Anatomy Overview 2 Flashcards
What is 1?
Right hypochondrium
What is 2?
Epigastrium
What is 3?
Left hypochondrium
What is 4?
Right lumbar
What is 5?
Periumbilical
What is 6?
Left lumbar
What is 7?
Right iliac fossa
What is 8?
Hypogastrium
What is 9?
Left lumbar
In this picture, what are the vertical and horizontal lines?
Vertical are midclavicular lines
Horizontal lines are subcostal plane (superior) and transpyloric plane (inferior)
What are some examples of foregut diseases?
Peptic ulcer
Gastric disease
Bilary disease
Pancreatic disease
Hepatic disease
What are some examples of midgut diseases?
Appendicitis
Small bowel obstruction
‘Proximal’ colon cancer
What are some examples of hindgut diseases?
Large bowel obstruction
Diverticular disease
Carcinoma of colon
Why do we divide the abdomen into 9 areas?
To localise pain to understand what disease/pathology is causing it
How long is the oesophagus?
25cm
How many constrictions does the oesophagus have?
3
What are the 3 constrictions of the oesophagus?
Cervical (pharyngo-oesophageal)
Thoracic (broncho-aortic) cross by arch of aorta and left main bronchus
Diaphragmatic where is passes through the oesophageal hiatus
How far is the cervical constriction of the oesophagus from the incisor teeth?
15cm
How far is the thoracic constriction of the oesophagus from the incisor teeth?
22.5cm and 27.5cm
How far is the diaphragmatic constriction of the oesophagus from the incisor teeth?
40cm
Why is awareness of the 3 oesophagus constrictions important?
For passing instruments through the oesophagus into the stomach
What are the different parts of the stomach?
Cardia
Fundus
Body
Pyloric
What are the 2 curvatures of the stomach?
Greater curvature
Lesser curvature
What is the purpose of the pyloric sphincter?
Control discharge of stomach contents into the duodenum
What is the stomach bed formed by?
Diaphragm, spleen, left kidney, adrenal gland, splenic artery, pancreas, transverse mesocolon and colon
What are some examples of clinical stomach issues?
Congenital pyloric stenosis
Carcinoma of the stomach
Gastric ulcers and vagotomy
What is congenital pyloric stenosis?
Thickening of the smooth muscle in the pyloris
Where does the liver lie relative to the ribs?
Deep to ribs 7 to 11 on the right side
What is the portal triad?
Distinctive component of a hepatic lobule found rubbing along each of the lobules corners that consists of branches of the hepatic artery, hepatic portal vein and bile ducts
What is the portal triad formed from?
Hepatic artery
Hepatic portal vein
Bile ducts
What do bilary ducts carry?
Bile from the liver to the gallbladder
Where is bile produced?
Liver
Where is bile stored?
Stored and concentrated in the gallbladder
What is the artery of the gallbladder?
Cystic artery
Where does the cystic artery lie?
In the triangle of calot
What is the pancreas?
Accessory digestive gland
What kind of gland is the pancreas?
Both exocrine and endocrine
What does the exocrine pancreas produce?
Pancreatic juice
What does the endocrine pancreas produce?
Insulin and glucagon
What are the different parts of the pancreas?
Head
Neck
Body
Tail
Where is the portal vein formed relative to the pancreas?
Behind the neck of the pancreas
What is the spleen?
Mobile haemo-lymphoid organ located in the left hypochondrium
What is the spleen covered by?
Completely covered by peritoneum except for the hilium
Where is the spleen relative to the ribs?
Related to ribs 9 to 11 on the left side
What is the most frequently injured abdominal organ?
Spleen
What is a typical disease of the spleen?
Splenomegaly due to anaemia or typhoid fever
What supplies blood to the foregut?
Celiac trunk
Where does the celiac trunk originate?
Abdominal aorta (level T12)
What are the main branches of the celiac trunk?
Left gastric artery
Hepatic artery
Splenic artery
What are some examples of midgut structures?
Small intestine including most of duodenum
Cecum
Appendix
Ascending colon
Right half to 2/3rds of the transverse colon
What is the duodenum?
Shortest, widest and most fixed part of the small intestine
What recieves secretions from the bile and pancreatic duct?
2nd part of duodenum
Explain the differences between the jejunum and the ileum?
Explain differences in colour of the jejunum and ileum?
Jejunum is deeper red
Ileum is pale pink
Explain the differences in the wall of the jejunum and ileum?
Jejunum is thick and heavy
Ileum is thin and light
Explain the differences in the vascularity of the jejunum and ileum?
Jejunum is greater
Ileum is less
Explain the difference in the vasa recta of the jejunum and ileum?
Jejunum is long
Ileum is short
Explain the difference in the arcades of the jejunum and ileum?
Jejunum has a few large loops
Ileum has many short loops
Explain the difference in the lymphoid nodules of the jejunum and ileum?
Jejunum has a few
Ileum has many
Explain the difference in the fat in the mesentery of the jejunum and ileum?
Jejunum has less
Ileum has more
What supplies blood to the midgut?
Superior mesenteric artery
What is the origin of the superior mesenteric artery?
Abdominal aorta (level L1)
What is the superior mesenteric artery crossed by anteriorly?
Splenic vein and neck of pancreas
What are some branches of the superior mesenteric artery?
Jejunal (main)
Ileal (main)
Middle colic
Right colic
Iliocolic
What are some hindgut structures?
Left one third of transverse colon
Descending colon
Sigmoid colon
Rectum
Upper part of anal canal
also includes epithelium of the urinary bladder and most of the urethra
What artery supplies the hindgut?
Inferior mesenteric artery
How can the large intestine be distinguished from the small intestine?
Omental appendices
Haustra or saculations
Teniae coli
What are omental appendices?
Small, fatty, peritoneal like projections
What are teniae coli?
Thickened bands of smooth muscle
What is haustra?
Small pouches caused by sacculation
What is the appendix?
Blind intestinal diverticulum with masses of lymphatic tissue
How can the appendix change from one person to the next?
The position of it is variable
What is the most common position of the appendix?
Retrocecal
What is the site of maximum tenderness in acute appendicitis called?
Macburney’s point
Where does the inferior mesenteric artery originate?
Abdominal aorta (level L3)
What are the branches of the inferior mesenteric artery?
Left colic
Sigmoid arteries
Superior rectal artery
What is the terminal branch of the inferior mesenteric artery?
Superior rectal artery
What is the pelvis part of the gut tube?
Rectum
Where is the rectum found?
At the retro-sigmoid junction, anterior to vertebrae S3
What sphincters does the anal canal contain?
External anal sphincter (voluntary)
Internal anal sphincter (involuntary)
What structures are palpated in a rectal examination for men?
Prostate and seminal gland
Collections in retrovesical fossa
Ischial spines and tuberosites
Enlarged internal iliac lymph nodes, swelling in the ischipinal fossa
Sacram and coccyx
What structures are palpated in a rectal examination for females?
Cervix
Rectouterine fossa
Ischial spines and tuberosites
Enlarged internal iliac lymph nodes, swelling in the ischipinal fossa
Sacram and coccyx
What gives the parasympathetic innervation to abdominal organs?
Vagas nerve (cranial nerve 10) for foregut and midgut
Pelciv splanchnic nerves (S2-S4) for hindgut
What cranial nerve is the vagus nerve?
10th cranial nerve
Where do the pelvic splanchnic nerve originate?
S2 to S4
What sympathetic nerves innervate the abdominal organs?
Abdominopelvic splanchnic nerves (greater T5-T9, lesser T10-T11 and least T12)
Abdominal aortic plexus
Where do the sympathetic nerves that innervate abdominal organs originate?
T5-L2/L3
What are the vertebrae levels of the greater abdominopelvic splanchnic nerves?
T5-T9
What are the vertebrae levels of the lesser abdominopelvic splanchnic nerves?
T10-T11
What are the vertebrae levels of the least abdominopelvic splanchnic nerves?
T12
What is venous drainage of the gut done by?
Portal vein
Where does the portal vein travel blood from and to?
From the GI tract including the spleen, pancreas and gallbladder to the liver
What is the portal vein formed by?
Union of the splenic vein and the supeior mesenteric vein
Where is the portal vein found?
Behind neck of pancreas (L2)
What are some sites of porto-systemic anastomoses?
Anarectal junction
Gastroesophageal junction
Around the umbilicus
What major vessel drains lymph from the abdomen?
Thoracic duct
What do lymphatic vessel run along?
Corresponding arteries
Where do lymphatic nodes form groups?
Around their major arteries and abdominal aorta
What are the 3 terminal groups of lymphatic lymph nodes?
Pre-aortic
Lateral aortic
Retro-aortic
What are examples of pre-aortic lymph nodes?
Celiac nodes
Superior mesenteric nodes
Inferior mesenteric nodes
What do pre-aortic lymph nodes drain?
Organs supplied by anterior branches of aorta
What do lateral aortic nodes drain?
Organs supplied by lateral aortic branches
What do retro-aortic nodes drain?
Posteror abdominal wall
What lymph nodes are foregut structures drained by?
Celiac group
What lymph nodes are midgut structures drained by?
Superior mesenteric group
What lymph nodes are hindgut structures drained by?
Inferior mesenteric group
Why is knowledge of lymphatic drainage essential?
To understand the spread of cancer
