exam 1 Flashcards
1-Ab wall
2-Ab wall layers
3-superficial fascia
4-muscles
5-endoab fascia
6-parietal periotenum
1-cavity between thoracoab diaphragm & pelvic brim
=abdominopelvic cavity
2-superficial to deep:
skin—superficial fascia—muscles—endoabdominal fascia—parietal periotenum
3-campers fascia—outer fatty
scarpas fascia—innermost membranous
4-external ab oblique
internal ab oblique
transversus abdominis
rectus abdominis
5-deep to muscles, made up of transversalis fascia, extraperitoneal fat, psoas, & iliacus fascia
6-serous membrane continuous w/ ab visceral peritoneum
1-ab digestive tract
2-large intestine
3-perioteneal cavity
4-parietal peritoneum
5-visceral peritoneum
6-peritoneal cavity
1-distal end of esophagus, stomach w/ curvatures & pyloric valve, small intestine (duodenum, jejunum (duodenojejunal junction), & illeum), then large intestine
2-cecum w/ ileocecal valve & vermiform appendix
- ascending colon
- transverse colon (at r. colic hepatic flexure)
- descending colon (at l. colic splenic flexure)
- sigmoid colon
- rectum
3-lines abdominopelvic cavity deep to transversalic fascia = peritoneum…thin, transparent serous
-is an enclosed sac where organs develop up against…making 2 layers
4-directly lines ab wall & is strong…sensitive to somatic stimuli (cutting, burning)
5-directly covers viscera & isnt as strong as parietal peritoneum…isnt sensitive to somatic stimuli
6-potential space between 2 layers that is empty except for serous fluid
1-ascites
2-intraperitoneal organs
3-peritonitis
4-subdivisions of cavity
1-abnormal accumulation of serous fluid bc of heart, kidney or liver failure
2-peritoneal cavity, lubricated by serous fluid allowing organs to move around & change shape/volume
3-inflammation of peritoneum
4-greater peritoneal sac
lesser peritoneal sac
omental foramen of winslow (opening between greater/lesser)
1-intraperitoneal
2-retroperitoneal
1-organs that protrude against peritoneal sac & become covered by peritoneal—stomach, liver, jejunum
- have a double layer of peritoneum suspending from post. ab wall=mesentery—allows movement of organs & brings nutrition type stuff
- BV, nerves, & lymp go to organs w/in mesentery
- mesentaries = ligaments (falciform or gastrocolic), mesointestines, & omenta (to stomach)
- mesentary allows intraperitoneal organs to move w/in ab cavity
- intraperioteneal protude against peritoneal sc, not located w/in peritoneal cavity
2-other organs protrude slightly against peritoneal sac & covered on 1 side by peritoneum
- organs grow up against post. ab wall, post. to parietal peritoneum
- retroperitoneal have no mesentary
- some organs start out as intraperitoneal but then develop against post. ab wall…secondarily retroperitoneal (duodenum, pancreas, cecum, ascending colon, descending colon)
1-greater omentum
2-lesser omentum
3-mesointestine
4-mesoappendix
5-transverse mesocolon
6-sigmoid mesocolon
7-falciform ligament
1-gastrocolic ligament runs from greater curvature of stomach to transverse colon
-omental apron hangs down inferior to transverse colon, shape & size varies greatly among individuals…help to seal off infection by sticking to a site of inflammation
2-from liver to lesser curvature of stomach & duodenum.
portion to duodenum= bile duct, hepatic artery proper & portal vein===portal triad
3-attaches to jejunum & ileum
-superior mesenteric vessels & autonomic nerves
course w/in in
4-attaches appendix to post. ab wall
5-attaches to inferior margin of transverse colon, root along pancreas
6-root attaches sigmoid colon to posterior ab wall
7-contains round ligament of liver in its free border
-remnant of fetal umbilical vein
1-stomach
2-greater omentum/lesser omentum
3-cardiac region
4-fundus
5-body
6-pyloric region
1-distal esophagus enters ab through opening in diaphragm = esophageal hiatus & opens into stomach at cardiac orifice
- reflux of food into esophagus from stomach is prevented by contraction of voluntary muscles of diaphragm & SM around cardiac orifice (lower esophageal sphincter)—physiological sphincter
- J-shaped dilation distal to esophagus
2-greater= attached to greater curvature lesser= attached to lesser curvature
3-near cardiac orifice
4-dilation/bulge that lies superior to horizontal line drawn to l. from region of cardiac notch
- rests against l. dome of thoracic diaphragm
- filled w/ gas (dark on x-ray)
5-largest portion of stomach
-below cardiac region & fundus to vertical line dropped from angular incisure
6-line dropped from angular incisure
- pyloric antrum= wider area adjacent to body
- pyloric canal= narrower region leading to pyloric sphincter
1-pyloric sphincter—valve
2-lining of stomach
3-function
4-hiatal hernia
1-junction between stomach & duodenum (SI)
- true anatomical sphincter= actual thickening of muscle along gut wall
- controls rate at which stomach empties…tonic contraction—-closed unless emitting stomach contents
2-gross folds of mucosa= rugae
3-distensible—blender/reservoir of food
- food enters stomach = bolus lump
- mixes w/ enzymes to form watery mixture= chyme
- peristaltic actions= move chyme from stomach/intestine
- stomach empties 2-3 hrs after eating
4-part of stomach bulges through esophageal hiatus into thoracic cavity
1-small intestine
2-duodenum
3-jejunum
4-ileum
1-attached proximally to stomach, distally to cecum of LI
-inner surface w/ mucosal folds= plicae circulares
2-2ndary retroperitoneal, but 1st part= intraperitoneal
- 12 finger length
- C shaped—cradles head of pancreas
- begins to r. of midline & ends to l. of midline & duodenojejunal junction
- 4 parts—superior, descending, horizontal, &ascending
- common bile & main pancreatic empty into l. side of 2nd part of duodenum at major duodenal papilla
- accessory pancreatic opens into 2nd part
3-intraperitoneal
- continuous w/ duodenum proximally & ileum distally
- no clear demarcation from ileum—upper 2/5
- prominent of proximal end
- often empty—wider diameter w/ thicker walls
- redder bc of vascularity
- prom. plicae circulares (passage of food & aids in absorption)
- BV in mesentary— 1-2 arcades & long vasa recta (straight arteries)
4-intraperitoneal
- continuous w/ jejunum prximally & cecum distally
- lower 3/5 of combine jejunoileum
- prom. at distal end
- **narrower diameter w/ thinner walls
- paler = less vascularized**
- *-absent plicae circulares**
- inc intermesenteric fat
- BV in mesentary= 4-5 arcades & short vasa recta
- *-peyers patch= submucosal lym tissue aggregates**
- meckels diverticulus—-fingerlike blind pouch (vitelline duct) & 2 ft from ileocecal junction, infamed= appendicitis
1-jejunum & ileum
large intestine
2-tenia coli
3-haustra
4-omental (epiploic) appendices
5-cecum
6-vermiform appendix
1-attached to posterior ab wall by mesentary
- double layer of peritoneum has BV, nerves & lymphs
- *-fan shaped**
- root of mesentary= short & goes obliquely superior to inferior & l. to r. across post ab wall from duodenjejunal flexure to ileocecal junction
- mesentary border= 6-7 m at pt of attachment of jejunum & ileum
2-outer longitudinal muscle layer= incomplete= 3 equally spaced bands
—inner surface of LI has mucosal folds called semilunar folds in between tenia coli
3-sacculations of gut wall that bulge between tenia coli
4-fat filled appendices
5-blind pouch—6-7 cm long
- secondarily retroperitoneal
- ileum enters cecum at ileocecal orifice
- ileocecal valve guards orifice—reflux prevented by contraction of terminal ileum
- appendicular origin in cecum=3 cm inferior to ileocecal valve
6-2-20 cm long
- root is fixed—closer to umbilic to anterior superior iliac spine—appendectomy incisions are focused (mcBurneys pt)
- position of rest of appendix varies
- commonly retrocecal or over pelvic brim
- intraperioteneal= mesoappendix & if inflamed=appendicitis
large intestine
1-ascending colon
2-transverse colon
3-descending colon
4-sigmoid colon
5-rectum/anal canal
1-2ndarily retroperitoneal
- from cecum proximally to r. colic hepatic flexures distally
- narrower than cecum
2-intraperitoneal
- largest & most mobile portion of LI
- r. colic hepatic flexure to l. colic splenic flexure—l. colic flexure is more superior & posterior than r.
- 2 mesenteric attachments—posteriorly= transverse mesocolon=courses across post. ab wall across duodenum & pancreas
- –anterior= gastrocolic ligament of greater omentum=follows curvature of stomach and hangs into pelvis
3-2ndarily retroperitoneal-–from l. colic flexure to sigmoid colon
-narrowest part
4-intraperitoneal
- s-shaped loop from descending colon to rectum
- attached to sigmoid mesocolon—v-shaped mesentery running along post. ab wall & pelvis
5-retroperitoneal—w/in true pelvis
- rectum= continuous w/ sigmoid colon…5 in lon
- anal canal is inferior 1/5 of GI—continuous w/ rectum at anorectal junction
1-liver
2-lobes
3-surfaces/borders
4-arterial blood
5-peritoneal attachment
1-largest organ, except skin
- soft & dark red
- carries out endocrine & exocrine= detox, glycogen storage, synth of blood proteins & bile secretion
2-r. & l. lobes
-quadrate & caudate lobes—visible from visceral aspect
3-diaphragmatic surface in contact w/ diaphragm & anterior body wall
- visceral surfaces faces down, left & posteriorly
- sharp inferior border extends beyond costal margin
4-from proper hepatic artery & autonomic nerve suppy, enters liver at porta hepatis
- *biliary ducts** exit here, along w/ the main lymph drainage
- but the venous drainage, from hepatic veins empty into inferior vena cava posterior to liver
5-liver covered by visceral peritoneum= intraperitoneal
- visceral peritoneum is absent in bare area
- falciform ligament has vertical attachment on diaphragmatic surface to r. of midline & carries round ligament of liver in inferior edge
- lesser omentum- attaches to porta hepatis & along ligamentum venosum
hepatic portal system
1-portal vessel carries blood from 1 capillary bed to another
2-hepatic portal v (superior mesenteric & splenic) brings blood from capillary beds of stomach, intestines, & spleen to capillary bed of liver
-blood= 75% of blood sent to liver…mixes w/ blood delivered from hepatic aa. Portal blood is low in O2, but rich in nutrients
-nutrients absorbed by intestines are brought to liver before going to rest of body
-liver adjusts conc —glucose can be stored as glycogen, fat will travel via lymphatics, alc can be detoxified by liver
-old RBCs broken down in spleen & hemoglobin sent to liver for bile production
3-after passing through hepatic capillary, blood exits via hepatic v—3 veins into inferior vena cava
4-portacaval anastomoses- between portal & systemic
- end of esophagus between l. gastric v (portal) & post thoracic wall veins (systemic)
- at anal canal between superior rectal v (portal) & inferior rectal v (systemic)
- others are behind retroperitoneal organs, at bare area of liver, & running through falciform
1-esophageal varices
2-hemorrhoids
3-round ligament of liver
4-ligamentum venosum
5-lymph drainage
***clinically if portal flow is obstructred= anastomoses enlarge
1-varicose veins beneath mucosa of esophagus—if rupture= bleeding in stomach
2-varicose veins beneath mucosa of anal canal
3-part of umbilical v. prenatally. carrying O2 blood from placenta to fetus
4-ductus venosus before birth, shunting blood from umbilical v to Inferior vena cava, bypassing liver
5-flows along arterial pattern in opposite direction. drainage into lymph nodes around celiac a & aorta into beginning of thoracic duct, the cisterna chyli
1-Gall Bladder
2-biliary ducts
1-intraperitoneal, covered by hepatic visceral peritoneum
- gall bladder in fossa on inferior surface of liver
- concentrates bile by absorbing H20, emuslifies fat & released when fatty food enters duodenum
2-carry bile from liver & gall bladder to duodenum
- intrahepatic biliary ducts (in liver) drain into r. & l. hepatic ducts that are extrahepatic…unite to form common hepatic duct in lesser omentum…unite to form cystic duct from gall bladder then making common bile duct
- common bile duct joins main pancreatic duct = hepatopancreatic ampulla
- opens into l. side of 2nd part of duodenum= major duodenal papilla —closed by sphincter, opens when there is fat to emulsify
- blockage= jaundice
1-pancreas
2-spleen
1-2ndarily retroperitoneal
- head, neck, body & tail—exocrine (digestive enzymes into ducts) & endocrine (insulin & glucagon)
- main pancreatic duct- has digestive enzymes, joins common bile duct & opens into duodenum onto major duodenal papilla
- accessory pancreatic duct- sometimes absent—drains superior portion of head, empties into duodenum superior to major duodenal papilla
- blockage= pancreatitis—digesting itself
- blood supply from splenic a branches
2-intraperitoneal
-largest lymph organ—soft purple
-filters & stores blood, creates RBCS, fetal development, lymphopoiesis
-hidden under diaphragm & against ribs on l. side
must be huge to be palpable, notched border identifies it
-thin capsule that can easily rupture
-hilus= portion of spleen where BV enter & exit
