Anatomy overview II Flashcards
How long is the oesophagus?
25cm?
What are the 3 constrictions of the oesophagus?
o Cervical (pharyngo- esophageal): – 15cm from incisor teeth (IT) o Thoracic (broncho – aortic): – crossed by arch of aorta (22.5 fromIT) and left main bronchus 27.5cm from IT) o Diaphragmatic: Where it passes through the oesophageal hiatus of the diaphragm- 40 cm from IT
How far from the incisor teeth is the cervical constriction of the oesophagus?
15cm
How far from the incisor teeth is the thoracic constriction of the oesophagus?
27.5cm
How far from the incisor teeth is the diaphragmatic constriction of the oesophagus?
40cm
What makes up the stomach bed?
Diaphragm, spleen, left kidney, adrenal gland, splenic artery, pancreas, transverse mesocolon and colon
Describe a vagotomy
Vagotomy is a surgical procedure that removes part of the vagus nerve that innervates the lower oesophagus and stomach, and therefore reduces the production of acid in stomach. This leaves the nerve of Laterjet in place to ensure the emptying function of the stomach remains intact.
What does the lesser omentum enclose?
The lesser omentum, enclosing the portal triad (portal vein, hepatic artery and bile duct), passes from the liver to the lesser curvature of the stomach and the first 2cm of the superior part of the duodenum
How many lobes does the liver have?
Right
Left
Caudate
Quadrate
What is the right sagittal fissure?
The right sagittal fissure is the continuous groove formed by the fossa for the gallbladder anteriorly and the groove for the IVC posteriorly
What is the left sagittal fissure?
The left sagittal fissure is the continuous groove formed anteriorly by the fissure for the round ligament and posteriorly by the fissure for the ligamentum venosum
What embryological feature becomes the round ligament of the liver?
The round ligament of the liver (L. ligamentum teres) is the remains of the umbilical vein
What embryological feature becomes the ligamentum venosum?
The ligamentum venosum is the fibrous remains of the foetal ductus venosus, which shunted blood from the umbilical vein to the IVC
How much bile can be stored in the gallbladder?
50ml
What artery supplies the gallbladder and where is it found?
Cystic artery
Lies in the triangle of calot (triangle between common hepatic duct, cystic duct and visceral surface of the liver)
Describe exocrine production by the pancreas
pancreatic juice
Describe endocrine production by the pancreas
insulin and glucagon
Where is the pancreas?
Lies along the transpyloric plane (L1/L2)
Where is the portal vein formed?
Behind the neck of the pancreas (L2)
Where is the spleen found?
- Located in the left hypochondrium
- Entirely covered by peritoneum except at the hilum
- Related to 9 to 11 ribs on the left side
What is the blood supply of the foregut?
Celiac trunk
Origin: Abdominal aorta (T12)
Main branches:
o Left gastric artery – runs along the lesser curvature of the stomach
o Hepatic artery – supply liver and gallbladder
o Splenic artery – Runs retroperitoneally along the superior (upper) margin of the pancreas
Where does the celiac trunk branch off the aorta?
T12
List some midgut structures
- Small intestine including most of duodenum
* The cecum, appendix, ascending colon, and the right half to two-thirds of the transverse colon
Which part of the duodenum receives bile and pancreatic secretions?
It’s second part receives bile and pancreatic duct secretions
What is the blood supply of the midgut?
Superior mesenteric artery
Where does the superior mesenteric artery branch off the aorta?
L1
List the branches of the superior mesenteric artery
Main branches: Jejunal and ileal arteries
Other branches: Middle colic, right colic and iliocoloic
List some hindgut structures
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
Describe the blood supply of the hind gut
Inferior mesenteric artery
Where does the inferior mesenteric artery branch off the aorta?
L3
How can you distinguish the large intestine from the small intestine?
Omental appedices – small, fatty, peritoneal like projections (yellow) of colon
Haustra or sacculations – pouches of the colon between the teniae
Teniae coli – Three thickened bands of smooth muscle (longitudinal layer)
Whats the most common position of the appendix?
Retrocecal
List the 3 branches of the inferior mesenteric artery
Left colic, sigmoid arteries and superior rectal artery
What is the terminal branch of the inferior mesenteric artery?
Superior rectal artery
At what level is the recto-sigmoid junction?
S3
What structures can be palpated in rectal examinations?
Structures palpated through rectum are: o 1) Male: Prostate and Seminal gland o 2) Female – Cervix In both the sexes: o Ischial spines & tuberosities o Enlarged internal iliac lymph nodes o Sacrum and coccyx o Collections in rectovesical (male) and rectouterine fossa (female)
Describe the parasympathetic innervation of the abdomen
o Vagus nerve (10th cranial nerve)
o Pelvic splanchnic nerves (S2,S3 & S4)
Describe the sympathetic innervation of the abdomen
o Abdominopelvic splanchnic nerves (greater – T5-T9, lesser-T10-T11 and least –T12)
o Preveretebral sympathetic ganglia
o Abdominal aortic plexus
Describe the formation of the portal vein?
By the union of splenic vein with the superior mesenteric vein
List 3 sites of porto-systemic anastomoses and their clinical significance
o Anorectal junction – Haemorrhoids or piles
o Gastroesophageal junction - esophageal varices
o Around the umbilicus – caput medusae
Describe lymphatic drainage of the abdomen
Lumbar nodes include 3 terminal groups
o Pre-aortic (celiac, superior and inferior mesenteric nodes) – Drains organs supplied by the anterior branches of aorta
o Lateral aortic – Drains organs supplied by lateral aortic branches
o Retro-aortic – drains the posterior abdominal wall
- Foregut structures – Celiac group
- Midgut structures- Superior mesenteric group
- Hindgut structures – Inferior mesenteric group
