ANATOMY Flashcards
3 constrictions of oesophagus
and why important?
cervical
thoracic
diaphragmatic
important to pass bolus through oesophagus and into stomach
bile made where?
liver
role of gallbladder?
store and concentrate bile
where does cystic artery lie?
in triangle of calot
triangle of calot created by?
common hepatic duct, cystic duct and visceral surface of liver
foregut structures?
oesophagus, stomach to duodenum
midgut structures?
end part of duodenum to 2/3 of transverse colon
differences between jejunum and ileum?
ileum - pale pink, less vascularity, thin wall, more fat
jejunum - deeper red, thick wall, more vascularity, less fat
blood supply to midgut?
superior mesenteric artery
blood artery to foregut?
celiac trunk
hindgut structures?
end 1/3 of transverse colon to anus
blood supply to hindgut?
inferior mesenteric artery
teniae coli?
thick bands of smooth muscle - longitudinal layer
parasympathetic innervation of abdomen by? 2
vagus nerve
pelvic splanchnic nerves S2,S3,S4
sympathetic innervation of abdomen by?
abdominopelvic splanchnic nerves
prevertebral sympathetic ganglia
abdominal aortic plexus
portal vein formed by?
union of splenic vein and superior mesenteric vein
3 sites of porto-systemic anastomoses?
anorectal junction
gastroesophageal junction
umbilicus
lumbar nodes in what three groups and explain each
pre-aortic = drains organs supplied by anterior branches of aorta
lateral aortic = drains organs supplied by lateral aortic branches
retro-aortic = drains posterior abdominal wall
level of portal vein? and where
L2 - behind neck of pancreas
mucosa layers?
inner = epithelium
lamina propria
outer = muscular mucosa
muscalris externa layers?
inner = circular outer = longitudinal
how to know if serosa or adventitia?
serosa - below diaphragm
adventitia - above diaphragm
what is the submucosa?
dense irregular, connective tissue -
nerves, bv, lymphatics here
and sometimes glands
myenteric plexus controls?
contractions of two layered muscles - c and l
submucosal plexus controls?
local secretion, absorption etc
what is enteric nervous system?
guts own nervous system - independent control
abdominal cavity bound by what?
diaphragm, pelvic diaphragm, abdominal muscle walls
visceral membrane and parietal membrane?
visceral - covers organs
parietal - lines cavity
peritoneum is what?
double layer serous membrane
intraperitoneal organ meaning?
completely covered by visceral, invaginated into sac, mesentery involved
retroperitoneal organ meaning?
only partially covered by peritoneum on one surface, anterior side, no mesentery involved
mesentery?
double layer of peritoneum due to invagination of peritoneum by organ (project off posterior wall)
omentum?
double layered extension of peritoneum passing from stomach and duodenum to adjacent organs
greater omentum?
connect stomach to transverse colon
lesser omentum?
connect stomach/duodenum to liver
mesentery of trasnverse colon called?
transverse mesocolon
peritoneal cavity divided into?
greater and lesser sac
lesser sac of peritoneal cavity called?
omental bursa
how are the two sacs of the peritoneal cavity conncted?
by epiploic foramen
where is omental bursa to stomach?
posterior
boundaries of abdominal wall describe:
-posterior, anterior, superior, inferior
posterior - vertebrae column
anterior - abdominal muscular wall
superior - by xiphoid process, costal cartilage
inferior - inguinal ligament, pubic crest
umbilicus at what level?
T10 dermatome ?
belly butTEN
level of L3 vertebrae
LINEA alba?
midline band extending from xiphoid process to pubic symphysis
ileac crest level? and where
L4
extends posteriorly from anterior superior iliac spine
anterior superior iliac spine?
sticky out bit of hip
name 9 regions of abdomen?
right/left column - hypochondriac - lumbar - inguinal
middle column - epigastric - umbilical - hypogastric
regions formed by what planes?
2 midclavicular planes
subcostal horizontal plane - in line of 10th costal cartilage
trans tubercular horizontal plane - through L5 vertebrae
4 quadrants formed by?
trans umbilical plane - through umbilicus - horizontal
median plane -vertical
external oblique muscles explain direction? function?
innervation?
top to down - run inwards
superficial inferomedially
compress and support abdominal organs - flex and route trunk
innervation = thoraco-abdominal and subcostal nerves - anterior rami T7-T12 spinal
internal oblique muscles explain direction? function?
innervation?
top to down- run outwards
intermediate, inferomedially
compress and support abdominal organs flex and rotate trunk
thoracic-abdominal nerves T7-T11 spinal, subcostal nerves and 1st lumber nerve
order of abdominal muscles - out to in?
external SUPERFICIAL
intermediate
transversus abdomens INNERMOST
TRansversus abdominis? direction? function?
innervation?
horizontal
compress and support abdominal organs
thoracic-abdominal nerves - anterior rami of T7-T11 subcostal and 1st lumber nerve
rectus abdominis?direction? function?
long, broad strap like muscle - on front side
flexes trunk and compresses abdominal organs
thoracic-abdominal and subcostal nerves - T7-T12 spinal
what is enclosed by rectus sheath?
rectus abdominis
rectus sheath what is it?
formed by WHAT?
large area of connective tissue
apneourosis of 3 flat muscles - internal, external and transversus
rectus sheath contains what ?
what borders does it have?
anterior and posterior wall
contains - rectus abdominis, pyramadalis muscles, epigastric arteries, veins and lymph vessels
explain by changes of rectus sheath occurs mean?
from superior to inferior the contents of rectus sheath changes
superior to costal margin - only apneoursis of external oblique - no posterior wall
arcuate line?
marks transition between posterior rectus sheath covering superior 3/4 of rectus abdomens to just transversals fascia covering inferior 1/4
superior to arcuate line? anterior and posterior wall
upper 3/4
anterior wall = apneauorsis of external and internal oblique
posterior wall = apneuroisis of internal and transversus
inferior to arcuate line? anterior and posterior wall
anterior wall = all 3 muscles
posterior wall = in direct contact with transversals fascia
function of pyramidal muscle?
tenses linea alba
conjoint tendon what occurs here?
internal oblique and transversus abdominal join medially
what is transversals fascia?
thin membrane which lies between transverse abdominal muscle and parietal membrane
superior epigastric artery supplies what?branch off
what?
branch off Internal thoracic artery
supplies upper part of rectus abdominis muscle
inferior epigastric artery supplies what?branch off what?
branch off external iliac artery
supplies lower rectus abdominis
lymph drainage of abdomen?
veins superior to umbilicus = drain to axillary LN
veins inferior to umbilicus = drain to superficial inguinal lymph nodes
inguinal region between what?
anterior superior iliac spine and pubic tubercle
inguinal region is what? common place of what?
place where structures enter/exit abdominal cavity - common place for hernia
inguinal canal? parallel to? function?
short passage runs inferomedially to abdominal wall
canal parallel and SUPERIOR to inguinal ligament
acts as pathway for structures to pass from abdominal wall to genitalia
structures of inguinal canal?
male
female
others?
male = spermatic cord female = round ligament of uterus
blood vessels, lymph and nerves(ilioguinal nerve)
ilioguinal nerve innervates?
sensory innervation of genitalia
openings of inguinal canal?
deep internal ring
TO (downwards)
superficial external ring
deep internal ring formed by?
location?
opening shape
formed by transversals fascia
located above midpoint of inguinal ligament/superolateral to pubic tubercle
oval opening
superficial external ring formed by?
location
opening shape
formed by invagination of external oblique
superior to pubic tubercle
triangle opening
roof of inguinal canal formed by?
transversals fascia
internal obligue
transversus abdominis
anterior wall of inguinal canal formed by?
apneourosis of external and internal oblique
floor of inguinal canal formed by?
inguinal ligament
posterior wall of inguinal canal formed by?
traversalis fascia
types of hernias of inguinal region?
direct and indirect
indirect hernia of inguinal region?
internal one
weakness of deep ring - allow stuff to enter and exit canal easily
direct hernia of inguinal region?
external one
pushing through weak spots in muscles making posterior wall of canal and enter and exit superficial ring
3 muscles of posterior abdomen wall and their location/direction AND FUNCTION?
psoas major - inferolateral- flexes thigh/trunk
iliacus - lateral - flexes thigh
quadratus lumborum - lateral - flexes vert. column
hiatuses of diaphragm and v level?
oesophageal - T10
IVC - T8
aortic = T12
ivc lies where to abdominal aorta?
to the right
at what level does abdominal aorta bifurcate AND TO WHAT?
at L4 splits into 2 common iliac arteries
side branches of abdominal aorta? and what level?
renal arteries - at L1-3
ANTERIOR branches of aorta? 3
explain each one and what they supply AND v level
celiac trunk - T12 supplies foregut(oesophagus to descending part of duodenum)
superior mesentery artery - L1 supplies midgut(duodenum to 2/3 of colon)
inferior mesentery - L3 supplies hindgut(last 1/3 of colon to rectum)
3 branches of celiac trunk?
common hepatic artery
splenic artery
left gastric artery
when does ivc form and at what?
forms by left and right iliac veins at L5
PORTAL VEIN ENTERS WHERE?
formed by?
into liver
splenic vein + superior mesenteric vein
inferior mesenteric vein drains into?
splenic vein
porto-systemic anastomoses? 4
oesophageal
para-umbilical
rectal
retroperitoneal
lymph nodes of abdomen?
lymph nodes lie along aorta/ivc
anterior branches of aorta - PRE-AORTIC LN
side vessels of aorta - PARA-AORTIC LN
sympathetic nerves of posterior wall?abdomen
greater, lesser, least sphlanic nerve
abdominal aortic plexuses
pre-vertebral sympathetic ganglia
parasympathetic nerves of posterior wall? abdomen
vagus
pelvic splanchic - S2,3,4
LUMBAR PLEXUS? branches top to bottom
- iliiohypogstric (from T12/L1)
- ILIOGUINAL L1
- GENITOFEMORAL L1/2
- LATERAL CUTANEOUS L2/3
- FEMORAL L2,3,4
- OBTURATOR L2,3,4
Lumbar plexus forms in?
psoas major muscle and emerges lateral/medial surface of muscle
kidneys sits at what level?
T12-L3
peritoneum of kidneys?
hilum of kidney order of enter/exit of structures
retroperitoneal
anterior - renal vein
renal artery
posterior - renal pelvis into ureter
3 sites of contractions of ureter?
at renal pelvis into ureter
as ureter enter pelvis
as ureter eneters bladder
intraperitoneal means?
completely covered by visceral peritoneum - invaginated into sac
retroperitoneal means?
outside peritoneal cavity - between parietal peritoneum and posterior wall
only covered on anterior surface and firmly attached to posterior wall
what is in peritoneal cavity?
peritoneal fluid NO ORGANS
ALL RETROPERITONEAL organs?
sad pucker
suprarenal gland - adrenal aorta/ivc duodenum pancreas ureters colon - a/d kidneys Eoesophagus rectum
peritoneal cavity splits into?
greater sac and mental bursa
greater sac is supra colic and infra colic compartments
epiploic foramen boundaries?
anterior - portal traed
posterior - ivc
superior - liver
inferior -part of duodenum
omentum is?
double layered extension of peritoneum from stomach/duodenum to adjacent organs
greater omentum attachments? ligaments here?
attaches from greater curvature of stomach to duodenum - like an apron over small I
gastro-ligmanets/hepato ligmanets
LESSER OMENTUM connects what to what?
lesser curvature of stomach to duodenum and to liver
mesentery?
double layer of peritoneum that occurs due to invagination of peritoneum by organ - propels it from wall
falciform ligament? function, what is it?
anterior liver connects ti anterior body wall
contains remnant of umbilical vein
trasnpyloric plane? what is it? CROSSES WHAT?
horizontal line at L1 -neck of pancreas -duodenum hilum of kidneys base of GB LOWER END OF SC
where does spinal cord end in adult?
L1/2
HOW TO FIND GB?
right
9th costal cartilage
in mid-clavicular line
how to find appendix?
junction of medial 2/3 and lateral 1/3 joining of anterior superior iliac spine and umbilicus
spleen how to find it?
under ribs 9-11 on left on mid-axillary line
order of gastric gland cells? top to bottom
- mucous cells
- parietal cells
- mucous and parietal cells
- chief cells and parietal cells
3 types of gastric glands explain each?
cardiac glands - mainly mucous - SHORT
fundic glands - LOTS of parietal and chief - long gland
pyloric glands - mostly mucous/ g cells - long pit
what histology of pancreas and liver look like? describe
pancreas - endocrine and exocrine parts and p duct
liver - lobules - hexagons
oesophagus artery supply/venous drainage/lymph drainage ?
oesophageal branches off left gastric artery (from celiac trunk)
to portal vein via left gastric vein
to left gastric LN AND celiac LN
PYLORIC sphincter is WHAt?
thickening of circular layer of smooth muscle
branches off from common hepatic artery from celiac trunk?
right gastric
gastro-duodenal artery downwards
stomach artery supply/venous drainage/lymph drainage?
left and right gastric arteries
left and right gastric veins into portal vein
drain into gastric LN and then into celiac LN
what other veins drain stomach?
left and right gastroepiploic veins
major and minor duodenal papilla?
major - opening of bile and pancreatic duct into duodenum
minor - termination of accessory p duct
what controls opening of duodenal papilla?
sphincter of Oddi
arcades of arteries?
anastomosing of arteries/branches of ileum and jejunum
vasa recta?
straight arteries come off arcades in mesentery to intestine
differences between ileum and jejunum
colour wall vascularity fat in mesentery lymphoid tissue
jejunum deeper red thick and heavy walls greater vascularity less fat in mesentery small amounts of lymphoid tissue
ileum paler pink thin and tight walls less vascularity more fat in mesentery lots of payers patches
colic flexures?
bends in colon pathway
tenaie coli?
three longitudinal bands of smooth muscle around the large I
Omental appendices of large I?
fat filled pouches that are attached to walls of large I
mcburneys point?
most common place for appendix to be attached to caecum
peritonisation of transverse colon and sigmoid colon?
both intra
rectum how is it done??
artery supply?
venous and lymph drainage?
rectum split into three parts - superior, middle,inferior thirds
superior and middle rectal arteries
rectal veins
pararectal and sacral LNs
pectinate line does what?
split anal canal into upper 2/3 and lower 1/3
protective mucosa found where?
oesophagus, anal canal etc
absorptive and secretory mucosa found where
absorptive - small I
SECRETORY - stomach
tubular glands found where In gi tract?
stomach
where in the gi tract is goblet cells found most?
small I
Change in epithelium from rectum to anus?
simple columnar to
stratified squamous
are goblet cells present in large I?
yes more dominant here
where can see caudate and quadrate lobes of liver
from behind not front
what is present in portal triad?
main portal vein
common hepatic artery
bile ducts
central vein goes into what?
portal vein
what vein formed posterior to neck of pancreas?
splenic vein
pancreas
artery supply
venous drainage
lymph
like duodenum
both celiac trunk and SMA
SMV into portal vein
pre-aortic LN of both celiac and SM
spleen? function
single mass of lymphoid tissue - immune response role in body -stroage of rbc phagocytosis make antibodies filter blood
does spleen move with respiration?
yes
histology of spleen made up of?
white pulp - WBC
red pulp - RBC
enterocyte?
epithelial cell
hasselbach/inguinal triangle?
boundaries
triangle deep in anterior abdominal wall
medial - border o frectus abdomenus muscle
lateral - inferior epigastric arteries
inferior - inguinal ligament
quadrate and casudate lobe - which one sits where?
quadrate sits next to GB
MMC in small intestine why good?
MMC - migrating motility complex
cleaning out small I
when one MMC finishes another MMC Starts
arrival of food in stomach causes cessation of MMC
Good as limits bacterial colonisation of small I
IN SMALL I the BER does it increase freq. down to anus?
NO - decreases !
VAGAL STIMULATION of salivary secretion?
NONE
VAGUS NERVE DOES NOT INNERVATE SALIVARY GLANDS
Lysozyme?
in saliva - acts to cleave polysaccharide component of bacterial cell walls
iliacus?
lateral hip muscle
openings od diaphragm location?
ivc - in central tendon
oesophageal - lower down - in diaphragm muscle
aortic - in vertebrae
h pylori test - what to avoid prior to the test ?
proton pump inhibitors - omeprazole
where are rug of stomach most apparent?
pyloric part and greater curve of stomach
colic group of pre-aortic nodes?
gastric nodes
hepatic nodes
pancreatic duodenal nodes
pancreaticosplenic nodes
how doe lumbar plexus in relation to poses major muscle?
genitofemoral - on surface of PM
femoral - lateral PM
obturator - medial PM
name all things found at trans-pyloric plane?
it’s level ?
L1
pylorus neck of pancreas hila of kidneys 9th costal cartilage transverse mesoderm fundus of GB
differences between jejunum and ileum?
jejunum - deeper red, more vascularity, thick wall, long vasa recta, few arcades, less lymphatics
ileum - pink, less vascularity, thin wall, short vasa recta, more arcades, more lympathics
location of mcburneys point?
1/3 lateral on line from umbilicus to anterior superior iliac spine
