Abdominal Viscera

Question 1

Phrenicoesophageal ligaments

Answer 1

ligamentous attachment b/w esophagus and diaphragm that allows independent movement of the esophagus
prevent herniation of esophagus into thorax

Question 2

Paraesophageal hiatal hernia

Answer 2

fundus of stomach herniates thrum hiatus anterior to the esophagus, may strangulate

Question 3

Sliding hiatal hernia

Answer 3

caused by a weakening of the phrenicoesophageal ligaments allowing the cardia and the fundus to herniate

Question 4

Stomach bed

Answer 4

Diaphragm 
spleen 
L kidney and suprarenal gland 
Pancreas 
Transverse colon and mesocolon

Question 5

First (superior) part of duodenum

Answer 5

continuous with pylorus
peritonealized, associated with the hepatoduodenal ligament (of lesser omentum)
called the duodenal bulb due to thin walls
( gastroduodenal a. lies posterior, susceptible to damage after an ulcer)

Question 6

second (descending) part of duodenum

Answer 6

descends R to LV1-LV3
retroperitoneal
has major duodenal papilla and minor duodenal papilla

Question 7

third (horizontal) part of duodenum

Answer 7

runs transversely from R to L at LV3
retroperitoneal
runs under superior mesenteric a. and can be compressed like in nut-cracker syndrome

Question 8

fourth (ascending) part of duodenum

Answer 8

ascends left of vertebral column from LV3–>LV2
retroperitoneal (except for last part)
duodenojejunal flexure is supported by the suspensory ligament of Treitz

Question 9

Peptic ulcers

Answer 9

lesions of the mucosa of the stomach (gastric) or duodenum (most common

can cause peritonitis, damage the pancreas, splenic a. or the gastroduodenal a.

Question 10

jejunum vs ileum

Answer 10

J= proximal 2/5th
J has thicker wall, wider diameter, more plica circulares
increased vascularity 
less fat
less peyer's patches 
more vasa recta 
less arterial arcades

Question 11

Tenia coli

Answer 11

longitudinal muscle from cecum to rectosigmoidal junction that is incomplete (3 distinct bands)
contractions create haustra

Question 12

arteries that create the marginal a.

Answer 12

SMA:
Ileocolic
R colic
M colic

IMA:
L colic
sigmoidal

Question 13

internal anal sphincter

Answer 13

surrounds superior 2/3 of anal canal
SNS L1 L2 fibers cause tonic constriction
PSNS S2-4 cause relaxation

Question 14

External anal sphincter

Answer 14

surrounds the inferior 2/3 of anal canal
voluntary muscle innervated by inferior rectal n.
tonically active

Question 15

venous drainage of anus

Answer 15

superior–>to superior and middle rectal vv.
inerior—>inferior rectal v.

**relative to pectinate line

Question 16

lymphatic drainage of anus

Answer 16

superior—>internal iliac lymph nodes
inferior—> superficial inguinal lymph nodes
**relative to pectinate line

Question 17

nerve supply to anus

Answer 17

superior—> autonomic
inferior= somatic
**relative to pectinate line

Question 18

epithelial lining of anus

Answer 18

superior= typical GI mucosal lining
inferior= Stratified squamous
**relative to pectinate line