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Y1 - Gastrointestinal > Anatomy - Abdominal pain and likely sources > Flashcards

Anatomy - Abdominal pain and likely sources Flashcards

1
Q

List the sections of the small intestine

A 
duodenum
-->
jejunum
-->
ileum
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2
Q

List the sections of the large intestine

A 
caecum
-->
ascending colon
-->
transverse colon
-->
descending colon
-->
sigmoid colon
-->
rectum
-->
anal canal
-->
anus
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3
Q

List the sections of the colon

A 
Caecum (--> appendix)
-->
ascending colon
-->
transverse colon
-->
descending colon
-->
sigmoid colon
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4
Q

List the abdominal GI organs

A

oesophagus (distal part)

stomach

liver

gallbladder

pancreas

Intestines

rectum

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5
Q

Describe the division of the abdominal GI organs

A
  • foregut
  • midgut
  • hindgut

Each region has a distinct supplies:

  • arterial
  • venous
  • lymphatic
  • nervous
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6
Q

What is the foregut?

A

oesophagus
–>
mid-duodenum

liver
gallbladder
spleen
1/2 of pancreas

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7
Q

What is the midgut?

A

mid-duodenum
–>
proximal 2/3rds of transverse colon

1/2 of pancreas

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8
Q

What is the hindgut?

A

distal 1/3rd of transverse colon
–>
1/2 of the anal canal

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9
Q

List the 9 regions of the abdomen

A
  • Right/Left Hypochondrium
  • Epigastric
  • Right/Left Lumbar
  • Umbilical
  • Right/Left Inguinal (iliac fossa)
  • Pubic (suprapubic)
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10
Q

Along what lines are the 9 abdominal regions divided

A

midclavicular line

subcostal line

trans-tubercular line

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11
Q

List the 3 quadrants of the abdomen

A

Right/Left Upper Quadrants

Right/Left Lower Quadrants

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12
Q

Along what lines are the 3 abdominal quadrants divided

A

medial line

trans-umbilical line

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13
Q

List the anterior and lateral muscles of the abdomen

A

anterior:
- Rectus abdominis

Lateral:

  • external oblique (outer)
  • internal oblique (middle)
  • transversus abdominis (inner)
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14
Q

What lines the walls of the abdominopelvic cavity and its organs?

A

Peritoneum

body wall = parietal peritoneum
organs = visceral peritoneum

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15
Q

Describe the peritoneum of the abdominopelvic cavity

A

semi-permeable

serous (secretes fluid)

a single continuous layer

is sensitive (nerves)

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16
Q

Define the peritoneal cavity

A

cavity between the visceral and parietal peritoneum

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17
Q

define the mesentary

A

double layer of peritoneum that attaches the intestines to the posterior abdominal wall

Double fold of peritoneum

Functions:

  • storing fat
  • supports blood vessels, lymphatics, and nerves
18
Q

List and define the relationships organs can have with the peritonuem

A

Intraperitoneal:

  • mostly enclosed in visceral peritoneum
  • connected to parietal peritoneum via a 2 layer sheet of peritoneum

Retroperitoneal:

  • not fully enclosed in peritoneum
  • is connected to the abdominal cavity wall

Mesenteric:
- with a mesentery

19
Q

Are the abdominal GI organs inside or outside the peritoneal cavity?

A

outside

20
Q

Contrast the organ mobility of intraperitoneal, retroperitoneal, and mesenteric organs

A

Intraperitoneal = minimal mobility

Retroperitoneal = no mobility

Mesenteric = very mobile

21
Q

Describe the greater and lesser sacs of the peritoneal cavity

A

2 areas separated by the omenta

But they communicate via the omental foramen

22
Q

describe the greater omentum

A

The peritoneum drapes off stomach then loops back to enclose the transverse colon

it is 4 layers thick

23
Q

describe the lesser omentum

A

superior to the stomach

24
Q

List the peritoneal pouches in males and females

A

Males:

rectovesical - (between bladder and rectum)

Female:

rectouterine - (between uterus and rectum)
vesico-uterine - (between bladder and uterus)

25
Q

Define ascitic fluid

A

excess fluid in the peritoneal cavity

often collects in the peritoneal pouches

26
Q

Define a paracentesis

(aka abdominocentesis)

A

draining ascitic fluid from the peritoneal cavity

  • Needle must be placed lateral to the rectus sheath to avoid the inferior epigastric artery
27
Q

Describe the inferior epigastric artery

A

Ascends deep to rectus abdominis

Arises from the external iliac

28
Q

Define referred pain

A

injury to one area that is felt in another region due to the area having shared innervation

29
Q

Describe the path of sympathetic nerves to the GI organs

except the adrenal glands

A 
Leaves spinal cord at T2-5
-->
enter the sympathetic chain
-->
leave the sympathetic chains in the abdominopelvic splanchnic nerves
-->
synapse at the prevertebral ganglia
-->
follow the aortic arterial branches (periarterial plexus)
30
Q

describe the prevertebral ganglia

A

located anterior to the descending aorta

at the bifurcations of the major aortic branches

  • abdominopelvic splanchnic come in
  • periarterial plexus leaves
31
Q

describe the periarterial plexuses

A

nerves that travel with arteries, surrounding them in a plexus

32
Q

Describe the sympathetic innervation of the adrenal glands

A

fibres leave the spinal cord at T10-L1
–>
enter the abdominopelvic splanchnic nerves
–>
follow the aortic arterial branches (periarterial plexus)
–>
synapse directly into adrenal gland

33
Q

Describe the parasympathetic innervation of the GI organs

A

Vagus (CN X):

  • everything (all organs!) until the distal transverse colon

Pelvic splanchnic nerves (S2,3,4):
- everything below the distal end of the transverse colon

34
Q

Describe the vagal innervation of the GI organs

A

Does everything until the distal transverse colon

Presynaptic fibres enter abdominal cavity on surface of the oesophagus
–>
Periarterial plexuses around the abdominal aorta
–>
Walls of the organs where they synapse in ganglia

35
Q

Describe the pelvic splanchnic innervation of the GI organs

A

does everything below the distal end of the transverse colon

parasympathetic

Leaves from S2,3,4

36
Q

How do visceral afferent nerve fibres get from the abdominal organs to the CNS?

A

Pain fibres from most of the abdominal organs run alongside sympathetic fibres to the spinal cord

From:
- foregut = enter at T6-T9

  • midgut = enter at T8-T12
  • hindgut = enter at T10-L2
37
Q

Where is abdominal GI visceral pain usually felt

A

Pain is usually felt along the dermatomes of the levels at which they enter the spinal cord (there is a little overlap)

Pain is usually felt centrally

(this is a type of referred pain)

38
Q

List some referred pain patterns

A

Usual dermatomal patterns

liver and gallbladder –> right shoulder

pancreas and stomach –> between shoulder blades

appendix –> umbilical region

39
Q

Describe the pain progression in appendicitis

A

visceral pain is referred to the umbilical region
(dull, general)

–>

inflammation rubs against the parietal peritoneum
(sharp, localised)

40
Q

Describe the somatic innervation of the abdomen

A

Somatic motor, somatic sensory and sympathetic nerve fibres

Carried in nerves that follow the dermatomes

Thoracoabdominal nerves (7th-11th intercostal nerves):

  • Travel anteriorly, then leave the intercostal spaces, travel in the plane between the internal oblique and transversus abdominis

The subcostal nerve (T12 anterior ramus)

The iliohypogastric nerve (half of L1 anterior ramus)

The ilioinguinal nerve (other half of L1 anterior ramus)

Y1 - Gastrointestinal (6 decks)

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