GI Anatomy - Abdominal Pain Flashcards

1
Q

What makes up the foregut?

A

Oesophagus to mid-duodenum
Liver and gall bladder
Spleen
1/2 pancreas

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2
Q

What makes up the midgut?

A

Midduodenum to the proximal 2/3rds of transverse colon

1/2 pancreas

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3
Q

What makes up the handgun?

A

Distal 1/3 of transverse colon to proximal 1/2 of anal canal

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4
Q

What is guarding?

A

Anterolateral abdominal wall muscles contract to ‘guard’ the abdominal organs when injury threatens or peritonitis

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5
Q

Describe the peritoneum?

A

Thin, transparent, semi-permeable serous membrane that lines the abdomino-pelvic cavity and organs

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6
Q

Peritoneum is a continuous membrane; parietal on the _______; visceral ______

A

body wall

engulfs the organs

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7
Q

Where is the peritoneal cavity?

A

Beween thee visceral and parietal peritoneum

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8
Q

Blood, pus or faeces i the peritoneal cavity will cause sever and painful inflammation called?

A

Peritonitis

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9
Q

Intraperitoneal organs are almost completely covered in?

A

Visceral peritoneum

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10
Q

How mobile are intraperitoneal organs?

A

Minimally mobile

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11
Q

Organs with a mesentery are covered in?

A

Visceral peritoneum (wraps around the organ to form a double layer called the mesentery)

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12
Q

What defines retroperitoneal organs?

A

Only has visceral peritoneum on its anterior surface

Located in retroperitoneum

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13
Q

What kind of rotation is there of abdominal organs during embryological development?

A

Left anterior right posterior

Turn clockwise

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14
Q

Mesentery usually connects?

A

Organs to the posterior body wall

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15
Q

What is omentum?

A

Double layer of peritoneum that connects organs to one another on body wall

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16
Q

What is peritoneal ligaments?

A

Double layer of peritoneum that connect organs to one another on body wall

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17
Q

Mesentery has a core of?

A

Connective tissue with blood, lymph, nerve, lump nodes and fat

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18
Q

The mesentery proper is associated with?

A

the small intestine

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19
Q

What are the other types of mesentery besides the mesentery proper?

A

Transverse and sigmoid mesocolon

Mesoappendix

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20
Q

How many layers does the greater momentum have?

A

4-layered

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21
Q

What is the macroscopic appearance of the greater momentum?

A

Hangs like an apron

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22
Q

What does the greater omentum attach to?

A

Attaches the greater curvature of the stomach to the transverse colon

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23
Q

How many layers does the lesser momentum have?

A

2

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24
Q

Where does the lesser momentum run?

A

Between the lesser curvature of the stomach and duodenum to the liver

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25
What is the characteristic feature of the lesser momentum?
Has a free edge
26
The omenta divide the peritoneal cavity into?
A greater and lesser sac
27
How do the greater and lesser sac communicate?
Via the mental foramen aka Foramen of Winslow
28
What makes up the portal triad?
Proper hepatic artery Hepatic portal vein Common bile duct
29
Inferiorly the peritoneum drapes over the superior aspect of the pelvic organs forming which pouches?
Males: retro-vesical pouch (aka Pouch of Douglas) Females: vesico-uterine pouch/recto-uterine pouch
30
What is ascites?
Collection of fluid in the peritoneal cavity
31
What most commonly causes ascites?
Liver disease (cirrhosis causes portal hypertension)
32
Ascites can be drained by which procedures?
Paracentesis | Abdominocentesis
33
How can the pouch of Douglas be drains?
Transvaginally
34
During abdo/para-cenesis a needle must be placed where? Why?
Lateral to the rectus sheath Avoids the inferior epigastric artery (main supply to the abdominal wall) Use USS guidance if available
35
Where do the inferior epigastric arteries arise from?
The external iliac medial to the deep inguinal ring
36
Between visceral and somatic pain; which is easy and which is hard to localise?
``` Somatic = easy to localise Visceral = hard to localise ```
37
What character is typical of visceral pain?
Dull, achy and nauseating
38
What character is typical of somatic pain?
Shape and stapping
39
What does colic pain indicate?
Obstruction
40
Organs with nthe abdominal cavity including visceral peritoneum are innervated by?
Visceral (sensory) afferents ENS ANS (can influence ENS)
41
The abdominal wall from skin to parietal peritoneum is innervated by (3)?
Somatic sensory Somatic motor Sympathetic nerve fibres (no real parasympathetic supply)
42
Sympathetic nerves to the abdominal organs leave the spinal cord between?
T5 and L2
43
Sympathetic nerves to the abdominal organs leave the spinal cord between T5 and L2 and enter the _____. How do they leave the sympathetic chains?
``` Sympathetic chains (bilaterally) They don't synapse - leave sympathetic chains within abdomino-pelvic splanchnic nerves and synapse at the pre vertebral ganglia which are located anterior to the aorta at the exit points of the major branches of the abdominal aorta. ```
44
Postsynaptic sympathetic nerves fibres pass from the pre vertebral ganglia (coeliac/SMA/etc.) onto the surface of?
the arterial branches of the abdominal aorta
45
The postsynaptic sympathetic nerve fibres from the pre vertebral ganglia (coeliac/SMA/etc.) take part in the ________ with other never fibres on arterial branches of the abdominal aorta
periarterial plexuses
46
How do postsynaptic sympathetic nerve fibres pass from the pre vertebral ganglia to the smooth muscle and glands of the organ?
By hitching a ride to/away with the other nerve fibres in the periarterial plexuses on the surface of the arterial branches of the abdominal aorta
47
How are sympathetic nerves for the adrenal gland unique?
Leave spinal cord at T10-L1 and enter the abdominosplanchnic nerves. Don't synapse at the pre vertebral ganglia Carried with periarterial plexus to the adrenal gland Synapse directly onto the cells
48
The vagus nerve pre-synaptic nerve fibres enter the abdominal cavity on the surface of the?
Oesophagus
49
The vagus nerve travels into ___________ around the abdominal aorta
periarterial plexuses
50
The vagus nerve supplies parasympathetic nerve fibres to what in the abdomen?
GI tract | Abdominal organs up to the distal end of the transverse colon
51
Pelvic splanchnic nerves (S2,3,4) presynaptic parasympathetic nerve fibres innervate?
Smooth muscle/glands of the descending colon to the anal canal (Supply genitalia and descending colon)
52
(RHYME): S2, 3, 4 keep..
...your guts off the floor
53
Where does foregut pain tend to be felt?
In the epigastric region
54
Where does midgut pain tend to be felt?
Umbilical
55
Where is hindgut pain usually felt?
Pubic
56
Foregut structures enter the spinal cord at approx.?
T6-T9
57
Midgut structures enter the spinal cord at approx.?
T8-T12
58
Hindgut structures enter the spinal cord at approx.?
T10-L2
59
Somatic motor sensory and sympathetic nerves supplying the abdominal body wall are conveyed within?
Thoracoabdominal nerves | 7-11th intercostal nerves
60
The 7th to 11th intercostal nerves travel anteriorly, then leave the intercostal spaces in the plane between?
The internal oblique and transversus abdominus as thorax-abdominal nerves
61
Where do subcostal nerves leave the spinal cord?
T12 anterior ramus
62
Where do Iliohypogastric nerves leave the spinal cord?
Half of the L1 anterior ramus
63
Where to Ilioinguinal nerves leave the spinal cord?
Half of the L1 anterior ramus
64
How does pain from an appendicitis usually present?
Usually initially dull, aching pain in the umbilical region | As an appendicitis worsens, the appendix will start to irritate the right iliac fossa
65
Why is pain from an appendicitis usually initially dull, aching pain in the umbilical region
Because visceral afferents from midgut organs enter the spinal cord between T8-T10 (appendix is T10 = umbilicus)