Anatomy - Abdominal Viscera I Flashcards
1
Q
2 parts of mouth in the digestive tract?
A
- Oral cavity2. Pharynx
2
Q
Esophagus region of abdomen?
A
Epigastric
3
Q
How does the esophagus enter the abdomen? Vertebral level?
A
Through right crus of diaphragm at T10
4
Q
Name of portion of stomach where esophagus enters? Location with regards to midline?
A
Cardial orifice of stomach, left of midline
5
Q
Function of esophagus?
A
Connects pharynx to stomach
6
Q
Vertebral levels of esophagus?
A
C6 to T11
7
Q
Position of esophagus with regards to the midline?
A
Anterior aspect of vertebrae in midline => anterior and to the left laterally to be anterior to the thoracic aorta to enter the diaphragm
8
Q
At what 4 locations can the esophagus be compressed/narrowed? What is at higher risk at these locations?
A
- Junction of esophagus and pharynx in the neck2. Aortic arch crossing over the esophagus in superior mediastinum3. Left main bronchus crossing over the esophagus in posterior mediastinum4. At esophageal hiatus in posterior mediastinum Higher risk of swallowed objects getting lodged at these locations and if the object is corrosive it would cause more damage at these locations
9
Q
Where do esophageal ruptures occur typically? Treatment?
A
Lower third of esophagus on the left Treatment: urgent surgical repair
10
Q
Only part of posterior mediastinum that lymphatically drains to abdomen?
A
Inferior 1/3rd of esophagus
11
Q
What do we call the vagus nerves right before they become the anterior and posterior trunks on the esophagus?
A
Right and left vagal trunks
12
Q
7 structures of the adult foregut?
A
- Esophagus (distal end)2. Stomach3. Duodenum (proximal half)4. Liver5. Gallbladder6. Pancreas7. Spleen
13
Q
8 structures of the adult midgut?
A
- Duodenum (distal half)2. Jejunum3. Ileum4. Cecum5. Appendix6. Ascending colon7. Hepatic flexure of colon8. Transverse colon (proximal two-thirds)
14
Q
5 structures of the adult hindgut?
A
- Distal third of the transverse colon 2. Splenic flexure of colon3. Descending colon4. Sigmoid colon 5. Rectum
15
Q
Describe the surgical procedure of esophageal resection to treat cancer. What is this called?
A
Transthoracic esophagectomy:1. Patient is placed in supine position 2. Laparotomy (surgical incision of abdomen) to assess evidence of disease in abdominal cavity3. Stomach is mobilized with preservation of right gastric and gastro-omental arteries4. Short gastric vessels and left gastric vessels are divided5. Pyloromyotomy is performed (incision in stomach on the pylorus, the furthest part of the stomach that connects to the duodenum)6. Abdominal wound is closed7. Patient is placed in left lateral position 8. Right posterolateral thoracotomy is performed through 5TH INTERCOSTAL SPACE9. Azygos vein divided to provide full access to the whole length of the esophagus 10. Stomach is delivered through the diaphragmatic hiatus 11. Esophagus is resected and stomach is anastomosed to the cervical esophagus
16
Q
How does esophageal cancer spread?
A
Submucosa or locoregional lymph nodes
17
Q
When are most esophageal cancers diagnosed? Survival rate?
A
LateSurvival rate: 25% 5-year survival rate
18
Q
What is the right side of the esophagus covered by?
A
Mediastinal pleura of right lung
19
Q
Position of thoracic duct in regards to esophagus in posterior mediastinum?
A
- Inferior portion: right side - Superior portion: left side
20
Q
4 structures that are posterior to the esophagus at some point in the posterior mediastinum?
A
- Thoracic duct2. Hemiazygos veins3. Right posterior intercostal arteries4. Thoracic aorta (near diaphragm)
21
Q
5 structures that are anterior to the esophagus at some point in the posterior mediastinum?
A
- Trachea2. Right pulmonary artery3. Left main bronchus4. LA 5. Aortic arch
22
Q
What arteries do esophageal arteries arise from? Where does each originate from?
A
CERVICAL segment:1. Inferior thyroid arteries from thyrocervical trunks which come from the subclavian arteriesTHORACIC segment:2. Thoracic aorta3. Right bronchial arteries4. Right posterior intercostal arteries from thoracic aorta ABDOMINAL segment:5. Left gastric artery from celiac trunk MAINLY6. Short gastric artery from splenic artery7. Left inferior phrenic artery from abdominal aorta
23
Q
What veins do esophageal veins drain into?
A
CERVICAL segment:1. Inferior thyroid vein THORACIC segment:2. Azygos vein3. Hemiazygos vein4. Accessory hemiazygos veinABDOMINAL segment: portal system through:5. Left gastric vein 6. Short gastric vein
24
Q
Lymphatic drainage of esophagus? 9 types of nodes.
A
- Internal jugular lymph nodes 2. Lower internal jugular lymph nodes 3. Tracheal lymph nodes4. Tracheabroncheal lymph nodes5. Retrocardiac lymph nodes6. Infracardiac lymph nodes7. Posterior mediastinal lymph nodes8. Diaphragmatic lymph nodes 9. Left gastric lymph nodes (inferior 1/3rd)
25
Innervation of esophagus?
Branches from vagus nerves and sympathetic trunks
26
Innervation of striated muscle in superior portion of the esophagus?
Branchial efferents from vagus nerves
27
Innervation of smooth muscle fibers in inferior portion of the esophagus?
Preganglionic fibers that are parasympathetic visceral efferents and synapse in the myenteric and submucosal plexuses of the enteric NS in the esophageal wall
28
Sensory innervation of esophagus? Which ones are responsible for transmitting pain information to the CNS?
Visceral afferents in :1. Vagus nerves2. Sympathetic trunks***3. Splanchnic nerves***
29
Are the visceral afferents from the vagus nerves involved in the relay of pain recognition?
NOPE
30
What are the 2 trunks formed by the esophageal plexus?
Trunks formed by the esophageal plexus just above the diaphragm:1. Anterior vagal trunk on anterior surface of esophagus mainly from fibers from left vagus nerve forming several smaller trunks2. Posterior vagal trunk on posterior surface of esophagus mainly from fibers from right vagus nerve forming a single trunk These continue through the diaphragm
31
Are glands, liver, and pancreas embryological outgrowths of the digestive tract?
YUP
32
Describe the strength of the lower esophageal sphincter compared to the pyloric sphincter or sphincter of Oddi. Clinical significance?
WEAK, but the esophageal hiatus provides some additional strengthIf the stomach is herniated through the esophageal hiatus, this extra support is lacking and the patient will experience GERD
33
What is the eaten apple sign?
Esophageal cancer on a CXR
34
What does the lining of the stomach form when it is empty?
Folds = rugae
35
Volume the stomach can hold?
~1/2 gallon
36
Effect of HCl on meat?
Softens connective tissue
37
What is the most dilated portion of the GIT?
Stomach
38
Regions of abdomen that stomach occupies?
1. Epigastric2. Left hypochondrium3. Umbilical
39
4 regions of stomach? Describe each.
1. The cardia, which surrounds the opening of the esophagus into the stomach 2. The fundus of the stomach, which is the area above the level of the cardial orifice below the diaphragm 3. The body of the stomach, which is the largest region of the stomach4. The pyloric part, which is divided into the pyloric antrum and pyloric canal and is the distal end of the stomach
40
What is the pyloric constriction?
External mark of pylorus on stomach
41
2 parts of pylorus?
1. Pyloric sphincter2. Pyloric orifice
42
Surface anatomy of pyloric orifice?
Just to the right of midline in transpyloric plane (L1)
43
What attaches to the greater curvature of stomach?
Point of attachment for the gastrosplenic ligament, the greater omentum, the gastrocolic ligament, and the gastrophrenic ligament
44
What attaches to the lesser curvature of stomach?
Point of attachment for the lesser omentum
45
What is the cardial notch of the stomach?
Superior angle created when the esophagus enters the stomach between esophagus and fundus of stomach
46
What is the angular incisure/notch of the stomach?
A bend on the lesser curvature where the body and pyloric antrum meet
47
What is the greater curvature of the stomach?
Longer, convex border
48
What is the lesser curvature of the stomach?
Shorter, concave border
49
Blood supply of stomach? Where does each arise from?
1. Right gastric artery – variable in origin – usually branches off hepatic artery proper 2. Left gastric artery – arises directly from celiac trunk3. Right gastroepiploic artery – 1 of 2 terminal branches of gastroduodenal artery4. Left gastroepiploic artery – arises from splenic artery5. Short gastric arteries (4-5) – arise from splenic artery (FUNDUS)6. Posterior gastric artery – arises from splenic artery BUT not always present
50
Other name for right/left gastroepiploic artery?
Right/left gastro-omental artery
51
Lymphatic drainage of stomach?
Celiac lymph nodes since follows arteries to stomach, which all branch directly or indirectly from the celiac trunk
52
3 structures located anterior to the stomach?
1. Left liver lobe2. Anterior body wall3. Diaphragm
53
2 structures located posterior to the stomach?
1. Pancreas2. Spleen
54
Arteries along lesser curvature of stomach?
Right and left gastric arteries
55
Arteries along greater curvature of stomach?
Right and left gastro-omental arteries
56
What is a trichobezoar?
Hair stuck in the stomach
57
Changes in diameter of small intestine throughout its course?
Narrowing
58
Beginning and end of duodenum?
1. Beginning: pylorus2. End: duodenojejunal junction
59
Vertebral levels of duodenum? What does this correspond to?
L1 to L3L1 is halfway between jugular notch and pubic area
60
4 parts of duodenum? Describe each along with their vertebral level. Which one is the longest?
1. The superior part (L1): extends from the pyloric orifice of the stomach to the neck of the gallbladder, is just to the right of the body of vertebra L1, mostly horizontal2. The descending part (L2/L3): curves around head of pancreas, just to the right of midline and extends from the neck of the gallbladder to the lower border of vertebra L33. The inferior part (L3)=horizontal part: longest section, crossing the IVC, the aorta, and the vertebral column 4. The ascending part (L2/L3): upward on, or to the left of, the aorta to approximately the upper border of vertebra L2 and terminates at the duodenojejunal flexure
61
Overall shape of duodenum?
C shaped
62
Where do most duodenal ulcers occur?
Superior first part of it
63
2 other names for superior part of duodenum?
The ampulla or duodenal cap
64
5 structures posterior to duodenum?
1. Bile duct2. Gastroduodenal artery3. Portal vein4. IVC5. Right kidney
65
What is the major duodenal papilla?
Common entrance for the bile and pancreatic ducts in the descending part of the duodenum
66
What passes the anterior surface of the descending part of the duodenum?
Transverse colon
67
What is the minor duodenal papilla? Where is it located with regards to the major duodenal papilla?
Entrance for the accessory pancreatic ductJust above the major duodenal papilla
68
Location of right kidney with regards to duodenum?
Posterior to descending part of duodenum
69
What 2 structures pass anteriorly to the horizontal part of the duodenum?
1. Superior mesenteric artery 2. Superior mesenteric vein.
70
Other name for horizontal part of duodenum?
Inferior part
71
What supports the duodenojejunal junction? Clinical significance?
Ligament of TreitzA surgeon can feel for this ligament in order to identify the junction
72
Other name for ligament of Treitz?
Suspensory muscle of the duodenum
73
Blood supply to duodenum? Where does each arise from? What part of the duodenum does each supply?
1. Branches from the gastroduodenal arterySUPERIOR DUODENUM:2. Supraduodenal artery from the gastroduodenal arteryDESCENDING DUODENUM:3. Duodenal branches from the anterior superior pancreaticoduodenal artery (from the gastroduodenal artery)4. Duodenal branches from the posterior superior pancreaticoduodenal artery (from the gastroduodenal artery)INFERIOR DUODENUM: 5. Duodenal branches from the anterior inferior pancreaticoduodenal artery (from the inferior pancreaticoduodenal artery from the SMA)6. Duodenal branches from the posterior inferior pancreaticoduodenal artery (from the inferior pancreaticoduodenal artery from the SMA)ASCENDING DUODENUM: 7. 1st jejunal branch from the SMA
74
What portion of the jejunum+ileum does the jejunum represent?
Proximal 2/5ths
75
Regions of abdomen that jejunum occupies?
LUQ / umbilical region
76
Average length of small intestine? Length required for survival?
10-30 feetCan survive with as little as 2 feet
77
Which has a thicker wall: jejunum or ileum?
Jejunum
78
Unique characteristics of jejunum compared to ileum?
1. LESS prominent arterial arcades 2. Longer vasa recta (straight arteries) 3. More and more prominent plicae circulares4. Less mesenteric fat 5. Less lymphatics and no Peyer's patches 6. Thicker walls
79
What are plicae circulares?
Numerous prominent folds circling the lumen of the inner mucosal lining beginning towards the end of the duodenum and are most prominent in the jejunum; they disappear about half way through the ileum
80
Blood supply to jejunum? Where does each arise from?
Jejunal arteries from the left SIDE of the SMA
81
Quadrant of ileum?
RLQ
82
What is the ileocecal fold? Function?
Two flaps projecting into the lumen of the large intestine surround the opening from ileum to cecum and come together at their end, forming ridges with musculature from the ileum continuing into each flap, forming a sphincter Possible functions of the ileocecal fold include preventing reflux from the cecum to the ileum, and regulating the passage of contents from the ileum to the cecum
83
Blood supply to ileum? Where does each arise from?
1. Ileal arteries from the left side of SMA2. An branch from the ileocolic artery from the right side of the SMA
84
What are the lymphatic organs of the ileum called?
Peyer's patches
85
What 3 structures increase surface area of small intestine? by how much?
1. Villi2. Microlli By 6-100 fold3. Plicae circulares1.6-2 fold
86
What is an ileal conduit?
Extraanatomical procedure performed after resection of the bladder for tumor:1. A short segment of ileum is identified2. The bowel is divided twice to produce a 20-cm segment of small bowel on its own mesentery: isolated segment of bowel used as a conduit (proximal end is anastomosed to the ureters, and the distal end is anastomosed to the anterior abdominal wall) and remaining bowel is joined together 3. Urine passes from the kidneys into the ureters and through the short segment of small bowel to the anterior abdominal wall4. Collecting bag is fixed to the anterior abdominal wall
87
What connects the ileum and jejunum to the posterior abdominal wall?
6 inch fan-shaped mesentery from left side of L2 to right iliac fossa = mesentery of small intestine
88
Does the large intestine secrete enzymes?
NOPE
89
Effect of bacteria of large intestine working on feces? Effect of systemic antibiotics?
Production of vitamin K and B-complex vitaminsAntibiotics could destroy these symbiotic bacteria
90
2 flexures of the large intestine? 2 names for each
1. Hepatic = right colic2. Splenic = left colic
91
What are omental appendices?
Omental sacs containing fat located on teniae coli of the colon
92
Length of large intestine?
5 feet
93
4 parts of large intestine?
1. Cecum2. Appendix3. Colon4. Rectum
94
Regions of abdomen that ascending colon occupies?
Right flank and right hypochondrium
95
Regions of abdomen that cecum and appendix occupy?
Right groin
96
What is located superiorly to right colic flexure?
Liver right lobe
97
Regions of abdomen that transverse colon occupies?
Right to left hypochondrium
98
What is located superiorly to left colic flexure?
Spleen
99
Regions of abdomen that descending colon occupies?
Left hypochondrium to left groin
100
Where are the taeniae coli most visible in the large intestine? Where are they less visible?
Primarily observed in the cecum and colon and less visible in the rectum
101
What part of large intestine enters pelvis?
Sigmoid colon
102
Position of cecum?
Inferior to the ileocecal opening and in the right iliac fossa
103
Can the cecum be in the pelvis?
Yes, sometimes
104
Where is the appendix located on cecum?
Attached to the posteromedial wall of the cecum, just inferior to the end of the ileum
105
What does the appendix contain?
Large aggregations of lymphoid tissue in its walls
106
How is the appendix suspended from the terminal ileum? What does this structure contain?
By the mesoappendix, which contains the appendicular vessels
107
Blood supply to cecum + appendix? Where does each arise from?
1. Anterior cecal artery from the ileocolic artery (from the SMA)2. Posterior cecal artery from the ileocolic artery (from the SMA)3. Appendicular artery from the ileocolic artery (from the SMA) (only one going to appendix)
108
Location of left colic flexure with regards to right one?
Higher and more posterior than the right colic flexure
109
What is the right colic flexure attached to?
Attached to the diaphragm by the phrenicocolic ligament
110
Blood supply to ascending colon? Where does each arise from?
ALL FROM SMA:1. Colic branch from the ileocolic artery 2. Anterior cecal artery from the ileocolic artery3. Posterior cecal artery from the ileocolic artery4. Right colic artery
111
What are the paracolic gutters? Where are they located? Clinical significance?
Immediately lateral to the ascending and descending colon are the right and left paracolic gutters = depressions formed between the lateral margins of the ascending and descending colon and the posterolateral abdominal wall and are gutters through which material can pass from one region of the peritoneal cavity to anotherBecause major vessels and lymphatics are on the medial or posteromedial sides of the ascending and descending colon, a relatively blood-free mobilization of the ascending and descending colon is possible by cutting the peritoneum along these lateral paracolic gutters
112
Lowest vertebral level of sigmoid colon?
S3
113
Shape of sigmoid colon?
S shaped
114
Attachments of sigmoid colon? What about in between?
1. Its beginning, where it continues from the descending colon2. Its end, where it continues as the rectumBetween these points, it is suspended by the sigmoid mesocolon to the posterior abdominal and pelvic walls
115
Blood supply to transverse colon? Where does each arise from?
1. Right colic artery from the SMA2. Middle colic artery from the SMA3. Left colic artery from the IMA
116
Blood supply to descending colon? Where does each arise from?
Left colic artery from IMA
117
Blood supply to sigmoid colon? Where does each arise from?
Sigmoid arteries from IMA
118
Location of root of appendix? Location of rest of appendix?
Where 3 taeniae coli meet at posteromedial aspect of cecum, inferior to the ileocecal junction Rest: appendix can lie anywhere the hands of aclock can lie
119
Vertebral levels of rectum?
S3 to coccyx
120
Blood supply to rectum + anal canal? Where does each arise from?
1. Superior rectal artery from the IMA2. Middle rectal artery: from inferior vesical artery in men and uterine artery in women, both from the internal iliac artery3. Inferior rectal arteries from the internal pudendal arteries (from the internal iliac artery)
121
Is the rectum fixed?
YUP
122
Length of rectum?
5 inches
123
2 other names for ascending colon?
Right colon = absorbing colon
124
2 other names for descending colon?
Left colon = storage colon
125
Consistency of feces in ascending colon?
Fluid
126
Consistency of feces in transverse colon?
Mush
127
Consistency of feces in descending colon?
Semi-solid
128
What can be palpated during a digital rectal exam?
MALES:1. Prostate2. Seminal vesiclesFEMALES1. Cervix2. Posterior fornix3. Maybe ovaries 4. Uterus cancer 5. Foreign objects in vaginaBOTH: potential distal colorectal tumors or polyps
129
What is BPH?
Benign prostatic hyperplasia
130
Blood supply of foregut? Vertebral level?
Celiac trunk: L1
131
Blood supply of midgut? Vertebral level?
SMA: L1
132
Blood supply of hindgut? Vertebral level?
IMA: L3
133
4 unpaired branches of the abdominal aorta? Location?
Located in the midline:1. Celiac trunk2. SMA3. IMA4. Median sacral artery
134
3 branches of the celiac trunk? Location for each?
1. Left gastric artery: descends on superior portion of the lesser curvature of stomach to anastomose with right gastric artery at the cardioesophageal junction 2. Splenic artery: along posterior surface of stomach and superior border of pancreas to spleen3. Common hepatic artery: very short branching to the right of the celiac trunk
135
Branches of left gastric artery?
Esophageal branches
136
4 branches of splenic artery? Location for each? List in branching order.
1. Dorsal pancreatic artery: proximal body of posterior pancreas2. Greater pancreatic artery: distal body of posterior pancreas SAME BRANCHING POINT:3. Short gastric arteries: on surface of fundus of stomach4. Left gastroepiploic artery: along greater curvature of stomach to anastomose with right gastroepiploic artery
137
3 branches of common hepatic artery? Location for each? List in branching order.
1. Gastroduodenal artery: posterior to superior duodenum2. Hepatic artery proper: extending to the right and superiorly directed to liver
138
3 branches of gastroduodenal artery? Location for each? List in branching order.
1. Supraduodenal artery to superior duodenum2. Anterior and posterior superior pancreaticoduodenal arteries on each side of the head of the pancreas 3. Right gastroepoploic artery: along greater curvature of stomach to anastomose with left gastroepiploic artery
139
Branches of hepatic artery proper? Location?
Left and right hepatic arteries
140
Branches of the SMA? Location for each? List in branching order.
LEFT SIDE:1. Jejunal arteries 2. Ileal arteries RIGHT SIDE:1. Inferior pancreaticoduodenal artery 2. Middle colic artery to transverse colon3. Right colic artery to ascending colon3. Ileocolic artery to cecum
141
Branches of ileocolic artery?
1. Anterior cecal artery 2. Posterior cecal artery3. Appendicular artery4. Ileal branch
142
Branches of the IMA? Location for each? List in branching order.
1. Left colic artery to descending colon2. Sigmoid arteries to sigmoid colon3. Superior rectal artery to rectum
143
Venous drainage of GIT?
Veins named after arteries and all drain into the portal vein => liver => IVC
144
What is intestinal lymph called? Why is it special?
ChyleSpecial because it transports fat
145
Lymph pathway of GIT?
Right and left lumbar trunks + pre-aortic nodes form the intestinal trunk => cisternal chyli => thoracic duct => enters thorax posterior to aorta through aortic hiatus => posterior mediastinum to the right of midline between thoracic aorta and azygos vein and posterior to esophagus and anterior to vertebrae => moves to left of midline at T5 and enters superior mediastinum => through superior mediastinum to neck => left jugular trunk and left subclavian trunk (draining left neck/head and left upper limb) join the thoracic duct => empties into junction of left subclavian and left internal jugular veins
146
Vertebral level of cisternal chyli?
L1
147
Referred pain area of foregut? Nerve?
Epigastric regionVisceral afferents in greater splanchnic
148
Referred pain area of midgut? Nerve?
Umbilical regionVisceral afferents in lesser splanchnic
149
Referred pain area of hindgut? Nerve?
Pubic regionVisceral afferents in lumbar splanchnic
150
Pain due to appendicitis? Test to diagnose?
Begins as central diffuse periumbilical (T10) colicky REFERRED pain from appendix that comes and goes => with time pain becomes DIRECT and constant from parietal peritoneum and localizes to the right iliac fossa in LRQ in the right groin (can occur even in the absence of ruptures of the appendix) and patient will guard themselves from touch => peritoneal infection moves to the undersurface of the diaphragm => pain sensation from an inflamed diaphragm is sent back to the CNS via the phrenic nerve, C3, C4, and C5 - cutaneous pain sensation from the right shoulder region also travels to the CNS via C3, C4, and C5 (supraclavicular nerves) so the brain is unable to distinguish the cause of the pain)Test: rebound pain test
151
Cause of appendicitis? Complications?
Appendix is obstructed by fecalith or enlarged lymphoid nodules => bacteria invade the walls => damage due to pressure necrosis => can lead to perforation which can lead to generalized peritonitis
152
What is Meckel's diverticulum? What does it appear as? Typical symptoms?
Failure of the vitelline duct to fully regress results in Meckel's diverticulum = remnant of the proximal part of the yolk stalk (vitelline duct) that extends into the umbilical cord in the embryo and lies on the antimesenteric border of the ileum It appears as a blind-ended tubular outgrowth of bowel. Typical findings include hemorrhage, intussusception, diverticulitis, ulceration, and obstruction
153
What is the rule of 2s for Meckel's diverticulum?
- Uncommon finding (occurring in approximately 2% of the population)- 2 times more common in males- Usually 2 inches long- 2 feet proximal from the ileocecal junction- Contains one of 2 ectopic tissues: gastric or pancreatic- Most commonly diagnosed in first 2 years of life
154
Lymph drainage of ileum?
Superior mesenteric lymph nodes
155
Innervation of ileum?
Superior mesenteric plexus
156
Lymph drainage of cecum?
1. Mesenteric lymph nodes2. Superior mesenteric lymph nodes
157
Innervation of cecum?
Superior mesenteric plexus
158
Lymph drainage of ascending colon?
1. Colic lymph nodes2. Superior mesenteric lymph nodes
159
Innervation of ascending colon?
Superior mesenteric plexus
160
Lymph drainage of transverse colon?
1. Colic lymph nodes2. Superior mesenteric lymph nodes 3. Inferior mesenteric lymph nodes
161
Innervation of transverse colon?
Superior and inferior mesenteric plexuses
162
Innervation of descending colon?
Inferior mesenteric plexus
163
Lymph drainage of descending colon?
1. Colic lymph nodes2. Inferior mesenteric lymph nodes
164
Lymph drainage of sigmoid colon?
1. Colic lymph nodes2. Inferior mesenteric lymph nodes
165
Innervation of sigmoid colon?
Inferior hypogastric plexus
166
Location of superior mesenteric artery and vein in regards to stomach?
Posterior to the pyloric antrum
167
Is the anal canal part of the large intestine?
NOPE, it's a continuation of it
168
Where is the junction between foregut and midgut located?
Inferior to major duodenal papilla
169
What passes the anterior surface of the superior part of the duodenum?
Left liver lobe
170
Which arteries supply the antrum of the stomach?
Branches from right gastric and right gastroepiploic arteries
171
Which arteries supply the body of the stomach?
Branches from right gastric and right and left gastroepiploic arteries
172
% of appendicites that rupture?
10-15% of cases
173
What are intestinal arterial arcades?
Anastomoses between intestinal vasa rectae
174
Length from duodenojejunal junction to ileocecal junction if you connect the dots diagonally?
15 cm
175
Length of ileum and jejunum combined?
6 meters
176
What 3 structures can be felt during a rectum exam in both men and women?
1. Coccyx2. Sacrum3. Ischial spines
177
Cystic artery branching?
From right hepatic artery
