Anatomy Flashcards
Abdominal esophagus definition
Little portion coming out from the hiatus in the diaphragm
Venous drainage of abdominal esophagus
Left gastric vein
Phrenic veins
Arterial supply for abdominal esophagus
L gastric artery (celiac trunk)
L inferior phrenic arteries (abdominal aorta)
Stomach portions
Cardiac (has lower esophageal sphincter)
Fundus
Body
Pylorus (antrum - canal - sphincter)
Arterial supply for stomach
L gastric artery (celiac truck)
R gastric artery (common hepatic artery)
R gastro-omental artery (gastroduodenal branch from common hepatic art)
Short gastric arteries (splenic artery)
L gastric-omental artery (splenic artery)
Venous drainage of the stomach
L and R gastric veins —> portal vein
L gastro-omental vein + short gastric veins—> splenic vein
R gastro-omental vein —> sup mesenteric vein
(Portal vein = splenic vein + sup mesenteric vein)
PS innervation stomach + liver
Vagus nerve (synapse in microganglia in the walls)
S innervation stomach + liver
Greater (T5-T9) + lesser splanchnic nerves (T10-T12) (synapse in celiac ganglion)
Liver ligaments
Teres/round ligament
Falciform ligament
Coronary ligaments
R triangular ligament and L triangular ligament
Area of the liver without ligaments
Bare area of the liver (R lobe)
Hepatic pedicle elements
Portal vein
Proper hepatic artery
Bile duct
Elements on the visceral face of the liver
Gallbladder
Caudate lobe + quadrate lobe (both in R lobe)
Impressions (colic, renal, gastric, esophageal)
Ligamentum venosum
Blood supply to the liver
Portal vein (70%)
Proper hepatic artery (30%)
Cystic artery (R hepatic art) for the gallbladder
Enterohepatic circulation
Portal system drains midgut and hindgut derivatives
Portal vein drains foregut derivatives —> branches: 3 suprahepatic veins (R, middle, L hepatic veins) drain into IVC after blood metabolism in the liver
Portosystemic anastomoses definition
Collateral veins to portal vein that the blood looks for when vascular resistance increases (ej: in cirrhosis)
Portosystemic anastomoses
Esophageal veins (—> azygos system)
Rectum (1º 2/3 —> inf mesenteric vein / last 1/3 into middle + inf rectal veins —> iliac veins —> IVC)
Umbilicus (—> paraumbilical veins)
Colon
Bile duct system formation
R+L hepatic ducts = common hepatic duct —> cystic duct —> bile duct
Bile duct system connection with duodenum
Common bile duct enter 2nd portion of duodenum (papilla)
Duodenum - origin, perit./retroperit.
1º portion: foregut
2º3º,4º portion: midgut
1º,4º portions: intraperitoneal
2,3º portions: retroperitoneal
Arterial supply duodenum
Supraduodenal artery (celiac trunk)
Sup pancreaticoduodenal arteries (celiac trunk)
Inf pancreaticoduodenal arteries (sup mesent art)
Pancreas important relationship at the level of uncinate process
Mesenteric vessels passing ant to the head of the pancreas and to the 3rd part of the duodenum.
Pancreas structures
Main pancreatic duct (—> major duodenal papilla, odds sphincter)
Accessory pancreatic duct
Arterial supply to pancreas
Dorsal pancreatic branch (splenic branch —> celiac trunk)
Greater pancreatic artery (splenic branch —> celiac trunk)
Superior pancreaticoduodenal artery (celiac trunk)
Inferior pancreaticoduodenal arteries (sup mesent art)
Venous drainage to pancreas
Splenic vein
Pancreaticoduodenal vein
Spleen origin
Dorsal mesogastrium
Spleen ligaments
Gastrosplenic ligament
Splenorenal ligament
Spleen surfaces
Parietal or costal surface
Visceral surface —> contact with stomach, colon (splenic flexure), left kidney
Arterial supply to spleen
Splenic artery (celiac trunk)
Venous drainage of spleen
Splenic vein
S innervation duodenum, pancreas and spleen
Greater thoracic splanchnic nerve (T5-T9) (synapses + exits from celiac ganglion)
PS innervation of duodenum, pancreas and spleen
Vagus nerve
S innervation foregut derivatives - NERVES
Thoracic splanchnic nerves
S innervation foregut derivatives - PATHWAY
Lat horn - white communicating ramus - S trunk - ganglia ant to abdominal aorta (synapsis) - postganglionic fibers together with arteries - viscera
PS innervation foregut derivatives - NERVES
Vagus nerve
PS innervation foregut derivatives - PATHWAY
1º neurons in the medulla (CNS) - vagus nerve - wall of the viscera -synapse at microganglia - short postganglionic neurons.
Visceral afferents foregut derivatives
Pain info -> splanchnic (S) nerves.
(neuron bodies in the dorsal root ganglia of spinal nerves)
Distension -> PS fibres.
(neuron bodies in ganglia from the vagus nerve, in brainstem, and then enter the NTS)
Intraperitoneal viscera
Stomach
Sup part of the duodenum
Jejuenum
Ileum
Cecum
Verniform appendix
Transv + sigm colon
Liver
Spleen
Primary retroperitoneal viscera
Kidneys
Suprarrenal glands
Ureters
Secondary retroperitoneal viscera
Pancreas
Desc + horizontal parts of the duodenum
Asc + desc colon
Foregut derivatives
Abdominal esophagus
Stomach
1º, 2º portions of duodenum
Pancreas
Liver
Spleen*
Midgut derivatives
3º,4º portions of duodenum
Jejunum
Ileum
Cecum, appendix
Asc colon
Up to 2/3 transv colon
Hindgut derivatives
Remaining 1/3 transv colon
Desc colon
Sigmoid colon
Only sup part of the rectum
Parietal branches of abdominal aorta
Inferior phrenic arteries
Lumbar
Common iliac artery
Median sacral artery (L5)
Visceral branches of aorta
Celiac trunk
Superior mesenteric artery
Renal arteries (L1)
Gonadal arteries
1º hepatic effect of the portal system
Oral drugs = metabolized by liver
Rectal-administered drugs = not metabolized by liver (inferior rectal veins)
Diaphragm location
Inferior thoracic aperture
Diaphragm anatomy
Tendinous portion from septum transversum
3 hiatus: IVC (T8), esophagus (T10), aortic (t12)
Structures in the diaphragm
Phrenic nerve
Azygos, hemiazygos —> lumbar veins
Inferior phrenic arteries
Small intestine anatomy
Jejunum and ileum
Small intestine arteries
Jejunal artery + ilial artery (superior mesenteric art)
Jejunal irrigation
Arcade: 1
Vasa recta: long
Lymph nodes: solitary
Ilial irrigation
Arcade: 2
Vasa recta: long
Lymph nodes: solitary + aggregated
PS innervation small intestine
Vagus nerve
S innervation small intestine
Greater (T5-T9) and lesser (T10-T12) thoracic splanchnic nerves
Large intestine differences with small intestine
Omental appendices
Taeniae coli
Haustras
Large intestine structures
Iliocecal fold
Iliocecal valve
Appendix
Large intestine relations
Hepatic / R colic flexure
Splenic / L colic flexure
Large intestine arteries
Iliocecal artery (sup mesenteric artery)
R colic artery (sup mesenteric artery)
Middle colic artery (sup mesenteric artery)
Left colic artery (inf mesenteric artery)
Sigmoid arteries (inf mesenteric artery)
Superior rectal artery (inf mesenteric artery)
(Middle + left anastomose)
PS innervation of the large intestine
Vagus nerve
Pelvic splanchnic nerves (S2-S4)
S innervation of the large intestine
Greater thoracic splanchnic nerves (T5-9) (sinapsis in sup mesenteric ganglia)
Lesser thoracic splanchnic nerves (T10-12) (sinapsis in sup mesent ganglia)
Lumbar splanchnic nerves (L3-4) (sinapsis in inf mesent ganglia)
Enteric nervous system - DEF, INPUTS, LOCATION, PLEXUSES, FUNCTION
Local nervous system only in GI tract
Input: S + PS fivers
Location: GI tract walls
Plexuses: Myenteric (Auerbach) + submucosal (Meissner) —> controlled by ANS
Functions: peristalsis, gastric secretions, GI blood flow…
Rectum - peritoneum in males
Covers bladder + ant part of the colon
Pouches in males
Rectovesical
Rectum - Peritoneum in females
Covers bladder + part of the colon + uterus
Pouches in females
Rectouterine pouch (Douglas’)
Vesicouterine pouch
Anal canal is separated from rectum by
Pectinate line
Sphincters in anal canal
Internal - involuntary - ANS
External - voluntary - Pudendal nerve
Rectum arteries
Superior rectal artery (inf mesenteric artery)
Middle rectal artery (internal iliac artery)
Inferior rectal artery (internal iliac artery)
Rectum veins
Portosystemic junction
Middle + inf rectal veins drain directly into caval system
Somatic innervation of the rectum
Pudendal nerve (from ant/vent horn S3-4)
PS innervation of rectum
Pelvic splanchnic nerves (S2-4)
S innervation of the rectum
Sacral splanchnic nerves (L2)
(Incorporate to inf hypogastric plexus and exit through foramina at the level they innervate)