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Gross Anatomy > Exam 3 Abdomen > Flashcards

Exam 3 Abdomen Flashcards

1
Q

The organs contained in the foregut are…

A
  • Esophagus
  • Stomach
  • Liver
  • Gallbladder
  • Pancreas
  • Spleen
  • Proximal duodenum
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2
Q

The organs contained within the midgut are…

A
  • Distal duodenum
  • Jejunum
  • Ileum
  • Cecum
  • Appendix
  • Ascending colon
  • Proximal transverse colon
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3
Q

The organs contained within the hindgut are…

A
  • Distal transverse colon
  • Descending colon
  • Sigmoid colon
  • Rectum
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4
Q

Parietal peritoneum has same somatic afferents as…

What does mean for sensitivity?

A
  • body wall
  • Same sensitivities as skin, maps as well-localized dermatomes
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5
Q

Visceral peritoneum visceral afferents follow…

What does this mean for sensitivity?

A
  • sympathetic pathway back to spinal cord
  • Poorly localized pain across broad levels
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6
Q

The retroperitoneal organs of the abdomen are…

A
  • Suprarenal glands
  • Pancreas (except head)
  • Kidneys
  • Duodenum (except proximal portion)
  • Ascending colon
  • Descending colon
  • Aorta
  • IVC
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7
Q

Greater omentum

  • Where does it attach?
  • What does it cover?
  • What ligaments comprise it?
A
  • Attached to greater curvature of stomach
  • Drapes across entire abdominal cavity and separates organs from abdominal cavity
  • Gastrophrenic ligament, gastrosplenic ligament, gastrocolic ligament
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8
Q

Coronary ligament

  • Function
  • What 2 other ligaments comprise it?
  • What is the bare area and what does it mean clinically?
A
  • Suspends liver from diaphragm
  • Right and left triangular ligaments make up lateral portion where ligament and peritoneum reflects back on itself
  • Bare are is large patch of liver without peritoneum
    • Potential site for spread of infection from abdomen to thoracic cavity
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9
Q

Falciform ligament

  • Function
A
  • Anchors liver to anterior abdominal wall
  • Separates liver into right and left lobes
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10
Q

Mesentery proper

  • Function
  • Why highly vascularized
A
  • Anchors jejunum and ileum to posterior abdominal wall
  • Highly vascular for the absorption of nutrients
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11
Q

Mesocolon

  • Function
  • What does it connect to?
A
  • Anchors organ to posterior abdominal wall
  • Transverse colon (transverse mesocolon), sigmoid colon (sigmoid mesocolon), appendix (mesoappendix)
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12
Q

Lesser omentum

  • What is it connected to?
  • What components make it up?
A
  • Connects from inferior liver to lesser curvature of stomach and proximal duodenum
  • Comprised from hepatoduodenal ligament and hepatogastric ligament
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13
Q

What is contained within the hepatoduodenal ligament?

A

Portal triad

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14
Q

Omental bursa (lesser sac)

  • Where is it located?
  • What is the opening called?
A
  • Located behind lesser omentum
  • Opening is epiploic foramen
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15
Q

Where is the celiac trunk located?

A

Just below the aortic hiatus

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16
Q

What organs does the celiac trunk supply?

A
  • Distal esophagus
  • Stomach
  • Spleen
  • Liver
  • Gallbladder
  • Pancreas
  • Proximal duodenum
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17
Q

Branches of the celiac trunk and their branches.

A
  • Common hepatic artery
    • Right gastric artery
    • Gastroduodenal artery
      • Right gastro-omental artery
      • Superior pacreaticoduodenal artery
    • Proper hepatic artery
      • Right and left hepatic arteries
  • Left gastric artery
    • Esophageal arteries
  • Splenic artery
    • Short gastric arteries
    • Left gastro-omental artery
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18
Q

Stomach

  • Function
  • Parts
  • Arterial supply
A
  • Temporary storage of bolus, secretes gastric joices, forms chyme
  • Parts: Fundus, body, cardia, pylorus, lesser curvature, greater curvature
  • Arterial supply:
    • Left and right gastric arteris supply lesser curvature
    • Left and right gastro-omental arteries supply greater curvature
    • Short gastric arteries
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19
Q

Spleen

  • Function
  • Location
  • Arterial supply
A
  • Lymphatic organ, recycles RBCs
  • Located posterolateral to body of stomach between ribs 9-12
  • Arterial supply: Splenic artery
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20
Q

Liver

  • Function
  • Location
  • Lobes
  • Arterial Supply
A
  • Peforms critical metabolic functions, stores glycogen, produces bile
  • Occupies most of RUQ
  • Lobes: Right lobe, left lobe, caudate lobe, quadrate lobe
    • Can also be divided into eight independent segments that can be resected without compromising other lobes
  • Arterial supply: Common hepatic -> proper hepatic -> right and left hepatic arteries
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21
Q

Portal-Systemic Anastomoses

  • What is the purpose of these?
  • Where are they located?
  • What can happen when things go wrong?
A
  • Offer alternate route for venous drainage should liver become compromised.
  • Located at esophageal veins, paraumbilical veins, colic veins, and rectal veins
  • Can become engorged if there is pressure build up in portal venous system
    • Can cause esophageal varices, caput medusae, or hemorrhoids
    • Can also cause ascites (edema in visceral tissues)
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22
Q

Passage of bile from liver into duodenum.

Know how gallbladder fills with bile.

A
  • Bile leaves the liver through: right and left hepatic ducts
  • It then enters the common hepatic duct
  • Common hepatic duct merges with the cystic duct to form common bile duct
  • Common bile duct merges with pancreatic duct to form hepatopancreatic ampulla
  • Bile and pancreatic juices empty into duodenum through major duodenal papilla
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23
Q

Gallbladder

  • Function
  • Arterial Supply
A
  • Stores and concentrates bile
    • Can develop gallstones from crystallization of cholesterol and bile salts in gallbladder
    • Releases bile in response to chyme in duodenum
  • Supplied by cystic artery
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24
Q

Cystohepatic Triangle (of Calot)

  • Borders
  • Contents
A
  • Lateral border: cystic duct
  • Inferior border: common hepatic duct
  • Superior border: inferior portion of liver
  • Contains cystic artery and Lund’s node
25
Q

Portal Triad

  • Where is it contained?
  • What is it?
A
  • Contained within hepatoduodenal ligament
  • Hepatic artery, hepatic portal vein, and common bile duct
26
Q

Lymphatics of Foregut

What is the path of lymph in the foregut?

A
  • Pyloric nodes and splenic nodes drain into celiac nodes
  • Celiac nodes drain into cisterna chyli that then drains into thoracic duct
27
Q
  • Sympathetic innervation of foregut
  • Parasympathetic innervation of foregut
  • What forms autonomic plexuses?
A
  • Sympathetic: Thoracic splanchnic nerves, Lumbar splanchnic nerves
    • Synapse in celiac ganglion
  • Parasympathetic: Vagus nerves
  • Postganglionic sympathetic fibers blend with parasympathetic (preganglionic) fibers to form autonomic plexuses that follow arteries to target organs
28
Q

The organs that the superior mesenteric artery supplies are…

A
  • Distal duodenum
  • Pancreas
  • Jejunum
  • Ileum
  • Appendix
  • Cecum
  • Ascending colon
  • Transverse colon (proximal 2/3)
29
Q

Pancreas

  • Function
  • Location
  • Parts
  • Relationships
A
  • Function: Digestion and endocrine organ
  • Location: Retroperitoneal between spleen and duodenum
  • Parts: Tail (articulates with spleen)
    • Body
    • Neck
    • Head (lies within “C” of duodenum)
    • Uncinate process (behind SMA and SMV)
  • Main panacreatic duct merges with common bile duct at hepatopancreatic ampulla.
    • Pancreatic juices released into duodenum via major duodenal papilla
    • Accessory pancreatic duct empties into duodenum via minor duodenal papilla
30
Q

Duodenum

  • Function
  • Location
  • Arterial supply
  • Parts and relationships
  • Internal structures
A
  • Major site of chemical digestion: chyme mixes with pancreatic juices and bile
  • Continuation of stomach and leads to jejunum
  • Supplied by branches of celiac trunk and SMA
  • Parts: Superior: anchored to liver via hepatoduodenal ligament
    • Descending: nestles head of pancreas
    • Horizontal: nestles uncinate process of pancreas
    • Ascending: anchored to diaphragm via suspensory ligament
  • Internal structures:
    • Duodenal cap smooth (following pyloric sphincter)
    • Plicae circulares: folds of mucosa that aid in digestion
    • Major and minor duodenal papilla
31
Q

Hepatic portal vein is formed by junction of what two veins?

A
  1. Splenic vein
  2. Superior mesenteric vein
32
Q

Branches of the superior mesenteric artery

A
  • Right colic artery
  • Middle colic artery
  • Ileocolic artery
    • Appendicular artery
  • *** Marginal artery supplied by right, middle, and ileo-colic arteries
  • Inferior pancreaticoduodenal arteries
  • Intestinal arteries
33
Q

Jejunum

  • Function
  • Location
  • Arterial supply
  • Identifying features
A
  • Majority of nutrient absorption
  • Intraperitoneal, continuation of duodenum to ileum
    • Anchored by mesentery proper
    • Anchored to posterior abdominal wall via oblique root
  • Supplied by intestinal arteries of SMA (arterial arcades -> vasa recta)
  • ID features: Tall plicae circulares
    • Few, wide arcades
    • Long vasa recta
    • Larger diameter
34
Q

Ileum

  • Function
  • Location
  • Arterial supply
  • Identifying features
A
  • Majority of nutrient absorption
  • Intraperitoneal, continuation of duodenum to cecum
    • Anchored by mesentery proper
    • Anchored to posterior abdominal wall via oblique root
  • Supplied by intestinal arteries of SMA (arterial arcades -> vasa recta)
  • ID features: Few plicae circulares
    • Many small arcades
    • Short vasa recta
    • Peyer’s patches (lymphoid nodules)
35
Q

Large Intestine

  • Function
  • Location
  • Parts
  • Arterial supply
A
  • Absorption of water and vitamins; storage and compaction of feces
  • Transverse colon and sigmoid colon intraperitoneal
    • Ascending and descending colon retroperitoneal
    • Frames small intestines
    • Anchored by transverse mesocolon
  • Parts: Cecum, Colon, Rectum
    • Appendix off cecum
  • Proximal 2/3 supplied by SMA, distal 1/3 supplied by IMA
36
Q

Colon can be further divided into which parts?

A
  • Ascending colon
  • Transverse colon
    • Hepatic flexure
    • Splenic flexure
  • Descending colon
  • Sigmoid colon
37
Q

Appendix

  • Function
  • Location
  • Arterial supply
A
  • Abundant lymphoid tissue
  • Intraperitoneal off cecum
    • Anchored by mesoappendix
  • Supplied by appendicular artery
38
Q

Internal structures of large intestine

A
  • Plicae semilunares
    • Form haustra
  • Taenia coli: 3 bands of longitudinal mm
39
Q

Lymphatics of midgut

A
  • Lacteals carry dietary lipids to bloodstream and liver
  • Superior mesenteric nodes drain into cisterna chyli -> thoracic duct
40
Q

Innervation of midgut

A
  • Sympathetic: Thoracic splanchnic nerves
    • Synapse in superior mesenteric ganglion
  • Parasympathetic: Vagal trunks
41
Q

Branches of inferior mesenteric artery

A
  • Left colic artery
    • Drains into marginal artery
  • Sigmoid arteries
  • Superior rectal artery
42
Q

The inferior mesenteric vein drains into…

A

the splenic vein that then drains into the hepatic portal vein

43
Q

Lymphatics of the hindgut

A

Inferior mesenteric lymph nodes drain into the cisterna chyli -> thoracic duct

44
Q

Innervation of hindgut

A
  • Sympathetic: Lumbar splanchnic nerves
    • Synapse in inferior mesenteric ganglion
  • Parasympathetic: Pelvic splanchnic nerves
45
Q

Organs that are retroperitoneal are…

A
  • Duodenum (except proximal portion)
  • Pancreas (except head and uncinate process)
  • Ascending colon
  • Descending colon
  • Kidneys
  • Ureters
  • Suprarenal glands
  • Abdominal aorta
  • IVC
  • Posterior wall muscles
46
Q

Retroperitoneal space bordered by…

A
  • Anterior border: parietal peritoneum
  • Lateral border: transversalis fascia
  • Posterior border: investing layers of thoracolumbar fascia
47
Q

Suprarenal Glands

  • Parts
  • Function
  • Location
  • Shape
  • Arterial Supply
A
  • Parts: Capsule, Cortex, Medulla
  • Function: Cortex produces coricosteroids and andgrogens
    • Medulla: produces catecholamines
      • Also site of preganglionic sympathetic fiber synapse
  • Location: Superior to kidneys
  • Right Suprarenal: Pyramid shaped
  • Left Suprarenal: Crescent shaped
  • Supplied by: Superior suprarenal a (off inferior phrenic a)
    • Middle suprarenal a (off aorta)
    • Inferior suprarenal a (off renal a)
48
Q

Kidneys

  • Function
  • Location
  • Parts
  • Arterial Supply
A
  • Function: Excretion of wastes and excess solutes, resorption of nutrients, Critical role in blood volume and pressure, produces urine
  • Located posterior to peritoneal organs
    • Left kidney shielded by ribs 11 and 12
    • Right kidney lower and covered only by rib 12
  • Parts: Renal sinus- passage for renal a/v, ureter, nerves and lymphatics
    • Cortex (majority of nephrons): stretch into medulla through renal columns
    • Medulla: renal pyramids that drain into renal papilla
    • Minor calyx: merge to form major calyces
    • Major calyx: drain into renal pelvis
    • Renal pelvis: drains into ureter
  • Arterial Supply: Renal arteries (Right renal a longer than left due to IVC)
49
Q

Ureters

  • Function
  • Sites where kidney stones can become lodged
  • Arterial Supply
A
  • Carries urine from kidneys to urinary bladder
  • Kidney stones can become lodged where ureter narrows:
    • As it courses medially to run along lumbar vertebrae
    • Where it crosses iliac arteries
    • Where it enters the urinary bladder posterolaterally
  • Arterial Supply: Ureteral a (off renal and gonadal aa)
50
Q

Lymphatics of retroperitoneal space

A

Lumbar nodes drain into cisterna chyli

51
Q

Quadratus lumborum

  • Proximal Attachment
  • Distal Attachment
  • Innervation
  • Action
A
  • Proximal Attachment: Iliac crest
  • Distal Attachment: 12th rib, L1-L4
  • Innervation: T12, L1-L4
  • Action: Lateral bending
52
Q

Psoas major

  • Proximal Attachment
  • Distal Attachment
  • Innervation
  • Action
A
  • Proximal Attachment: Transverse process/body of T12-L5
  • Distal Attachment: Lesser trochanter of femur
  • Innervation: Lumbar plexus
  • Action: Flex and rotate hip
    • Laterally bend and flex trunk
53
Q

Iliacus

  • Proximal Attachment
  • Distal Attachment
  • Innervation
  • Action
A
  • Proximal Attachment: lliac fossa
  • Distal Attachment: Lesser trochanter of femur
  • Innervation: Femoral nerve
  • Action: Flex and laterally rotate hip
54
Q

Psoas minor

  • Proximal Attachment
  • Distal Attachment
  • Innervation
  • Action
A
  • Proximal Attachment: Body of T12-L1
  • Distal Attachment; Iliopectineal arch
  • Innervation: Lumbar plexus
  • Action: Weakly flexes trunk
  • ***Absent in 50% of people
55
Q

Diaphragm

  • Proximal Attachment
  • Distal Attachment
  • Innervation
  • Action
A
  • Proximal Attachment: Ribs 7-12, costal cartilage, xiphoid, L1-L3
  • Distal Attachment: Central tendon
  • Innervation: Phrenic nerve
  • Action: Depresses floor of thoracic cavity, compresses abdominal cavity
56
Q
  • What are the three ligaments of the diaphragm (excluding central tendon)?
  • What passes through each ligament?
A
  • Lateral arcuate ligament: passage of quadratus lumborum and subcostal neurovasculature bundle
  • Medial arcuate ligament: passage of psoas major and sympathetic trunk
  • Median arcuate ligament: forms aortic hiatus
57
Q

Where are the three openings of the diaphragm and what passes through each?

A
  • Caval foramen: at T8, IVC passes through here
  • Esophageal hiatus: at T10, esophagus and vagal trunks pass through here
  • Aortic hiatus: at T12, aorta and thoracic duct pass through here
58
Q

Autonomic innervation of retroperitoneal space

A
  • Sympathetic: via lumbar splanchnic nn from paravertebral ganglia
    • Only grey rami communicans present below L2
  • Parasympathetic: some from vagal trunks, also from pelvic splanchnic nn
59
Q

What is posterior to the superior duodenum?

A
  • Common bile duct
  • Gastroduodenal artery
  • SMA
  • SMV
  • IVC
  • Aorta
  • Neck of the pancreas

Gross Anatomy (21 decks)

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