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Anatomy II Test I - Jourdan > Abdominal Viscera > Flashcards

Abdominal Viscera Flashcards

0
Q

What is the esophageal hiatus?

A

The area that the thoracic esophagus pierces the diaphragm slightly left of midline

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1
Q

Where does the thoracic esophagus pierce the diaphragm?

A

At T10

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2
Q

At about T11, describe the esophagus

A

Turns sharply left to enter the stomach at the cardia orifice
The abdominal esophagus is about 2.5 cm

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3
Q

What part of the esophagus is physiologic, but not well-defined anatomically?

A

The esophageal sphincter

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4
Q

What structure passes through the diaphragm at T8?

A

Inferior vena cava

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5
Q

What structure passes through the diaphragm at T12?

A

The aorta

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6
Q

What are openings in the diaphragm called?

A

“hiatuses”

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7
Q

Define “sliding” hiatal hernia?

A

Esophageal hiatus of diaphragm enlarges or weakens

Abdominal esophagus and parts of the stomach (cardia and sometimes fundus) herniate into the thorax

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8
Q

Define paraesophageal hiatal hernia

A

A defect in diaphragm next to the esophageal hiatus

Permits fundus of stomach to herniate (not usually the esophagus)

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9
Q

What is the location of the stomach?

A

Left hypocondriac and epigastric regions
Left end fixed at T10-11
Right end fixed at L1-2

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10
Q

What are the parts of the external stomach?

A 
Fundus
Cardiac pat, cardiac orifice
Body 
Pylorus
Pyloric antrum: entrance to pylorus
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11
Q

What are the parts of the internal stomach?

A

Rugae
Pylorus (pyloric sphincter)
Pyloric orifice: entrance to the duodenum

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12
Q

What are the curvatures of the stomach?

A

Curvatures: Lesser and greater
Angular incisure
Pylorus
Pyloric antrum

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13
Q

What are the posterior surfaces of the stomach?

A 
Splenic surface 
Renal surface
Pancreatic surface
Colomesocolic surface
Phrenic surface
Suprarenal surface
Hepatic surface
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14
Q

What is posterior to the stomach?

A 
Diaphragm
Spleen (posterior and lateral)
Left suprarenal gland
Upper left kidney
Pancreas
Left colic flexure
Left transverse colon
Transverse mesocolon
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15
Q

What are the anterior surfaces of the stomach?

A

Hepatic surface
Phrenic surface
Epigastric surface

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16
Q

What is anterior to the stomach?

A

Anterior abdominal wall
Left costal margin
Left diaphragm
Left and quadrate lobes of the liver

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17
Q

What are the muscularis externa layers of the stomach?

A

Longitudinal layer
Circular layer
Oblique layer

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18
Q

Where is the small intestine located?

A

Between the stomach and the large intestine

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19
Q

What is the small intestine subdivided into?

A

3 parts
Duodenum, Jejunum, Ileum
D.J ilium

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20
Q

Describe general characteristics of the duodenum

A

C-shaped
10 inches long
Located approximately at L1 to L4 vertebral bodies
Starts at the pylorus of the stomach and ends at the duodenal-jeju junction

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21
Q

What is the duodenum subdivided into?

A

Superior
Descending
Horizontal
Ascending

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22
Q

Is the duodenum primarily or secondarily retroperitoneal?

A

Secondarily retroperitoneal except for some of the 1st and 4th parts

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23
Q

What is most of the duodenum anteriorly covered by?

A

Peritoneum except where the mesocolon of the transverse colon crosses the 2nd part

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24
Q

What is the 1st part of the duodenum surrounded by?

A

The hepatoduodenal ligament

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25
Q

Where does the root of the mesentery begin?

A

Begins at the duodeno-jejunal flexure

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26
Q

What are the features of the 1st part (superior) of the duodenum

A

Starts at the pyloric sphincter
About 2 inches long
Held in place by the hepatoduodenal ligament
Portal vein, hepatic artery and bile duct are therefore posterior and superior to the ligament
Duodenal bulb (widened area)
Head of the pancreas is inferior to the bulb

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27
Q

Describe the features of the 2nd part (descending) of the duodenum

A

About 3 inches long
All retroperitoneal (2arily)
The fundus of the gall bladder, right lobe of the liver, transverse colon are all anterior
The right kidney and ureter are posterior
The head of pancreas is medial
The bile and pancreatic ducts enter into this section of the duodenum at the major duodenal papilla

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28
Q

What are the features of the 3rd part (horizontal) of the duodenum?

A

The superior mesenteric artery and vein and the root of the mesentery cross the anterior surface of this section
The head of the pancreas is superior
The jejunum is anterior and inferior

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29
Q

What are the features of the 4th part (ascending) of the duodenum?

A

Not covered by peritoneum
The root of the mesentery and jejunum are anterior
The left margin of the aorta and medial border of the psoas muscle are posterior
Held in place by suspensory ligament (or muscle) of the duodenum (of Treitz)
The suspensory ligament anchors the section to the right crus of the diaphragm

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30
Q

What are the general features of the jejunum and ileum?

A

Occupy most of the peritoneal cavity of the abdomen and pelvis
Coiled and about 20 feet long
The jejunum begins at duodenal-jejunal junction and the ileum ends at the ileo-cecal valve
—This part of the small intestine is very mobile and is held to posterior wall by THE mesentery

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31
Q

What frames the jejunum and ileum?

A

Large intestines

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32
Q

What parts are called the “free” small intestine?

A

Jejunum and ileum

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33
Q

What are the characteristics of the jejunum?

A

8-10 feet long
2/5 of the free small intestine

Compared to the ileum, the jejunum has:
Long vasa recta; simple vascular arcades; more vascular
More plicae circularis; greater diameter; thicker

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34
Q

What are the characteristics of the ileum?

A

10-12 feet long
3/5 of the free small intestine

Compared to the jejunum the ileum has:
Has compound vascular arcades; shorter vasa recta; less vascular
Smaller diameter, thinner wall, fewer plicae circularis

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35
Q

What is meckel’s (ileal) diverticulum?

A 
A possible feature of the ileum
Most common congenital anomaly of the small intestine 
Occurs in about 2% of the population
About 2 feet from the ileocecal junction
Average is 2 inches long
Remnant of vitelline duct
clinically difficult to distinguish from appendicitis 
May contain other types of tissue

**Almost like an extra appendix

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36
Q

What is the jejunum and ileum supported by?

A

THE mesentery

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37
Q

Describe THE mesentery in relation with the jejunum and ileum

A

15 cm long at the root

Attaches the jejunum and ileum to the posterior body wall

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38
Q

What does THE mesentery cross?

A 
LV1-2
3 part of duodenum
aorta
IVC
right ureter
right gonadal vessels
right psoas major
ends at right S.I. joint
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39
Q

Describe THE mesentery

A

2 layers of peritoneum with nerves, lymph nodes, and vessels
fat, arteries and veins running between the layers

6 to 7 inches long at it’s root and 20 feet long at it’s intestinal border

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40
Q

What are the regions of the large intestine?

A 
Cecum and vermiform appendix
Ascending colon (AC)
Right colic flexure (RCF)
Transverse colon
Left colic flexure (LCF)
Descending colon 
Sigmoid colon
Rectum and anal canal are in the pelvis
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41
Q

What are the general characteristics of the large intestine?

A

Highly mobile and location of its parts is variable

Functions: fecal formation, transport and evacuation, water absorption and mucus secretion

42
Q

What are 3 bands of longitudinal muscles on the outside of the colon called?

A

Taenia coli

43
Q

Where do taenia coli converge?

A

At the root of the appendix

44
Q

What do taenia coli produce?

A

Haustrae (sacculations) that slow the movement of feces

45
Q

What are tags of fat on the large intestine?

A

Appendices epiploicae

46
Q

What are structures of the cecum?

A

No epiploic appendages: blind “pouch” inferior to ileocecal orifice
Iliocolic valve: 2 folds that are not a true sphincter
ileal papilla: cone-like projection of the ileum into the cecum
The opening for the appendix is inferior to the ileal papilla

47
Q

What is the vermiform appendix?

A

Structure attached to the postero-medial part of the cecum
Located at the junction of 3 taenia coli
9-10 cm long and supported by a mesoappendix
Position variable

48
Q

Describe the ascending colon

A

Right colic flexure (hepatic flexure)
Secondarily retroperitoneal (usually)
Except the lowest part

49
Q

Describe the transverse colon

A

Left colic flexure (splenic flexure)

Intraperitoneal (transverse mesocolon)

50
Q

Describe the descending colon

A

Secondarily retroperitoneal

51
Q

Describe the sigmoid colon

A

Intraperitoneal (sigmoid mesocolon )

52
Q

What is the size, shape and location of the spleen?

A

Left hypochondriac region
Parallels left ribs 9, 10, and 11
Midaxillary line, between stomach and diaphragm
About the size of a hand
Normally not palpable below the costal margin

53
Q

What is the spleen covered by?

A

Peritoneum

54
Q

The peritoneum that covers the spleen develops where?

A

In the dorsal mesentery from the mesoderm

55
Q

What are the mesenteries of the spleen?

A

Gastrosplenic ligament and splenorenal ligament

56
Q

Where is the diaphragm in reference to the spleen

A

Posterior

57
Q

The stomach, left colic flexure and tail of the pancreas are (anterior/superior/inferior/posterior) to the spleen?

A

Anterior

58
Q

The left kidney and phrenicocolic ligament are _______ to the spleen

A

Inferior

59
Q

The diaphragmatic surface of the spleen is _____

A

Against the diaphragm and smooth

60
Q

The visceral surface of the spleen has impression made by what?

A

Colic, gastric and renal

61
Q

The hilum of the spleen is on what surface?

A

The visceral surface

62
Q

What does the hilum of the spleen have?

A

Gastrosplenic and spleorenal ligaments (houses vessels going into the spleen)

63
Q

The pancreas is primarily or secondarily retroperitoneal?

A

2arily

64
Q

Where is the pancreas located?

A

About L1 and L2

65
Q

What are the parts of the pancreas?

A

Head, body, neck, and tail

66
Q

Describe the head of the pancreas

A

Has uncinate process

and is in the duodenal curve

67
Q

Describe the body of the pancreas

A

Triangular cross-section

68
Q

Describe the neck of the pancreas

A

Constricted part between head and body

69
Q

Describe the tail of the pancreas

A

Some of the tail is located in the splenorenal ligament

Anterior to the hilus of the spleen

70
Q

What are posterior to the neck of the pancreas?

A

Superior mesenteric artery and vein

71
Q

What runs horizontally superior to or posterior to the body of the pancreas?

A

Splenic vein and artery

72
Q

What is the tail of the pancreas against?

A

The spleen

73
Q

What is anterior to the spleen?

A

The stomach

74
Q

What is posterior to the body of the pancreas?

A

Inferior vena cava and aorta

75
Q

What is superior, right and inferior to the head of the pancreas?

A

The duodenum

76
Q

What lies anterior and inferior to the pancreas?

A

Transverse colon

77
Q

The main or major pancreatic duct joins the bile duct and they enter the 2nd part of the duodenum together through what?

A

Common hepatopancreatic ampulla

78
Q

What forms the major duodenal papilla?

A

Hepatopancreatic ampulla

79
Q

The accessory pancreatic duct (if present) enters the duodenum where?

A

At the more superior minor duodenal papilla

80
Q

Where is most of the liver located?

A

Right upper quadrant

81
Q

Where is the smaller left lobe of the liver located?

A

In the left upper quadrant

82
Q

What are the lobes of the liver?

A

Left lobe
Right lobe
Caudate lobe
Quadrate lobe

83
Q

What double layer of peritoneum that connects liver to the anterior wall?

A

The falciform ligament

84
Q

Describe the diaphragmatic surface of the liver

A

Smooth, fits concavity of diaphragm

85
Q

What is the “bare area” of the liver?

A

between the two layers of the coronary ligament lies the bare area of the liver, and is attached to the diaphragm by areolar tissue.

Peritoneum that attaches the liver to the anterior body wall and the peritoneum splits to enclose a “bare area”

86
Q

What does the bare area include?

A

The area where the IVC is posterior to the liver and the hepatic veins drain into it

87
Q

What structure is between the caudate and left lobe of the liver?

A

Ligamentum venosum

88
Q

What structure can be found between the quadrate and the left lobe of the liver?

A

Ligamentum teres h.

89
Q

What fossa is found between the quadrate and right lobe of the liver?

A

Hepatic fossa for gall bladder

90
Q

What surface features are found on the visceral posterior surface of the liver?

A

Porta hepatis
Ligamentum teres
Ligamentum venosum
Hepatic fossa for gall bladder

91
Q

Describe the porta hepatis of the liver

A

A transverse fissure between caudate and quadrate lobes that transmits the portal triad

92
Q

What is the portal triad?

A

Hepatic artery (proper)
Portal vein
Bile duct

93
Q

describe the ligamentum teres

A

It is in the edge of the falciform and is the obliterated umbilical vein

94
Q

Describe the ligamentum venosum

A

It is the “old” ductus venosus

It was used to connect the umbilical vein with the inferior vena cava

95
Q

What are peritoneal attachments of the liver?

A

Falciform ligament with ligamentum teres

Lesser omentum with hepatoduodenal and hepatogastric ligaments

96
Q

Where does the gall bladder lie?

A

In the hepatic fossa

97
Q

What is the fundus of the gallbladder

A

The lowest, widest part
Contacts anterior abdominal wall at the midclavicular line, 9th or 10th costal cartilage
Usually located on the transpyloric line

98
Q

What are the parts of the gall bladder?

A

Fundus, body and neck

99
Q

What are the extrahepatic bile passages?

A

Right hepatic duct (R)

Left hepatic duct (L)

100
Q

What do the extrahepatic bile passages form together?

A

The common hepatic duct

101
Q

What is the structure between the common hepatic duct and the gall bladder?

A

Cystic duct

102
Q

What is the common bile duct?

A

Formed from the cystic and common hepatic ducts
Runs in the edge of the lesser omentum (hepatoduodenal ligament)
Goes posterior and inferior to the 1st part of the duodenum, posterior to the head of the pancreas, enters the 2nd part of the duodenum with the pancreatic duct

Anatomy II Test I - Jourdan (10 decks)

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