Chapter 4: The Abdomen pt 2 Flashcards
1
Q
- the largest visceral organ in the body
- in the right hypochondrium and epigastric regions
- has diaphragmatic and visceral surfaces
A
the liver
2
Q
- smooth and domed
- Associated with it are the subphrenic and hepatorenal recesses
A
diaphragmatic surface
3
Q
part of the peritoneal cavity
A
hepatorenal recess
4
Q
are continuous anteriorly
A
The subphrenic and hepatorenal recesses
5
Q
divided into to right and left areas by the falciform ligament
A
subphrenic recess
6
Q
covered by visceral peritoneum, except in the fossa for the gallbladder and the porta hepatis (gateway to the liver)
A
visceral surface of liver
7
Q
serves as the point of entry for the portal vein, exit point for the hepatic ducts
A
porta hepatis
8
Q
attaches the liver to the abdominal wall
A
The falciform ligament
9
Q
covered in visceral peritoneum except for the bare area
A
liver
10
Q
connect the liver to the stomach (hepatogastric ligament), duodenum (hepatoduodenal ligament), the diaphragm (left and right triangular ligament and anterior and posterior coronary ligaments)
A
Additional folds of the peritoneum
11
Q
divided into right and left lobes by the fossa for the gallbladder and the inferior vena cava
A
liver
12
Q
arise from the right lobe but are functionally distinct
A
quadrate and caudate lobes
13
Q
made up of the neck, body, and fundus
A
gallbladder
14
Q
what is the liver supplied by?
A
the right and left hepatic arteries, both of which arise from the hepatic artery proper
15
Q
what is the gallbladder supplied by?
A
supplied by the cystic artery from the right hepatic artery
16
Q
secondarily retroperitoneal (except for a small part of the tail)
A
pancreas
17
Q
lies in the C-shaped concavity of the duodenum
A
head of pancreas
18
Q
project off the head of the pancreas
A
uncinate process and neck
19
Q
distal from the head of the pancreas
A
body and tail
20
Q
- begins in the tail and passes through the body into the head
- joins the bile duct and forms the hepatopancreatic ampulla which enters the duodenum at the major duodenal papilla
A
pancreatic duct
21
Q
empties into the duodenum via the minor duodenal papilla
A
accessory pancreatic duct
22
Q
what is the arterial supply to the pancreas?
A
***ultimately arises from the celiac trunk
-common hepatic and
splenic branches which
feed the pancreas
23
Q
- drain respective lobes of the liver
- combine to form the common hepatic duct
A
right and left hepatic ducts
24
Q
joins the cystic duct and forms the bile duct
A
common hepatic duct
25
drains into the duodenum
bile duct
26
produced in the liver and stored in the gallbladder until it is needed in the duodenum
bile
27
- develops as part of the vascular system in the dorsal mesentery
- lies against the diaphragm and stomach and is therefore found in the upper left quadrant
spleen
28
- attached to the greater curvature of the stomach by the gastrosplenic ligament and to the left kidney by the splenorenal ligament
- covered in visceral peritoneum except for the hilum
spleen
29
- the entry point for the splenic vessels
| - Occasionally the tail of the pancreas reaches this area
hilum of the spleen
30
what is the arterial supply of the spleen?
comes from the splenic artery which comes off the celiac trunk
31
extends from the aortic hiatus to the branch of the common iliac arteries
abdominal aorta
32
what are the anterior branches of the abdominal aorta that go to the GI tract?
- celiac trunk
- superior mesenteric
- inferior mesenteric
33
begins with the abdominal esophagus and ends at the major duodenal papilla and is supplied by the celiac trunk
foregut
34
begins just inferior to the major duodenal papilla and ends 2/3 of the way along the transvers colon and is supplied by the superior mesenteric
midgut
35
begins 2/3 of the way along the transverse colon and ends at the upper part of the anal canal and is supplied by the inferior mesenteric
hindgut
36
- arises immediately inferior to the aortic hiatus
| - divides into left gastric, splenic, and common hepatic arteries
celiac trunk
37
- extends superiorly and curves back down the surface of the lesser curvature of the stomach
- anastomoses with the right gastric
left gastric artery
38
the largest branch off the celiac trunk
splenic artery
39
- passes along the superior margin of the pancreas and gives off numerous branches to the neck, body, and tail
- Approaching the spleen it gives off the short gastric and left gastro-omental artery
splenic artery
40
runs to the right and divides into the hepatic artery proper and the gastroduodenal artery
common hepatic trunk
41
proper ascends toward the liver and divides into left and right hepatic arteries
hepatic artery
42
divides into supraduodenal, right gastro-omental, and the anterior superior pancreaticoduodenal arteries
gastroduodenal artery
43
The 1st branch off the superior mesenteric (SM)
the inferior pancreaticoduodenal artery
44
what does the superior mesenteric give off after the inferior pancreaticoduodenal artery?
jejunal and ileal branches to the left and middle and right colic and ileocolic arteries
45
supple the jejunum and most of the ileum
jejunal and ileal arteries
46
supplies the transverse colon
Middle colic artery
47
supplies part of the ascending colon
right colic artery
48
supplies part of the ascending colon, cecum, and appendix
ileocolic artery
49
branches into left colic, several sigmoid, and superior rectal arteries
inferior mesenteric artery
50
splits into ascending and descending branches which supply the distal end of the transverse colon and the upper and lower descending colon
left colic artery
51
supply the lowest part of the descending colon and the sigmoid colon
sigmoid arteries (2-4 branches)
52
supply the rectum
superior rectal arteries
53
where is the Venous drainage of the spleen, pancreas, gallbladder, and abdominal GI tract (except for inferior part of rectum) through?
the portal system
54
formed by the union of the splenic and superior mesenteric vein
portal vein
55
receives gastric veins, cystic veins, and para-umbilical veins
the portal vein as it ascends toward the liver
56
what are the tributaries to the splenic vein?
- short gastric
- left gastro-omental
- pancreatic
- inferior mesenteric veins
57
begins in the right iliac fossa as veins drain the terminal ileum, cecum, and appendix
superior mesenteric vein
58
- drains the rectum, sigmoid and descending colon, and splenic flexure
- begins as the superior rectal vein
inferior mesenteric vein
59
drain into pre-aortic lymph nodes
Lymph from the rectum, spleen, pancreas, gallbladder, and liver
60
divided into: celiac, superior mesenteric, and inferior mesenteric groups
Pre-aortic lymph nodes
61
innervated by both intrinsic and extrinsic components of the nervous system
abdominal viscera
62
involve sending and receiving impulses from the CNS
Extrinsic components
63
involve the enteric system
intrinsic components
64
travel between the viscera and CNS via the spinal nerves, sympathetic trunks, splanchnic nerves, prevertebral plexus , and the vagus nerve
Afferent sensory fibers, sympathetic, and parasympathetic fibers
65
- carry sympathetic fibers
| - travel from sympathetic ganglia to the prevertebral plexus
Thoracic, lumbar, and sacral splanchnic nerves
66
- carries parasympathetic fibers
| - originate directly from anterior rami and travel to the hypogastric plexus
pelvic splanchnic nerve
67
what are the 3 major divisions of the prevertebral plexus?
- celiac plexus
- aortic plexus
- superior hypogastric plexus
68
provides parasympathetic innervation to the foregut and midgut
vagus nerve
69
provides parasympathetic innervation to the hindgut
pelvic splanchnic nerve
70
- A local neural network of the GI tract
| - Controls many intestinal functions including peristalsis
enteric system
71
what are the 2 interconnecting networks of the enteric system?
- myenteric plexus
| - submucosal plexus
72
- posterior to the abdominal GI tract
- contains the abdominal aorta and associated nerve plexuses, inferior vena cava, sympathetic trunks, lymphatics, kidneys, and adrenal glands
posterior abdominal region
73
what are the bones of the posterior abdominal region?
- The 5 lumbar vertebrae and intervertebral discs project into this region
- ribs, sacrum, and ilia form components of the bony make up of this posterior region
74
what are the muscles of the posterior abdominal region?
- Superiorly- the diaphragm
- Medially- psoas major and minor
- Laterally- quadratus lumborum
- Inferiorly- iliacus
75
arise from bodies of the vertebrae TXII and all 5 lumbar (minor- TXII and L1) and passes inferiorly along the pelvic brim onto the lesser trochanter of the femur
Psoas major and minor
76
fills the space between the pelvis and rib XII
quadratus lumborum
77
fills the iliac fossa and joins the psoas major to become the iliopsoas
iliacus
78
ORIGIN: lateral surface of bodies of TXII and LI to LV vertebrae; transverse processes of the lumbar vertebrae, and intervertebral discs between TXII and LI to LV vertebrae
psoas major
79
insertion: lesser trochanter of the femur
psoas major
80
innervation: anterior rami of L1 to L3
psoas major
81
function: flexion of thigh at hip
psoas major
82
ORIGIN: lateral surface of bodies of TXII and LI vertebrae and intervening intervertebral disc
psoas minor
83
INSERTION: pectineal line of the pelvic brim and iliopubic eminence
psoas minor
84
innervation: anterior rami of L1
psoas minor
85
FUNCTION: weak flexion of lumbar veterbral column
psoas minor
86
ORIGIN: transverse process of LV vetebrae; iliolumbar ligament and iliac crest
quadratus lumborum
87
INSERTION: transverse processes of LI to LIV vertebrae and inferior border of ribs XII
quadratus lumborum
88
INNERVATION: anterior rami of T12 and L1 to L4
quadratus lumborum
89
FUNCTION: depress and stabilize rib XII and some lateral bending of the trunk
quadratus lumborum
90
ORIGIN: upper 2/3 of iliac fossa; anterior sacro-iliac and iliolumbar ligaments, and upper lateral surface of sacrum
iliacus
91
INSERTION: lesser trochanter of femur
iliacus
92
INNERVATION: femoral nerves (L2 to L4)
iliacus
93
function: flexion of thigh at hip joint
iliacus
94
- consists of the central tendon surrounded by muscle
- anchored to the lumbar vertebrae via the left and right crura which blend with the longitudinal ligament of the vertebral column
diaphragm
95
are connected across the midline by the median arcuate ligament
crura
96
attach medially to the transverse process of LI and laterally to rib XII
lateral acruate ligaments
97
innervated by the phrenic nerve
diaphragm
98
***these structures pass throug the:........
-Aorta
-Thoracic duct
-Azygous and
hemiazygous vein
-Esophagus
-Vagal trunks
-Left gastric artery and
vein
-Inferior vena cava
-Right and left phrenic
nerve
-Splanchnic nerves
-Sympathetic trunks
-Epigastric vessels
diaphragm
99
retroperitoneal in the posterior abdominal region
kidneys
100
are located superiorly to the kidneys
suprarenal glands
101
associated with the diaphragm, psoas major, quadratus lumborum, and transversalis abdominis
posterior side of the kidneys
102
Immediately outside the renal capsule
perinephric fat which completely surrounds the kidney
103
encloses the perinephric fat, kidney, and suprarenal gland
renal fascia
104
surrounds the renal fascial compartment
paranephric fat
105
has a smooth anterior and posterior surface covered in a fibrous renal capsule
each kidney
106
what structures are found in the kidney?
- Hilum
- Renal cortex
- Renal columns
- Renal pyramids
- Renal sinus
- Renal papilla
- Minor calyx
- Major calyx
- Renal pelvis
107
supply and drain the kidneys
Renal arteries and veins
108
divides into the anterior and posterior branches
renal artery
109
drain renal lymph
lateral aortic nodes
110
- muscular tubes that transport urine from the kidneys to the bladder
- continuous with the renal pelvis at the uteropelvic junction
ureters
111
at what 3 points do the ureters narrow?
- 1st at the uteropelvic junction
- 2nd at the pelvic inlet
- 3rd at the entrance to the bladder
112
can get lodged at the constrictions of the ureters
kidney stones
113
found on the superior poles of the kidneys
suprarenal glands
114
what is the blood supply to the suprarenal glands?
- Superior suprarenal
- Middle suprarenal
- Inferior suprarenal arteries
115
what is the venous drainage of the suprarenal glands?
the suprarenal veins that drain into the renal veins
116
- begins at the abdominal hiatus
| - passes down the midline and ends as a split into right and left common iliac arteries
abdominal aorta
117
what do branches off the abdominal aorta supply?
- organs (visceral),
- diaphragm and body wall (posterior)
- terminal branches (common iliacs)
118
- Branch= anterior
- origin= Immediately inferior to the aortic hiatus of the diaphragm
- supplies= abdominal foregut
celiac trunk
119
- branch= anterior
- origin= Immediately inferior to the celiac trunk
- supplies= abdominal midgut
superior mesenteric
120
- branch= anterior
- origin= inferior to renal arteries
- supplies= abdominal hindgut
inferior mesenteric artery
121
- branch= lateral
- origin= Immediately superior to the renal arteries
- supplies= suprarenal glands
middle suprarenal artery
122
- branch= lateral
- origin= Immediately inferior to superior mesenteric
- supplies= kidneys
renal arteries
123
- branch= paired anterior
- origin= Inferior to renal arteries
- supplies= testes/ovaries
testicular/ovarian artery
124
- branch= lateral
- origin= Immediately inferior to aortic hiatus
- supplies= diaphragm
inferior phrenic artery
125
- branch= posterior
- origin= usually in 4 pairs
- supplies= posterior abdominal wall and spinal cord
lumbar artery
126
- branch= posterior
| - origin= Just superior to the aortic bifurcation, passes inferiorly across lumbar vertebrae, sacrum, and coccyx
median sacral artery
127
- branch= terminal
| - origin= bifurcation usually occurs at LIV vertebra
common iliac artery
128
- returns blood from all structures below the diaphragm
| - formed when the 2 common iliac veins join just to the right of the midline
inferior vena cava
129
***receives these tributaries:
-Common iliac veins
-Lumbar veins
-Right testicular or
ovarian vein
-Renal veins
-Right supernal
-Inferior phrenic veins
-Hepatic veins
inferior vena cava
130
do all lumbar veins drain directly into the inferior vena cava?
no
131
long, anastomosing venous channels that connect the common iliac, iliolumbar, and lumbar veins with the azygous and hemiazygous
ascending lumbar vein
132
- generally drains into nodes associated with the major blood vessels
- then predominately drains into the thoracic duct
lymph of abdominal
133
anterior to the aorta
pre-aortic nodes
134
lateral (left and right sides) of the aorta
lateral aortic nodes
135
found in the posterior abdominal region
sympathetic trunks, splanchnic nerves, plexuses, and ganglia associated with the aorta
136
extend off ganglia on the sympathetic trunks and connect to the prevertebral plexus
Splanchnic nerves
137
- extends along the aorta from the diaphragm to the bifurcation into the common iliacs
- divided into the celiac plexus, aortic plexus, superior hypogastric plexus
prevertebral plexus
138
- found in the prevertebral plexus
- named after nearest abdominal branch
- celiac
- superior mesenteric
- aorticorenal
- inferior mesenteric
prevertebral ganglia
139
- formed by the anterior rami of nerves L1-L4
| - forms in the substance of the psoas major muscle
lumbar plexus
140
what are the nerves that emerge from the lumbar plexus?
- Iliohypogastric
- Ilio-inguinal
- Genitofemoral
- Lateral cutaneous
- Iliacus
- Femoral
- Obturator
141
what are the nerves relative to the psoas major?
- Genitofemoral emerges anteriorly
- Obturator emerges medially
- Iliohypogastric, ilio-inguinal, femoral, and lateral cutaneous emerge laterally
142
have certain cutaneous and muscular distributions in the leg
nerves that emerge from the lumbar plexus
