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Semester 4: Nutrition and Metabolism > Anatomy Topic 4 Case 2 > Flashcards

Anatomy Topic 4 Case 2 Flashcards

1
Q

What is the peritoneum?

A
  • Membrane that lines the abdominal cavity and covers much of the viscera
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2
Q

Identify the two layers of peritoneum

A
  • Parietal peritoneum lines the walls of the abdominal cavity
  • Visceral peritoneum covers the organs
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3
Q

How are abdominal viscera suspended in the peritoneal cavity?

A
  • Mesenteries
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4
Q

What is the difference between intraperitoneal and extraperitoneal organs?

A
  • Intraperitoneal organs are located within the peritoneal cavity
  • Retroperitoneal organs are located outside of the peritoneum with only one surface in contact with the peritoneum
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5
Q

What is the greater sac and where does it extent between?

A
  • Largest space in peritoneal cavity, deep to parietal peritoneum
  • Beginning superiorly at the diaphragm and continuing inferiorly into the pelvic cavity
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6
Q

What is the omental bursa and where is it located?

A
  • Smaller subdivision of the peritoneal cavity

- Located posterior to the stomach and liver

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7
Q

How is the omental bursa continuous with the greater sac?

A
  • Through the omental foramen
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8
Q

Identify the structures surrounding the omental foramen

A
  • Portal vein and hepatic artery proper
  • Bile duct anteriorly
  • Inferior vena cave posteriorly
  • Caudate lobe of the liver superiorly
  • First part of the duodenum inferiorly
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9
Q

What is the purpose of peritoneal fluid in the peritoneal cavity?

A
  • Lubricates movement of the viscera suspended in the abdominal cavity
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10
Q

Identify an advantage and a disadvantage of the large surface area of the peritoneal cavity

A
  • Can be used for administering certain types of treatments and a number of procedures e.g. ventriculoperitoneal shunts for obstructive hydrocephalus.
  • Facilitates the spread of disease through the peritoneal cavity and over the bowel and visceral surfaces.
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11
Q

Identify three types of peritoneal folds

A
  • Omenta
  • Mesenteries
  • Ligaments
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12
Q

Identify two roles of peritoneal folds

A
  • Contain nerves and vessels

- Maintain proper positioning of viscera

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13
Q

What is the embryological origin of the greater omentum?

A
  • Dorsal mesentery
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14
Q

What are the attachments of the greater omentum?

A
  • Greater curvature of the stomach and first part of the duodenum.
  • After descending it turns posteriorly and ascends
  • Where it becomes adherent to superior surface of transverse colon
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15
Q

Which vessels are positioned between the two layers of the greater omentum?

A
  • Right and left gastro-omental vessels
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16
Q

What does thickening of the greater omentum indicate?

A
  • Metastasis
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17
Q

What is the embryological origin of the lesser omentum?

A
  • Ventral mesentery
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18
Q

What are the attachments of the lesser omentum?

A
  • Lesser curvature of stomach
  • First part of duodenum,
  • inferior surface of liver
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19
Q

Identify the two ligaments of the lesser omentum

A
  • Hepatogastric ligament between liver and stomach

- Hepatoduodenal ligament between liver and duodenum

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20
Q

What is the anatomical significance of the hepatoduodenal ligament?

A
  • Ends laterally as a free margin

- Which serves as the anterior border of the omental foramen

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21
Q

What is enclosed within the free edge of the hepatoduodenal ligament?

A
  • Hepatic artery proper
  • Bile duct
  • Portal vein
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22
Q

What are mesenteries?

A
  • Peritoneal folds that attach viscera to the posterior abdominal wall
  • That allow some movement and provide a conduit of vessels, nerves and lymphatics
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23
Q

Identify the embryological origin of the mesenteries?

A
  • Dorsal mesentery
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24
Q

What is the mesentery?

A
  • Large, fan shaped, double-layered fold of peritoneum

- That connects the jejunum and ileum to posterior abdominal wall

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25
Q

What is are the superior and inferior attachments of the mesentery?

A
  • Superior: duodenojejunal junction

- Inferior: Ileocecal junction

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26
Q

What is the transverse mesocolon?

A
  • Double layered fold of peritoneum that connects the transverse colon to the posterior abdominal wall
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27
Q

What is the anterior layer of the transverse mesocolon adherent to?

A
  • Posterior layer of greater omentum
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28
Q

What is the sigmoid mesocolon?

A
  • V-shaped peritoneal fold
  • That attaches the sigmoid colon to the abdominal wall
  • Wit the apex of the V near the left common iliac artery
  • Left limb along the medial border of the left psoas muscle
  • Right limb descending into pelvis at level L3
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29
Q

What are ligaments?

A
  • Two layers of peritoneum that connect two organs to each other or an organ to the body wall
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30
Q

Identify the four parts of the stomach

A
  • Cardia
  • Fundus
  • Body
  • Pyloric part
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31
Q

Identify the different parts of the pyloric part of the stomach

A
  • Pyloric antrum
  • Pyloric canal
  • Pylorus
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32
Q

Identify the different parts of the pylorus

A
  • Pyloric constriction
  • Pyloric sphincter
  • Pyloric orifice
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33
Q

At which vertebral level is the pylroic orifice located?

A
  • Lower border of L1 (transpyloric plane)
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34
Q

Identify which artery the left gastric artery arises from and the part of the stomach that it supplies

A
  • Branches from coeliac trunk

- Lower third of oesophagus + upper right part of stomach

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35
Q

Identify which artery the right gastric artery arises from and the part of the stomach that it supplies

A
  • Hepatic artery proper

- Lower right part of stomach

36
Q

Identify which artery the short gastric arteries arises from and the part of the stomach that it supplies

A
  • Splenic artery

- Fundus

37
Q

Identify which artery the left gastro-omental artery arises from and the part of the stomach that it supplies

A
  • Splenic artery

- Upper part of greater curvature

38
Q

Identify which artery the right gastro-omental artery arises from and the part of the stomach that it supplies

A
  • Gastroduodenal branch of hepatic artery proper

- Lower part of greater curvature

39
Q

Which vessel do the left and right gastric veins drain into?

A
  • Directly into portal vein
40
Q

Which vessel do the short gastric veins drain into?

A
  • Splenic vein
41
Q

Which vessel do the left-gastro-omental veins drain into?

A
  • Splenic vein
42
Q

Which vessel do the right-gastro-omental veins drain into?

A
  • Superior mesenteric vein
43
Q

Outline the lymphatic drainage of the stomach

A
  • Left and right gastric nodes
  • Left and right gastro-omental nodes
  • Short gastric nodes
  • Into coeliac nodes around the root of the coeliac artery on the posterior abdominal wall
44
Q

Outline the parasympathetic nerve supply to the stomach

A
  • Anterior and posterior vagal trunks
  • Anterior vagal trunk gives off a large pyloric branch
  • Posterior vagal trunk passes to coeliac and superior mesenteric plexuses
45
Q

Outline the sympathetic nerve supply to the stomach

A
  • Preganglionic fibre from T6
  • Passes through white ramus communicans into sympathetic trunk
  • Synapses with coeliac ganglion
  • Gives off postganglionic neuron which accompanies branches of coeliac trunk to supply stomach
46
Q

Identify the histological layers of the stomach

A
  • Mucosa composed of gastric pits
  • Muscularis mucosae
  • Submucosa
  • Inner oblique muscle layer
  • Inner circular layer
  • Outer longitudinal layer
47
Q

Identify five types of cells of gastric glands and their function

A
  • Neck mucus cells, secrete mucus
  • Parietal cells, secrete gastric acid and intrinsic factor
  • Chief cells, secrete pepsinogen
  • Stem cells, replace old cells
  • Neuroendocrine cells, secrete hormones (e.g. G cells that secrete gastrin)
48
Q

Identify the structure of a gastric parietal cell

A
  • Plasma membrane forms canaliculi that extent throughout the cytoplasm
  • Which consists of membrane bound vesicles which include a proton pump
49
Q

Identify the mucosal transition at the pyloric sphincter

A
  • From glandular secretory type

- To villous absorptive type

50
Q

What are Brunner’s glands?

A
  • Mucus-secreting glands
  • Located exclusively in submucosa of duodenum
  • Secrete a thin, alkaline mucus
51
Q

Identify the three anterior branches of the abdominal aorta and the region of the primitive gut tube that each supplies

A
  • Coeliac trunk (foregut)
  • Superior mesenteric artery (midgut)
  • Inferior mesenteric artery (hindgut)
52
Q

Identify the contents of the foregut

A
  • Abdominal oesophagus
  • Stomach
  • Spleen
  • Duodenum
  • Liver
  • Gallbladder
53
Q

Identify the contents of the midgut

A
  • Jejunum
  • Ileum
  • Cecum
  • Appendix
  • Ascending colon
  • Right 2/3 of transverse colon
54
Q

Identify the contents of the hindgut

A
  • Left 1/3 of transverse colon
  • Descending colon
  • Sigmoid colon
  • Rectum
  • Upper part of anal canal
55
Q

Identify the three branches of the coeliac trunk

A
  • Left gastric artery
  • Splenic artery
  • Common hepatic artery
56
Q

Outline the course taken by the left gastric artery and identify its branches

A
  • Ascends to the cardioesophageal junction
  • Sends oesophageal branches to the abdominal oesophagus which anastomose with oesophageal branches of thoracic aorta
  • Turns right and descends along lesser curvature to anastomose with right gastric artery
57
Q

Outline the course taken by the splenic artery and identify its branches

A
  • Travels along superior border of pancreas
  • Gives off branches to supply neck, body and tail of pancreas
  • Passes in splenorenal ligament and enters hilum of spleen
  • Gives off short gastric artery and left gastro-omental artery which anastomoses with right gastro-omental artery
58
Q

Outline the course taken by the common hepatic artery and identify its branches

A
  • Runs to the right and divides into hepatic artery proper and gastroduodenal artery
59
Q

Outline the course of the hepatic artery proper and identify its branches

A
  • Ascends toward liver in free edge of lesser omentum
  • Runs to left of bile duct and anterior to portal vein
  • Divides into right and left hepatic artery
  • Right hepatic artery gives of cystic artery
60
Q

Outline the course of the gastroduodenal artery and identify its branches

A
  • Gives off supraduodenal artery and posterior superior pancreaticoduodenal artery
  • Descends posterior to superior part of duodenum
  • Gives off its terminal branches, right gastro-omental and anterior superior pancreaticoduodenal artery
61
Q

Which veins unite to form the portal vein? At which vertebral level does this occur?

A
  • Splenic vein and superior mesenteric vein

- L2

62
Q

Outline the course of the portal vein

A
  • Ascends towards liver
  • Enters the right margin of the lesser omentum
  • Divides into right and left branches which enter liver parenchyma
63
Q

Identify three tributaries of the portal vein and what they drain

A
  • Right and left gastric veins (draining lesser curvature and abdominal oesophagus)
  • Cystic veins (draining gallbladder)
  • Para-umbilical vein (anterior abdominal wall)
64
Q

Outline the course of the splenic vein

A
  • Leaves hilum of spleen
  • Passes right through splenorenal ligament
  • Passes over pan
  • Joins superior mesenteric vein to form portal vein
65
Q

Identify four tributaries of the splenic vein and what they drain

A
  • Short gastric veins (fundus)
  • Left gastro-omental vein (greater curvature)
  • Pancreatic veins (body and tail of pancreas)
  • Inferior mesenteric vein
66
Q

What do the coeliac nodes drain into?

A
  • Cisterna chyli
67
Q

What are the sympathetic trunks

A
  • Two parallel nerve cords that descend on either side of the vertebral column
68
Q

Describe the positioning of the sympathetic trunks as they descend through the thorax and abdomen

A
  • Posterior to carotid sheath
  • Anterior to neck of ribs in upper thorax
  • Lateral aspect of vertebral bodies in lower thorax
  • Anterolateral to lumbar bodies continuing into pelvis
69
Q

How many of the each of the different types of ganglia are there in the sympathetic trunks?

A
  • 3 cervical
  • 11 thoracic
  • 4 lumbar
  • 4 sacral
  • Ganglion impar anterior to coccyx
70
Q

How are the ganglia and trunk connected to adjacent spinal nerves?

A
  • Grey rami communicantes
71
Q

How are the ganglia and trunk connected in the region of T1-L2?

A
  • White rami communicantes
72
Q

What are splanchnic nerves?

A
  • Pass from sympathetic trunk

- To sympathetic ganglia

73
Q

Identify the three types of thoracic splanchnic nerve, from where they arise and to which ganglion they travel to

A
  • Greater: 5-9th thoracic ganglia to coeliac ganglion
  • Lesser: 10-11th thoracic ganglia to aorticorenal ganglion
  • Least: 12th thoracic ganglia to renal plexus
74
Q

To which nerve plexus do lumbar splanchnic nerves pass to?

A
  • Prevertebral plexus
75
Q

To which nerve plexus do pelvic splanchnic nerves pass to?

A
  • Inferior hypogastric plexus (extension of prevertebral plexus in pelvis)
76
Q

Why are pelvic splanchnic nerves unique?

A
  • They carry parasympathetic fibres
  • Meaning they do not originate from sympathetic trunk
  • Rather, they arise from anterior rami of S2 to S4
77
Q

What do the pelvic splanchnic nerves innervate?

A
  • Distal 1/3 of transverse colon
  • Descending colon
  • Sigmoid colon
78
Q

What is the abdominal prevertebral plexus?

A
  • Collection of nerve fibres that surrounds the abdominal aorta
79
Q

Identify the three major divisions of the abdominal prevertebral plexus

A
  • Coeliac plexus
  • Aortic plexus
  • Superior hypogastric plexus
80
Q

Identify the ganglia associated with the coeliac plexus

A
  • Two coeliac ganglia
  • One superior mesenteric ganglion
  • Two aorticorenal ganglia
81
Q

Identify the ganglia associated with the aortic plexus

A
  • Inferior mesenteric ganglion
82
Q

Identify the ganglia associated with the superior hypogastric plexus

A
  • Numerous small ganglia
83
Q

Identify fibres to the abdominal prevertebral plexus

A
  • Preganglionic parasympathetic fibres from vagus nerve

- Preganglionic sympathetic fibres from splanchnic nerves

84
Q

Identify two sources of parasympathetic innervation to the abdominal viscera

A
  • Vagus nerves which give off vagal trunks which give off branches containing preganglionic parasympathetic fibres to prevertebral plexus
  • Pelvic splanchnic nerves, carrying preganglionic parasympathetic fibres from S2-S4 to hypogastric plexus
85
Q

Identify two two plexuses of the enteric nervous system, where they are located and what they control

A
  • Myenteric plexus between outer longitudinal and inner muscular layers, controlling GI movements
  • Submucosal plexus in submucosa controlling GI secretions and local blood flow
86
Q

Which regions of the abdomen is the stomach located in?

A
  • Left hypochdonrium
  • Epigastric region
  • Umbilical region

Semester 4: Nutrition and Metabolism (17 decks)

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