Exam #4: Abdominal Cavity I

Question 1

Where does the esophagus pass through the diaphragm? Where should the esophagogastric junction be in relation?

Answer 1

• Esophageal hiatus

- Inferior

Question 2

What is the most superior portion of the stomach?

Answer 2

Fundus

Question 3

Where does the food bolus enter the stomach?

Answer 3

Cardiac portion

Question 4

Gastrohepatic Ligament

Answer 4

Part of the lesser omentum connecting the liver to the lesser curvature of the stomach

Question 5

How many parts are there of the duodenum? Are these parts intraperitoneal, primarily retroperitoneal, or secondarily retroperitoneal?

Answer 5

• 5 parts
• 1st & 5th parts are intraperitoneal
• 2nd-4th parts are secondarily retroperitoneal

Question 6

Is the jejunum intraperitoneal, primarily retroperitoneal, or secondarily retroperitoneal?

Answer 6

Intraperitoneal

Question 7

Is the ileum intraperitoneal, primarily retroperitoneal, or secondarily retroperitoneal?

Answer 7

Intraperitoneal

Question 8

What three characteristics distinguish the large intestine from the small intestine?

Answer 8

1) Taenia coli
2) Haustra
3) Epiploic appendages

Question 9

Houstra

Answer 9

Pouches along the large intestine

Question 10

Tenia Coli

Answer 10

3 separate longitudinal ribbons of smooth muscle running the large intestine

Question 11

Is the cecum intraperitoneal, primarily retroperitoneal, or secondarily retroperitoneal?

Answer 11

Intraperitoneal

Question 12

Is the ascending colon intraperitoneal, primarily retroperitoneal, or secondarily retroperitoneal?

Answer 12

Secondarily retroperitoneal

Question 13

What forms the right paracolic gutter?

Answer 13

Ascending colon (space between the abdominal wall & the colon)

Question 14

Is the transverse colon intraperitoneal, primarily retroperitoneal, or secondarily retroperitoneal?

Answer 14

Intraperitoneal

Question 15

What forms the left paracolic gutter?

Answer 15

Descending colon

Question 16

Is the descending colon intraperitoneal, primarily retroperitoneal, or secondarily retroperitoneal?

Answer 16

Secondarily retroperitoneal

Question 17

Is the sigmoid colon intraperitoneal, primarily retroperitoneal, or secondarily retroperitoneal?

Answer 17

Intraperitoneal

Question 18

Are the anus & rectum intraperitoneal, primarily retroperitoneal, or secondarily retroperitoneal?

Answer 18

Primarily retroperitoneal

Question 19

What are the three main branches of the celiac trunk? What are these individual arteries supplying oxygenated blood to?

Answer 19

1) Left gastric artery (proximal lesser curvature of stomach)
2) Splenic artery (spleen)
3) Common hepatic artery (liver)

Question 20

What are the three branches of the splenic artery? What are these individual arteries supplying oxygenated blood to?

Answer 20

1) Pancreatic arteries (pancreas)
2) Short gastric arteries (stomach)
3) Left gastro-omental artery/ gastroepiploic (left side of greater curvature)

Question 21

What are the three branches of the common hepatic artery? What are these individual arteries supplying oxygenated blood to?

Answer 21

1) Gastroduodenal artery
2) Right gastric artery (right lesser curvature of the stomach)
3) Proper hepatic artery

Question 22

What are the three branches of the gastroduodenal artery? What are these individual arteries supplying oxygenated blood to?

Answer 22

1) Right gastro-omental/ gastroepiploic artery (right side of the greater curvature)
2) Superior pancreaticoduodenal artery (stomach, pancreas & duodenum)
3) Supraduodenal artery (superior duodenum)

Question 23

What are the branches of the proper hepatic artery?

Answer 23

1) Right hepatic artery

2) Left hepatic artery

Question 24

What artery supplies blood to the gallbladder? Where does it usually branch off of?

Answer 24

Cystic artery, from the right hepatic artery

Question 25

What arteries branch off the SMA?

Answer 25

1) Inferior pancreaticoduodenal artery (head of pancreas & duodenum) 2) Intestinal branches (jejunum & ileum) 3) Ileocolic artery (distal ileum & cecum) 4) R. colic artery (ascending colon) 5) Middle colic artery (transverse colon) 6) Marginal artery

Question 26

What are the branches of the IMA?

Answer 26

1) Left colic artery (descending colon) 2) Sigmoid artery (sigmoid colon) 3) Superior rectal arteries (proximal rectum)

Question 27

If the right right gastro-omental artery is blocked, what artery anastomoses with it & "takes over" blood supply? What region is affected?

Answer 27

- Left gastro-omental artery | - Greater curvature of the stomach

Question 28

If the left gastro-omental artery is blocked, what artery anastomoses with it & "takes over" blood supply? What region is affected?

Answer 28

- Right gastro-omental artery | - Greater curvature of the stomach

Question 29

If the right gastric artery is blocked, what artery anastomoses with it & "takes over" blood supply? What region is affected?

Answer 29

- Left gastric artery | - Lesser curvature of the stomach

Question 30

If the left gastric artery is blocked, what artery anastomoses with it & "takes over" blood supply? What region is affected?

Answer 30

- Right gastric artery | - Lesser curvature of the stomach

Question 31

If the superior pancreaticoduodenal artery is blocked, what artery anastomoses with it & "takes over" blood supply? What region is affected?

Answer 31

- Inferior pancreaticoduodenal artery (SMA) | - Pancreas & duodenum

Question 32

If the inferior pancreaticoduodenal artery is blocked, what artery anastomoses with it & "takes over" blood supply? What region is affected?

Answer 32

- Superior pancreaticoduodenal artery (celiac trunk) & jejunal arteries - Pancreas & duodenum

Question 33

If the jejunal arteries are blocked, what artery anastomoses with it & "takes over" blood supply? What region is affected?

Answer 33

- Inferior pancreaticoduodenal artery | - Jejunum

Question 34

What arteries does the marginal artery connect?

Answer 34

1) Ileocolic 2) Right colic 3) Middle colic (all SMA) 4) Left colic (IMA)

Question 35

If the superior rectal arteries are blocked, what artery anastomoses with it & "takes over" blood supply? What region is affected?

Answer 35

- Middle & inferior rectal arteries | - Rectum

Question 36

If the middle & inferior rectal arteries are blocked, what arteries anastomose with it & "take over" blood supply? What region is affected?

Answer 36

- Superior rectal | - Rectum

Question 37

Where does deoxygenated blood from the gut pass through before entering the IVC?

Answer 37

Hepatic portal system

Question 38

What are the three main branches of the hepatic portal system?

Answer 38

Splenic vein (foregut) Superior mesenteric vein (midgut) Inferior mesenteric vein (hindgut)

Question 39

What is portal hypertension & what is the cause? What are the clinically relevant consequences?

Answer 39

Portal hypertension= liver disease--> increased resistance through the liver-->blood "finds alternate route" via 1) Esophagus-->esophageal varices 2) Rectum--> internal hemorrhoids 3) Umbilicus--> caput medusa 4) Colon

Question 40

Describe the sympathetic innervation of the foregut.

Answer 40

- Arise from T5-T9 - Presynaptics pass through sympathetic chain & greater splanchnic nerve - Synapse at celiac ganglia - Postsynaptics follow branches of the celiac trunk

Question 41

Describe the parasympathetic innervation of the foregut.

Answer 41

- Arise from brain - Pass through vagus nerve (X), celiac plexus, & follow branches of celiac trunk to target organs - Synapse in ganglia in gut plexus - Postsynaptics reach targets via short postsynaptic fibers

Question 42

Describe the sympathetic innervation of the midgut.

Answer 42

- Arise from T10-T12 - Presynaptics pass through sympathetic trunk & lesser/least splanchnic nerves - Synapse at superior mesenteric ganglion - Postsynaptics follow branches of the SMA to targets

Question 43

Describe the parasympathetic innervation of the midgut.

Answer 43

- Arise from brain - Pass through vagus nerve (X), superior mesenteric plexus, & follow branches of SMA to target organs - Synapse in ganglia in gut plexus - Postsynaptics reach targets via short postsynaptic fibers

Question 44

Describe the sympathetic innervation of the hindgut.

Answer 44

- Arise from L1-L2 - Presynaptics pass through sympathetic trunk & lumbar splanchnic nerves (L1 & L2) - Synapse at inferior mesenteric ganglion - Postsynaptics follow branches of the IMA to targets

Question 45

Describe the parasympathetic innervation of the hindgut.

Answer 45

- Arise from S2-S4 spinal levels - Pass through sacral spinal nerves (S2-S4), pelvic splanchnic nerves, cranially--> hypogastric plexus & caudally-->inferior mesenteric plexus, & follow branches of IMA to target organs - Synapse in ganglia in gut plexus - Postsynaptics reach targets via short postsynaptic fibers