Abdominal Organs Flashcards by Annamaria Melton

Foregut is supplied by

Celiac trunk

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Foregut contains

Abdominal esophagus
Stomach
Proximal duodenum
Pancreas
Liver
Gall bladder
And spleen

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Spleen important to know with peritoneal stuff

It is not a gut derivative

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Abdominal esophagus

Peritoneal

Intraperioneal

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Abdominal esophagus

Hollow muscular tube that transmits food from pharynx to stomach

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Abdominal esophagus comes through

The esophageal hiatus/right crus

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Esophagogastric junction

Where esophagus meets stomach
Functions as external physiological sphincter when diaphragm contracts
Food temporarily stops here before entering stomach
Helps prevent gastric reflux into esophagus

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Phrenico-esophageal ligaments

Permit independent movement of diaphragm and esophagus

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Gastro-esophageal reflux disorder (GERD)

“Heartburn”
Regurgitation of gastric acids into esophagus
Failure of external esophageal sphincter

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Hiatal hernia

Protrusion of stomach/esophagus through hiatus

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Para-esophageal hiatal hernia

Less common
Little regurgitation of gastric acids
Z line is still in same spot

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Sliding hiatal hernia

More common
Likely regurgitation of gastric acids
Displaced z line
More serious/discomfort

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Stomach parts

Cardia
Fund us
Body
Pyloric part

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Pyloric part of the stomach included

Angular notch
Pyloric antrum and canal
Pyloric sphincter

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Stomach peritoneal?

Intraperitoneal

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Inside stomach

Mucosa organized into temporary longitudinal folds called rugae

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Cell type of stomach lining

Simple columnar

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Gastric ulcers

H pylori
Erodes protective mucosa
Vulnerable to gastric acids and digestive enzymes
Can erode through wall - risk of lethal hemorrhage

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Duodenum parts

Superior
Descending
Horizontal/ inferior
Ascending

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Minor duodenal papilla

Accessory pancreatic duct

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Major duodenal papilla

Bile and main pancreatic duct

Division between foregut and midgut

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Ascending duodenum

Midgut
Joins jejunum at duodenojejunal flexure
Contraction widens angle at flexure to aid in movement of contents

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Pancreas parts

Head and uncinate process
Neck
Body
Tail

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Main pancreatic duct

From tail to head

Joins bile duct to form hepatopancreatic ampulla at major duodenal papilla

Pyloric stenosis

Single bubble sign Projectile vomiting Hypertrophy in pylorus Narrows pyloric canal and restricts gastric emptying

Duodenal atresia

Double bubble sign Dilation of stomach and duodenum Vomit is bilious Closure of duodenojejunal junction. (Overproduction of amniotic fluid, down’s syndrome)

Caudate lobe

Postero - superior

Quadrate lobe

Anterior-inferior lobe

Functional/ portal lobes

Divided by arterial supple Each lobe has own branch of hepatic artery, portal vein, hepatic duct 8 surgically respectable hepatic segments

Portal venous system

System of vessels that drain blood from abdominal viscera to the liver. Portal vein passes blood through 2nd capillary network (liver sinusoids) before reaching systemic circulation Maintains a higher bp than IVC

Hepatic portal vein

Formed from superior mesenteric v and splenic v. | Hepatic veins take blood from liver and return it to general circulation

Portal caval anastomoses

Collateral pathways to systemic circuit when blocked

How are portal caval anastomoses possible

Possible since hepatic portal vein and tributaries lack valves Blood can flow in reverse direction to IVC

Cirrhosis of the liver

Replacement of cells by fat and fibrous tissue Hobnail appearance - fibrous formation. Firm Obstructs circulation Hepatocytes unable to break down blood products, increase in bilirubin, jaundice Buildup of toxins worsens by portosystemic shunts that bypass liver Portal hypertension

Portal caval anastomoses Collateral pathways Left gastric>

Esophageal v

Portal caval anastomoses Collateral pathways Paraumbilical >

Epigastric

Portal caval anastomoses Collateral pathways Superior rectal

Middle and inferior rectal

Portal caval anastomoses Collateral pathways Colic

Retroperitoneal

Portal caval anastomoses Resultant varies Inferior esophageal

Esophageal varices

Portal caval anastomoses Resultant varices Periumbilical regions

Caput medusae

Portal caval anastomoses Resultant varices Anal canal

Hemorrhoids

Portal caval anastomoses Resultant varices Secondary retroperitoneal

Ascites

Clinical signs of portocaval anastomoses

Esophageal varices Caput medusae Hemorrhoids Ascites

Gall bladder

Stores and concentrate bile

Gall bladder sphincter

Sphincter of bile duct prevents bile from entering ampulla. Closes off bile> goes back up. Bile passes upward along cystic duct to gallbladder for concentration and storage

Gallstones

Cholesterol crystals | Big enough to obstruct a duct, accumulation of bile or inflammation of the gallbladder

Cholecystoenteric fistula

If gallbladder is inflamed may develop adhesions with adj viscera May ulcerate tissue between gallbladder and GI tract Mainly in duodenum and transverse colon

Cystohepatic triangle of calot

Common hepatic duct Cystic duct Liver

Porcelain gallbladder

Chronic cholelithiasis can lead to scarring and calcification of wall

Sympathetic innervation of the foregut

Presynaptic fibers t5-t9 enter sympathetic chain Do not synapse Exit chain as greater splanchnic nerves Synapse with celiac ganglion Post synaptic fibers travel to organs via plexuses surrounding arterial branches that supply those organs

Parasympathetic innervation of the foregut

Vagus nerve CNX

Celiac trunk branches

Splenic a Left gastric a Common hepatic a

Splenic a branches into

Pancreatic branches Left gastroomental a Short gastric aa

Left gastric a branches into

Esophageal branches

Common hepatic artery branches into

Hepatic artery proper Gastrodudenal a Right gastric a

Hepatic artery proper branches into

Left and right hepatic a

Right hepatic a turns into

Cystic a

Gastrodudenal a branches into

Right gastro omental a Anterior and posterior superior pancreaticduodenal aa Duodenal branches