Anatomy Abdomen Exam 3 Flashcards
What artery supplies the foregut ?
Celiac Artery
What artery supplies the midgut?
Superior mesenteric Artery
What artery supplies the hindgut?
Inferior Mesenteric Artery
What is the portal triad
The portal triad is made of the proper hepatic artery, the hepatic portal vein, and the common bile duct
describe where the superior pancreaticoduodenal artery comes from
it is a branch off of the gastroduodenal artery which comes from the common hepatic artery coming off of the celiac trunk
What is anterior to the superior part of the duodenum
peritoneum, gallbladder and the quadrate lobe of the liver
What is posterior to the superior part of the duodenum
the bile duct, the gastroduodenal artery, the hepatic portal vein, and the IVC
What is superior to the superior part of the duodenum?
neck of the gall bladder
What is anterior to the descencing part of the duodenum?
the transverse colon the transverse mesocolon an the small intestine
WWhat is posterior to the descending part of the duodenum?
the hilum of the right kidney, renal vessels, ureter and posaos major
What is medial to the descending part of the dudodenum?
the head of the plancreas, the pancreatic duct and the bile duct
What is anterior to the inferior (horizantal) duodenum?
the SMA, the SMV
What is posterior to the inferior (horizantal) duodenum?
right psaos major, the IVC, the aorta and the right ureter
What is SUPERIOR to the inferior (horizantal) duodenum?
head and uncinate process of the pancreas, superior mesenteric vessels
What is medial to the ascending part of the duodenum?
SMA, SMV and the uncinate process of the pancreas
what level is the SMA at?
L1
What is anterior to the stomach?
diaphragm, left lobe of the liver
What is posterior to the stomach?
oental bursa and pancreas
what is inferolateral to the stomach?
the transverse colon
What is the bed on which the stomach rests made of?
left dome of the diaphragm, spleen left kidney, suprarenal gland, splenic artery and transverse mesocolon
what are tenia coli
the three distinct longitudinal bands
What is associated with the tail of the pancreas?
the hilum of the spleen
What is associated with the posterior surface of the body of the pancreas?
aorta, SM, left suprarenal gland, left kidney and renal vessels
What is anterior to the uncincat process?
the SMA
What is associated with the posterior surface of the head of the pancreas?
the IVC, right renal artery and vein, and the left renal vein
where does the pancreas get its blood supply?
- the splenic artery gives pancreatis braches.
- The gastroduodenal artery (from the common hepatic A of the celiac trunk) gives the superior pancreaticoduodenal A
- The SMA gives a branch called the inferior pancreaticoduodenal A
What ribs protect the spleen?
9-12
What two important anatomical structures lie posterior to the first part of the duodenum?
common bile duct and the gastroduodenal artery
also the IVC and the hepatic portal vein
Which anatomical structures pass anterior to the third part of the duodenum?
SMA, SMV
Cite the anatomical relationship each of the following has with the pancreas:
- duodenum
- spleen
- formation of portal vein
- SMA/V
- Spenlic a
- Hilus of spleen
- duodenum surrounds head of pancreas
- pancreas is medial to spleen (tail sits in splenorenal ligament, only part that’s not retroperitoneal)
- formation of portal vein lies deep to pancreas
- SMA/V lie deep to pancreas BETWEEN UNCINATE PROCESS & NECK
- splenic artery behind upper border (sometimes through) the pancreas
- Hilus of spleen is where the tail
List the 3 parts of the small intestinal, in order, from proximal to distal. Which of these 3 regions is predominantly retroperitoneal? Which of these 3 regions are mesenterized?
The duodenum is predominantly retroperitoneal whereas the jejunum and ileum are predominantly covered by mesentery.
How many lobes are there in each kidney?
18
How many segmental branches are there from each renal artery?
5
What is closely associated with the right suprarenal gland?
the IVC and the liver
What is closely related to the left suprarenal gland?
the spleen, splenic artery, pancreas and stomach
where are the right and left kidneys found?
left = slightly higher @ 11th and 12th rib right = 12th rib
Name the 3 sites where kidney stones are likely to become impaled and cause pain along the length of the ureter.
- where the ureter begins to descnd down the body (narrowing of the pelvic inlet)
- where the ureter crosses sacrum, bends over the common iliac into the pelvis at L5 (pelvic inlet)
- where ureter enters the bladder (course through wall of bladder)
What is the blood supply to the suprarenal gland?
- superior suprarenal A come from inferior phrenic artery
- Middle suprarenal arteries come from the aorta
- inferior suprarenal A come from the renal artery
what are the ureter supplied by?
- renal A
- middle A
- illiac A
what must you be suuuuper careful about when doing ovarian surgery?
not cutting the ureters which run in close proximity
List the muscles that comprise the posterior abdominal wall.
Quadratus lumorum, iliacus and psoas major.
innervation of quadratus lumborum
ventral rami L1-L3
innervtion of psoas major
ventral rami L1-L3
innervation of illiacis
femoral Nerve
Pasoas sign
can indicate an inflamed appendix
Which two ligaments of the diaphragm are formed by thickenings of the fascia over the musculature of the posterior abdominal wall.
The medial and lateral arcuate ligaments.
muscles involved in the medial arcuate lig
Fascia over the psoas major thickens to form the medial arcuate ligament;
muscles involved in the lateral arcuate lig
facsia of the quadratus lumborum thickens to form the lateral arcuate ligament.
Which crus of the diaphragm forms a sling around the esophagus?
right crus
To which vertebral levels does each diaphragmatic crus extend inferiorly?
The left crus extends to L1/2; the right crus extends to L3/4
List the various openings in the diaphragm, their vertebral level, and what traverses them.
Caval: T8 - inferior vena cava; esophageal: T10 - esophagus & vagus nn.; aortic T12-aorta
Which ventral rami contribute to the lumbar plexus?
L1 through L4.
What nerves are formed by the lumbar plexus?
Iliohypogastic, ilioinguinal, genitofemoral, lateral femoral cutaneous, femoral, obturator, lumbosacral trunk.
What does the aortic hiatus transmit?
the azygous vein and the thoacic duct
what does the esophageal hiatus transmit?
the vagus nerve
what does the caval hiatus transmit?
the right phrenic nerve
pain sensation from the lesser sac is carried by which nerve?
lower intercostal nerves
what nerves carry sensory fibers from the wall of the stomach
geater splanchnic nerves and white rami communicans
What carries pain sensation from the central tendon of the diaphragm?
phrenic nerve
What carries pain sensation from the peripheral part of the diaphragm
receives fibers from the lower interostal nerve
What nerve will be damages during an appendectomy @ the mcburney point?
the illiohypograstric nerve
what is in the medial umbilical fold?
the umbilical A
what is in the median umbilical fold?
the fibrous remnant of the urachus
what is in the lateral umbilical fold?
the epigastric A and V
What contains the fibrous remnant of the umbilical vein?
ligamentum teres hepatic / round ligament
What is the ligamenrum venosum?
remnant of the fetal ductus venosus
describe the location of the common bile duct in relation to the portal vein and the proper hepatic artery
lateral to the proper hepatic artery
anterior to the portal vein
What nerves cause pain due to a peptic ulcers
the greater splanchnic nerve carries pain fibers from the upper GI tract.
What are the 4 most important portal-caval anastamoses
- left gastric vein and the esophageal vein
- the superior rectal vein and middle and inferior rectal veins
- the paraumbilical vein and the superficial and inferior epigastric veins
- the retroperitoneal veins draining the colon and the renal, suprarenal and gonadal veins
What does the gastric vein anastamose with to form a portal caval anastamosis?
esophageal vein
What does the superior rectal vein anastamose with to form a portal caval anastamosis?
middle and inferior rectal veins
What does the paraumbilicl vein anastamose with to form a portal caval anastamosis?
the superficial and inferior epigastric veins
What does the the retroperitoneal veins draining the colon anastamose with to form a portal caval anastamosis?
the renal, suprarenal and gonadal veins
what is a meckel diverticulum?
it is a persistent remnant of the yolk sac
the quadrate lobe of the liver is part of which lobe of the liver?
the left lobe
what is directly anterior to the part of the aorta btw the celiac tunk and the SMA?
the neck of the pancreas
what 5 things does the renal fascia surround
the kidneys, suprarenal glands, ureters, major vessles, and fat
where is the right renal artery in relation to the IVC
the right renal artery runs posterior to the IVC
where do the renal veins drain?
the IVC
where does the left renal vein drain and what structures does it cross?
It crosses the aorta posterior to the SMA and drains into the IVC
where does the left suprarenal vein drain?
Into the left renal V
Where does the left inferior phrenic vein drain?
into the L suprarenal vein –> L renal vein –> IVC
The suprarenal glands are derived mainly from what nerves?
thoracic splanchnic nervses
pain from the kidneys will go to where?
T11-T12
pain from the ureters will go where
T12-L2
which renal A is longer?
the right renal A is longer than the left renal A
Which organs are secondarily retroperitoneal
The ascending and descending colon, the duodenum, pancreas and upper rectum
Retroperitoneal organs
- Kidney
- adrenal
- ureter
- aorta
- inf vena cava
- lower rectum
- Anal canal
breaking your 9th through 12th ribs will result in
rupture of the spleen
what forms the posterior wall of the epiploic foramen
The caudate lobe of the liver forms the posterior wall of the epiploic foramen.
Which vessel passes behind the first part of the duodenum
gastroduodenal
identify the structures that make the line that separates the true/functional lobes of the liver
gallbladder fossa and inferior vena cava
What will obstruct the common bile duct?
Tumors in the head of the pancreas often obstruct the common bile duct, blocking the normal bile recycling circuit.
what is the central tendon
he central tendon is the tendon in the middle of the diaphragm where all the fibers of the diaphragm attach. It provides an opening for the inferior vena cava.
nerve that innervates the cells of the suprarenal medulla
Greater thoracic splanchnic nerve
he central tendon of the diaphragm has which opening?
the caval opening
The aortic hiatus is formed by
he median arcuate ligament,
Lateral arcuate ligament transmits what
passage of quadratus lumborum M, subcostal neurovascular bundle
Medial arcuate ligament transmits what
passage of psoas major M, sympathetic trunk
Median arcuate ligament does what?
forms the aortic hiatus
what nerve runs along the medial border of the psoas major muscle
the obturator nerve
what nerve lies along the lateral border of the psoas major muscle,
Femoral
what nerve pierces psoas major then lies on top of that muscle.
genitofemoral
What nerve nerve emerges at the lateral border of psoas major, then travels laterally.
illioinguinal
