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Anatomy Flashcards

1
Q

Parietal layers of serous cavity are innervated by what? The visceral layer is innervated by what?

A

parietal - spinal innervation

visceral - autonomic nerves

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2
Q

when the diaphragm contracts, what happens to the thorax and abdomen?

A

diaphragm contracts, thorax increases in size, decreasing abdominal volume

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3
Q

what are the abdominal wall layers, starting with the skin and going to the peritoneum?

A 
skin
superficial fascia 
 - Campers
 - Scarpas
deep fascia
muscles/aponeurosis
transversalis fascia
extraperitoneal fat
peritoneum
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4
Q

what is scarpa’s fascia continuous with?

A

dartos fascia (deep to scrotal skin/fascia labia majora), superficial penile fasacia, and Colle’s fascia (perineum)

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5
Q

what muscles aponeurosis helps form the inguinal ligament, rectus sheath and linea alba?

A

external oblique

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6
Q

What direction do EO muscle fibers run? IO?

A

EO run inferior and medial; IO runs superior and medial (perpendicular to each other)

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7
Q

What is the lateral border of the rectus abdominis called?

A

semilunar line

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8
Q

What denotes the transition of aponeurotic layers between the umbilicus and pubis?

A

arcuate line

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9
Q

What muscles make up the anterior and posterior rectus sheath superior to the arcuate line? Inferior to the line?

A

superior anterior: EO and IO
superior posterior: IO and TA
inferior anterior: EO, IO, TA
inferior posterior: transversalis fascia

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10
Q

What muscle is responsible for posterior pelvic tilt?

A

rectus abdominis

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11
Q

If the R EO and L IO contract simultaneously, what movement is caused?

A

L rotation of the torso

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12
Q

All muscles of the abdomen do what two things?

A

protection above the arcuate line, and increase intra-abdominal pressure

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13
Q

What two arteries feed the anterolateral abd wall and go between the IO and TA?

A

posterior intercostal arteries (10 and 11) with subcostal artery

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14
Q

Superior epigastric artery is a branch from what? Where is it and what does it supply?

A

Terminal branch of internal thoracic artery on posterior surface of RA, supplying upper RA

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15
Q

Inferior epigastric artery is a branch from what? Where will it be found and what does it supply?

A

branch of external iliac on posterior surface of RA against transversalis fascia, within rectus sheath at arcuate line, supplying lower RA

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16
Q

Veins of the abdominal wall drain to what?

A

azygos system, internal throacic, external iliac, femoral, and great saphenous veins

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17
Q

What forms a communication between the axillary and femoral veins?

A

thoracoepigastric vein

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18
Q

Superficial superior lymphatics of the abdomen drain where? superficial inferior to where? deep abdomen to where?

A

superficial superior lymphatics to axillary lymph nodes;
superficial inferior lymphatics to superficial inguinal lymph nodes;
deep abdomen lymphatics drain to external/common iliac veins and abdominal aorta

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19
Q

What levels of spinal nerves innervate the abdominal muscles?

A

T7 to L1

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20
Q

What two nerves come from L1 level?

A

iliohypogastric nerve (to skin above pubis) and ilioinguinal nerve (skin in inguinal region)

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21
Q

On the interior anterior abdominal wall, what folds are there? What are they remnants of ?

A

median umbilical fold - remnant of urachus/allantois; goes bladder to umbilicus
medial umbilical fold - remnant of umbilical arteries
lateral umbilical fold - contains inferior epigastric artery and is used for hernia classification
ligamentum teres - remnant of umblicial vein within free edge of falciform ligament, passing from umbilicus to liver

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22
Q

is a direct hernia medial or lateral to the lateral umbilical fold? A direct hernia would then be considered in what area?

A

direct hernia is medial to lateral umbilical fold, putting the hernia in the inguinal (Hesselbach’s) triangle

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23
Q

Testes and ovaries develop in the ________ space and descend toward the labioscrotal swelling by the _________.

A

retroperitoneal; gubernaculum

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24
Q

the labioscrotal swelling is the precursor to what?

A

labia majora

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25
Q

as testes descend, an outpocket of peritoneum is pulled into the LS swelling called what?

A

processus vaginalis

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26
Q

after testes with their BV, nerves and connecting duct go inside the processus vaginalis, what happens?

A

processus vaginalis gets pinched off and becomes tunica vaginalis

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27
Q

how many layers does the tunica vaginalis have? What layer is missing?

A

has a parietal and visceral layer with a cavity in between; dorsal layer is missing, so it only covers 3/4

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28
Q

Within the vaginalis, the fibrous outer layer of testes is called what? What does it do?

A

tunica albuginea, septates testis into lobules

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29
Q

what is the pathway/connections after the seminiferous tubules collect sperm?

A

to rete testis - efferent ductile - head of epididymis confluence - body - tail - ductus deferens

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30
Q

Is the pathway from tubules to ductus deferens inside or outside of tunica vaginalis?

A

pathway is outside of tunica vaginalis

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31
Q

spermatic cord attaches the testis back to the abdominal wall. What is in this cord?

A

ductus deferens, a of dd, pampiniform venous plexus, autonomic nerves and genitofemoral n, testicular a, lymph vessels

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32
Q

what nerve supplies the anterior part of scrotum, or labia majora? it also supplies the TA and IO

A

ilioinguinal nerve (L1)

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33
Q

What does the inguinal canal primarily do? What ligament does it give off?

A

inguinal canal conducts the spermatic cord from retroperitoneal position to the scrotum; gives off lacunar ligament

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34
Q

What nerves innervates posterior scrotum?

A

perineal nerve (S2-S4)

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35
Q

The IO and TA arch over the inguinal canal and join together to form what?

A

conjoint tendon

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36
Q

the opening of the deep inguinal ring goes through what?

A

transversalis fascia

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37
Q

what is the iliopubic tract?

A

thickening of transversalis fascia that covers the inguinal ligament posteriorly

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38
Q

What two nerves go through the inguinal canal? What is their relationship to the spermatic cord?

A

ilioinguinal n (L1) goes on the surface of the spermatic cord; genitofemoral n stays inside the spermatic cord

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39
Q

What nerve innervates the cremaster muscle? What is the origin of the cremaster muscle?

A

genitofemoral n. ;

derived from the IO

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40
Q

What are the layers covering the spermatic cord?

A

external spermatic fascia (from EOA), cremaster muscle, internal spermatic fascia (transversalis fascia)

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41
Q

What is a way to classify hernias?

A

based off location in relation to inferior epigastric vessels - medial is direct, lateral is indirect

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42
Q

Does the spermatic cord pass medial or lateral to the inferior epigastric vessels?

A

lateral

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43
Q

the ovaries do not descend into LS swelling, instead, what happens?

A

gubernaculum partially gets attached to the lateral side of the uterus, stopping the descent

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44
Q

In female development, some of the gubernaculum continues to descend through the deep ring, canal, and superficial ring to attach to what? What is this then called?

A

attaches to deep surface of the labia majora; round ligament of the uterus

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45
Q

Women are more prone to get what kind of hernia?

A

direct hernia

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46
Q

A femoral hernia passes where?

A

inferior to the inguinal ligament

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47
Q

How does the esophagus attach to the diaphragm?

A

phrenico-esophageal ligaments

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48
Q

When the esophagus goes through the diaphragm, it is encricled by what?

A

muscles of the R crus of diaphragm

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49
Q

What are the arterial supplies for the esophagus?

A

small branches of thoracic aorta to thoracic region;

L gastric artery from celiac trunk to abd/thoracic regions

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50
Q

Blood above the diaphragm drains to wear?

A

azygos venous system then to superior vena cava

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51
Q

blood below the diaphragm drains to wear?

A

L gastric vein to portal venous system

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52
Q

The overlap of two venous systems in the esophagus is an example of what?

A

portal-caval anastomoses

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53
Q

innervation of the esophagus is by what nerve?

A

branches off vagus for both sensory and motor

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54
Q

lymphatic drainage of the abdominal portion of esophagus goes where?

A

to L gastric lymph nodes to celiac lymph nodes

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55
Q

Where is the hepatogastric ligament?

A

part of lesser omentum, attaches stomach to liver

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56
Q

What lines the interior of the stomach, arranged in thick mucosal folds, longitudinally?

A

gastric rugae

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57
Q

What layer of smooth muscle does the stomach have that the SI and LI do not have?

A

oblique layer of smooth muscle

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58
Q

The omental bursa lies where and opens to the greater sac through what?

A

lies posterior to stomach and opens to greater sac through epiploic foramen (of Winslow)

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59
Q

Where is the epiploic foramen of Winslow?

A

posterior to the hepatoduodenal ligament

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60
Q

Transverse colon is attached to greater omentum and greater curvature of stomach by what?

A

its mesentery - transverse mesocolon

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61
Q

What direct branch of the celiac artery goes to the lesser curvature of the stomach?

A

L gastric a

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62
Q

What arteries supply the fundus of the stomach? Where does this come from?

A

short gastric arteries from the terminal part of splenic a

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63
Q

What pair of arteries go to greater curvature and what are they branches from?

A

gastroepiploic arteries - R is terminal continuation of gastroduodenal a - L is branch of splenic artery

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64
Q

R gastric a is a branch of what? Where does it go and anastomose with?

A

branch of hepatic proper a going to lesser curvature to anastomose with L gastric a

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65
Q

Most all venous drainage in this region around the stomach goes to where?

A

portal vein

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66
Q

lymph drainage from the region around the stomach ends in a single large duct called what? What does this duct connect to?

A

cisterna chyli, connecting to thoracic duct

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67
Q

What two segments of duodenum are considered intraperitoneal?

A

first (2 cm) and fourth segments

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68
Q

What is the proximal part of the first segment of duodenum called?

A

ampulla, or duodenal cap

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69
Q

What is the second segment of duodenum described as? What happens here? What is this area called?

A

descending segment, bile duct and main pancreatic duct empty into the second part at the major duodenal papillae (of Vater)

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70
Q

The initial section of duodenum is anterior to what?

A

portal vein and IVC

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71
Q

second part of duodenum is where?

A

to the R of the IVC and anterior to the hilum of R kidney

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72
Q

What crosses anterior to the third duodenal segment?

A

SMA and SMV

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73
Q

arterial supply to the duodenum is from what?>

A

celiac trunk and SMA; inferior pancreaticoduodenal a branch of SMA

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74
Q

lymph from around duodenum goes where?

A

to nodes and channels adjacent to aorta and IVC

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75
Q

What suspends the junction between the duodenum and jejunum to the posterior abdominal wall?

A

ligament of treitz (fibromuscular)

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76
Q

Jejunum and ileum are suspended from the posterior abdominal wall by what?

A

THE mesentery

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77
Q

Which section of the SI has a larger diameter and more muscular wall?

A

jejunum

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78
Q

Which section of the SI has smoother internal walls?

A

ileum

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79
Q

What are peyers patches and where are they found?

A

groups of lymphoid follicles in the ileum

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80
Q

What is the arterial supply to jejunum and ileum like?

A

both supplied by SMA, terminal branches make arcades, perpendicular to which are vasa recta that pass to bowel

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81
Q

Where does venous blood drain to? What two veins converge to make this?

A

portal vein from SMV and splenic vein

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82
Q

How is the cecum attached to the posterior abdominal wall?

A

it is not attached, it lacks mesentery

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83
Q

What is attached to the inferior margin of the cecum and where is it located 2/3 of the time?

A

vermiform appendix, retrocecal

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84
Q

What converges at the distal end of the cecum?

A

taniae coli

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85
Q

Describe the position of the ascending colon .

A

secondarily retroperitoneal, superior to R lobe of liver, but R hepatic flexure is posterior to liver; anterior to R kidney

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86
Q

Liver and GB are enterior to what?

A

R part of transverse colon

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87
Q

Are the ascending and descending colon intraperitoneal or retroperitoneal?

A

retroperitoneal

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88
Q

What is the most mobile part of the large intestine?

A

transverse colon

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89
Q

The junction from transverse to descending colon is attached to the diaphragm by what?

A

an extension of transverse mesocolon - phrenicocolic ligament

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90
Q

The root of the sigmoid colon crosses what vessels and structure?

A

L common iliac vessels and L ureter

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91
Q

What are the lobules of fat attached along the colon called?

A

epiploic appendices

92
Q

Enlargement of cicrcular muscle throughout the colon causes sacculations called what? what is between this?

A

haustra, with semilunar folds in between

93
Q

What artery supplies the R half of the colon? L half?

A

SMA gets R half; IMA gets L half

94
Q

What is the name of the anastomotic supply between the SMA and IMA

A

marginal artery of drummond

95
Q

Venous drainage from the colon can go to what two main sites?

A

IVC or portal vein

96
Q

lymph drains superiorly from what, to accumulate where, to drain ultimately to what?f

A

from aortic nodes to accumulate in cisterna chyli and then to thoracic duct

97
Q

lymph from organs with retroperitoneal surface can drain where?

A

adjacent body wall

98
Q

What are four functions of the liver?

A
  1. secrete bile and hormones
  2. synthesize serum proteins and lipids
  3. process products/toxins/drugs
  4. eliminate particles and senescent cells from blood stream
99
Q

What ligament contains the portal triad?

A

hepatoduodenal ligament

100
Q

What are the parts of the portal triad? Where are they in relationship to one another?

A

common bile duct on R, proper heaptic a on L, hepatic portal vein posterior

101
Q

What is the coronary ligament?

A

reflection of peritoneum from liver to diaphragm, encircles the bare area of the liver, direct contact with the diaphragm

102
Q

What is on the R and L of the coronary ligament?

A

triangular ligaments

103
Q

What does the falciform ligament enclose?

A

ligamentum teres hepatis (round ligament of the liver)

104
Q

What is the falciform ligament continuous with?

A

coronary ligament on superior surface and lesser omentum at porta hepatis

105
Q

What recess is between the anterior liver and diaphragm?

A

supphrenic recess

106
Q

What is the hepatorenal recess called? Why is this area important?

A

Morrison’s pouch, will show fluid accumulation on FAST exam s/p trauma

107
Q

When supine, fluid from where will flow into the hepatorenal recess? What communicates with the hepatorenal recess?

A

omental bursa (posterior to stomach); R subphrenic recess

108
Q

What recess is between the L lobe of the liver and diaphragm while below the posterior layer of coronary ligament?

A

superior recess of omental bursa

109
Q

Vessels and ducts enter and leave the liver through what structure?

A

porta hepatis

110
Q

What are four structures of the visceral surface of the liver leading to the porta hepatis?

A

fossa for GB (ant/R)
groove for IVC (posterior aspect near midline)
fissure for ligamentum teres hepatis (ant/L)
fissure for ligamentum venosum (posterior aspect)

111
Q

anatomical R and L lobes of liver are separated by what? (not surgical)

A

falciform ligament

112
Q

What is between the GB and ligamentum teres on the anterior part of the liver?

A

quadrate lobe

113
Q

What is between the ligamentum venosum and IVC, posterior to the porta hepatis?

A

cuadate lobe with possible inferior projection called papillary process

114
Q

How are functional/morphological lobes of the liver identified?

A

established by intrahepatic branching of vasculature - 8 hepatic segments

115
Q

What two vessels supply blood to the liver? which has more nutrients?

A

portal vein (more nutrients) and hepatic artery (more oxygen)

116
Q

What forms the hepatic portal vein?

A

SMV and splenic vein

117
Q

What are four tributaries of the splenic vein?

A

Short gastric veins
L gastro-omental vein
pancreatic veins
IMV which drains distal part of LI

118
Q

SMV runs with the mesentery of SI to ultimately terminate posterior to the neck of pancreas into what?

A

portal vein

119
Q

What are four tributaries of the portal vein?

A

R and L gastric veins
posterior pancreaticoduodenal veins
cystic veins
paraumbilical veins

120
Q

Portal vein ascends to the liver ________ to first part duodenum, in free margin of ________, and posterior to _________ and _________

A

posterior; lesser omentum; bile duct and proper hepatic artery

121
Q

Common hepatic artery divides into what?

A

gastroduodenal a and proper hepatic a

122
Q

Primary lymphatic drainage of the liver goes to what two places?

A

phrenic nodes near and above the diaphragm and hepatic nodes near porta hepatis

123
Q

Where does the sympathetic innervation of the liver and GB come from?

A

T6-T9: pre-g in greater splanchnic nerves to post-g in celiac ganglion

124
Q

Where does the parasympathetic innervation of the liver come from?

A

pre-g from vagus, post-g in ganglia within or near organ wall

125
Q

What nerve provides afferent fibers related to diaphragmatic parietal peritoneum?

A

R phrenic nerve

126
Q

What are three functions of the GB/bile?

A
  1. stores and concentrates bile
  2. bile emulsifies lipids and aids in digestion
  3. excretion pathway
127
Q

What plane is the GB fossa in? Where is the fundus of the GB located?

A

transpyloric plane;

at the tip of the 9th costal cartilage

128
Q

What does the neck of the GB have that allows it to join to the cystic duct?

A

spiral valves/folds

129
Q

The bile duct merges with what, passing through the posterior medial wall of the second part of duodenum?

A

pancreatic duct

130
Q

What three things make up the border of the cystohepatic triangle of Calot?

A

cystic duct, common hepatic duct, and liver

131
Q

What is within the cystohepatic triangle?

A

R hepatic artery and cystic artery with possible accessory bile ducts

132
Q

What is the location of the pancreas?

A

secondarily retroperitoneal, to the R side of L1-3, abutting the hilum of spleen

133
Q

What part of the pancreas enters the splenorenal ligament?

A

tail

134
Q

What does the pancreas produce?

A

exocrine and endocrine products

135
Q

What is posterior to the pancreas?

A

aorta, renal arteries to L kidney, renal veins, IVC and portal vein

136
Q

What is anterior to the pancreas?

A

omental bursa then stomach

137
Q

What runs the entire length of the pancreas, from L to R, midway between the superior and inferior borders, nearer the posterior surface of the gland?

A

main pancreatic duct (of Wirsung)

138
Q

Where do the bile duct and main pancreatic duct end?

A

major duodenal papillae

139
Q

What is the dilation of the lumen of bile duct and pancreatic duct within the major duodenal papillae called?

A

hepatopancreatic ampulla of Vater

140
Q

What encloses and constricts the ampulla, causing bile movement?

A

hepatopancreatic sphincter of oddi

141
Q

Accessory pancreatic duct drains the anterior superior part of pancreatic head and opens onto what?

A

minor duodenal papillae

142
Q

What is the arterial supply to the pancreas?

A

celiac trunk > splenic a > dorsal pancreat a and great pancreatic a
OR
celiac trunk > common hepatic a > gastroduodenal a > sup. PD arteries
OR
SMA . > inf. PD arteries

143
Q

What is the venous drainage of the pancreas?

A

pancreas to splenic v or SMV both to portal vein

144
Q

Lymphatic drainage of nodes superior to attachemnt site of transverse mesocolon go where? Inferior to attachement go where?

A

above go to celiac nodes and below goes to SM nodes

145
Q

Where is sympathetic innervation from? parasympathetic from?

A

symp from greater splanchnic nerves; parasymp from vagus

146
Q

Inferior pancreas receives innervation from what ganglion?

A

superior mesenteric ganglion

147
Q

What are three functions of the spleen?

A

Filters blood for immune system, recycles RBCs, stores platelets and WBCs

148
Q

What ribs are the spleen under?

A

9-11 ribs

149
Q

Lower pole of the spleen contacts what ligament?

A

phrenicocolic ligament

150
Q

What ligament contains the splenic a and v?

A

splenorenal ligament

151
Q

Splenic a is the largest branch of what? This artery enters what ligament on the way to the hilum of the spleen?

A

celiac trunk, enters splenorenal ligament

152
Q

Lymphatics of the spleen drain to what nodes?

A

celiac nodes

153
Q

What is Kehr’s sign?

A

When spleen irritates the diaphragm, referred pain to L shoulder

154
Q

What are the hilar structures of the kidney from anterior to posterior?

A

renal vein, renal artery, renal pelvis

155
Q

renal papillae project into what? These join to form what? then those join to form what?

A

renal papillae into minor calyx, minor calices join to form major calices, which join to form expansive pelvis

156
Q

At hilum of kindey, pelvis narrows to a tube and forms what? Where does it go?

A

ureter, going to the urinary bladder

157
Q

What is the sympathetic innervation for renal and suprarenal areas?

A

T10-L1 utilize renal plexus, from lesser thoracic/splanchnic nerves, celiac ganglion, and aorticorenal ganglion

158
Q

The medulla is stimulated by what, causing it to be considered what type of ganglion?

A

stimulated by pre-g fibers, considering it a sympathetic ganglion

159
Q

Is parasympathetic innervation from the vagus nerve going to both kidneys and suprarenal glands?

A

no, vagus only goes to kidney, not suprarenal glands

160
Q

What are the muscular boundaries of the posterior abdominal wall?

A

psoas (medial)
quadratus lomborum (lateral)
iliacus (inferior)
diaphragm (superior)

161
Q

What two muscles in the posterior abd wall join together at their insertion point on the greater trochanter of the femur?

A

psoas major and iliacus

162
Q

Where does the psoas minor insert?

A

pectineal line and iliopubic eminence

163
Q

Where is quadratus lumborum located?

A

deep and lateral to psoas major, between rib 12 and iliac crest

164
Q

What muscle depresses and stabilizes rib 12 and is a weak lateral flexor of torso?

A

quadratus lumborum

165
Q

What muscle does the femoral nerve innervate in post. abd wall?

A

iliacus

166
Q

The diaphragm is lower (ant/post) and is higher on the (R/L)

A

lower posterior and higher on the R

167
Q

Contraction of the diaphragm does what?

A

depresses the diaphragm, increasing negative pressure in the pleural cavity

168
Q

L and R crura join to form what? what passes through here?

A

median arcuate ligament (aortic hiatus); aorta and thoracic duct go through

169
Q

What is and what is within the T8 aperature of the diaphragm?

A

caval foramen; IVC, terminal branch of R phrenic nerve, lymphatics

170
Q

What is and what is within the T10 aperature of the diaphragm?

A

esophageal hiatus; esophagus, anterior and posterior vagal trunks, lymphatics, esophageal branch of L gastric artery

171
Q

What is the arterial supply to the superior surface of the diaphragm?

A

internal thoracic artery branches: musculophrenic a and pericardiophrenic a. along with superior phrenic aa off of the aorta

172
Q

What is the arterial supply to the inferior surface of the diaphragm?

A

inferior phrenic arteries

173
Q

What is the pattern of venous drainage from the superior surface of the diaphragm?

A

surface> pericardiophrenic v and musculophrenic v> internal thoracic v
OR
surface> superior phrenic vein> IVC or L suprarenal

174
Q

How is the diaphragm innervated?

A

motor- phrenic n (central rami C3-C5); sensory - phrenic n (T7-T11 and T12)

175
Q

What two fascias make up transversalis fascia of the posterior abdominal wall?

A

thoracolumbar fascia (wrapping around muscles and getting different names) and iliac fascia

176
Q

What are the three visceral unpaired branches of the abdominal aorta?

A

celiac trunk (T12), SMA(L1), and IMA (L3)

177
Q

What are the three visceral paired branches off the abdominal aorta?

A

middle suprarenal arteries(L1), renal arteries (L1-L2), and gonadal arteries(L2)

178
Q

What are the parietal branches off the abdominal aorta?

A

inferior phrenic a (paired), lumbar artery (4 pairs), median sacral a (unpaired)

179
Q

What spinal level is the IVC formed at and where does it ascend?

A

L5, ascend to the R of the aorta, piercing the diaphragm at T8, going posterior to liver in caval groove

180
Q

What veins drain to the IVC around post. abd wall?

A

R gondal, R suprarenal, and both renal veins

181
Q

Where do lumbar veins drain to?

A

1 and 2 go to azygos system, 3 and 4 go to IVC

182
Q

What is nutcracker syndrome?

A

compression of L renal vein by the SMA and AA. causes hematuria, flank pain, L testicular pain and varicocele

183
Q

Where do pre-aortic lymph nodes drain?

A

para-aortic lymph nodes

184
Q

What is the saccular dilation of the joining of L and R lymphatic trunks?

A

cisterna chyli

185
Q

Where is the subcostal nerve from and what does it innervate?

A

ventral ramus of T12, to motor EO and sensory ant/lat abdominal wall

186
Q

Where does the lumbar plexus form?

A

in psoas major muscle

187
Q

What nerve pierces the psoas major muscle and goes posterior to ureter?

A

genitofemoral n

188
Q

What nerve pierces the TA and IO anteriorly to enter the inguinal canal?

A

ilioinguinal n

189
Q

What nerve is on the medial side of the psoas major and articulates the hip joint?

A

obturator nerve

190
Q

What are the layers from the inside to the outside of the kidney?

A

fibrous capsule, perirenal fat, renal fascia, pararenal fat

191
Q

Where do renal arteries arise from?

A

just inferior the SMA on AA

192
Q

Are ureters intraperitoneal or retroperitoneal?

A

retroperitoneal

193
Q

Do ureters cross anterior or posterior to bifurcation of common iliac a?

A

anterior

194
Q

What are the three points along a ureter for potential sites of obstruction?

A

ureteropelvic junction, crossing over pelvic brim (and bifurcation), passage through wall or urinary bladder

195
Q

Where is the superior suprarenal a from?

A

inferior phrenic a

196
Q

Where does the venous drainage of suprarenal glands go?

A

L side goes to suprarenal vein> L renal vein

R side goes to R suprarenal vein to IVC

197
Q

Where are sympathetic pre-g neurons within the spinal cord for T1-L2/3

A

lateral column of spinal cord

198
Q

What connects the paravertebral sympathetic trunk with the prevertebral sympathetic trunk?

A

splanchnic nerves - all descend and all cross diaphragm (greater, lesser, and least splanchnic) to converge and forme pre-g prevertebral chain

199
Q

What are the prevertebral sympathetic chain ganglia and what splanchnic nerves do they associate with?

A

celiac ganglion - greater splanchnic nerve
SM ganglion - lesser splanchnic nerve
IM ganglion - lumbar splanchnic nerve
aorticorenal ganglion

200
Q

Splanchnic nerves are formed from what?

A

pre- g nerves that cross without synapsing on sympathetic trunk

201
Q

What two plexi are ENS and receive pre-gs

A

myenteric and submucosal plexuses

202
Q

Trace from the visceral receptor to segmentor part of PNS

A

visceral afferents goes with sympathetic nerves so -

receptor> pre vertebral> paravertebral chain > white communicating ramus> segmentor part of PNS

203
Q

What kind of neurons are found in the dorsal root of spinal cord?

A

pseudounipolar neurons

204
Q

Where do lumbar splanchnic nerves travel?

A

through sympathetic trunk to posterior abd wall to synapse on IM ganglion or post-g sympathetic neurons in pelvis

205
Q

Where do anterior and posterior vagal trunks synapse?

A

on or near organs, not in ganglia, even if passing through

206
Q

When the primitive gut tube forms, what two things are left out?

A

yolk sac and allantois

207
Q

What are the two membranes that close off the primitive gut tube?

A

buccopharyngeal membrane and cloacal membrane

208
Q

What are the cut off areas of foregut, midgut, and hindgut?

A

foregut - pharyngeal gut from BP membrane to respiratory diverticulum part of foregut, remainder of foregut lies caudal to pharyngeal and goes to liver bud
midgut - liver to adult TC
hindgut - from distal 1/3 TC to cloacal membrane

209
Q

What artery supplies foregut, midgut, and hindgut respectively?

A

celiac a, SMA, IMA

210
Q

endodermal lining of primitive gut tube is lined by what?

A

splanchnic mesoderm

211
Q

What does the dorsal mesentery suspend?

A

caudal ends of foregut, midgut and large part of hindgut (from lower esophagus to cloacal region)

212
Q

What is ventral mesentery derived from? What does it suspend

A

septum transversum; suspends terminal esophagus, stomach, and upper doudoenum from ventral abdominal wall

213
Q

What are subdivisions of ventral mesentery?

A

falciform ligament and lesser omentum

214
Q

Describe the development of the stomach starting in week 4

A

dilation of tube, then 2 rotations

  1. ro in transverse plane (ant becomes R side, posterior becomes L side) L side grows faster - becomes greater curvature, R side slower - becomes lesser curvature
    - displaces dorsal mesentery, creating omental bursa between posterior stomach and post abd wall
    - also causes formation of greater omentum and fusion with transverse mesocolon
    - causes ventral mesentery to go R, causing lesser omentum to go from stomach/duodenum to liver
  2. ro in frontal plane (pyloric part moves superior and R, cardiac part moves inf and L)
215
Q

How is the duodenum formed? Arteries involved?

A

duodenum gets both celiac and SMA arteries
as stomach rotates, duodenum forms C shaped loop and rotates R, goes retroperitoneal except for duodenal bulb, initial segment

216
Q

Hepatic diverticulum formation at level of duodenum during third week is induced by what?

A

cardiac mesoderm

217
Q

What does the hepatic diverticulum make?

A

GB, liver, biliary duct system

218
Q

What is the septum transversum?

A

site where vitelline veins form sinusoids, Kupffer cells, connective tissue of liver develop

219
Q

How is the bile duct formed?

A

hepatic cells penetrate septum transversum, connection between duodenum and hepatic diverticulum narrows, becoming bile duct (ventral outgrowth is cystic duct and GB)

220
Q

What direction does the bile duct enter the duodenum?

A

initially is anterior, but with rotation, is posterior

221
Q

The ventral bud of the pancreas makes up what part of the mature pancreas?

A

lower part of head of pancreas and uncinate process

222
Q

How and when is the spleen formed?

A

in the fifth week, a block of mesenchyme develops, dorsall mesentery gets pushed against posterior abdominal wall and degenerates, allowing spleen attachment to posterior body wall (intraperitoneal)

223
Q

How is the Primary intestinal loop formed and what makes it up?

A
  • suspended dorsally by mesentery and anteriorly communicating with yolk sac via vitelline duct
  • SMA and vitelline duct act as axis, midgut forms primary intestinal loop (PIL) with a cephalic and caudal limb
  • cephalic limb is distal duodenum, jejunum, and prox ileum
  • caudal limb is distal ileum, cecum, appendix, AC and 2/3 TC
224
Q

How does the PIL rotate and displace?

A

in 6th week, midgut undergoes physiological herniation, entering the extraembryonic cavity in the umbilical cord - during which - 90 degree rotation occurs, counterclockwise

  • limbs of PIL elongate and cephalic involves coiling
  • by week 10, it returns to abdominal cavity with another 180 degrees of rotation counterclockwise
225
Q

What is the cavity lined by endoderm and ventrally covered by ectoderm?

A

cloaca

226
Q

How is the anorectal canal and the urogenital sinus formed?

A

hingut enters the cloaca posteriorly to make anorectal canal
allantois enters the cloaca anteriorly to make urogenital sinus
the urorectal septum of mesoderm separates
end of week 7 cloacal membrane ruptures making 2 openings.
ectoderm closes anal canal but is recanalized in week 9

GI (6 decks)

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