Final Exam- Weeks 8-9 Flashcards
deoxygenated blood flow of the heart
- SVC/IVC
- right atrium
- tricuspid valve
- right ventricle
- pulmonary valve
- pulmonary trunk
- pulmonary arteries
oxygenated blood flow of the heart
- pulmonary veins
- left atrium
- bicuspid valve
- left ventricle
- aortic valve
- aorta
coronary circulation components
- ascending aorta
- left coronary artery (LCA)
- right coronary artery (RCA)
- aortic valve
- aortic sinus
systole
aortic valve opens
- coronary arteries blocked
diastole
aortic valve closes
- coronary perfusion occurs (passing of blood)
arterial coronary circulation - left
- LCA
- circumflex artery
- left anterior descending artery
arterial coronary circulation - right
- RCA
- marginal artery
- posterior descending artery
venous coronary circulation
- coronary sinus
- small cardiac vein
- middle cardiac vein
- great cardiac vein
aortic arch
- brachiocephalic trunk
- left common carotid artery
- left subclavian artery
- right subclavian artery
- right common carotid artery
pathway for systemic circulation
- pulmonary v
- left atrium
- bicuspid valve
- left ventricle
- aortic valve
- aorta
what arteries supply the head and neck
left and right common carotid arteries
internal carotid artery
supplies the brain
external carotid artery
supplies the head and neck
what does the internal carotid artery exit via
carotid canal
external carotid artery branches
- superior thyroid artery
- ascending pharyngeal artery
- lingual artery
- facial artery
- occipital artery
- posterior auricular artery
- maxillary artery
- superficial temporal artery
mnemonic to remember external carotid artery branches
S - snails
P - prefer
M - moist
O - oily
A- and
F - fluffy
L - leaves
S - sir
upper limb arterial supply
- subclavian artery
- axillary artery
- brachial artery
- ulnar artery
- radial artery
hand arterial supply
- ulnar artery (superficial palmar branch)
- radial artery (superficial palmar branch)
- superficial palmar arch
- digital branches
arterial supply of the thorax
- aortic arch
- subclavian artery
- descending (thoracic) aorta
- posterior intercostal arteries
- internal thoracic artery
- anterior intercostal arteries
venous drainage of the head and neck
- facial vein
- internal jugular vein
- external jugular vein
- anterior jugular vein
- subclavian vein
- brachiocephalic vein
venous drainage of the upper limb
- median cubital vein
- basilic vein
- cephalic vein
- brachial veins
- axillary vein
- subclavian vein
what branches off the superior vena cava
- brachiocephalic veins
- subclavian vein
- internal jugular vein
what does the brachiocephalic vein drain
upper limb and head/necks
what does the subclavian vein drain
upper limbs
what does the internal jugular vein drain
head and necks
venous drainage of the thorax
- aygous vein
- accesory hemiazygous vein
- posterior intercostal veins
- hemiazygous vein
unpaired branches in the abdominal aorta
- celiac trunk
- superior mesentaric artery (SMA)
- inferior mesentaric artery (IMA)
celiac trunk branches
- left gastric artery
- common hepatic artery
- splenic artery
what does the left gastric artery supply
lesser curvature of stomach
what does the common hepatic artery supply
liver
what does the splenic artery supply
spleen
common hepatic artery branches
- cystic artery
- proper hepatic artery
- right gastric artery
- gastroduodenal artery
what does the cystic artery supply
gallbladder
what does the proper hepatic artery supply
liver
what does the right gastric artery supply
the lesser curvature of the stomach
branches of the gastroduodenal artery
- superior pancreaticoduodenal arteries
- right gastro-omental artery
what do the superior pancreaticoduodenal arteries supply
pancreas and duodenum
what does the right gastro-omental artery supply
greater curvature of the stomach
splenic artery branches
- short gastric artery
- left gastro-omental artery
- pancreatic branches
what does the short gastric artery supply
fundus
what does the left gastro-omental artery supply
greater curvature of the stomach
route of blood supply to the greater curvature of the stomach
- celiac trunk
- common hepatic artery
- gastroduodenal artery
- right gastro-omental artery
superior mesentaric artery branches
- middle colic artery
- inferior pancreaticduodenal artery
- right colic artery
- jejunal arteries
- ileocolic artery
- ileal arteries
what does the middle colic artery supply
transverse colon
what does the inferior pancreaticoduodenal artery supply
pancreas and duodenum
what does the right colic artery supply
ascending colon
what does the ileocolic artery supply
cecum
what does the ileul artery supply
ilium
what do the ilial and jejunal arteries branch into
arterial arcades - give off the vasa recta
which arteries form an anastomosis between the celiac trunk and SMA
superior and inferior pancreaticoduodenal arteries
inferior mesentaric artery branches
- left colic artery
- sigmoid arteries
- superior rectal artery
what does the left colic artery supply
descending colon
what does the sigmoid arteries supply
sigmoid colon
what does the superior rectal artery supply
rectum
paired branches
- right renal artery
- left renal artery
right vs left renal artery supply
right renal artery - right kidney
left renal artery - left kidney
pelvic blood supply
- abdominal aorta
- common iliac arteries
- external iliac artery
- internal iliac artery
what does the external iliac artery supply
lower limb
what does the internal iliac artery supply
pelvis
branches of the internal iliac artery
- posterior division - pelvic muscles
- anterior division - pelvic viscera
arterial supply of the lower limb
- abdominal aorta
- common iliac artery
- external iliac artery
- popliteal artery
- femoral artery
- deep femoral artery
- superior genicular arteries
- inferior genicular arteries
- anterior tibial artery
- posterior tibial artery
- fibular artery
venous drainage of the abdomen
- superior mesenteric vein
- inferior mesenteric vein
- splenic vein
- portal vein
- hepatic veins (3)
- IVC
- left and right renal veins
what does the portal vein drain
GI tract
what does the superior mesenteric veins drain
small intestine
what does the inferior mesenteric veins drain
large intestine
pelvic venous drainage
- external iliac vein
- internal iliac vein
- common iliac vein
- IVC
lower limb venous drainage
- anterior tibial veins
- posterior tibial veins
- popliteal vein
- great saphenous vein
- femoral vein
- external iliac vein
- up pelvis
which renal vein travels anterior to the aorta
left renal vein
anterolateral abdominal wall
- external obliques
- internal obliques
- transversus abdominis
anterior abdominal wall
- rectus abdominis
- rectus sheath
external oblique
- most superficial
- hand in pock’E’ts
ORIGIN of external oblique
ribs 5-12
INSERTION of external oblique
- iliac crest
- pubis
ACTION of external oblique
Bilateral: flexion of trunk
Unilateral: contralateral rotation of trunk (rotating towards opp sides - bicycle crunch
internal oblique
- middle layer
- hands in armp’I’ts
ORIGIN of internal oblique
- inguinal ligament
- iliac crest
- lumbodorsal fascia
INSERTION of internal oblique
ribs 10-12
ACTION of internal oblique
Bilateral: abdominal compression
Unilateral: ipsilateral rotation (same side rotation)
transversus abdominis
- deepest layer
- straight across fibres
ORIGIN of transversus abdominis
- costal margin
- iliac crest
- inguinal ligament
- thoracolumbar fascia
INSERTION of transversus abdominis
- linea alba
- xiphoid process
- pubis symphysis
ACTION of transversus abdominis
rotation and flexion of the trunk
ORIGIN of rectus abdominis
pubic bone
INSERTION of rectus abdominis
- xiphoid process
- ribs 5-7
ACTION of rectus abdominis
- trunk flexion
- aides in pelvic stability
rectus sheath
surrounds rectus abdominis anteriorly and posteriorly
what forms the rectus sheath
- external oblique aponeurosis
- internal oblique aponeurosis
- transversus abdominis aponeurosis
arcuate line
between umbilicus and pubis
- separates layers of the rectus sheath
anterior rectus sheath
- external oblique aponeurosis
- 1/2 internal oblique aponeurosis
posterior rectus sheath
- 1/2 internal oblique aponeurosis
- transversus abdominis aponeurosis
transversalis fascia
deep to the rectus sheath
- in direct contact with rectus abdominis
***posterior
above the arcuate line
- anterior rectus sheath
- posterior rectus sheath
below the arcuate line
- anterior rectus sheath
- transversalis fascia
superficial to deep around the rectus abdominis muscle at the level of the umbilicus
- external oblique aponeurosis
- internal oblique aponeurosis
- rectus abdominis
- internal oblique aponeurosis
- transversus abdominis
anterior abdominal wall muscles
- EO
- IO
- tranversus abdominis
- inguinal ligament
- linea alba
posterior abdominal wall muscles
- psoas minor
- psoas major
- quadratus lumborum
- illiacus
ORIGIN of illiacus
iliac fossa
INSERTION of illiacus
lesser trochanter
ACTION of illiacus
flexion and external rotation of the hip
ORIGIN of psoas major
transverse processes T12-L5
INSERTION of psoas major
lesser trochanter
ACTION of psoas major
flexion of hip
ORIGIN of psoas minor
lateral aspect of T12 and L1
INSERTION of psoas minor
iliopectineal line
ACTION of psoas minor
assists in trunk flexion
ORIGIN of quadratus lumborum
iliac crest
INSERTION of quadratus lumborum
- transverse processes of L1-L5
- rib 12
ACTION of quadratus lumborum
Bilateral: trunk extension
Unilateral: lateral trunk flexion
quadratus lumborum
in lumbar region
inguinal region
left and right hypogastric regions
key structures of the inguinal region
- inguinal ligament
- inguinal canal
inguinal ligament bony attachements
ASIS attaches to pubis
functions of the inguinal ligament
- anchors abdominal muscles
- supports soft tissues of the groin
location of the inguinal canal
- lower anterior abdominal wall (4cm)
- extends from deep inguiinal ring to the superficial inguinal ring for termination
superficial inguinal ring
opening in external oblique aponeurosis
- inferior termination point
deep inguinal ring
evagination in transversalis fascia
borders of the inguinal canal
anterior wall: EO aponeurosis
posterior wall: transversalis fascia
inferior (floor): inguinal ligament
superior (roof): fibres of transversus abdominis and IO
contents of the inguinal canal in males
- spermatic cord
- gonadal vessels (testicular artery and vein)
- ilioinguinal nerve
- lymphatics
contents of the inguinal canal in females
- round ligament of the uterus
- ilioinguinal nerve
- lymphatics
sensory innervation of the abdomen
dermatomes
motor innervation of the abdomen
- thoracoabdominal nerves
- subcostal nerve
- lumbar plexus
dermatomes
- cutaneous innervation
- arranged in inferiorly sloping parallel rows around the abdomen
- T10 (umbilical) and L1 (inguinal)
thoracoabdominal nerve innervation
T7-T11
subcostal nerve innervation
T12
lumbar plexus innervation
L1
- iliohypogastric nerve
- ilioinguional nerve
location of the lumbar plexus
- posterior abdominal wall
- lumbar spinal nerves L1-L4
- innervation mainly to lower limb
iliohypogastric nerve
L1
ilioinguinal nerve
L1
genitofemoral nerve
L1,L2
lateral femoral cutaneous nerve
L2, L3
femoral nerve
L2, L3, L4
obturator nerve
L2, L3, L4
lumbosacral trunk
L4, L5
lymphatic drainage - superficial
drains cutaneous and subcutaneous structures
lymph drainage above the umbilicus
axillary nodes
lymph drainage below the umbilicus
superficial inguinal nodes
lymphatic drainage - deep
- superficial inguinal nodes
- deep inguinal nodes
- common iliac nodes
- lumbar nodes
- into cisterna chyli
lymphatic drainage - return to venous circulation - left abdomen below umbilicus
- cisterna chyli (drains into thoracic duct)
- axillary nodes (left)
- thoracic duct
lymphatic drainage - return to venous circulation - right abdomen above the umbilicus
- axillary nodes (right)
- right lymphatic duct
muscles of facial expression
- superficial (subcutaneous) muscles
- origins - facial bones of adjacent
- insertions - skin
functions of the muscles of facial expression
- sphincters/dilators
- facial expression alteration
frontalis
epicranial group (occipitofrontalis)
action of frontalis
draws scalp back and raises eyebrows
innervation of frontalis
CN VII (temporal branch)
blood supply to frontalis
internal and external carotid artery
venous drainage of frontalis
ophthalmic vein
corrugator supercilii
orbital group
action of corrugator supercilii
draws eyebrows medially and inferiorly
innervation to corrugator supercilii
CN VII (temporal)
blood supply to corrugator supercilii
ophthalmic artery
venous drainage of corrugator supercilii
superior ophthalmic vein
orbicularis oculi
orbital group
1. orbital part
2. palpebral part
3. lacrimal part
actions of orbicularis oculi
- wink (tightly close eye)
- blink (loosely close eye)
- compress lacrimal sac (release tears)
innervation of orbicularis oculi
CN VII (temporal and zygomatic)
blood supply to orbicularis oculi
- facial artery
- superficial temporal artery
- ophthalmic artery
venous drainage to orbicularis oculi
facial vein
orbicularis oris
oral group
action of orbicularis oris
purses and protrudes the lips
innervation of orbicularis oris
CN VII (buccal and mandibular)
blood supply of orbicularis oris
facial artery
venous drainage of orbicularis oris
facial vein
buccinator
oral group
action of buccinator
pulls cheeks inward
innervation of buccinator
CN VII (buccal)
blood supply of buccinator
buccal and facial artery
venous drainage of buccinator
- pterygoid plexus
- internal maxillary vein
zygomaticus major
oral group
actions of zygomaticus major
superior/lateral movement of mouth corners
innervation of zygomaticus major
CN VII (zygomatic and buccal)
blood supply of zygomaticus major
facial artery
venous drainage of zygomaticus major
facial vein
zygomaticus minor
oral group
- same as major
- major holds up minor
platysma
neck group
action of platysma
inferior movement of mouth corners
innervation of platysma
CN VII (cervical and mandibular)
blood supply of platysma
facial artery
venous drainage of platysma
facial vein
muscles of mastication
both superficial and deep muscles
functions of the muscles of mastication
movement of mandible
4 muscles of mastication
- temporalis
- masseter
- medial pterygoid
- lateral pterygoid
ORIGIN of temporalis
temporal bone
INSERTION of temporalis
coronoid process of mandible
ACTION of temporalis
elevate and retract mandible
innervation of temporalis
CN V3 (deep temporal)
blood supply of temporalis
maxillary artery
venous drainage of temporalis
deep temporal vein
ORIGIN of masseter
zygomatic arch
INSERTION of masseter
- coronoid process
- ramus of mandible
ACTION of masseter
- elevate mandible
- approximate teeth
innervation of masseter
CN V3 (masseteric)
blood supply of masseter
maxillary artery
venous drainage of masseter
masseteric vein
ORIGIN of medial pterygoid
- maxillary tuberosity
- lateral pterygoid plate
INSERTION of medial pterygoid
- medial ramus
- angle of mandible
ACTION of medial pterygoid
- elevation
- side-to-side movement of mandible
innervation of medial pterygoid
CN V3 (medial pterygoid)
blood supply of medial pterygoid
maxillary artery
venous drainage of medial pterygoid
pterygoid plexus
pterygoid plexus components
- maxillary vein
- retromandibular vein
- internal jugular vein
ORIGIN of lateral pterygoid
- greater wing
- lateral pterygoid plate
INSERTION of lateral pterygoid
condylar process of mandible
ACTION of lateral pterygoid
- protraction
- side-to-side movement of mandible
innervation of lateral pterygoid
CN V3 (lateral pterygoid)
blood supply of lateral pterygoid
maxillary artery
venous drainage of lateral pterygoid
pterygoid plexus
major muscles of the superficial anterior neck
- platysma
- sternocleidomastoid (SCM)
ORIGIN of SCM
- manubrium
- clavicle
INSERTION of SCM
mastoid process
ACTION of SCM
Unilateral: head rotation and lateral flexion
Bilateral: flexion
innervation of SCM
CN XI
blood supply of SCM
superior thyroid artery
venous drainage of SCM
internal jugular vein
deep anterior neck groups
- hyoid muscles
- scalene muscles
suprahyoid muscles
- digastric
- stylohyoid
- mylohyoid
- geniohyoid
infrahyoid muscles
- omohyoid
- sternohyoid
- thyrohyoid
- sternothyroid
ORIGIN of digastric
inferior border of mandible
INSERTION of digastric
temporal bone
ACTION of digastric
- elevate hyoid
- depress mandible
innervation of digastric
CN V3 (anterior) and CN VII (posterior)
blood supply of digastric
- facial artery (anterior)
- occipital artery/posterior auricular artery (posterior)
venous drainage of digastric
internal jugular vein
ORIGN of stylohyoid
styloid process
INSERTION of stylohyoid
hyoid
ACTION of stylohyoid
- elevate/retract hyoid
- elevate tongue
innervation of stylohyoid
CN VII
blood supply of stylohyoid
occipital artery
venous drainage of stylohyoid
internal jugular vein
ORIGIN of mylohyoid
mylohyoid line (body of mandible)
INSERTION of mylohyoid
other mylohyoid and hyoid
ACTION of mylohyoid
- elevate hyoid
- support tongue
- depress mandible
mylohyoid
oral diaphragm
innervation of mylohyoid
CN V3 (inferior alveolar)
blood supply of mylohyoid
- facial artery
- inferior alveolar artery
venous drainage of mylohyoid
internal jugular vein
ORIGIN of geniohyoid
inferior mental spine (body of mandible)
INSERTION of geniohyoid
hyoid
ACTION of geniohyoid
elevate/protrude hyoid
innervation of geniohyoid
C1 (sheath of CN XII)
blood supply of geniohyoid
lingual artery
venous drainage of geniohyoid
internal jugular vein
ORIGIN of omohyoid
scapula
INSERTION of omohyoid
hyoid
ACTION of omohyoid
depress hyoid
innervation of omohyoid
ansa cervicalis (C1-3)
blood supply of omohyoid
superior and inferior thyroid artery
venous drainage of omohyoid
superior and inferior thyroid vein
ansa cervicalis
nerve loop formed by cervical spinal nerves contributing to the innervation of the muscles in the neck
ORIGIN of sternohyoid
manubrium (sternum)
INSERTION of sternohyoid
hyoid
ACTION of sternohyoid
depress hyoid
innervation of sternohyoid
ansa cervicalis (C1-3)
blood supply of sternohyoid
superior thyroid artery
venous drainage of sternohyoid
superior thyroid vein
ORIGIN of thyrohyoid
thyroid cartilage
INSERTION of thyrohyoid
hyoid
ACTION of thyrohyoid
depress hyoid
innervation of thyrohyoid
C1 (sheath of CN XII)
blood supply of thyrohyoid
superior thyroid artery
venous drainage of thyrohyoid
superior thyroid vein
CN XII sheath
- sheath covering the hypoglossal nerve that supplies the tongue
- C1/C2 supplies geniohyoid and thyrohyoid
ORIGIN of sternothyroid
manubrium (sternum)
INSERTION of sternothyroid
thyroid cartilage
ACTION of sternothyroid
- depress hyoid
- open laryngeal inlet
innervation of sternothyroid
ansa cervicalis (C1-3)
blood supply of sternothyroid
superior thyroid artery
venous drainage of sternothyroid
superior thyroid vein
what muscles are not innervated by ansa cervicalis
thyrohyoid and geniohyoid
scalene muscles
3 muscles in the deep neck
ORIGIN/INSERTION of scalene muscles
- between ribs 1/2
- transverse processes of C1/C2 vertebrae
functions of the scalene muscles
neck flexion and rotation
innervation of the scalene muscles
C3-8
blood supply of the scalene muscles
inferior thyroid artery
venous drainage of the scalene muscles
inferior thyroid vein
suboccipital triangle muscles
- remove trapezius
- remove splenius capitis
- reflect levator scapulae
- reflect semispinalis capitis
3 major muscles of the suboccipital triangle
- obliquus capitis superior
- rectus capitis posterior major
- obliquus capitis inferior
adjacent muscle of the suboccipital triangle
- rectus capitis posterior minor
functions of the rectus capitis posterior minor
- neck extension and rotation
- postural support
vessels in the suboccipital triangle
- vertebral artery
- greater occipital nerve
what muscle is the most superficial muscle of the suboccipital triangle
rectus capitis posterior minor muscle
where do chemical processes begin
the mouth
2 areas of the oral cavity
- oral vestibule
- oral cavity proper
oral vestibule anterior border
lower lip and upper lip
oral vestibule posterior border
teeth
associated structures of the oral vestibule
- gingivae (gums)
- inferior labial frenulum
- superior labial frenulum
superior and inferior labial frenulum
attaches the lip to the gums
oral cavity proper superior border
hard and soft palate
oral cavity proper anterior border
tongue (links the border)
oral cavity proper posterior border
- palatoglossal arch
- palatopharyngeal arch
associated structures of the oral cavity proper
- uvula
- palatine tonsils (lymphoid tissue)
- lingual frenulum (attaches tongue to the floor)
organs associated with the oral cavity
- parotid gland
- submandibular gland
- sublingual gland
- minor glands
***can be mucous, serous, or sercomucous
types of enzymes
- mucous (lubrication)
- serous (enzyme-containing)
- seromucous
parotid gland
- anterior to ears
- between masseter and skin
duct associated with the parotid gland
stensons duct
stensons duct
opens behind second upper molar - SEROUS
- empties parotid gland
what innervates the parotid gland
CN IX
submandibular gland
inferior to mandible and in between the digastric muscles
duct associated with the submandibular gland
whartons duct
whartons duct
opens lateral to lingual frenulum - SERCOMUCOUS
- empties submandibular gland
what innervates the submandibular gland
CN VII
sublingual gland
floor of the oral cavity inferior to the tongue
duct associated with the sublingual gland
bartholins duct
bartholins duct
connects with whartons duct - MUCOUS (lubricates mouth)
***both bartholins and whartons empty lateral to sublingual gland
what innervates the sublingual gland
CN VII
2 areas of the tongue
- posterior 1/3
- anterior 2/3
structures of the tongue
- sulcus terminalis
- epiglottis
- lingual tonsil
- foliate papillae
- fungiform papillae
- filiform papillae
- circumvallate papillae
what structures of the tongue have taste buds
- foliate papillae
- fungiform papillae
- lingual tonsil (lymphoid tissue)
what structures of the tongue don’t have taste buds
- circumvallate papillae
- filiform papillae (only chewing)
general sensation innervation
- CN X (epiglottis)
- CN IX (posterior)
- CN V3 (mandibular branch - anterior)
taste innervation
- CN X (epiglottis)
- CN IX (posterior)
- CN VII “chorda tympani” (anterior 2/3)
anatomy of teeth
- crown
- neck
- root
structures of the teeth
- dentin (produced by odontoblasts)
- periodontal ligaments
- apical foramen
- enamel (produced by ameloblasts)
- pulp cavity
- alveolar bone
pulp cavity
- contains blood vessels and nerves
- give sensation - cold sensitivity
periodontal ligaments
attaches teeth to the maxilla
apical foramen
nerves and vessels pass through that supply the teeth
4 types of teeth
- molar (grinding & slicing food)
- premolar (grinding & slicing food)
- canine (shredding food)
- incisor (slicing food)
deciduous teeth (baby teeth)
4 quadrants with 3 structures
1. 2 incisors
2. 1 canine
3. 2 molars
- per quadrant
permanent teeth (adult teeth)
4 quadrants with 4 structures
1. 2 incisors
2. 1 canine
3. 2 premolars
4. 3 molars
why do we gain pre molars and another molar with permanent teeth
because our diet changes so we need teeth to better chew
why do we need teeth?
- increases digestive SA for mechanical digestion
- work in conjunction with saliva to begin the process of digestion in the mouth
esophagus
- runs along vertebral column posterior to trachea and aorta
- enters abdomen at T10 through the esophageal hiatus
- joints the stomach at the cardiac orifice
- continuation of the oropharynx
- has 2 sphincters
esophageal muscles
work with the pharyngeal constrictors to push food towards the stomach
superior portion of the esophagus
voluntary control
inferior portion of the esophagus
autonomic control
upper esophageal sphincter
closes to lock food in the esophagus
lower esophageal sphincter
closes to lock food in the stomach
sphincter
prevents reflux of food or bolus from going where it shouldn’t
3 stages of swallowing
- oral
- pharyngeal
- esophageal
oral phase (1)
- food is broken down mechanically and chemically
- bolus is moved posteriorly until is reaches the oropharynx
- complete when bolus reaches the oropharynx
*** VOLUNTARY
pharyngeal phase (2)
- soft palate and epiglottis close and breathing stops (closes off nasopharynx)
- pharyngeal constrictors move bolus inferiorly until it reaches the upper esophageal sphincter
- complete when bolus reaches the UES
*** INVOLUNTARY
esophageal phase (3)
- bolus passes through upper esophageal sphincter
- peristalsis
- bolus passes through lower esophageal sphincter into stomach
- complete when LES closes
peritoneum
- serous membrane that lines the walls of the abdominal and pelvic cavities, and covers many organs
- forms a sac that encloses the peritoneal cavity
mesentary
double fold that connects parietal and visceral peritoneum
- arteries & veins of GI tract are in here
2 types of peritoneum
- parietal = “of walls”
- visceral = “of organs”
parietal peritoneum
outer ring of the abdominal cavity
lines:
1. inferior surface of diaphragm
2. abdominal & pelvic walls
3. roof over pelvic viscera
visceral peritoneum
covers the organs (liver, stomach, GI tract)
peritoneal cavity - greater sac
extends from the diaphragm down to the pelvis
- separated by the greater curvature
peritoneal cavity - lesser sac
- behind the stomach
- found in between layers of the greater omentum
where can the lesser sac extend
- upward to the diaphragm
- downward between the layers of the greater omentum
- left to the spleen
- right to the epiploic foramen of Winslow
epiploic foramen of Winslow
only natural communication between the greater sac and lesser sac
- on lesser omentum, behind stomach
borders on the epiploic foramen of Winslow
- anterior: free border of lesser omentum (gastrohepatic lig)
- posterior: IVC
- superior: liver (caudate lobe)
- inferior: 1st part of duodenum
intraperitoneal (visceral)
HANGING in ab cavity via mesentary
1. completely covered by peritoneum
2. liver, stomach, spleen, jejunum, ileum
retroperitoneal (parietal)
BEHIND parietal paritoneum on posterior ab wall
1. anterior surface covered
2. SAD PUCKER
SAD PUCKER
S: suprarenal/adrenal glands
A: abdominal aorta & IVC
D: duodenum (parts 2-4)
P: pancreas
U: ureters
C: colon (ascending & descending)
K: kidneys
E: esophagus
R: rectum (proximal 1/3)
double peritoneal folds
- mesentery
- lesser omentum
- greater omentum
- ligaments
innervation of parietal peritoneum (retro-)
- segment nerves: overlying skin & muscles (T6-L1)
- phrenic nerves
- pain is WELL LOCALIZED
innervation of visceral peritoneum (intra-)
- visceral afferents (secondary nerves)
- pain is POORLY LOCALIZED (since visceral afferents are not direct)
gut tube
- foregut (celiac trunk)
- midgut (SMA)
- hindgut (IMA)
***need to all work together
foregut
- runs from abdominal esophagus to proximal 1/2 of duodenum
- esophagus, stomach, liver, gallbladder, bile ducts, pancreas, proximal duodenum
- DIGESTION begins
midgut
- runs from distal 1/2 duodenum to proximal 2/3 of transverse colon
- distal duodenum, jejunum, ileum, cecum, appendix, ascending colon, proximal 2/3 transverse colon
- ABSORPTION begins & DIGESTION ends
hindgut
- runs from distal 1/3 of transverse colon to proximal anal canal
- distal 1/3 transverse colon, descending colon, sigmoid colon, upper anal canal
- REMOVAL begins
foregut - structures
- esophagus
- stomach
- liver
- gallbladder
- bile ducts
- pancreas
- proximal duodenum
foregut - celiac trunk branching
- celiac axis
- common hepatic a. (supplies liver)
- left gastric a. (supplies lesser curvature
- splenic a. (looks like a pig tail)
midgut - SMA structures
- inferior pancreaticoduodenal a.
- jejunal aa. (feed jejunum - middle SI)
- ileal aa. (feed ileum - inferior SA)
- distal duodenum
- jejunum
- ileum
- cecum
- appendix
- ascending colon
- proximal 2/3 transverse colon
midgut - SMA branching
- middle colic a. (superior transverse colon)
- right colic a. (ascending colon)
- ileocolic a.
hindgut -structures
- distal 1/3 transverse colon
- descending colon
- sigmoid colon
- upper anal canal
hindgut - IMA branching
- left colic a.
- sigmoidal a. (supplies sigmoid colon)
- superior rectal a. (supplies rectum)
abdominal esophagus - foregut
- mechanical digestion & transfer of bolus to stomach
- passing through diaphragm @
- esophageal hiatus (T10)
- lower esophageal sphincter (LES)
blood supply of the abdominal esophagus - foregut
esophageal branch of the left gastric artery
acronym for remembering abdominal esophagus
I 8 (ate) 10 Eggs At 12
I= IVC
E= esophagus
A= abdominal aorta
cardia of stomach
opening into stomach via esophageal sphincter
rugae of stomach
- allows contraction & expansion of stomach
- allows secretion of gastric juices due to increased SA
blood supply to the greater curvature
right and left gastro-omental arteries
- gastroduodenal artery (branch off the hepatic artery)
blood supply to the lesser curvature
right and left gastric arteries
blood supply to the fundus
celiac trunk>splenic a.>short gastric a.
small intestine
- breaking down proteins, lipids, carbs and absorption
- specialization of surface area for more absorption
- runs from pyloric orifice to ileocecal junction
duodenum
- 20-25 cm
- 1st part of the small intestine
- c-shaped (so pancreas fits)
- mostly retroperitoneal
superior (1st) part of duodenum
- intraperitoneal (hanging)
- anterior to IVC
- equal to celiac trunk
- contains duodenal cap
descending (2nd) part of duodenum
- retroperitoneal
- contains minor papilla & major papilla
inferior/horizontal (3rd) part of duodenum
- retroperitoneal
- inferior to SMA
ascending (4th) part of duodenum
- retroperitoneal
- contains duodenojejunal flexure and suspensory lig
minor papilla and major papilla
where bile and gastric juices enter from pancreas, gallbladder and liver
- drain into hepatopancreatic ampulla of vater
suspensory ligament of the duodenum
helps hang the duodenal flexure
4 parts of duodenum
1st & 2nd part>foregut (proximal duo.)>anterior & posterior superior pancreaticoduodenal aa.
3rd & 4th part>midgut (distal duo.)>anterior & inferior pancreaticoduodenal aa.
posterior inferior pancreaticoduodenal a. + anterior inferior pancreaticoduodenal a.
comes directly off the SMA
jejunum
- left upper quadrant of abdomen
- begins at the duodenojejunal flexure
ileum
- right lower quadrant of abdomen
- ends at the ileocecal junction
blood supply of jejunum
superior mesenteric a.>jejunal aa.>arterial arcades>vasa recta
blood supply of ileum
SMA>ileal aa.>arterial arcades>vasa recta
arcades and vasa recta of jejunum
arcades: bigger
vasa recta: longer and less
arcades and vasa recta of ileum
arcades: smaller
vasa recta: shorter and more