Anatomy

Question 1

How is the Abdomen divided?

Answer 1

4 quadrants and the 9 regions

Question 2

What are the names of the 9 regions?

Answer 2

Right hypochondrium, epigastrium, left hypochondrium,
right flank, umbilical region, left flank,
right groin, suprapubic region and left groin.

Question 3

Where does the foregut end?

Answer 3

Halfway along the duodenum

Question 4

Where does the midgut end?

Answer 4

2/3 along the transverse colon

Question 5

Where does the hindgut end?

Answer 5

The upper anal canal

Question 6

What 3 main arteries branch off the abdominal artery to supply the foregut, midgut and hindgut?

Answer 6

Celiac trunk, superior mesenteric artery and the inferior mesenteric artery

Question 7

Peritoneum

Answer 7

Serous lining. Parietal peritoneum lines the inner aspect of the abdominal wall. Visceral peritoneum covers organs within.
Thin cavity between the 2 layers called the peritoneal cavity, contains peritoneal fluid.

Question 8

Innervation of Peritoneum

Answer 8

Parietal peritoneum is innervated by somatic nerves. (well localised, sharp and severe)
Visceral peritoneum is innervated by the same visceral sensory nerves that innervate the organs it covers. (poorly localised, vague, dull)

Question 9

The abdominal aorta

Answer 9

Left of midline on posterior abdominal wall.
Bifurcates at L4/5 into right and left common iliac arteries. Abdominal aorta gives rise to paired and unpaired branches.

Question 10

Right and left common iliac arteries supply…

Answer 10

the pelvis and lower limbs

Question 11

Abdominal aortic aneurysm can present as

Answer 11

Sudden onset severe abdominal or back pain, rapid bleeding, circulatory shock. Has high mortality.

Question 12

3 unpaired branches which leave the anterior aspect of the abdominal aorta and supply the gut…

Answer 12

Coeliac trunk at T12 (foregut)
Superior mesenteric artery at L1 (midgut)
Inferior mesenteric artery at L3 (hindgut)

These arteries further divide which anastomose with each other.

Question 13

Branches of the coeliac trunk

Answer 13

Left gastric artery (stomach)

Splenic artery (spleen, stomach and pancreas. Also has left gastro-omental branching off.)

Common hepatic artery (supplies liver, gallbladder, stomach, duodenum. Divides into gastro-duodenal which bifurcates into right gastro-omental, hepatic artery proper which bifurcates into right and left hepatic arteries)

Question 14

Superior Mesenteric artery (SMA) branches

Answer 14

Jejunal and ileal branches (supply jejunum and ileum)

Ileocolic artery (supplies ileum, caecum, appendix, ascending colon)

Right colic artery (supplies ascending colon)

Middle colic artery (supplies transverse colon)

Question 15

Inferior Mesenteric Artery (IMA) branches

Answer 15

Left colic artery (supplies descending colon)

Sigmoid branches (supplies sigmoid colon)

Superior rectal artery (supplies upper rectum)

Question 16

Veins of abdomen

Answer 16

Systemic veins, carry blood to IVC. Renal veins hepatic veins

Portal system, carries nutrient-rich venous blood from the gut to the liver. From liver, blood enters hepatic veins and returns to IVC.
Splenic, superior mesenteric and inferior mesenteric veins.

Question 17

Liver

Answer 17

Has 2 lobes
2 smaller accessory lobes (caudate next to IVC and quadrate next to the gallbladder)
Mostly covered by peritoneum

Question 18

Falciform ligament

Answer 18

Separates left and right lobes.

Remains of embryological mesenteries.

Connects the liver to the anterior abdominal wall.

Continuous with the coronary ligaments (anterior and posterior merge together to from left triangular ligament. Anchor the liver to the diaphragm)

Question 19

Areas of liver with no peritoneum

Answer 19

Porta hepatis (where blood vessels come in), the bare area and under gallbladder

Question 20

Porta hepatis

Answer 20

region on the liver where the vessels and ducts enter and exit the liver. Run in free edge of the lesser omentum.

Question 21

Portal triad

Answer 21

Bile duct, hepatic artery proper and the hepatic portal vein.

Question 22

Gallbladder

Answer 22

small hollow organ,
stores and concentrates bile.

Question 23

Gallstones

Answer 23

Usually composed of cholesterol, usually asymptomatic. Don’t show up on x-ray. Use ultrasound.

Question 24

Gallstone in bile duct

Answer 24

Blockage bile drainage (jaundice)
Bile backed up into liver and spills into blood –> jaundice
water retention
distention

Question 25

Gallstone in hepato pancreatic ampulla

Answer 25

Jaundice and pancreatitis. Inflammation of pancreas.
Common cause is alcoholism.
When bile backs up into pancreas, breaks down tissue of pancreas.

Question 26

Gallstone causing right shoulder pain

Answer 26

Gallbladder making contact with diaphragm. Phrenic nerves irritated. C3,4,5, also receives sensory information of skin of shoulder. Brain interprets pain from shoulder rather than diaphragm.

Question 27

Endocrine function of pancreas

Answer 27

production of insulin and glucagon

Question 28

Exocrine function of prancreas

Answer 28

production of pancreatic juice. enters second part of duodenum at hepatopancreatic ampulla and major duodenal papilla.

Question 29

Pancreas anatomy

Answer 29

Lies on posterior body wall.
Posterior to stomach.
Tail lies close to spleen, head and uncinate process are adjacent to duodenum.

Question 30

Pancreatic ducts

Answer 30

Main pancreatic duct opens into duodenum at the major duodenal papilla.

Accessory duct opens at minor duodenal papilla.