Abdominal Viscera Flashcards
What is the length of the oesophagus?
25cm
Where does the oesophagus start?
pharynx
(level of cricoid cartilage, C6)
What is the significance of the oesophagogastric junction?
Abrupt change (z-line) where the lining of the oesophagus (stratified epithelium) ends and the gastric mucosa of the stomach begins
What are the points of oesphageal narrowing?
cervical - the upper oesophageal sphincter (swallowing)
thoracic - aortic arch & LMB
abdomen - diaphragmatic orifice at T10
What is the arterial supply to the cervical oesophagus?
inferior thyroid artery
What is the arterial supply to the thoracic oesophagus?
oesophageal branches of the aorta
What is the arterial supply to the abdominal oesophagus?
left gastric from the aorta
What is the venous drainage of the cervical oesophagus?
brachiocephalic (drains into caval system/SVC)
What is the venous supply of the thoracic oesophagus?
azygous (drains into caval/SVC)
What is the venous supply of the abdominal oesophagus?
L gastric portal (drains into the portal venous system)
What is the lymphatic drainage of the cervical oesophagus?
deep cervical LNs
What is the lymphatic drainage of the thoracic oesophagus?
mediastinal LNs
What is the lymphatic drainage of the abdominal oesophagus?
pre-aortic LNs
What is a hiatus/hiatal hernia?
herniation of part of the stomach through the oesophageal hiatus into the posterior mediastinum
What is the most common type of hiatus hernia?
sliding - 95%
oesophagus and stomach pulled up through hiatius at T10
What is the uncommon type of hiatus hernia?
paraoesophageal - 5%
stomach comes up through hiatus at T10, beside the oesophagus
What closes the superior opening of the stomach?
cardiac orifice/cardiac sphincter
What clsoes the distal end of the stomach?
pyloric sphincter
What is the significance of the angular notch of the stomach?
defines the end of the body of the stomach
The gastrosplenic ligament
tethers the greater curvature of the stomach to the spleen (greater omentum)
R & L gastric arteries run in the
lesser curvature of the stomach
R & L gastroepiploic arteries run in the
greater curvature of the stomach
veins of the stomach drain into the
portal circulation
The length of the duodenum is
10 inches (4 parts)
Which parts of the duodenum are retroperitoneal?
all but the first inch
What is the primary function of the duodenum?
absorbtion of digestion products
What is the first part of the duodenum?
duodenal cap, 2 inches
(1st inch is intraperitoneal, 2nd inch is retroperitoneal)
the majority of peptic ulcers occur in the
duodenal cap
due to imbalance of acid secretion and mucosal defences
the duodenal cap sits on
the right psoas, just medial to the R kidney
the second part of the duodenum is
3 inches long, vertical
passes next to head of the pancreas and the hilum of the R kidney on psoas major
the second part of the duodenum contains the
1.5 inches/halfway down posteromedial wall
major duodenal papilla: opening of the bile & pancreatic ducts
1 inch above lies the minor duodenal papilla (accessory pancreatic duct)
the third part of the duodenum is
4 inches long, horizontal; retroperitoneal
crosses R psoas to L psoas over the lumbar VC, IVC, and abdo aorta
the fourth part of the duodenum
1 inch long, curving anteriorly into the jejunum
attached by fibrous tethering to L psoas
the length of the small intestine not including the duodenum is
4-6 metres
the duodenojejunal flexure is
where the duodenum ends and the jejunum begins