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Block 5 > Anatomy > Flashcards

Anatomy Flashcards

1
Q

Transpyloric plane marks where the neck of (Blank A) is and end of the (Blank B) is

A

Blank A : Neck of Pancreas

Blank B: End of stomach

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2
Q

Transpyloric plane lies at what level of the vertebral column?

A

L1

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3
Q

Where is McBurney’s Point?

A

McBurney’s point is the name given to the point over the right side of the abdomen that is one-third of the distance from the anterior superior iliac spine to the umbilicus (navel).

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4
Q

T10 innervates the skin around (Blank)

A

the umbilicus

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5
Q

The (Blank) nerve is the only nerve to pass through the superficial inguinal ring

A

the ilioinguinal nerve

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6
Q

What two nerves come from L1?

A
  1. Iliohypogastric nerves

2. Ilioinguinal nerves

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7
Q

Layers of the Abdominal Wall

What two layers make up the superficial fascia? (also put alternative names)

A
  1. Fatty layer (Camper’s fascia) - more superficial/closer to the skin
  2. Membranous layer (Scarpa’s fascia)
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8
Q

Layers of the Abdominal Wall

Are campers and scarpas fascia found everywhere in the body?

A

Scarpa’s is only found in umbilicus area.

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9
Q

What are the last three layers of the abdominal wall (closest to intestine)?

  • skin
  • superficial fascia (fatty and membranous layer)
  • Deep fascia
  • Muscles
  • (Blank A)
  • (Blank B)
  • (Blank C)
A

Blank A = *Transversalis fascia
Blank B = *Extraperitoneal fat/fascia
Blank C = *Parietal peritoneum

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10
Q

What is the difference between parietal peritoneum and visceral peritoneum?

A
  1. The peritoneum is defined as a continuous membrane which functions to line the abdominal cavity and therefore hold and protect the abdominal organs (also known as the abdominal viscera).
  2. The visceral peritoneum is the membrane which folds back (or turns inside out to cover most of the abdominal organs. It is also formed from somatic mesoderm during embryonic stages.
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11
Q

What is the difference between Scarpa’s and Colles’ fascia? (these are both membranous layers)

A

Scarpa’s is the deep (membranous) layer in the abdomen and then in the pelvis (near scrotum) it becomes the colles’ fascia.

***Scarpa attaches to the inguinal line and abdominal muscles- so any fluid in the abdomen can’t get into the thigh.

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12
Q
  1. Where does the superior epigastric artery flow into?

2. Where does the inferior epigastric artery flow into?

A
  1. Internal thoracic artery

2. External iliac artery

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13
Q

What are the superficial lymphatics for the abdomen?

A
  1. axillary nodes

2. superficial inguinal nodes

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14
Q

What forms the inguinal ligament?

A

Aponeurosis of the external oblique

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15
Q

What vessels flow under the inguinal ligament?

A
  1. femoral artery and vein
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16
Q

What forms the conjoint tendon?

A

lower most fibers of internal oblique and transversus abdominis join to form the conjoint tendon

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17
Q
  1. What does the conjoint tendon attach/join?

2. Where is it located in relation to superficial inguinal ring?

A
  1. The pubic crest and pectineal line
  2. posterior to the superficial inguinal ring (remember superficial inguinal ring is at the end of the inguinal ligament near the pubic tubercle)
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18
Q

What does the rectus sheath cover?

A

Rectus abdominis

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19
Q

Transversalis fascia is deep to what muscle?

A

Deep to the transversus abdominis muscle

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20
Q
  1. The deep inguinal ring is found within what structures?

2. What about the superficial inguinal ring?

A
  1. The “top” of the inguinal canal (farthest from pubic tubercle) AND transversalis fascia
  2. The “bottom” of the inguinal canal (closest to the pubic tubercle) AND aponeurosis of the external oblique
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21
Q

The inferior epigastric vessels enter the rectus sheath at the (Blank)

A

Blank = arcuate line

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22
Q
  1. What is the processus vaginalis?

2. What does it become after embryologic development?

A
  1. A peritoneal outpouching that protrudes through the layers of the abdominal wall and as it protrudes it acquires covering from each layer. —- The processus vaginalis is the peritoneal tunnel through which the testes migrate from the retroperitoneum toward the scrotum or ovaries descend into pelvic cavity during embryological development
  2. It forms the inguinal canal
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23
Q
  1. What is the gubermaculum?

2. male vs female

A
  1. It is ligament that guides the testes/ovaries down.
  2. In men - it becomes the scrotal ligament which anchors testis down to scrotum. In women - this is the round ligament of uterus.
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24
Q

What is the cremasteric reflex?

A

found in males. When inner part of the thigh is stroked it causes the cremaster muscle to contract and pull the testicle toward inguinal canal

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25
Q

What is the spermatic cord?

A

a bundle of nerves, ducts, and blood vessels connecting the testicles to the abdominal cavity.

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26
Q

Inguinal canal in men vs females?

A

Men: spermatic cord and ilioinguinal nerve
Female: round ligament and ilioinguinal nerve

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27
Q
  1. What is found in the anterior wall of the inguinal canal?
  2. What about roof
  3. What about posterior wall
  4. What about inferior wall?
A
  1. External oblique and internal oblique
  2. internal oblique and transversus abdominis
  3. transversalis fascai and conjoint tendon
  4. lateral one half of inguinal ligament and lacunar ligament
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28
Q

What are the three layers of the spermatic cord? (the spermatic cord is covered by three layers of fascia)

A
  1. internal spermatic fascia
  2. Cremasteric fascia
  3. External spermatic fascia
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29
Q
  1. Indirect inguinal hernia pass through which of the inguinal rings?
  2. why does it happen?
  3. It occurs lateral to what structure(s)?
A
  1. BOTH deep and superficial inguinal rings. (follows path of testicular descent)
  2. congenital defect - the processus vaginalis doesn’t close
  3. Lateral to inferior epigastric vessels- it is covered by all layers of spermatic fascia
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30
Q
  1. Direct inguinal hernia pass through which of the inguinal rings?
  2. why does it happen?
  3. It occurs medial to what structure(s)?
A
  1. superficial inguinal ring
  2. Happens because transversalis fascia is weakened and allows hernia to push through Hesselbach triangle and arrive at superficial ring
  3. medial to the inferior epigastric vessels (covered only by external spermatic fascia)
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31
Q

what is the medial, lateral, inferior borders of the Hesselbach triangle?

A
  1. Medial - rectus abdominis
  2. Lateral - inferior epigastric artery
  3. Inferior - Inguinal ligament
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32
Q

What is a spigellan hernia?

A

Hernia that occurs in the lower abdomen where the posterior rectus sheath is deficient and within the area of aponeurosis between rectus abdominis and linea semilunaris

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33
Q

Type 1 sliding hiatus hernia vs Type 2 paraesophageal hernia

A

Type I : when the stomach moves up through the diaphragm and essentially moves the gastro-esophageal junction up
Type II: When part of the stomach moves up through the diaphragm BUT keeps the gastro-esophageal junction in place

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34
Q

What is made from the foregut? (8)

A
  1. pharynx
  2. respiratory system
  3. esophagus
  4. stomach
  5. liver
  6. pancreas
  7. biliary apparatus
  8. proximal duodenal
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35
Q

What is made from the midgut? (4)

A
  1. small intestine (after proximal duodenum)
  2. cecum
  3. ascending colon
  4. right half of transverse colon
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36
Q

What is made from the hindgut? (5)

A
  1. Left half of transverse colon
  2. Descending colon
  3. Sigmoid colon
  4. Rectum
  5. superior anal canal
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37
Q
  1. What is the arterial supply to the foregut?
  2. What is the venous drainage from the foregut?
  3. What is the lymphatic drainage from the foregut?
A
  1. Celiac trunk
  2. Portal vein
  3. Celiac lymph nodes
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38
Q
  1. What is the arterial supply to the midgut?
  2. What is the venous drainage from the midgut?
  3. What is the lymphatic drainage from the midgut?
A
  1. Superior mesenteric artery
  2. Superior mesenteric vein
  3. SM lymph nodes
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39
Q
  1. What is the arterial supply to the hindgut?
  2. What is the venous drainage from the hindgut?
  3. What is the lymphatic drainage from the hindgut?
A
  1. Inferior mesenteric artery
  2. Inferior mesenteric vein
  3. IM lymph nodes
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40
Q

What is the nerve supply of foregut?

A
  1. sympathetic trunk

2. vagus nerve

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41
Q

What is the nerve supply of midgut?

A
  1. sympathetic trunk

2. vagus nerve

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42
Q

What is the nerve supply of hindgut?

A
  1. sympathetic trunk

2. splanchnic nerves

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43
Q

At what vertebral column does the esophagus start?

A

Cricoid cartilage - C6

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44
Q

What are the 4 sites of constriction of esophagus?

A
  1. Junction of esophagus with pharynx
  2. Where esophagus is crossed by arch of aorta
  3. Where esophagus is compressed by left main bronchus
  4. At the esophageal hiatus
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45
Q

What is the arterial supply of the esophagus at the

  1. Cervical part
  2. Thoracic part
  3. Abdominal part
A
  1. Inferior thyroid artery
  2. Thoracic aorta
  3. Left gastric artery
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46
Q

What is the venous drainage of the esophagus at the

  1. Cervical part
  2. Thoracic part
  3. Abdominal part
A
  1. Inferior thyroid vein
  2. Azygous vein
  3. Left gastric vein
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47
Q

What is the lymphatic drainage of the esophagus at the

  1. Cervical part
  2. Thoracic part
  3. Abdominal part
A
  1. Deep cervical lymph nodes
  2. Mediastinal lymph nodes
  3. Left gastric lymph nodes
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48
Q
  1. Parasympathetic nerve supply to esophagus?

2. Sympathetic nerve supply to esophagus

A
  1. Vagus

2. Greater splanchnic nerve

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49
Q

At what vertebral level is the pylorus of the stomach?

A

L1 vertebral level

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50
Q

What is found within the pylorus of stomach?

A

The pyloric antrum, pyloric canal, and pyloric sphincter

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51
Q

What is pyloric stenosis?

A

When the muscles of sphincter get big and closes off lumen -> leads to nutrients not being absorbed. Leads to vomiting in babies.

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52
Q

What are the three muscular coats of the stomach?

A
  1. (most interior) inner oblique layer
  2. middle circular layer
  3. (exterior) outer longitudinal layer
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53
Q

What is the only thing that is anterior of the stomach ?

A

Left lobe of the liver

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54
Q

What arteries makes up the celiac trunk? (3)

A
  1. Left gastric artery
  2. Splenic artery
  3. Common hepatic artery
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55
Q

Where does the left gastric artery supply blood to? (3)

A

The upper right portions of the fundus and body of the stomach (lesser curvature of stomach), as well as the distal (abdominal) esophagus.

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56
Q

Where does the right gastric artery supply blood to? (1)

A

The lesser curvature of the stomach

anastomose with left left gastric artery

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57
Q

What does the splenic artery supply blood to?

A
  1. The spleen
  2. Large portions of the pancreas
    3, Parts of stomach.

It runs anterior to the left kidney and suprarenal gland, and posterior to the stomach, through the peritoneal splenorenal ligament and along the tail of the pancreas

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58
Q

What does the common hepatic artery supply blood to? (5)

A

Liver, stomach, pancreas, duodenum, and gallbladder

  • *some of the arteries that come off of the common hepatic artery are
  • > right gastric artery (stomach)
  • > right and left hepatic artery (liver)
  • > supraduodenal artery (duodenum)
  • > right gastro-omental artery (blood to the stomach on the greater curvature)
  • > superior pancreaticoduodenal artery (pancreas)
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59
Q

What arteries supply blood to lesser curvature of stomach?

A
  1. left gastric artery (from celiac trunk)

2. right gastric artery (from hepatic artery proper, from common hepatic artery, from celiac trunk)

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60
Q
  1. What arteries supply blood to fundus of stomach?

2. what is fundus more vulnerable for?

A
  1. The short gastric arteries (from splenic vein, from celiac trunk)
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61
Q

What arteries supply blood to greater curvature of stomach?

A
  1. Left gastro-omental artery (from splenic artery, from celiac trunk)
  2. Right gastro-omental artery (from gastroduodenal artery, from common hepatic artery, from celiac trunk)
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62
Q

What veins drain the lesser curvature of the stomach?

A
  1. Left gastric vein
  2. Right gastric vein
    * *both drain into portal vein
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63
Q

What veins drain the fundus of the stomach?

A

The short gastric veins (which drain into splenic vein and then drain into portal vein)

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64
Q

What veins drain the greater curvature of the stomach?

A
  1. left gastro-omental vein (which drains into the splenic vein which drains into portal vein)
  2. right gastro-omental vein (which drains into sup. mesenteric vein which drains into portal vein)
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65
Q

What are the four parts of the duodenum (small intestine)?

A
  1. superior part
  2. descending part
  3. inferior part
  4. ascending part
  • together it makes a C shaped structure
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66
Q

What parts of the duodenum are retroperitoneal vs intraperitoneal?

A
  1. The first part the duodenum (1/4) is intraperitoneum (covered by peritoneum)
  2. The other three parts of the duodenum is retroperitoneum
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67
Q

What does the first part of the duodenum align with? (T… plane)

A

Transpyloric plane

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68
Q

A perforated duodenal ulcer may cause bleeding from the (BLANK) artery

A

Gastroduodenal artery

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69
Q

What is important of the second part of the duodenum? (what empties into it?)

A
  1. Major duodenal papilla

2. Minor duodenal papilla

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70
Q

What is the SMA syndrome?

A

Compression of duodenum between the superior mesenteric artery and abdominal aorta secondary to MASSIVE WEIGHT LOSS.
this is a rare cause of bowel obstruction

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71
Q

What is the suspensory ligament of the duodenum?

A

The ligament of Treitz - found at the fourth/ascending part of the duodenum

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72
Q
  1. What does the ligament of Treitz attach?

2. What is this a landmark of?

A
  1. Attaches the duodenum to the diaphragm

2. It divides the GI tract into upper and lower parts

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73
Q

What enters into the major duodenal papilla and the minor duodenal papilla?

A
  1. the bile duct and pancreatic duct enter major duodenal papilla
  2. the accessory pancreatic duct enters the minor duodenal papilla
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74
Q

Where does the foregut end and midgut begin?

A

Foregut ends inferior to the major duodenal papilla and right after begins the midgut

75
Q

What arterial supply is given to the proximal half of the duodenum? (2)

A
  1. supraduodenal artery (from gastro-duodenal artery, from common hepatic artery, from celiac trunk)
  2. superior pancreaticoduodenal artery (from gastro-duodenal artery, from common hepatic artery, from celiac trunk)
76
Q

What arterial supply is given to the distal half of the duodenum? (2)

A
  1. inferior pancreaticoduodenal artery (comes from SMA)

2. first jejunal branch artery (comes from SMA)

77
Q

What is the venous drainage of the proximal half of the duodenum? (1)

A
  1. superior pancreaticoduodenal vein (flows into portal vein)
78
Q

What is the venous drainage of the distal half of the duodenum? (1)

A
  1. inferior pancreaticoduodenal vein (flows into SMV -> then flows into PV)
79
Q
  1. What is the lymphatic drainage of the upper half duodenum?
  2. What is the lymphatic drainage of the lower half duodenum?
A
  1. superior pancreaticoduodenal LNs (drains into gastroduodenal LN then into celiac LNs)
  2. inferior pancreaticoduodenal LNs (drains into superior mesenteric LNs)
80
Q

What organs are considered intraperitoneal organs?

  1. (Blank A) esophagus
  2. Stomach
  3. Duodenum (Blank B - part)
  4. Jejunum
  5. (Blank C)
  6. Cecum
  7. Appendix
  8. (Blank D) colon
  9. Sigmoid colon
  10. Liver
  11. Spleen
  12. Tail of (Blank E)
A
  1. Abdominal esophagus
  2. Stomach
  3. Duodenum (1st part)
  4. Jejunum
  5. Ileum
  6. Cecum
  7. Appendix
  8. Transverse colon
  9. Sigmoid colon
  10. Liver
  11. Spleen
  12. Tail of pancreas
81
Q

What is an omentum?

A

A two-layered fold of peritoneum that connects stomach to another viscus

82
Q

What is the purpose of greater omentum?

A
  1. Hangs from greater curvature of stomach and helps to wall of infection and prevents it from spreading
83
Q

What is the purpose of lesser omentum?

A
  1. Connects the lesser curvature of the stomach+ first part of the duodenum TO the liver (at the porta hepatis)
84
Q

Hepatoduodenal ligament is between what organs and what does it hold within it?

A
  1. IT IS A PORTION OF THE LESSER OMENTUM - between porta hepatis of the liver and proximal duodenum
  2. Within it is the common bile duct, hepatic artery proper, and portal vein (the portal triad)
85
Q
  1. Where is the greater sac
  2. Where is the lesser sac
  3. Epiploic (omental, winslow’s) Foramen
A
  1. Cavity within the greater omentum
  2. Cavity within the lesser omentum
  3. opening between the lesser and greater sac
86
Q
  1. Where is the jejunum is quadrants of the body?

2. What about the ileum

A
  1. left upper quadrant

2. Right lower quadrant

87
Q

Jejunum vs Ileum

  1. Which has more arterial arcades
  2. Which has longer vasa recta
  3. Which has larger lumen and thicker wall
  4. Which is more red in appearance
  5. Which has more mesenteric fat
  6. Which has peyer’s patches
A
  1. Ileum
  2. Jejunum
  3. Jejunum
  4. Jejunum
  5. Ileum
  6. Ileum
88
Q

What is the most common position position of the appendix?

A
  1. Retrocecal (retrocolic)

* other positions are sub-cecal, pelvic, pre-ileal, post-ileal

89
Q

Appendicitis pain starts where and moves where when it gets worse?

A
  1. Starts at umbilicus and then moves to McBurney’s point
90
Q
  1. What is the paracolic gutter?
A
  1. A “gutter” of sorts on the right side of the ascending colon. It travels from the pelvis to the subphrenic space and if there is inflammatory fluid it travels here and can irritate the diaphragm.
  2. There is also one on the left side but it more easily happens on the right side
91
Q

What differentiates left and right paracolic gutters?

A

Left paracolic gutter has phrenicocolic ligament that shortens the gutter and prevents fluid from getting close to diaphragm.

92
Q

What is a mesentery?

A

2 layered peritoneal fold that connects an organ to the posterior abdominal wall. Allows blood vessels, nerves, and lymphatics to pass between its folds to the gut.
for support that holds organ to abdominal wall

*omentum is more of a covering

93
Q

What are the three types of mesenteries?

A
  1. mesentery proper (jejunum and ileum getting attached to abdominal wall)
  2. Transverse mesocolon
  3. Sigmoid colon mesentery
94
Q

An organ suspended by a mesentery is referred to as a (BLANK) organ

A

Peritoneal/intraperitoneal organ

95
Q

Superior, middle, lower part of rectum — which parts have peritoneal covering?

A
  1. superior part has anterior and lateral sides covered by peritoneum
  2. middle third has only anterior surface covered by peritoneum
  3. lower third has no peritoneal covering
96
Q
  1. What are the two major flexures in the anteroposterior plane?
  2. What is special about the most inferior flexure?
A
  1. sacral and perineal
  2. This is a sharp angle - It is caused by a sling of puborectalis muscle that goes around rectum. During defecation this muscle relaxes and angle will become less sharp to allow feces to pass through
97
Q

What arteries supply blood to the colon?

  1. The proximal 2/3
  2. The distal 1/3
A
  1. superior mesenteric artery

2. inferior mesenteric artery

98
Q

What are the main branches off of the SMA in colon blood supply?

A
  1. Middle colic artery (aimed towards region around right/hepatic flexure)
  2. Right colic artery (ascending colon)
  3. Ileocolic artery
99
Q

What are the main branches off of the IMA in colon blood supply?

A
  1. Left colic artery
  2. Sigmoid arteries
  3. Superior rectal artery
100
Q

What are the watershed areas in the GI tract?

A
  1. Splenic flexure - here is where the SMA and IMA anastomose. Splenic flexure is vulnerable to ischemia during hypoperfusion.
  2. Rectosigmoid junction (Sudek’s point)
101
Q

What three arteries supply the rectum and anal canal?

A
  1. superior rectal artery (from IMA)
  2. Middle rectal artery (from internal iliac artery)
  3. Inferior rectal artery (from internal pudendal artery, from internal iliac artery)
102
Q

Above vs below pectinate line of anal canal

  1. which has columnar vs stratified squamous epithelium
  2. endodermal vs ectodermal in origin
  3. presence/lack of anal columns, valves, and sinuses
A
  1. Above - columnar epithelium;;; below - stratified squamous epithelium
  2. Above - endodermal ;;; below - ectodermal
  3. Above- presence ;;;; below - lack
103
Q

Internal vs external sphincter

1. which is voluntary vs involuntary

A
  1. Internal is involuntary (smooth muscle) while external is voluntary (skeletal)
104
Q

Are internal or external hemorrhoids painful?

A

external

105
Q

What are the two surfaces of the liver?

A
  1. diaphragmatic (has posterior, superior, and anterior surfaces)
  2. Visceral
106
Q

What are the fissures and structures forming the H on the visceral surface of the liver?

A
  1. Left sagittal (umbilical) fissure
  2. Right sagittal (principal) fissure
  3. Porta hepatis
107
Q

Left sagittal fissure contains what two structures?

A
  1. Ligamentum teres (round ligament) - in prenatal life used to be umbilical vein and bring oxygenated blood from placenta;;;;; found within falciform ligament
  2. Ligamentum venosum;;; found within the falciform ligament as well.

*both of these are found within the visceral side of liver while falciform ligament is found on diaphragmatic side

108
Q

Right sagittal fissure contains what two fossas?

A
  1. Fossa for gallbladder

2. fossa for inferior vena cava

109
Q
  1. What does the porta hepatis contain?
  2. What is NOT present in porta hepatis?
  3. How is porta hepatis different than portal triad?
A
  1. Right and Left hepatic bile ducts
  2. right and left hepatic arteries
  3. portal vein
  4. lymph nodes
  5. nerves

NOT PRESENT
1. hepatic veins (these are veins draining blood from the liver- diff from portal vein)

  1. portal triad is only the portal vein, common hepatic artery, and common bile duct
110
Q

What does the coronary ligament hold together?

A

Coronal ligament Attaches the liver to the diaphragm, and the right kidney and adrenal gland
* on right side of liver *

111
Q

What does triangular ligaments

(right and left) connect?

A
  1. Left triangular ligament - connects the posterior part of the upper surface of the left lobe to the diaphragm; its anterior layer is continuous with the left layer of the falciform ligament. (also suspensory ligament of liver)
  2. Right triangular ligament - on right side of liver. Suspensory ligament of liver
112
Q

Function of falciform ligament?

A

Its purpose is to help hold the liver in place inside the body. It connects to the diaphragm and rectus walls, ensuring that the liver stays in its proper place

113
Q

How many functional lobes are there?

A

8 lobes

114
Q

What are the anatomical lobes of the liver?

A
  1. right
  2. left
  3. caudate (between left and right lobe - and more superior)
  4. quadrate (between left and right lobe - and more inferior….larger than caudate)
115
Q

What is the arterial supply to liver? (2)

A
  1. right hepatic artery
  2. left hepatic artery

but liver receives 80% of the blood from portal vein

116
Q

Hepatic veins drain into…

A

The IVC

117
Q

What lymph nodes drain from the liver?

A
  1. Celiac nodes (at the porta hepatis)

2. posterior mediastinal nodes (via bare area)

118
Q

What are the pre-aortic nodes? (3)

A
  1. celiac nodes
  2. superior mesenteric nodes
  3. inferior mesenteric nodes
119
Q

Arterial supply of gallbladder?

A

cystic artery

120
Q

Venous drainage of gallbladder? (1)

A
  1. cystic veins (then drains into portal vein)
121
Q
  1. What makes up/contribute to the common hepatic duct?

2. Where does this come from?

A
  1. Right and left hepatic duct

2. liver

122
Q
  1. What makes up/contribute to the bile duct? (2)

2. where does each come from

A
  1. cystic duct and common hepatic duct

2. cystic duct comes from gallbladder and common hepatic duct comes from liver

123
Q

What ducts contribute to the major duodenal papilla?

A
  1. main pancreatic duct

2. bile duct

124
Q

Hepatopancreatic ampulla (ampulla of vater) vs major duodenal papilla

A
  1. Hepatopancreatic ampulla (ampulla of vater) - where the bile duct and main pancreatic duct meet. Behind the major duodenal papilla
  2. The point where juices enter the duodenum
125
Q

What is the sphincter of ampulla (sphincter of oddi)

A

The sphincter of Oddi is a muscular valve responsible for controlling the flow of bile and pancreatic secretions through the ampulla of vater

126
Q

What is the arterial supply of the pancreas (3)?

A
  1. Gastroduodenal artery
  2. Superior mesenteric artery
  3. Splenic artery
127
Q

What is the venous drainage of pancreas? (3)

A
  1. splenic vein
  2. superior pancreaticoduodenal vein (from portal vein)
  3. inferior pancreaticoduodenal vein (from SMA)
128
Q

What is the lymphatic drainage of the pancreas? (2)

A
  1. Pancreaticoduodenal nodes

2. Pancreaticosplenic nodes

129
Q

What does the hilum of the spleen contain?`

A

splenic artery and splenic vein

130
Q
  1. What is function of the splenorenal ligament?

2. What is in inside of it?

A
  1. It connects the hilum of the spleen with the left kidney.
  2. It has blood supply to spleen and tail of pancreas
131
Q
  1. What is function of the gastrosplenic ligament?

2. What is in inside of it?

A
  1. It connects the superior third of the greater curvature of the stomach to the splenic hilum.
  2. Contains short gastric vessels and left gastroepiploic vessels
132
Q

What forms the portal vein?

A

Formed from the SMV and splenic vein

the portal vein is formed from behind the neck of the pancreas

133
Q

parasympathetic vs sympathetic

1. which one has prevertebral ganglia?

A

sympathethic

134
Q

What are the abdominal prevertebral plexus? (4)

A
  1. celiac plexus
  2. aortic plexus
  3. superior hypogastric plexus (communicates w/inf. hypo. plexus)
  4. inferior hypogastric plexus
135
Q

What is the function of the celiac plexus?

A
  1. The function of the celiac plexus is to transmit visceral sensory impulses (like pain or reflexes) from the foregut and midgut [SYMPATHETIC]
136
Q

What is the function of the aortic plexus?

A

A network of pre- and post-ganglionic nerves overlying the abdominal aorta, which is primarily involved with the sympathetic innervation to the mesenteric, pelvic and urogenital organs.

137
Q

What is the function of the superior hypogastric plexus?

A

responsible for the sympathetic innervation of pelvic organs and extrapelvic genitals in humans of both sexes.

138
Q

What are the splanchnic nerves?

A

The splanchnic nerves are paired visceral nerves (nerves that contribute to the innervation of the internal organs), carrying fibers of the autonomic nervous system (visceral efferent fibers) as well as sensory fibers from the organs (visceral afferent fibers). All carry sympathetic fibers except for the pelvic splanchnic nerves, which carry parasympathetic fibers.

139
Q

[SYMPATHETIC]

  1. what splanchnic nerves innervate the foregut?
  2. What about the midgut?
  3. What about the hindgut?
A
  1. Thoracic splanchnic nerves innervate foregut and midgut

2. lumbar splanchnic nerves innervates hindgut

140
Q

[PARASYMPATHETIC]

  1. What nerve innervates foregut?
  2. What nerve innervates midgut
  3. What nerve innervates hindgut
A
  1. Vagus nerve innervates foregut and midgut

2. Pelvic splanchnic nerves S2-S4 (only splanchnic nerve to have parasympathetic nerves)

141
Q

Positive psoas sign can indicate which organs are may be inflamed? (6)

A
  1. kidneys
  2. ureters
  3. pancreas
  4. cecum
  5. appendix
  6. sigmoid colon
142
Q

Origin and Insertion of psoas major?

A

Origin: T12 & L1-L5 vertebrae and IV discs

Innervation: lesser trochanter of femur

143
Q

Origin and Insertion of psoas minor?

A

Origin: T12 and L1 vertebrae
Innervation: pubic bone

144
Q

Origin and innervation of Illiacus?

A

Origin: iliac fossa and lateral sacrum
Insertion: Lesser trochanter of femur

145
Q

Origin and Insertion of quadratus lumborum?

A

Origin: iliac crest, L5, iliolumbar ligament
Insertion: transverse process of L1-L4 and Rib 12

146
Q

Nerve supply of

1. psoas major

A
  1. Anterior rami of L1-L3
147
Q

Nerve supply of

1. psoas minor

A
  1. Anterior rami of L1
148
Q

Nerve supply of

1. quadratus lumborum

A
  1. Anterior rami of T12 and L1-L4
149
Q

Nerve supply of

1. Iliacus

A
  1. Femoral nerve
150
Q

Main action of

1. psoas major

A
  1. Flexion of the thigh at hip joint
151
Q

Main action of

1. psoas minor

A

Weak flexion of lumbar vertebral columm

152
Q

Main action of

1. quadratus lumborum

A
  1. Depress and stabilize rib 12 + some lateral bending of the trunk
153
Q

Main action of

1. iliacus

A
  1. flexion of the thigh at the hip joint
154
Q

Which kidney is higher?

A

Left kidney is higher

155
Q

What organs are anterior to the right kidney? (list them from superior to inferior) (5)

A
  1. right suprarenal gland
  2. liver
  3. descending part of duodenum
  4. right colic flexure
  5. small intestine
156
Q

What organs are anterior to the left kidney? (list them from superior to inferior) (7)

A
  1. left suprarenal gland
  2. stomach
  3. spleen
  4. pancreas
  5. left colic flexure
  6. descending colon
  7. jejunum
157
Q

The [left/right] kidney is covered by both rib 11 and rib 12?

A

LEFT KIDNEY

158
Q

The renal arteries branch off of aorta…

The renal arteries are located [superior/inferior] to SMA between L1 and L2

A

inferior

159
Q
  1. Which renal artery is longer?

2. Which renal vein is longer?

A
  1. Right renal artery is longer

2. Left renal artery is longer

160
Q

Renal arteries branch into what arteries?

A

Segmental arteries near hilum

161
Q

The left renal vein is between what two structures?

A

SMA and aorta

162
Q

The left gonadal vein drains into what vein?

A

The left renal vein

163
Q

What is the nutcracker syndrome?

A

Compression of the left renal vein between the SMA and aorta.
***This causes left testicular pain, blood or protein in urine, abdominal pain, nausea/vomiting

164
Q

What are is lymphatic drainage for the kidneys?

A 
Lateral aortic (lumbar; para-aortic) nodes
*positioned on both sides of the aorta*
165
Q

What does water under the bridge mean for ureters?

A

relationship of ureter underneath uterine arteries in females and underneath ductus deferens in males

166
Q

Proximal, middle, and distal part of ureters

–> What arteries give blood supply to each part?

A
  1. proximal - renal arteries
  2. middle - gonadal arteries and common iliac arteries
  3. internal iliac arteries
167
Q

What what constrictions of the ureter are kidney stones more likely to form and obstruct ureter? (3)

A
  1. ureteropelvic junction (near kidney hilum)
  2. Crossing of iliac vessels at pelvic inlet
  3. entrance to bladder
168
Q

What does from loin to groin mean?

A

Described the referred pain associated with ureters. This referred pain is moved to skin over T11 - L2 dermatomes.

169
Q

visceral afferent fibers in the ureter return to (Blank) spinal cord levels and indicate if there is pain in ureter.

A

T11 - L2 spinal cord levels

170
Q

Proximal, middle, and distal part of ureters

–> What lymph nodes drain each part?

A
  1. proximal part: lateral aortic nodes
  2. middle part: common iliac nodes
  3. Distal part: internal and external iliac nodes
171
Q
  1. Where is the bladder found when empty vs when full?

2. What about at birth -> puberty

A
  1. in pelvic cavity when empty and abdominal cavity when full
  2. Almost entirely abdominal
  3. Descended to adult position in pelvic cavity
172
Q

What is the function of trigone in bladder?

A

Smooth, triangular area inside bladder; sensitive to stretch –> signals need to urinate

173
Q

What is the name of the smooth muscle of bladder?

A

detrusor muscle - found on walls of bladder

174
Q

What is the pelvic pain line?

A

Pain from superior bladder transmitted via sympathethic fibers and pain from inferior bladder transmitted via parasympathetic fibers.

175
Q

the bladder drains its lymph into what lymph nodes? (2)

A

External and internal iliac nodes

176
Q

In a kidney transplant… the transplant vessels are surgically anastomosed to what vessels? + ureter is connected to (Blank)

A
  1. external iliac vessels

2. bladder

177
Q

What nerve levels forms the lumbar plexus?

A

T12 and L1-L4

178
Q

LUMBAR PLEXUS

What nerve level contributes to iliohypogastric and ilioinguinal nerves?

A

L1

179
Q

LUMBAR PLEXUS

What nerve level contributes to genitofemoral nerve?

A

L1-L2

180
Q

LUMBAR PLEXUS

What nerve level contributes to lateral cutaneous nerve of the thigh?

A

L2-L3

181
Q

LUMBAR PLEXUS

What nerve level contributes to Obturator nerve?

A

L2-L4

182
Q

LUMBAR PLEXUS

What nerve level contributes to femoral nerve?

A

L2-L4

183
Q

Cremasteric reflex

  1. afferent limb +its purpose
  2. efferent limb + its purpose
A
  1. ilioinguinal nerve (takes in sensory info)

2. genital branch of genitofemoral nerve (shortens the scrotum when it innervates cremasteric muscle)

Block 5 (7 decks)

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