General anatomy- Gastro anatomy Flashcards
what is the aa supply of the foregut, midgut and hindgut
foregut- celiac trunk
midgut- sup mesenteric aa
handout- inf mesenteric
what does the foregut give rise to
esophagus
stomach
prox half of duodenum
what does the midgut give rise to (3)
- distal half of duodenum
- small intestine
- prox half of long intestine up to prox 2/3 of transverse colon
what does the hindgut give rise to
to the rest of the large intestine from the distal 1/3 of the transverse colon to prox half of anal canal
how common is meckels diverticulum, where is it located, what kina tissue is it and how common is it
occurs in 2% of pop
2 inch long, 2 feet prox to the ileocecal junction
2x mc in males
made of gastric and pancreatic tissue
where is the t7,10,L1 dermatome lvls
T7- xiphoid lvl
t10- umbilical lvl
L1- inguinal region
How many layers is there in the ant abdominal wall and what are they from out to in
skin subcutaneous tissue mm transversals fascia exztraperitoneal fascia parietal peritoneum
what is the anterior abdominal wall innervated by
- lower 5 intercostal nerves (T7-11)
- subcostal nerve (T12)
- Iliofypogastric and ilioinguinal nerves (L1)
where is the arcuate line located
posterior to the rectus mm, midway between the umbilicus and the symphysis
how is the anterior + posterior layer of the rectus sheath made above the arcuate line
ant- consists of ext oblique aponeurosis and ant layer of internal oblique aponeurosis
post- post layer of aponeurosis of the internal oblique and aponeurosis of traverses abdomens
how is the rectus sheath made below arcuate line
ant- aponeurosis of the ext oblique, int oblique and transverses abdominis
post- only covered by transversals fascia
what are the contents of the rectus sheath (3)
rectus abdominis mm
pyramidalis mm
sup and inf epigastruc aa and veins
what does the peritoneum consist of and is it sensitive to pain
- is the inner layer of the abdominal cavity
Parietal layer- sensitive to pain (inn by same nerves as ab wall)
Visceral layer- not sensitive to pain but sensitive to distension
what is the abdominal cavity divided into and how are they connected
2 compartments: greater + lesser sacs
-Lesser sac lies behind the stomach and opens into the greater sac via the epiploeic foramen of Winslow
What are the retroperitoneal structures (9)
AC DC PARK AID
Ascending colon Descending colon Pancreas Adrenals Rectum (lower 2/3) Kidneys Aorta Inf vena cava Duodenum (2nd-4th parts)
what kind of epithelium is in the stomach and how many muscular layers are around it
columnar epithelium
outer-longitudinal
inner-circular
innermost-oblique
what type of cells are located in the stomach and what do they each produce
chief cells- pepsinogen
parietal cells- hydrochloric acid, intrinsic factor
the stomach is supplied by which arteries (4)
- left gastric (from celiac trunk)
- Right gastric (from common hepatic/proper hepatic)
- Left gastro epiploid and short gastric (from splenic
- Right gastro epiploic (from gastroduodenal)
What is the upper and lower parts of the duodenum supplied by
upper (above major duodenal papilla) supplied by pancreatico duodenal artery
lower supplied baby inf pancreatic duodenal artery
where does the common bile duct open
2nd part of duodenum
what part of the duodenum does the superior mesenteric vein and aa pass over
3rd part of duodenum
which parts of the duodenum are interperitoneal and retroperitoneal
1st inch of first part of duodenum is intraperitoneal
rest of the duodenum is retroperitoneal
what is the biliary tree made up of
R+L hepatic ducts join to form common hepatic duct
Cystic duct (from gall) joins common hepatic duct to form common bile duct
What is callots triangle
triangle between cystic duct, common hepatic duct and contains the cystic artery
what does the common bile duct connect with
passes thru head of pancreas and is joined by the main pancreatic duct to open into the 2nd part of the duodenum (guarded by sphincter of Oddi)
what is the proximal and distal parts of the sm intestine after duodenum
prox- jejunum- thicker/wider and more vascualr
distal- ileium- thinner, narrower and less vascular
difference bw mesentery of jejunum and ileum
jejunum- large translucent windows with few large vascular arcades with longer vasa recta
Ileum- small opaque windows, numerous smaller arcades and numerous short vasa recta
Where are Peyers patches located
Ileum (lymphoid aggregates)
What does the sup mesenteric aa supply
Supplies all small intestine and the large intestine up to prox 2/3 of transverse colom
What does the L intestine have that the short doesnt
Haustra, tania coli, appendices epiplocia
what are the subdivisions of the colon
cecum ascending transverse descending sigmoid
Where is the appendix usually found (3 w %)
behind cecum 65%
Pelvis 30%
Retro ideal or pre iliac 5%
What is the appendix supplied by
appendicular aa
Where is mcBurneys point
2/3 along a line from umbilicus to the ASIS
what is the L intestine supplied by
L intestine derived from both mid and hindgut so supplied by both superior and inferior mesenteric aa
What is the watershed area of the L intestine and where is it located
Junction of the prox 2/3 and distal 1/3 transverse colon
-where blood supply may be compromised during hypovolemic shock
Where do lymphatics of colon drain
pericoloic
paracolic
mesenteric
para aortic nodes
what covers the upper, mid and lower 1/3s of the rectum
upper 1/3- pelvic peritoneum on ant and lat sides
mid 1/3- peritoneum only on ant
Lower 1/3- no peritoneum covering (considered retroperitoneal)
what aa supplies rectum
sup rectal branch of inf mesenteric aa
what is the lymphatic drainage of rectum
drains into the inf mesenteric nodes
what is the pectineal lone
divides the upper and lower part of anal mucosa
what is the upper and lower parts derived from and are they sensitive to pain
upper- served from hind (endoderm), insensitive to pain
Lower- from ectoderm, sensitive to pain
blood supply above and below pectineal line
above- inf mesenteric
below- inf rectal branch of internal pudendal aa
Lymphatic drainage above and below pectineal line
above- inf mesenteric nodes
below- Lat group of superficial inguinal nodes in groin
