Anatomy II (Viscera) Flashcards
How long is the esophagus?
25-30cm long
What level does the esophagus begin?
C6 - cricoid cartilage
What level does the esophagus pass through in the diaphragm?
T10
T/F? esophagus enters left hand side of stomach?
False. Right hand side
Is the entire esophagus in the thorax?
Nope. last half inch in abdomen
Describe the esophagogastric junction.
Z-line, abrupt change from esophageal stratified epithelium to stomach lining
what is the cervical narrowing of the oesophagus called?
oesophageal sphincter
What does the left main bronchus do to the esophagus?
extrinsically compresses it
Where does the cervical and thoracic reagions of esophagus drain it’s venous blood to?
Caval system
Two kinds of esophageal hernias are?
Paraesophageal hernia
Sliding hernia
what quadrant is the stomach in?
lefft upper quadrant
what shape is the stomach and name the two orifices:
‘J’ shaped
cardiac orifice (Right side)
pyloric orifice
Where is the fundus of the stomach?
above cardiac orifice
sits underneath left diaphragm
Can you see the fundus on x-ray?
usually yes, see the air bubble
curvatures of stomach are?
lesser
greater
What is the pyloric antrum?
funnel narrowing of stomach towards pyloric canal/lumen
What’s the reason behind having a pyloric sphincter?
allows slow release into duodenum
What does the lesser omentum attach?
liver to lesser curvature of stomach
what does greater omentum attach?
greater curvature of stomach to the spleen and lower area
4 main arteries to stomach?
R and L gastric
R and L gastroepiploic
How long and how many parts is the duodenum?
10 inches long
4 parts ‘C’-shaped
What part of the duodenum is retroperitoneal?
all but the first inch
How long are each of the 4 parts of the duodenum ?
First: 2-inches - duodenal cap
Second: 3-inches
Three: 4-inches
Four: 1-inch
Describe the 2nd part of the duodenum:
vertical next to head of pancreas/hilum of right kidney on psoas major
describe the path of the 3rd part of the duodenum
retroperitoneal from right to left psoas, crossing L3, IVC, and aorta
How is the 4th part of the duodenum attached to which psoas?
via fibrous tissue to left psoas
Where is the opening of the bile and pancreatic duct located?
2nd part of the duodenum, the descending portion: 1.5 inches down
What is a duodenal papilla? how many do we have?
Major: below: bile/pancreatic
Minor: above: accessory duct from pancreas
Where does the jejenum become the ileum?
No clear demarkation
How long is the small intestine?
4-6 metres long from Duodenal-jejunum flexure
% of small intestine is jejunum/ileum
jejunum: 40%
ileum: 60%
small intestine are retroperitoneal?
NOPE. INTRAperitoneal
What conducts the neurovasculature to the small intestine?
messentary
jejunum or ileum is thicker/larger lumen, more mucosal folds?
jejunum
in surgery, how can you tell if you are looking at jejunum?
less fat in mesentry
very few arterial arcades
many long vasa recta
in surgery, how can you tell if you are looking at ileum?
more fat in ileum
a lot of arterial arcades
shorter vasa recta
How long is the large intestine?
1.5 metres
large intestine longitudinal has 3 bands they are?
- three tenia coli
- Haustra (saculations)
- fat tags (epiploic appendices)
What is the cecum?
patch hanging down the ileal-cecal junction
Where is the appendix attached to?
posterolateral portion cecum where 3 tenia converge
how long is the appendix, how many % of people with pelvic vs. retrocecal?
7-10cm long
65% retrocecal
20% pelvic
What sides are the hepatic and splenic flexures of the large intestine on?
right side= hepatic flexure
left side = splenic flexure
what happens after the descending colon?
sigmoid colon
How and where is the mesocolon placed?
hang down in the pelvis
What happens at the rectosigmoid junction to teniae
they spread out and become longitudinal muscle layer
8 functions of the liver
- storage of energy sources
- production of cellular fuels
- plasma proteins and clotting factors
- metabolism of toxins and drugs
- modification of hormones
- bile acid production
- excretion of billirubin
- storage of iron and vitamins
what are the 2 surfaces of the liver?
diaphragmatic: smooth dome
visceral
what are you feeling when you feel an enlarged liver below the costal margin?
inferior margin of liver
what is the ligamentum teres of the liver?
remnants of umbilical vein
what is the falciform ligament
double folded peritoneum that connects liver to anterior abdo wall.
which liver lobe is bigger? L or R?
Right
4 lobes on visceral surface of liver, they are?
Quadrate
Caudate
Left
Right
Where is the gall bladder located?
between quadrate and right lobe
What is between the caudate and right lobe?
IVC
Where is the IVC located on the visceral liver?
between the caudate and right lobe
What was the ligamentum venosum?
was the ductus venous, a shunt to bypass blood in the liver.
Name the structures at the port hepatis
posterior: portal vein
middle: hepatic artery
anterior: hepatic bile duct
Nerve plexuses are too hidden
What runs in the free edge of the lesser omentum ?
portal vein
hepatic artery
bile duct
What’s the difference between hepatic veins and portal veins?
- hepatic veins drains directly into IVC, not part of hilum
2. portal vein brings products from GI system to process in liver
Describe the ducts from the liver to the common bile duct:
right and left hepatic duct form hepatic duct, then joined by cystic duct to become the common bile duct
trace the path of the common bile duct to where it empties halfway down the descending duodenum
along free edge of lesser omentum
behind first part of duodenum
behind head of pancreas
into papilla
3 parts of gall bladder are:
fundus
body
neck
2 parts of the cystic duct of gall bladder are:
spiral near neck of gallbladder
smooth after spiral part
What is the ampulla of Vater?
last part of the common bile duct as it attaches to papilla
Where is the spinster of oddi?
at the ampulla of Vater to control bile and pancreatic fluid release
mechanism of bile storage?
no digestion = contraction of sphincter of oddi, bile backs up the common bile duct into the gall bladder and chills there until needed.
Where is the anatomical landmark for the gallbladder on the external abdominal surface?
where right costal margin meets right line semilunaris
what kind of gland is the pancreas?
exocrine
endocrine
describe the exocrine functions of the pancreas
excretes into duct digestive enzymes: starches, fat, proteins and bicarbonate to neutralize stomach acid
describe the endocrine functions of the pancreas
into blood stream:
somatistatin
glucagon
insulin
4 parts of pancreas are:
Head
Neck
body
tail
Pancreas is intra or retroperitoneal?
retroperitoneal
Where does the tail of the pancreas lead to?
hilum of the spleen
What is the uncinate process of pancreas?
the lingula of head of pancreas
Where is the neck of the pancreas located?
deep to the pylorus of stomach
Where is the body of the pancreas located?
above the D-J flexure
The right hand side of the body of the pancreas passes over what structures?
aorta
IVC
vertebral column
What does the accessory duct of the pancreas drain, and into where?
drains head and neck of pancreas, into the minor papilla 1-inch proximal to the major papilla
Where is the spleen and how big is approximately?
left upper quadrant near left dome of diaphragm
‘fist’ sized
Superior margin of spleen is ALWAYS ______?
Notched.
Which ribs are the right side of the spleen close to? significance?
9,10,11
if fractures could rupture spleen = bad news
