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GI Exam 1 > Anatomy > Flashcards

Anatomy Flashcards

1
Q

Internal thoracic vessels

A

superior epigastric vessels branch from the internal thoracic

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2
Q

Transumbilical plane

A

vessels blow drain to the femoral vein

vessels above drain upward

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3
Q

Intercostal nerves travel in between which 2 layers?

A

Internal and Inner most intercostal muscles

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4
Q

Nerves of abdominal wall

A

Travel between internal obliques and transverse abdominis

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5
Q

Nerve distribution landmarks

A

T7 –> just below sternum
T10 –> umbilicus
L1 –> ilioinguinal nerve

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6
Q

Fatty Layer (Camper’s)

A

superficial adipose tissue

- fluid from perineum can fill this potential space and move into lower abdomen but will not enter thigh

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7
Q

Membranous Layer (Scarpa’s)

A

has an extra layer of tissue

attaches to deep fascia of thigh (fascia lata) –> cannot pass

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8
Q

Anterolateral abdominal wall layers

A 
External oblique (hands in pocket)
Internal oblique (arms crossed on chest) --> forms part of the conjoint tendon
transverse abdominis (transverse) --> forms part of conjoint tendon
- 1 midline vertical muscle --> rectus abdominis (6 pack) --> has tendinous intersections
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9
Q

Linea alba

A

where aponeuroses of 3 flat muscles intersect

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10
Q

Inguinal ligament

A

formed by lower border of aponeuroses of external oblique (folds under)
From ASIS –> pubic tubercle

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11
Q

External iliac vessels

A

inferior epigastric vessels branch from external iliac

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12
Q

Arcuate Line

A

landmark –> crescent shaped border of posterior layer of Rectus sheath
Located superior & anterior –> IO, EO, Rectus abdominis
Located inferior & anterior –> IO, EO, Scarpa’s fascia, and aponeuroses

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13
Q

Spigelian hernia

A

hernia of semilunar line –> common in obese individuals

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14
Q

Umbilical hernia

A

common in newborns

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15
Q

Epigastric hernia

A

through linea alba in epigastric region

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16
Q

Inguinal Triangle

A

Borders

  1. Inguinal ligament
  2. inferior epigastric vessels
  3. lateral border of rectus abdominis
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17
Q

Muscles in abdomen that correlate to layers around testicle

A

External Spermatic Fascia –> external oblique
Cremaster muscle –> internal oblique
Internal Spermatic Fascia –> fascia transversalis

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18
Q

Fascia transversalis

A

lines entire abdominal cavity and is separated from peritoneum by fat-filled extraperitoneal tissue

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19
Q

Indirect inguinal hernia

A

congential
bowel herniates lateral to inferior epigastric vessels
follows route taken by testes

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20
Q

Direct inguinal hernia

A

not congenital

bowel herniates medial to inferior epigastric vessels

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21
Q

Varicocele

A

made up of veins with inadequate valves
decreased fertility, increased risk of cancer
R –> directly into IVC
L –> L renal vein –> IVC (99% of the time)

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22
Q

Umbilical Folds

A

Lateral –> covers inferior epigastric vessels
Medial –> obliterated umbilical artery
Median –> urachus

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23
Q

Hydrocele

A

excess fluid in a persistent processus vaginalis and may be associated with an indirect inguinal hernia

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24
Q

Parietal peritoneum

A

lines the peritoneal cavity –> continuous with visceral

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25
Q

Visceral peritoneum

A

covers the peritoneal organs –> continuous with parietal

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26
Q

mesentary peritoneum

A

covers intestines

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27
Q

omentum peritoneum

A

folds of peritoneum connecting the stomach to another organ
Lesser omentum –> 2 layers connecting stomach to liver
Great omentum –> 2 layers connecting stomach to colon –> becomes 4-layered structure after fusion

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28
Q

Mesentary

A

2 layers of perioteum that suspend an organ

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29
Q

Omental bursa

A

also called lesser peritoneal sac –> becomes located behind stomach after the greater omentum layers fuse
- formed by rotation of stomach and dorsal mesentary creating space

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30
Q

Gastrophrenic ligament

A

part of greater omentum –> connects stomach to diaphragm

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31
Q

Gastrosplenic ligament

A

part of greater omentum –> connects stomach to spleen

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32
Q

Heptoduodenal ligament

A

part of lesser omentum –> connects duodenum to liver (contains portal triad)

  • common bile duct
  • hepatic artery proper
  • portal vein
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33
Q

Omental foramen

A

connects greater and lesser sacs

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34
Q

Dorsal mesentary

A

continuous from pharynx to the anus

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35
Q

Ventral mesentary

A

stops above the umbilicus

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36
Q

Foregut

A

supplied by the celiac artery

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37
Q

Midgut

A

supplied by superior mesenteric artery

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38
Q

Hindgut

A

supplied by inferior mesenteric artery

39
Q

Intraperitoneal

A

abdominal organ that grows into the peritoneal cavity –> completely covered by visceral peritoneum

40
Q

Retroperitoneal

A

organs outside peritoneal cavity –> only peritoneum on anterior surfaces

41
Q

Stomach and parts

A

Cardia –> where esophagus attaches
Fundus –> large bulge on superior surface
Body –> large portion of stomach
Greater Curvature –> large curve (greater omentum)
Lesser Curvature –> small curve (lesser omentum)
Pylorus –> Antrum, Canal, Sphincter

42
Q

Order of small intestine

A

Duodenum
Jejunum
Ileum

43
Q

Duodenum

A

partly retroperitoneal –> becomes peritoneal again at paraduodenal fossa
- possible place for herniation

44
Q

Colon

A

Cecum –> ascending colon –> transverse colon –> descending colon –> sigmoid colon –> rectum
*Ascending & descending colon are retroperitoneal

45
Q

Right infracolic space

A

Closed space where fluid cannot exit

46
Q

Lesser omentum

A

hepatoduodenal ligament

hepatogastric ligament

47
Q

Spleen

A

not part of GI tract but develops in dorsal mesentary and is supplied by celiac trunk

48
Q

Abdominal aorta

A

begins at aortic hiatus at T12 –> divides into common iliac arteries at L4

49
Q

Celiac Trunk

A 
T12, supplies foregut
Branches
1. Common hepatic
2. L Gastric
3. Splenic
50
Q

Common hepatic artery

A

branch off Celiac trunk

  • supplies liver (hepatic artery proper)
  • has R gastric branch that anastomosis’ with L gastric
  • gastroduodenal artery
51
Q

L Gastric artery

A

branch off celiac trunk

  • anastamoses’ with R gastric artery on lesser curvature
  • esophageal branches anastamose with thoracic branches
52
Q

Splenic artery

A

branch off celiac trunk

  • very coiled –> supplies spleen
  • has branch of L gastro-omental artery –> anastomoses with R gastro-omental on greater curvature
53
Q

Pancreatiduodenal artery

A

Branch off the hepatic artery –> anastamoses’ with inferior pancreatiduodenal artery (branch of SMA)

54
Q

Ampulla

A

proximal most portion of duodenum –> directly after pyloric sphincter
- SMOOTH LINING –> ulcer can eat through posterior wall into gastroduodenal artery

55
Q

Superior Mesenteric Artery

A 
L1, midgut
Branches
1. Jenjunal & Ileal
2. Appendicular
3. Ileocolic
4. R colic
5. Middle colic
56
Q

Jejunal and Ileal branches

A

supply their respective portions of small intestine

- no distinct demarcation between them but jejunal has longer vasa recta and ileal has shorter vasa recta

57
Q

Middle Colic artery

A

most proximal artery

58
Q

R Colic artery

A

2nd after middle colic

59
Q

Ileocolic

A

distal after R colic –> appendicular artery branches off of this to supply appendix

60
Q

Inferior Mesenteric Artery

A 
L3, hindgut
Branches
1. L colic
2. Sigmoidal
3. Superior rectal
61
Q

Left colic artery

A

most proximal branch of IMA

62
Q

Sigmoidal artery

A

2nd branch of IMA –> supplies sigmoid colon

63
Q

Superior rectal arteries

A

distal branch of IMA –> supplies rectum

64
Q

Marginal artery of Drummond

A

Very large anastamoses from middle colic to sigmoidal artery

65
Q

Areas of colon susceptible to ischemia

A

Right colon –> poorly developed marginal artery
Splenic flexure –> marginal artery absent sometimes
Rectosigmoid junction –> last collateral connection with proximal arteries

66
Q

Ileocecal valve/orifice

A

Opening of ileum into cecum

67
Q

Portal system

A

arrangement of vasculature whereby blood must pass through 2 capillaries before returning to heart (liver)

68
Q

Hepatic portal vein

A

collects blood from GI tract and delivers to liver for metabolism of nutrients

69
Q

Portal HTN

A
  • obstruction of portal vein –> engorgment of anastomotic sites –> varicosity
70
Q

Duodenum

A

C-shaped around head of pancreas

  • Ampulla, descending, horizontal, ascending
  • secondarily retroperitoneal
71
Q

Hepatopancreatic ampulla

A

enters into major duodenal papilla –> opening of common bile duct into duodenum
secretions controlled by sphincter of oddi

72
Q

Cystic artery

A

branch of R hepatic artery which is branch of hepatic artery proper –> avoid cutting during cholecystectomy

73
Q

Cystohepatic Triangle

A

Liver tissue
Cystic Duct
Common Hepatic Duct

74
Q

Common bile duct

A

formed by cystic duct and common hepatic duct

- common hepatic duct formed by L and R hepatic ducts

75
Q

Gall bladder

A

has fundus, body, and neck

- also has spiral folds that act as valves in cystic duct

76
Q

Biliary Colic

A

intense spasmodic pain felt in epigastric region on RUQ

77
Q

Cholecystectomy

A

gall bladder removal

78
Q

Ligamentum teres

A

remnant of umbilical vein

79
Q

Caudate and Quadrate lobes

A

anatomically R liver

functionally L liver

80
Q

Adrenal Glands

A

3 Blood supplies
1. Superior –> from inferior phrenic arteries
2. Middle –> from aorta
3. Inferior –> from renal arteries
Cortex –> exocrine function derived from mesoderm
Medulla –> secretes adrenaline and is derived from neural crest cells
- presynaptic fibers from spinal cord synapse directly on cells in medulla (preganglionic fibers)

81
Q

Drainage from adrenal glands

A

R adrenal gland drains directly into IVC

L adrenal gland drains into L renal vein –> then into IVC

82
Q

Course of the ureter

A

Travels under the gonadal vessels and over top of the iliac vessels and then under the uterine vessels

83
Q

Inferior Phrenic arteries

A

branches of the aorta that travel superiorly to supply adrenal glands and the diaphragm

84
Q

Arcuate ligaments

A

Median –> where aorta comes through
Medial –> psoas muscle travels under (L2)
Lateral –> quadratus lumborum travels under (right by 12th rib)

85
Q

Lumbocostal triangle

A

formed by the pleuroperitoneal membrane –> if fails to form patient gets congenital diaphragmatic hernia

86
Q

Nerve plexuses

A 
Celiac ganglion and plexus
Superior mesenteric ganglion and plexus
Intermesenteric plexus --> No ganglion
Inferior mesenteric ganglion and plexus
Superior hypogastric plexus
87
Q

Cisterna chyli

A

terminis of thoracic duct

88
Q

Lumbar plexus

A

L1-L3 and half of L4

89
Q

Subcostal nerve

A

T12

90
Q

Iliohypogastric and Ilioinguinal

A

L1

91
Q

Lateral femoral cutaneous

A

L2 and L3

92
Q

Femoral nerve

A

L2 - L4

93
Q

Obturator Nerve

A

L2 - L4

GI Exam 1 (7 decks)

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