Internal abdomen Flashcards
Types of abdo organs
Retroperitoneal, 2nd retroperitoneal, intraperitoneal
Two embryonic mesentaries
dorsal (both) and ventral (foregut only)
2nd retroperitoneal organs
duodenum, pancreas, asc. and dec. colon,
Derivatives of ventral mesentary
Lesser omentum, falciform ligament, coronary and triangular ligaments
4 parts of colon
anc, transverse, dec, sigmoid
Derivatives of dorsal mesentary
Greater omentum, splenorenal and gastrosplenic ligaments, mesentary of small intestine, transverse mesocolon, sigmoid mesocolon
Peritoneal spaces of greater sac
Supracolic and intracolic compartments, R and L infracolic compartments, rectouterine pouch, subphrenic recesses, subhepatic recesses, paracolic gutters
Connection between greater and lesser sacs
epiploic foramen
4 portions of stomach
cardia, fundus, body, pylorus (antrum and canal)
Connection bw stomach and liver
lesser omentum
connection bw stomach and spleen
gastrosplenic ligament
Connection bw duodenum and stomach
pyloric sphyncter
Name of gastric folds
rugae
connection bw stomach and esophagus
cardiac sphyncter
Number of sections of duodenum
4
portions of duodenum with mesentary
1
3 part of small int in order
duodenum, jujuenun, ileum
marker of jujenum from duodenum
where regains the mesentary
name where ileum joins colon
ileocecal juntion
Portions of colon with mesentary
transverse and sigmoid (mesocolons)
first pocket of colon (attaches with appendix)
cecum
3 main abdominal artery branches and their levels
Celiac (T12), Sup mesenteric (L1), inf mesenteric (L3)
blood supply to lesser curvature of stomach
L gastric artery
blood supply to greater curvature
gastroepipoloic artery
branches of celiac artery
L gastric, common hepatic, splenic
blood path along greater curvature of stomach (anastamoses)
celiac>splenic>gastroepiploic>gastroduodenal>common hepatic
Branches of sup. mesenteric arteries
inf and sup pancreaticoduodenal, ileal and jujenal branches, middle and right colic, ileo colic
branches of inf mesenteric arteries
left colic, sigmoidal, superior rectal
3 veins that meet create portal vein
sup and inf mesenteric veins, splenic vein
3 systemic anastamoses and their illnesses
lower esoph (esophageal varices), rectum/anal canal (hemorroids, umbilicus (caput medusae)
What does vagus nerve ennervate in abdomen
stomach, small int, colon as far as distal transverse colon – extent of SMA
Locations of sacral parasympathetic innervation
follows the IMA - pelvic splancnic nerve
Source of abdomenal sym innervation?
greater, lesser, least splanchnic nerves – synapse on preaortic plexus
3 main areas of referred abdo pain and thier blood supply
epigastric (celiac), umbilical (SMA), hypogastric (IMA)
Organs supplied by celiac artery (foregut)
esoph, stomach, prox. duodenum, liver, gall bladder, pancreas
Organs supplied by sup mes art. (midgut)
distal duodenum, jujenum, ileum, asc colon, prox trans colon
Organs supplied by inf. mes. art. (hindgut)
distal trans colon, desc. colon, sig colon, rectum
Retroperitoneal organs
kidneys, ureters, suprarenal glands, rectum
Intraperitoneal organs
stomach, duadenum 1, jujenum, ileum, trans colon, sig colon, liver, spleen
2nd retroperitoneal
duodenum 2-4, pancreas, asc and dec colon
Parts of coronary ligament
faliciform ligament, L and R triangular ligaments
4 lobes of liver
L, R, quadrate, caudate
Liver peritoneal attachments (and to what)
lesser omentum (stomach + duadenum), falciform ligament (diaph + ant wall), coronary L and R triangular (diaph), capsule of liver ( bare)
arterial blood supply path to liver
celiac>hepatic proper>L (L, caudate, quadrate lobes) and R common hepatic (R lobe)
blood supply to liver
portal vein (70%), hepatic arteries (30%)
Path of bile
R and L hepatic ducts>common hepatic duct>joined by cystic duct (bladder)>common bile duct
Parts of pancreas
head, neck, body, tail
path of pancreatic juice
main or accessory pancreatic duct>hepatopancreatic ampulla>to duodenum
opening of pancreatic ducts
duodenal papilla
pancreatic blood supply (head and rest)
head - gastroduodenal, ant and post pancreaticoduodenal
body - splenic artery
Region of kidneys
T12-L3
Layers surrounding kidney
perinephric fat>renal facia>paranephric
Breakdown within medulla
columns and lobes
What is in the kidney lobe
renal pappillae
Blood supply within kidney
Renal artery>segmental arteries>interlobar arteries
Path of urine out of kidney
mino calyces>major calyces>renal pelvis>ureter
blood supply to adrenal glands
suprarenal arteries, inferior phrenic arteries, branches of renal arteries
parts of adrenals and secretions
cortex (mineral and glucocorticoids), medulla (epinephrine and norepinephrine)
Names of lumbar nerves below T12
Subcostal T12, Iliohypogastric L1, ilioinguinal L1, genitofemoral L1,2, lateral femoral L2,3, femoral, obruator L2,3,4, accessory obturator
Level the IVC, thoracic art, and eso penetrate diaphram
T8, T12, T10
Level of celiac, SMA, IMA
T12, L1, L3
Blood supply to paired branches
Inf phrenic, suprarenal, renal, gonadal, lumbar, common iliac arteries
Blood supply to unpaired branches
Celiac, SMA, IMA
Veinous drainage of paired and unpaired orgasn
paired -IVC, unpaired - portal vein
Lymphatic drainage of paired and unpaired organs
Paired - to paraaortic nodes , unpaired - to preaortic nodes
Level of aortic bifurcation
L4
Band of 3 muscles that run along colon (where they meet)
Tinea coli (meet at appendix)
Difference between jejunum and illeum
jejunum has less elaborate acades and longer vasa recta, more plicae semilunaris
Order of blood supply to small intestine from SMA
SMA>intestinal arteries>acades>vasa recta
Level of bifurcation of IVC
L5
End of lymphatic drainage from testicles and scrotal skin
testicles - paraaortic nodes
skin - inguinal nodes
dangler of pancreas
uncinate process
point where pancreatic ducts enter
major and minor duodenal papilla
source of blood supply to pancreas (head, body, tail)
- splenic artery (body + tail)
- gastroduodenal > superior panreaticoduodenal art (head)
- SMA > inferior pancreaticoduodenal arts
Branches of desc aorta from sup to inf
phrenic>celiac>suprarenal>SMA>gonadal>IMA>common illiac
Function and attachments of psoas
hip flexion/rotation
L1-5 > femur
Subcostal nerve level and function
T12, motor to ant. wall + rectus abd., sensory to skin and peritoneum
Nerve content of post abdomemal wall
lumbar symp chain, subcostal nerve, ant. primary rami of lumbar spinal nerves
Level and function of iliohypogastric and ilioinguinal
L1
between trans abdom and internal oblique
-motor to ant. wall + rectus abd., sensory to skin and peritoneum
- illioinguinal goes through spermatic cord to provide sensory to ant scrotum or lab majora
Level and function of gentiofemoral
L1,2
- Femoral branch under ing. ligament to skin of upper thigh
- Genital branch through ing canal to supply motor to cremaster/dartos or sense to labia
level and function of later cutaneous nerve of thigh
L2,3 to lateral thigh
level and function of femoral nerve
L2,3,4
- between psoas and illiacus to under ing ligment
- motor to ant thigh and sense to hip joint and ant thigh
level and function of lumbosacral trunk
L4,5
- to lumbosacral plexus
Level and function of obtuator nerve
L2,3,4
medial to psoas and passes through obturator canal
- medial compartment of thigh and sensory to hip joint and skin of medial thigh
Blood supply to esophageous
bronchial, esophageal, L gastric
Parts of diaphragm and their attachments
Central tendon - center
Sternal - attach to post xyphoid process
Costal - attach to inferior 6 ribs
Lumbar - two crura and muscle fibers that arise from medial and lat arcuate ligs
Peritoneal ligaments and their attachments
Gastrosplenic - spleen to L greater curve
Splenorenal - spleen to kidney with splenic art
Gastrophrenic - upper greater curve to diaph
Gastrocolic - stomach to trans colon
Phrenicolic - colic flexure to diaph
Falciform-
Teres
Venosum
Coronary
