Foregut & Liver Flashcards
Esophagus
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
abdominal esophagus
enters with 2 vagal trunk
ant is left
post is right
from esophageal aperture of T10 diaphragm to cardia [
Stomach
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
variation of position of stomach
hypertonic: pushed up
orthotonic: pushed up and compress to left
hypotonic: sags down
atonic: sags down and stretched
feature of stomach
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
neurovasculature of stomach
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
small intestine
extend from pyloric orifice to ileocecal fold
divided into duodenum, jejunum & ileum
duodenum
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
arterial suply of duodenum
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
pancreas role location retro or intra peritoneal anatomy
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)
Duct system of pancreas
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
arterial supply of head of pancreas
superior pancreaticoduodenal a. from gastroduodenal a. ant and post.
inferior pancreaticoduodenal a. from superior mesenteric a.
neck/body/ tail: pancreatic branches of splenic artery
liver:
role
location
surfaces
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
suspensory system of liver
superior/anterior/ posterior
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)
lobes of liver
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
Porta hepatis
location: visceral surface/ between caudate and quadrate
content:
right, left hepatic ducts, hepatic arteries, portal vein
also contain in hepatoduodenal ligament
blood supply of liver
right/left hepatice artery and proper hepatic artery
venous drainage: hepatic veins drain into IVC near caudate lobe
extrahepatic biliary system
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
gall bladder
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
spleen
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
