Abdominal Viscera Flashcards
Celiac trunk
Supplies foregut
Distal esophagus, stomach, liver, gallbladder, spleen, 1/2 duodenum
SMA
Supplies midgut
1/2 duodenum to 2/3 transverse colon
IMA
Supplies hindgut
1/3 transverse colon to anus
Esophagus
Begins at pharyngo-esophageal junction, ends at esophageo-gastric junction
Esophageal constrictions
Upper esophageal sphincter
Thoracic when arch of aorta and left main bronchus cross
Esophageal hiatus at T10
Esophageal innervation
Esophageal plexus
Cervical vagus nerves
Run parallel to esophagus
Left vagus - ant vagal trunk
Right vagus - post vagal trunk
Stomach
J shaped
Cardia, fundus, body, pylorus
Peritoneal ligaments
Lesser omentum
Greater omentum
Lesser omentum
Hepatogastric & hepatoduodenal
Greater omentum
Policeman
Gastrophrenic, gastrosplenic, gastrocolic
Interior of stomach
Rugae and canal along lesser curve
Small intenstine
Pylorus to ileoceal junction
1st part of duodenum = intraperitoneal, rest = 2ary retroperitoneal
Root of the mesentery
Duodenojejunal junction to ileocecal junction
The Mesentery
Jejunum and ileum
Duodenum
Superior - L1, starts at hepatoduodenal ligament
Descending - L1-L3, bile & pancreatic duct enter
Horizontal - L3, passes over IVC, aorta: under SMA
Ascending - L3-L2, supported by suspensory ligament of duodenum (Ligament of Treitz)
1ST part of duodenum
Superior
Hepatoduodenal ligament
Intraperitoneal
2ND part of dudoenum
Descending
Common bile and pancreatic ducts empty in major, lower papilla
Retroperitoneal
3RD part of dudoenum
Horizontal
In front of IVC & aorta, behind SM vessels
Retroperiotoneal
4TH part of duodenum
Suspensory ligament/Ligament of Treitz
Duodenum arterial supply
Supplied 1/2 by celiac, 1/2 by SMA
Anastamosis at superior and inferior pancreatoduodenal a.
Peptic ulcers
Lesion of mucosa
Can treat with antibiotics or vagotomy
Posteriorly could affect stomach bed organs
Paraduodenal hernias
Retroperitoneal portions protrude intraperitoneally
Be careful of IMV and ascending l. colic a
Jejunum
Mostly at LUQ, starts of Ligamentum of Treitz
Ileum
RLQ
Communicates with LI at ileocecal junction
Jejunum vs ileum
Jejenum has less large arterial arches
Jejunm has more tightly packed plicae circularis
Large intenstines
Tenaie coli - muscle bands
Haustra - sacs
Omental appendages
Cecum
Intraperitoneal
RLQ
Appendix
Intraperitoneal
Comes off cecum
Covered in mesoappendix
Ascending colon
Retroperitoneal
Ileocecal junction to right colic flexure
Trasnverse colon
Intraperitoneal
Right colic flexure to left colic flexure
Descending colon
Retroperitoneal
Left colic flexure to pelvic
Sigmoid colon
Intraperitoneal, S shaped
Runs in midline to rectum
Rectum/anus
Retroperitoneal
Top 2/3 = visceral
Bottom 1/3 = somatic
Ampulla stores feces
Appendicitis
Inflaammation of appendix
Pain starts around umbilicus (T10) then spreads to RLQ - McBurney’s point
Treat with appendectomy
Diverticulosis
Presence of tiny bulges, usually in sigmoid colon
Diverticulitis
Inflammation or infections of diverticula
Intussusception
Invagination of bowel segments not another
Usually ilecocecal - ileum into cecum
Common in babies - currant jelly poop
