GI anatomy Flashcards
Where do the lowermost fibres of internal oblique muscle take origin from?
lateral 2/3 of inguinal ligament
Which artery perfuses the pancreas?
Splenic artery
At what vertebral levels are preganglionic sympathetic fibres for the hindgut derived from?
T12-L2
In which quadrant is the jejunum?
LUQ
Which kidney is slightly more superior?
Left
Which is brighter on CT: fat or soft tissue?
Soft tissue
Which organ is just below the celiac trunk?
Pancreas
What is the surface marking for the fundus of the gall bladder?
Intersection of linea semilunaris with costal margin on right side
What do we call the aponeurotic envelope that contains the rectus abdominus on each side of the midline?
Rectus sheath
Where is the deep inguinal ring?
Exactly half way between ASIS (ant sup iliac spine) and the pubic tubercle and a fingers breadth above the inguinal ligament
What are the 4 muscles in the paravertebral gutter?
Psoas major. Psoas minor. Quadratus lumborum. Iliacus
What contributes to the major duodenal papilla?
Bile duct and pancreatic duct
Is the pancreas intraperitoneal or retroperitoneal?
Retroperitoneal
Where do the unpaired intraperitoneal structures have venous drainage to?
Portal venous system
How is the transpyloric plane identified on surface anatomy?
The intersection of the lines semilunaris with costal margin
What does the proper hepatic artery divide into?
The right and left hepatic arteries
Where do the lower most fibres of the transverse abdominus originate?
Lateral 1/2 of ingiunal ligament
What is the ligamentum teres a remnant of?
Umbilical vein
Which aspect of the rectus sheath is present all the way from superior to inferior?
Anterior
What defines the limits of the fundus of the stomach?
Cardiac notch (incisure) and angular notch
Is the horizontal part of the duodenum intraperitoneal or retroperitoneal?
Retroperitoneal
Which part of the duodenum is intraperitoneal?
The first inch of the duodenal cap
Is the cecum intra- or retro-peritoneal?
Intraperitoneal
What does the aorta bifurcate into?
Common iliac arteries
Between which muscles is the neurovascular bundle of the anterior abdominal wall?
Between internal oblique and abdominis transversus muscles
How many segmental arteries are there from the renal artery?
5
Which muscles arch up and over to insert into the pubic crest via conjoined tendon
Inner oblique and transverse abdominus
What is the rectus sheath?
An aponeurotic envelope that contains the rectus abdominus on each side of the midline
Which arteries supply the greater curvature of the stomach?
Left and right gastro-epiploic arteries
How long are the ureters?
20-30cm
Which has more numerous mucosal folds: jejunum or ileum?
Jejunum
Where are the 3 tendinous intersections of the rectus abdominis?
At level of umbilicus At level of xiphisternum At level half way between these two
What is the esophageal opening part of the stomach called?
The cardiac orrifice
If there is an inflamed gall bladder, where will tenderness be noted?
Junction of right costal margin with linea semilunaris
Which muscle does the kidney overlie?
Quadratus lumborum
What is the inferior epigastric artery a branch of?
External iliac artery
What surrounds the head of the pancreas?
Duodenum
What does the ‘C’ shape of the duodenum curl around?
Head of the pancreas
Where is pain from the hindgut referred to?
Suprapubic region
What lies just lateral to the duodenal cap?
Right kidney
Which is darker on CT: fat or soft tissue?
Fat
Define aponeuroses
Layer of flat, broad tendon
What are the 3 free edges of the external oblique?
Superior aponeurotic edge (which pec major takes origin from) Free posterior muscular edge Free inferior edge (between ASIS and pubic tubercle)
What do we call the clear lateral border of rectus abdominis?
Linea semilunaris
What is the surface landmark for the base of the appendix
McBurney’s point
What do the left and right hepatic ducts unite to form?
Common hepatic duct
Which hormones does the pancreas release?
Glucagon. Insulin. Somatostatin.
Where does the internal oblique muscle take its origin from inferiorly?
anterior 2/3 of iliac crest
How long is the esophagus?
25cm
What is the anatomical border separating the right and left halves of the liver?
Falciform ligament
How can you identify a piece of small intestine is jejunum and not ileum?
Thicker wall with more numerous mucosal folds. Less fat is mesentery so it’s easier to see vessels in the mesentery. Mesentery has long vessels (vasa recta) instead of the many arterial arcades seen in the ileum
At what vertebral level is the transpyloric plane?
L1
Where is the junction of the midgut and hindgut?
2/3 of the way along the transverse colon, towards the splenic flexure
What does the common hepatic artery branch into?
Proper hepatic artery and gastroduodenal artery
What does the gastroduodenal artery divide into?
Anterior superior pancreaticduodenal artery. Right gastroepiploic artery
What does the portal vein pass behind?
First part of the duodenum
Under which ribs does the spleen lie?
9, 10 and 11
Where can the cystic artery branch off? Which is more common?
Right hepatic artery most commonly, but also can branch from proper hepatic artery
Which passes to the right of the other: hepatic ducts or hepatic artery?
Hepatic ducts
What structures does the left gastric artery supply?
Abdominal esophagus. Lesser curvature of stomach.
What is the lesser curvature of the stomach attached to? And via what?
To liver via lesser omentum
Where is the junction of the foregut and midgut?
Major duodenal papilla
What are the 2 components of the dual venous system of the abdomen?
Inferior vena cava (caval system) Portal vein (portal venous system)
What vascular structures are behind the pancreas?
Splenic artery and vein
Where will irritation of the mid-sigmoid colon to rectum be referred?
Peri-anal
Where is the junction between foregut and midgut?
The major duodenal papilla
What is a landmark for the dermatome of L1?
Groin
What is the first part of the large intestine called?
Cecum
What are the 2 surfaces of the liver?
Diaphragmatic and visceral surface
Which aspect of the rectus sheath is only present superiorly?
Posterior
What is posterior to the head and neck of the pancreas?
IVC and aorta
What does the right renal artery pass behind?
IVC
What are the 3 layers that surround the testicular neurovascular bundle?
Internal spermatic fascia Cremasteric fascia External spermatic fascia
Where does the left renal vein pass with relation to the aorta?
Anterior
What attaches the liver to the anterior abdominal wall?
Falciform ligament
What is behind the foramen of Winslow?
IVC
What is the superior epigastric artery a branch of?
internal thoracic aa
What forms the superficial inguinal ring?
The triangular opening in external oblique between its attachment between the pubic tubercle and the pubic crest
Which artery supplies the abdominal oesophagus?
Left gastric artery
Which muscles do external obliques iie edge to edge with?
Pec major and serratus anterior
Where does psoas major lie?
In the paravertebral gutter between bodies and transverse processes of lumbar vertebrae
Where is the appendix is 65% of people?
Retrocecal
Where does the portal vein empty into?
Hepatic sinusoids
In what does the portal triad run?
Between two layers of lesser omentum
Where do the paired retroperitoneal structures have venous drainage to?
Systemic caval system
What do we call the point of junction from esophagus to stomach?
Z line
Where should a vein always pass relative to an artery?
Anterior to the artery
What is the orientation of internal oblique muscles?
Postero-inferior (back pockets)
What is the linea semilunaris?
Clear lateral border of rectus abdominis.
Where does external oblique meet with the contralateral external oblique?
In a strong vertical line of insertion (linea alba = white line)
From which artery does the hepatic artery arise?
Celiac trunk
At what vertebral levels are preganglionic sympathetic fibres for the foregut derived from?
T6-T9
How is the superior margin of the liver identified on surface anatomy?
Plane between the nipples
Where is pain from the midgut referred to?
Periumbilical region
Where is McBurney’s point?
1/3 of the way from the right ASIS to the umbilicus
How many free edges does the external oblique have?
3
In which quadrant is the ileum?
RLQ
Where is the junction between hindgut and midgut?
2/3 the way along the transverse colon, towards the splenic fleexure
What do we call the line at the inferior end of the posterior segment of the rectus sheath?
Arcuate line
Is the jejunum intraperitoneal or retroperitoneal?
Intraperitoneal
What are the ridges of the stomach called?
Rugae
Haematemesis due to eroded duodenal ulcer is likely to involve which artery?
Gastroduodenal artery
While looking at the posterior surface of the liver, what are the 4 lobes starting at 12 o’clock and moving clockwise?
Caudate. Right. Quadrate. Left
Where does the internal oblique muscle take its origin from posteriorly?
Thoracolumbar fascia
How many free edges does the internal oblique have?
None
What is the greater curvature of the stomach attached to? And via what?
Spleen via greater omentum
Is the duodenal cap intraperitoneal or retroperitoneal?
First inch is intraperitoneal. Second inch is retroperitoneal
What are the 3 branches off the celiac trunk?
Splenic artery. Left gastric artery. Common hepatic artery
Through what do the greater and lesser sacs communicate?
The epiploic foramen of Winslow
At what level does the esophagus pass through the diaphragm?
T10
At what dermatome level is the umbilicus?
T10
Where does the minor duodenal papilla enter the duodenum?
Just proximal to the major duodenal papilla
How long is the small intestine from the point of the D-J flexure?
4-6 meters
What forms the common bile duct?
Common hepatic duct and cystic duct
What is the most posterior structure at the renal hilum?
Renal pelvis
Is the stomach intraperitoneal or retroperitoneal?
Intraperitoneal
What forms the opening of the common bile duct?
Sphincter of Oddi
What forms the minor duodenal papilla?
Accessory pancreatic duct
Where does the tail of the pancreas lead?
The hilum of the spleen
Where does the foregut begin?
Abdominal esophagus
Where does rectus abdominis attach inferiorly?
To body and crest of pubis
How big is the spleen?
Clenched fist
What forms the common hepatic duct?
Left and right hepatic ducts
What is the most superior part of the stomach called?
The fundus
Never put an artery in front of a ______
Vein
What vertebral levels do the kidneys span?
T12 to L3
Which muscles from the roof of the inguinal canal?
Internal oblique and transversus abdominis
Is the ascending colon intraperitoneal or retroperitoneal?
Retroperitoneal
Which organs does the splenic artery perfuse?
Spleen, pancreas and stomach
At what level does the inferior mesenteric artery branch off the aorta?
L3
What is the blind end of the gall bladder called?
Fundus
What is the most distal part of the stomach?
Pyloric sphincter
How long is the appendix?
7-10 cm
In which quadrant is the spleen?
LUQ
What is a landmark for T10 dermatome?
Umbilicus
What gives the liver its visceral peritoneum?
The lesser omentum
At what level does the aorta end?
L4
What are the 4 parts of the duodenum?
Duodenal cap. Descending. Horizontal. Ascending.
Is the ilieum intraperitoneal or retroperitoneal?
Intraperitoneal
What part of the stomach is most likely to show as a gas bubble on X ray?
Fundus
Never put a ________ in front of a ______
An artery in front of a vein
Where does blood from the rectum drain to?
Caval system or hepatic portal system
Which part of the duodenum is retroperitoneal?
All but the first inch of the duodenal cap
What is the only dead-straight horizontal branch of the lateral aspect of the aorta?
Renal artery
At what vertebral levels are preganglionic sympathetic fibres for the midgut derived from?
T8-T12
What organ is just behind the pancreas?
Left kidney
Is the ascending part of the duodenum intraperitoneal or retroperitoneal?
Retroperitoneal
Where does the ileum end?
At the ileo-cecal junciton
What is the free inferior edge of the liver called?
Ligamentum teres
Which arteries supply the lesser curvature of the stomach?
Left and right gastric arteries
Which muscle of the anterior abdominal wall underlaps the costal margin?
Transverse abdominus
What is formed by an opening in the transversalis fascia?
Deep inguinal ring or internal inguinal ring
Behind which organ does the portal vein form?
Neck of the pancreas
What are the structures in the renal hilum from anterior to posterior?
Renal vein. Renal artery. Renal pelvis
At what level does the superior mesenteric artery branch off the aorta?
L1
Where does the testis exit the inguinal canal during development?
Superficial (or external) inguinal ring
What does the duodenal cap lie on?
Right psoas major
In which quadrant is the liver?
RUQ
What does the sphincter of Oddi envelope?
Common bile duct and pancreatic duct
What loops over the left renal vein as it passes the aorta?
Superior mesenteric artery
At what vertebral level does the portal vein form?
L2
Where is visceral pain from the foregut referred to?
Epigastric region
Where is visceral pain from the midgut referred to?
Peri umbilical region
Where is visceral pain from the hindegut referred to?
Supra pubic region
Where is the junction between foregut and midgut?
Major duodenal papilla
Where is the junction between midgut and hindgut?
2/3 the way along the transverse colon, towards the splenic flexure
What are the 3 most common locations of kidney stones?
Uretopelvic junction. Crossing of iliac artery. Uretovesicle junction.
At what vertebral level does the esophagus begin?
C6
How long is the duodenum?
10cm
What passes through the porta hepatis?
Portal vein. Proper hepatic artery. Hepatic ducts. Nerves. Lymphatics
Which gland sits on the kidney?
Adrenal gland
In which quadrant is the gall bladder?
RUQ
At what vertebral level is the celiac trunk?
T12
What is in front of the foramen of Winslow?
Portal triad
Is the transverse colon intraperitoneal or retroperitoneal?
Intraperitoneal
What is the common site of opening of the bile duct and pancreatic duct called?
Major duodenal papilla
What are the 3 muscular layers of the anterolateral abdominal wall from superficial to deep?
External oblique Internal oblique Transversus abdominus
What is the z line?
Esophogeal-gastic junction
In which quadrant is the stomach?
LUQ
Where is pain from the foregut referred to?
Epigastric region
What landmark defines the boundary between the body and fundus of the stomach?
The cardiac notch or incisure
Where linea semilunaris intersects with costal margin on the right side is the surface marking for what?
Fundus of gall bladder
What overlies the neck of the pancreas?
Pylorus
What artery supplies the head of the pancreas?
Anterior superior pancreaticduodenal artery
What is above the foramen of Winslow?
Quadrate lobe of liver
Where does the iliac crest end?
At the ASIS (anterior superior iliac spine)
What is the most posterior structure in the porta hepatis?
Portal vein
Where is the rectus abdominis wider?
Superiorly
From which artery does the splenic artery arise?
Celiac trunk
Where does the major duodenal papilla enter the duodenum?
Half way down the posteromedial wall of the descending segment of the duodenum
At what vertebral levels are preganglionic sympathetic fibres derived from?
T6-L2
What is the dermatome of the loins?
L1
In what direction does abdominus transversus run?
Horizontal
What is the part of the stomach distal to the body?
Antrum
Which lobes of the liver is the gall bladder between?
Quadrate and right.
Which lobes of the liver is the IVC between?
Caudate and right.
Is the sigmoid colon intra- or retro-peritoneal?
Intraperitoneal
What is the part of the stomach between the pyloric sphincter and the antrum?
Pyloric canal
What does THE mesentery connect?
Posterior abdominal wall to jejunum and ileum
What is the largest part of the stomach called?
Corpus or body
Where do superior and inferior epigastric arteries anastamose with each other?
Behind rectus abdominis in posterior rectus sheath
Where is visceral pain from the foregut referred to?
Epigastric region in the midline
Is the horizontal part of the duodenum intraperitoneal or retroperitoneal?
Retroperitoneal
What forms the inguinal ligament?
The free inferior edge of the external oblique extending from the anterior superior iliac spine to the pubic tubercle
What is the orientation of external oblique muscles?
Antero-inferior (front pockets)
What demarcates the lateral edge of the pubic crest?
Pubic tubercle
What forms the floor of the inguinal canal?
Inguinal ligament
What is an approximate radiological landmark for the descent of the ureters?
Tips of lumbar transverse processes
Which artery does the left gastroepiploic artery branch from?
Splenic artery
What are the 3 parts of the esophagus?
Cervical, thoracic, abdominal
Is the descending part of the duodenum intraperitoneal or retroperitoneal?
Retroperitoneal
The rami of which spinal nerves contribute to the lumbar plexus?
L1-L4
Which artery does the superior rectal artery come from?
Inferior mesenteric artery
How long does the esophagus extend in the abdomen before it enters the stomach?
1.25 cm
What sits directly above the fundus of the stomach?
Left hemidoaphragm
Where do the unpaired retroperitoneal structures have venous drainage to?
Portal venous system
Which arteries supply derivatives of the fore-, mid- and hind-gut?
Celiac trunk, superior mesenteric artery, inferior mesenteric artery
What are the 6 layers of the antero-lateral abdominal wall from superficial to deep?
1 skin 2 superficial fascia 3 abdominal muscles 4 fascia transversalis 5 extraperitoneal fat 6 parietal peritoneum
How long is the large intestine?
1.5 meters
Is the descending colon intraperitoneal or retroperitoneal?
Retroperitoneal
To which organs does the greater omentum attach?
Greater curvature of the stomach and transverse colon
