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Bloc E - GI & Metabolism > Feb2 M3-Anatomy Lecture 4 > Flashcards

Feb2 M3-Anatomy Lecture 4 Flashcards

1
Q

spleen 1x3x5x7x9x11 rule

A
  • size is 1x3x5 inches
  • weight is 7 oz
  • position is between 9th and 11th rib
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2
Q

name of abd region where spleen is + anterior and posterior structure

A

left hypochondriac region
A: splenic flexure of the colon
P: diaphragm

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3
Q

relationship of organs and mesentery near spleen in primitive embryonic stage

A

anterior to posterior: liver, stomach, spleen, aorta. all peritoneal

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4
Q

relationships of organs near the spleen in adults and how lesser sac is formed

A

intraperitoneal: spleen goes to the left. stomach a bit anterior. liver to the right. tail of pancreas
retroperitoneal: pancreas (head and neck), aorta, ..

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5
Q

ligament connecting the spleen to the back wall (of abd wall)

A

splenorenal (or lienorenal) ligament: between kidney and pancreas

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6
Q

ligament connecting spleen at the front

A

gastrosplenic ligament

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7
Q

ventral mesentary connecting the liver to the umbilicus

A

falciform ligament

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8
Q

2 surfaces of the spleen + 3 impressions

A 
diaphragmatic surface (outer)
visceral surface (inner): renal impression, colic impression and gastric impression
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9
Q

ligament that supports the spleen but that doesn’t connect to it

A

phrenicocolic ligament (between diaphragm and colon)

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10
Q

2 ligaments that support the spleen: components and composition

A

lienorenal and gastrosplenic (contain vessels and CT)

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11
Q

splenic artery vs splenic vein

A

splenic a.: curly, sup border of pancreas

splenic v: straight. middle back of pancreas

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12
Q

3 veins forming portal vein

A

splenic vein, SMV, IMV

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13
Q

splenomegaly def and causes

A

enlargement of the spleen. back pressure from portal htn or spleen working too hard (hemolytic anemia) or infiltration from leukemia or lymphoma

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14
Q

4 functions of the spleen

A
  1. storage of RBCs
  2. destruction of worn-out RBCs
  3. Removal of foreign material from the blood
  4. Production of mononuclear leukocytes
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15
Q

organs that take over the spleen when it’s removed

A

liver and bone marrow

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16
Q

pancreas head relations + special portion

A

is in curve of D2. posterior: IVC and bile duct
anterior: SMA and SMV
uncinate process: elongation to the left

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17
Q

common bile duct is junction of what

A

cystic duct from gallbladder and common hepatic duct in the liver

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18
Q

where common bile duct and main pancreatic duct join and name of region where they’re joined before entering D2

A 
in head of the pancreas
hepatopancreatic ampulla (ampulla of Vater)
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19
Q

name of sphincter and name of opening where hepatopancreatic ampulla opens in D2

A

sphincter of Oddi

major duodenal papilla

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20
Q

sphincter of Oddi (or sphincter of ampulla) composition

A

muscular valve

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21
Q

in people with extra pancreatic duct, name of the duct + name of opening

A
  • accessory pancreatic duct (or duct of Santorini)

- minor duodenal papilla

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22
Q

blood supply to the pancreas (each part)

A

head: ant and post superior PD a. + ant and post inferior PD a.
neck: dorsal pancreatic a
body and tail: splenic a. and transverse pancreatic a.

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23
Q

2 surfaces of the liver and what covers them

A

diaphragmatic = top, visceral peritoneum on it

visceral surface = bottom, visceral peritoneum on it

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24
Q

bare area intra or retroperitoneal + what defines it

A

retroperitoneal. area in back of liver not covered with perit. bc greater sac stopped on one side and lesser sac stopped on other side

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25
Q

falciform ligament function

A

attaches the liver to the anterior body wall

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26
Q

ligamentum teres hepatis: meaning in english, what it comes from and where it is

A

round ligament of the liver. remnant of fetal umbilical veins. hangs down falciform ligament

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27
Q

what traverses the bare area and what surrounds it

A

traversed by IVC and esophagus

surrounded by coronary ligament

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28
Q

coronary ligament of the liver def

A

parts of the peritoneal reflections that hold the liver to the inferior surface of the diaphragm

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29
Q

3 ligaments in the liver extending from the coronary ligament

A
  • right triangular ligament
  • left triangular ligament
  • falciform ligament
30
Q

if lift the liver at the front and flip it upwards to see the visceral surface, what forms the H shape

A

right arm: gallbladder (top) and IVC (bottom) but reversed IRL
left arm: ligamentum teres (top) and ligamentum venosum bottom but reversed IRL

31
Q

4 lobes of the liver surrounding the H shape

A

right lobe, left lobe, quadrate lobe (top) and caudate lobe (bottom) but reversed IRL

32
Q

trick for remembering caudal vs quadrate lobe

A

Caudate is near inferior vena Cava (two Cs)

33
Q

porta hepatis def

A

middle of H shape: hepatic ducts and branches of portal vein and hepatic artery

34
Q

ligamentum venosus origin

A

ductus venosus shunting portion of left umb vein blood directly to IVC (to allow O2 blood from placenta to bypass liver)

35
Q

anatomical vs functional separation of the left and right lobes of the liver

A

anatomical: -separated at falciform ligament and lig teres hepatis
- functional: separated at gallbladder and IVC

36
Q

functional segments of the liver: what separates them

A

hepatic veins cut between the segments vertically. and vein cutting liver in 2 horizontally

37
Q

functional segments of liver in right lobe ( right of IVC)

A

top row: 7-8

bottom row: 6-5

38
Q

functional segments of liver in left lobe (left of IVC)

A

1 in the back
top row: 4a and 2
bottom row: 4b and 3

39
Q

3 parts of gallbladder + where it empties

A

fundus, body and neck. empties in cystic duct at bottom

40
Q

visible portion of cystic duct on radiology + function

A

spiral valve. helps keep the duct open

41
Q

gallbladder function

A

stores bile produced by the liver that backs up in GB when sphincter of Oddi is shut

42
Q

portal triad and their relations

A
  • portal vein in the back
  • front left: proper hepatic artery
  • front right: bile duct
43
Q

the portal triad is found in which structure

A

hepatoduodenal ligament

44
Q

what branches lead to forming the bile duct (common bile duct)

A
  • right and left hepatic ducts form common hepatic duct

- common hepatic duct (left) + cystic duct (right) join to make common bile duct

45
Q

names of the 3 hepatic veins

A

right hepatic vein, middle HV and left HV

46
Q

name of veins that do the same thing as azygos and hemiazygos but below subcostal vein (T12)

A

ascending lumbar veins give 4 lumbar veins on each side of the IVC that enter the IVC

47
Q

location of the 4 lumbar veins (superior and inferior limits)

A

superiorly, lumbar vein 1 at level of renal vein

inferiorly, lumbar vein 4 before IVC divides in right and left common iliac v.

48
Q

lumbar veins in abdomen are equivalent to what in thorax

A

intercostal veins

49
Q

4 portocaval anastomoses (locations)

A
  1. esophageal
  2. paraumbilical
  3. rectal
  4. retroperitoneal
50
Q

esophageal portocaval anastomosis

A

venous blood can go to portal system or to azygos vein

51
Q

paraumbilical portocaval anastomosis

A

at the superficial abdomen level near ligamentum teres + on body wall, blood may go to portal system or superior epigastric vein

52
Q

rectal portocaval anastomosis (no exam Q on that in GI)

A

middle and inferior rectum drain in caval system not portal like superior rectum

53
Q

retroperitoneal portocaval anastomosis

A

ascending and descending colon are retroperitoneal and blood goes to IVC

54
Q

how esophageal portocaval anastomosis may manifest clinically

A

can get esophageal varices and spit blood if they rupture bc buildup from portocaval htn

55
Q

how paraumbilical portocaval anastomosis may manifest clinically

A

from portal htn, can get backup of venous blood in umbilical region

56
Q

type of innervation on front (abd) wall

A

somatic

57
Q

splanchnic nerve 3 divisions and spinal origins + what nervous system

A

SS.
greater splanchnic: T5-T9
lesser splanchnic: T10-T11
least splanchnic: T12

58
Q

how SS nerves get to organs in abdomen

A

follow blood vessels (initially aorta)

59
Q

how SS postganglionic nerves get to stomach, intestine + colon and also lower GI

A

to stomach: follow celiac trunk
to intestine and colon: follow SMA
to lower GI tract: follow IMA

60
Q

name of 3 MAIN ganglia the SS system synapses on in the GI tract

A

celiac ganglion
superior mesenteric ganglion
inferior mesenteric ganglion

61
Q

how PSS pregang fibers get to their organs

A

follow vagus nerve

62
Q

where are the ganglia for the PSS system in GI tract + can they be located

A

can’t be seen bc synapses occur in the organs

63
Q

PSS innervation below intestines and why

A

through pelvic splanchnic nerves (S2 to S4) bc vagus doesn’t get below intestines

64
Q

SS innervation below intestines and origin

A

sacral splanchnic nerves (L5, S1, S2, S3) from SS chain

65
Q

GI PSS innervation (2 components) + how fibers get to organs

A
  • vagus nerve (esophagus to proximal 2 thirds of transverse)
  • pelvic splanchnic nerve (distal third of transverse until rectum)
  • pre-gangl fibers use vessels to get to organs
66
Q

GI organ with no PSS innervation

A

spleen

67
Q

SS innervation, nerves and corresponding ganglia + how fibers get to organs

A
  • thoracic splanchnic (greater to celiac gang., lesser and least to aorticorenal gangl)
  • lumbar splanchnic nerves (L1-2) to sup and inf mesenteric glanglia.
  • POST gangl fibers use vessels to get to organs
68
Q

lumbar splanchnic nerves spinal origin

A

L1-L2

69
Q

PSS innervation to the stomach and analogy to esophagus

A

posterior vagal trunk (was right vagus n. in thorax) and anterior vagal trunk (was left vagus n. in thorax)

70
Q

stomach orientation compared to esophagus

A

rotated 90 degrees to the right compared to esophagus

Bloc E - GI & Metabolism (58 decks)

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