Abdominal Viscera Flashcards
What parts of the GI tract are derived from the embryonic foregut
esophagus stomach upper deuodenum liver gallbladder pancreas (associated outgrowth organs)
The parts of the GI tract are derived from the embryonic foregut are supplied by what artery
celiac trunk
What parts of the GI tract are derived from the embryonic midgut
lower duodenum jejunum ileum cecum appendix ascending colon proximal 2/3 of the transverse colon lower part of pancreas
The parts of the GI tract are derived from the embryonic midgut are supplied by what artery
superior mesenteric artery
What parts of the GI tract are derived from the embryonic hindgut
distal 1/3 of transverse colon
descending colon
sigmoid colon
superior part of rectum
The parts of the GI tract are derived from the embryonic hindgut are supplied by what artery
inferior mesenteric artery
The esophagus passes through diaphragm through what opening and at what spinal level
esophageal hiatus
T10
The stomach is located in what regions of the anterior abdominal wall
left hypochondriac
epigastric
the stomach empties into what?
duodenum
what are the 4 features (parts) of the stomach
Cardia- where esophagus meets stomach
Fundus- superior to esophageal junction usually filled with air
Body- major part (variable in size)
Pylorus- distal end, divided into regions
Name the regions of the pylorus
angular notch
pyloric antrum
pyloric canal
pyloric sphincter
what are rugae
longitudinal ridges (folds) on inner surface of stomach raised folds of mucosa that allow for stomach expansion
transpyloric plane (what is it, what does it pass through)
useful landmark that lies between xiphoid process and umbilicus
at level L1
passes through: pylousi of stomach, duodenojejunal junction, hila of kidneys, and tips of 9th costal cartilage
duodenum (what is it, how long is it, whats it shape)
first and shortest part of small intestine (10 inches)
curves around head of pancreas in C shape
divided into 4 parts
stomach (what is it, whats its shape)
expansion of gut tube between esophagus and small intestine
resembles the letter J
empties into duodenum
name the 4 parts of the duodenum
1st superior part (distal to pyloric orfice)
2nd descending part
3rd horizontal part (between descending and ascending duodenum)
4th ascending part
What does the descending duodenum (2nd part) do
receives common bile duct and mind pancreatic ducts via hepatopancreatic ampulla
major duodenal papilla (of Vater)
what is it
small profusion on the internal surface of the duodenum where the hepatopancreatic ampulla enters
Hepatopancreatic Sphincter (of Oddi) (what is it)
circular smooth muscle that surrounds the ampulla of the descending duodenum
controls bile and pancreatic secretions
what does the major duodenal papilla mark?
junction between foregut and midgut
Ascending Duodenum (4th part) (how is it secured and what does it empty to)
secured to diaphragm by the suspensory muscle of the duodenum (ligament of Treitz)
empty into jejunum
suspensory muscle of the duodenum (ligament of Treitz)
what is it and where does it run
musculo-tendinous band
runs from ascending duodenum to right crus of diaphragm
what part of small intestine is found in all 4 quadrants
jejunum and ileum
jejunum (what is it, how long is it)
middle part of small intestine
begins at dudodenojejunal junction
about 8 feet long
ileum (what is it, how long is it)
distal 12 feet of small intestine
ends at cecum
describe the diameter of jejunum and ileum
jejunum: larger (thick walls)
ileum: smaller (thinner walls)
describe the arterial arcades of jejunum and ileum
jejunum: few tiers
ileum: many tiers
describe the vasa recta of jejunum and ileum
jejunum: long, few
ileum: short, many
describe the “windows” of jejunum and ileum
jejunum: relatively large
ileum: small or absent
describe the associated fat (how much) of jejunum and ileum
jejunum: little
ileum: encroaches over intestine
describe the plicae circulares (infoldings) on inner surface of jejunum and ileum
jejunum: many, large
ileum: few, small
cecum (what is it, what quadrant is it in, whats associated with it)
first part of large intestine
lower right quadrant
dilated sac that is continuous with ascending colon
contains associated appendix
vermiform appendix (what is it)
worm-like appendage to cecum
most commonly retrocecal
base lies deep to McBUrney’s point
ascending colon (path)
ascends along right side of abdominal wall to hepatic )right colic) flexure
is the stomach intraperitoneal or retroperitoneal (describe)
intraperitoneal- almost completely covered with peritoneum
is the duodenum intraperitoneal or retroperitoneal (describe)
partially retroperitoneal- fixed to posterior abdominal wall by the peritoneum
are the jejunum and ileum intraperitoneal or retroperitoneal (describe)
intraperitoneal- attached to posterior abdominal wall by fan shaped mesentery
mobile
is the cecum intraperitoneal or retroperitoneal (describe)
intraperitoneal- almost completely covered with peritoneum and moves freely (no mesentery)
is the vermiform appendix intraperitoneal or retroperitoneal (describe)
intraperitoneal- contains short triangular mesentery (mesoappendix)
is the ascending colon intraperitoneal or retroperitoneal (describe)
retroperitoneal- usually find to the right side of the posterior abdominal wall
immobile
transverse colon (path)
extends across abdomen from hepatic (right colic) flexure to splenic (left colic) flexure
is the transverse colon intraperitoneal or retroperitoneal (describe)
intraperitoneal- has a mesentery
most mobile part of large intestine (position varies)
descending colon (path)
descends along left abdominal wall from splenic (left colic) flexure to sigmoid colon
is the descending colon intraperitoneal or retroperitoneal (describe)
retropertioneal- bound to posterior abdominal wall
immobile
sigmoid colon (path)
s-shaped loop of colon b/w descending colon and rectum
is the sigmoid colon intraperitoneal or retroperitoneal (describe)
intraperitoneal- usually has a long mesentery and thus considerably mobility to vary in position
what is the most mobile part of large intestine
transverse colon
teniae coli (what are they)
three longitudinal muscle bands formed by the large intestines outer muscular coat
haustra (what is it)
sacculations of colon produced by the teniae coli
slightly shorter than the gut
plicae semilunaris (what are they)
infoldings of intestinal wall between haustra
appendices epiploicae (what are they)
peritoneum-covered pouches of fat attached in rows along the teniae
the minor duodenal papilla is connected to what duct
accessory pancreatic duct
are the rectum and anal canal intraperitoneal or retroperitoneal (describe)
retroperitoneal- rectosigmoid junction marked by end of sigmoid mesocolon
spleen (embryonic origin)
independent from the gut tube
spleen (what is it and location)
large lymph organ
left hypochondrial region lying against the diaphragm and ribs 9-10
is the spleen intraperitoneal or retroperitoneal (describe)
intraperitoneal- covered b peritoneum except for at hilum
name and describe the anatomical relations of the spleen
stomach- anterior
diaphragm- posterior and superior
left colic flexure- inferior
left kidney- medal
what connects spleen to greater curvature of stomach
gastrosplenic ligament of peritoneum
what connects the spleen to the left kidney
splenorenal ligaent
pancreas (what is it and where is it found)
digestive (exocrine) and endogrine organ
epigastric region
left hypochondrial region
is the pancreas intraperitoneal or retroperitoneal (describe)
retroperitoneal- except for small part of its tail that lies in the splenorenal ligament
name the features of the pancreas
head neck body tail uncinate process
main pancreatic duct of Wirsung (how does it run, what does it join)
runs tail to head
joins bile duct to form hepatopancreatic ampulla before entering 2nd part of duodenum at the major duodenal papilla
accessory pancreatic duct of Santorini ( what does it drain, where does it open)
drains small part of the head
often communicates with main pancreatic duct
opens into minor duodenal papilla
the head of the pancreas lies where?
curvature of duodenum
what is anterior to pancreas
stomach
what is posterior to pancreas
IVC
aorta
left kidney
what is the largest visceral organ in the body
liver
liver
right hypochondrial region
epigastric region
divided into 4 anatomical lobes s
what is the largest gland found in the body
liver
is the liver intraperitoneal or retroperitoneal (describe)
intraperitoneal- except bare area on diaphragmatic surface where liver contacts diaphragm
what forms the coronary and falciform ligaments and right and left triangular ligaments
free folded edges of peritoneum that attach the liver to diaphragm
what is the bare area of the liver
diaphragmatic surface of liver that is devoid of peritoneum
what is the coronary ligament
peritoneum that forms the right and left triangular ligament
what is the falciform ligament
fold of peritoneum that connects the liver to anterior abdominal wall
contains ligamentum teres hepatis (round ligament)- obliterated umbilical vein
name the 4 lobes of the liver
left
right
caudate
quadrate
what is the largest lobe of liver and what does it give rise to
right lobe
gives rise to caudate and quadrate lobes
the left lobe is separated along groves for what?
ligmentum teres- obliterated umbilical vein (connected liver to umbilical veins)
ligamentum venosum- obliterated ductus venous (fetal connection b/w umbilical vain and IVC)
porta hepatis (what is it and what does it transmit)
transverse fissure between quadrate and caudate lobes transmits: portal vein hepatic arteries lymphatic vessels hepatic nervous plexus hepatic ducts
hepatoduodenal ligament (what is it and what does it contain)
fold of peritoneum connecting the duodenum and liver in the edge of the lesser momentum
contains portal triad
portal triad (what is it)
bile duct
hepatic artery
portal vein
gallbladder (locaton)
located at 9th costal cartilage and lateral border of rectus abdominis
right upper quadrant
inferior surface of liver between right and quadrate lobes
gallbladder (function)
stores and concentrates bile with a capacity of 30-50mL
is the gallbladder intraperitoneal or retroperitoneal (describe)
intraperitoneal- covered in peritoneum closely adherent to liver
name the features of the gallbladder
fundus
body
neck
cystic duct
cystohepatic triangle (of Calot) (what forms it)
important surgical landmark:
visceral surface of liver (superiorly)
cystic duct (inferiorly)
common hepatic duct (medially)
cystohepatic triangle (of Calot) (contents)
cystic artery lymph node (of calot)- becomes enlarged during gall bladder inflammation
right and left hepatic ducts (where do they leave liver)
through porta hepatis
common hepatic duct (formed by what)
union of left and right hepatic duct
cystic duct (does what)
fills and drains the gall bladder
bile duct (formed by what and travels where)
formed by union of common hepatic and cystic ducts
descends posterior to 1st part of duodenum and runs though head of pancreas
main pancreatic duct (joins what and forms what)
joins bile duct
forms hepatopancreatic ampulla
Ileal Diverticulum (of Meckel) (what is it)
congenital abnormality of the small intestines
finerlike pouch in ileocecal junction
remnant of embryonic yolk sac
most people asymptomatic
rule of 2’s (2% of people, 2 inches in length, within 2 feet of ileocecal orifice, two types of tissue)
Volvulus (what is it and what does it cause)
abnormal twisting of intestine
can cause intestinal obstruction and interruption of blood supply (leads to necrosis of tissues)
Situs Inversus (what is it)
left to right inversion of the boys organs
occurs during development and is
can occur totally or partially
Gallstones (what are they, what doe they consist of)
calcifications (calculi) formed int the gall bladder or bile passages
consist of cholesterol and bile pigment
can lodge and obstruct bile passages
obstructive jaundice
caused by blockage of bile ducts from gallstones, tumor, and/or compression of pancreas
leads to jaundice- yellowing of the skin and whites of the eyes due to excess bile pigment (bilirubin) in the plasma
how are cancers in the head of the pancreas often detected
obstructie jaundice
fractured rib or blows to the left hypochondrium can rupture what viscera
spleen
relationship to posterior abdominal wall at levels 9-10
why is it usually not possibly to completely resect the pancreas (even in cases of cancer or chronic pancreatitis)
close anatomical relationships of pancreas with duodenum, bile ducts, and their vasculature
