Lecture 13: Glands/Lymph/Blood Supply to Abdominal Cavity Flashcards
1
Q
Role of inferior vena cava
A
Returns deoxygenated blood to the heart
2
Q
Role of venous portal system
A
Allows absorbed nutrients to be returned to liver via hepatic portal vein.
3
Q
What is the one main lymphoid organ in the abdomen
A
Spleen
4
Q
Where does the spleen reside
A
Upper left quadrant (left hypochondriac region)
5
Q
What is the largest aggregation of lymphoid tissue in the body?
A
Spleen
6
Q
What are the two main regions of the spleen
A
Visceral and diaphragmatic surface
7
Q
What are the subdivisions of the visceral surfaces
A
Gastric, renal, colic sufaces, and hilus
8
Q
Gastric surface
A
Superior boarder that comes into contact with the stomach notched
9
Q
Renal surface
A
Mostly on the posterior aspect of the spleen where it contacts the left kidney
10
Q
Colic surface
A
Contacts transverse colon
11
Q
Renal hilus
A
Where the vessels enter and leave the spleen. 2 ligaments attach to the hilum
12
Q
What are the 2 ligaments of the hilus
A
Gastrosplenic, and Splenorenal ligaments
13
Q
Arterial blood supply to the spleen
A
Splenic artery
14
Q
What arteries are contained in the gastrosplenic ligament?
A
Short gastric arteries and left gastroepiploic a.
15
Q
What are the structures held in the splenorenal ligament
A
Tail of pancreas and splenic artery and vein
16
Q
What are the two recesses that the spleen sits in
A
Renal and gastric recesses
17
Q
Posterior to what ribs lies the spleen?
A
Ribs 9-11
18
Q
What are the four lobes of the liver
A
Right (big), Left, Caudate, and Quadrate lobes
19
Q
What are the two fossae in the right lobe
A
Fossa for galbladder and inferior vena cava
20
Q
Location of caudate lobe
A
Posterior, lies between the fissure for the ligamentum venous and the fossa for the inferior vena cava
21
Q
Quadrate lobe location and shape
A
Quadrangle anterior lies between the fissure for the ligamentum teres and the gallbladder
22
Q
Left functional lobe
A
Includes the caudate and quadrate lobe
23
Q
Blood supply to the left functional lobe
A
Left hepatic a.
24
Q
Right functional lobe blood supply
A
Right hepatic a.
25
What are the two main surfaces of the liver
Diaphragmatic (dome shaped) and visceral surfaces (flat)
26
Is the liver covered in paritoneum?
Yes except for the bare area
27
What creates the bare area
Reflection of coronary ligaments on diaphragmatic surface
28
What are the 5 peritoneal ligaments that attach to the liver
Falciform ligament, lesser omentum, ligamentum teres, ligamentum venosum, and coronary ligament
29
Falciform ligament
Attaches the liver to the anterior body wall, path go umbilical vein, derivative of ventral mesentery
30
Ligamentum teres
Remnant of umbilical v. contained within falciform ligament
31
Ligamentum venosum
Remnant of ductus venosum, connected to portal vein via inferior vena cava in embryo
32
Coronary ligaments
Attach liver to diaphragm
33
Lesser omentum
Connects stomach to liver
34
What are the two ligaments in the lesser omentum
Hepatoduodenal and hepatogastric ligament
35
Role of umbilical vein in embryo
Brough O2 and nutrients from mom to fetus
36
What was the role of the ductus venosum in embryo
Role was to shunt blood away from the liver and into inferior vena cava remanent of ductus venosum
37
Porta hepatis
H shaped fissure on the visceral surface of the liver. Considered the gateway into the liver. Contains the left and right hepatic arteries, right and left bile ducts, and hepatic portal vein
38
What does the hepatic artery proper arise from
common hepatic a.
39
What are the two branches of the hepatic artery proper
left and right hepatic arteries (supply the left/quadrate/caudate lobes and the right lobe respectively)
40
Different regions of the gallbladder
Fundus, body, neck
41
Where does the gallbladder lay?
The the visceral surface of the liver in the gallbladder fossa
42
Is the gallbladder covered in peritoneum
Yes
43
Function of the gallbladder
Concentrate and store bile
44
Where is the bile in the gallbladder released
Cystic duct
45
What is the arterial supply to the gall bladder
Cystic artery
46
What does the cystic artery branch off of?
The right hepatic a.
47
What are the origins of the left and right bile ducts
liver
48
What do the left and right bile ducts combine to form?
The common hepatic duct
49
What makes up the Common bile duct
When the cystic duct joints the common hepatic duct
50
Where does the common bile duct enter to secrete bile?
Descending duodenum in ampulla of vater
51
What guards the entrance of the common bile duct and main pancreatic duct at the major duodenal papilla?
The sphincter of Oddi
52
What does the sphincter of Oddi consist of?
- Choledochal sphincter around the distal portion of the common bile duct
- Hepatorenal sphincter around the common bile duct and main pancreatic duct
53
When is bile released?
When chyme is present in the duodenum
54
If there is no food in the duodenum with the sphincter of Oddi be open or closed?
Closed- allowing the bile to travel back into gallbladder.
55
Choledochal sphincter
This is the part of the sphincter of Oddi that controls the common bile duct. strips= muscle. Part over common bile duct (strongest part)
56
Is the pancreas an endocrine or exocrine gland?
Both. Endocrine function= Secrete insulin. Exocrine function= release lipase and other digestive enzymes
57
What regions of the abdomen are the pancreas located in
The epigastric and left hypochondriac
58
3 parts of the pancrease
head, body, tail
59
Where does the head of the pancreas sit
in the C-shaped curve of the duodenum
60
Uncinate process
Region of the head of the pancreas that lies posterior to the superior mesenteric vessels
61
What part of the pancreas is not secondarily retroperitoneal and why?
The tail because it is taken up by the splenorenal ligament
62
Blood supply to the pancreas
superior and inferior pancreaticoduodenal a.a and splenic a. (to body and tail)
63
Embryology of the ventral and dorsal parts of the pancreas
large dorsal and small ventral component. Fusions of these two creates a main and accessory pancreatic duct.
64
Divisions of arterial branches that supply the abdominal wall
Unpaired visceral, paired visceral, paired parietal, unpaired parietal , and terminal branches
65
List the unpaired arteries in the abdominal wall
Celiac trunk, Superior mesenteric, and Inferior mesenteric a.
66
What are the paired visceral arteries in the abdomen
Renal arteries, testicular/ovarian arteries, and middle suprarenal arteries
67
What are the Unpaired Parietal arteries of the abdomen?
Median sacaral artery
68
What are the paired parietal arteries of the abdomen
Inferior phrenic a. and lumbar a.
69
Embryonic formation of the pancreas
There are 2 pancreases when we start. Little ventral pancreatic bud and large dorsal pancreatic bud in embryo. Duodenum straight at this point. The gut then rotates causing ventral pancreatic bud with bile duct and duodenum to swing to the back. Ventral pancreatic bud joins the dorsal pancreatic bud. This is why the Head is always lower than the body and tail.
70
At what vertebral level is the celiac trunk
T12
71
Where does the superior mesenteric a emerge
Behind the pancreas (can't see well)
72
Where does the inferior mesenteric a. emerge
Comes out near umbilicus close to the bifrication of the two common iliac arteries
73
Arteries in celiac trunk
I know these well- Some reminders
- Short gastric arteries supply the funds of the stomach.
- Anastomoses- Inferior and superior pancreaticoduodenal a.a, left and right gastroepiploic a.a. and left and right gastric a.a
74
List the organs supplied by the celiac trunk
Esophagus, stomach, liver, gallbladder, pancreas, duodenum (forgut portion), spleen
75
What anastomoses represents dual origin of the duodenum from the midgut and forgut
The anastomose between the superior and inferior pancreaticoduodeunal a.a
76
Where does the superior mesenteric artery arise from?
Ventral surface of aorta slightly inferior to celiac trunk
77
What organs are supplied by the superior mesenteric a.
duodenum (midgut region), jejunum, ileum, cecum, appendix, ascending colon, proximal 2/3 of transverse colon.
78
1st branch of the superior mesenteric a.
-inferior pancreaticoduodenal trunk- supplies duodenum and anastomoses with superior pancreaticoduodenal a.
79
2nd branch of the superior mesenteric a.
Intestinal arteries- supplies jejunum and ileum forming a series of arches (arterial arcades and vasa recta)
80
3rd Branch of superior mesenteric a.
Ileocolic a.- Supplies cecum, appendix, and ascending colon
81
4th branch of superior mesenteric a
Right colic a.- ascending colon and hepatic fluxure- not commonly seen in majority of individuals (normally formed by anastomoses between the middle and ileocolic a.a)
82
5th branch of superior mesenteric a
Middle colic- Supplies 2/3 of transverse colon
83
Location of inferior mesenteric a
Just above the bifurcation of the aorta into the common iliac a.a
84
Organs supplied by inferior mesenteric a.
Remained of transverse colon, descending colon, sigmoid colon, and rectum,
85
1st Branch of the Inferior mesenteric a.
Left colic- supplies the 1/3 left portion of transverse colon and splenic flexor of descending colon. Has an inferior and superior branch
86
2nd branch of the inferior mesenteric a.
Sigmoid arteries- supply sigmoid colon (there are 4-6 sigmoid arteries)
87
3rd branch of inferior mesenteric a.
Superior rectal arteries- Supplies superior portion of the rectum
88
Marginal artery *important anastomose*
Between the middle colic and the superior branch of the left colic. This is important because it is a connection between the superior and inferior mesenteric a.a
89
Renal a
Bellow superior mesenteric a supplies the kidneys (paired visceral a.)
90
Testicular/ovarian a.
Supply testes and ovaries. High origin depicts the embryonic origin of these organs before their descent (paired visceral a.)
91
Middle suprarenal arteries
1 of three blood supplies to suprarenal gland (paired visceral a.)
92
Median sacral a
Only unpaired parietal a. arises at the bifurcation of aorta, supplies sacrum, anastomoses with the lateral sacral arteries from the internal iliac arteries
93
Inferior phrenic a.
Supplies diaphragm (Paired parietal a)
94
Lumbar arteries
Supplies muscles of posterior wall (Paired parietal a)
95
Inferior vena cava two confluences from...
Common iliac veins
96
At one vertebral level does the inferior vena cava pierce the diaphragm
T8
97
What is the normal direction of blood flow
Artery-capillary-vein
98
Direction of blood flow in hepatic portal system
Hepatic portal vein-sinusoids-inferior vena cava (Vein-sinus-vein)
99
Purpose of venous portal system
Return nutrients absorbed in GI tract to the liver to be metabolized
100
What are the 2 tributaries that form the hepatic portal vein
The inferior mesenteric v, superior mesenteric v. and splenic v (most of the time the inferior mesenteric v. does into the splenic v and not the hepatic portal v.)
101
Where does blood flow from the venous portal once the blood has been delivered to the liver
sinusoids-capilaries (nutrients absorbed)-Inferior vena cava
102
Anastomoses between systemic and portal circulation (5)
- left gastric v. (portal) to esophageal v. (systemic)
- Superior rectal v. (portal) with middle and inferior rectal v. (systemic)
- paraumbilical v (portal) with cutaneous v. of abdominal wall (superficial epigastric v.) (systemic)
- Splenic and pancreatic v. (portal) with renal veins (systemic)
- Colic veins with systemic retroperitoneal v.
103
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