Final Exam- Weeks 10-11 Flashcards
cecum
- blind-ended pouch
- covered in peritoneum, but not mesentery
- contains ileocecal (ileocolic) valve (1-way)
vermiform appendix
- 8-10 cm long
- aggregations of lymphoid tissue
- no longer necessary - more trouble than functional
- suspended by mesoappendix (houses arteries/veins)
variable positions: retrocecal, retrocolic, pelvic
McBurneys Point of the vermiform appendix
point on anterior ab wall that is the lateral 1/3 of the distance from the ASIS to umbilicus
1. dull pain - doctors visit
2. sharp pain - emergency
4 parts of the colon
- ascending - right upper
- transverse
- descending - left upper
- sigmoid (pelvic)
structures of colon
- left colic flexure (splenic)
- right colic flexure (hepatic)
features of colon
- teniae coli
- haustra
- epiploic appendages
muscular components of the colon
- taeniae coli
- haustra
taeniae coli
3 longitudinal bands of smooth muscle that run along the outer layer of the entire colon
haustra
- series of pouches in the wall of colon
- created by muscle tone in taeniae coli
- permit expansion and elongation of colon
peritoneal coverings of the colon - mesocolon
- complete covering
- partial covering
- mesoappendix
complete covering
transverse & sigmoid mesocolons (intraperitoneal)
partial covering
ascending, descending & rectal mesocolons (retroperitoneal)
mesoappendix
connects appendix to ileum & cecum
what feature does the cecum not contain?
mesenteric attachment
where does the midgut transfer to the hindgut
distal 1/3 of the transverse colon
large intestine blood supply (SMA)
SMA
- ileocolic
- right colic
- middle colic
***MRI
large intestine blood supply (IMA)
IMA
- left colic
- sigmoidal
- superior rectal (hemorrhoidal)
I Love Singing Songs
large intestine blood supply (marginal artery of drummond)
anastomoses between right, middle, and left colic arteries
- key for collateral circulation of alternative supply
parts of pancreas
- tail
- body
- neck
- head
- uncinate process
large intestine venous drainage - splenic vein
- hilum of spleen
- posterior to tail and body of pancreas
- join superior mesenteric vein
what does the splenic vein drain
- spleen
- lower esophagus
- part of stomach
- pancreas
large intestine venous drainage - superior mesenteric vein
- ascends in root of mesentery
- pass anterior to 3rd part of duodenum (transverse)
- joins splenic vein posterior to neck of pancreas
what does the superior mesenteric vein drain
areas supplied by the SMA
1. iliocecum
2. left colic
3. middle colic
large intestine venous drainage - inferior mesenteric vein
- ascends on left posterior ab wall
- join splenic vein posterior to pancreas
what does the inferior mesenteric vein drain
areas supplied by the IMA
1. left colic
2. sigmoidal
3. superior rectal
hepatic portal vein
- created by splenic vein and superior mesenteric vein uniting
- carries nutrients from digestive tract to liver
portosystemic obstruction
result of obstructed venous return to liver
accessory digestive organs
- liver
- gallbladder
- pancreas
- salivary glands
function of the accessory digestive organs
produce, store, and secrete digestive enzymes and buffers
liver
largest visceral organ
metabolic function of the liver
hepatocytes regulate circulating levels of nutrients; remove metabolic wastes and toxins
hematological function of the liver
- acts a blood reservoir
- filters circulating debris
digestive function of the liver
synthesizes and secretes bile
“hepato”
related to liver
location of the liver
- immediately inferior to diaphragm
- in right upper abdomen
- sits superior and lateral to stomach, right kidney and intestines
diaphragmatic surface of the liver
- superior and anterior surfaces
- smooth and follows curve of diaphragm and body wall
bare area of the diaphragmatic surface
area of liver in direct contact with diaphragm
- no visceral peritoneum (shiny)
visceral surface of diaphragmatic surface
- posterior and inferior surfaces
- has impressions from stomach, small intestine, right kidney, and large intestine
lobes of liver
- right lobe
- left lobe
- caudate lobe (adjacent to IVC)
- quadrate lobe (adjacent to gallbladder)
ligaments of liver
made up of double folds of peritoneum - anchor liver
1. falciform lig
2. coronary lig
3. right & left triangular ligs
4. round lig
falciform ligament
attaches liver to anterior body wall and divides liver into left and right lobes
coronary ligament
suspends liver from the diaphragm
- superior
right and left triangular ligaments
on superior aspect, towards lateral body wall
round ligament (ligamentum teres)
thickening of inferior margin of falciform ligament, embryological remnant of umbilical vein
bile
- gallbladder stores and concentrates bile produced by liver
- bile helps in digestion of dietary lipids through emulsification
gallbladder location
- hollow, pear-shaped, muscular sac on the right visceral surface of liver
- lateral to stomach
- closely related to the duodenum
gross anatomy of the gallbladder
- cystic duct
- neck
- infundibulum
- fundus
ducts connecting the liver and gallbladder
- right and left hepatic duct
- common hepatic duct
- cystic duct
- common bile duct
common hepatic duct
joins the cystic duct to form common bile duct
common bile duct
empties into duodenum
arterial supply of the gallbladder
cystic artery (branch of hepatic artery proper)
venous drainage of the gallbladder
cystic vein into the hepatic portal vein
the porta hepatis contents - doorway to liver
also known as hilum of the liver
1. hepatic portal vein
2. hepatic artery proper
3. common hepatic duct
origin of the artery in porta hepatis (hepatic proper artery)
abdominal aorta>celiac trunk>common hepatic artery>hepatic proper artery
origin of the vein in the porta hepatis (hepatic portal vein)
formed by the union of the SMV and splenic vein, posterior to pancreas
hepatic portla vein pathway
carries blood from…
1. small intestine
2. large intestine
3. stomach
4. pancreas
5. gallbladder
6. spleen
hepatic portal system
- connection between two capillary beds
- nutrient-rich venous blood drains from the stomach and intestines and travels to the liver for processing
steps of hepatic portal system
- small intestine absorbs products of digestion
- nutrient molecules travel in hepatic portal vein to liver
- liver monitors the blood content
- blood enters general circulation by way of hepatic veins
- hepatic veins empty into the IVC
processing at liver
done via lobules
lobules of liver
- functional unit of the liver for processing
- hexagonal in shape
- contain a central vein at the centre of each lobule
contain a portal area with a portal triad at each corner of the lobules
portal area of the lobule (triad)
triad of portal area contains:
1. small branch of the hepatic portal vein
2. s small branch of the hepatic artery proper
3. a bile duct
blood flow towards the central vein
- blood provided by hepatic artery proper and hepatic portal vein flows from portal area towards central vein
- as blood flows towards centre, hepatocytes absorb and secrete substances altering blood entering systemic circulation
- central veins coalesce into hepatic veins
hepatic veins
drain each segment of the liver into IVC and eventually empties filtered blood into right atrium of the heart to be pumped to rest of body
alcohol consumption
- stomach and SI absorb alcohol
- hepatic portal vein carries blood to liver
- enzymes metabolize alcohol in liver
- hepatic veins carry the blood to IVC to go back into systemic circulation
origin of the duct in porta hepatis (common hepatic duct)
formed by the fusion of the left and right hepatic ducts
bile flow towards the portal areas
- hepatocytes produce bile and bile flows outward to portal areas
- bile canaliculi carry bile to bile duct of closest portal area
- bile duct branch which leads to the rest of the duct system
hepatic artery proper
delivers oxygenated blood to liver
- has a right and left branch
hepatic portal veins
delivers deoxygenated, but nutrient-rich blood from the digestive tract
common hepatic ducts
carries bile produced by the liver aways
exocrine function of the pancreas
- produces digestive enzymes and alkaline buffers to neutralize acidic chyme
- duct system within pancreas carries the fluid to duodenum
endocrine function of the pancreas
produces hormones such as insulin
exocrine
substances secreted into duct system to an epithelial surface
endocrine
substance is secreted into interstitial fluid and then into bloodstream
pancreas
- approx 15 cm long
- pinkish, greyish colour
location of pancreas
- posterior to stomach
- head of pancreas is nestled in curve of duodenum
- extends left, towards the spleen
greater omentum
drapes over the rest of abdominal contents like an apron
anatomy of the pancreas
- neck
- body
- tail
- uncinate process of pancreas (hooks)
- head
- pancreatic duct
- accessory pancreatic duct
what anastomosis occurs behind the head of the pancreas
superior mesenteric vein + splenic vein form the portal veins
arterial blood supply to pancreas
branches of splenic artery and pancreaticoduodenal artery
venous drainage to the pancreas
splenic veins
what does the pancreas empty into
secretions from gallbladder and pancreas are transported to duodenum via duct systems
how does fluid from gallbladder and pancreas enter the duodenum
papilla
papilla
small, rounded protuberance on an organ
minor and major duodenal papilla
empty secretions from the gallbladder and pancreas into the duodenum
spleen
- lymphatic organ
- triangular shaped
- intraperitoneal
function of spleen
- filtration of red blood cells to remove old, larger and deformed cells
- prevention of infection
location of spleen
- upper left quadrant of abdomen
- between ribs 9-11 at the midaxillary line
- superior to the large intestine and kidney
- anterior to diaphragm
- tail of pancreas inserts to central area of spleen
posterior surface of the spleen
diaphragmatic area
superior surface of the spleen
gastric area (close to stomach)
anterior surface of the spleen
colic area
inferior surface of the spleen
renal area (spleen comes into contact with left kidney
blood supply to the spleen
via splenic artery
hilum of spleen
- medial concave area of spleen
- vascular attachment site
hilum of the spleen contents
- splenic artery
- splenic vein
peritoneum of spleen - hilum lines
- splenogastric ligament
- pocket for tail of pancreas
- splenorenal ligament
splenogastric ligament
connects stomach and gastric area of spleen
splenorenal ligament
connects left kidney to renal area of spleen
what surface of the spleen is associated with the large intestine
the anterior surface
the kidneys
- retroperitoneal organs
- kidney-bean shaped
position of the kidneys
- posterior abdominal wall
- right kidney sits lower than left (cause liver is so big)
- T12-L3/L4 (L3=left, L4=right)
functions of kidneys
- urine production
- regulation of blood ionic concentration
- regulation of blood pH
- regulation of blood volume and pressure
- production of hormones
- regulation of blood glucose
- excretion of waste and foreign substances
protective coverings of the kidney
- PERIrenal fat
- renal capsule
- renal fascia
- PARArenal fat
PERIrenal fat
fatty mass that protects from trauma and holds in place
renal capsule
connective tissue that is the deepest form of protection