GI anatomy: Abdominal Pain Flashcards
What are the component of the small intestine?
Duodenum
Jejunum
Ileum
What are components of the large intestine?
caecum appendix ascending colon transverse colon descending colon sigmoid colon
What organs are found in the foregut?
oesophagus to mid duodenum
liver and the gall bladder
spleen
1/2 pancreas
what are the midgut organs?
mid-duodenum to proximal 2/3rds of the transverse colon
inferior 1/2 of the pancreas
what organs are found in the hindgut?
distal 1/3rd of the transverse colon to proximal 1/2 of the anal canal
what are the 9 regions of the abdomen?
epigastric umbilical pubic L and R hypochodrium L and R lumbar L and R inguinal
Which peritoneum engulfs the organs?
visceral
which peritoneum is found on the body wall?
parietal
intraperitoneal organs?
completely covered by visceral peritoneum
retroperitoneal organs?
only the anterior surface of the organ is covered by the visceral peritoneum
List intraperitoneal organs:
liver and gall bladder stomach spleen some small intestine transverse colon
list retroperitoneal organs:
kidneys adrenal glands pancreas ascending colon descending colon
Mesentery?
A double layer of peritoneum that connects organs to the posterior body wall, providing blood supply and innervation.
Lesser omentum?
A peritoneal formation which connects the lesser curvature of the stomach top the liver.
Greater omentum?
An apron-like peritoneal formation, which hangs from the stomach’s greater curvature, connecting it to the transverse colon.
List the peritoneal ligaments:
hepatoduodenal ligament
hepatogastric ligament
gastrosplenic ligament
splenorenal ligament
What is the peritoneal pouch in males called?
Retrovesicular pouch
Located between the bladder and the rectum
What are the peritoneal pouches in females?
Vesicouterine pouch (between the bladder and the unterus). Recto-uterine pouch of Douglas (between the uterus and the rectum)
What is ascites?
A collection of fluid in the peritoneal cavity.
What are the main causes of ascites?
Liver disease, such as cirrhosis and portal hypertension.
Describe visceral pain.
Dull, achy, nauseating
Originates in an organ
Describe somatic pain.
Sharp and stabbing, originates a the body wall.
What nerve fibre types supply the abdominal organs?
visceral afferents (sensory) enteric nervous system (network of nerves in the GI tract's wall driving peristalsis) autonomic motor nerves (parasympathetic and sympathetic)
What nerve fibres supply the wall of the abdominal cavity?
somatic sensory nerves
somatic motor nerves
sympathetic fibres
At what spinal cord levels do the sympathetic nerves innervating the abdominal organs leave the CNS?
between T5 and L2
Where do these sympathetic nerves synapse?
They enter the sympathetic chains, but then travel on and only synapse at the prevertebral ganglia, located at the exit points of major branches of the abdominal aorta.
They then travel along the aortal branches towards the target organ.
Sympathetic nerves supplying the adrenal glands. How are they different?
They synapse directly onto the cells, rather than the prevertebral ganglia.
How do parasympathetic nerves reach abdominal organs?
Vagus nerve (CN X) - supplies the abdominal organs up to the distal end of the transverse colon.
Pelvic Spanchnic Nerves (S2,3,4) - supply the smooth muscle and glands of the descending colon to the anal canal.
To which organs does epigastric pain correspond?
Foregut organs:
oesophagus to mid duodenum, liver, gallbladder, spleen, 1/2 pancreas
What about umbilical pain?
Midgut:
Mid-duodenum to proximal 2/3 of the transverse colon, inferior 1/2 of pancreas.
Pain in the pubic region?
Hindgut:
Distal 1/3rd of the transverse colon to proximal 1/2 of the anal canal.
What is the cause of referred pain?
Pain fibres from abdominal organs travel up to the spine alongside the sympathetic fibres. Pain is perceived in the dermatomes which enter the spinal cord at the same level.
What nerves contain the somatic motor, somatic sensory and sympathetic nerve fibres supplying the abdominal body wall?
Thoracoabdominal nerves
Subcostal nerve
Iliohypogastric nerve
Ilionguinal nerve
Appendicitis - pain?
First dull, aching pain in the umbilical region.
Then sharp pain in the right iliac fossa, as the parietal peritoneum becomes irritated.
