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1
Q

Describe the areas of the abdomen.

A

R hypochondrium - Epigastrium - L hypochondrium
R lumbar - Periumbilical - L lumbar
R iliac fossa - Hypogastrium - L iliac fossa

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2
Q

What lines create the 9 areas of the abdomen?

A

Midclavicualar lines vertically and Subcostal/transpyloric/addison’s and transtubercular line horizontally

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3
Q

How are the muscles of the abdomen arranged from external to internal.

A

External oblique and rectus sheath
Rectus abdominus with linea alba
Internal oblique
Transversus abdomenus

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4
Q

What direction do the external oblique fibres run?

A

Inferior - medial

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5
Q

What is the function of the rectus abdominus?

A

Flex lumbar spine

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6
Q

What is the function of the external oblique?

A

Flex torso and contralateral trunk rotation

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7
Q

What is the function of the transversus abdominus?

A

Compress abdo contents

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8
Q

At what level is the umbilicus located?

A

L3/4

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9
Q

How are the abdominal muscles arranged above the umbilicus?

A

Anterior AND posterior of rectus sheath

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10
Q

What innervates the anterior abdominal wall?

A

Ventral rami of T7-L1

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11
Q

What are the attachments of the inguinal ligament?

A

Anterior superior iliac spine and pubic tubercle

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12
Q

What fascia is below the transversus abdominus?

A

Transversalis fascia

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13
Q

In males and females what emerges through the inguinal ligament?

A 
Males = spermatic cord
Females = round ligament
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14
Q

What causes an inguinal hernia?

A

Direct (weak spot in posterior muscle, superficial ring) or indirect (weakness in deep ring)

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15
Q

What is most lateral, the superficial or deep inguinal rings?

A

Superficial

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16
Q

What are the main epigastric vessels?

A

Superior and inferior

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17
Q

Where does the superior epigastric vessel arise from?

A

Internal thoracic artery

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18
Q

Where does the inferior epigastric vessel arise from?

A

External iliac artery

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19
Q

Name the layers of the gut tube?

A

Mucosa
Submucosa
Muscularis propria
Serosa (or adventitia)

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20
Q

What are the layers of the mucosa of the gut tube?

A

Epithelium
Lamina propria
Muscularis mucosae

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21
Q

What is the structure of the muscularis propria/externa?

A

Circular and longitudinal layers

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22
Q

What are the 4 basic mucosal types?

A

Protective
Secretory
Absorptive
Protective/Absorptive

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23
Q

What epithelium is found in the oesophagus and anal canal?

A

Stratified squamous

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24
Q

What epithelium is found in the stomach?

A

Simple columnar with tubular glands

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25
Q

What epithelium is found in the small intestine?

A

Villi with short crypts (Brunner’s glands)

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26
Q

What epithelium is found in the large intestine?

A

Closely packed straight glands with goblet cells

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27
Q

What layer of peritoneum is more sensitive to pain?

A

Parietal peritoneum

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28
Q

What layer of peritoneum results in autonomic referred pain?

A

Visceral

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29
Q

What nerves stimulate the parietal peritoneum?

A

Lower 6 thoracic and L1 somatic

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30
Q

Name 4 intraperitoneal organs.

A

Stomach
Transverse Colon
Sigmoid colon
Ileum

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31
Q

Name 4 retroperitoneal organs.

A

Kidneys
Ascending colon
Descending colon
Pancreas

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32
Q

What are the 2 sacs formed from the peritoneum?

A

Greater and lesser

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33
Q

What links the greater and lesser sacs of the peritoneum?

A

Epiploic foramen

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34
Q

What is connected by the greater omentum?

A

Greater curvature of stomach to transverse colon

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35
Q

What is connected by the lesser omentum?

A

Lesser curvature of stomach to the liver

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36
Q

What is the function of the greater omentum?

A

“Abdominal policeman” - adheres to infection and wraps round infected organs/protects against serious/diffuse peritonitis

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37
Q

Describe the blood supply to the gut tube (off the abdominal aorta).

A

Celiac trunk
Superior mesenteric
Inferior mesenteric

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38
Q

What is the level of the celiac trunk?

A

T12

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39
Q

What is the level of the superior mesenteric?

A

L1

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40
Q

What is the level of the inferior mesenteric?

A

L3

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41
Q

What artery supplies the foregut?

A

Celiac trunk

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42
Q

What artery supplies the hindgut?

A

Inferior mesenteric artery

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43
Q

What artery supplies the midgut?

A

Superior mesenteric artery

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44
Q

Where does blood from the abdominopelvic gastrointestinal tract drain?

A

Via portal system to liver

superior mesenteric + inferior mesenteric + splenic vein –> hepatic portal vein

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45
Q

Name 4 sites of portocaval anastomoses.

A

Distal oesophagus
Oesophageal junction
Around umbilicus
Anorectal junction

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46
Q

In portal hypertension the portocaval anastomoses become congestion and cause dilatations resulting in?

A

Oesophageal varices
Haemorrhoids
Caput medusae

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47
Q

What is the SNS supply to abdominal viscera?

A

Greater, lesser and least abdominopelvic splanchnic nerves (prevertebral ganglia and abdominal aortic plexus)

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48
Q

What is the PNS supply to abdominal viscera?

A

Pelvic splanchnic nerves (S2, 3 and 4) (anterior and posterior vagal trunks)

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49
Q

What action does the SNS have on the abdominal viscera?

A

Decrease secretion
Decrease motility
Vasoconstriction

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50
Q

What action does the PNS have on the abdominal viscera?

A

Increase secretion
Increase motility
Vasodilatation

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51
Q

What else is located in the oesophageal opening of the diaphragm?

A

Vagus
Left inferior phrenic vessels
Oesophageal arteries

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52
Q

What is the artery supply of the abdominal aorta?

A

Branches of the left gastric artery

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53
Q

What are the nodes associated with the abdominal oesophagus?

A

Left gastric and celiac nodes

54
Q

What veins drain the oesophagus?

A

Left gastric vein –> portal

Azygous vein –> systemic

55
Q

How is the pyloric sphincter formed?

A

Thickening of the muscularis externa

56
Q

What forms the rugal folds?

A

Mucosa and submucosa

57
Q

Where is the regal folds most apparent?

A

Greater curvature and pyloric antrum

58
Q

What arteries supply the stomach?

A

Celiac trunk -> left gastric artery, right gastric artery, left gastro-omental, right gastro-omental

59
Q

What lymph nodes does the stomach drain into?

A

Superior gastric
Supra-pyloric
Inferior gastric sub-pyloric
Pancreaticosplenic

60
Q

What is the nerve supply of the stomach?

61
Q

What does the vagus nerve do to the stomach?

A

Constriction of pyloric

Increase gastric secretions

62
Q

What are the parts of the small intestine?

A

Duodenum - Jejunum - Ileum

63
Q

How is the duodenum peritonised?

A

Part 1 = intraperitoneal

Part 2-4 = retroperitoneal

64
Q

Where is the foregut/midgut boundary?

A

Between 1st and 2nd parts of the duodenum

65
Q

What part of the small intestine has greater vascularity?

66
Q

What part of the small intestine has more fat in the mesentery?

67
Q

What part of the small intestine has low and sparse circular folds?

68
Q

What causes reduced secretion and motility of the small intestine?

A

Sympathetic splanchnic nerves

69
Q

What are the characteristic features of the large intestine?

A

Omental appendices
Haustra
Teniae coli

70
Q

Name three organs that are retroperitoneal.

A

Ascending colon
Descending colon
Pancreas

71
Q

Name three organs that are intraperitoneal.

A

Caecum
Transverse colon
Sigmoid colon

72
Q

What does the superior mesenteric supply up to?

A

Up to 2/3 transverse colon

73
Q

Where does the inferior mesenteric artery supply from?

A

Last 1/3 of the transverse colon

74
Q

What opens into the cecum?

A

Ileum and appendix

75
Q

What is McBurney’s point?

A

Site of max tenderness in acute appendicitis

76
Q

What is the blood supply to and from the rectum?

A

Superior, Middle and inferior

77
Q

How is the rectum peritonised?

A 
Super = anterolateral
Middle = retroperitoneal
Inferior = no peritoneum
78
Q

What can structurally be seen in the rectum?

A

Columns of morgagni, pectinate line

79
Q

What is the visceral innervation of the rectum?

A

Inferior hypogastric plexus

80
Q

What is the somatic innervation of the rectum?

A

Inferior anal nerves

81
Q

What is the falciform ligament a remnant of?

A

Umbilical vein

82
Q

What does the falciform ligament contain?

A

Round ligament

83
Q

Where are the paracolic gutters located?

A

Between colon and abdominal wall

Lateral to ascending and descending colons

84
Q

What is the clinical significance of the parabolic gutters?

A

Pus and fluid can collect here

Surgeons can store abdominal contents here

85
Q

What epithelium is found in the oesophagus?

A

Stratified squamous non-keratinised epithelium

86
Q

What is found in the muscularis mucosae in the oesophagus?

A

Smooth muscle

87
Q

What cells are found in the stomach?

A

Goblet cells
Parietal cells
Chief cells

88
Q

What type of epithelium is found in the small intestine?

A

Simple columnar non-keratinised

89
Q

When do glands extend past the muscularis mucosae?

90
Q

How do you locate the trans-pyloric plane?

A

Hands breadth below the xiphoid process

91
Q

What is found on the transpyloric plane?

A

Pyloris of stomach, origin of portal vein, neck of pancreas, duodenojejunal flexure

92
Q

What radiological tests exist for looking at the gut tube?

A

Barium meal –> Stomach
Barium follow-through –> SI
Barium enema –> LI

93
Q

What is the function of the spleen?

A

Lymphoid organ
Immune response
Blood filter
Stores RBCs

94
Q

What connects the pancreas to the duodenum?

A

Ampulla of Vater

95
Q

What is significant about the bare area of the liver?

A

No peritoneal covering

96
Q

What lobe of the liver is located beside the gall bladder?

A

Quadrate lobe

97
Q

What is present in the porta hepatis?

A

Portal vein, hepatic artery, hepatic duct (wrapped with visceral peritoneum)

98
Q

Where is bile produced?

99
Q

Where is bile stored?

A

Gall bladder

100
Q

What forms the common bile duct?

A

Common hepatic duct and cystic duct

101
Q

What forms Calot’s cystohepatic triangle?

A

Inferior surface of liver, common hepatic duct and cystic duct

102
Q

What type of mucosa is found in the oesophagus?

A

Protective

103
Q

What type of mucosa is found in the stomach?

104
Q

What type of mucosa is found in the SI?

A

Absorptive

105
Q

What type of mucosa is found in the LI?

A

Absorptive/secretory

106
Q

What is the difference between adventitia and serosa?

A

Serosa = peritonised

Adventitia = non-peritonised

107
Q

What is the function of the internal oblique muscles?

A

Compress abdomen and ipsilateral trunk rotation

108
Q

What muscle is responsible for contralateral trunk rotation?

A

Contralateral trunk rotation

109
Q

What direction do the transversus abdominal muscles travel?

A

Horizontally

110
Q

What thoracic spinal segments innervate the anterior abdominal wall?

111
Q

What type of hernia is women most likely to get?

A

Indirect femoral > inguinal

112
Q

Name three contents of the inguinal canal in men.

A

Ileolingual nerve, femoral artery and spermatic cord

113
Q

Name three contents of the inguinal canal in women.

A

Ileolingual nerve, femoral artery and round ligament of uterus

114
Q

Name the posterior abdominal wall muscles.

A

Psoas major
Psoas minor
Quadratus lumborum
Iliacus

115
Q

What is the affect of vagotomy on gastric secretion?

116
Q

What is vagotomy used to treat?

A

Peptic ulcers

117
Q

What is the anterior to posterior arrangement of structures entering the hilum of the kidney?

A

Renal vein -> Renal artery -> Ureter

118
Q

Name the 4 groups of lymph nodes that drain the stomach.

A

Superior gastric
Inferior gastric
Pancreatocolineal
Supra-pyloric

119
Q

What group of lymph nodes do the 4 groups of lymph nodes eventually drain into?

A

Celiac trunk

120
Q

In the anal canal, what are somatic nerves sensitive to?

A

Pain, temp, touch and pressure

121
Q

In the anal canal, what are visceral nerves sensitive to?

122
Q

What drains the first part of the duodenum?

A

Portal system

123
Q

What are the hepatoduodenal and hepatogastric ligaments a part of?

A

Lesser omentum

124
Q

How is the spleen peritonised?

A

Intraperitoneal

125
Q

What is present in Calot’s cystohepatic triangle?

A

Cystic artery

126
Q

What is found in red and white pulp in the spleen?

A 
Red = blood cells, platelets, granulocytes, RBCs
White = lymphatic tissue
127
Q

At what vertebral level is the recto-sigmoid junction?

A

Anterior to S3

128
Q

What are the 3 muscular layers of the stomach?

A

Inner oblique
Middle circular
External longitudinal

129
Q

What is the rule for obstruction when looking at scans?

A

Should be SI < 3cm, LI < 6cm, Caecum <9cm

130
Q

What are plaice circulars?

A

Folds of the SI seen in imaging

131
Q

On imaging, if there is air in the rectum, what is this a sign of?

A

No obstruction

Anatomy (11 decks)

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