Anatomy Overview 2 Flashcards
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
What might pain in the foregut be associated with?
Peptic ulcer
Gastric disease
Biliary / pancreatic disease
Hepatic disease
What might pain in the midgut be associated with?
Appendicitis
Small bowel obstruction
Proximal colon cancer
What might pain in the hindgut be associated with?
Large bowel obstruction
Diverticular disease
Carcinoma of colon
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
What are the different parts of the stomach?
Body, fundus, cardia, pyloric part (antrum and canal)
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
What composes the stomach bed?
Diaphragm, spleen, left kidney, adrenal gland, splenic artery, pancreas, transverse mesocolon and colon
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.
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
What composes the portal triad?
Hepatic artery
Portal vein
Bile duct
What is the function of the biliary ducts?
Carries bile from the liver to the gallbladder
How much bile can the gallbladder store?
50ml
What is the name given to the artery of the gallbladder?
Cystic artery
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
What is a biliary colic?
Gallbladder attack or gallstone attack, pain occurs due to a gallstone temporarily blocking the bile duct.
Where is the pain of a biliary colic felt?
Right hypochondrium and it can radiate to the shoulder
What are the exocrine and endocrine products of the pancreas?
Exocrine - pancreatic juice
Endocrine - Insulin and glucagon
What is the placement of the pancreas in respect to the peritoneum?
Retroperitoneal
What plane does the pancreas lie on?
The transpyloric plane (L1/L2)
What are the different parts of a pancreas?
Head, neck, body and tail
Where is the portal vein of the pancreas?
Behind the neck of the pancreas
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
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
- Pre-aortic (celiac, superior and inferior mesenteric nodes) – Drains organs supplied by the anterior branches of aorta
- Lateral aortic – Drains organs supplied by lateral aortic branches
- Retro-aortic – drains the posterior abdominal wall
Foregut structures – Celiac group
Midgut structures- Superior mesenteric group
Hindgut structures – Inferior mesenteric group
