Anatomy Of The Abdomen And Pelvis

Question 1

What is the foregut made up of?

Answer 1

Distal 3rd of the oesophagus to the 2nd part of the duodenum at entrance of the bile duct (major duodenal papilla)

Question 2

What is the midgut made up of?

Answer 2

2nd part of the duodenum to two thirds along the transverse colon

Question 3

What is the hindgut made up of?

Answer 3

Distal third of the transverse colon to the rectum

Question 4

What does intraperitoneal mean and give an example of such a structure?

Answer 4

They are organs that are almost completely covered by the visceral peritoneum. These are structures that may be suspended form the abdominal wall by mesenteries. E.g. Most of the small intestine.

Question 5

What does retroperitoneal mean and give and example of such a structure?

Answer 5

Structures that lie between the parietal peritoneum and abdominal wall. E.g. Kidneys and great vessels

Question 6

Describe innervation of the gut consider both sympathetic and parasympathetic components.

Answer 6

Abdominal viscera supplied by autonomic system. Parasympathetic sensory comes from vagus nerve and pelvic splanchnic nerves (S2-S4) Sympathetic sensory mediates pain and occurs via thoracic splanchnic (T5-T12) and lumbar splanchnic (L1+L2)

Question 7

What vessel supplies the foregut, liver, pancreas and spleen?

Answer 7

Coeliac trunk

Question 8

What vessel supplies the midgut?

Answer 8

Superior mesenteric artery

Question 9

What vessel supplies the hindgut?

Answer 9

Inferior mesenteric artery

Question 10

How is the liver connected to the anterior abdominal wall?

Answer 10

Falciform ligament

Question 11

What connects the stomach and the liver?

Answer 11

The lesser omentum

Question 12

What divides the liver into right and left lobe (diaphragmatic surface)?

Answer 12

Ligamentum terres

Question 13

What divides the liver into left and right functional lobes?

Answer 13

Gall bladder and inferior vena cava

Question 14

What major venous vessels join to form the hepatic portal vein?

Answer 14

Superior mesenteric vein, inferior mesenteric vein and splenic vein

Question 15

What artery supplies the liver?

Answer 15

The common hepatic artery which branches from the coeliac axis

Question 16

How does venous blood from the liver drain to reach heart?

Answer 16

Drains into inferior vena cava via 3 short hepatic veins

Question 17

Why are anastomoses between systemic and portal system important?

Answer 17

If there is raised pressure in the portal system (e.g. Caused by tumour) blood is shunted into the systemic system. This is sufficient to a point, but can cause problems because the vessel walls are thin so varisces (swellings) may form. These may burst leading to haemorrhage

Question 18

Where does the spleen lie? What is it?

Answer 18

Lies posterior love you on the left side under ribs 9-11 and is suspended in dorsal foregut mesentery.

it is the largest lymphoid organ in the body

Question 19

What systemic and portal vessels are involved in the abdominal anastomoses shown below as A,B,C and D?

Answer 19

A: systemic = oesophageal vein, portal = left gastric vein

B: systemic = inferior rectal vein, portal =

Question 20

What are the retro-peritoneal structures?

Answer 20

Organs are retroperitoneal if they only have

Question 21

What is a secondary retroperitoneal organ?

Answer 21

these organs originally developed with a mesentery, then became secondary retroperitoneal organs when the

Question 22

What are primary retroperitoneal organs?

Answer 22

• Abdominal aorta and its branches
• inferior vena cava and its tributaries
• kidneys and ureters
• adrenal glands
• Nerves (lumbar plexus and sympathetic trunk)

Question 23

How do the renal veins and arteries compare from left and right kidney? Where do the veins lie in comparison to the arteries?

Answer 23

veins are anterior to arteiries

The left kidney has a longer renal vein as the IVC is on the right side

the right kidney has a longer renal artery as the abdominal aorta is further to the left

Question 24

Where do the left and right kidney lie?

Question 25

What visceral relations does the left kidney have?

Answer 25

• adrenal gland on the top of kidney
• Ascending colon and stomach
• spleen
• Tail of pancreas
• coils of small intestine

Question 26

What visceral relations does the right kidney have?

Answer 26

• adrenal gland
• liver
• 2nd part of the duodenum
• some twists of small intestine but less so than seen on left kidney

Question 27

The inginal ligament is formed by the aponeurosis of which muscle?

Answer 27

external oblique

Question 28

What is the approximate male:femal ratio of inguinal hernias?

Answer 28

9:1

Question 29

What is the most common cause of indirect inguinal hernnias, which are normall found in younger adults and children?

Answer 29

slack deep ring or patent prosessus vaginalis

Question 30

What forms the posterior, anterior, roof and floor of the inguinal canal?

Answer 30

floor: inguinal ligament

anterior surface: exteranl oblique aponeurosis and internal oblique

posterior surface: transversalis fascia and conjoint tendon

roof: internal oblique

Question 31

Through what structures does bile flow through from liver to duodenum?

Answer 31

right and left hepatic duct → common hepatic duct → bile duct → major papilla → 2nd part of duodenum

Question 32

At what level does the aorta bifurcate?

Answer 32

L4

Question 33

The greater splanchic nerve comprises of nerves originating from which sympathetic ganglion?

Answer 33

T5-T9

Question 34

sympathetic innervation of the abdomen and pelvi comes from nerves orginating at what spinal level?

Answer 34

T5-L2

Question 35

The initial pain from appenicitis would be in which abdmoinal region?

Answer 35

umbilical

Question 36

In which abdominal region is the pain felt when the inflammation of the appendix has spread to include the parietal peritoneum?

Answer 36

right inguinal

Question 37

Which ligament contains the uterine tubes and arteries and joins the uterus to the pelvic wall?

Answer 37

broad ligament