Anatomy Overview 2 Flashcards by Jam E

What are the following zones of the abdomen?

Right hypochondrium

Epigastrium

Left hypo chondrium

Right Lumbar

Periumbilical

Left Lumbar

Right Iliac Fossa

Hypogastrium

Left Iliac Fossa

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What might pain in the foregut be associated with?

Peptic ulcer

Gastric disease

Biliary / pancreatic disease

Hepatic disease

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What might pain in the midgut be associated with?

Appendicitis

Small bowel obstruction

Proximal colon cancer

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What might pain in the hindgut be associated with?

Large bowel obstruction

Diverticular disease

Carcinoma of colon

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What are the three constrictions of the oesophagus?

Cervical (15 cm from incisor teeth)

Thoracic - crossed by arch of aorta and left main bronchus

Diaphragmatic - Where it passes through the oesophageal hiatus of the diaphragm

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What are the different parts of the stomach?

Body, fundus, cardia, pyloric part (antrum and canal)

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What is the name of the sphincter at the distal end of the stomach, and what is its function?

Pyloric sphincter, control of discharge of stomach contents into the duodenum

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What composes the stomach bed?

Diaphragm, spleen, left kidney, adrenal gland, splenic artery, pancreas, transverse mesocolon and colon

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What are some of the clinical scenarios associated with the stomach?

Congenital pyloric stenosis, carcinoma of the stomach, gastric ulcers and vagotomy (this is the cutting one or more branches of the vagus nerve, this has the effect of reducing the rate of gastric secretion.

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How does the liver lie in comparison to the ribs on the right hand side of the body?

Lies deep to ribs 7-11 on the right side

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What composes the portal triad?

Hepatic artery

Portal vein

Bile duct

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What is the function of the biliary ducts?

Carries bile from the liver to the gallbladder

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How much bile can the gallbladder store?

50ml

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What is the name given to the artery of the gallbladder?

Cystic artery

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Where is the cystic artery found?

In the triangle of calot, triangle between the common hepatic duct, cystic duct and the visceral surface of the liver

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What is a biliary colic?

Gallbladder attack or gallstone attack, pain occurs due to a gallstone temporarily blocking the bile duct.

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Where is the pain of a biliary colic felt?

Right hypochondrium and it can radiate to the shoulder

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What are the exocrine and endocrine products of the pancreas?

Exocrine - pancreatic juice

Endocrine - Insulin and glucagon

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What is the placement of the pancreas in respect to the peritoneum?

Retroperitoneal

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What plane does the pancreas lie on?

The transpyloric plane (L1/L2)

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What are the different parts of a pancreas?

Head, neck, body and tail

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Where is the portal vein of the pancreas?

Behind the neck of the pancreas

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Where is the spleen located?

Left hypochondrium

Which part of the spleen is covered by the peritoneum?

All of the spleen minus the hilum

Which ribs is the spleen located next to?

Ribs 9 to 11

What are some of the causes of splenomegaly?

Anaemia, typhoid fever

What is the blood supply of the foregut?

The celiac trunk

What are the main branches of the celiac trunk?

The left gastric artery Hepatic artery Splenic artery

What are the midgut structures

* Small intestine including most of duodenum * The cecum, appendix, ascending colon, and the right half to two-thirds of the transverse colon

What does the secnd part of the duodenum receive?

Bile and the pancreatic duct

Where do duodenal ulcers normally occur?

In the first part of the duodenum

Fill in the blanks

What is the blood supply for the midgut?

The Superior mesenteric artery

What is the origin of the superior mesenteric artery?

Branch of abdominal aorta

What does the hindgut contain?

* Left one-third of transverse colon, descending colon, sigmoid colon, rectum and upper part of anal canal * Epithelium of the urinary bladder and most of the urethra

What is the artery of the hindgut?

The inferior mesenteric artery

How can the large intestine be distinguidshed form the small intestine?

* Omental appendices – small pouches of the peritoneum filled with fat and situated along the colon * Haustra or sacculations (small pouches) - responsible for the segmented appearance of the colon * Teniae coli – Thickened bands of smooth muscle (longitudinal layer)

What is the appendix?

Blind intestinal diverticulum with masses of lymphatic tissue

What is the most common position of the appendix?

Retrocecal

What is meant by Macburney's point?

The site of maximum tenderness in acute appendicities

What is the origin of the inferior mesenteric artery?

Anterior branch of the abdominal aorta (L3)

What are the main branches of the superior mesenteric artery?

Jejunal and ileal arteries

What are the main branches of the inferior mesenteric artery?

Left colic, sigmoid arteries, superior rectal (this is the terminal branch)

Where is the rectosigmoid junction?

Anterior to S3 vertebra

What sphincters exist in the anal canal?

External and internal

What structures can be palpated through the rectum?

1) Male: Prostate & Seminal gland 2) Female – Cervix

What is responsible for parasympathetic innervation of abdominal organs?

* Vagus nerve (10th cranial nerve) * Pelvic splanchnic nerves (S2,S3 & S4)

What is responsible for sympathetic innervation of abdominal organs?

**T5 to L2/3** •Abdominopelvic splanchnic nerves (greater – T5-T9, lesser-T10-T11 and least –T12) * Preveretebral sympathetic ganglia * Abdominal aortic plexus

What is the function of the portal vein?

It collects poorly oxygenated but nutrient rich blood from the abdominal part of GI tract, including the spleen, pancreas, and gall bladder and carries it to liver

How is the portal vein formed?

By the union of the splenic vein with the superior mesenteric vein

Where is the portal vein found?

Behind the neck of the pancreas (L2 vertebral level)

What are portocaval shunts?

Venous enlargements during portal obstruction

What are the common sites for portocaval shunts?

Anorectal junction - Haemorrhoids or piles ## Footnote Gastroesophageal junction - Esophageal varices Around the umbilicus - Caput medusae

Describe the lymphatic drainage of the GI tract

* Thoracic duct receives most of the lymph from abdominal wall and abdominal organs * Lymphatic vessels run with their corresponding arteries * Lymphatic nodes form groups around the major arteries and abdominal aorta

What are the three lumbar nodes?

3 terminal groups exist 1. Pre-aortic (_celiac_, _superior and inferior mesenteric_ nodes) – Drains organs supplied by the anterior branches of aorta 2. Lateral aortic – Drains organs supplied by lateral aortic branches 3. Retro-aortic – drains the posterior abdominal wall Foregut structures – Celiac group Midgut structures- Superior mesenteric group Hindgut structures – Inferior mesenteric group