Abdominal Viscera Flashcards
What is a sliding hiatal hernia?
- esophageal hiatus of diaphragm enlarges or weakens
- abdominal esophagus and parts of the stomach (cardia and fundus) herniated into thorax
What is a paraesophagegal hiatal hernia?
- defect in diaphragm next to the esophageal hiatus
- permits fundus of the stomach to herniate (not usually the esophagus)
Where is the stomach?
- left hypochondriac and epigastric regions
- left end fixed at T10-11
- right end fixed at L1-2
What are the different parts of the stomach?
- fundus
- cardiac part, cardiac orifice
- body
- pylorus
- pyloric antrum
What are the surfaces of the stomach?
- rugae
- pylorus(pyloric sphincter)
- pyloric orifice -> entrance to duodenum
What organs are posterior to the stomach?
- diaphragm
- spleen
- left suprarenal gland
- upper left kidney
- pancreas
- left colic flexure
- left transverse colon
- transverse mesocolon
What structures are anterior to the stomach?
- anterior abdominal wall
- left costal margin
- left diaphragm
- left and quadrate lobes
What are the three subdivisions of the small intestine?
- duodenum
- jejunum
- ileum
What are some general features of the duodenum?
-C shaped
-10in long
-located at L1 to L4 vertebral bodies
-subdivided into 4 parts
+superior
+descending
+horizontal
+ascending
What ligaments and mesenteries is the duodenum covered by?
- covered anteriorly by peritoneum except where the mesocolon of the transverse colon crosses and 2nd part
- the 1st part is surrounded by the hepatoduodenal ligament
- the root of the mesentery begins at the duodeno-jejunal flexure
What are the features of the superior duodenum?
- starts at pyloric sphincter
- 2in long
- held in place by the hepatoduodenal ligament
- portal veins, hepatic artery, and bile duct and post. And sup to this part
- duodenal bulb
- head of pancreas is inf to this part
What are the features of the descending duodenum?
- 3in long
- all retroperitoneal
- the fundus of the gallbladder, right lobe of the liver, transverse colon are all anterior
- right kidney and ureter are posterior
- head of pancreas is medial
- bile and pancreatic ducts enter into the second part of the duodenum at the major duodenal papilla
What are some features of the horizontal duodenum?
- their sup mesenteric artery and vein and the root of the mesentery cross the anterior surface
- head of pancreas is superior
- jejunum is anterior and inferior
What are the features of the ascending duodenum?
- not covered by peritoneum
- root of mesentery and jejunum
- left margin of the aorta and medial border of the psoas muscle are posterior
- held in place by the suspensory ligament of the duodenum (of Treitz)
- anchors to the right crus of the diaphragm
What are some general features of the jejunum and ileum?
- occupy most of the peritoneal cavity of the abdomen and pelvis
- coiled and about 20ft long
- begins at duodenal-jejunum junction and ileum ends at ileo-decal valve
- very mobile and held to the posterior wall by the mesentery
- framed by the large intestine
What are some features of the jejunum?
- simple vascular arcades, long vasa recta, more vascular
- greater diameter, thicker, more plicae circularis
What are some anatomical features of ileum?
- 3/5 of the SI
- has compound arcades, shorter vasa recta, is less vascular
- smaller diameter, thinner wall
- fewer plicae circularis
What is Meckel’s diverticulum?
Most common congenital anomaly of the SI
- occurs in about 2% of the population
- 2ft from ileo-cecal junction
- remnant of vitelline duct
- clinically difficult to distinguish from appendicitis
- may contain other tissue types
What does the mesentery attach the jejunum and ileum to?
The posterior body wall
What does the mesentery cross???
- L1-2
- 3rd part of duodenum
- aorta
- IVC
- right ureter
- right gonadal vessels
- right psoas major
- ends at right SI joint
What are the features of mesentery on the jejunum and ileum?
- made up of 2 layers of peritoneum with nerves, lymph nodes, vessels, fat, arteries, and veins running between them
- 6-7in long at it’s root and 20ft long at its intestinal border
What are the regions in the large intestine?
- cecum and veriform appendix
- ascending colon
- right colic flexure
- transverse colon
- left colic flexure
- descending colon
- sigmoid colon
- rectum and anal canal
What are the general characteristics of the large intestine/
-highly mobile
-functions: fecal formation, transport and evacuation, water absorption and mucus secretion
-Taenia coli are 3 bands of longitudinal muscle on the outside of the colon
+converge at root of appendix
+produce haustrae that slow the movement of feces
-appendices epiplicae
+tags of fat
+characteristic of the large intestine
What is the cecum?
- no epiploic appendages
- blind pouch inferior to ileocecal orifice
- ileocolic valve is 2 folds that are not a true sphincter
- ideal papilla is a cone-like projection of the ileum into the cecum
- opening for the appendix is inferior to the ideal papilla
