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Abdomen > Abdominal Esophagus, Stomach and Duodenum > Flashcards

Abdominal Esophagus, Stomach and Duodenum Flashcards

1
Q

At what level does the esophagus lie?

A

C6-T11

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2
Q

How long is the esophagus

A

25-30cm in adult male

Slightly less in female

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3
Q

What is the average diameter of the esophagus

A

2cm

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4
Q

What level is the Cervical Part of the Esophagus

A

C6-C7

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5
Q

What level is the Thoracic part of the Esophagus

A

T1-T10

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6
Q

How long is the adbominal part of the esophagus

A

1.25cm

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7
Q

What attaches the oesophagus to the diaphragm in the adbominal cavity

A

Phrenico-esophageal Ligament

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8
Q

Where in relation to other structures does the esophagus enter the stomach?

A

At the cardiac orifice
T11 vertebra (6th costal cartilage)
3cm from Median Plane

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9
Q

What are the points of constriction of the esophagus and how far is each from the incisor teeth?

A

Cervical:

  • 15cm from incisor teeth
  • Due to Inferior Constrictor Muscle

Thoracic (Aortic Arch)
-22.5cm from incisor teeth

Thoracic (Left main bronchus)
-27.5 cm from incisor teeth

Diaphragmatic
37-40cm from incisor teeth

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10
Q

Describe the course and relations of the esophagus

A

1: Median at its commencement opp. C6
2: Deviates slightly to left up till C7
3: Returns to median plane at T5
4: Inclines to left and forward at T7
5: Enters abdomen and shaply deviates to left at T10
6: Joins stomach at T11

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11
Q

What is the blood supply of the cervical part of the esophagus

A

Inferior thyroid arteries and veins

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12
Q

What is the blood supply to the thoracic part of the esophagus

A

Arterial Supply:

  • Esophageal branches (from descending thoracic aorta)
  • Bronchial arteries

Venous drainage:

  • Azygos vein
  • Hemiazygos vein
  • Accessory hemiazygos vein
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13
Q

What is the blood supply to the Abdominal part of the esophagus

A

Arterial supply:

  • Left gastric Artery (from Celiac Trunk)
  • Left Inferior Phrenic Artery

Venous drainage:

  • Esophageal vein (via Azygous vein)
  • Left gastric vein (via portal vein)
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14
Q

What is the lymphatic drainage of the esophagus

A

Cervical part: Deep Cervical Nodes

Thoracic part: Posterior mediastinal nodes

Abdominal part: Left gastric nodes

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15
Q

What is the nerve supply to the Cervical part of the esophagus

A

Recurrent laryngeal nerve

Cervical sympathetic trunk (distributed via the plexus around the Inf. Thyroid Arteries from MIDDLE CERVICAL GANGLION)

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16
Q

What is the nerve supply to the Thoracic part of the esophagus

A

Vagal Trunk (above root of lung)
Esophageal plexus (below root of lung)
Sympathetic Trunk
Greater Splanchnic Nerve

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17
Q

What is the nerve supply to the Abdominal Part of the esophagus

A

Vagal trunks (anterior and posterior)

Thoracic Sympathetic Trunk:

  • Greater Splanchnic
  • Plexus around Left Gastric and Inferior Phrenic Arteries
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18
Q

What is the location of the stomach, with relation to abdominal regions

A

Epigastric (entirely)
Umbilical (partly)
Left Hypochondriac (only if full)

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19
Q

What is the mean capacity of the stomach at the various stages of life?

A

Birth - 30ml
Puberty - 1L
Adult - 1.5L

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20
Q

What is the position of the Fundus

A

Lies posterior to the left 6th rib at the Mid-clavicular line

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21
Q

What is the postition of the pyloric of the stomach?

A

Lies at the distal end of the stomach.
L1
Transects the 8th costal cartilage plane
1.25cm from the midline

22
Q

What two parts are the pyloric divided into

A

Wider pyloric antrum

Pyloric canal ending at pyloric sphincter
-Pyloric canal has a thickened wall of smooth muscle due to the sphincter

23
Q

What is the course of the Lesser Curvature in relation to the stomach

A

Extends from cardiac to the pyloric orifice.

24
Q

What are the contents of the lesser curvature of stomach

A

Right and left gastric arteries

25
What attaches to the lesser curvature of the stomach
Lesser omentum
26
What is the course of the greater curvature in relation to the stomach
4-5 times longer than lesser curvature of stomach. Runs from cardiac incisura to the highest point of the fundus and inferiorly below pyloric antrum and canal.
27
What is the position of the highest point of the fundus in males?
At the left 5th intercostal space below the left nipple in males
28
What attaches to the greater curvature of the stomach
Peritoneum Gives attachment to: - gastrosplenic ligament - greater omentum.
29
What are the anterior relations of the stomach
Diaphragm Upper and left part is related to the spleen Right half to the left lobe of liver (at its hepatic surface) Anterior Abdominal wall (at its epigastric surface)
30
What are the posterior relations of the stomach
FORMS THE STOMACH BED (left dome of) diaphragm (at phrenic surface) omental bursa Left suprarenal gland and kidney (at renal and suprarenal surfaces) Spleen and splenic artery pancreas (at pancreatic surface)
31
What are the inferior relations of the stomach
Transverse mesocolon (and splenic flexture) AT THE COLOMESOCOLIC SURFACE
32
What are the superior relations of the stomach
Left dome of the diaphragm
33
What is the arterial supply to the stomach
Left gastric artery (from coeliac trunk) Right gastric artery (from common hepatic artery) Right gastro-omental artery ( from gastroduodenal artery of common hepatic artery) Left gastro-omental artery (from splenic artery) Short gastric arteries - normally 6 or 7 (from splenic artery)
34
What is the venous drainage of the stomach
(Omental Vein - running into Splenic Vein): - -Short gastric vein - -Left Gastro-omental vein Right gastro-omental vein (running to SMV) Left and Right Gastric Veins (running into Hepatic Portal Vein)
35
Explain the Parasympathetic supply to the stomach
PNS Supply comes from: -Ant and Post Vagal Trunks Provide: - secretomotor function to glands - Motor function to muscles
36
Explain the Sympathetic supply to the stomach
From the coeliac plexus (T6-T9; Greater Splanchnic Nerve) Provides: - Vasomotor function (to blood vessels) - Motor function to pyloric sphincter This plexus runs along with the Gastric and Gastro-omental Arteries
37
Explain the lymphatic drainage of the stomach
Superior 2/3: -Aortic LN (Via the Celiac LN) Inferior 1/3 (right 2/3): -Sub-pyloric LN Inferior 1/3 (left 1/3): -Supra-pancreatic LN (and then to aortic LN)
38
What is the extent of the duodenum?
25 cm | From Pylorus to the Duodenojejunal Flexure
39
Describe the shape of the duodenum
C-shape with convexity to right side | Concavity enclosing head of pancreas on left side
40
What is the location of the duodenum with relation to the abdominal regions
Epigastric region | Umbilical region
41
What are the LENGTHS and POSITIONS of the parts of the duodenum
superior: - 5cm - Lies at L1 descending: - 8.5cm - L1-L3 inferior: - 7cm - L3 ascending: - 5cm - L3-L2 (runs superomedially from right to left ---- at left side of body at this point)
42
What are the relations of the Superior part of the duodenum?
Anterior: - Peritoneum - Gallbladder - Quadrate lobe of liver Posterior: - Bile duct - Gastroduodenal artery - Hepatic Portal vein - IVC Medial: -Pylorus Superior: -Neck of gallbladder Inferior: -Neck of pancreas
43
What are the relations of the decending part of the duodenum
Anterior: - Transverse colon - Transverse mesocolon - Coils of small intestine Posterior: - Hilum of right kidney - Renal vessels - Ureter - Psoas major Medial: - Head of pancreas - Pancreatic duct - Bile duct Superior: -Superior part of duodenum Inferior: Inferior part of duodenum
44
What are the relations of the Inferior part of the duodenum
Anterior - SMA - SMV - Coils of small intestine Posterior - Right psoas major - IVC - Aorta - Right ureter Superior: - Head and Uncinate process of pancreas - Superior mesenteric vessels Inferior -coils of small intestine (ileum)
45
What are the relations of the ascending part of the duodenum
Anterior - Beginning of root of mesentery - coils of jejunum Posterior - Left psoas major - Left margin of aorta Medial - SMA - SMV - Uncinate process of pancreas Superior -Body of pancreas Inferior -Coils of jejunum
46
What is the arterial supply of the duodenum
Gastroduodenal Arteries (from supraduonenal Arteries) (From SMA): - Superior Pancreaticoduodenal Artery - Inferior Pancreaticoduodenal Artery
47
Explain how the venous drainage of the duodenum works
Venous drainage through corresponding veins directly into: -Portal vein Indirectly into: - Splenic Vein - SMV
48
What is the lymphatic drainage associated with the duodenum
Pancreaticoduodenal LN Superior Mesenteric LN
49
Explain the Nerve supply of the duodenum
Via the Celiac and Superior Mesenteric Plexuses: - --Sympathetic--- - Greater Splanchnic Plexus - Lesser Splanchnic Plexus - --Parasympathetic--- - Vagus Nerve
50
What are the types of ulcers that are associated with the abdomen?
``` Oesophageal ulcer Posterior gastric ulcer Peptic ulcer (Pyloric canal) Ulceration in Splenic Artery Duodenal ulcer ```
51
What are the duodenal recesses? And what are the clinical implications of these?
There are small pockets or fossae in the peritoneal cavity, which are bounded by folds of peritoneum called peritoneal recesses ``` Superior Inferior Paraduodenal Retroduodenal Duodenojejunal Mesentericoparietal (of Waldeyer) ``` Implications: - Intestinal obstruction after herniation - Accumulation of fluid (e.g. in infection)

Abdomen (10 decks)

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