Lower Abdomen Flashcards
What is the entrance into the stomach from the esophagus called?
Cardiac Orifice
What is the Stomachs exit to the duodenum called?
Pyloric sphincter
What are Rugae?
Temporary folds within the stomach that help to churn the food for digestion
Is the Duodenum fixed or mobile?
Fixed
What is the combined length of the Jejunum and ileum?
20 feet
Are the Jejunum and ileum fixed or mobile
Tethered by the mesentary proper but highly mobile
What are Plicae Circularis?
Permanent fold within the small intestine that become ever more dissapearing as you go distally in the tract.
What are the 4 parts of the duodenum?
1) Superior or ampulla
2) Descending
3) Inferior or horizontal
4) Ascending
What are two key note characteristics of the Jejunum?
Abundant Plicae Circularis
Longer Sharper arteriole arcades (arcs)
What are two key note characteristics of the Ileum?
Very few plicae circularis
Broader flatter arcades (arcs)
What is Meckel’s diverticulum?
It is a remnant of the embryonic yolk stalk that is located 1 m proximal to the ileocecal valve, if inflamed and mimic appendicitis
Where is the Veriform Appendix?
Cecum inferior to the ileocecal
What is the mesentarythat attaches the appendix to the posterior wall
Mesoappendix
What are the three stages of pain associated with appendicitis.
1) Vague pain begins in the periumbilical region from the afferent pain referred to T10 level
2) Severe pain in the Right lower quadrant from the irritation of the peritoneum of the posterior abdominal wall
3) Most severe pain over the Spinoumbilical point between the ASIS and Umbilicus (McBerney’s point)
What are the Segments and flexures of the intestines.
The 5 segments are the cecum, ascending colon, transverse colon, descending colon, and sigmoid colon
The two flexures are the Right colic (hepatic) flexure and the Left colic (splenic) flexure.
What are the three parallel muscle bands that run along the Colon called?
Teniae coli (Libera, omentalis, and mesocolica)
What are the Colon out pouchings caused by the Teniae Coli?
Houstra Coli
What is the name of the fat tags along the colon?
Epiploic appendages
What is the Second major unpaired branch of the Abdominal aorta?
Superior Mesenteric Artery
What is the cutoff for the supply from the Superior Mesenteric Artery?
The Proximal tract up to 2/3 of the Transverse colon.
What are the three branches of the Superior Mesenteric Artery that we must know?
Ileocolic, R. Colic and middle colic
What is the Third Major unpaired branch off of the abdominal aorta?
Inferior Mesenteric Artery
What does the inferior mesenteric artery supply and via which arteries?
The rest of the colon from the distal 1/3 of the transverse colon via the Left colic artery the sigmoid arteries and the superior rectal
Where is there collateral circulation between the SMA and IMA?
Between the R and L colic arteries (marginal a. of Drummond)
What are the components off the pancreatic arterial anastomosis?
Three components:
Superior pancreaticoduodenal from the Gastroduodenal
Inferior pancreaticoduodenal from the Superior Mesenteric Artery
Splenic Artery that supplies the rest of the pancreas
At what level do the Renal Arteries exit the abdominal aorta?
At the level of the SMA
What structures do the renal arteries supply?
adrenal glands, kidney and the ureters
What are the lateral branches off the abdominal aorta just inferior to the renal arteries?
Gonadal arteries
What is the path of the ovarian arteries?
Crosses over the ureters and the iliac vessels, descends to pelvis to supply ovaries.
What is the path of the testicular arteries?
Crosses over ureters and enters the inguinal canal then descends into the scrotum to supply the testes
What is the largest vein in the body?
Inferior vena cava
What areas of the body does the IVC drain?
Lower Limbs, most of the back, abdominal walls and abdominopelvic viscera (via the Hepatic Portal system) all to the Right Atrium of the heart
What are the 4 Portal Caval Anastomoses and their components (Portal and Caval)
1) Gastric and Esophageal
2) Paraumbilical and Epigastric
3) Superior Rectal and Middle/Inferior rectal
4) Colic and retroperitoneal
What causes the varicose veins in the caval system?
There are no valves in the portal system so if there is a blockage and the blood backflows into the caval system the veins become engorged and dilations and varicosities occur.
What do Dilated esophageal v. produce?
Esophageal varices
What do dilated epigastric v. produce?
caput medusae
What do dilated Inf. and Mid. rectal cause
hemorrhoids
Where do the Preganglionic splanchnic nerves of the sympathetics synapse? (general)
Collateral ganglia (prevertebral)
What do the post ganglionic fibers travel along to reach their targets?
Along all main arterial branches.
What are the names of the Lower Thoracic Splanchnic nerves?
Greater (T5 Through 9) Lesser (T10 and T11) Least (T12)
What are the 4 ganglions found for the Sympathetics?
Celiac Ganglion
Aorticorenal Ganglion
Superior Mesenteric Gang.
Inferior Mesenteric Gang.
Which 3 Ganglions receive thoracic splanchnic nerves and CN X branches?
Celiac, Aorticorenal, and Superior mesenteric
Which ganglion receives lumbar splanchnic nerves and fibers from S2 and S4
Inferior Mesenteric
Where do the synapses occur for the parasympathetic nervous system?
At the Effector organs
