Abdominal Overview Flashcards
Main arteries that supply their specific part of the gut tube
Foregut: Celiac trunk
Midgut: superior mesentary
Hindgut: inferior mesentary
Parts of the foregut
Abdominal esophagus
Stomach
Proximal duodenum
Liver and gallbladder
Pancreas
all supplied by celiac trunk
What is supplied by the celiac trunk but is gut derivative?
Spleen
Parts of Midgut
Distal duodenum
jejunum
ilium
cecum
Ascending colon
Proximal transverse colon
all supplied by superior mesentery artery
Parts of the hindgut
Distal Transverse colon
Descending colon
Sigmoid colon
Rectum
Superior anal canal
all supplied by the inferior mesentery artery
Ligament of the lesser omentum
Hepatogastric: separates stomach from liver
Hepatoduodenal: separates duodenum and liver.
Hepatoduodenal ligament significance
Contains portal triad, epiploic foramen of Winslow and the lesser sac (omental bursa)
What is contained in the portal triad?
Hepatic portal vein
Hepatic artery
Bile duct
Ligaments of the peritoneal
Root of mesentery
Suspensory ligament of Trietz
Falciform ligament
Gastrophrenic ligament of greater omentum
Gastrosplenic ligament of greater omentum
Gastronomic ligament of greater omentum
- separates stomach and transverse colon
Subdivisions of peritoneal cavity
Greater peritoneal sac
Lesser peritoneal sac
Transverse mesocolon
- divides abdominal cavity into supracolic and infracolic
How does the greater and lesser peritoneal sacs communicate?
Through the epiploic foramen
How do supracolic and infracolic compartments communicate?
Freely through parabolic gutters
Psoas major attachment, innervation and functions
Attaches to lesser trochanter
Innervated by L2-L4 anterior rami
Functions to:
- bilaterally flex and externally rotate hips
- raises trunk from a supine position
- unilaterally bends trunk to ipsilateral side
Illiacus Attachment, innervation and functions
Attachment is lesser trochanter
Innervated by femoral nerve (L2-L4)
Functions to
-bilaterally adducted and externally rotates hip
Quadratics lumborum Attachment, innervation and functions
Iliolumbar ligament/internal iliac crest
Innervation: subcostal iliohypogastric, ilioinguinal-inguinal nerves and anterior rami of L2-L4
Functions: bilaterally adducted and externally rotates hip ipsilaterally.
Three muscle layers of diaphragm
Sternal, coastal and lumbar
Ligaments of lumbar diaphragm
Median arcuate: midline union of right and left Crura
Medial arcuate: between lumbar bodies and transverse processes.
Lateral arcuate: from T12 transverse process to rib 12
Muscles that pass respective diaphragm ligaments
Median: none
Medial: psoas major and lumbar sympathetic trunk
Lateral: quadratus lumborum
3 passage ways in the diaphragm
Canal opening (around T8) - IVC passes here
Esophageal hiatus (around T10) - esophagus, gastric vessels and some lymphatics pass here
Aortic hiatus: (between right and left crura)
- aorta passes here
Sensory and motor innervation for diaphragm
Motor: right and left phrenic (T3-5)
Sensory: intercoastal nerves, phrenic nerve and subcostal nerves
T3-T12
Vasculature of diaphragm
Thoracic surface: pericadiacophrenic, musculophrenic and superior phrenic arteries/veins
Abdominal surface: inferior right and left phrenic arteries and veins
Abdominal aorta positioning
Begins at T12 via aorta hiatus
Depends until L4 where it divides into right and left common iliac arteries
Unpaired visceral branches of abdominal aorta
Celiac trunk, superior mesentery and inferior mesentery.
Paired visceral branches of the abdominal aorta
Right and left middle suprarenal arteries
Right and left renal arteries
Right and left testicular/ovarian arteries
Parietal branches of abdominal aorta
Unpaired median sacral artery
right and left inferior phrenic arteries
Right and left lumbar arteries
Right and left sympathetic chains join where and become what?
Join at the anterior coccyx as the ganglion impar
Myenteric (Auerbach) plexus
Located within muscularis externa
- control motility and blood flow within muscularis externa
Submucosal (Meissner) Plexus
Located within the submucosal layer of the gut.
Secretion, blood flow, micromotility and immune activity within the muscosa
Enteric nervous system overview
Found in the wall of the GI tract and consists of two plexus (Myenteric and submucosal)
- operates independently from CNS (no spinal nerves)
- does receive input from postsynaptic sympathetic fibers and postsynaptic parasympathetics still
What is the abdominal policeman of the abdominal cavity?
Greater omentum
Will wall off infected portion if a part is infected, preventing spread.
Psoas major
Origin in the lumbar transverse processes
Insertion in the lesser trochanter of the femur
Bilaterally flexes and external rotates hip
Raises trunk when supine
Unilaterally bends trunk to same side
Innervated by anterior rami of L2-L4
Illiacus (iliopsoas)
Origin is the illiac crest
Insertion is the lesser trochanter of the femur
Bilaterally hip flexion
Innervated by femoral nerve
Quadratics lumborum
Origin is rib 12
Insertion is iliac crest
Unilaterally bends trunk to same side
Innervated by T12-L4 anterior rami