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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
Q

What attaches to the lesser curvature of the stomach

A

Lesser omentum

26
Q

What is the course of the greater curvature in relation to the stomach

A

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
Q

What is the position of the highest point of the fundus in males?

A

At the left 5th intercostal space below the left nipple in males

28
Q

What attaches to the greater curvature of the stomach

A

Peritoneum

Gives attachment to:

  • gastrosplenic ligament
  • greater omentum.
29
Q

What are the anterior relations of the stomach

A

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
Q

What are the posterior relations of the stomach

A

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
Q

What are the inferior relations of the stomach

A

Transverse mesocolon (and splenic flexture)

AT THE COLOMESOCOLIC SURFACE

32
Q

What are the superior relations of the stomach

A

Left dome of the diaphragm

33
Q

What is the arterial supply to the stomach

A

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
Q

What is the venous drainage of the stomach

A

(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
Q

Explain the Parasympathetic supply to the stomach

A

PNS Supply comes from:
-Ant and Post Vagal Trunks

Provide:

  • secretomotor function to glands
  • Motor function to muscles
36
Q

Explain the Sympathetic supply to the stomach

A

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
Q

Explain the lymphatic drainage of the stomach

A

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
Q

What is the extent of the duodenum?

A

25 cm

From Pylorus to the Duodenojejunal Flexure

39
Q

Describe the shape of the duodenum

A

C-shape with convexity to right side

Concavity enclosing head of pancreas on left side

40
Q

What is the location of the duodenum with relation to the abdominal regions

A

Epigastric region

Umbilical region

41
Q

What are the LENGTHS and POSITIONS of the parts of the duodenum

A

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
Q

What are the relations of the Superior part of the duodenum?

A

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
Q

What are the relations of the decending part of the duodenum

A

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
Q

What are the relations of the Inferior part of the duodenum

A

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
Q

What are the relations of the ascending part of the duodenum

A

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
Q

What is the arterial supply of the duodenum

A

Gastroduodenal Arteries (from supraduonenal Arteries)

(From SMA):

  • Superior Pancreaticoduodenal Artery
  • Inferior Pancreaticoduodenal Artery
47
Q

Explain how the venous drainage of the duodenum works

A

Venous drainage through corresponding veins directly into:
-Portal vein

Indirectly into:

  • Splenic Vein
  • SMV
48
Q

What is the lymphatic drainage associated with the duodenum

A

Pancreaticoduodenal LN

Superior Mesenteric LN

49
Q

Explain the Nerve supply of the duodenum

A

Via the Celiac and Superior Mesenteric Plexuses:

  • –Sympathetic—
  • Greater Splanchnic Plexus
  • Lesser Splanchnic Plexus
  • –Parasympathetic—
  • Vagus Nerve
50
Q

What are the types of ulcers that are associated with the abdomen?

A 
Oesophageal ulcer
Posterior gastric ulcer
Peptic ulcer (Pyloric canal)
Ulceration in Splenic Artery
Duodenal ulcer
51
Q

What are the duodenal recesses? And what are the clinical implications of these?

A

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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