EX2 Lower Abdomen Flashcards
What is the opening and the exit of the stomach
cardiac orfice; entrance from esophagus
pyloric sphincter; exit to duodenum
What are the temporary folds in the stomach
rugae
What is the main purpose of the stomach
mixing of the mass of food (bolus)
beginning the enzymatic digestion
chyme production
This is the first section of the small intestine, is retroperitoneal, and fixed/relatively immobile
duodenum
These portions of the small intestine are tethered by root of mesentery proper but are very mobile
jéjunum and ileum
These are permanent folds within the intestine; are more prominent in the jejunum
plicae circularis
The ileum empties into the cecum at which junction
ileocecal junction
What is the name of the arterial loops in the jejunum and ileum
arterial arcades
This is a remnant of embryonic yolk sac appearing as a finger like pouch located 1m proximal to ileocecal valve
Meckel’s (ileal) diverticulum
What is the clinical significance of Meckel’s diverticulum
may become inflamed and mimic appendicitis
This opens into the cecum inferior to ileocecal orifice; commonly retrocecal
veriform appendix
What type of mesentery covers the appendix
triangular mesentary –> mesoappendix
Appendicitis causes vague pain where?
the periumbilical region; afferent pain referred to T10 level
Appendicitis causes severe pain where?
later from the right lower quadrant; from the irritation of peritoneum of posterior abdominal wall (pain where inflammation is found)
Where is the pain most severe with appendicitis
over spinoumbilical point between the ASIS and umbilicus
This is divided into 5 segments and 2 flexures
large intestine (colon)
What are the 5 segments of the colon
cecum ascending colon transverse colon descending colon sigmoid colon
What are the flexures of the transverse colon
right colic (hepatic) left colic (splenic)
Where does the large intestine terminate into
the rectum
What frames the small intestines
the colon
These are 3 smooth muscle bands paralleling the length of the colon
teniae coli
These are outpouchings produced by teniae coli
haustra coli
These are fat tags found along the colon
epiploic appendages
What are the unpaired branches of the abdominal aorta starting with the most superior
celiac trunk
superior mesenteric artery
inferior mesenteric artery
This artery supplies the liver, gall bladder, esophagus, stomach, pancreas, and the spleen
celiac trunk
What are the branches of the celiac trunk
common hepatic
left gastric
splenic artery
This artery sends 15-18 intestinal arteries to the small intestine and supplies the proximal 2/3 of transverse colon
superior mesenteric artery
What branches of superior mesenteric supply the proximal 2/3 of the transverse colon
ileocolic
right colic
middle colic
This artery supplies the colon from distal 1/3 of transverse colon
Inferior mesenteric artery
What are the branches of the inferior mesenteric artery
left colic
sigmoid (4)
superior rectal
True or False
The patterns of SMA and IMA branching is variable
True; anastomoses are important
Collateral circulation of the lower abdomen is supplied by which anastomoses
colic branches
The consistent vascular arc around the colon is supplied by what
marginal artery of Drummond
Which organ is a major site of anastomoses between the superior and inferior mesenteric arteries
pancreas
What artery besides SMA/IMA anastomose in the pancreas
inferior pancreaticoduodenal artery
posterior superior pacreacticoduodenal artery (branch of gastroduodenal artery)
This paired artery sends lateral branches of abdominal aorta (lateral to SMA) which enter the hilum of each kidney to supply it
renal artery (left and right)
What are the branches of the renal artery
sends branches to adrenal glands and ureters
What are the branches of the adrenal glands
branches from renal artery
branches from inferior phrenic artery and aorta
This paired artery sends lateral branches of abdominal aorta inferior to renal arteries
gonadal artery (left and right)
These arteries cross over ureters and iliac vessels and descends to plevis to supply ovaries
ovarian arteries (found only in females)
These arteries cross over utters and enter inguinal canal and descends into scrotum to supply testes
testicular arteries (found only in males)
What gonadal artery is typically found to be more superior than the other
left gonadal artery
This is the largest vein in the body it begins at roughly the L5 level at the union of common iliac veins
inferior vena cava
What does the inferior vena cava transport and to where
returns poorly oxygenated blood from LL, most of the back, abdominal wall, and abdominopelvic viscera
to the right atrium
Where does the blood from the viscera drain to
portal venous system
There are how many portal-cava anastomoses
four
The portal gastric vein anastomoses with which caval vein
esophageal vein
The caval epigrastric vein anastomoses with which portal vein
paraumbilical vein
The portal superior rectal vein anastomoses with which caval vein
middle/inferior rectal vein
The caval retroperitoneal vein anastomoses with which portal vein
colic vein
True or False
The portal system has no valves
True; reverse flow is possible into the cabal veins
Reversal of the blood flow from the portal venous system to the caval venous system can lead to what
restriction of blood flow resulting in engorged cabal veins
may become dilated and varicose and easily nicked
Dilated esophageal veins produce what
esophageal varices
Dilated epigastric veins produce what
caput medusae
Dilated inferior and middle rectal veins produce what
hemorrhoids
The innervation to the viscera is via what nerve plexus
autonomic; parasympathetic/sympathetic
Where do the sympathetic fibers that supply the abdomen originate
T5-L2(3)
thoracolumbar
Where do the parasympathetic fibers that supply the abdomen originate
CN X and S2-4
craniospinal
The preganglionic splanchnic nerves synapse where
collateral (prevertebral) ganglia
Postganglionic fibers leave the ganglia and travel where to reach what
travel with the main arterial branches (celiac truck, IMA, SMA, renal, etc.)
the effector organs
This is the name of the axons from the preganglionic sympathetic cell bodies
greater (running with celiac trunk)
lesser (running with SMA)
least (running with IMA)
In which gland would you find postganglionic cell bodies
adrenal gland
Preganglionic parasymapthetic nerves from what travel on the celiac trunk, SMA, renal artery and their branches
CN X
Preganglionic parasymapthetic nerves from what travel on the IMA and branches
S2-S4
Where to the synapses of the parasympathetic division occur
within the effector organs
This plexus travels with celiac branches
celiac ganglion
This plexus travels with SMA branches
superior mesenteric ganglion
This plexus travels with renal branches
aorticorenal ganglion
This plexus travels with IMA branches
inferior mesenteric ganglion
The celiac, SM, and aorticorenal ganglion receive what nerve branches
thoracic splanchnic and CN X branches
The IM ganglion receives what nerve branches
lumbar splanchnic and S2-S4 branches