gi anatomy yr2 Flashcards
1
Q
what are the 3 main functions of the abdomen
A
house and protect organs
assist in breathing
assist with bodily functions
2
Q
what are the 6 boundaries of the abdomen
A
- costal margin & xiphoid process
- lumbar vertebrae
- posterior abdominal wall muscles
- lower ribs 11 and 12
- lateral abdominal wall
- anterior abdominal wall
3
Q
3 cavities
A
thorax
abdomen
pelvic
4
Q
layers of the abdominal wall from skin inwards
A
- skin
- superficial fascia fatty layer=camper’s fascia
- superficial fascia deeper layer=scarpa’s fascia
- parietal peritoneum
- extra peritoneal fascia
- fascia of muscles
- muscles
5
Q
what 2 types of muscles are in the anterior abdominal wall
A
- 3 flat muscles: external, interior oblique and transverse abdominus
- 2 vertical muscles: rectus abdominus and pyramidalis
6
Q
what line divides the abdomen
A
linea alba
7
Q
what is the aponeurosis of the external obliques
A
sheet like fibrous membrane or flattened tendon that serves as a fascia to bind muscles to connect
8
Q
what are the borders of the external oblique
A
-lower 8 ribs of the iliac crest and aponeurosis
9
Q
what are the borders of the internal oblique
A
- thoracolumbar fascia
- iliac crest
- lateral part of inguinal ligament to inferior border of lower 3 ribs and to aponeurosis/linea alba
10
Q
what is the transverse abdominis
A
- deep to ribs
- thoracolumbar fascia (deep membrane), iliac crest, lateral part of inguinal ligament and costal cartilages of the lower 6 rigs to aponeurosis/ linea alba, pubic crest and pectineal line
11
Q
order of the abdominal wall
A
- external oblique point down
- internal oblique point up
- transverse abdominis horizontal
12
Q
what are the 2 deeper muscles
A
rectus abdominis (6) pyramidalis
13
Q
features of the rectus sheath in the upper 3/4
A
- encloses the rectus abdominus in the internal oblique
- anterior rectus sheath: external obliqueaponeurosis and ant. lamina inferior oblique
- posterior rectus sheath: post. lamina of internal oblique and transverse abdominus
14
Q
features of the rectus sheath in the lower 1/4
A
- no aponeurosis below rectus sheath as aponeurosis travels infront of it instead
- ie no posterior aponeurosis
- as the internal oblique aponeurosis and the TA aponeurosis merge into one and pass superficial
15
Q
what line does the rectus sheath pass from upper 3/4 to lower 1/4
A
arcuate line
16
Q
what are the posterior abdominal wall muscles 3
A
psoas major and minor
iliacus
quadratus lumborum
17
Q
key anatomical features of the vertebrae
A
- vertebral body
- vertebral foramen
- pedicle
- transverse process
- superior articular process
- inferior articular process
- lamina
- spinous process
- mamillary process
- inferior and superior vertebral notch
18
Q
blood supply to the anterior abdominal wall
A
- superior epigastric arteries supply from internal thoracic
- inferior epigastric arteries from external iliac arteries
19
Q
nerve supply to abdominal wall
A
- T7-T12 AND L1 spinal nerves
- pass around the body from posterior to anterior in an inferomedial ie towards inferior and medial direction
- then give off branches to supply the anterolateral wall muscles
20
Q
areas of the abdomen
A
right and left hypochondriac region
epigastric region
right and left lumbar region
suprapubic/ hypogastric
21
Q
what organ pulls the testes and ovaries down from the posterior abdominal wall to the pelvis in development
A
gubernaculum
22
Q
what does the gubernaculum become in females
A
the round ligament of the uterus
23
Q
what does the processus vaginalis become
A
the inguinal canal ie the path the testes./ ovaries descended down
24
Q
where are the superficial and deep inguinal ring
A
deep is in the transversalis fascia
and superficial is through the aponeurosis of the external oblique
25
what does the inguinal canal convey
the round ligament of the uterus or the spermatic cord
26
layers of the inguinal canal in to out
```
parietal peritoneum
extraperitoneal fascia
transversalis fascia
ta and internal oblique aponeurosis and muscle
external oblique aponeurosis and muscle
```
27
what are the external oblique aponeurosis, internal obliqe fascia internal oblique musclee and transversalis fascia called in the spermatic canal
external o aponeurosis= external spermatic fascia
internal o fascia= cremasteric fascia
internal o muscle=cremaster muscle
transversalis fascia= internal spermatic fascia
28
in to out of spermatic cord
```
testes
visceral tunica vaginalis
cavity of tunica vaginalis
parietal tunica vaginalis
internal spermatic
cremaster muscle
cremasteric fascia
external spermatic fascia
```
29
contents of the spermatic cord
```
ductus deferens
artery to dd
testicular artery
pamniform plexus
cremaster artery
genitofemoral nerve
sympathetic nerve
lymphatic vessels
remanants of process vaginalis
```
30
what 2 types of inguinal hernias are there
direct and indirect
31
what is an inguinal hernia
protrusion of a peritoneal sac through a weakened area of the abdominal wall into the inguinal canal
32
what is an indirect hernia
lateral to inferior epigastric vessels so will go through the inguinal canal= more emergency due to strangulation
33
what is a direct hernia
medial to inferior epigastric vessels so won't go through
34
the 2 aponeuroses of inguinal ligament
pubic tubercle and anterior superior iliac spine
35
why can healing take a while for abomen
because the blood supply do not cross over the midline
36
what is the nerve supply to the anterior abdominal wall
segmental arrangment
upper 3/4 from the lower intercostal nerves and subcostal nerves
lower 3/4 below arcuate line from the lumbar nerves
37
what is the inguinal region and where does it lie
lies between the superior iliac spine and the pubic tubercle-
38
what is the inguinal ligament and what forms it
thickening of the inferior margins of the aponeurosis of the external oblique
the inguinal canal is found in the medial part of the inguinal ligament
39
what nerve level is the umbilicus and nipples
nipple=t4
| umbilcus =t10
40
characteristics of indirect and direct hernia
- age
- site
- descent
- exam
- neck of hernia
indirect direct
young old
unilateral commonly bilateral
scrotum not
exam: by reducing the hernia and pressing on the deep inguinal ring by the thumb asking the patient to cough the hernia will bulge medially in direct but will not bulge in indirect. also implulse can be felt in indirect
neck: lateral medial to inferior epigastric
41
what is the peritoneum
a single membranous sac lining the abdominopelciv cavity and covers the viscera
42
what 3 types of perioneal may an organ be
intraperitoneal: in the peritoneum
mesentry: on a mesentry off
retroperitoneal : behind the peritoneum
ie based on whether it is behind in front or on the peritoneum
43
what is the omenta
double folds passing from the stomach and duodenum to other organs
44
what do omenta and mesenteries carry in their double folds
arterial branches to peritonised organs
45
label which 3 of these organs are on the peritoneum
- kidney
- pancreas
- ascending colon
- transverse colon
- liver
- spleen
- duodenum
- caecum
- stomach
- rectum
- sigmoid colon
- aorta and ivc
- small intestine jejunum and ileum
```
retroperitoneum
tail=intraperitoneum but rest= retro
retro
on a mesentry
intraperitoneum
intraperitoneum
retro (except superior)
intra
intra
retro
on a mesentry
retro
on a mesentry
```
46
draw the spaces of the greater and lesser sacs 7
sub-phrenic space: space superior to liver and diaphragm
hepatorenal recess: space inferior to liver and kidney
retro-uterine pouch of douglas: between rectum and uterus
vesico-uterine pouch: between bladder and uterus
supracolic: above greater omentum contains stomach, liver and spleen
infracolic: below greater omentum contains smaller intestine and ascending descending colon
47
what is the falciform ligament
also called roung ligament divides liver in half"
48
what is the peritoneal cavity and draw
contains only peritoineal fluid between visceral and parietal peritoneum
in 2 sacs linked by a short neck the epiploic foramen
greater and lesser omentum sacs
lift up greater omentum to greater sac
then lift up lesser omentum to lesser sac
above stomach lesser curvature=lesser omentum
below stomach greater curvature=greater omentum
49
what are the 3 types of double folds
mesentry visceral to abdominal wall
omentum: stomach to proximal duodeum
ligaments: organs to other organs eg stomach to liver
50
what is the transverse mesocolon
layer of mesentry to transverse colon to posterior wall
51
clinical implications of the lesser sac
is a blind alley so inflammation, infection and fluid can be trapped there and as the pancreas lies posteriorly can lead to fatlity
52
other name for epiploic foramen and what 3 vessels run through
foramen of winslow
bile duct
hepatic artery
portal vein
53
what muscles are the tonsils between
palatoglossal and palatopharyngeal muscles
54
what is the pharynx
a musculofascial half cylinder linking the oral and nasal cavities in the head to the larynx and oesophagus of the neck
55
what is the tongue muscle called
the gengioglossus
56
3 parts of the pharynx
nasopharynx: air
oropharynx: food
laryngopharynx
57
3 overlapping muscles of the pharynx
superior constrictor
middle: stylohyoid ligament and styloid process and stylopharyngeus muscle of swallowing
inferior constrictors: attach thyroid to cricoid
-inferior constrictor is on the outside
58
constrictions of the osephagus4
1. junction of osephagus with pharynx
2. where oseophagus is crossed by arch of the aorta
3. where oseophagus is compressed by left main bronchus
4. at the oseophageal hiatus
59
what level does the stomach lie at and key features label
```
t1 standing, l2 sitting
cardiac notch
fundus
cardia
lesser curvature
angular incisure
body
greater curvature
pyloric antrum
pyloric canal
pyloric sphinctery: thickening of innermembranes
rugae: temporary folds of the stomach as expands
```
60
duodenum vertebral levels 4 parts 3 levels
starts at l1 superior
then descends to l3
then inferior part then ascends to l2
61
which part of the duodenum receives bile and pancreatic juices/ what is this entrance called
descending over the hilum of kidney receives pancreatic duct and common bile duct entry and duodenal papilla
62
jejunum versus ileum 4 differences
1. pliacae are larger in the jejunum then ileum so jejunum feels fuller
2. jejunum has longer vasa recta so fewer arterial arcades whereas ileum has shorter vasa recta so appears more vascular on mesentery
3. jejunum has less fat than mesentry compared to the ileum
4. jejunum is upper left
and ileum is lower right
63
label the large intestines
ileocecal junction, appendix, caecum, taeniae coli, ascending colon (proximal), right colic flexure, hepatic flexure, transverse colon, splenic left colic flexure, omental appendices, haustra of colon, distal descending colon, sigmoid colon, rectum, anal canal
64
what are taminae coli
outer longitudinal 3 bundles at 120 degrees to each other that contract pushing bowel into haustra of colon
65
blood supply to colon
- proximal supplied by right and middle colic artery from sma
- distal supplied by inferior m left colic artery
66
what is the pectinate line and 3 differences above and below the line
divides the upper 2/3 of the anal canal from the lower third of anal canal
- change from simple columnar to stratified squamous epithelium
- above line endoderm and below line ectoderm
- superior rectal arteries before line and middle and inferior rectal arteries below line
67
label coeliac trunk branches 3 vertebral level
left gastric
common hepatic artery to hepatic artery proper
gastroduodenal artery off hepatic
splenic artery t12
68
sma 6 branches vertebral level
right and middle colic artery
inferior pancreaticduodenal artery
ileocolic artery
jejunal and ileal arteries l1
69
ima 3 branches and level
superior rectal arteries
left colic artery
sigmoid arteries
70
venous system of the abdomen label
hepatic portal vein formed by joining of splenic vein and superior mesenteric vein
-inferior mesenteric veins joins onto splenic
71
what is portal hypertension and clincal conditions assoc.
hbp of portal system becuase no valves so can push back to leading to haemorrhoids and ano rectal varices, splenomegaly and oseophageal varices due to rising pressure and caput medusa due to umbilical vein hypertension
72
what is mcburney's point
indicates the surface marking of the base of the appendix where it attaches to the caecum
pain indicates acute appendicitis
also appendectomy
1/3 along line from superior iliac spine of pelvis to umbilicus
73
label the liver anterior
```
inferior border
gallbladder
costal impressions
right and left lobe
right triangular ligament
coronary ligament (liver reflection)
fibrous appendix
falciform ligament with round ligament/ ligamentum teres at the end
```
74
posterior liver label and what are the ligaments remanant of
quadrate (inf) and caudate lobe (superior)
left sagittal fissure for lig teres and right sagittal fossa for ivc
-ligamentum venosum remanant of ductus venosum
-ligamentum teres remnant of umbilical vein
-gastric impression, esopheageal impression, colic impression, renal impression, bare area
- anterior and posterior coronary ligaments
-suprarenal impression
75
internal structures of the liver 6
```
portal vein
hepatic artery
interlobular triad: above 2+ biliary duct
sinusoid
central vein
bile canaliculi
```
76
gallbladder gross anatomy
neck body fundus
| cystic duct: bile canaliculi form common hepatic duct that joins cystic duct to form common bile duct
77
pancreatic blood supply and anatomy
superior and inf pancreaticduo supplied head
| and splenic supplies tail neck and body
78
2 ducts to the pancreas
accessory duct and principal duct/ major duodenal papilla with hepatopancreatic ampulla forms the opening in pancreas
79
what ribs is the spleen located
ribs 9 to 11 in costodiaphragmatic recess hence fracture ribs spleen rupture
80
blood supply to the foregut ie pancreas, liver, spleen and gall bladder
liver=coeliac trunk
pancreas=coeliac and sma
spleen= coeliac trunk
gallbladder=coeliac as cystic artery off right hepatic proper
81
what ligament do the portal triad pass in and is also the roof of the epiploic foramen
the heaptoduodenal ligament
82
what ligaments enclose the bare area and what spaces do they limit
the anterior and posterior coronary ligament
anterior= limits right subphrenic space
posterior= limits the hepatorenal space
