Anatomy Flashcards
Bottom three regions of the classification of the abdomen?
Right iliac, hypogastic (middle) and left iliac
Middle three regions of the classification of the abdomen?
Right lumbar, Umbilical, and left lumbar
Upper three regions of the classification of the abdomen?
Right hypochondrium, epigastric, left hypochondrium
Three main arteries that supply the gut?
Celiac trunk
Superior mesenteric artery
Inferior Mesenteric artery
Boundaries of the Foregut. Midgut and hindgut?
Foregut to Midgut is halfway along the C of the duodenum
Midgut to Hindgut is 2/3rds along the transverse colon
The lymph and nervous nodes all grouped by what three things?
The Celiac, Sup. Mesenteric and inferior mesenteric arteries.
Arterial, venous, and symp + Psymp supply to the foregut?
Arterial: Celiac trunk
Venous: Splenic/portal vein
Sympathetic: Via celiac plexus
Parasympathetic: Vagus
What is the foramen that connects the lesser sac to the greater sac?
Epiploic foramen
What does the umbilical vein become in adult anatomy?
Ligamentum teres
What does the ductus venosus become in adult anatomy?
Ligamentum venosum
What is a porto-systemic anastomoses?
An area where communication occurs between portal and systemic drainage
Some consequences of portal hypertension?
Splenomegaly
Oesophageal varices
Anorfectal varices
Caput medusae
What is caput medusae?
Enlarged superficial veins in anterior abdominal wall
How does the proximal limb of the gut tube rotate in embryology?
90o to the right
180o upwards
270o in a circle
what does the transverse melocolon connect?
The transverse colon to the posterior surface of the abdominal wall
What is an omplalocele?
When the gut fails to re-enter in week 10, leaving it outside of the gut
What is a vitelline regression?
Vitalline duct failing to regress during development - can cause fistula, or volvulus both bad, volvulus worse
Types of rotation abnormalities?
Non-rotation: failure of the gut tube to rotate at all
Volvulus: Distal duodenum pinch closed casing obstruction
Reverse rotation: duodenum anterior to colon (sup. mesenteric constricts duodenum
For the rectum to form at week 12, what elongates?
The urorectal septum
What line marks the split between endoderm and ectoderm derived anal canal?
Pectinate line
Whats a pneumoperitoneum?
Air leaking into the peritoneal cavity, often visualised as bubble under the diaphragm
Pancreatitis can cause bleeding where?
Retroperitoneal space or track through the peritoneum
Where is appendicitis pain normally located?
Felt in the umbilical region, later localises to the right iliac region
What stimuli are painful to viscera and what are not?
Painful:
- Ischaemia
- Distension
- Inflammation
Non-painful:
- Cutting
- Burning
Order of structures in the intestines starting from stomach
Stomach - duodenum - jejunum - ileum - cecum - ascending colon - transverse colon - descending colon - sigmoid colon
Three main arteries that come off the celiac trunk?
Left gastric
Splenic
Common hepatic
<p>What does the left gastric artery supply?</p>
<p>Lesser curvature of the stomach and 3rd part of the Oesophagus</p>
What does the splenic artery supply?
What does it then divide into?
Spleen, pancreas
Short gastric, left gastro-epiploic
What do the short gastric and left gastro-epiploic arteries supply?
Short gastric - fundus of the stomach
Left gastro-epiploic - greater curvature of the stomach
What does the common hepatic artery go on to form? What do these arteries supply?
Hepatic artery proper - liver (divides into right and left hepatic arteries
Right gastric - lesser curvature of the stomach (inferiorly)
Gastroduodenal - supplies pylorus and gives off right gastroepiploic which supplies the greater curvature of the stomach inferiorly
What three structures run through the lesser omentum?
Bile duct, hepatic artery proper, hepatic portal vein
What is the bare area of the liver?
The area of the liver normally covered by the diaphragm - it lacks the peritoneal covering of the other areas of the liver
Main veins of the GI system?
Splenic vein, which the superior and inferior mesenteric arteries join onto to, it then joins the hepatic portal vein
Arteries that supply the small intestine and cecum?
Superior mesenteric forms the jejunal arteries and ileal arteries
The ileocolic artery supplys the end of the ileum and the cecum
Main arteries that supply the large intestine that branch of the superior mesenteric artery, what they supply?
Right colic - ascending colon
middle colic - transverse colon (2/3rds)
Main arteries that supply the colon and rectum that branch from the inferior mesenteric artery?
Left colic - end of transverse and the descending colon
Sigmoid arteries - sigmoid colon
Superior rectal artery - rectum
After the main arteries branch off the superior/inferior mesenteric to supply the colon, they all join one artery that runs along the colon, what is it?
Marginal artery
What are the small arteries that branch off the marginal artery to supply the colon called?
Vasa recta
Three arteries that supply the rectum, and where athey are located roughly?
Superior rectal - comes in superiorally from above the pelvic floor
Middle rectal - runs along the muscles of the pelvic floor
Inferior rectal - runs below the pelvic floor in the foramen
Main nerve of the pelvic floor?
Inferior rectal nerve - runs in foramen below the pelvic floor
Arterial supply of the oesophagus?
Upper third is supplied by the inferior thyroid artery, middle third by branches from thoracic aorta, lower third by left gastric artery
Venous drainage of the oesophagus?
Upper third by the inferior thyroid vein, middle by the azygos system and lower third by the left gastric vein
Lymphatic drainage of the oesophagus?
Lymph from the upper third drains into deep cervical nodes, the middle into the superior and posterior mediastinal nodes, and the lower third into nodes along the left gastric artery
What is inside the peritoneal cavity?
A small amount of peritoneal fluid
What is the dorsal and ventral mesogastrium?
The two areas of the peritoneum that attach to the anterior abdominal wall (ventral) and the posterior wall (dorsal)
What do the lienorenal and gastrosplenic ligaments attach?
Lienorenal attaches spleen to posterior surface of peritoneum (over the kidneys)
Gastrosplenic - attaches stomach to spleen
Nerve supply of the oesophagus?
Sympathetic - splanchnic from the sympathetic chain
Parasympathetic - Vagus
What exactly is the peritoneum?
The serous membrane lines the wall of the abdominopelvic cavity, and invests the organs
What structures of the adult gut are retroperitoneal?
Duodenum, ascending/descending colon and rectum.
Lymphatic drainage of the stomach?
Left gastric nodes, pyloric nodes, pancreatosplenic nodes, right gastrosplenic nodes - then all onto the celiac nodes
Spinal cord values for sympathetics of the stomach?
6th-9th
Parasympathetic nerve supply to the stomach?
Vagus nerve, anterior and posterior vagal trunk
What is the area that the bile duct and pancreatic duct empty into the duodenum?
The major duodenal papilla
Blood supply of the duodenum?
Foregut (before major duodenal papilla) supplied by superior pancreatoduodenal artery and after this the inferior pancreatoduodenal artery
The blood supply/lymph and nerve supply of the parietal/visceral peritoneum is the same is which structures?
Blood supply/lymph/nerve supply of visceral peritoneum is the same as the organ below it and the parietalis the same as the abdominal wall above it
Difference in mesentery and mesocolon?
Mesentery - small intestine
Mesocolon - Transverse/sigmoid colon
What are the omenta?
Greater - flaps that lie inbetween the stomach and the posterior abdominal wall
Lesser connects the stomach to the liver
What do the ascending and descending colon lack?
Mesentery
What embryological tissue do the greater and lesser omenta arise from?
Greater from the dorsal mesogastrium
Lesser from the ventral mesogastrium
What is the epiploic foramen bordered by?
Inferior vena cava, free edge of lesser omentum
The divisions of the pancreas?
Head (with uncinate process), neck, body and tail
What vessels travel between the head and neck of the pancreas?
Superior mesenteric artery and vein
When the bile duct and pancreatic duct join together what is this structure called?
Hepatopancreatic ampulla
Lymph drainage of the pancreas?
To the pancreatosplenic nodes
The physiological division of the liver?
Between the gallbladder and inferior vena cava
What are the structures called that collect bile in the liver?
Bile canaliculi
Three divisions of the gallbladder?
Fundus - most anterior
Body
Neck
One way to make the gall-bladder radio-opaque?
Ingestion of iodine
Artery that supplies the gall bladder?
Cystic artery
Sympathetic and parasympathetic nerve supply of the gallbladder?
Sympathetic - from celiac ganglion
Parasympathetic - anterior vagal trunk
Functions of the umbilical vein and ductus venosus in the fetus?
Umbilical vein - carries oxygenated blood into the fetus (from the placenta) ends at the hepatic portal vein in porta hepatis
Ductus venosus connects porta hepatis to inferior vena cava
Together enable blood to bypass the liver in the fetus
What are porto-systemic anastomoses?
Parts of the intestine where blood is drained both to the the inferior vena cava and the hepatic portal vein
Sites of porto-systemic anastomoses?
Lower end of oesophagus between left gastric and azygous
Wall of anal canal
Umbilicus
Nerve supply to the liver?
Sympathetic - from celiac plexus travelling along the porta hepatis
Parasympathetic - from both posterior and anterior vagal trunks
What vessels are contained in the lienorenal ligament?
Splenic artery and vein
What vessels are enclosed within the gastrosplenic ligament?
Short gastric and left gastroepiploic vessels
Changes from jejunum to ileum?
Wall of jejunum is thicker and more vascular
There are more folds (plicae circularis
Ileum has large numbers of peyers patches
Branches off the superior mesenteric?
Inferior pancreatoduodenal artery
Jejunal and ileal arteries
Middle colic
Right colic
Ileocolic artery
Sympathetic and parasympathetic nerve supply to the small intestine?
Both from the prevertebral plexus
Sympathetic from 9th and 10th thoracic spinal cord segments and synapse in celiac/superior mesenteric plexus before travelling through the superior mesenteric plexus
Parasympathetic from the vagus nerve, distributed with branches of the superior mesenteric artery
What are teniae coli, and appendices epiploicae?
Teniae coli: The three bands of longitudinal muscle in the large intestine
Appendices epiploicae: Deposits of fat between colonic wall and visceral peritoneum
what is the bend from ascending colon to transverse colon called?
Right colic (hepatic) flexure
What is the bend from transverse colon to descending colon called?
Left colic (splenic) flexure
Are peyers patches present in the large intestine?
NO
What are the cisterna chyli?
The opening of the thoracic duct, just below the diaphragm that lymph from the small and large intestine drains into
Nervous supply to the large intestines?
The parasympathetic supply as far at proximal two thirds of transverse colon derived from the vagus nerve through celiac and superior mesenteric plexi, without synapsing. From the distal third of the transverse colon to the rectum the parasympathetics come from pelvic splanchnics
Sympathetics come from T11 to L2 - synapse in superior and inferior mesenteric plexi. From cecum to 2/3rds it is superior mesenteric and the rest is inferior mesenteric
What are the anal columns?
6-10 longitudinal mucosal folds that contain blood vessels from superior rectal artery/vein, the lower ends are made up of the anal valves.
Nerve supply to internal and external sphincters?
Internal - circular smooth muscle autonomic
External - striated muscle supplied by inferior rectal (from pudendal)
Arterial supply to rectum, what do they branch from?
Superior rectal - inferior mesenteric
Middle rectal - internal iliac
Inferior rectal - internal pudendal
lymph drainage of the rectum?
Upper part to pararectal nodes then onto cisternae chyli
from anorectal region - middle rectal vessels to internal iliac nodes
below the anal canals to superficial inguinal nodes then onto cisternae chyli
Venous drainage of the rectum?
Internal and external venous plexi without valves surround the rectum and anal canal, they then lead to superior, middle and inferior rectal veins
Nervous supply of the rectum?
T11 to L2 sympathetic supply synapse in inferior mesenteric ganglion then onto inferior hypogastric plexi
Parasympathetic from S2,3 and 4, then onto inferior hypogastric plexi
