Anatomy GI Flashcards
cutaneous innervation of the anterolateral abdominal wall
FROM T7-L1
- Thoraco-abdomincal nerves T7-11
- lateral branch of Subcostal nerve T12
- Anterior branch of Subcostal nerve T12
- Iliohypogastric nerve L1
- Ilio-linguinal nerve L1
arterial supply anterolateral abdominal wall
6
1-Musculophrenic artery
2-Superior epigastric artery
3-lateral ABS= 10,11th Posterior intercostal arteries
4-central ABS = inferior epigastric
5-superficial epigastric artery =V line
6-Superficial Circumflex arteries =V line
venous drainage of the anterolateral abdominal wall
superior and inferior?
4
blood from plexus-->Internal Thoracic vein + lateral thoracic vein (superior )
inferior= superficial, inferior epigastric vein
lymphatic Drainage of the anterolateral abdominal wall
2
- axillary nodes in arm pit = above the transumbilical plane
- superficial inguinal lymph nodes = v line = everything below the transumbilical plane
external oblique
- where is it
- fiber direction
First most superficial layer of muscle in ABS
- muscle fibres = hands in front pockets
- aponeurosis of external oblique muscle = flattened tendon
internal oblique
direction of fibers
deep to external oblique= hands-on boobs =
transverse abdominis muscle
deep to Transversus abdominis muscle= horizontal fibers
transverse abdominis muscle
2
deep to internal oblique muscle= horizontal fibers
rectus sheath
LOOK MORE AT HOW IT IS MADE ( TRY TO UNDERSTAND )
encloses rectus abdominus muscles = anterior and posterior part
- anterior part = formed by aponeurosis of external oblique muscle
rectus abdominis muscle
3
- The rectus abdominis muscle, also known as the “abdominal muscle”, is a paired muscle running vertically on each side of the anterior wall of the human abdomen
- separated into discrete sections by tendinous intersections
location and boundaries of the superficial inguinal ring
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anterior wall
posterior wall
roof
floor
4
~~~
-Canal located between the deep(internal) and superficial (external) inguinal ring
anterior wall = external oblique aponeurosis
Posterior wall = Conjoint tendon medially
Roof = Fibres of internal oblique + transversus abdominus muscle
floor= Lower edge of the inguinal ligament
identify bony landmarks of the pubic bones
pubic bones :
sacro-iliac joints +anterior scar-iliac ligament
inferiorly = pubic symphis
superior pubic ligament in the middle + pubic symphis +pubic crest +pubic tubercle+pectineal line+pubic crest
location of 9 regions and 4 quadrants
9
1-Right hypochondriac 2-Epigastric region 3-Left hypochondriac 4-Right Flank 5-Umbilical region 6-Left flank 7-Right iliac fossa 8-SupraPubic region 9-Left iliac fossa
peritoneal cavity
6
serous membrane = small amount of peritoneal fluid
parietal peritoneum = lines abdominopelvic cavity
Visceral Peritoenum = covers ABS + organs
divided into :
greater and lesser sacs
the lesser and greater omenta: omenta = double folds of the peritoneum
-lesser omentum= from the stomach to the liver
Greater omentum =stomach and extends downwards, and moves to protect us towards the side of infection to limit the spread of the infection in the abdominal cavity.
lymphatic drainage of the abdominal cavity
Foregut = pre-aortic lymph nodes
Midgut=pre-aortic lymph nodes
HIndgut =pre-aortic lymph nodes
quadrants of ABS
4
One line down centre = median plane dissected by transumbilical plane .
1-Right Upper Quadrant
2-Left Upper Quadrant
3-Right lower Quadrant
4-Left Lower Quadrant
what are mesenteries?
2
1- double layer folds of the peritoneum
2- small Intestine = anchors SI to the abdominal wall
what is the transverse meso-colon?
1
1-broad meso-fold of the peritoneum, which connects the transverse colon to the posterior wall
embryological development
3
1- Foregut –> esophagus, liver, gall bladder, etc= ARTERIAL SUPPLY FROM COELIAC TRUNK
2-Midgut–>distal duodenum , jejunum , ileum , caecum etc= SUPERIOR MESENTERIC ARTERY
3-Hindgut–> transverse colon, descending colon, sigmoid colon, rectum, upper region of the anal canal = INFERIOR MESENTERIC ARTERY
1)Identify the abdominal aorta and the branches of this vessel
2)Describe the course and relations of the abdominal aorta
CSI
Abdomincal Aorta travels through the abdomen through T12 aortic hiatus and terminates at L4 as Illiac arteries
Anterior branches : CSI
1-Celiac trunk
2-Superior Mesenteric
3-Inferior Mesenteric (inferior to Gonadals arteries)
Lateral : renal
1-Middle Suprarenal
2-Renal arteries
Paired lateral:
1-Gonadal
2-Inferior Phrenic Arteries
Posterior :
1-Lumbar
2-Medial Sacral
Identify the inferior vena cava and the tributaries of this vessel
Describe the course and relations of the inferior vena cava
(starts and terminates)
starts at L5 (ascending on the RHS of Abdomininal Aorta)
Passes throuhg diaphragm through T8
Major tributeries : 1-Common illiac veins 2-Lumbar veins (posteriorly ) 3-Right gonadal 4-Renal Veins 5-Right Suprarenal veins 6-Inferior Phrenic 7-Hepatic veins
Identify the coeliac trunk and the branches of this vessel
(3)
CGS
Coeliac trunk :
1-common hepatic branch
2-Left gastric Branch
3-Splenic branch
(stomach , spleen , liver, gall bladder, parts of pancreas and duodenum )
Identify the coeliac trunk and the branches of this vessel
3
Coeliac trunk :
1-common hepatic branch
2-Left gastric Branch
3-Splenic branch
(stomach , spleen , liver, gall bladder, parts of pancreas and duodenum )
Identify the superior mesenteric artery and the branches of this vessel
(MRI)
SMA = supplies SI , proximal half of colon
1-Middle colic branch
2-Right colic branch
3-Illeocolic branch
Anterior brnahces of Abdomincal aorta
CSI
Coelic artery
Superior Meseneteric
Inferior Mesenteric
Lateral branches of abdomincal aorta
1) non paired (2)
2) paried (2)
1)Non paired
1-Renal arteries
2-Middle Suprarenal arteries
2) Paired
inferior phrenic arteries
gonadals arteries
Posterior branches of aorta (2)
1-Lumbar
2-Medial Sacral arteries
circulation of the liver
1- portal circulation (A->C->P->C->Venule)
2-Hepatic artery (30%)
3-portal vein(70%)
surface anatomy of the liver
2
1-R side = 5th IC space to 10th rib in the midclavicular line
2-L side = 5th IC space
caudate lobe
quadrate lobe
what are the 4 lobes of the liver?
Ligaments ? (4)
1-right lobe 2-Left lobe both are seperated by falciform ligament+ coronary ligament 3-Quadrate lobe 4-Caudate lobe
The round ligament is the remains of the umbilical vein = Obliterated Umbilical vein. It is a part of the Falciform Ligament
- the coronary ligament turn into the triangle ligament at the edges of the liver = attaches to the diaphragm
Ligaments of the liver?
4
1- Falciform ligament
2-Coronary ligament
The round ligament is the remains of the umbilical vein = Obliterated Umbilical vein. It is a part of the Falciform Ligament
- The coronary ligament turn into the triangle ligament at the edges of the liver = attaches to the diaphragm
circulation of the liver
1-Hepatic portal vein (75%)
2-Proper Hepatic artery (25%)
Inferior Vena Cava ( systemic Venous system so it picks up venous blood from liver–>RA)
PORTAL SYSTEM ANASTOMOSES
Anatomy of the gall bladder
- where is it
- Billary tree
- What is the 2nd part of duodenum called ?
Bile stored in the gall bladder, just beneath the liver
(fundus, body , neck–>systic duct)
Tip of the 9th costal cartilage
Gall bladder Billary tree:
1- right hepatic duct + left hepatic duct = common hepatic duct
2-Common + cystic duct =bile duct
3-Bile duct = behind the head of the pancreas + pancreatic duct open into the duodenum
2nd part of duodenum =ampella of vater
Hepatic /portal vein system
2
This circulation of nutrient-rich blood between the gut and liver is called the portal circulation–>Liver–>Systemic circulation
Porto-systemic anastomoses
when the blood pressure is high the porto systemic system open ( x>12mm/mg)
like an alternative dual carriage way when motor way is closed
where do the pancreatic duct and bile duct normally join ?
cool words
1-2nd part of the duodenum surrounded by the sphincter of ODDI
2-THEY open into the hepatopancreatic Ampulla= ampulla OF VATERRRR
What lies in the retroperitoneal cavity (9)
SAD PUCKER
SAD PUCKER
S: suprarenal (adrenal) gland
A: aorta/IVC
D: duodenum (second and third part)
P: pancreas (except tail)
U: ureters
C: colon (ascending and descending)
K: kidneys
E: Oesophagus
R: rectum
descending abdominal aorta branches from diaphragm to iliac
People create such Silly rhymes to learn in school
Phrenic Celiac Superior Mesenteric Suprarenal Renal Testicular Lumbar Inferior Mesenteric Sacral
What are the muscles which support the spine ?
(7)
one group + 4 loners
erector spinae (I love spines) -Illiocostalis -Longissimus -Spinallis ( enclosed by thoracic-lumbar fascia)
- Quadratus lumborum lies infront of the erector spinae group ( 12th rib, upper three lumbar vertebrae + inserts onto medial part of the iliac crest and transverse process of l5 ) ==> Lateral flexion of the spine
- Psoas major is medial to quadrates lumborum
- iliacus
- iliopsoas
Psoas major
Where is it ?
Iliacus - where is it ?
what do they both join and make ?
Medial to quadratus lumborum ( next to spine)
-arises from T12-L5–>through sacroiliac joint
Illiacus = fills iliac fossa
Iliacus medial fibres + lateral fibres of psoas major join => iliopsoas , passed behind the inguinal ligament
Flexion of HIP joint
Kidney - Where are they ? - What are the veins ? - What are the arteries ? (3)
in front of rib 11,12 ( behind peritoneum)
Renal vessels:
- veins lie infront of the arteries
( left and right renal veins )
- Renal arteries, below superior mesenteric ( pass sharply backwards) and enter at hilum
Bladder
lined with ?
urine enters ?
urine leaves ?
smooth muscle lined with mucosa
ureteric ostium where the ureter opens into the bladder
urine level via internal uretheral meatus–>urethra ( urine leaves)
what are the nerves going down from the abdomen (lumbar plexus )
I (twice) get laid on Friday
or Intrested in getting lunch on Friday
L1 -Illiohypogastric L1-Illioinguinal L1,2- Genitofemoral L2,3- Lateral cutaneous nerve L2,3-Obturator nerve L2-4- Femoral nerve
what 2 nerves pass through the inguinal canal ?
1) ilioinguinal nerve
2) Genitofemoral nerve
