Guts n Stuff Flashcards
What are the boundaries of the epiploic foramen?
Superior = Liver
Inferior = Duodenum
Posterior = IVC
Anterior = Hepatoduodenal ligament
What composes the portal triad of the hepatoduodenal ligament?
- Hepatic Portal Vein
- hepatic Artery Proper
- Common Bile Duct
What structure does the falciform ligament derive from?
-the primitive ventral mesentary
What does the obliterated umbilical vein become?
-round ligament of the liver -or- ligamentum teres hepatis
Where is the jejunum generally located?
-left upper quadrant of the abdomen
Where is the ileum generally located?
-right lower quadrant of the abdomen
What are the primarily retroperitoneal structures?
- aorta
- IVC
- Kidneys
What are the secondarily retroperitoneal structures?
- duodenum
- ascending colon
- descending colon
- pancreas
What are the three sections of the developing gut tube based on arterial supply?
- foregut = celiac trunk
- Midgut = superior mesenteric
- Hindgut = Inferior mesenteric
What composes the forgut?
-lower esophagus to 2nd stage of duodenum
What composes the midgut?
-2nd stage of duodenum to proximal 2/3 of transverse colon
What composes the hindgut?
-distal 1/3 of transverse colon to rectum
What vertebral level is the transpyloric plane?
L1
What is located in the transpyloric plane?
- pyloric sphincter
- gall bladder
- hilum of left kidney
- body of the pancreas
What surface feature of the stomach identifies the pylorus?
-the angular notch
Angular incisure
What are the folds inside the stomach called?
-rugae
What structure is inside the stomach along the lesser curvature?
the gastric canal
Which portion of the duodenum receives the bile duct?
-2nd stage
What portion of the duodenum is supported by the ligament of treitz?
-4th stage
What stages of the duodenum are retroperitoneal?
2nd, 3rd, and 4th
A cross section at which vertebral level will cross through the middle portion of the 2nd stage of the duodenum?
L2
Within what structure does the tail of the pancreas lie?
-the lienorenal ligament
The main pancreatic duct joins the common bile duct and empties into the duodenum via what structure?
-the major duodenal papilla
What are the boundaries of the triangle of calot?
- the common hepatic duct
- the cystic duct
- the surface of the liver
- the origin of the cystic artery
What is contained within the triangle of calot?
the cystic artery
What is the real FUNCTIONAL division between the left and right lobes of the liver?
-An imaginary line from the gall bladder to the IVC
What is the division of the anatomical loves of the liver?
The falciform ligament
What are the relationships of the spleen?
- kidney
- diaphragm (and costal diaphragmatic recess)
- stomach
- pancreas (Tail)
- Colic flexure
What is ileal Diverticulum, and what are possible contributions of it?
- a remnant of the vitelliine duct is found in 2% of the population
- sometimes it may still be attached to the umilicus and may serve as a source for twisting or strangulations of the gut tube
Around what vertebral level marks the bifurcation of the aorta?
L4
What is the meandering mesenteric artery of Moskowitz?
an anastomotic connection between the middle colic and left colic arteries
What are the circular folds on the interior of the small intestine called?
-plicae circularis
What is the surface marker of the appendix?
- 1/3 of the way between the ASIS and the umbilicus.
- McBurne’s point
What is rebound tenderness indicative of?
-perotinitis
What are the regions of portal/systemic anastomosis?
- around esophagus
- around the umbilicus
- around retroperitoneal bowel
- Veins around the rectum
What are esophageal varices?
-enlargement of the veins around the esophagus
What veins may become enlarged as a result of portal hypertension?
- esophageal veins
- paraumbilical veins
- veins of the retroperitoneal body wall (lumbar, azygous, hemiazygous)
- Rectal veins
What is Gerota’s Fascia?
-a layer of fascia that surrounds the kidneys posterior to the peritoneum
Which is most anterior, renal vein or artery?
-Renal vein
What is most posterior, renal vasculature or ureter/pelvis?
-renal ureter and pelvis
What are the three constriction points of the ureters where kidney stones may get stuck?
- at junction with renal pelvis
- at bifurcation of common iliacs
- at entry into urinary bladder
What is the blood supply to the adrenal glands?
- aorta directly
- renal arteries
- inferior phrenic arteries
At what vertebral level does the aorta pass posterior to the diaphragm?
-T12
At what vertebral level does the celiac trunk exit the aorta?
T12
At what vertebral level is the transpyloric plane?
L1
At what vertebral level is the hilum of the right kidney and second stage of the duodenum?
L2
At what vertebral level does the inferior mesenteric artery exit the aorta?
L3
At what vertebral level does the superior mesenteric artery exit the aorta?
L1
At what vertebral level does the umbilicus lie?
L3/L4
At what vertebral level does the aorta bifurcate?
L4
At what vertebral level does the inferior vena cava form?
L5
