FINAL!!!DMS 121 Flashcards
Planes divide the body into Inferior and superior
TRANSVERSE
What divides the body into Right and Left
LOGITUDINAL
What divides the body into Anterior and Posterior
SAGGITAL OR CORONA
What else can be used to described Superior
Cranial or Cephalic
What else can be used to described Inferior
Caudal
What else can be used to described Anterior
Ventral
What else can be used to described Posteior
Dorsal
What divides into two layers in the peritoneum
Visceral (covers the organ) and Parieta (lines the wall)
What is a 2 layered or double layered fold of peritoneum
MESENTERY
Whatr extensive peritoneal pouch is posterior to stomach
Lesser omentum/ Lesser Sac
What specific thing can occur in the peritoneum with phatalogy?
Aascites, fluid, infectious, accumulation, pus, blood, bile etc
What organs are in the peritoneal name 10
- Kidneys
- Ureters
- Adrenal
- Pancreas
- Great Vessels
- Bladder
- Uterus
- Duodenum
- Prostate
- Colon
What makes up the portal triad?
Portal Vein
Hepatic artery
Common Bile Duct
from the portal triad which one is more lateral
Lateral-CBD
Medial- Hepatic artery
Described the way the Portal Vein is entering?
Is the blood Deoxygenated or Oxygenated
How much?
Horizontally or oblique
Oxygenated
70 or 80%
How many liver lobes
Name them
4 Right lobe Left lobe Caudate lobe Quadrate Lobe
Which lobe in the liver is the smallets?
Quadrate
What ligament separates the right and left lobe and caudate lobe
Ligamentum Venosum
Hepatic Vein dumps into which vessel
IVC
What does the falciform ligament connects to
The anterior abdominal wall
What part is most medial? to the kidney which pole
The upper pole
Whats the relationship from the kidney to the psoas muscles
inferiorly and medial
What pouch relates to kidney and liver?
Marrisons
Whats the functional unit of the Kindey
Nephron
Where does the tail relate to
Hilum of the spleen
What are the portions of the pancreas
Head, neck, body and tail
What vessels does the pancreas has
GDA
CBD
Splenic Vein
What connects the GB to Portal Vein in imaging
MIF Main lobar fissure
3 Parts of GB
Which one is most anterior
neck, body and fundus
The Fundus
Study the flow of the GB ducts
study
What makes up the pelvic diaphrgrahm
Levantor Ani and Cocyggeous
Cordlike thickening in broad ligament that connects the ovary to the lateral wall of the uterus
Ovarian ligament
Extension of broad ligament that carries ovarian vessels and attaches ovary
Suspensory ligament
Extends laterally from the body of uterus to lateral walls of pelvis
Round ligament
Peritoneal fold that extends from the sides of the uterine wall to the pelvic floor
Broad ligament
Liver Location
The liver occupies most of the Rt. Hypochondrium,
the epigastrium, and extends into the left
hypogastrium. May extend to the Left Mamillary
line.
The Liver is an Intraperitoneal Organ
Intraperitoneal Organ: Liver
The surface of the liver in enclosed by peritoneum
except the “Bare Area”, which is the posterior surface
that comes in contact with the Diaphragm.
Bare area is bordered by Coronary Ligaments
(peritoneal reflections)
Surrounding Organs: Liver
Rt. Kidney lies inferior and posterior Great vessels lie Posteriorly Portal Triad enters medially
Surrounding Organs Liver
Pancreas lies inferior and posterior
Left lobe of liver can serve as a window to image the
pancreas
Liver Size, Shape and Location
Right lobes exceeds the left by a 6:1 ratio
Weight: 1400 to 1600g
Length: us. 15-17 cm
Lower border at costal cartilage of 8-9 rib
Each Lobule is 1 X 2 mm
Vascular Anatomy
Receives nutrients from HA and PV
PV is 80% saturated and supplies 50-60% of oxygen
requirements for hepatocytes
PV and HA both have echodense walls
Collegen connective sheaths cause reflections.
HV walls less echodense
PV runs in horizontal plane (oblique) intralobar path
HV vary in calliper with location and breathing
HV run more longitudinally between segments
The hepatic veins
The hepatic veins are divided into three components:
right, middle, and left. They all drain into the inferior
vena cava at the level of the diaphragm.
Function of the Liver
Simplified
Formation of Bile 2. Activity of Reticulo-Endothelial Tissues 3. Metabolism of Carbs, Lipids, Proteins for preparation and excretion. 4. Storage Depot Blood Reservoir 6. Heat Production 7. Detoxification 8. Lymph Production
Four Fossa in Liver
IVC FOSSA (Right Sagittal)
Portal Fossa
Left Sagittal Fossa
Gallbladder Fossa
IVC Fossa
Short linear depression
located on posterior surface between caudate lobe
and bare area of liver
Separates Quadrate lobe in front from caudate lobe
behind
Separated from portal
by caudate
Left Sagittal Fossa
Separates right /left Porta joins at rt angle and divides in 2 parts Falciform liagment telescopes into ligament of terres inferiorly
Portal Fossa
Short deep fissure Extends transversely across under surface of left lobe Separates quadrate lobe in front from caudate behind Transmits PV, HA, BD, nerves, Lymphatic
GB FOSSA
Separates Rt/ Left Shallow and oblong Located on undersurface of right lobe of the liver Extends from anterior free margin of liver to right extremity of Porta fossa
Left Lobe
Contains medial and lateral segments
• Medial segment often referred to as the quadrate
lobe
• Smaller and flatter than right
• situated in epigastrium and Lt Hypochondria
• Upper surface convex and molded onto diaphragm
• Under surface presents the gastric impression and
omental tuberosity
CAUDATE LOBE OF LIVER
Situated upon the posterior surface of right • lies opposite T11-12 • Bounded anteriorly and caudad by the porta • bounded posterior by IVC • Bounded on left by Lt Sagittal Fossa
Quadrate lobe
Obsolete term for medial aspect of left
lobe
• situated on the under surface of left lobe
• Boudned anteriorly by the anterior margin
of liver/ posteriorly by ports; right by GB
fosse, and on left by Lt sagittal fossa
• Oblong in shape
Left Sagittal Fossa
Holds the falciform ligament
• Separates right and left lobes
• Porta joins it at a right angle and divdes
into two parts
• Recanilization of Umb vein would occur in
this fossa
Gallbladder Fossa
Shallow and oblong fossa • Located on undersurface of rt. lobe • Extends from anterior free margin of liver to right extremity of porta • Can be used to Seperate lt/rt lobe
Inferior Vena Cava Fossa
Short depression of posterior surface between caudate lobe and bare area of the liver • Separated from the porta by the caudate lobe • Holds the IVC
Porta Fossa
Short deep fissure extending transversely
across under surface of left lobe
• Separates quadrate lobe anteriorly from
caudate lobe behind
• Transverse portal vein, Hepatic artery,
nerves lymphatics and Bile ducts
pre vertebral Vessels
Arteries arising from aorta • Veins draining into IVC • Portal Venous System Combo Bring blood to Liver
Posterior View of Liver
Posterior view of the diaphragmatic surface of the liver. The caudate lobe is located on the posterosuperior surface of the right lobe, opposite the tenth and eleventh thoracic vertebrae
Main Lobar Fissure
Main lobar fissure (MLF) extends between the long axis neck of the gallbladder (GB) and the main portal vein (PV) on the longitudinal image. B, Falciform ligament extends from the umbilicus to the diaphragm in a longitudinal plane
Main Lobar Fissure
Main lobar fissure (MLF) extends between the long axis neck of the gallbladder (GB) and the main portal vein (PV) on the longitudinal image. B, Falciform ligament extends from the umbilicus to the diaphragm in a longitudinal plane.
Ligamentum teres
(LT, arrows) appears as a bright echogenic focus in the left lobe of the liver on a transverse image.
Whats the verticle line that extends from the Xiphoid to the Symphysis pubis
Linea alba
ABDOMINAL CAVITIES
Cavities in the Human body contain internal organs (viscera) . –Body divided into two portions: Dorsal and Ventral Cranial Thoracic Vertebral Abdominal Spinal Canal
Abdominal Cavity
Upper portion of the abdominopelvic
cavity
Excludes the retroperitoneum
Excludes the pelvis
Boundaries
Separates cavities or viscera
parts
Usually anatomical structure
or plane
Abdominal Cavity
Bounded superiorly by Diaphragm Anteriorly by abdominal wall Posteriorly by spine, ribs and iliac fossa Inferiorly by pelvic cavity
Other Abdominal Structures
Diaphragm Some shaped muscle separates the thorax from abd. Muscular component rises from margins of thoracic outlet Rt. crus of it arises from sides of bodies of L1-3 Lt. crus of it arises from lateral bodies of L1-2
Peritoneum
Serous membrane Lines the abd covity Covers the peritoneal organs Formed by a single layer of cells MESOTHELIUM
Mesothelium
Single layer of cells Rests on thin layer of connective tissue If damaged or removed peritoneal two layers may adhere This may form adhesions (Scarring
Peritoneum
Divided into two layers
Parietal
Visceral
Parietal and Visceral Layer
Parietal Portion that lines the abdominal wall Does not cover the organs Visceral Covers organs
Peritoneal Caity
Potential space between the parietal and visceral layers.. Cavity that contains small amount of lubrication Serous fluid lubricates with serous fluid and helps organs move on one another without friction What happens with pa
What happens with pathology
This space may become distended with fluid May actually contain several liters Interstitial fluid referred to as ASCITES Can be benign (simple) or Malignant
Mesentary
Two layered fold of peritoneum Attaches part of intestines to posterior abd wall and includes mesentery of small intesine, transvers mesocolon and sigmoid mesocolon
Other fluids found here
Blood, pus, bile, fecal material or ruptured intestine. These may accumulate in this cavity. Fecal material would lead to peritonitis , shock and possibly death
OMENTUM
Two-layered peritoneum that
attaches the stomach to
another viscus organ
OMENTUM
Broken into
Greater Omentum
Lesser Omentum
Greater Omentum
Attached to greater curvature of stomach and hangs down like an apron in space between sm. intestine and abd. wall Folded back on itself and attached to inferior border of the colon
Lesser Omentunm
Slings the lesser curvature of stomach to the undersurface of the liver Gastrosplenic omentum ligament connects stomach to spleen
SACS
Greater and Lesser Sac
Division of peritoneal
cavity
Greater Sac
Primary compartment of peritoneal
cavity
Extends across anterior abdomen
and from diaphragm to pelvis
Lesser Sac
Extensive peritoneal pouch located behind the lesser omentum and stomach Extends upward to diaphragm and inferior between the layers of the greater omentum
LESSER SAC
Upper abdominal dissection, with part of the left lobe of the liver and the lesser omentum removed to show the area of the epiploic foramen. Posterior to the foramen lie the celiac trunk, portal vein, bile duct, and related structures; one of the most important regions in the abdomen.
RETROPERITONEUM
Space posterior to Peritoneal cavity Contains the following: Kidneys *Uterus Ureters *Duodenum Adrenals Prostate Pancreas *COLON Great Vessels Bladder
Retroperitoneal Spaces
Anterior Pararenal space Vs Gerota’s fascia and post peritoneum Asc and Descending colon also in this area Posterior Pararenal Space vs. post renal fascia and PAW muscles only fat and vessels in this area
Retroperiotneal area
Perirenal Space directly around the kidney enclosed by renal fascia Kidneys, adrenals, lymph nodes, vessels and perirenal fat iin this area
GI SYSTEM
STOMACH Dilated portion of GI System Reesponsible for early stages of Digestion
Location of Stomach
Located under left dome of diaphragm
Superior portion joins esophagus at the cardiac
orafice
This forms the esophagogastric junction
STOMACH
Two borders: Lesser Curve Greater curve Superior border of stomach is the fundus Inferior border Pyloric antrum Body-largest part vs two curves
STOMACH
Pyloric antrum empties into the duodenum through pyloric sphincter Anterior surface lies in contact with diaphragm, AAW and left lobe of liver Posterior, gastric portion of spleen Level of T11-L1
INTESTINES
SMALL INTESTINE Average length 6-7 meters in length Subdivided into three parts: Duodenum Jejunum Ileum
Duodenum
Begins at eh gastric pylorus
Three parts
1
st, superior, 2nd portion and 3rd (inferior)
Curves around the head of the pancreas
Located mainly in the retroperitoneal space
less mobile than rest of bowel due to location
When duodenum enter peritoneum, becomes
jejunum
JEJUNUM
Loops of jejunum occupy the umbilical region
then becomes the ileum
longest portion of the small intestine
3.5m in length
mainly located in RLQ of abdomen
Terminates at the ileocecal valve (lg bowel)
Large Intestine
Location is inferior to stomach and liver Frames the small intestine Diameter larger than small intestine Begins at the ileocecal juntion Terminates at the anus parts include: Cecum, colon, rectum Appendix attaches to cecum
Large Intestine
Colon largest portion
Four subdivisions: Transverse, descending,
ascending, and sigmoid
Flexures: Hepatic splenic
Sigmoid empties into rectum
Blood: Mesenteric arteries and veins
Function: Absorb water and storage of feces
Which of the following spreads into the white matter
Basal ganglia
Gyri can be described as the furrows between the sulci
true or false
False
Which of the following is part of the basal ganglia
the caudate nucleus
the deep cleft between the hemisphere is the
interhemisphere reticulum
The Surface layer of the brain is
Gray matter
Which of the following connects the two hemispheres
corpus callosum
chloroid plexus is often at the posterior horn
False
pathway of the cerebral spinal fluid forms the lateral of the 3rd ventricle is the
foramen of monroe or interventricular
The third ventricle is a midline structure and its located____________ to the 4th ventricle
Superior
Cerebral spinal fluid is primaly in the
Chloroid plexus
which is not a lobe of the brain
cerebrum
which of the following is not a region of the brain
All of the above are regions of the brain
from the band of fibers
medulla oblongota
which of the flowolling in not a lateral interventricular sysmten
???
Which structure borders the lateral wall of the 3rd ventricle
thalamus
which plane of view demostrtate the right and left
Coronal
passway of fluid 3rd and 4rth ventricle is the
aqueduct of sylvius
which horn of the ventricular system is inferior to the hemithalamus
inferior
which of the following has a relationship csp
the Anterior horm
which of the following is not a midline structure of the
caudate nucleus
which of the following is another name for the hemispheres
longitudinal
the CSP is anterior to the
Thalamus
which horn is located more medial to the rest
the anterior horn
longitudinal view for the lateral ventricle is
parasagittal
which horn is …..
occipital
which of the following lies in the subpendymal space
general matrix
which of the following is a routine
transverse
which portion of the lateral ventricle
body of the chlo
hypothalamus is part of the
diencephalon
seminular valves communicates the left ventricle with
aortic
right atrium is superior to the IVC
mm
which portion is more anterior in the chest
right the ventrcile
another name for bicuspid is
mitral valve
all the following are openings in the diapghram except the
mesenteric
the visceral layer of the serious peri cardium is also known as the
epicardium
main layer for responsible for contractions is the
myocardium
the flow of deoxygenated blood from the right ventrcile to which of the following is next
pulmonary trunk
the surface of the heart is mainly made up by
right venrtricle and left ventricle
The base of the heart is most_______________than the apex
posterior
which of the following passes to the 3rd ventricle and
masa intermedia
which of the followoing are arteries that branches from subclavian
vertebral
which of the following is not part of the willis
external arteries
Which portion of the heart makes up the right surface
right atrium
which chamber of the takes up the largerst portion in the inferior surface the
left ventricle
Which muscle is lateral to the rectum
piriformis
piriformis
,,,
Whats the size of the uterus
7.5 X 5 X3
Ovaries are stationary to bowel T or F
False
meet at two layers at the serous
Vaginalis
The Endometrial layer is inferior and the thinkest
False its superior and thinnest
Rectus abdominis lie deep in the female pelvis
False its superficial in the anterior abdominal wall
Inferior portion of the pelvis is
True pelvis
illiopsoas muscles are _____ to psoas major
Inferior
main function of the uterus
house and nourish the fetus
obturator internal muscle lie are paired
medial to the urinary bladder they hammock the bladder
muscle lie anteriorly to the sacrum is the
piriformis
which of the following muscles extend inferior to abductus abdominis and anterior to the symphysis pubis
,,,,
Which is the muscle that gives main support and it form the diapgram
Levantor ani
where does the femur joins
Acetabulum
which of the following its not part of inominate bone
sacrum
cerebral orbits lies anterior to the
anus
imaginary line seperates the true and false pelvis
in the symphysis pubis at the sacral promantory
serous layer of the uterus is
perimetrium
internal portion of the ovary is the
medulla
the ventral portion testes is the
rede testis
efferent tubules convert
false
ovaries receives ovarian and utrerus
,,,
portion of the uterus responsible for contractions is the
myometrium
the uterus layer that changes during mestrual cycle is the
endometrium
the main support organs in the pelvis is
broad ligament
attaches the ovaries posterior
mesoovarian
sacral promantory is _____ to the sacrum
anterior
inferior landmark of the pelvis is
symphysis pubis
the dome of the uterus is the
fundus
portion of the oviducts that enters is the cornua
interstitial
peritoneal cavity is close in males
True
and open in females
the rectum is posterior to the piriformis muscle
False its medial
uterus position at a acute bend away from the bladder
retroflexed
which portion of the bladder covers the peritoneum
superior
fornices how many
4 lateral
bhjn
septum raphe
there is peritoneal tissue in the socral sac
true
fibrous capsule is the of the testes
tunica albuginiea
teste form the endocrine and excocrine
true
teste originate by the kidneys
true
flat tubular structure on the posterior surface
epydidimys
double fold of peritoneum in the ovaries
broad ligament
portion fallopian tube wideest
ampulla
Length of the fallopian tube
ll
External to pelvic diapghram and utero…
perineum
which of the following is not part of the pelvic diapgram
external
majory in the femal reproductive lie in the true pelvis
true
posterior and anterior the vein is most posterior , artery is anterior
first comes the Vein then artery and ureters
then list them post to anterior