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abdominal notecards Flashcards

1
Q

testes

A

male gonads (reporductive glands) produce sperm and male hormones, contain tunica albuginea, tunica vaginalis, and efferent segments

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2
Q

tunica albuginea

A

deep to the tunica vaginalis, tough fibrous outer surface

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3
Q

tunica vaginalis

A

a closed peritoneal sac partially suggounding the testis, which is the closed off distal part off embryonic processus vaginalis.

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4
Q

efferent ductules

A

is continoues with the head of the epididymis and transports newly formed sperm to epidiymis

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5
Q

development of peritoneum

A

In embryo, peritoneum derives from the mesoderm in the abdomen, forms a closed sac. The lumen = peritoneal cavity. The wall of this sac = parietal peritoneum, along body wall. As abdominal organs develop, they protrude into this cavity to varying degrees, acquiring a covering of peritoneum at the same time = visceral peritoneum. As organs develop, space within peritoneal cavity is greatly reduced. By birth, peritoneal cavity is only very thin layer between visceral and parietal peritoneum; small amount of peritoneal fluid inside potential space. As gut tube differentiates and becomes suspended in peritoneal cavity, a mesentery is formed from the splanchnic lateral mesoderm

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6
Q

Mesentery

A

is a double layer of peritoneum, connects organs to body wall, conduit for neurovaxculature, named after organ it connects (transverse mesocolon, sigmoid mesocolon, mesgastrium, the mesentery= mesetery of small intestines)

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7
Q

greater omentum

A

four layers, attached from greater curvature of stomach to transverse colon, helps subdivide abdominal cavity, can patch areas of trauma or infections to contain the spread, site of fat diposite

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8
Q

lesser omentum

A

four layers, from lesser curviture of stomach to liver,

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9
Q

peritoneal ligament

A

consists of a double layer of peritoneum that connects an organ to abother oregon or abdominal wall

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10
Q

falciform ligament

A

connects liver to abdominal wall, sorrounds ligamentum teres and paraumbilical vein, runs inbetween left and right lobes

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11
Q

hepatogastric ligament

A

part of lesser omentum connects stomach to liver, surrounds left gastric vessels

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12
Q

hepatoduodenal ligament

A

connects liver to duodenum, is a thickened free edge of the lesser omentum, which conducts the portal triad (portal vein, hepatic artery, and bile ducts)

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13
Q

gastrophrenic ligament

A

connects the abdominal esophagus to the inferior surface of the diaphragm, apart of the greater omentum

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14
Q

gastrosplenic ligament

A

connects the stomach to the spleen and reflects the hilum of the spleen, apart of the greater omentum

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15
Q

gastrocolic ligament

A

apron like part of greater omentum

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16
Q

coronary ligament

A

attaches the liver to the anterior surface of the diaphragm

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17
Q

phrenicocolic

A

attaches the splenic flexure of the colon to the diaphragm

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18
Q

peritoneal recess

A

a pouch of peritoneum that is formed by a peritoneal fold, in women there are rectouterine (b/s uterus and rectum) pouch and vesicouterine pouch (between uterine and bladder), in males only one rectovesical pouch (b/w rectum and bladder)

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19
Q

lesser peritoneal sac

A

also called omental bursa, sac like cavity behind stomach formed by coronary ligament, liver, lesser omentum, stomach, superior part of greater omentum, transverse colon and mesentry

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20
Q

greater peritoneal sac

A

contains anterior superior (supracolic) and everything inferior to transverse mesentery (infracolic)

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21
Q

epiploic foramen

A

also called omental foramen or foramen of winslow, opening from lesser sac to greater sac, formed by free edge of hepatodudenal ligament

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22
Q

peritonitis

A

Infection and inflammation of the peritoneum. Likely cause: Gas, fecal matter, bacteria etc enter peritoneal cavity due to penetration or rupture of sac, either during surgery or from trauma. Exudates accumulate in peritoneal cavity

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23
Q

ascities

A

Excess fluid in peritoneal cavity. Abdomen may distended with several litters of abnormal, ascitic fluid (fluid has diverse origin: blood, pus, serum + exudates). Tx: drain ascitic fluid (paracentisis), addressing underlying cause of excess fluid

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24
Q

flow of ascitic fluid

A

Excess fluid especially likely to flow within Paracolic Gutters, and may cross from side to side (see green arrows on middle image here). in upright position, fluid may flow to lowest point = pelvis, rectovesicle or rectouterine pouch. In Supine position, fluid may flow superiorly, commonly found in Hepatorenal Recess (Morison Pouch)

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25
paracolic gutters
grooces between the lateral and aspect of the ascending of descending clon and the posterolateral abodominal wall, allows free communication occurs between the supracolic and infracolic compartments
26
foregut
includes esophagus, stomach, 1st 1/2 of duodenum, liver, gallbladder, pancreas; spleen is not apart of digestive track but is included in its profusion
27
midgut
2nd hald of duodenum, jejunum, ileum, cecum, appendix, ascending colon, first 2/3rds of transverse colon
28
hindgut
distal 1/3rd of transverse colon, descending colon, sigmoid colon, and rectum
29
intraperitoneal organs
organs that protrude almost completely into peritoneal sac and become nearly fully covered by visceral peritoneum and suspended by mesentery
30
primary retroperitoneal
organs that protrude very little into peritoneal cavity from its embryonic development, eg kidneys, aorta and IVC, rectum
31
extraperitoneal organs
organs that are outside of peritoneum but not strictly behind it, eg bladder and ovaries
32
secondary retroperitoneal organs
organs that were originally intraperitoneal but loses most of its peritoneum covering during development, eg ascending and descending colon and most of duodenum and pancrease
33
mnemonic for retroperitoneal organs
SAD PUKR (suprarenal gland, aorta/ivc, duodenum (2nd and 3rd parts), pancreas (except tail), ureters, colon (ascending and descending), kidneys, and rectum
34
esophagus
contains longitudinal and circular muscles, passes into abdominal cavity through esophageal hiatus
35
esophageal hiatus
the opening in the diaphragm where the esophagus passes into abdominal cavity at the level of T10, acts as a physiological sphincter
36
cardiac orfice
where the esophagus connects to stomach at the level of T11
37
fundus
the portion of the stomach that is superior to the cardial orfice
38
body of stomach
the majority of the stomach, b/w the fundus and pyloric part (funnel to pylorus)
39
pyloric orfice
the stomach's opening to duodenum
40
Hiatial Hernias
2 types, Occurs when part of the stomach protrudes through the esophageal hiatus into the mediastinum of the thorax
41
paraesophageal hiatial hernia
Less common. Pouch of peritoneum + part of the fundus extends superiorly through esophageal hiatus, anterior to the esophagus. The abdominal esophagus + cardia of stomach remain in normal position. No regurgitation of stomach contents (b/c cardia intact)
42
sliding hiatial hernia
More common. Abdominal esophagus, cardia, + parts of fundus slide superiorly through esophageal hiatus. Especially when pt. lying down or bends over. Regurgitation of stomach contents b/c cardia no longer clamped by physiological sphincter
43
pyloric sphinchter
a thick circular muscle fibers create another sphincter, controlling outflow of chyme from stomach
44
stomach
basically a bag of smooth muscle, is the location of both mechanical and chemical digestion
45
gastric folds
folds pointing in direction of pyloris, helps to guide chyme
46
spleen
highly cascularized, serves as reservoir for blood, performs waste management for RBC (breaks them down and recycles iron), has concentration of lymphocytes
47
free part of duodenum
also called superior part, intraperitoneal, part of foregut
48
descending part of duodenum
runs inferiorly, curving around the head of the pancrease,initialy lies parallel and to the right of IVC, it is retroperitoneal (like pancrease), accepts fluids from the bile duct and the pancreatic duct, contains major and minor duodenal ampulla
49
horizontal part of duodenum
runs transversly to the left inferior to the head of the pancrease, crossing over IVC, aorta, and L3, is crossed by the superior mesenteric artery and the root of the mesentary of the jejunum and ileum, is retroperitoneal (just like IVC)
50
major duodenal ampulla
the opening connecting the pancreatic duct to the duodenum for the release of bile
51
minor duodenal papilla
the opening connecting the accessory pancreatid duct to the duodenum (not always present)
52
ascending part of duodenum
runs along left side of aorta to reach inferior borderof the body of the pancreas, where it curves anteriorly to join the jejunum and the duodenojejunal flexure, where suspensory muscle of the duodenum help to expand the final segment, is retroperitoneal
53
doudenum
1st part of small intertine, smallest and most fixed, portions 1 and 2 are considered foregut and supplied by celiac trunk, 3 and 4 are midgut and supplied by superior mesenteric
54
jejunum
the 2nd part of the small intestine, begins at duodenojujunal flexure where the gi become intraperitoneal again, lies mostly in the ULQ, is responsible for absorption, has larger and more circular folds (vili) increasing the surface area for absorption and fewer arcades
55
ileum
the third part of small intestine ends at iliocecal juction, mostly in RLQ, absorbs remenants, vitamins, and bile salts
56
subphrenic recesses
superior extensions of the peritoneal cavity (greater sac), exist between diaphragm and the anterior and superior aspects of the diaphragmatic surface of the liver, seperated in left and right by falciform ligament
57
hepatorenal recess
also called morison pouch is the posterosuperior extension of the subhepatic space, lying between right part of visceral surface of liver and right kidney and suprarenal gland, where fluid collects when pt is lying down
58
coronary ligament
reflection of peritoneum from the diaphragm onto the liver (anterior and posterior) within these two ligaments is the bare area of the liver, anterior layer is continuos with falciform and posterior layer is continuous with the right layer of the lesser omentum
59
left and right triangular ligament
where the coronary ligaments meet up, left is near the apex of the liver
60
round ligament of the liver
the fibrous remnant of the umbilical vein, which carried well-O2 and nutrient rich blood from the placenta to the fetus, along with the paraumbilicus veins course the free edge of the falciform ligament, also called teres ligament
61
hepatorenal ligament
reflection of coronary ligament onto the right kidney
62
lienorenal ligament
attaches spleen to kidney and surrounds splenic vessels
63
phrenicocolic ligament
attaches splenic flexure of colon to diaphragm
64
visceral surface of liver
also covered by peritonium except in the fossa for the gallblader and porta hepatis, alos where the ligamentum venosum is (remenant of ductus venosus, where blood shunted from umbilical vein to the ivc, bypassing the liver)
65
porta hepatis
a transverse fissure where the hepatic portal vein, hepatic artery and lymphatic vessels, hepatic nerve plexus and hepatic ducts that supply and drain the liver enter and leave it
66
groove for the vena cava
where the ivc traverses within the bare area of the liver
67
quadrate lobe
anterior to transverse porta hepatis
68
caudate lobe
posterior to transverse porta hepatis
69
portal triad
enclosed in the lesser omentum, contains bile ducts, hepatic artery, and hepatic portal vein as it passes from the liver to the lesser curvature of the stomach and the superior part of the duodenum
70
omental bursa
lesser sac
71
vascular supply of liver
vein devide and meet up with different parts of the liver to venous sinusiods, liver gets up to 50% of O2 from hepatic portal vein
72
gallbladder
three parts, fundus- wide blunt end that projects from inferior border of liver, body-main portain tha contacts the visceral portion of liver, trans. colon, and superior part of duodenum, and neck- narrow tappered end directed towards porta hepatis before joining cystic ducts
73
common bile duct
left and right hepatic duct meet up to form common hepatic duct, which then meets up with cystic duct to form common bile duct, which descends posteriorly where the common pancreatic ducts meets up from the left to form hepatopancreatic ampulla and enters into the major duodenal papilla
74
head of the pancreas
the expanded part of the gland that is embraced by the c-shaped curve of the duodenal to the right of the superior mesenteric vessels and attaches to the medial aspect of the descending and horizontal parts of the duodenum, the bile duct lies in a groove on the posterosuperior surface of the head or embedded in it
75
neck of the pancreas
is short and overlies the superior mesenteric vessels, which forms a groove in its posterior aspect, anterior surface is covered with peritoneum, and is adjacent to the pylorus of the stomach, also posterior to here SMV joins the splenic vein posterior to the neck to form the hepatic portal vein
76
body of the pancreas
continues from the neck and lies to the left of the superior mesenteric vessels, passing fover the aorta and L2 vertebra, posterior to the omental bursa, forms part of stomach bed
77
gallstones
accretions within gallbladder, may irritate and inflame gallbladder, blocking opening of cystic duct, may also pass through cystic duct into bile duct
78
appendices epiploicae
small, fatty, omentum-like projections, ends at beginning of rectum
79
teniae coli
three distinct longitudinal bands, is shorter then colon creating haustra
80
haustra
sacculations of the wall of the colon between the teniae
81
ileocecal junction
juction between cecum and ileal
82
colon
cecum (RLQ)-> right colic flexure-> ascending colon-> transverse colon-> splenic (left) flexure-> descending colon-> sigmoid colon (LLQ)
83
appendix
inferior portion of cecum, often retrocecum, may act as a reservoi of good gut bacteria
84
how organs become secondary retroperitoneal
In embryo, initially suspended from the center of the peritoneal cavity by a posterior mesentery attached to the posterior body wall, as the organs grow, tight space pushes parts of the gut against the posterior abdominal wall, which causes the posterior mesenteries of those organs to become reduced and covered only anteriorly by peritoneum
85
rectal ampulla
the dilated portion of the rectum where fecees are stored until limination
86
rectum
end of appendices epiploicae and teniae coli, retroperitoneal
87
anal canal
end of digestive tract, superior 2/3rds is smooth muscle (internal sphincter), inferfior 2/3rds somatic muscle (external sphincter), both are tonicly contracted
88
anal columns
longitudinal ridges in superior half of anal canal, contain superior rectal arteries and veins
89
anal valves
at inferior ends of the anal columns
90
anal sinuses
small recesses, superior to the valves, when compressed by feces, releases mucus
91
pictinate line
indicates the junction between visceral (embryonic hindgut) and somatic (embryonic proctodeum) innervation, blood suplly and lymph drainage differes across line
92
above pectinate line
nerves are visceral motor (sympathetic and parasympathetic) and sensory innervation, arteries are from mesenteric artery, veins drain to portal venous system
93
below pectinate line
nerves are somatic motor and sensory innervation, arteries are from internal iliac artery, and veins drain into caval venous system

unit 2 (10 decks)

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