Foregut & Liver

Question 1

Esophagus

Answer 1

connecting laryngopharynx to the stomach
part of digestive and GI
divided into 3 regions:
cervical: from inf. border of cricoid cartilage (C6) to jugular notch
thoracic: jugular notch to diaphragm
descends ant. to thoracic vertebrae
passes ant to throacic aorta in inf. portion of the mediastinum
passes through diaphragm: esophageal aperture (T10)
abdominal: diaphragm to cardia portion of the stomach

Question 2

abdominal esophagus

Answer 2

enters with 2 vagal trunk
ant is left
post is right
from esophageal aperture of T10 diaphragm to cardia [

Question 3

Stomach

Answer 3

location: epigastric, umbilical, left hypochondrium
cardia: surround opening of esophageus into stomach
fundus: sup dilation on left and above cardia
body: large expansion below fundus
pyloric part: outflow portion leading to 1st part of duodenum
composed of: pyloric antrum, pyloric antrum, pyloric canal, pyloric sphincter, pyloric orifice

Question 4

variation of position of stomach

Answer 4

hypertonic: pushed up
orthotonic: pushed up and compress to left
hypotonic: sags down
atonic: sags down and stretched

Question 5

feature of stomach

Answer 5

greater curvature: point of attachment of gastrosplenic ligament and greater omentum
lesser curvature: point of attachment for lesser omentum
cardiac notch: sup. angle between esophagus & stomach
can stretch up to 3L
rugae: longitudinal folds, allow distension
intraperioneal: peritoneum on stomach of ant. & post. surface unite to form greater omentum hanging from greater curvature

Question 6

neurovasculature of stomach

Answer 6

arterial supply:
left gastric: from celiac trunk
right gastric: from hepatic proper artery
right gastroomental: from gastroduodenal artery
left gastroomental: from splenic artery
short gastric for fundus: also from splenic
venous: same as arteries
drains into portal venous system
innervation: visceral innervation from celiac nerves plexus
sympathetic: vasoconstriction &inhibition of peristalsis
parasympathetic: stimulate gastric secretion & peristalsis

Question 7

small intestine

Answer 7

extend from pyloric orifice to ileocecal fold

divided into duodenum, jejunum & ileum

Question 8

duodenum

Answer 8

location: around head of pancreas
above umbilicus: epigastic & umbilical regions
retroperitoneal, except for the 1st portion
4 parts:
1st: sup. part, connected to hepatoduodenal ligament (lesser omentum)
2nd: descending part, site of junction of foregut and midgut
contains 2papillae:
minor duodenal: entrance of accessory pancreatic duct
major duodenal: entrance of bile&pancreatic ducts (tgt called hepatopancreatic duct)
3rd: inf part, crosses IVC and aorta, sup. mesenteric vessels passes over
4th: ascending part, ends into duodenojejunal flexure

Question 9

arterial suply of duodenum

Answer 9

first 2 parts: 
superior pancreaticduodenual: ant. and post 
branch from gastroduodenal a. 
last 2 part:
inferior pancreaticoduodenal: ant. and post
branches from superior mesenteric A
venous drainage: same 
innervation: same as stomach

Question 10

pancreas
role
location
retro or intra peritoneal 
anatomy

Answer 10

lobulated gland
exocrine: digestive enzymes
endocrine: hormones (insulin/ glucagon)
location: posterior to stomach
from duodenum to spleen on the left
epigastric & left hypochondriac region
retroperitoneal: head neck and body NOT TAIL
Head: lies within C-shaped duodenum
uncinate process: projection of the head post to sup. mesenteric vessels
neck: ant. & sup. to sup mesenteric vessels
body: elongated part from neck to tail
tail: into splenorenal ligament (intraperitoneal)

Question 11

Duct system of pancreas

Answer 11

exocrine
main pancreatic duct: traverse its length
join common bile duct at hepatopancreatic ampulla
drain into duodenum at major duodenal papilla
acessory duct: drain through minor duodenal papilla

Question 12

arterial supply of head of pancreas

Answer 12

superior pancreaticoduodenal a. from gastroduodenal a. ant and post.
inferior pancreaticoduodenal a. from superior mesenteric a.
neck/body/ tail: pancreatic branches of splenic artery

Question 13

liver:
role
location
surfaces

Answer 13

primary role in carb/protein/ fat metabolism
produce bile & bil pigments 
detoxifies substance from GI 
store vitamins/ minerals 
site of hemtopoiesis
location: intraperitoneal
right hypochondriac region
epigastric- left hypochondriac region
visceral surface: posterior, has esophagus, stomach, right kidney and colon imprints
diaphragmatic surface

Question 14

suspensory system of liver

superior/anterior/ posterior

Answer 14

cover by peritoneum except diaphragmatic surface
superior: peritoneum reflects coronary ligatments
anterior +posterior coronary: join to make triangular ligament
right triangular and left triangular
anterior: attached to ant. abdominal wall
falciform ligament (extending to ligamentum terres)
posterior:
lesser omentum: hepatoduodenal ligament
encloses the portal triad (hepatic artery, portal vein and bile duct)

Question 15

lobes of liver

Answer 15

4 lobes
right and left: divided by left sagittal fissure
featuring ligamentum teres anteriorly & ligamentum venosum posteriorly
quadrate& caudate: arises from right lobe
quadrate: anterior on visceral surface
between lig. teres and fossa of gall bladder
caudate: posterior on visceral surface, between ligamentum venosum and IVC

Question 16

Porta hepatis

Answer 16

location: visceral surface/ between caudate and quadrate
content:
right, left hepatic ducts, hepatic arteries, portal vein
also contain in hepatoduodenal ligament

Question 17

blood supply of liver

Answer 17

right/left hepatice artery and proper hepatic artery

venous drainage: hepatic veins drain into IVC near caudate lobe

Question 18

extrahepatic biliary system

Answer 18

duct system for bile secreted by liver connects with gallbladder
composed of: right+left hepatic ducts
combining into 1 common hepatic duct (in hepatoduodenal ligament)
joins cystic duct from gallbladder, form bile duct
empties main pancreatic duct through major duodenal papilla

Question 19

gall bladder

Answer 19

lies between quadrate and right lobe
store bil from liver/concentrate it, release through extra hepatic biliary duct system
neck: continues with cystic duct
body: enlargement projected anteriorly to the first part of duodenum
fundus: protrude from inferior border of the liver

Question 20

spleen

Answer 20

part of vascular system
function as lymphoid gland
location: 
left hypochondriac region
inferior to left dome of diaphragm 
posterior to stomach 
ribs 9,10,11
notched anterior border 
hilum on medial surface (entry of vessels) 
visceral impression: 
renal, gastric and colic