GI Week 1 Workbook Flashcards
What dermatome is the umbilicus in?
T10
T10 for bellybut-TEN
The vertebral level of the umbilicus is
l3-l4
innervation of external oblique
Thoraco-abdominal
and subcostal nerves
Anterior rami of T7-
T12
innervation of internal oblique
Thoraco-abdominal nerves- anterior rami of T7-T11
Subcostal and first lumbar
innervation of transverse abdominus
Thoraco-abdominal nerves- anterior rami of T7-T11
innervation of rectus abdominis
what are they branches of
Thoraco-abdominalnerves
Anterior rami of T7-T12
action of external oblique
Compress and support organs
Flexion and rotation
action of internal oblique
Compress and support organs
Flexion and rotation
action of transversus abdominis
Compression and support
forced expiration
action of rectus abdominis x3
Flexes lumbar vertebra
Compresses organs
Stabilizes and controls tilt of pelvis
whats the linea alba made from
and it’s overall function
aponeuroses of external oblique, internal oblique and transversus abdominis
attachment site for muscles
what 2 muscles lies within the rectus sheath
- Rectus abdominus
- pyramidalis
name for horizontal line in rectus sheath
linea alba
function of the pyramidalis
tense the linea alba
what does the rectus sheath end in
arcuate line
Above the umbilicus the lymphatic drainage goes to the
anterior or … nodes
axillary
Below the umbilicus the lymphatic drainage goes to the
…… nodes.
superficial inguial
whats the inguinal canal
a canal that provides a passage for structures from the abdomen
to the genital region
origin and attachment of inguinal ligament
originates at the anterior superior iliac spine
attaches to the pubic terbucle.
The inguinal ligament is formed from the aponeurosis of which muscle?
EO
The superficial inguinal ring is a break in the aponeurosis of what muscle layer?
EO
What anatomical point is used surgically to determine the location of the superficial inguinal ring?
pubic terbecle
Where is the deep inguinal ring positioned in relation to the pubic tubercle?
above midpoint- between pubic terbecle and ant sup iliac spine
The deep inguinal ring is an oval shaped opening in which muscle layer’s fascia?
transversalis fascia
The 4 borders of the inguinal canal
- Anterior wall: medially aponeurosis of the external oblique, laterally internal oblique muscle
- Posterior wall: transversalis fascia
- Roof: transversalis fascia, internal oblique, and transversus abdominis.
- Floor: inguinal ligament
contents of inguinal canal x3: males
- spermatic chord
- Ilioinguinal and Genital branch of the genitofemoral nerve
- blood and lymphatics
contents of inguinal canal x3: females
- round ligament
- Ilioinguinal and Genital branch of the genitofemoral nerve
- blood and lymphatics
psoas major nerve supply
ventral rami of L1-3
3 muscles on post abdo wall
psoas major
illiacus
quadratus lumborum
action of psoas major
flexes thigh, spine and trunk (with illiacus)
and provides balance to trunk
action of illiacus x3
flexes thigh
stabilises hip
acts with psoas to flex trunk
vertebral level of caval opening
T8
vertebral level of oesophageal haitus
T10
vertebral level of aortic hiatus
T12
action of quadratus lumborum
extends and laterally flexes spine
and fixes 12 rib during inspiration
mnemonic for diaphragm openings
‘I ate 10 Eggs At 12’
I ate(8)- IVC (caval) T8
10 Eggs T10
At 12 - Aorta T12
what sits more ant- IVC or aorta
IVC
fore gut, midgut and hindgut lengths
- The foregut runs from the oesophagus to the duodenum (including liver, gall bladder, spleen and pancreas)
- The midgut runs from the duodenum to the rfirst 2/3rds transverse colon
- The hindgut runs from the last 1/3 transverse colon to the upper anal canal
3 vessels that come off aorta
what area of gut they supply
and vertebral level
- Celiac- foregut, T12
- Superior mesentary- midgut, L2
- Inferior mesentary- hindgut, L3
3 branches of ceoliac trunk
- splenic
- hepatic
- Left gastric
At what vertebral level does the abdominal aorta divide into 2 common iliac arteries?
L4
The portal vein is formed by the union of which 2 major veins of the abdominal cavity?
- splenic Vein
- superior mesenteric Vein
Where does the inferior mesenteric vein drain to?
Splenic vein
portal venous system blood journey
carries venous blood (rich in nutrients that have
been extracted from food)
to the liver for processing
what parts of trunk drain blood via systemic venous system
Blood from the gut tube superior to the diaphragm
and inferior to the pelvic floor
what parts of trunk drain via portal system
Blood from the abdominopelvic gastrointestinal tract
4 sites of the portal-systemic anastomoses?
- Oesophageal
- rectal
- retroperitoneal
- paraumbilical
what does oesophageal anastomose obstruction lead to
oesophageal varices
what does rectal anastomose obstruction lead to
haemorrhoids
what does paraumbilical anastomose obstruction lead to
caput medusa
all lymph for foregut structures will drain to the…. nodes at ….
pre-aortic
T12
visceral nerve supply: sympathetic x3
- Abdominopelvic splanchnic nerves (greater, lesser and least)
- Prevertebral sympathetic ganglia
- Abdominal aortic plexuses
sympathetic visceral abdominopelvic splanchnic nerves more specific
greater- celiac ganglion T5-9
lesser-T10-11
least- sup mesenteric ganglion T12
sympathetic abdominal aortic plexus more specific x3
celiac
sup and inf mesenteric
sup and inf hypoglossal
visceral nerve supply x2
*vagus
* Pelvic splanchnic nerves (S2, S3 and S4)
What is the effect of vagotomy on gastric secretion?
reduction
lumbar plexus origin
muscle association
ventral rami of L1-4
psoas major
branches of lumbar plexus x6
obturator
femoral
iliohypogastric
iliolinguinal
gentofemoral
lateral cutaneous
reffered pain regions of abdo
Foregut- Epigastric
Midgut- Umbilical
Hindgut- Suprapubic
What is the anterior- to- posterior arrangement of the structures entering and leaving the hilum of kidney?
vein
artery
pelvis- renal pelvis (top of ureter)
How are the kidneys peritonised?
retro
How are the ureters peritonised?
retro
What is the term used to describe the expanded upper part of the ureter?
renal pelvis
3 constriction points of ureter
- At the junction of the ureters and renal pelvis (pelviureteric junction)
- where they cross pelvic inlet
3.during passage through bladder wall
Which layer of the peritoneum is more sensitive to pressure, pain, heat & cold?
parietal
what does the peritoneal cavity contain x2
potential space
peritoneal fluid
retro peritoneal structures x9
SAD PUCKER
- S: suprarenal (adrenal) gland
- A: aorta/IVC
- D: duodenum (second and third part)
- P: pancreas (except tail)
- U: ureters
- C: colon (ascending and descending)
- K: kidneys
- E: (o)esophagus
- R: rectum
What are the lesser and greater sacs and where do they lie?
part of peritoneal cavity
lesser= behind stomach
greater= rest
whats an omentum
double layer extension of peritoneam between stomach and duodenum
what do the greater and lesser sacs communicate through
epiploic foramen
The greater omentum attaches from the …. to the …
greater curvature of stomach
proximal duodenum
The lesser omentum attaches from the …. to the …
liver
lesser curvature of stomach
What is the difference between the omenta and mesentery attachments?
omenta- attach to stomach
mesentery- attach to posterior abdominal wall
The hepatoduodenal and hepatogastric ligaments are parts of the ….. omentum.
lesser
what does the falciform ligament do
connects liver to ventral wall of abdo
What structure in the free edge of the falciform ligament is a remnant of an embryonic blood vessel?
and name for vessel in embryo
round ligament
umbilical vein
List 3 abdominal viscera which lie in the free edge of a double layer of peritoneum described as the mesentery.
appendix
small intestine
transverse mesocolon
What is the transpyloric plane?
and how would you locate it
imaginary horizontal plane at L1
midway between sternal angle and pubic symphysis
5 structures present the transpyloric plane
1.pylorus
2.neck of pancreas
3.fundus of gallbladder
4.kidneys
5.superior mesenteric artery
Which costal cartilage is the surface marking of the gall bladder?
9th
how does the liver move with the respiration?
inferior
what ribs does the spleen lie under
9 to 11
whats the orange muscle
what does it do
transverse abdominus
compress viscera
rotate trunk
whats the blue muscle
what does it do
rectus abdominis
compress
flex
expiration
whats the green thing
rectus sheath
whats the dark red muscle
trasversus abdominis
whats the light red muscle
and its actions
internal oblique
all:
flex
compress
expiration
rotation
whats the purple muscle
and its actions
external oblique
all:
flex
compress
expiration
rotation
whats the grey thing
linea alba
whats the light and dark blue things
light= superficial ring
dark = deep ring
what are the red, dark red and pink things
red: quadratus lumborum
dark red: iliacus
pink: psoas major
what are the light and dark purple things
light = common iliac artery
dark = external iliac artery
whats the grey thing
inguinal ligament
whats the blue thing
IVC
whats the green thing
lumbar sympathetic trunk sitting on top of abdominal aorta
what are the blue, brown and red openings
and what vertebral level do they sit at
blue = caval T8
brown= oesophageal T10
red = aortic T12
whats the red bit
and what level is it at
coeliac
T12
whats the dark and light blue bits
what level are they at
SMA- L 1-2
IMA- L3
whats the purple and pink bits
what level are they at
renal artery- L2-3 (same as SMA)
common iliac- L5
what are the purple and green veins
purple = portal
green = splenic
what are the dark and light blue veins
dark = SMV
light = IMV
what is the pink nerve
lateral cutaneous
what is the purple nerve
obturator
what is the yellow nerve
femoral
whats the red, blue and yellow vessels
red = renal artery
blue = renal vein
yellow = renal pelvis- dilated ureter
Artery first as first in alphabet
vein next as needs to be next to other blood vessel
what renal vessel is furthest forward (most anterior)
vein
order from front to back is vein, artery, pelvis VAP
what are the dark and light blue things
dark = lesser omentum
light = =greater omentum
what are the dark and light blue things
dark = greater sac
light = lesser sac
what are the dark and light purple things
dark = greater omentum
light = lesser omentum
whats the yellow thing
epiploic foramen
whats the brown thing
mysentery
whats the blue and red things
blue = IVC
red = aorta
whats the green thing
spleen
whats the orange purple and red thing
orange = left kidney
purple = liver
red = transverse colon
what are the blue and red things
blue = IVC
red = aorta
whats the dark red and green thing
red- rectus abdominis
green- external oblique
whats the light yellow thing
lumbar vertebrae
what does the greater omentum connect to
greater curvature of stomach
to transverse colon
what vertebral layer are kidneys at
t12
