abdominal viscera 1 and 2 and posterior abdominal wall

Question 1

is the stomach periotnealized

Answer 1

yes

Question 2

what 5 structures make up the stomach bed

Answer 2

diaphragm
spleen
left kidney and suprarenal gland
pancreas
transverse colon and transverse mesocolon

Question 3

what structures are anterior
posterior
inferior
to the first part of duodenum

Answer 3

anterior and superior - liver and gallbladder

posterior common bile duct, gastroduodenal artery portal vein

inferior - head of pancreas

most common site for perforating ulcers and this can affect the gastroduodenal artery cause hemorrhaging

Question 4

what is anterior , posterior and superior to the third part of duodenum

Answer 4

anterior SMA, root of mesentery
posterior - right psoas, IVC, aorta, right gonadal vessels

superior head and uncinate process of pancreas

Question 5

where is the junction from foregut to midgut

Answer 5

between 2nd and 3rd parts of duodenum

this is also where the branches of SMA and IMA form anastomoses

Question 6

which type of ulcer is more common

Answer 6

duodenal 4 : gatric ulcer 1

Question 7

what are fusion fascias and why are they improtant

Answer 7

fusion fascia’s
during development the ascnding and descending colon intially have mestnery
but are then pushed against posterior body wall
mesenteries fuse to the peritoneum forming fusion fascia
important b/c it provides a plane of separation to remove the colon from the posterior body wall

Question 8

what is the level of the rectosigmoidal junction

Answer 8

SV3

Question 9

what sympathetic fibers innervte the internal anal sphincter and what do they cause it to do>

parasympathetic?

Answer 9

symp–> L1 and L2
constriction

parasy–> S2-S4 relaxation

Question 10

what innverates the external anal sphincer

Answer 10

inferior rectal n.

Question 11

what are the 4 changes that occur at the pectinate line

Answer 11

venous drainage–
superior–> drains to superior and middle rectal v. (portal system)
inferor –> drains to inferior rectal v (caval system)

lymphatic drainage
superio–> internal iliac lymph nodes
inferior –> superficial inguinal lymph nodes

nerve supply
superior - autonomic
inferior - somatic

epithelial
superior–> typical GI mucous lining
inferior –> stratified squamous

Question 12

what innervate the cremastor muscle

Answer 12

genitofemoral

Question 13

what are the recesses of the liver

Answer 13

subphrenic - extensions of greater sac between anterior surface of liver and diaphragm
separated into right and left portions by falciform

hepatorenal - extension of greater sac between visceral surface of liver and kidney
deepest part of peritoneal cavity when patient is supine

Question 14

what does each functional lobe of the liver receive

Answer 14

primary branch of hepatic artery, portal vein and is drained via a hepatic duct

(right lobe, left lobe (quadrate included), and caudate lobe

the functional lobes are divided into segments and one diseased segment can be removed without affecting functioning of surrounding segments

Question 15

what is a liver lobule

in which direction does blood from the portal vein and hepatic artery run

in which direction does bile run

Answer 15

small unit of liver

composed of 6 hepatocytes arragned around 1 central vein

blood from vein and artery run through sinusoids to central vein

bile runs within bile canaliculi towards the periphery to an interlobular bile duct

Question 16

where does pain from the gallbladder localize

Answer 16

intitially epigastric region

often shift to right T8-T9 dermatomes due to infllmation of surrounding parietal peritoneum

can go to C3-C5 dermatiomes b/c of sensory innervation from phrenic