Book Flashcards
1
Q
1. What is the name of the upper horizontal plane and where is it located?
A
- Subcostal plane, on costal cartilage 10
2
Q
- What is the name of the lower horizontal plane and where is it located?
A
- Transtubecular plane, on iliac tubercles
3
Q
- What is the name of the vertical planes and where do they come off of?
A
- Midclavicular, coming off the midpoint of the clavicle
4
Q
- What is the upper right quadrant called and what is in it?
A
- Right hypochondriac, liver
5
Q
- What is the upper middle quadrant called and what is in it?
A
- Epigastric, stomach
6
Q
- What is the upper left quadrant called and what is in it?
A
- Left hypochondriac, spleen
7
Q
- What is the middle right quadrant called and what is in it?
A
- Right lumbar, right kidney and ascending colon
8
Q
- What is the middle middle quadrant called and what is in it?
A
- Umbilical, transverse colon
9
Q
- What is the middle left quadrant called and what is in it?
A
- Left lumbar, left kidney and descending colon
10
Q
- What is the lower right quadrant called and what is in it?
A
- Right inguinal, appendix and cecum
11
Q
- What is the lower middle quadrant called and what is in it?
A
- Hypogastric, small intestine
12
Q
- What is the lower left quadrant called and what is in it?
A
- Left inguinal, sigmoid colon
13
Q
- How do clinicians divide the abdomen?
A
- Into four quadrants via the transumbilical and median planes
14
Q
- What is the peritoneal cavity formed from?
A
- Intraembryonic coelomic cavity
15
Q
- What is the peritoneal cavity?
A
- It is the space between the parietal and visceral peritoneums
16
Q
- How many organs are contained in the peritoneal cavity?
A
- None
17
Q
- What is peritoneum?
A
- A serous membrane
18
Q
- What is a mesentery?
A
- A double layered peritoneum that surrounds an organ and attaches it to the body wall. Blood vessels also pass to the organs via a mesentery.
19
Q
- What is a peritoneal ligament and name an example?
A
- A double layered peritoneum that attaches an organ to another organ or to the body wall. Falciform ligament attaches liver to umbilicus
20
Q
- What does retroperitoneal mean?
A
- An organ that slightly protrudes into the peritoneum and lacks a mesentery
21
Q
- What does primarily retroperitoneal mean and name an organ that is primarily retro?
A
- This means that the organ developed without a mesentery, kidneys
22
Q
- What does secondarily retroperitoneal mean and name organs that are secondarily retro?
A
- This means that the organ developed in a mesentery but that it was reabsorbed by the body. The pancreas, duodenum, ascending and descending colon
23
Q
- What is a recess?
A
- A blind ended sac or pouch
24
Q
- Name some 3 recesses and the importance of 2 of them
A
- Subphrenic, Hepatorenal, Retrocecal. Hepatorenal is bounded by the liver, duodenum, colon and right kidney and is the lowest point of peritoneal cavity when person lies down. Retrocecal contains the vermiform appendix
25
Q
- What are the names for the larger part of the peritoneal cavity?
A
- Peritoneal cavity proper or greater sac
26
Q
- What are the names for the smaller part of the peritoneal cavity?
A
- Omental Bursa or lesser sac
27
Q
- What is the omental bursa located between?
A
- Posterior to the stomach and anterior to the pancreas, laterally it is bounded by the gastrosplenic and lienorenal ligaments
28
Q
- What three things are included in the omental bursa?
A
- Superior recess between liver and diaphragm, main portion and inferior recess between double layers of gastrocolic ligament (obliterated in adults)
29
Q
- What does the omental bursa allow for?
A
- It allows for stomach distension
30
Q
- How is it connected to the greater sac?
A
- Via the epiploic foramen of Winslow aka omental foramen
31
Q
- What are the three mesenteries attaching to the posterior body wall and what do they suspend?
A
- Mesentery proper containing ileum and jejunum, Transverse mesocolon containing transverse colon, Sigmoid mesocolon containing sigmoid colon
32
Q
- Where is the greater omentum suspended from?
A
- The greater curvature of the stomach
33
Q
- What are the major and minor ligaments that comprise it?
A
- Gastrocolic is major, gastrosplenic and gastrophrenic are minor
34
Q
- What mesentery is it a derivative of?
A
- Dorsal Mesentery
35
Q
- Where is the lesser omentum suspended from?
A
- The lesser curvature of the stomach
36
Q
- What are the major ligaments that comprise it?
A
- Hepatogastric and hepatoduodenal
37
Q
- What mesentery is it a derivative of?
A
- Ventral Mesentery
38
Q
- Where does the esophagus pierce the diaphragm?
A
- Esophageal hiatus, T10 level
39
Q
- Where does the esophagus enter the stomach?
A
- At the cardiac orifice
40
Q
- What two arteries supply the esophagus?
A
- Left gastric artery from celiac trunk and left inferior phrenic artery
41
Q
- What are the notches on the greater and lesser curvatures of the stomach respectively?
A
- Cardiac notch, angular notch
42
Q
- What are the four parts of the stomach?
A
- Cardiac antrum, fundus, body and pylorus
43
Q
- What 3 arteries and their branches supply the stomach?
A
- Left gastric, splenic (short gastric and left epiploic branches) and common hepatic (right gastric and gastroduodenal branches) all arising from celiac trunk
44
Q
- Name the boundaries of the foregut, midgut and hindgut?
A
- Foregut: pharynx to proximal duodenum. Midgut: distal duodenum to transverse colon. Hindgut: descending colon to anal canal
45
Q
- What are the four parts of the duodenum?
A
- Superior (aka duodenal bulb), descending, horizontal, ascending
46
Q
- What parts are completely retroperitoneal?
A
- Descending and horizontal
47
Q
- What parts are not completely retroperitoneal?
A
- Superior and ascending
48
Q
- At what vertebral levels are the parts of the duodenum found?
A
- Superior at L1, descending to L3, horizontal at L3, ascending to L2
49
Q
- Where do the common bile duct and main pancreatic duct enter the duodenum?
A
- Via the ampulla of Vater in the descending portion
50
Q
- What marks the entrance of the common bile duct and main pancreatic duct inside the duodenum?
A
- The main duodenal papilla
51
Q
- Which portions of the duodenum are susceptible to ulcers?
A
- Superior and descending, above the main duodenal papilla
52
Q
- Describe the arcades and vasa recta of the jejunum and ileum.
A
- Jejunum has more arcades and longer vasa recta while ileum has fewer arcades and shorter vasa recta
53
Q
- Are plicae circularis (spiral folds of mucous membranes) more prominent in jejunum or ileum?
A
- Jejunum
54
Q
- What arteries supply the jejunum and ileum?
A
- Intestinal arteries branching off of the superior mesenteric artery
55
Q
- What parts of the colon have a mesentery?
A
- Transverse colon (transverse mesocolon) and sigmoid colon (sigmoid mesocolon)
56
Q
- What three features distinguish the large intestine from the small intestine?
A
- Taenia coli, haustra and appendices epiploicae
57
Q
- What is Taenia coli?
A
- Incomplete longitudinal muscle layer that forms three stripes on surface of the large intestine
58
Q
- What is haustra?
A
- Sacculations on large intestine
59
Q
- What are appendices epiloicae?
A
- Fat-filled peritoneal sacs
60
Q
- What are the two flexures in the large intestine and what do they connect?
A
- Left hepatic (ascending and transverse) and Right splenic (transverse and descending)
61
Q
- What artery supplies the transverse colon?
A
- Middle colic artery from superior mesenteric artery
62
Q
- What artery supplies the ascending colon?
A
- Right colic artery from superior mesenteric artery
63
Q
- What artery supplies the cecum and appendix?
A
- Iliocolic artery (gives off appendicular branch) from superior mesenteric artery
64
Q
- What artery supplies the descending colon?
A
- Left colic artery from inferior mesenteric artery
65
Q
- What artery supplies the sigmoid colon?
A
- Sigmoid arteries from inferior mesenteric artery
66
Q
- What artery supplies the rectum?
A
- Superior rectal artery from inferior mesenteric artery
67
Q
- How do gastric ulcers cause hemorrhage?
A
- They can erode the gastric wall and the splenic artery
68
Q
- What is ascites?
A
- Peritoneal cavity fills with fluid
69
Q
- What causes peritonitis?
A
- Gastric ulcers releasing stomach contents into omental bursa
70
Q
- What are adhesions?
A
- Scar tissue connection parietal and visceral peritoneums
71
Q
- What are the four peritoneal gutters?
A
- Right lateral paracolic, left lateral paracolic, and gutters to the right and left of the mesentery
72
Q
- Which gutter has a special significance?
A
- Right lateral paracolic because it serves as a pathway for infection from the hepatorenal pouch to the pelvis
73
Q
- Is the autonomic nervous system generally considered efferent or afferent?
A
- Efferent
74
Q
- What is the embryonic origin of the PSNS and SNS?
A
- Neural crest
75
Q
- Where are preganglionic and postganglionic fibers of PSNS and SNS found?
A
- Preganglionic neuron found in CNS and postganglionic neuron found in PNS
76
Q
- Where do preganglionic sympathetic neurons arise?
A
- In the lateral horn at levels T1-L2/3
77
Q
- Describe the sympathetic trunk (other names, where it goes, ganglia, how it ends)
A
- This is also called the sympathetic chain or paravertebral ganglion, it goes from the base of the skull to the coccyx, it has 3 cervical/11 thoracic/4 lumbar/4 sacral ganglia, it ends by both trunks uniting in coccygeal region at ganglion impar
78
Q
- How many white rami communicans are there and what is their function?
A
- There are 14 pairs and they are the site through which all preganglionic sympathetic fibers pass through
79
Q
- What is the preganglionic sympathetic neurotransmitter?
A
- Acetylcholine
80
Q
- What is the postganglionic sympathetic neurotransmitter?
A
- Norepinephrine (noradrenaline)
81
Q
- What is the exception to the postganglionic sympathetic neurotransmitter?
A
- Acetylcholine goes to the sweat glands
82
Q
- Describe the 4 pathways that preganglionic sympathetic fibers can pass through.
A
- First: preganglionic fibers from lateral horn in CNS levels T1-L2/3 leave via the ventral root into the white rami communicans before they synapse on a postganglionic neuron in the sympathetic chain and pass through the gray rami commnicans to leave via the dorsal and ventral primary rami
83
Q
- Describe the four prevertebral ganglion and what they supply
A
- Celiac Ganglion: Greater splanchnic nerves (T6-9) synapse and supplies foregut
84
Q
- What do the first, second and third pathways supply respectively?
A
- First and Second: blood vessels, sweat glands and arrector pili muscles
85
Q
- What is the neurotransmitter of the PSNS?
A
- Acetylcholine
86
Q
- What 4 cranial nerves make up PSNS?
A
- CN III, VII, IX, X
87
Q
- What does cranial nerve X supply?
A
- Neck, thorax, gut up to transverse colon with preganglionic fibers going all the way to the gut and synapsing on the gut wall in terminal ganglia. It is a preganglionic parasympathetic fiber
88
Q
- What levels form the sacral portion of PSNS?
A
- S2, S3, S4
89
Q
- What are these nerves (2 types) called?
A
- Nervi erigens and pelvic splanchnic nerves
90
Q
- What do they innervate?
A
- Nervi erigens innervate the penis and clitoris while pelvic splanchnic innervate hindgut, organs in pelvis and genitalia
91
Q
- How do PSNS and SNS affect gut?
A
- PSNS increases peristalsis, SNS decreases peristalsis
92
Q
- How do PSNS and SNS affect heart?
A
- PSNS decreases heart rate, SNS increases heart rate
93
Q
- How do PSNS and SNS affect sweat glands?
A
- Only SNS increases secretion
94
Q
- How do PSNS and SNS affect bronchioles?
A
- PSNS constricts bronchioles, SNS dilates bronchioles
95
Q
- How do PSNS and SNS affect eyes?
A
- PSNS constricts for light vision, SNS dilates for dark vision
96
Q
- How do PSNS and SNS affect peripheral and skeletal blood vessels?
A
- Only SNS vasoconstricts peripheral and vasodilates skeletal
97
Q
- How do PSNS and SNS affect sex organs?
A
- PSNS erects penis/clitoris, SNS promotes ejaculation
98
Q
- How do PSNS and SNS affect adrenal gland?
A
- Only SNS enhances secretion of adrenalin via preganglionic fibers
99
Q
- How do PSNS and SNS affect salivary glands?
A
- PSNS increases secretion, SNS decreases secretion
100
Q
- Where do visceral afferent fibers not pass through?
A
- Gray rami communicans, only pass through white rami communicans
101
Q
- What is the major function of the spleen?
A
- Lymphoid organ
102
Q
- What are the two surfaces of the spleen and the divisions of one of the surfaces?
A
- Diaphragmatic and visceral. The visceral is divided into the gastric, renal and colic surfaces
103
Q
- What is the hilus of the spleen?
A
- Where vessels go into the spleen
104
Q
- What is the arterial supply of the spleen?
A
- Splenic artery from celiac trunk
105
Q
- What are the four anatomical lobes of the liver?
A
- Right lobe, caudate (posterior), quadrate (anterior), left lobe
106
Q
- What are the two functional lobes of the liver and their blood supply?
A
- Right lobe (right hepatic artery), Left lobe including caudate and quadrate (left hepatic artery). Both arise from celiac trunk
107
Q
- What is the significance of the bare area of the liver?
A
- It is not covered by peritoneum
108
Q
- What are the five ligaments of the liver?
A
- Falciform (connects liver to umbilicus), Ligamentum Teres (remnant of umbilical vein within falciform), Ligamentum venosum (remnant of ductus venosum), coronary ligaments (liver to diaphragm), lesser omentum ligaments (hepatogastric, hepatoduodenal)
109
Q
- What artery supplies the gall bladder?
A
- Cystic artery usually a branch off of the right hepatic artery
110
Q
- What is contained in the porta hepatis?
A
- Hepatic artery, right and left hepatic ducts, hepatic portal vein
111
Q
- Describe the biliary duct system
A
- The right and left livers give off right and left hepatic ducts, which come together to form the common hepatic duct, which joins the cystic duct of the gall bladder to form the common bile duct. The common bile duct and common pancreatic duct join together and empty into the descending duodenum at the Ampulla of Vater into the major duodenal papilla. Emptying occurs via opening of the sphincter of Oddi
112
Q
- What is the name of the process on the head of the pancreas?
A
- Uncinate process
113
Q
- Which portion of the pancreas is not retroperitoneal?
A
- Tail
114
Q
- Where does the left gastric artery come off of and what does it supply?
A
- Celiac trunk, supplies the esophagus and stomach
115
Q
- Where does the common hepatic artery come off of and what are its branches?
A
- Celiac trunk, hepatic artery proper and gastroduodenal artery
116
Q
- What does the right gastric artery supply and what does it anastomose with?
A
- Stomach, left gastric artery
117
Q
- What does the right hepatic artery supply?
A
- Right functional lobe of the liver and gives off cystic artery to supply gall bladder
118
Q
- What does the left hepatic artery supply?
A
- Left functional lobe of the liver
119
Q
- What are the branches of the hepatic artery proper?
A
- Right hepatic, Left hepatic, Right gastric
120
Q
- What are the branches of the gastroduodenal artery and what do they supply?
A
- Supraduodenal (superior duodenum), superior pancreaticoduodenal (anastomoses with inferior pancreaticoduodenal from superior mesenteric artery), right gastroepiploic (anastomoses with left gastroepiploic to supply greater curvature of stomach)
121
Q
- Where does the splenic artery come off of and what are its branches?
A
- Celiac trunk, splenic, short gastric, left gastroepiploic
122
Q
- What does the superior mesenteric artery supply in general?
A
- The midgut
123
Q
- What are the branches of the superior mesenteric artery and what do they supply?
A
- Inferior pancreaticoduodenal (duodenum), intestinal arteries (jejunum and ileum), iliocolic (cecum, appendix), right colic (ascending colon), middle colic (transverse colon)
124
Q
- What does the inferior mesenteric artery supply in general?
A
- Hindgut
125
Q
- What are the branches of the inferior mesenteric artery and what do they supply?
A
- Left colic (transverse colon and descending colon), sigmoid arteries (sigmoid colon), superior rectal artery (rectum)
126
Q
- What are the three paired visceral arteries?
A
- Renal arteries, middle suprarenal arteries (from abdominal aorta), testicular/ovarian arteries
127
Q
- What is the only unpaired parietal artery?
A
- Median sacral artery that anastomoses with lateral sacral arteries
128
Q
- What are the two paired parietal arteries?
A
- Inferior phrenic arteries and lumbar arteries
129
Q
- At what vertebral level does the vena cava pierce the diaphragm and name its foramen?
A
- T8, inferior vena caval foramen
130
Q
- Describe portal circulation of the liver and its function
A
- Blood flow from the GI tract through the hepatic portal vein, through sinusoids and then leaves the liver via the hepatic vein to the inferior vena cava. Its function is to bring things from the GI tract to be metabolized in the liver
131
Q
- What two veins form the hepatic portal vein?
A
- Superior mesenteric vein and splenic vein
132
Q
- Where are the five anastomoses for the hepatic portal vein and systemic circulation?
A
- Left gastric vein with esophageal veins, Colic vein with systemic retroperitoneal veins, Splenic and Pancreatic veins with renal veins, paraumbilical veins with cutaneous veins of anterior body wall, superior rectal veins with middle and inferior rectal veins