Abdominal Viscera

Question 1

At what vertebral level does the esophagus pierce the diaphragm to enter the abdomen?

Answer 1

T9/10

Question 2

What happens to the vagal trunks associated with the esophagus in the thorax?

Answer 2

The left and right vagi become anterior/posterior respectively and pass through the diaphragm to supply parasympathetic innervation to the prevertebral plexuses of the abdomen.

Question 3

Is there an anatomical sphincter at the gastroesophageal junction?

Answer 3

No

Question 4

What keeps gastric reflux from normally occurring at the gastroesophageal junction?

Answer 4

It is a physiological sphincter, the negative pressure of the thorax keeps the esophagus pressed closed.

Question 5

Be able to label the various anatomical regions of the stomach.

Answer 5

Diagram on page 195.

Question 6

List organs that have an anatomical relationship with a specific aspect of the stomach.

Answer 6

Anterior/superior: anterior abdominal wall, left costal margin, diaphragm; Left: spleen; Right: quadrate and left lobes of the liver; Posterior: diaphragm, left suprarenal gland, upper pole of left kidney, pancreas and left colic flexure.

Question 7

Be able to label the various surface anatomical features of the liver.

Answer 7

Diagrams on pages 196-197 and information from the lab.

Question 8

What divides the right and left lobes of the liver anatomically when viewed from its
anterior aspect?

Answer 8

The falciform ligament.

Question 9

What does the anatomical arrangement between the visceral peritoneum of the liver and the diaphragm form by its reflection.

Answer 9

It creates the bare area of the liver, left triangular ligament and right coronary ligaments.

Question 10

What does the bare area of the liver come into contact with? Be specific.

Answer 10

The bare underside of the diaphragm.

Question 11

Why is the bare area of the liver important?

Answer 11

Liver abcesses can pass “silently” up through the diaphragm giving little notice before perforating through into the pleural cavity.

Question 12

Be able to label a diagram of the biliary tree.

Answer 12

This is important (page 198). See X-rays in the course CD as well.

Question 13

What is the function of the gallbladder?

Answer 13

To store and concentrate bile secreted by the liver.

Question 14

Why does the gallbladder have a serosa and an adventitia?

Answer 14

That portion of the gallbladder exposed to the abdominal cavity is covered with peritoneum, that portion attached to the underside of the liver has no peritoneum = adventitia.

Question 15

List the 3 parts of the small intestinal, in order, from proximal to distal.

Answer 15

Duodenum, jejunum, ileum.

Question 16

Which of these 3 regions is predominantly retroperitoneal?

Answer 16

The duodenum.

Question 17

Which of these 3 regions are mesenterized?

Answer 17

Jejunum and ileum.

Question 18

In which direction does the root of the mesentery cross the posterior abdominal wall?

Answer 18

From upper left to lower right.

Question 19

How can you differentiate the ileum from the jejunum?

Answer 19

The fat within the mesentery does not encroach upon the wall of the jejunum leaving “mesenteric windows” (except in obese individuals); in the ileum the fat comes right up to the ileal wall obliterating these windows.

Question 20

Be able to label a diagram of the surface anatomy of the large intestine.

Answer 20

This is important. Page 199. Has been on the exam before. Also be aware of these features in the lab specimens.

Question 21

What is taeniae coli?

Answer 21

One of 3 longitudinal bands of smooth muscle.

Question 22

What is the function of these 3 taeniae?

Answer 22

They “shorten” the tube, gathering it up and creating pocket-like compartments called haustra.

Question 23

What is the function of a haustral compartment?

Answer 23

They slow down the movement of feces through the large intestine allowing water resorption to occur.

Question 24

Where do the taenia coalesce into a complete outer layer of longitudinal smooth
muscle?

Answer 24

On the surface of the rectum as well as over the surface of the appendix.

Question 25

Identify the abdominal organs considered to be retroperitoneal.

Answer 25

Descending aorta, duodenum, pancreas, inferior vena cava, suprarenal glands, kidneys, ureters, ascending and descending colon.

Question 26

List the 4 parts of the duodenum.

Answer 26

1st (superior); 2nd (descending); 3rd (horizontal); and 4th (ascending).

Question 27

Which portion contains the duodenal papilla?

Answer 27

The 2nd (descending).

Question 28

What empties into the duodenal lumen at this papilla?

Answer 28

Bile and pancreatic enzymes.

Question 29

What organ is found nestled within the C-shape concavity of the duodenum?

Answer 29

The head of the panmcreas.

Question 30

What two important anatomical structures lie posterior to the 1st part of the duodenum?

Answer 30

Biliary duct (common bile duct) and main pancreatic duct.

Question 31

Which anatomical structures pass anterior to the 3rd part of the duodenum and behind head of pancreas?

Answer 31

The supermester mesenertic vein and artery.

Question 32

Cite the anatomical relationship each of the following has with the pancreas:
duodenum, spleen, formation of the hepatic portal vein, superior mesenteric a. and
v., the splenic a., and the hilus of the spleen.

Answer 32

Duodenum: head of pancreas nestled in C-shaped concavity; hepatic portal vein: formed behind the neck; Superior mesenteric a. and v.: pass anterior to the uncinate process; splenic a.: often lies embedded along the superior border of the pancreas; spleen: the tail of the pancreas lies in the hilus of the spleen.

Question 33

List the 3 main arterial trunks off the aorta that are responsible for supplying the G.I.T.

Answer 33

Celiac trunk; superior mesenteric and inferior mesenteric aa.

Question 34

Which general region of the gut does each of these 3 main arteries of the aorta supply?

Answer 34

Celiac trunk: foregut; superior mesenteric a.: midgut; and inferior mesenteric a.: Hindgut.

Question 35

What specific portions of the tubular G.I.T. are contained within each of these regions?

Answer 35

Foregut: lower esophagus to mid duodenum; midgut: mid duodenum to mid transverse colon; hindgut: mid transverse colon to rectum.

Question 36

Be able to label a diagram of the vessels off the celiac trunk, the superior mesenteric a. and the inferior mesentery a.

Answer 36

This is important, see diagrams on pages 203 and 205. The small intestinal aa. are tested primarily via x-rays. The diagram, on page 202 has also been tested using a matching question - matching the viscera with the “stump” of the artery concerned.

Question 37

Know the anatomical extent of each of viscera supplied by each of these 3 aa.

Answer 37

Celiac trunk: lower esophagus to mid duodenum; superior mesenteric a.: mid duodenum to mid transverse colon; inferior mesenteric a.: mid transverse colon to rectum.

Question 38

Be able to label a diagram of the vessels forming the hepatic portal vein.

Answer 38

This is very important (bottom, page 205). It is often on the exam.

Question 39

Where does the formation of the hepatic portal vein occur?

Answer 39

Posterior to the head/neck of the pancreas.

Question 40

What is the function of the hepatic portal system?

Answer 40

To ensure that ingested materials from the G.I.T. are screened by the liver prior to release into the systemic circulation.

Question 41

What is the importance of the portocaval anastomoses?

Answer 41

They are indicative of a blockage of either of the two circulatory systems (hepatic portal and systemic) concerned.

Question 42

Name the location of at least 3 of the more clinically relevant ones.

Answer 42

Esophagus: esophageal varices, anal canal: hemorrhoids, and umbilicus: caput medusa.