Abdominal Organs Flashcards
Stomach relations
6th cc T11 to 8th cc L1
L lobe liver is ant
Omental bursa and pancreas post
Inf is transverse colon
Gastric ruggae at pylorus and greater curvature
Stomach blood
Less curve gastric
Greater curve gastroepioloic and short gastric
Venous drainage
Gastric - portal
Sort gastric + gastroomental - splenic - smv - portal
R gastroomental - smv - portal
Duodenum relations
Sup L1 - post to gallbladder
Desc L1-3 - around panc head
Ampulla vater enters supmedially
Inferior L3 - crosses IVC aorta, post to sma and smv
Ascending L3-2 - goes to lig treitz
Duodenal blood and lymph
Sup panc duodenal until ducts enter descending, inf panc duodenal after
Lymph - ant to pancreaticoduodenal to pyloric
Post to SMA nodes
Jejenum vs ileum
Jejenum more red and thick walled, more vasc, long vasa recta, few large arcades, large tal circular folds
Ileum more pale, has peyers patches lymph, fatty mesentery
Blood all smv
Different large from small bowel
Omental appendices
Teniae coli
Haistra
Caecum and appendix
Caecum:
7.5x7.5
Ileocolic art
No mesentary
Appendix
Retro 64%
Ileal mesentry
Both: lyymph tonileocolic nodes to sup mesenteric
Colon blood supply
Ascending - ileocolic and right colic, drains lymph epicokic and paracolic to sup mes
Transverse - r colic middle colic art, drains straight smv, lymph drains middle colic to sup mesenteric
Desc + sig - l colic and sig (IMA), lymph epi and para colic to inf mes
Asc and trans nerve sup mes
Rest sup lumar symp and para inf hypogastric
Spleen
Largest lymph organ, intraperitoneal
Ant to 9-11 ribs, hehind stomach
Hilum in contact tail pancreas
Attached stomach gastrosolenic, kidney splenorenal
Pancreas anatomy
L1-2 retroperitoneal
Under stomach, lat over l kidney,ant attached transverse mesocolon
Panc duct joins bike duct
Veins - splenic and smv
Lymph pancreaticosplenic and pyloric
Liver ligaments
Falciform - to ant abdo, free edge ligamentum teres left umb vein remnant
Coronary - attaches diaphragm
Triangular - r and l attaches diaphragm
Lesser omentum - to lesser curve stomach and 1st part duodenum
Ligamentum venosum attaches l branch portal vein (remnant ductus venosum)
Lymph drainage liver
25-50 thoracic duct
Ant and deep to helatic to celiac to cysterna chyli
Post to phrenic to deep.mediastinal
Blood supply bile duct
Goes post to sup duodenum, post head panc
Blood supply sup to inf
Cystic
Right hepatic
Superior pancreaticoduodenal
Hepatic portal vein
Runs within hepatoduodenal lig
Goes r and l
Formed L1 near neck panc
Splenic + smv +- imv
Position kidneys
T12-L3
11th 12th ribs
Hilum a to p vein,art, duct
Post to kidneys sc nerve and vessels,j ilioinguinal and iliohylogastric nerves
Inf post to kidney is psoas major and quad lumborum
Suprarenal what they secrete
Cortex - corticosteroids made from mesoderm
Medulla - catecholamines made from neural crest cells
ureter blood supply
A: renal, gonadal, abdo aprta, common iliac
V: renal and gonadal
Suprarenal blood supply
A: branch inf phrenic, middle supra and branch renal
V: r to IVC, L to phrenic to l renal to IVC
Sympathetic supply abdomen
T5-L2/3
IML nucleus to ant root to ant ramus
To symp trunks
Pass through paravert ganglia
Synapse on pre vert ganglia
Go to nerve plexi by aorta
Supply abdominal splanchnic symp
Spinal level
Greater t5-9 liver gallbladder stomach pancreas spleen
Lesser t10-11 distal duodenum, small bowel, proximal 2/3 of transverse
least t12 kidneys
Lumbar rest of large bowel, bladder and genitalia
Parasymp abdo
Vagus to colic flexure
Pelvic splanchnic s2-4 after
Enteric nervous system
Myenteric plexus - in gut wall, for motility and stimach secretion
Submucosal plexus - submucosa mainly small ibtestine, vasomotion, micromotility, immune function
Diaphragm attachments
Xiphoid
Inf 6th costal cartilages
Lumbar l1-3
Arcuate ligaments
Median - fusion of crura
Medial - psoas major fascia from transverse process T1
Lateral - quad lumborum fascia L1+2 tps to tip 12th rib
Superior diaphragm blood and lymph
A: sup phrenic, pericatdiaco phrenic and musculophrenic
V: to sup phrenic or internal thoracic
L: phrenic to parasternal and post mediastinal
Inferior diaphragm blood and lymph
A: inferior phrenic
V: same, to ivc / ivc and suprarenal on left
L: superior lumbar nodes
Diaphragm innervation
Motor phrenic
Sensory central phrenic,lateral t5-12
Caval opening diaphragm
T8 Central tendon right of midline
IVC, terminal right phrenic, lymph from liver
Oesophageal opening diaphragm
T10 right crus slightlt left
Oesophagus, vagal, owsophageal branch l gastric, lymphatics
Aortic opening diaphragm
T12 posterior to median arcuate midkine
Aorta, azygous +- hemi, thoracic duct
Ductus deferens
Fibromuscular tube continuation of epididymus amd excretory duct of testes
30-45cm
Ampulla superior to prostate
Seminal vesicles join to form common ejaculatiru ducts prior to prostate
Epithelium ciliated and pseudostratified
Blood supply from.superior vesicular artery
Meckels diverticulum
Ileum
2% population
2 feet from caecum, 2 inches long
End vitellointestinal duct
Gallbladder epithelium and capacity
Internal columnar epithelium
Capacity 50ml
Cystic duct 2-3cm
Attached to int surface liver
Epiploeic formane of winslow
Ant - free edge lesser omentum hepatoduodenal ligament (common bile duct, hepatic artery proper, portal vein)
Post - IVC
Sup - caudate lobe
Inf - D1, hepatic artery proper
Communication between greater peritoneal cavity and lesser sac
Transpyloric plane
L1
pylorus
D1 part of the duodenum
duodeno-jejunal flexure
root of the transverse mesocolon
hepatic flexure of the colon
splenic flexure of the colon
fundus of the gallbladder
neck of the pancreas
hila of the kidneys (L)
hilum of the spleen
ninth costal cartilage
termination of spinal cord and superior portion of conus medullaris
origin of superior mesenteric artery
splenic vein joins superior mesenteric vein to form portal vein
cisterna chyli
Plexus auerbach and meissner
Auerbach - myenteric, between two muscle layers gut
Meissner - submucosal plexus
Brunners glands
Crypts of lieberkuhn
Brunners - secrete mucous,only in duosenum
Crypts - througgout small bowel, invagination columnar mucosa, paneth cells at base secrete lysozyme
Location caudate lobe liver
Posteriorly between ivc and fissure for ligamentum venosum
Pancreatitis dermatomes
T6-T10
Pain from stomach felt at
T7/8
Sympathetic nerve levels to abdomen
T5-L3
Lymph drainage rectum
Inf mesenteric
Internal iliac
Superficial inguinal
