Block 2: Abdomen, Gray's Text Flashcards
1
Q
Inferior thoracic aperture f(x)
A
forms the superior opening to the abdomen; is closed by the diaphragm
2
Q
What 2 ways can the abdominal viscera be presented?
A
- suspended in the peritoneal cavity by mesentery
2. positioned b/w the cavity & the musculoskeletal wall
3
Q
List the components of the abdominal viscera
A
- major elements of GI system
- spleen
- components of the urinary system
- suprarenal glands
- major neurovascular structures
4
Q
What are the major GI elements included in the abdomen?
A
- caudal end of esophagus
- stomach
- small & large intestine 4. liver
- pancreas
- gallbladder
5
Q
What components of the urinary system are included in the abdomen?
A
kidneys and ureters
6
Q
What are the major functions of the abdomen? (3)
A
- house & protect major viscera
- assist in breathing
- changes in intraabdominal presssure
7
Q
How does the abdomen protect visera?
A
2 ways
- situating organs under the dome of the diaphragm
- protection by muscular walls of the abdomen
8
Q
How does the abdomen assist in breathing?
A
inspiratin: relaxes to accommodate thoracic cavity expansion & inferior displacement of viscera during diaphragm contraction
2. during expiration, it contracts to assist in elevating diaphragm domes (reducing thoracic volume)
9
Q
General organization of the abdominal cavity
A
a central GI system suspended form the posterior & anterior wall by mesentaries
10
Q
What are the types of abdominal mesentaries
A
ventral
dorsal
11
Q
Peritoneum (fx & structure)
A
lines the abdominal cavity
epithelial like single layer of cells (mesothelium) w/ a supportive layer of connective tissue
12
Q
Parietal peritoneum
A
lines the abdominal wall
13
Q
Visceral Peritoneum
A
covers suspended organs
14
Q
Abdominal viscera are either
A
intraperitoneal or retroperitoneal
15
Q
Intraperitoneal structures
A
suspended from the abdomen walls by mesentaries
16
Q
Ex of intraperitoneal structures
A
elements of the GI system
17
Q
Retroperitoneal structures
A
structures that are not suspended in the abdominal cavity by a mesentary
18
Q
Ex of retroperitoneal structures
A
kidneys and ureters
19
Q
Diaphragm f(x) (in relation to abdominal cavity)
A
separates the abdomen from the thorax
20
Q
Crus structure & f(x)
A
a muscular extension of the diaphragm
anchors it to the anterolateral surface of the vertebral column
21
Q
Primitive gut tube consists of
A
foregut, midgut & hindgut
22
Q
Foregut gives rise to
A
distal end of the esophagus, the stomach, & proximal part of the duodenum
23
Q
Midgut gives rise to
A
distal part of the duodenum and the jejunum, ileum, ascending colon, and proximal 2/3 of transverse colon
24
Q
Hindgut gives rise to
A
distal 1/3 of transverse colon, sigmoid colon, & superior part of the rectum
25
Innervation of skin & muscle of abdominal wall
intercostal nerves T7 to T11
subcostal nerve of T12
26
Innervation of upper parts of external oblique of abdominal wall
T5-T6
27
Pattern of abdominal muscle innervation
innervated segmentally in patterns that reflect the patterns of the overlying dermatomes
28
What's significant about the groin?
the groin (inguinal region) is a weak area in the abdominal wall and the site of inguinal hernias
29
Inguinal Canal
passage through the anterior abdominal all created by the processus vaginalis
30
What 3 major arteries supply the GI system and its derivatives?
celiac artery
superior mesenteric artery
inferior mesenteric artery
31
Celiac artery supplies
the foregut
32
Superior mesenteric artery supplies
the midgut
33
Inferior mesenteric artery supplies the
hindgut
34
What is the major systemic vein in the abdomen?
inferior vena cava
35
Left Renal Vein f(x)
drains the kidney, suprarenal gland, & gonad on the same side
36
Left Common Iliac Vein f(x)
drains the lower limbs, pelvis, perineum and parts of the abdominal wall
37
All venous drainage from the GI system passes through what organ?
the liver
38
Hepatic Portal Vein
distributes blood to small endothelial lined hepatic sinusoids
39
What is the consequence of blockage of the hepatic portal vein or of vascular channels in the liver?
can affect the pattern or venous return from abdominal parts of the GI system
40
Consequence of portal hypertension
can result in esophageal and rectal varaices
41
Abdominal viscera are largely innervated by
a large prevertebral plexus associated w/ anterior and lateral aortic surfaces
42
The prevertebral plexus contains what types of components?
sympathetic
parasympathetic
visceral sensory
43
4 quadrant system designations
right upper
left upper
right lower
left lower
44
Superior bounds of the abdominal wall
xiphoid process & costal margins
45
Posterior bounds of the abdominal wall
vertebral column
46
Inferior bounds of the abdominal wall
upper parts of the pelvic bones
47
The most superficial layer of superficial fasica of the abdomen is called
Camper's Fascia
48
The deeper, membranous layer of superficial fascia
Scarpa's fascia
49
What are the 2 layers of superficial fascia of the abdomen?
camper's fascia
| scarpa's fascia
50
3 flat muscles of the abdomen
external oblique
internal oblique
transversus abdominis
51
2 vertical muscles of the abdomen
rectus abdominis
| pyramidalis muscle
52
The lower border of the external oblique aponeurosis forms
the inguinal ligament
53
F(x) of the inguinal ligament
plays an important role in the formation of the inguinal canal
54
Lacunar Ligament
crescent shaped, attaches to the pecten pubis
55
Viscera in the retroperitoneal fascia are referred to as
retroperitoenal
56
T10 f(x)
supplies the skin around the umiblicus
57
T11-L1
supply the skin from just below the umbilicus to the pubic region
58
What artery supplies the superior part of the abdominal wall?
musculophrenic and superior epigastric arteries
59
What artery supplies the inferior part of the abdominal wall?
the superficial epigastric artery and the superficial circumflex iliac artery
60
Superficial lymphatics above the umbilicus drain to
the axillary nodes
61
Lymphatic drainage below the umbilicus passes to
the superficial inguinal nodes
62
Deep lymphatic drainage goes to
parasternal nodes
63
Why is the groin weak?
the abdominal wall is weakened from changes that occur during development
64
Inguinal Hernia
diverticulum that protrudes through the abdominal wall in the inguinal region, the weakest area of the abdominal wall
65
Innervation of the Peritoneum
parietal peritoneum is innervated by somatic afferents carried in branches of the associated spinal nerves
66
Divisions of the peritoneal cavity
greater sac
| omental bursa
67
What accounts for most of the space in the peritoneal cavity?
the greater sac
68
F(x) of fluid in the peritoneum
lubricate movement of the viscera suspended in the abdominal cavity
69
What is the clinical significance of the large surface area of the peritoneal space?
it facilitates the spread of disease through the peritoneal cavity and over the bowel and visceral surfaces
70
Greater Omentum
a large, apron like peritoneal fold that attaches to the greater curvature of the stomach
71
What are the omenta of the peritoneum?
greater omentum
| lesser omentum
72
Mesentaries f(x)
attach visera to the posterior abdominal wall
allow some movement & provide a conduit for vessels, nerves, & lymphatics to reach the viscera
73
Mesentery
large, fan shaped, double layered fold of peritoneum that connects the jejunum and the ilieum to the posterior abdominal wall
74
Transverse Mesocolon
fold of peritoneum that attaches the transverse colon to the posterior abdominal wall
75
Sigmoid Colon
attaches the sigmoid colon to the abdominal wall
76
List all the arterial supplies to the stomach
left and right gastric arteries
right and left gastro-omental arteries
posterior gastric artery
77
What are the 4 regions of the stomach?
cardia
fundus
body
pyloric part
78
pyloric sphincter
a thickened ring of gastric circular muscle that surrounds the pyloric orifice
79
What's the longest part of the GI tract?
small intestine
80
Arterial supply to the ileum
ileal arteries
| ileal branch from the ileocolic atery
81
F(x) of the large intestine
absorbs fluids and salts from the gut contents, forming feces
82
Parts of the large intestine
cecum, appendix, colon, rectum, and anal canal
83
What are the general characteristics of the large intestine?
large internal diameter
peritoneal covered fat
taeniae coli
haustra of the colon
84
Taeniae coli
3 narrow bands of longitudinal muscle segregations in the large intestine
85
Haustra of the Colon
sacculations of the colon
86
Arterial supply to the ascending colon
colic branch from the ileocolic artery
anterior cecal artery from the ileocolic artery
posterior cecal artery
right colic artery
87
Arterial supply to the transverse colon
right colic artery
middle colic artery
left colic artery
88
Arterial supply to the descending colon
left colic artery
89
Arterial supply to the sigmoid colon
sigmoidal arteries from the inferior mesenteric artery
90
Malrotation
incomplete rotation and fixation of the midgut
91
Volvulus
twisting of the bowel
92
Bowel obstruction types
functional or due to a true obstruction
93
Functional Bowel Obstruction
due to the inability of the bowel to peristalse
94
Diverticular disease
development of multiple colonic diverticula
95
What are the palpable landmarks to delineate the extent of the abdomen on the surface of the body?
costal margin above
| pubic tubercle, anterior superior iliac spine, iliac crest below
96
RUQ Organs
liver, gallbadder
97
LUQ Organs
stomach and spleen
98
RLQ organs
cecum and appendix
99
LLQ organs
end of descending colon and sigmoid coon
100
Common surface projection of the kidney
McBurney's Point
101
Omental Bursa
smaller subdivision of peritoneal cavity posterior to the stomach and the liver
102
Largest visceral organ in the body
Liver
103
subphrenic recess
separates the diaphragmatic surface of the liver from the diaphragm
104
What divides the subphrenic regions into R and L portions?
falciform ligament
105
All portions of the liver are covered with visceral peritoneum except
the fossa for the gallbladder
| porta hepatis
106
Porta Hepatis
point of entry into the liver for hepatic arteries and portal vein
exit point for hepatic ducts
107
Hepatogastric Ligament
connects the stomach to the liver
108
Hepatoduodenal Ligament
connects the liver to the duodenum
109
R & L Triangular Ligaments
connect the liver to the diaphragm
110
Anterior and Posterior Coronary Ligaments
connect the liver to the diaphragm
111
Liver lobe distinctions
R lobe: bigger
| left lobe: smaller
112
Arterial supply to the liver
R and L hepatic artery from the hepatic artery proper
113
Arterial supply to the gallbladder
cystic artery from the right hepatic artery
114
Gallbladder f(x)
receive, concentrates, and stores bile from the liver
115
Is the pancreas intra or retroperitoneal?
retroperitoneal (secondary) except for a small part of its tail
116
What are the components of the bile duct?
common hepatic duct and the cystic duct
117
What are the components of the bile duct?
common hepatic duct and the cystic duct
118
Arterial supply to the spleen
splenic artery
119
Gallstones
mixture of cholesterol and bile pigment that may have undergone calcification
120
Significance of Gallstones & Hartmann's Pouch
when gallstones lodge here, the gallbladder can't empty normally and contractions of the gallbladder will cause pain
121
Jaundice
yellow discoloration of the skin caused by excess bile pigment
122
When does splenic rupture occur?
when there is localized trauma to the left upper quadrant
123
What is the clinical significance of splenic rupture?
the spleen is highly vascular, so when it's ruptured it bleeds profusely into the abdominal cavity
124
Where does the abdominal aorta begin?
the aortic hiatus of the diaphragm
125
Terminal branches of the abdominal aorta?
2 common iliac arteries
126
Foregut is supplied by the
celiac trunk
127
Midgut is supplied by the
superior mesenteric artery
128
Hindgut is supplied by the
inferior mesenteric artery
129
Portal Vein
final common pathway for the transport of venous blood from the spleen, pancreas, gallbladder, and abdominal part of the GI tract
130
cirrhosis
widespread hepatic fibrosis that implies previous or continuous liver cell damage
131
Parasympathetic innervation of the abdominal part of the GI tract is carried out by
the vagus nerves the the pelvic splanchnic nerves
132
How does the vagus nerve enter the abdomen?
as the anterior and posterior vagal trunks
