Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Gross Anatomy 2 > Lecture Exam 3 > Flashcards

Lecture Exam 3 Flashcards

1
Q

How many regions is the abdomen divided into topographically?

A

9 regions by two vertical and two horizontal planes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Which plane extends inferiorly from the midpoints of the clavicles to the midpoints of lines joining the anterior superior iliac spine to the pubic symphysis?

A

Midclavicular plane

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Which plane is a horizontal plane joining the lowest point of the costal margin on each side. It lies at the inferior margin of rib 10 (L. V. 3 level)

A

Subcostal plane

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Which plane lies at the inferior margin of rib 10 (L.V. 3 level)?

A

Subcostal plane

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Which plane is a horizontal plane which joins the tubercles of the iliac crests (L.V. 5 level)

A

Trans tubercular plane

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What are the nine regions of the abdomen?

A
  1. Right hypochondrium
  2. Epigastric
  3. Left hypochondrium
  4. Umbilical
  5. Left flank (lateral)
  6. Right flank (lateral)
  7. Right groin (inguinal)
  8. Left groin (inguinal)
  9. Pubic
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

The liver lies in mostly which regions of the abdomen?

A

Right hypochondrium and epigastric region

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

The spleen and the fundus and body of the stomach are found in which region of the abdomen?

A

Left hypochondrium region

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

The simple version of dividing up the abdomen is called what?

A

Quadrants, involving diving the abdomen up into four parts

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Using the quadrant system, how are the regions divided up? (Which planes are used?)

A 
Median plane (vertical plane through midline)
Transumbilical plane (horizontal plane through the umbilicus)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What are the names of the quadrants?

A

Right upper quadrant
Left upper quadrant
Right lower quadrant
Left lower quadrant

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is a variable landmark which lies between L.V. 2 and L.V. 5?

A

The umbilicus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Name the layers of the anterior abdominal wall from superficial to deep

A 
Skin
Superficial layer of superficial fascia (Camper’s Fascia)
Deep layer of the superficial Fascia (Scarpa’s fascia)
Deep (investing) Fascia
External Oblique muscle
Internal Oblique muscle
Transversus Abdominis Muscle
Transversalis Fascia
Extraperitoneal Fascia
Parietal peritoneum
Peritoneal Cavity
Visceral Peritoneum
Abdominal Organs
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

The fascia of the anterior abdominal wall consists of how many major layers? Names of those layers?

A

2 layers
Superficial fascia
Deep (investing) Fascia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

The superficial fascia is further subdivided into how many layers?

A

Subdivided into two layers

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What are the two subdivisions of the superficial fascia?

A 
superficial layer (Camper’s Fascia)
Deep Layer (Scarpa’s Fascia)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Which layer is a thin fatty layer of fascia which is continuous with the superficial fascia of the perineum and thigh?

A

Superficial layer (Camper’s Fascia)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Which layer is a membranous layer of fascia which is firmly fastened to the fascia Alta of the thigh, just below the inguinal ligament?

A

Deep layer (Scarpa’s Fascia)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Which layer covers each of the anterior abdominal wall muscles on its anterior and posterior surface?

A

Deep (investing) fascia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Extravasation of Urine refers to a potential space between two layers of fascia, what two layers are they?

A

Scarpa’s Fascia and deep (investing) fascia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

In Extravasation of Urine, this structure when ruptured allows accumulation of urine within this space?

A

Rupture of the Spongy Urethra

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Is extravasation more common in males or females and why?

A

More common to males (exclusively) due to urethra being longer, more superficial, and more horizontally oriented than in females

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

This structure is a median tendinitis raphe which extends from the xiphoid process to the pubic symphysis. Anterior abdominal wall muscles insert into this raphe via their aponeurosis.

A

Linea Alba

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

The fibers of the external oblique run….?

A

Run downward and forward

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

The fibers of the internal oblique run….?

A

Run downward and backward

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

This muscle acts as an internal back brace

A

Transversus Abdominis muscle

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

The fibers of the transversus Abdominis muscle run…?

A

Run horizontally across the abdomen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

What lies in between the left and right rectus abdominis muscles

A

Linea Alba

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

This structure is a curved line along the lateral border of the rectus abdominis muscle

A

Linea semilunaris

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

This structure is 3 bundles of connective tissue which run transversely across the rectus abdominis muscle and which fuse with the rectus sheath

A

Tendinous intersections

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

This muscle is a small and often absent slip of muscle which lies anterior to the rectus abdominis within its sheath

A

Pyramidalis muscle

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Low back pain is often due to….

A

Weak abdominal muscles

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

Anterior abdominal wall muscles are active in the following 6 actions

A
  1. Coughing
  2. Sneezing (1 and 2 are forced expiration)
  3. Vomiting
  4. Micturition
  5. Defecation
  6. Parturition
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

This structure is formed by the aponeurosis of the external oblique, internal oblique, and transversus abdominis muscles

A

Rectus sheath

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

The rectus sheath encloses these 5 structures

A
  1. Rectus abdominis muscle
  2. Pyramidalis muscle (when present)
  3. Superior epigastric artery and vein
  4. Inferior epigastric artery and vein
  5. Anterior primary rami of lower 6 thoracic nerves
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

The rectus sheath consists of a ______ and _____ layer. The composition of those layers changes when one passes above or below the ______

A

Anterior
Posterior
Arcuate line

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

This structure is a crescent shaped line in the posterior layer of the rectus sheath located midway between the umbilicus and pubic crest

A

Arcuate Line

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

When above the arcuate line, the anterior layer of the rectus sheath is composed of…..

A

Composed of the aponeuroses of the external and internal oblique muscles

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

When above the arcuate line, the posterior layer of the rectus sheath is composed of….

A

Composed of the aponeuroses of the internal oblique and transversus Abdominis muscles

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

Above the arcuate line, the aponeurosis of the _____ ______ muscle splits to enclose the rectus abdominis

A

Internal oblique muscle

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

When below the arcuate line, the anterior layer of the rectus sheath is composed of…..

A

Composed of the aponeuroses of the external oblique, internal oblique, and transversus abdominis muscles

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

When below the arcuate line, the posterior layer of the rectus sheath is formed by….

A

Formed by the transversalis fascia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

How many folds are present on the posterior surface of the anterior abdominal wall, below the umbilicus?

A

5 folds are present

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

Each of these folds on the posterior surface of the anterior abdominal wall are formed by _____ _____ overlying a structure

A

Parietal peritoneum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

This structure extends from the apex of the bladder to the umbilicus. It contains the urachus

A

Median umbilical fold

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

The median umbilical fold contains the….

A

The urachus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

This structure extends from the side of the bladder to the umbilicus. It contains the obliterated umbilical artery.

A

Medial umbilical fold

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

The medial umbilical fold contains the…

A

The obliterated umbilical artery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

This structure extends from the deep inguinal ring to the arcuate line. It contains the inferior epigastric vessels.

A

Lateral umbilical fold

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

The lateral umbilical fold contains the…..

A

The inferior epigastric umbilical artery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

The median umbilical, medial umbilical, and lateral umbilical folds form the boundaries between these three paired fossae

A

Supravesical fossa
Medial inguinal fossa
Lateral inguinal fossa

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

The supravesical fossa is between…

A

Between the median and medial umbilical folds

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q

The medial inguinal fossa is between….

A

Between medial and lateral umbilical folds

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
54
Q

The lateral inguinal fossa is between….

A

Between lateral to the lateral umbilical fold

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
55
Q

This structure lies above the umbilicus and contains the obliterated umbilical vein.

A

Ligamentum teres

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
56
Q

The ligamentum teres is the ____ ____ of the falciform ligament, which is attached to the liver.

A

Free edge of the falciform ligament

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
57
Q

What arteries supply blood to the anterior abdominal wall?

A
  1. Superior epigastric artery (from internal thoracic artery)
  2. Inferior epigastric artery (from the external iliac artery)
  3. Lumbar arteries (from the abdominal aorta)
  4. Deep circumflex iliac artery (from the external iliac artery)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
58
Q

What nerves supply the anterior abdominal wall?

A

Lower 6 thoracic nerves

Run between the internal oblique and transversus abdominis muscles

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
59
Q

This structure is formed by the lower edge of the external oblique aponeurosis. It extends from the anterior superior iliac spine to the pubic tubercle

A

Inguinal ligament

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
60
Q

The inguinal ligament extends from the ________ to the _________

A

Anterior superior iliac spine

Pubic tubercle

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
61
Q

This structure is the most medial fibers of the inguinal ligament which are inserted into the superior pubic ramus

A

Lacunar ligament

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
62
Q

This structure is a lateral extension of the lacunar ligament along the pecten pubis (pectinal line)

A

Pectinal ligament

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
63
Q

What is another name for the pecten pubis?

A

Pectinal line

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
64
Q

This structure is an oblique passage 3 to 5 cm in length through the anterior abdominal wall

A

Inguinal canal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
65
Q

How long is the inguinal canal through the anterior abdominal wall?

A

3 to 5 cm in length

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
66
Q

The inguinal canal begins at the ______ and ends at the _______

A

Deep inguinal ring

Superficial inguinal ring

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
67
Q

The deep inguinal ring within the anterior abdominal wall lies…..

A

Lies lateral and internal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
68
Q

The superficial inguinal ring within the anterior abdominal wall lies…..

A

Medial and external

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
69
Q

Is the inguinal canal larger in males or females?

A

Larger in males

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
70
Q

These three things are transmitted in the inguinal canal

A 
Spermatic cord (males)
Round ligament of the uterus (females)
Ilioinguinal nerve (both)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
71
Q

This structure is formed by the fusion of the aponeuroses of the internal oblique and transversus abdominis muscles as they insert into the pubic crest and pecten pubis deep to the inguinal ligament.

A

Conjoint tendon (inguinal Falx)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
72
Q

The conjoint tendon (inguinal Falx) helps by….

A

Strengthens the posterior wall of the medial half of the inguinal canal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
73
Q

What is another name for the conjoint tendon?

A

Inguinal Falx

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
74
Q

What are the boundaries of the inguinal canal?

A
  1. Anterior wall
  2. Posterior wall
  3. Roof
  4. Floor
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
75
Q

The anterior wall boundary of the inguinal canal is formed by….

A

Formed by the aponeurosis of the external oblique muscle

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
76
Q

The posterior wall boundary of the inguinal canal is formed by…

A

Formed by the conjoint tendon and transversalis fascia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
77
Q

The roof boundary of the inguinal canal is formed by…

A

Formed by the arching fibers of the internal oblique and transversus abdominis muscles

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
78
Q

The floor boundary of the inguinal canal is formed by…

A

Formed by the inguinal and lacunar ligaments

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
79
Q

This structure is a triangular opening in the external oblique aponeurosis. It lies immediately lateral to the pubic tubercle.

A

Superficial inguinal ring

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
80
Q

The superficial inguinal ring lies immediately lateral to the….

A

Pubic tubercle

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
81
Q

The superficial inguinal ring transmits this structure in males, this structure in females and this structure in both sexes

A

Spermatic cord in males
Round ligament of the uterus in females
Ilioinguinal nerve in both sexes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
82
Q

The structures that exit the inguinal canal become ______ at the superficial ring

A

Become subcutaneous at the superficial ring

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
83
Q

The superficial inguinal ring is formed by the splitting of this muscle aponeurosis

A

Splitting of the external oblique aponeurosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
84
Q

The splitting of the external oblique aponeurosis for the formation of the superficial inguinal ring is split up into how many crura? Names for those crura

A

Two crura
Lateral crus
Medial crus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
85
Q

The lateral crus of the superficial inguinal ring inserts into the ____. Some of its fibers reflect to the ______ as the lacunar ligament.

A

Pubic tubercle

Superior pubic ramus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
86
Q

The medial crus of the superficial inguinal ring inserts into the _______.

A

Pubic crest

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
87
Q

This structure strengthens the apex of the superficial inguinal ring

A

Intercrural fibers

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
88
Q

This structure is an opening within the transversalis fascia. It is located above the inguinal ligament midway between the anterior superior iliac spine and the pubic symphysis. It lies just lateral to the inferior epigastric vessels

A

Deep inguinal ring

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
89
Q

The deep inguinal ring lies just lateral to the…..

A

Inferior epigastric vessels

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
90
Q

The deep inguinal ring is located above the _____ between the anterior superior iliac spine and the pubic symphysis.

A

Inguinal ligament

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
91
Q

This structure is an area of potential weakness in the anterior abdominal wall. Direct inguinal hernias occur here

A

Inguinal triangle

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
92
Q

The inguinal triangle is bounded by these structures

A

Medially: by the lateral edge of the rectus abdominis muscle
Laterally: by the inferior epigastric vessels
Inferiorly: by the inguinal ligament

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
93
Q

Is the inguinal canal present before birth?

A

Yes, but is shorter and much less oblique than in the adult

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
94
Q

During development of the inguinal canal, lets say before/ around the time of birth, the superficial inguinal ring lies almost directly _____ to the deep inguinal ring

A

Directly anterior

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
95
Q

During childhood development, this structure lengthens and assumes it characteristically oblique position

A

The inguinal canal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
96
Q

Contraction of the muscles of the anterior abdominal wall during coughing and straining elevates what in the abdomen, potentially forcing abdominal contents into the canal.

A

Elevates intra-abdominal pressure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
97
Q

What two anatomical adaptations function to strengthen the inguinal canal?

A
  1. Inguinal canal is oblique in adults, allows canal to be compressed by muscles of anterior abdominal wall when they contract
  2. Paradoxically, the same muscles which increases intra-abdominal pressure (promoting hernia) also narrow the inguinal canal (preventing hernia)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
98
Q

This structure reinforces the posterior wall of the inguinal canal

A

Conjoint tendon

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
99
Q

This is an abnormal protrusion of tissue through an opening

A

A hernia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
100
Q

In inguinal hernias, what protrudes through the inguinal region

A

Abdominal viscera (usually the small intestine)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
101
Q

Are inguinal hernias more common in males or females

A

Males

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
102
Q

What are two reasons why inguinal hernias are more common in males

A
  1. Large diameter of the inguinal canal in males, for passage of spermatic cord
  2. The fact the scrotum is an outpouching of the anterior abdominal wall. It creates a large potential space for the abdominal viscera to fill
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
103
Q

What structure is homologous to the males scrotum in females?

A

The labia majora, but it is mostly filled with fat

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
104
Q

What are two kinds of inguinal hernias (general)

A

Indirect hernias

Direct hernias

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
105
Q

In indirect inguinal hernias, describe the passageway before descending into the scrotum (or labia majora)

A

Passes through the deep inguinal ring, inguinal canal, and superficial inguinal ring before descending into the scrotum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
106
Q

In indirect inguinal hernias, the abdominal viscera passes _____ to the inferior epigastric vessels

A

Lateral to the inferior epigastric vessels

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
107
Q

Can indirect hernias be congenital, acquired, or both?

A

Can be both

  • Congenital (associated with a patent processus vaginalis)
  • Acquired (through forced opening of the passage)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
108
Q

What percentage of inguinal hernias are indirect?

A

75%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
109
Q

This structure is an embryological outpouching of peritoneum which forms the inguinal canal and the tunica vaginalis of the scrotum. It normally obliterates. When it does not, it leaves a sizeable passageway for intestines to pass into the scrotum.

A

Processus Vaginalis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
110
Q

Does the processus vaginalis stay intact or obliterate?

A

Eventually obliterates

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
111
Q

What happens if the processus vaginalis does not obliterate?

A

It leaves a sizeable passageway for intestines to pass into the scrotum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
112
Q

In direct inguinal hernias, what is the passageway for the visceral abdominal organs?

A

Punches directly through the posterior wall of the inguinal canal, bypassing the deep inguinal ring

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
113
Q

In direct inguinal hernias, the visceral abdominal organs pass ____ to the inferior epigastric vessels, through the inguinal triangle

A

Pass medial to the inferior epigastric vessels

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
114
Q

In direct inguinal hernias, there is usually a general bulging of the anterior abdominal wall, but does not decent into what structure?

A

The scrotum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
115
Q

Are direct inguinal hernias congenital or acquired?

A

Always acquired - due to weakness in the conjoint tendon or transversalis fascia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
116
Q

What is the percentage of getting direct inguinal hernias? Who does it occur mostly in?

A

25% of inguinal hernias

Mostly in men over 40 years old

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
117
Q

What kind of subluxations may affect the functioning of the anterior abdominal wall muscles, increasing the risk of inguinal hernias?

A

Lower thoracic and lumbar subluxations may affect

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
118
Q

This type of hernia passes through the femoral canal

A

Femoral hernia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
119
Q

Femoral hernias occur inferior to the ______, while inguinal hernias occur superior to the ______

A

Inguinal ligament for both fill ins

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
120
Q

Does femoral hernias occur more in males or females?

A

Females

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
121
Q

This type of hernia usually results from incomplete closure of the anterior abdominal wall after ligation of the umbilicus at birth

A

Umbilical hernia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
122
Q

Umbilical hernias can also occur due to defects in the _____

A

Linea alba

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
123
Q

This structure begins at the deep inguinal ring and ends at the testis

A

The spermatic cord

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
124
Q

The spermatic cord is covered by how many concentric layers of fascia derived from the anterior abdominal wall

A

Three concentric layers of fascia derived from the anterior abdominal wall

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
125
Q

Name the three concentric layers of the fascia covering the spermatic cord

A

External spermatic fascia
Cremasteric fascia
Internal spermatic fascia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
126
Q

The external spermatic fascia is derived from the…..

A

Derived from the external oblique aponeurosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
127
Q

The cremastic fascia is derived from the….

A

Derived from the internal oblique aponeurosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
128
Q

The cremastic fascia layer can be recognized by the presence of many bundles of muscle fibers, collectively referred to as the _____. This muscle is derived from the ______

A

Cremaster muscle

Internal oblique muscle

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
129
Q

This muscle functions in temperature regulation of sperm

A

Cremaster muscle

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
130
Q

The internal spermatic fascia is derived from the…

A

Derived from the transversalis fascia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
131
Q

Subluxations of ____,____ may affect male fertility (hypothesis)

A

L1, L2

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
132
Q

The spermatic cord contains these structures

A 
Ductus deferens
Testicular artery
Pampiniform plexus of veins
Artery to the ductus deferens
Cremastic artery
Genital branch of genitofemoral nerve
Remnant of processus vaginalis
Autonomic nerves
Lymphatics
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
133
Q

This structure is a muscular duct which transports sperm from the epididymis to the ejaculatory duct

A

Ductus deferens

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
134
Q

The testicular artery is a branch of the….

A

Abdominal aorta

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
135
Q

This structure is an extensive network of veins which makes up the bulk of the spermatic cord. These structures join together at the deep inguinal ring to form the testicular vein

A

Pampiniform plexus of veins

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
136
Q

The left testicular vein drains into the……

The right testicular vein drains into the….

A

Into the left renal vein

Drains directly into the inferior vena cava

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
137
Q

Artery to the ductus deferens is a branch of the…..

A

Superior vesicular artery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
138
Q

Cremastic artery is a branch of the….

A

Inferior epigastric artery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
139
Q

This nerve supplies the cremaster muscle

A

Genital branch of the genitofemoral nerve

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
140
Q

The lymphatics in the spermatic cord drain into the…..

A

Drain into the lumbar lymph nodes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
141
Q

This nerve runs through the inguinal canal and superficial inguinal ring. It accompanies the spermatic cord but is not part of it

A

Ilioinguinal nerve

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
142
Q

What are the two branches of the ilioinguinal nerve

A

Femoral branch

Anterior scrotal or anterior labial nerve

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
143
Q

The femoral branch of the ilioinguinal nerve supplies the…..

A

Supplies the upper medial part of the thigh

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
144
Q

The anterior scrotal or anterior labial nerve branch of the ilioinguinal nerve supplies the…

A

Supplies the root of the penis and anterior part of the scrotum. (Anterior scrotal nerve)
Or supplies the mons pubis and anterior part of the labia majora (anterior labial nerve)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
145
Q

What is a varicocele

A

Varicose veins within pampiniform plexus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
146
Q

This structure is an outpouching of the anterior abdominal wall

A

Scrotum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
147
Q

Why is the skin of the scrotum thin with little to no fat?

A

Important for maintaining a temperature below body temperature

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
148
Q

What are the structures the scrotum contains?

A

Testes
Epididymis
Lower part of the spermatic cord

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
149
Q

The scrotum consists of a series of concentric layers which are derived from corresponding layers of the…..

A

The anterior abdominal wall

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
150
Q

The homolog of skin for the anterior abdominal wall is this structure for the scrotum

A

Anterior abdominal wall. Scrotum

1. Skin. 1. Skin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
151
Q

The homolog of the subcutaneous tissue, superficial and deep fascia in the anterior abdominal wall is what structure in the scrotum

A

Anterior abdominal wall. Scrotum
2. Subcutaneous tissue, 2. Dartos muscle
Superficial and deep fascia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
152
Q

The homolog of the external oblique muscle in the anterior abdominal wall for the scrotum what

A

Anterior abdominal wall Scrotum

3. External oblique. 3. External spermatic fascia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
153
Q

The homolog of the internal oblique muscle in the anterior abdominal wall is what for the scrotum

A

Anterior abdominal wall Scrotum

4. Internal oblique muscle. 4. Cremastic fascia and cremaster muscle

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
154
Q

The homolog of the transversus abdominis muscle in the anterior abdominal wall is what for the scrotum?

A

Anterior abdominal wall. Scrotum

5. Transversus abdominis muscle. 5. No continuations

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
155
Q

The homolog of the transversalis fascia in the anterior abdominal wall is what for the scrotum

A

Anterior abdominal wall. Scrotum

6. Transversalis fascia. 6. Internal spermatic fascia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
156
Q

The homolog of the extraperitoneal fascia in the anterior abdominal wall is what for the scrotum

A

Anterior abdominal wall Scrotum

7. Extraperitoneal fascia 7. No continuation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
157
Q

The homolog of the peritoneum in the anterior abdominal wall is what for the scrotum?

A

Anterior abdominal wall. Scrotum

8. Peritoneum. 8. Tunica vaginalis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
158
Q

This muscle has smooth muscle fibers which are firmly adherent to the skin of the scrotum. This muscle functions in temperature regulation. (This is other one besides cremaster)

A

Dartos muscle

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
159
Q

The tunica vaginalis consists of how many layers?

A

2 layers

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
160
Q

What are the two layers of the tunica vaginalis?

A

The parietal layer

The visceral layer

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
161
Q

The parietal layer of the tunica vaginalis has what orientation in the body?

A

Superficial, lies internal to the internal spermatic fascia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
162
Q

The visceral layer of the tunica vaginalis has what orientation in the body?

A

Deep, firmly adherent to the testis and epididymis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
163
Q

What is hydrocele?

A

Accumulation of fluid within the cavity of the tunica vaginalis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
164
Q

This structure are paired, mobile organs in the scrotum

A

Testis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
165
Q

Name the functions of the testis

A

Production of spermatozoa

Secretion of androgens

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
166
Q

This structure is the fibrous covering of the testis. It lies deep to the visceral layer of the tunica vaginalis, which is the deepest layer fo the scrotum

A

Tunica albuginea

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
167
Q

The testis is divided by septa into numerous wedge shaped portions called…..

A

Lobules

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
168
Q

This structure is a fibrous compartment in the posterior part of the testis where the septa converge

A

Mediastinum testis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
169
Q

This structure is the functional, sperm producing portion of the testis.

A

Seminiferous tubules

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
170
Q

Each lobule has how many seminiferous tubules?

A

2 to 3

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
171
Q

Seminiferous tubules will eventually unite in each lobule to form ____ tubules

A

Straight tubules

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
172
Q

Rete has what meaning?

A

Mesh like or net like

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
173
Q

This structure is an elaborate network of canals located within the mediastinum testis into which the straight tubules empty.

A

Rete testis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
174
Q

This structure is a duct which connect the rete testis to the head of the epididymis

A

Efferent ductules

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
175
Q

This structure is a C-shaped structure attached to the superior and posterior aspect of the testis

A

Epididymis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
176
Q

What is the function of the epididymis

A

Function is to store sperm until they mature

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
177
Q

What are the three parts of the epididymis

A

Head of the epididymis
Body of the epididymis
Tail of epididymis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
178
Q

The head of the epididymis is connected to the ______ ______ of the testis by the ______ _____.

A

Superior surface of the testis

By the efferent ductules

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
179
Q

The body of the epididymis is located along the _____ ______ of the testis

A

Posterior surface of the testis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
180
Q

The tail of the epididymis ends in the……

A

Ends in the ductus deferens

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
181
Q

For lymphatic drainage, the testis drain into the…..

A

Lumbar nodes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
182
Q

For lymphatic drainage, the scrotum drawings into the…..

A

Superficial inguinal nodes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
183
Q

Where do the testes develop?

A

In the lumbar region inside the abdominal cavity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
184
Q

The testes normally descend through the ______ into the scrotum just before birth

A

Inguinal canal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
185
Q

This structure is a ligament present in the fetus which connects the testis to the scrotum. It contracts to pull the testis downward and through the inguinal canal during its descent.

A

Gubernaculum testis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
186
Q

What is cryptorchidism

A

Testes are undescended into proper place

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
187
Q

What percentage of full term infants have cryptorchidism?

What percentage of premature infants?

A

3 % of full term infants

30 % of premature infants

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
188
Q

In cryptorchidism, what is the most common place to find the undescended testes and is it bilateral or unilateral.

A

Most commonly found in the inguinal canal

Condition is usually unilateral

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
189
Q

In what week do the testes usually descend after birth?

A

Most descend within the first week after birth

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
190
Q

If the testes do not descend, is the patient still fertile or infertile? What about androgens?

A

Infertility, but androgens secretions not impaired

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
191
Q

Are undescended testes at risk for cancer?

A

They are at greatly increased risk for cancer

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
192
Q

This structure is a smooth membrane which lines the abdominal cavity

A

Peritoneum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
193
Q

The peritoneum is similar to the ____ and the _____ in its arrangement

A

Pleura and pericardium

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
194
Q

The parietal peritoneum lines the….

A

Abdominal walls

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
195
Q

The visceral peritoneum covers the….

A

Abdominal organs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
196
Q

This is a potential space between the parietal and visceral peritoneum. It is empty except for a film of serous fluid

A

Peritoneal cavity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
197
Q

Infection of the peritoneal cavity via the uterine tubes occur in these two types of conditions

A
  1. Immunocompromised women

2. Unsanitary conditions during parturition

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
198
Q

The peritoneal cavity is what in males?

A

Completely closed sac in males

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
199
Q

The peritoneal cavity in females communicates with the exterior through the ______.

A

Uterine tubes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
200
Q

If an infection of the vagina spreads, how will it spread?

A

It will spread via the uterine tubes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
201
Q

If doing the test for patency of the uterine tubes, and the dye that was introduced in the uterus does go through the uterine tubes, but then not the peritoneal cavity, what does this indicate?

A

This indicates an obstruction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
202
Q

What are the functions of the peritoneum

A

To minimize friction between organs
To resist infection
Fat storage

203
Q

Define retroperitoneal organs

A

They lie posterior to the peritoneum and are covered by peritoneum only on their anterior surface (example: kidney)

204
Q

Define ascites

A

An accumulation of fluid within the peritoneal cavity

205
Q

In ascites, this represents an imbalance between what two things?

A

Imbalance between fluid production and absorption. Several liters of fluid may accumulate

206
Q

In a healthy person, peritoneums are highly what?

A

Highly absorbant

207
Q

The peritoneal cavity is mainly used for what?

A

Used for kidney dialysis

208
Q

What are the causes of ascites?

A 
Malnutrition
Congestive heart failure
Liver failure
Kidney failure
Peritonitis
209
Q

What is peritonitis?

A

Inflammation of the peritoneum, usually from infection

210
Q

What are the causes of peritonitis?

A

Trauma - bad belly button piercings
Inflammation bowel disease (including ruptured appendix)
Vaginal infections
Perforated ulcers

211
Q

What does peritonitis usually result in?

A

Usually results in adhesions between the parietal and visceral peritoneum - get stuck to body walls

212
Q

The parietal peritoneum is supplied by nerves of the adjacent body wall, name them

A 
Phrenic nerve
Intercostal nerves
Subcostal nerves
Iliohypogastric nerve
Ilioinguinal nerve
213
Q

Is the parietal peritoneum sensitive to pain?

A

Very sensitive to pain

214
Q

Visceral peritoneum is supplied by ____ nerves which travel within the organs it invests

A

Autonomic

215
Q

Is the visceral peritoneum sensitive to pain?

A

Insensitive to pain

216
Q

This structure is a broad, apronlike reflection of the peritoneum. There are two within the abdominal cavity

A

Omentum

217
Q

This omentum has a large apronlike structure which hangs from the greater curvature of the stomach, coving abdominal viscera.

A

Greater omentum

218
Q

The greater omentum reflects ____ to attach to the transverse colon and transverse mesocolon.

A

Posteriorly

219
Q

What are the three parts of the greater omentum

A

Gastrophrenic ligament
Gastrosplenic ligament
Gastrocolic ligament

220
Q

The gastrophrenic ligament is inbetween what two things?

A

Between greater curvature of stomach and diaphragm

221
Q

The gastrosplenic ligament is inbetween what two things?

A

Between greater curvature of stomach and spleen

222
Q

The gastrocolic ligament is in between what two things?

A

Between greater curvature of stomach and colon

223
Q

Why is the greater omentum called the “abdominal policeman”

A

It is very mobile and often adheres to areas of inflammation, wrapping itself around inflamed organs and restricting spread of infection.

224
Q

This structure is a double layer of peritoneum which extends form the porta hepatis (hilum) of the liver to the lesser curvature of the stomach and the beginning of the duodenum.

A

The lesser omentum

225
Q

How many parts consists of the lesser omentum?

A

Two parts

226
Q

Name the parts of the lesser omentum

A

Hepatogastric ligament

Hepatoduodenal ligament

227
Q

The hepatogastric ligament is inbetween what two things?

A

Between the liver and the lesser curvature of the stomach

228
Q

The hepatoduodenal ligament is inbetween what two things?

A

Between the liver and the duodenum

229
Q

What is the general term for mesentery

A

Any double layer of peritoneum which connects a portion of intestine to the body wall

230
Q

What is the specific term for mesentery?

A

The double layer of peritoneum which connects the jejunum and the ileum to the body wall. This mesentery is sometimes referred to as the “mesentery proper”

231
Q

The mesentery for the jejunum and ileum suspends them to what wall and transmits what to the corresponding structures?

A

Suspends them to the posterior body wall and transmits nerves and vessels which supply them.

232
Q

What does the transverse mesocolon connect?

A

Connects the transverse colon to the posterior body wall

233
Q

What does the sigmoid colon connect?

A

Connects the sigmoid colon to the pelvic wall

234
Q

What does the mesoappendix connect?

A

Connects the appendix to the mesentery of the ileum

235
Q

What does the phrenicocolic ligament connect?

A

Attaches the left colic flexible to the diaphragm, below the spleen

236
Q

The peritoneal cavity is divided into what two things?

A

The omental bursa and greater sac

237
Q

This structure is an irregularly shaped space which lies posterior to the liver, lesser omentum, and stomach. It is a closed sac except for its opening into the greater sac through the omental foramen

A

Omental bursa (lesser sac)

238
Q

This structure extends from the diaphragm to the pelvic floor and across the entire breadth of the abominal cavity

A

The greater sac

239
Q

What are the subdivisions of the greater sac?

A 
Right subphrenic space (recess)
Left subphrenic space (recess)
Subhepatic space (recess)
Right paracolic gutter
Left paracolic gutter
240
Q

Where is the right subphrenic space located?

A

Located below the diaphragm and above the liver, to the right of the falciform ligament

241
Q

Where is the left subphrenic space located?

A

Located below the diaphragm and above the liver, to the left of the falciform ligament

242
Q

Where is the subheptic space located?

A

Between the liver and the transverse colon

243
Q

What is a subdivision of the subhepatic space?

A

Hepatorenal recess

244
Q

What is the hepatorenal recess?

A

Posterosuperior extension of the subhepatic space, between the liver and right kidney

245
Q

What is the right paracolic gutter?

A

A longitudinal depression lateral to the ascending colon

246
Q

What is the left paracolic gutter?

A

A longitudinal depression lateral to the descending colon

247
Q

The spaces of the greater sac are clinically important for what reason?

A

They channel and compartmentalize peritoneal fluid and infectious processes

248
Q

This structure is the opening between the omental bursa and greater sac

A

The omental foramen

249
Q

What are the boundaries of the omental foramen

A

Liver (superiorly)
First part of the duodenum (inferiorly)
Free edge of the lesser omentum (anteriorly)
Peritoneum covering the inferior vena cava (posteriorly)

250
Q

What are the structures which pass through the porta hepatis and which are surrounded by the lesser omentum?

A 
Bile duct ( anterior and to the right)
Hepatic artery (anterior and to the left)
Portal vein (behind)
251
Q

Early in embyrological development, the alimentary tract consists of how many parts?
Name those parts

A

3 parts
Foregut
Midgut
Hindgut

252
Q

What does the foregut form?

A

Forms the distal esophagus, stomach and part of the duodenum. Foregut ends within the second part of the duodenum, at the entrance of the bile duct

253
Q

What does the midgut form

A

Begins at the entrance of the bile duct into the second part of the duodenum, and ends with the right 2/3 of the transverse colon

254
Q

What does the hindgut form?

A

Begins with the left 1/3 of the transverse colon, and ends in the upper part of the anal canal

255
Q

The adult derivates of the foregut, midgut, and hindgut of each share what together?

A

Share a unified blood supply and autonomic nerve supply

256
Q

What is the blood supply of what foregut, midgut, and hindgut?

A

Foregut - branches of the celiac trunk
Midgut - branches of the superior mesneteric artery
Hindgut - branches of the inferior mesenteric artery

257
Q

What are the sympathetic nerve innervations for the foregut, midgut, and hindgut?

A

Foregut - greater splanchnic nerves (T5-9) and lesser splanchnic nerve (T10-11)
Midgut - greater splanchnic nerves (T5-9) and lesser splanchnic nerve (T10-11)
Hindgut - lumbar splanchnic nerve (L1-2)

258
Q

What are the parasympathetic nerve innervations of the foregut, midgut, and hindgut

A

Foregut - vagus nerve
Midgut - vagus nerve
Hindgut - pelvic splanchnic nerve (S2-4)

259
Q

What does sympathetic innervation have on the gastrointestinal tract

A

Decreases motility and tone and contracts sphincters

260
Q

What does parasympathetic innervation have on the gastrointestinal tract

A

Increases motility and tone and relaxes sphincters

261
Q

What are the layers of the gut wall?

A

Mucosa
Submucosa
Muscularis externa
Serosa or adventitia

262
Q

What does the mucosa form?

A

Mucous membrane, which forms the innermost layer and contains the muscularis mucosa, a thin layer of smooth muscle

263
Q

What does the submucosa form?

A

A loose connective tissue layer containing blood vessels and lymphatics

264
Q

What does the muscularis externa form?

A

A thick layer of smooth muscle responsible for peristalsis

265
Q

What are the layers of the muscularis externa

A

Inner circular layer

Outer longitudinal layer

266
Q

What is peristalsis?

A

Propulsive movement of the gut. Contractile ring appears and moves distally

267
Q

When does reverse peristalsis happen

A

Occurs in vomiting

268
Q

What does the serosa or adventitia form

A

Visceral peritoneum is referred to as serosa. Retroperitoneal organs are covered with a connective tissue coat called adventitia

269
Q

What is the enteric nervous system

A

Regional system of nerves specific to the gut.

270
Q

Is the enteric nervous system dependent or independent of the CNS

A

It is semi-independent of the CNS

271
Q

Where does the submucosa plexus orient?

A

Within the submucosa near border with muscularis externa

272
Q

What does the submucosa plexus carry

A

Postganglionic fibers supply muscularis mucosa and mucus secreting glands

273
Q

Where does the myenteric plexus orient

A

Between circular and longitudinal layers of the muscularis externa

274
Q

What does the myenteric plexus carry

A

Postganglionic fibers supply these smooth muscle layers and stimulate peristalsis

275
Q

What shape is the stomach when empty

A

J shaped

276
Q

This structure is a distensible organ which lies in the left hypochondrium, epigastric, and umbilical regions of the abdomen.

A

Stomach

277
Q

What is the function of the stomach

A

Primarily digestive rather than absorptive, stores and mixes food with gastric secretions, converting it to chyme

278
Q

What are the parts of the stomach

A

Cardia
Fundus
Body
Pyloric part

279
Q

What is the cardia of the stomach

A

Where esophagus joins the stomach (surrounds the cardia orifice)

280
Q

What is the fundus of the stomach

A

Above the cardia

281
Q

What is the body of the stomach

A

Between the fundus and pyloric part

282
Q

What is the pyloric part of the stomach

A

The most distal portion, adjacent to the duodenum

283
Q

What are the curvatures and notches of the stomach

A

Greater curvature
Lesser curvature
Cardial notch - between esophagus and fundus
Angular incisure - between body and pyloric part

284
Q

What are the openings of the stomach

A

Cardial openings - between the esophagus and stomach

Pyloric orifice - between the stomach and duodenum

285
Q

What are the subdivisions of the pyloric part of the stomach and what they are (definition or term)

A

Pyloric antrum - wide proximal part
Pyloric canal - narrow distal part
Pylorus distal - termination of the pyloric part which contains:
-pyloric orifice - into duodenum
-pyloric sphincter - a circular muscle layer which surrounds the pyloric orifice

286
Q

The pylorus is marked externally by the…..

A

Pyloric constriction

287
Q

This structure are longitudinal folds of mucous membrane, located within the cavity of the stomach.

A

Gastric folds (rugae)

288
Q

Definition of congenital hypertrophic pyloric stenosis

A

A tumor like increase in the size of the pyloric sphincter, which reduces size of the pyloric canal

289
Q

What does congenital hypertrophic pyloric stenosis result in?

A

Results in projectile vomiting - may be present at birth

290
Q

With congenital hypertrophic pyloric stenosis, what is the drug in a study done that showed increase risk postnatally?

A

The antibiotic crythromycin

291
Q

What is the proper treatment for congenital hypertrophic stenosis?

A

Surgical intervention early in infancy

292
Q

Definition of plyorospasm

A

Spasmodic contraction of the pyloric sphincter - sometimes present in infants

293
Q

What happens to food in people with plyorospasm?

A

Food does not pass easily from the stomach to the duodenum

This causes the stomach to become overly full, which results in vomiting, sometimes projectile

294
Q

Subluxations of what vertebral levels may play a role in pylorospasms?

A

Subluxations of T5-9

295
Q

Definition of a gastric ulcer

A

A crater like depression in the mucosa of the stomach

296
Q

In gastric ulcers what happens to the lining of the alkaline mucus

A

The alkaline mucus can sometimes be not adequate enough, and begins to erode away from the gastric acid. This forms a gastric ulcer

297
Q

Causal factors for gastric ulcers

A

Excess acid secretion: often related to stress
Inadequate mucus barrier: usually related to the presence of bacteria (hello after pylori), which erode the mucus barrier
Secretion of gastric acid (by parietal cells) is controlled by the vagus nerve subluxations of T5-9 may play a role

298
Q

Where does the stomach lie in comparison to the lesser sac and pancreas

A

Lies anterior

299
Q

Where does the stomach lie in comparison to the diagphragm, left lobe of the liver, and anterior abdominal wall

A

It lies posterior to all of them

300
Q

Blood supply of the stomach

A

Branches from the celiac trunk

301
Q

What is the innervation of the stomach

A

Nerve supply is from the celiac plexus.
Sympathetic: greater splanchnic nerve (T5-9)
Parasympathetic: vagus nerve

302
Q

The celiac trunk is the first what from the abdominal aorta. It arises where from the aortic hiatus of the diaphragm

A

First unpaired branch from the abdominal aorta

Arises immediately below aortic hiatus of the diaphragm

303
Q

What are the branches of the celiac trunk

A

Left gastric artery
Splenic artery
Common hepatic artery

304
Q

What structure is the smallest branch of the celiac trunk and runs along the lesser curvature writhing the lesser omentum to anastomose with the right gastric artery

A

Left gastric artery

305
Q

What are the branches of the left gastric artery

A

Esophageal branches

Gastric branches

306
Q

This structure is the largest branch of the celiac trunk, it runs posterior to the stomach, along the superior border of the pancreas to terminate in the spleen

A

Splenic artery

307
Q

Branches of the splenic artery and where they go

A

Pancreatic branches: multiple branches to the pancreas
Short gastric arteries: to the fundus of the stomach
Left gastro-omental (gastroepiploic) artery: runs to the right along the greater curvature of the stomach within the greater omentum

308
Q

This structure runs to the right along the superior border of the pancreas. It becomes the haptic artery proper after giving off the gastroduodenal artery

A

Common hepatic artery

309
Q

Branches of the common hepatic artery and where they go

A

Gastroduodenal artery: descends behind the first part of the duodenum and gives off three branches
Supraduodenal artery: to the superior aspect of the duodenum
Right gastro-omental (gastroepiploic) artery: runs to the left along the greater curvature of stomach within the greater omentum. It anastomoses with the left gastro-omental artery
Superior pancreaticoduodenal artery: passes between the duodenum and head of the pancreas
Hepatic artery proper: participates in the formation of the anterior border of the omental foramen. The bile duct is to its right and the portal vein lies behind it.

310
Q

What are subdivisions of the hepatic artery proper and where do they go

A

Right gastric artery: runs along the lesser curvature of the stomach within the lesser omentum to anastomose with the left gastric artery
Right hepatic artery: to the right lobe of the liver
-cystic artery: to the gall bladder
Left hepatic artery: to the left lobe of the liver

311
Q

Where does the small intestine extend from and to and how long?

A

Extends from the pyloric orifice to the ileocecal junction and is about 7m in length

312
Q

What is the functional differences between the small intestine and large intestine

A

Small intestine almost entirely does absorption of nutrients and the large intestine mostly absorbs water

313
Q

Small intestine consists of what three parts

A

Duodenum
Jejunum
Ileum

314
Q

Duodenum contains Brunner (duodenal) glands, what is their function

A

Secrete a dilute alkaline mucus. -neutralize stomach acid

315
Q

What is the shape of the duodenum

A

C-shaped tube which surrounds the head of pancreas

316
Q

How long is the duodenum

A

Shortest (25 cm) and widest part of the small intestine

317
Q

What are the four parts of the duodenum and their corresponding orientations and parts

A

Superior (first) part - runs to the right. The beginning of the superior part is called the duodenal Cap (Ampulla)
Descending (second) part - contains the junction of the foregut and midgut, where the bile duct and pancreatic duct empty
Inferior or horizontal (third) part - the longest part. It runs to the left, anterior to the inferior vena cava, aorta, and vertebral column
Ascending (fourth) part - ascends to the left of the aorta and terminates at the duodenojejunal flexure

318
Q

This structure is a fibromuscular band which extends from the diaphragm to the duodenojejunal flexure

A

Suspensory muscle (ligament) of the duodenum

319
Q

The duodenum is entirely retroperitoneal except for the….. which is free (mobile)

A

Duodenal cap

320
Q

Which artery and vein pass anterior to the third part of the duodenum

A

Superior mesenteric artery

Superior mesenteric vein

321
Q

What is the blood supply to the duodenum

A

Superior pancreaticoduodenal artery (from gastroduodenal artery)
Supraduodenal artery (from gastroduodenal artery)
Inferior pancreaticoduodenal artery (from superior mesenteric artery)

322
Q

The inferior pancreaticoduodenal artery supplies what parts of the duodenum

A

The third and fourth parts of the duodenum

323
Q

What is the innervation of the duodenum

A

Autonomic fibers form the celiac and superior mesenteric plexuses

324
Q

Definition of a duodenal ulcer

A

Mucosa in the duodenum is eroded to form a crater-like depression

325
Q

Where is the duodenal ulcer most commonly located

A

Within the duodenal cap

326
Q

Ulcers may perforate, allowing contents to escape into the peritoneal cavity, causing peritonitis. Explain the route for perforation in duodenal ulcers

A

Fluid travels from the A) subhepatic recess to the B) right paracolic gutter to the C) right iliac fossa

327
Q

What organs are often damage due to proximity by perforated duodenal ulcers

A

Liver, pancreas, and gall bladder

328
Q

Erosion of the gastroduodenal artery by a perforated duodenal ulcer can result in..

A

Severe hemorrhage

329
Q

Both gastric and duodenal ulcers have been found to be associated with what kind of subluxations

A

Midthoracic subluxations

330
Q

The jejunum makes up what part of the small intestine

A

Proximal 2/5ths of the small intestine

331
Q

Where does the jejunum start and orients where

A

Begins at duodenojejunal flexure and lies mostly in the left upper quadrant of the abdomen, also joins the cecum at the ileocecal junction

332
Q

How are the jejunum and ileum suspended?

A

Suspended from the posterior abdominal wall by the mesentery, which carries blood vessels, nerves, and lymphatics to them.

333
Q

Main functional differences between jejunum and ileum

A

Jejunum - most involved with nutrient uptake

Ileum - absorbs fat soluble vitamins B12, bile salts

334
Q

This structure in the small intestine are straight terminal branches of the arteries which travel through the mesentery to supply the small intestine

A

Vasa Recta

335
Q

This structure in the small intestine are circular folds found within the small intestine

A

Plicae Circulares

336
Q

This structure in the small intestine are aggregations of lymphoid tissue found within the walls of the small intestine

A

Peyer’s patches

337
Q 
Organize the contrast between the jejunum and ileum for:
Color
Vascularity 
Diameter
Walls
Vasa recta
Mesenteric fat
Plicae circulares
Peyer’s patches
A 
Jejunum first, ileum second
Color  - dark red,      Pale pink
Vascularity - greater ,      Lesser
Diameter -  larger ,       Smaller
Walls -   Thicker,   Thinner
Vasa recta -  longer,     Shorter
Mesenteric fat -   Less,      More
Plicae circulares - tall many    , short few
Peyer’s patches    - absent ,      Present
338
Q

What is the blood supply of the jejunum and ileum

A

Jejunal and Ileal branches of the superior mesenteric artery

339
Q

Innervation of the jejunum and ileum

A

Autonomic fibers from the superior mesenteric plexus

340
Q

Definition of ileal (Meckel’s) diverticulum

A

A common malformation of the digestive tract

341
Q

In legal (meckel’s) diverticulum, what exactly happens with tissue malformation

A

Remnant portion of the embryonic vitelline duct,
Finger like pouch which projects from the distal ileum
Contains all layers of the ileum and may contain gastric or pancreatic tissue, gastric tissue may secrete acid
Diverticulum often becomes inflamed, mimicking appendicitis

342
Q

Definition of crohn’s disease

A

Inflammatory bowel disease which most commonly effects the distal ileum and adjacent colon, but can affect any part of the digestive tract.
Affects all layers of the intestine and results in thickening and ulceration of the affected segment
Results in pain, diarrhea, and malabsorption
Etiology - unknown, produces “cobblestone” radiographic appearance

343
Q

Since motility of the small intestine is controlled ,in part, by the autonomic nervous system (vagus, greater and lesser splanchnic nerve) what can we say about chiropractics and motility?

A

Subluxations of the lower thoracic may affect motility, contributing to conditions such as crohn’s disease

344
Q

The large intestine does synthesis of which kind of vitamins?

A

Vitamins that required bacterial action (vitamin K)

345
Q

Where does the large intestine extend to and how long is it?

A

Extends from the ileocecal junction to the anus and is about 1.5 m in length

346
Q

The primary function of the large intestine?

A

Function is to convert the liquid contents of the ileum into semisolid feces by absorbing water

347
Q

What is the cecum of the large intestine

A

A blind pouch found below the ileocecal junction. It lies within the right iliac fossa.

348
Q

What is the ileal fold?

A

Consists of two flaps which surround the ileal orifice (opening of terminal ileum into the cecum) the flaps fuse laterally to form the frenula

349
Q

What is the appendix?

A

A narrow muscular tube which contains lymphoid tissue in its wall. It arises from the psoteromedial aspect of the cecum, and is attached to the mesentery of the ileum by the mesoappendix

350
Q

What is the position of the appendix (is it always in the same place?)

A

It’s variable, but most common position is retrocecal. Second most common position is pelvic

351
Q

What is appendicitis

A

Inflammation of the appendix
Most common intra-abdominal inflammatory condition
Symptoms usually begin as umbilical pain which then localizes to the right lower quadrant
Position of the appendix is variable and can affect where pain is felt
If untreated, the appendix may rupture, leading to peritonitis
Caused by obstruction of the lumen due to) lymphoid hyperplasia 2.) fecal impaction

352
Q

The colon consists of four parts

A

Ascending colon
Transverse colon
Descending colon
Sigmoid colon

353
Q

Give the orientations of the parts of the colon

A

Ascending - from ileocecal junction to the right colic (hepatic) flexure
Transverse - from the right colic flexure to the left colic (splenic) flexure
Descending - from the left colic flexure to the pelvic brim
Sigmoid - from the pelvic brim to the front of the sacrum, where it becomes the rectum

354
Q

What are the orientations of the appendix and cecum

A

They are intraperitoneal

355
Q

What are the orientation of the ascending and descending colon

A

Retroperitoneal

356
Q

Where do the transverse and sigmoid colon lie

A

Lie within the peritoneal cavity and are attached to the posterior body wall by the transverse and sigmoid mesocolon

357
Q

This structure of the colon has three narrow longitudinal bands o muscle seen most prominently in the cecum and ascending colon

A

Taeniae coli

358
Q

This structure of the colon has sacculations or outpouchings of the colon

A

Haustra of colon

359
Q

This structure of the colon has small masses of fat which are covered with visceral peritoneum, and which extend from the colon

A

Omental appendices

360
Q

This structure has terminal portions of the large intestine. They will be described with the pelvis

A

Rectum and anal canal

361
Q

What is diverticulosis

A

Herniation of the mucosa of the colon through the muscular layer, without inflammation most common in individuals over 40 years of age
Occurs most commonly in the sigmoid colon
If the diverticuli becomes inflammed, the condition is called diverticulitis
It results in abdominal pain, diarrhea, and in some cases, abcess
Related to a lower fiber diet - may be treated with laser endoscopy
Radiographically, it is characterized by numerous outpouchings along the colon

362
Q

What is ulcerative colitis

A

Severe inflammation and ulceration of the rectum and lower colon
Usually restricted to the mucosa
Abdominal pain and diarrhea are symptoms
Bowel perforation may occur
Radiographically, the bowel appears constricted

363
Q

What is irritable bowel syndrome

A

A common condition recurrent abdominal pain and diarrhea with no inflammation or deterioration in health
Symptoms are caused by abnormal muscular contractions of the colon
The cause is unknown, but the symptoms are often brought on by stress and anxiety

364
Q

Blood supply to the small and large intestine

A

Superior mesenteric artery
Inferior mesenteric artery
Marginal artery
Vasa Recta

365
Q

The superior mesenteric artery arises from the ____ below the celiac trunk. It’s branches supply the intestine from the ____ part of the duodenum (where the bile duct joins) through the _____ of the ____ colon

A

Abominal aorta below the celiac trunk
Second part of the duodenum
Through the right 2/3 of the transverse colon

366
Q

Branches of the superior mesenteric artery and what they supply

A

Inferior pancreaticoduodenal artery - supplies the pancreas and distal part of the duodenum
Jejunal and ileal arteries - 12 to 15 arteries which branch and anastomose within the mesentery to form a series of arcades. They supply the jejunum and ileum
Ileocolic artery - descends to the ileocecal junction. It supplies the ascending colon, cecum, and appendix
Right colic artery - supplies the ascending colon
Middle colic artery - supplies the transverse colon

367
Q

Inferior mesenteric artery arises from the lower part of the ______. It’s branches supply the ____ from the left ____ of the _____ colon to the upper part of the anal canal

A

Lower part of the abdominal aorta
Supply the large intestine
From the left 1/3 of the transverse colon

368
Q

What does anastomosis do?

A

Allows collateral circulation

369
Q

What is a bowel infarction

A

Complete occlusion of intestinal vessels

370
Q

What is a trans mural bowel infarction

A

Extreme bowel infarction usually resulting in a 95% fatality rate

371
Q

Branches of the inferior mesenteric artery and what they supply

A

Left colic artery - supplies the descending colon
Sigmoid arteries - supply the sigmoid colon
Superior rectal artery - supplies the rectum and upper part of the anal canal. This is the terminal ranch of the inferior mesenteric artery

372
Q

What is the marginal artery and what empties into it

A

An anastomotic channel which runs from the cecum to the sigmoid colon. All of the branches of the superior and inferior mesenteric arteries empty into it

373
Q

The vasa recta has straight terminal branches from the _____ artery to the large intestine (also found in the small intestine)

A

From the marginal artery to the large intestine

374
Q

The innervation for the cecum through the right 2/3 of transverse colon is supplied by what

A

Autonomic fibers from superior mesenteric plexus

375
Q

The innervation of the left 1/3 of transverse colon to upper part of anal canal

A

Autonomic fibers from inferior mesenteric plexus and hypogastric plexus (lowest part)

376
Q

Diarrhea, constipation, and other colon problems may be related to what kind of subluxations?

A

Lower thoracic, upper lumbar, or sacral subluxations

377
Q

Chronic constipation is associated with increased risk of what conditions?

A

Hiatal hernia, inguinal hernia, diverticulosis, and colon cancer

378
Q

What are the two linked venous systems within the trunk?

A

Portal venous system

Canal (systemic) venous system

379
Q

What does the portal venous system drain

A

Drains the gastrointestinal tract, spleen, pancreas, and gallbladder

380
Q

What nutrient does not pass through the portal system to the liver

A

Fats, those are picked up by lymphatic vessels of the small intestine called lacteals and bypass the liver

381
Q

Blood flow of the portal venous system

A

From the abdominal organs named above
To tributaries of the portal vein
Then to the portal vein, which divides into left and right branches
Then to the liver sinusoids
Then to the inferior vena cava (caval system) via the hepatic veins

382
Q

Blood flow of the caval (systemic) venous system

A

From the body wall and organs
To tributaries of the superior and inferior vena cava
Then to the superior and inferior vena cava

383
Q

The portal vein is formed ____ the head of the pancreas by the union of the ____ vein and ____ vein

A

Portal vein is formed behind head of pancreas

Splenic and superior mesenteric vein

384
Q

What are the tributaries of the portal vein

A

Splenic vein
Superior mesenteric vein
Left gastric vein
Paraumbilical vein

385
Q

What are the subdivisions of the splenic vein

A 
Short gastric vein
Left gastro-omental vein
Pancreatic veins
Inferior mesenteric vein
    -left colic vein
    -sigmoid veins
    -superior rectal vein: unites with sigmoid vein to form inferior mesenteric vein
386
Q

What are the subdivisions of the superior mesenteric vein

A 
Jejunal and ileal veins
Ileocolic vein
Right colic vein
Middle colic vein
Right gastro-omental vein
Pancreaticoduodenal vein
387
Q

What do the paraumbilical veins accompany?

A

Accompany the ligamentum teres to the umbilicus

388
Q

All of the tributaries of the portal vein accompany arteries of what?, except for the paraumbilical vein

A

Tributaries of portal vein accompany arteries of the same name

389
Q

What is cirrhosis of the liver

A

A condition characterized by destruction of hepatic cells and their replacements by fibrous tissue and fat
Liver becomes nodular and hard, and tends to constrict the portal vein at the porta hepatis, causing portal hypertension
Causes:
Alcoholism, chronic obstruction of bile duct, congestive heart failure

390
Q

What is portal hypertension

A

Abnormal deviation of pressure within the portal system, often due to cirrhosis of the liver
Portal vein is constricted within the porta hepatis
Portal system has no valves-flow is reversed, by passing the liver
Blood backs up into the caval system in the regions where portal-caval anastomoses occurs
The veins in these areas become varicose (dilated, tortuous, and then walled), and may rupture

391
Q

Given the site, name the caval vein, portal vein, and obstruction sign for portal-caval anastomoses

A

Distal esophagus, esophageal, left gastric, esophageal varices

Around umbilicus, superficial veins of ant. Abdominal wall, paraumbilical, caput medusae

Rectum and anal canal, middle and inferior rectal, superior rectal, hemorrhoids

392
Q

What is esophageal varices

A

Can hemorrhage, with severe and often fatal bleeding

393
Q

What is caput medusae

A

Pronounced snake-like veins radiating around umbilicus

Usually present only in severe cases

394
Q

What are hemorrhoids

A

Not diagnostic for portal hypertension alone

395
Q

This structure is the largest visceral organ and the largest gland in the body

A

The liver

396
Q

Functions of the liver

A

Bile secretion - emulsifies fat
Metabolism of proteins, fats, and carbohydrates
Storage of glycogen, vitamins, and iron
Detoxification

397
Q

Name two surfaces of the liver

A

The diaphragmatic surface

Visceral surface

398
Q

What does the diaphragmatic surface cover?

A

Superior and convex. It is separated from the visceral surface by a sharp, inferior border

399
Q

What does the visceral surface cover

A

Inferior and concave

400
Q

What is the porta hepatis

A

It is the hilum of the liver.

401
Q

What does the porta hepatis contain?

A 
Common hepatic duct (to the right)
Hepatic artery (to the left)
Portal vein (behind)
402
Q

What helps to form the anterior border of the omental foramen. It becomes the common hepatic duct prior to passing through the porta hepatis

A

The bile duct

403
Q

What are the anatomical lobes of the liver

A

Right lobe
Quadrate lobe
Caudate lobe
Left lobe of the liver

404
Q

Orientation of the gall bladder and inferior vena cava on the right lobe of liver

A

Gall bladder lies in a fossa on its visceral surface (anteriorly).
The inferior vena cava lies posterior to the gall bladder

405
Q

Orientation of the quadrate lobe

A

Lies between the right and left lobes, anterior to the porta hepatis. The gall bladder is immediately to the right of it.

406
Q

Orientation of the caudate lobe of the liver

A

Lies between the right and left lobes, posterior to the porta hepatis

407
Q

Orientation of the left lobe of the liver

A

To the left of the falciform ligament. It is smaller than the right lobe

408
Q

Are anatomical lobes used for functional purposes?

A

No, only used for descriptive purposes.

409
Q

What would be the functional division through the liver.

A

Functional division of the live would be made to the right of the falciform ligament. The division would be made forward fro the inferior vena cava through the gall bladder

410
Q

The division using the falciform ligament splits the left and right half’s into what?

A

Into nearly equal weight

411
Q

The left and right functional half’s are further subdivided into what?

A 
8 hepatic segments 
Hepatic segments (1-4 in the left functional)
Hepatic segments (5-8 in the right functional)
412
Q

What structures distribute to the right and left functional halves of the liver

A 
Hepatic arteries (left and right branches)
Portal vein (left and right branches)
Common hepatic duct (left and right hepatic ducts)
Hepatic veins (left and right tributaries
413
Q

What is the bare area of the liver

A

Liver is covered with visceral peritoneum except at the bare area, located on the posterior aspect of the diaphragmatic surface. The liver maintains contact with the diaphragm at the bare area.

414
Q

What lies within the bare area?

A

The inferior vena cava

415
Q

What are the ligaments of the liver

A 
Falciform ligament 
Coronary ligament
Right and left triangular ligament
Ligamentum teres
Ligamentum venosum
Ligament of the inferior vena cava
416
Q

What does the falciform ligament connect

A

Connects the liver to the diaphragm and anterior abdominal wall

417
Q

What does the coronary ligament do

A

As the falciform ligament passes posteriorly along the diaphragmatic surface of the liver, its two layers split to become the coronary ligament.

418
Q

What does the coronary ligament form borders for?

A

Forms the borders of the bare area, and reflects onto the diaphragm. It consists of a superior (anterior) and inferior (posterior) layer.

419
Q

How are the right and left triangular ligaments formed?

A

Formed at the junction of the superior and inferior layers of the coronary ligament on each side

420
Q

What does the ligamentum teres form

A

Forms the free edge of the falciform ligament and is the remnant of the obliterated umbilical vein

421
Q

Where is the location of the ligamentum venosum

A

Located between the left and caudate lobes. It is the remnant of the ductus venosus

422
Q

What does the ligament of the inferior vena cava cover?

A

Covers the inferior vena cava within the bare area of the liver.

423
Q

What letter do the fissures of the liver form on its visceral surface

A

The letter H

424
Q

Where is the fissure for the ligamentum teres

A

Between the left lobe and the quadrate lobe

425
Q

Where is the fissure for the ligamentum venosum

A

Between the left lobe and the caudate lobe

426
Q

Where is the fossa for the gallbladder

A

Between the right and the quadrate lobe

427
Q

Where is the fissure for the inferior vena cava

A

Between the right lobe and the caudate lobe

428
Q

What forms the crossbar of the H on the liver

A

The porta hepatis

429
Q

The portal vein has what percentage of blood supply to the liver

A

75-80% of deoxygenated blood

430
Q

The hepatic artery has what percentage of blood supply to the liver

A

20-25% of oxygenated blood

431
Q

What is the blood supply to the liver

A

Dual blood supply from portal vein and hepatic artery

432
Q

What is the innervation for the liver

A

Autonomic and pain fibers are from the hepatic plexus which is an extension of the celiac plexus

433
Q

What is the shape of the gallbladder and its location

A

Pear-shaped and located in a fossa on the visceral surface of the liver

434
Q

What are the three parts of the gallbladder

A

Fundus
Body
Neck

435
Q

Where does the gallbladder drain into?

A

Drains into the cystic duct

436
Q

What is the function of the gallbladder and how does this process work

A

The gallbladder stores bile and concentrates it by absorbing water. It contracts to expel the bile into the duodenum when food arrives there. Contraction is initiated by the hormone cholecystokinin (CCK)

437
Q

Blood supply to the gallbladder

A

Cystic artery from right hepatic artery

438
Q

Innervation of the gallbladder

A

Autonomic and pain fibers from the celiac plexus

439
Q

What are the ducts of the biliary duct system

A 
Right and left hepatic ducts
Common hepatic ducts
Cystic duct
Bile duct
Hepatopancreatic ampulla (ampulla of Vater)
440
Q

What do the right and left hepatic ducts drain

A

Drain the corresponding functional halves of the liver

441
Q

What forms the common hepatic duct

A

Formed by the union of the right and left hepatic duct

442
Q

What does the cystic duct drain

A

Drains the gallbladder

443
Q

What forms the bile duct

A

Formed by the union of the common hepatic duct and cystic duct

444
Q

What forms the hepatopancreatic ampulla (ampulla of Vater)

A

Formed by the union of the bile duct and pancreatic duct. It empties into the second part of the duodenum at the major duodenal papilla

445
Q

The sphincter of the ampulla surrounds what

A

Surrounds the hepatopancreatic ampulla

446
Q

What does the sphincter of the bile duct surround

A

Surrounds the inferior terminus of the bile duct

447
Q

What does the sphincter of the pancreatic duct surround

A

Surrounds the terminal part of the pancreatic duct

448
Q

Where are the spiral folds (valves) located? Function?

A

Located within the cystic duct.

They function to keep the cystic duct open

449
Q

What are gallstones?

A

Hard masses formed by the solidification of bile constituents
Mainly composed of cholesterol crystals
Most commonly become compacted at the distal end of the hepatopancreatic ampulla (at the sphincter of ampulla), as this is the narrowest point in the biliary passages
Blockage at this location causes backup of bile through the pancreatic duct. Acute pancreatitis results

450
Q

Risk factors for gallstones

A

Being female
Obesity
Pregnancy
High fat diet

451
Q

Upper abdominal disease involving the liver, gallbladder, or stomach may refer pain to what spinal cord segments?

A

Lower thoracic spinal cord segments (T8-T12)

452
Q

A gallbladder attack most commonly causes pain in what region of the abdomen?

A

Right upper quadrant

453
Q

In what percentage of patients, pain is also referred to the right subscapular region of the back

A

30%, also have written only 5%?

454
Q

What kind of gland is the pancreas

A

Both an exocrine and endocrine gland

455
Q

What is the exocrine and endocrine function of the pancreas

A 
Exo = secretion of digestive enzymes
Endo = secretion of hormones insulin and glucagon
456
Q

What are the five parts of the pancreas

A 
Head
Neck
Body
Tail
Uncinate process
457
Q

What is the uncinate process

A

A projection of the head to the left behind the superior mesenteric

458
Q

Where does the pancreas lie?

A

Lies posterior to the stomach within the epigastric and left hypochondrium regions. It is a retroperitoneal organ except for the tip of the tail, which lies within the splenorenal ligament

459
Q

Where does the head of the pancreas lie?

A

Within the C-shaped concavity of the duodenum

460
Q

The superior mesenteric artery and veins pass where to the neck and and where to the uncinate processes of the pancreas

A

Posterior to the neck

Anterior to the uncinate process

461
Q

The splenic artery runs along the superior surface of the ______, while the splenic vein runs along its _____ surface

A

Surface of the pancreas

Posterior surface

462
Q

What drains the pancreas

A

Pancreatic duct

Accessory pancreatic duct

463
Q

What specific parts does the pancreatic duct drain

A

Drains the neck, body, and tail. It joints the common bile duct to form the hepatopancreatic ampulla, which in turn empties into the major duodenal papilla within the second part of the duodenum

464
Q

What parts of the pancreas does the accessory pancreatic duct drain

A

Drains the head and uncinate process. It empties into the minor duodenal papilla, also located within the second part of the duodenum, 2 cm above the major duodenal papilla

465
Q

What is the blood supply for the pancreas

A

Pancreatic branches of splenic artery
Superior pancreaticoduodenal artery (from gastroduodenal)
Inferior pancreaticoduodenal artery (from superior mesenteric)

466
Q

What is the innervation of the pancreas

A

Autonomic and pain fibers from the celiac plexus

467
Q

How does rupturing of the pancreas normally occur?

A

Often occurs when there is a forceful compression of the abdomen, as in an auto accident when a person is thrown against the steering column
The steering column acts as a hammer, the vertebral column acts as an anvil
Release of digestive enzymes into the body cavity causes a lot of damage to adjacent tissue

468
Q

Pain from the pancreas is referred to what area of spinal segments

A

Lower thoracic segments

469
Q

Pain from the head of the pancreas is referred to the ____ of the vertebral column, pain from the body and tail is referred to the _____

A

Right of vertebral column

Left of vertebral column

470
Q

This is a large lymphatic organ which has several functions

A

Spleen

471
Q

Functions of spleen?

A

Produces lymphocytes in the newborn
Removes worn out RBCs and other cellular debris from circulation
Stores RBCs

472
Q

Where does the spleen lie?

A

Lies against the diaphragm and ribs 9 to 11 within the left hypochondrium region

473
Q

What surface of the spleen has a convex surface which lies against the diaphragm

A

Diaphragmatic surface

474
Q

What surface of the spleen has a concave surface which lies against abdominal viscera. It has three subdivisions, name those as well

A

Visceral surface
Gastric surface - lies against stomach
Colic surface - lies against colic flexure
Renal surface - lies against the left kidney

475
Q

This structure of the spleen is located on the visceral surface. It transmits nerves and vessels

A

Splenic hilum

476
Q

What are the two ligaments of the spleen and what do they attach

A

Gastrosplenic ligament - attaches the stomach to the spleen

Splenorenal ligament - attaches the spleen to the left kidney

477
Q

Blood supply to the spleen

A 
Splenic artery (from celiac trunk)
Splenic vein (from portal vein)
478
Q

Innervation of spleen

A

Mainly sympathetic from celiac plexus

479
Q

What is splenomegaly?

A

Enlarged spleen

480
Q

How does rupturing of the spleen normally occur, is this common?

A

This is the most frequently injured abdominal organ
Particularly vulnerable to blows to the left hypochondrium region
Results in severe hemorrhage and shock
May be ruptured directly by trauma

481
Q

What makes the spleen more fragile to rupturing

A

Mononucleosis
Sickle-cell anemia
Malaria
Septicemia

482
Q

What needs to be done with patients with active mononucleosis
What happens when you surgically remove the spleen

A

Use caution in adjusting patients with active mono

When spleen is removed, kepffer cells of the liver take over its function, phagocytize worn out RBCs

483
Q

This nerve supplies preganglionic parasympathetic fibers to the esophagus, stomach, small intestine, and large intestine through the right 2/3 of the transverse colon.
Other abdominal viscera which receive their parasympathetic innervation from this include what organs?

A 
Vagus nerve (CN X)
Liver, spleen, pancreas, kidney
484
Q

This nerve supplies preganglionic parasympathetic fibers to the left 1/3 of the transverse colon through the upper part of the anal canal

A

Pelvic splanchnic nerves (S2,3,4)

485
Q

Preganglionic parasympathetic fibers carried by vagus and pelvic splanchnic nerves synapse where?

A

Synapse in terminal ganglia which lie within the organs they innervation

486
Q

Where do preganglionic sympathetic cell bodies lies within the spinal cord segments?

A

Spinal cord segments T1 to L2

487
Q

This trunk enters the abdomen by passing posterior to the medial arcuate ligament. It descends on the vertebral column, medial to the psoas major muscle

A

Sympathetic trunk

488
Q

Where do the right and left trunks of the sympathetic trunk lie?
Both trunks continue to where

A

Right trunk lies behind the inferior vena cava
Left trunk lies lateral to the aorta
Both trunks continue into the pelvis anterior to the sacrum

489
Q

The sympathetic trunk gives rise to these two nerves, which contain preganglionic sympathetic and afferent fibers. These nerves arise from sympathetic trunk ganglia.

A

Thoracic and lumbar splanchnic nerves

490
Q 
Name the following cord segments for the list of nerves below
Greater splanchnic nerve
Lesser splanchnic nerve
Least splanchnic nerve
Lumbar splanchnic nerve
A

Greater - T5-9
Lesser - T10-11
Least - T12
Lumbar - L1-4

491
Q

Sympathetic innervation to the stomach through the right 2/3 of the transverse colon originate in what spinal cord segments?

A

5 through 11 thoracic spinal cord segments

492
Q

Preganglionic fibers from the 5 through 11 thoracic spinal segments pass through what structure and are carried by the greater and lesser splanchnic nerves to the ____ and _____, where they synapse

A

Pass through the sympathetic trunk

To the celiac and superior mesenteric plexuses, where they synapse

493
Q

Sympathetic innervation to the left 1/3 of the transverse colon through the upper part of the anal canal originates in what spinal cord segments

A

Lumbar spinal cord segments

494
Q

Preganglionic fibers from the lumbar spinal cord segments pass through the sympathetic trunk and are carried by what nerves to the inferior mesenteric plexus

A

Lumbar splanchnic nerves to inferior mesenteric plexus

495
Q

These structures contain the cell bodies of postganglionic sympathetic neurons.

A

Celiac, superior mesenteric, and inferior mesenteric ganglia

496
Q

The preganglionic sympathetic fibers carried by the splanchnic nerves synapse in these ganglia, and postganglionic fibers travel from the ganglia to the organs they innervate via what plexus

A

Periarterial plexuses

497
Q

From the stomach to the middle of the sigmoid colon

Fibers carrying pain sensations run with sympathetic skin of what spinal sensory ganglia

A

Sympathetic to thoracic and lumbar spinal sensory ganglia

498
Q

From the stomach to the middle of the sigmoid colon

Visceral afferent fibers carrying reflex information run with what sensory ganglia

A

Run with the vagus to vagal sensory ganglia

499
Q

Distal to the middle of the sigmoid

Both pain sensation and reflex information are carried to what ganglia

A

Carried to spinal sensory ganglia of S2,3,4

500
Q

The various autonomic plexuses of the abdomen lies in front of what structure and extends along its branches

A

The aorta

501
Q

What various autonomic plexuses of the abdomen that lies in front of the aorta carries what kind of fibers

A

Parasympathetic fibers
Sympathetic fibers
Afferent fibers
Autonomic ganglia

502
Q

How are the autonomic plexuses of the abdomen named? What are the names of these plexuses

A 
Named for the arteries which they lie upon and include
Celiac plexus
Superior mesenteric plexus
Aortic plexus
Inferior mesenteric plexus
503
Q

What is the name of the plexus that lies between the superior and inferior mesenteric Artie’s and is a portion of the aortic plexus

A

Intermesenteric plexus

504
Q

What is the name of the plexus where it is just below the bifurcation of the aorta and is an extension of the aortic plexus

A

Aortic plexus continues downward to form the superior hypogastric plexus just blow the bifurcation of the aorta

Gross Anatomy 2 (1 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions