problems and back pain
    - severe pain around costovertebral angle
    - test: percussion test (hit hand on kidney)
  2. retroaortic left renal vein and back pain

DPT Anatomy (8 decks)

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